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Children's Health

Lead Poisoning Remains Problem Even as Incidence Drops

Years after lead paint and leaded gas have been banned, lead lingers in household environments. Residents of old houses sometimes find themselves and their family members exposed, much to their surprise.

Part 1 of 2 stories.

By Whitney Isenhower

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Stephanie Jones and her husband purchased their Asheville home five years ago. Built in 1922, large windows, separated by wooden panels, frame the home’s front door. Her husband also keeps a woodworking studio in the basement.

About four years after moving in, the couple had a son. When he was a year old, in February of last year, Jones took him to his pediatrician for a routine check-up. The doctor ran some tests, including one analyzing the level of lead in his blood. Results came back, and her son was found to have a lead level of six micrograms per deciliter of blood, one microgram above what the state considers to be an elevated blood lead level.

The window by the front door where Stephanie Jones' son was chewing the white panes between the glass panels.

The window by the front door where Stephanie Jones’ son was chewing the white panes between the glass panels. Photo credit: Stephanie Jones

Since that first test, the boy’s levels have jumped up and down. When he was tested again in May, his blood lead level was three. When he was tested around September, his level was at 10.4, just above the previous N.C. classification of 10 as an elevated level of lead in the blood.

(The state’s classification was lowered from 10 to five in 2012 following a Centers for Disease Control and Prevention recommendation of when the level is sufficiently high that interventions should be taken to remove lead from a child’s system.)

Three weeks after the September test, her son’s level was at 9.9.

“We don’t have any explanation as to why it jumped so much,” Jones said.

Because her son’s level had reached above 10, it was reported to the county and state. If a child has two consecutive tests with blood lead levels at 10 or above in the same six-month period, state inspectors come to the home to determine any sources of possible lead exposure.

Two tests are recommended also because of the possibility of the first one being inaccurate. The inspectors visit the home with an X-ray gun, which can determine if lead paint was ever used, and do a spot wipe to check for lead dust.

Since their son’s tests, Jones and her husband have taken measures to eliminate lead both from his body and their home. Homes, particularly those built before 1978, are the most likely place that children and individuals come in contact with lead.

Young children are at higher risk for lead exposure in the home because of things they come in contact with while crawling on the floor and from chewing on things they shouldn’t. And as children are still growing, lead exposure can be more detrimental to them than to adults. Lead can affect a child’s central nervous system and brain development, among other factors.

A search for the source

To help identify potential sources of lead to which the Jones’ son could have been exposed, a local inspector first came out in September; state inspectors then visited following her son’s tests of 9.9 and 10.4.

The Asheville-based inspector, Linda Block, a certified lead-risk assessor in the city and director of the former Healthy Homes and Lead Safety program, helped the Jones family identify some culprits where lead could hide.

In his studio, Jones’ husband crafted picture frames using old painted wood that could have had lead in it. Though his studio is in the basement, Jones said it’s possible lead dust from the frames could have been tracked up to the house and then ingested by her son.

The couple also suspect their son chewed the wood panels framing the front-door windows, which could have lead in them. “We had caught him looking at the window and putting his mouth on that,” Jones said.

Now they’re getting close to fine cleaning the basement and have put acrylic glass on the front-door window.

As of December, Jones’ son’s blood lead level was 3.6.

She said they’re still looking into thoroughly cleaning the home and getting rid of lead sources, but those services can be expensive. One estimate she received was $7,000. She’s also only found one agency that seems aware of lead-specific concerns, with several companies she talked to saying they would treat it as they would mold.

“This has been the hardest thing, mentally,” Jones said. “What do you do next?”

Decline in rates

Rates for lead poisoning and detected blood lead levels in children have dropped across North Carolina, particularly since increased outreach and awareness efforts were implemented in the 1990s.

Click on map to see N.C. zip codes at high risk of home lead contamination. Data: NC DHHS.

Ed Norman, program manager in the Environmental Health Section of the state Department of Health and Human Services (DHHS) Division of Public Health, has worked with childhood lead exposure in the state for more than 20 years. He started working on this issue at the state Department of Environmental and Natural Resources before transitioning to DHHS in 2011.

Norman said that while detected lead blood levels are still higher in rural areas, where lower-income, older housing is more prevalent, such as in the eastern part of the state, rates have declined overall.

“Prevalence everywhere has come down,” he said, “It’s amazingly much lower.”

According to 2010 DHHS data, 0.4 percent of children in the state who were tested at 1 and 2 years old had a blood lead level that classified as elevated or poisoned, compared to 7 percent having that same classification in 1995.

Decline in funding

But while rates are on the decline, programs and funding for lead initiatives have also been scaled back.

The Centers for Disease Control and Prevention cut funding for lead-related programs in the state, according to Norman, and eliminated its Healthy Homes Initiative. The program sought to reduce lead poisoning and exposure and address other in-home environmental hazards.

A porch ceiling with peeling lead paint in Greensboro.

A porch ceiling with peeling lead paint in Greensboro. Photo courtesy Greensboro Housing Coalition.

Block, who inspected the Jones’ home, was one person affected by the cuts, when funding for her work ended in July 2012. She was one of six sub-grantees for the CDC Healthy Homes Initiative budget.

She still inspects homes in Asheville and the surrounding area, and accepts donations.

Some lead-related programs at the health departments in Craven, Edgecombe, Guildford, Forsyth, Mitchell, Avery, Buncombe, Union and Wayne counties also were reduced following cuts. Norman said a U.S. Department of Housing and Urban Development grant, designed for local housing agencies to address lead and other home concerns, is ending in February.

HUD does offer grants focusing on low-income housing, particularly to help landlords and individuals get lead out of pre-1978 homes. These grants are part of the Lead-Based Paint and Lead Hazard Reduction Demonstration Grant Programs.

Norman said that High Point, Charlotte and Greensboro all have HUD grants for lead control. Greensboro’s Lead Safe Housing Program started about five years ago. It includes a community-outreach component, whereby health educators visit homes, schools and day-care centers to provide information about sources of lead exposure and when and how to get a child tested.

Though the Greensboro program still relies on outreach, Norman said advocacy about lead testing and prevention has suffered since funding cuts. So the state is working more closely with medical providers to reach out to parents and educate them about testing their children and limiting lead exposure.

“This is something we should be able to eliminate,” Norman said.

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