Lead Poisoning Persists Despite Progress

Stephanie Lee
April 24, 2013
San Francisco Chronicle

Two years ago, Desmond Dollison and his family started renting a West Oakland house builtin the 1900s. It wasn't in the best shape - paint on one side of the house was peeling off- but the affordable rent sealed the deal for him, his wife and their two children.

Then he took his daughter, a year old at the time, to a routine visit to the doctor, who told him the girl's blood had toxic levels of lead, a condition that put her at risk of brain damage, a short attention span and behavioral problems.

The culprit? Dollison figured out that the old paint on the house's exterior was probably lead-based and contaminating the soil in which his daughter loved to play.

"I knew that lead can do damage," said Dollison, 34, a culinary arts student at Laney College. "I didn't know it was a problem, moving into a neighborhood and having to worry about lead."

Poor kids at risk

Childhood lead poisoning is no longer nearly as widespread as it was three decades ago, when national measures to reduce exposure took effect. But the environmental illness still disproportionately harms low-income, minority children, who often live in neighborhoods where lead in paint, soil and other sources persists for decades.

"We're glad the rates have gone down, but we also are still concerned about kids that are getting exposed to lead and the effect it has on them," said JulieTwichell, outreach and communications manager for the Alameda County Lead Poisoning Prevention Program.From 1976 to 1980, before lead poisoning was restricted, 88 percent of U.S. children under age 6 had high blood lead levels of at least 10 micrograms per deciliter. Children are more vulnerable to this toxicity than adults because their brains are still developing.

Since then, national laws have removed lead from gasoline, reduced lead paint in homes and decreased lead levels in children's products. Screening has also increased.

The number of affected children has dramatically fallen, and in a report this month, the U.S. Centers for Disease Control and Prevention estimated that 535,000 children under age 6 - or 2.6 percent of children - have too much lead in their systems. And that's after the agency lowered its "level of concern" last year to 5 micrograms per deciliter.

But experts say there's still reason to worry, since no level of lead is considered safe.

Lead poisoning is significantly higher among children who are African American, poor and on Medicaid, according to theCDC.Itis also the most common childhood environmental illness in California.

Acute problem

This problem is acutely felt in Alameda County, where more than 75 percent of the housing - nearly 407,000 units - were built before 1978, when lead was banned from house paint. In Oakland alone, 90 percent of the housing was built before then, according to census data.

"If you live in a pre-'78 house, you're living in a structure that's just coated in lead paint," Twichell said. And many families, she said, can't afford to move to a healthier home or don't know how to properly renovate their old ones.Several other factors also put the county's children at greater risk, experts said. Those who live near freeways, such as Interstate 880, may be crawling in backyard soil contaminated long ago by leaded gasoline exhaust. Living near factories or other facilities that use toxic chemicals is also potentially hazardous.

Cultural traditions contribute to the risk, too. Mexican families, for instance, sometimes use clay pots or herbal remedies laced with lead, such as a powder called azarcon.

Food is another possible, though less common, source, experts said. A lawsuit in Alameda County Superior Courtis seeking to force baby-food makers to label products with lead, and a recent analysis detected high levels of lead in imported rice from certain countries. Manufacturers say lead in small doses is virtually unavoidable in industrial societies.

Spreading the word

California in general saw a significant drop in the number of children with high blood lead levels as recently as between 2007 and 2010, from approximately 60,000 to20,000, said Dr. Valerie Charlton, chief of the state Department of Public Health's Childhood Lead Poisoning Prevention Branch.

"I'd like to think we've been getting the message out," she said.

About 2 percent of Alameda County children tested in 2010 - 466 children - had high blood lead levels. ButTwichell said the true number is probably higher because not enough children are being checked.

"One of the problems is that children don't show the effects of exposure until later into life, when it's too late to stop the exposure," Twichell said. "We really need to get kids screened when they're very young, 1to 2 years old."

Parents' questions

Otherwise, parents like Evelia Servin, 45, of Hayward are left wondering years later if they should have stepped in earlier.

Servin raised her first son in a run-down house in Mexico. His crib, she recalls, was pressed up to a wall with paint hanging off in shards.

Her son, now 21, struggles with attention-deficit disorder. "After learning aboutlead poisoning and the effects of lead poisoning in children,I strongly believe he was affected," she said.

Individuals react differently to different dosages, so it's difficult to determine the point at which lead poisoning's effects become irreversible. Most long-term damage tends to be neurological, but lead can also harm the gastrointestinal system, hearing and kidneys, said Dr. Erin Tsuchimoto, a pediatrician at Highland Hospital in Oakland. Short-term effects can include stomachaches, loss of appetite, constipation and anemia.

"It's really hard to know because it can be symptomatic in different ways," she said.

In extreme cases, Tsuchimoto said, patients can undergo chelation therapy, a drug treatment that removes heavy metals from the body. Usually, however, the problem can be fixed by cleaning up the home environment.

Reducing exposures

In Alameda County, the lead-poisoning prevention program offers consultations about home safety, classes on safe home renovation, and financial assistance for repair work to reduce lead hazards.

Dollison, the Oakland father, ended up working with a nonprofit to lay burlap bags and 6 inches of mulch over the potentially contaminated soil outside his house last winter. His daughter's lead level has since dropped, he said. He urged parents to gettheir children checked.

"Do what you can to protect your kids," he said. "It shouldn't be happening to me or anyone else."

http://www.sfchronicle.com/health/article/Lead-poisoning-persists-despite-progress-4458066.php

Stephanie M. Lee is a San Francisco Chronicle health reporter.