Pittsburgh Post-Gazette – Under a new threshold, the number of Pa. children with high lead levels is expected to almost double.
After a fire at his home in Knoxville in July 2020, Roy Blankenship noticed a crocodile pattern in chipped and cracked paint on the walls.
Mr. Blankenship, 46, was working for Pittsburgh Hilltop Alliance Property Stabilization Program to help residents in the community be alert to the hazards of lead in their homes, when he realized he might need the program’s services himself.
He is a parent of 14, ages 13 to 30, and a grandparent of six, ranging from 4 to 8 years old. On a daily basis, Mr. Blankenship is taking care of two of his young grandchildren who attend school near his home.
In a house so full of life, it was important for him not to have to worry about putting his family’s health in jeopardy.
In 2020, Mr. Blankenship applied for a free home lead inspection through Allegheny County Economic Development. His home was found to have so much lead, as well as other hazards like mold, that the family qualified for free repairs through the Lead Safe Homes Program.
This year, more Pittsburgh families will begin to be eligible for home lead testing because of the Pennsylvania Health Department’s adoption of the CDC’s lowered threshold for considering children to have “high lead levels” in their blood. Exposure to lead, even at low levels, can cause intellectual, behavioral and academic deficits.
The state Health Department’s annual Childhood Lead Surveillance Report, released in January, shows in 2020, using the old threshold for considering high lead levels in blood, 5 micrograms per deciliter, more than 6,000 children had elevated blood lead levels after their routine lead tests.
What will the change mean?
With the new level of 3.5 micrograms per deciliter applied for this year, almost double the number of children across the Commonwealth are expected to test positive, said Colleen McCauley, co-chair of the Lead-Free Promise Project and health policy director for Children First.
Data from the 2020 Childhood Lead Surveillance report from the Pennsylvania DOH showed the rate of children with elevated blood lead levels to be about 4.65. This is a rate two times higher than children poisoned in Flint, Mich., at the peak of the city’s crisis, according to a recent statement from the Lead-Free Promise Project, a nonprofit in Pennsylvania.
Children with high lead levels, and lead poisoning qualify for a free screening from Pennsylvania’s Early Intervention program which offers coaching support and services to families with children, from birth to age five, with developmental delays and disabilities.
“The best treatment is prevention,” said Dr. Robert Cicco, a retired pediatrician and neonatologist currently working with lead safe groups in Pittsburgh.
While there is a medical treatment for those with extremely high lead levels, he said, most often, children who test positive for high lead levels are referred to Early Intervention.
Dr. Edward Ketyer, an Allegheny Health Network pediatrician and member of American Academy of Pediatrics Council on Environmental Health and Climate Change, explained the danger of lead exposure for children.
Lead can be absorbed through the skin, through the lungs and through the intestinal tract, according to Dr. Ketyer. For children, this means lead gets easily into the bloodstream and through the blood-brain barrier to cause direct, irreversible damage to the brain and nervous system, he said.
“It’s important that people understand that there is no safe level of lead in the blood in a child or adult. 3.5 is still higher than we would like to see,” Dr. Ketyer said.
How are children exposed to lead?
Lead paint was banned in 1978, but around 80% of homes in Allegheny County were built before that ban, according to Ms. McCauley.
“We’re an old state and there’s a lot of lead paint on the walls of our homes,” she said. “The No. 1 way that children are exposed to lead in their homes is dust.”
In November, Pittsburgh passed a lead safety law which states: “Inspections for lead paint, dust and soil hazards will occur in rental homes and child care centers built before 1978. If found, lead must be remedied and subject to reinspection.”
How can children get tested?
Since 2018, Allegheny County has required all children to be tested for lead exposure at approximately 9-12 months old and then again at approximately 24 months old.
Public insurances, Medicaid and the Children’s Health Insurance Program (CHIP), require and cover the cost of lead tests, but babies covered with private insurance are still more likely to be tested, according to Ms. McCauley.
One in three Pennsylvania children with Medicaid health insurance are not being tested for lead poisoning before their second birthday, according to testing data collected for the Pennsylvania Department of Health 2017-2018 Birth Cohort report.
If the family’s pediatrician does not have a lab on-site that can conduct a child lead test, parents have to make a trip to a second location. And it can be a disincentive, especially knowing there will be a finger prick involved, said Ms. McCauley.
Just as many other aspects of routine health care have lapsed in the COVID-19 pandemic, there has been a drop in the number of children getting tested for lead exposure.
Testing dropped by 34% between January and May of 2020, according to a report published by Council for a Strong America in May, 2021.
Mr. Blankenship said having his home tested proactively and remediated saved his family members from greater harm. He encourages all parents to fill out the application with the Allegheny Lead Safe Homes Program.
“The application might seem a little lengthy, but it’s well worth taking that five minutes to fill the application out,” he said. “I recommend that no resident gets discouraged on filling out the forms because it’s your children and your family’s well-being that’s involved with that.”
How to get help
The Lead Free Promise Project recently released a Lead Poisoning Resource Toolkit, providing steps for the families of children who have tested positive exposure for lead.
Families who have not yet had a child test positive for lead may wish to hire a lead inspector. The federal Environmental Protection Agency and state Department of Labor both list certified lead inspectors.
With the updated threshold promising more families will require lead tests, Allegheny County’s Department of Economic Development is set to assist with the cost of home tests and repair.
Since 2017, the department has received a grant from the U.S. Department of Housing and Urban Development for a program called the Allegheny Lead Safe Homes Program.
In 2020, the program again received $5.6 million to aid with lead testing and remediation in Pennsylvania homes. No additional funding is expected with the new lowered threshold for high lead levels in blood, but Jennifer Saks, program manager for Allegheny Lead Safe Homes Program, assures parents “funding is locked in until 2024.”
The program provides free lead inspection risk assessments to those who qualify in which “they test all the painted surfaces in the house to determine where there is lead paint, or any that’s chipping and peeling,” Ms. Saks said.
When lead is detected, the program coordinates repairs with the Urban Redevelopment Authority to ensure the hazards are eliminated, Ms. Saks said.
While the program prioritizes testing the homes of children who were found positive for high levels of lead in their blood, Ms. Saks said the program has had no trouble providing assistance for qualified families who apply.
“As of now,” she said, “we have adequate funding so we haven’t had to make any decision about whom to serve or not to serve.”
For more information about qualification for free lead inspections and the funding available for Allegheny County residents, visit www.alleghenycounty.us/leadsafeprogram, or call Action Housing Inc., a nonprofit group in Pittsburgh that provides assistance with home repairs, at its lead program hotline: (412) 227-5700.
What to do if someone in your family experiences lead poisoning
The organization Get the Lead Out Pittsburgh offers the following tips:
* Consult with your physician.
* Identify the potential sources of lead.
* Take steps to minimize future exposure.
* Children with cognitive and behavioral problems should participate in early intervention programs to curtail developmental delays.