Pittsburgh Post-Gazette -Hundreds of children throughout Allegheny County have been found with elevated levels of lead in their blood since universal screening began in 2018 and thousands more children were tested. At the same time, efforts to prevent exposure in the first place have been slow to gain momentum, including a county-led pilot program to offer property owners help in removing lead hazards in older homes.
The county’s $4 million Lead Safe Homes program — mostly funded by the federal government — has struggled to get certified contractors to do the work for two years now, so far completing only 22 projects out of its three-year goal of 175 properties.
Health and housing officials say there’s still much work to be done to protect children from lead, a neurotoxin that has irreversible effects.
No level of lead is safe, said Dr. Karen Hacker, director of the Allegheny County Health Department. Even low levels of lead have been linked to a child’s IQ and ability to pay attention, how well he or she does in school and other behavioral issues.
With universal lead testing in 2018, a total of 23,057 children were tested and elevated levels — of at least 5 micrograms of lead per deciliter of blood — were confirmed in 480 children.
“It’s exactly what we hoped for,” Dr. Hacker said in a recent interview, explaining the department’s attempts to find children who have been exposed. The Health Department directs the effort to find them and connect their families to help in removing lead hazards from the home and resources such as early intervention to help with any developmental delays in a child. Paint and dust in homes built before 1978 are the most common sources of lead exposure.
In Allegheny County in 2015-18, a total of 1,764 children in the county have been found with elevated levels. In that period, some census tracts in the county averaged more than 10% of children tested with elevated levels. In Pittsburgh, 11 tracts range from Bloomfield (10%) to Spring Garden (19.18%). Outside of the city, they include one tract in Bellevue (11.18%), two tracts in McKeesport (11.43%, 12.75%), one in Reserve (11.86%) and one in Wilkinsburg (18.02%).
Even with many more children tested in 2018, Dr. Hacker said, the vast majority had normal levels: Those showing lead exposure made up 2.08%. Most of them — 336 children — were tested at levels of 5-9 micrograms. Those at or above 10 micrograms numbered 144, or .62% of all children tested.
LuAnn Brink, chief epidemiologist, said the department continues to work with doctors to improve testing rates, and is tracking birth records and mapping areas in the county where children are being missed.
Another step will be to improve the validity of the early test results, Dr. Hacker said. The universal screening usually begins with a finger prick (capillary test). Those showing elevated levels then receive a more accurate test, in which blood is taken from a child’s arm. But 40% of those initially showing elevated levels registered normal when the more accurate follow-up test was given.
“We’d like to close the gap,” Dr. Hacker said about the test results. The Health Department’s website describes testing procedures and offers resources for families with children who have confirmed elevated levels. In addition to Lead Safe Homes, the department’s Safe and Healthy Homes program can help low-income families eliminate sources of lead exposure in their homes or apartments.
“It comes down to the older housing stock,” said Allegheny County Executive Rich Fitzgerald. “The good news is if we get more children tested and see the levels come down … We want to keep improving.”
Lead Safe Homes
Terri Thompson, Bellevue mother of three, said she knew about the dangers of lead in children, but was surprised to hear the three-story house she bought a year ago, built in 1920, had lead hazards throughout the place.
“It was chipped paint,” she said. “Outside there was some chipping and on steps to the basement there was some chipping.”
She took advantage of Allegheny County’s Lead Safe Homes program, which did renovations in March to remove hazards that would put her youngest child, now 5 months old, at risk from lead.
Babies are considered at risk of eating lead in paint chips and dust once they crawl and explore as babies do, testing everything with their mouths. So far, none of Ms. Thompson’s children has been found with elevated blood lead levels.
She said she learned about the Lead Safe Homes program when applying for a home improvement loan and the inspection turned up lead. She signed up a year ago. In March, the work was done as the family was relocated for two weeks in a North Shore hotel.
“My neighbors told me people working in the house were in hazmat suits,” she said. Everything was covered in plastic as the workers replaced the windows, painted the front door and put mulch over bare ground in the backyard.
“Overall it was a good experience. They did a good job,” she said. “It’s worth the wait, for sure.”
Offered to qualified homeowners and renters in the county, Lead Safe Homes does free lead-paint testing and hires the contractors, paying up to $12,000.
There are 68 homes on the waiting list, according to Cassandra Collinge, assistant director of Housing and Human Services at Allegheny County Economic Development.
“Unfortunately, there’s a very long waiting list,” she said. “This is because we don’t have enough contractors to do the work. The wait time is much longer than we would like.”
To expand the number of certified contractors, Lead Safe Homes pays for fees associated with training, testing and state certification.
This spring, Ms. Collinge said, 11 firms applied to the contractor training program; eight were accepted and seven firms sent 12 people to a four-day class. Everyone passed, she said, and now they’re waiting to take a test administered by the state.
With the new crews, work should pick up, Ms. Collinge said, adding that if 175 homes aren’t completed before the end of 2020, the county will apply for an extension with federal Housing and Urban Development.
The challenge has been stringent HUD and state requirements, Ms. Collinge said.
“For a contractor right now to do remodeling work in a home [built] before 1978, he’s required to do one-day training and pay an [Environmental Protection Agency] fee once every three years. Most contractors in the area have complied with that requirement.”
One contractor certified in December said his company recently completed one home in the county program: “We replaced 20 some windows, did a little bit of painting, paint stabilizing, as well as cleaning. … On friction surfaces, the impact surfaces, there’s usually an old base layer with lead paint. Once it’s down to dust and chips, those are things to be concerned about,” said John Botti, president of Disaster Restoration Services of Greater Pittsburgh. The home they worked on now has vinyl windows and commercial-grade stair treads protect the basement stairs.
His 35-year firm does work for the Mon Valley Initiative so he’s familiar with the safety concerns with lead paint. To participate in the county program, the additional training is an obstacle for contractors, he said. Although a portion of the cost is paid for, some firms may not have the resources to participate, he said.
Reporting some progress in developing partnerships for lead prevention is Lead Safe Allegheny, a coalition of nonprofit and public agencies, including the Health Department. Dr. Hacker said the focus is how to prevent children’s exposure to lead and raise awareness of lead hazards.
Policy change is necessary, according to coalition member Ray Firth of Monroeville, a retired policy initiatives director at the Office of Child Development at the University of Pittsburgh.
“It should no longer be acceptable to wait till a kid is poisoned and then let them go back to their home,” he said. “The map today where the high-risk communities are is the same map as before you did universal testing. OK, now what do we do?”
In February 2018, Mr. Firth joined with the heads of Women for a Healthy Environment and Conservation Consultants, Inc., to publicly propose some actions to prevent lead exposure that could start right away. They were partners in the Get the Lead Out, Pittsburgh coalition, and have lent their expertise on lead risks to the community in recent years.
They called for actions by home-based childcare providers, rental property owners, water authorities and at-risk communities to adopt lead-safe renovation, repair and painting practices.
“Connecting and building partnerships has been invaluable,” said WHE executive director Michelle Naccarati-Chapkis in a recent interview. Late last year, she and Dr. Hacker created what is now Lead Safe Allegheny; Hanna Beightley is lead coalition coordinator.
For now, they say, the coalition focus is on deciding policy goals; how to use more data and resources; and education and outreach. On Friday, the coalition held a meeting with a HUD official to share insights on using federal funds to employ lead-safe practices to create lead-safe homes.
Policy expert Firth said a priority should be safe housing, particularly in rental properties. He said the county executive and local legislators could help landlord associations get the resources they need.
Finding children already exposed to lead isn’t the answer, Mr. Firth said. “It’s a distraction if there’s no treatment. It’s a distraction if you don’t use the data to aid in prevention. … Clean up the housing for heaven’s sake.”
Resources: Allegheny County Health Department Safe and Healthy Homes and its Housing and Community Environment program: 412-350-4046
Allegheny Lead Safe Homes Program: 412-227-5700