Lead poisoning: the plague of America's inner cities

USA Today (Society for the Advancement of Education), July, 1995 by Andrea L. Stevens

Unless the government changes Medicaid testing programs, thousands of low-income children suffering from dangerous levels of lead in their blood will go untreated.

ENOUGH IS KNOWN about lead poisoning for the disease to have been eradicated completely. Yet, it presently is the number-one environmental threat to children. Leaded gasoline and paint, which were identified in the 1970s as prime contributors to lead poisoning, no longer are widely available to consumers, Congress has placed many regulations on the lead industry; and local agencies have done much to stop childhood lead poisoning. Nevertheless, it continues to strike inner-city, low-income youngsters at alarming rates. Of impoverished black children aged three to five living in American inner cities, 90% have elevated blood-lead levels.

Elevated levels of blood lead may cause serious health complications in developing children. Because low-level lead toxicity may not show symptoms, many youngsters are not tested or treated. Parents and teachers may attribute changes in behavior to problems in school and/or attention disorders. Kids with low-level lead poisoning may be victims of negative social and emotional development.

Children with higher levels of lead poisoning may suffer from sporadic vomiting, convulsions, loss of muscle control, and lower IQs. The U.S. Department of Health and Human Services has estimated that millions of youngsters have lead concentrations in the blood severe enough to cause nervous system damage. Lead poisoning is particularly harmful to the developing brain and nervous systems of fetuses and infants.

Inner-city children are more likely to be exposed to dangerous levels of lead. Those who live in residences built before 1980 are at high risk of exposure because the paint on the walls most likely contain lead. When paint chips fall off, children either nibble them or the chips break down to dust and the contaminants are inhaled. The Centers for Disease Control (CDC) indicate that about 3,000,000 tons of lead remain in an estimated 57,000,000 occupied private housing units built before 1980, of which 14,000,000 are believed to contain lead paint.

Another source of exposure is soil, which may contain lead from old buildings that have been demolished. Although leaded gasoline, for the most part, has been eliminated, an estimated 4-5,000,000 metric tons of lead from the years this fuel was utilized remain in soil near heavily traveled highways. Lead deposited from the air into soil generally is retained in the upper inch or two of undisturbed soil. Since urban soil is turned over at a much higher rate than in rural areas, contamination is much deeper. Inner-city children inhale dust from lead-contaminated soil or ingest lead-tainted dirt from hand-to-mouth contacts.

They also may be exposed to lead-tainted dust if a parent works around the substance. For example, the clothes of bluecollar workers may be covered with contaminated dust particles, which can be transferred to other members of the family when their garments are laundered in the same washing machine.

A third source of exposure is through drinking water. An Environmental Protection Agency (EPA) study showed that 130 water supplies across the nation serving more than 32,000,000 people contain unhealthy levels of lead. A number of older apartment buildings draw water through lead pipes or copper pipes with lead solder joints. These conduits can contaminate water that has been stagnant for just a few hours. The EPA suggests running water for several minutes before drinking to flush out lead contaminants and using cold tap water for cooking.

Contaminated drinking water also may be present in pipes at schools, office buildings, and public meeting places. This exposure is even more critical since the human body absorbs lead from water at a much higher rate than from other sources.

In 1985, the Centers for Disease Control identified 25 micrograms of lead per deciliter of whole blood (ug per d1) as the acceptable standard for childbood bloodlead levels. In 1992, the CDC lowered it to 10 ug per d1. However, the most common test for lead poisoning, erythrocyte protoporphyrin (EP), can reveal 25 ug per d1, but is unable to detect lower levels. Although more sensitive testing methods are available, adequate laboratory equipment and chemists are too expensive for some state facilities, so the EP continues to be used by many technicians.

The CDC calls for a series of steps to be taken if a child has an unacceptable bloodlead concentration. It suggests that youngsters with levels between 15 and 19 ug per d1 be screened every four months. Moreover, the family should be given educational counseling and an environmental history should be taken to identify sources of lead exposure.

The CDC stresses the importance of lead poisoning prevention through cleaning up the environment. It encourages public health and ecological agencies as well as parents and teachers to conduct environmental case management so treated children can live safely in lead-free surroundings. A primary step is abatement of lead-based paint in homes, day care centers, and schools.