By Harriet Okatch
In 1978, the Consumer Product Safety Commission banned consumer use of lead-based paint. And yet more than 40 years later, lead poisoning rates in our children remain embarrassingly high.
In 2017, more than 2,206 children in Pennsylvania suffered lead poisoning, a problem mirrored nationwide. Lead-poisoning is completely preventable, but diagnoses usually aren’t made until it is too late to reverse the effects.
This week, Oct. 20-26 is National Lead Poisoning Prevention Week, and we mustn’t let another year go by where thousands of children are left at risk unnecessarily.
Fortunately, Pennsylvania Gov. Tom Wolf recently announced an effort to create a lead-free Pennsylvania. The multi-pronged initiative aims to increase access to lead-testing, and increase the number of local response teams and the number of certified lead remediation contractors.
Identifying the risk factors of lead poisoning is a fundamental step in this critical public health issue. Several studies proved the danger of living in pre-1978 homes that contain lead-based paint. Other risk factors of lead include yard soils; some consumer products like toys, spices and metal charms; herbal remedies; cosmetics products like kohl for eye makeup, and lead-containing water pipes.
The lead-free Pennsylvania initiative ushers the state into a hopeful period to limit the outcomes associated with lead poisoning, including developmental delays, lower IQs and behavioral problems in children; and hypertension in adults.
But we’ve much work to do.
In my public health research in Lancaster, Pa. our team identified several risk factors.
First, knowledge about lead and lead poisoning is strikingly low. Unless parents are aware that lead poisoning exists and how to prevent it, high rates of lead poisoning will likely persist. It is critical to inform caregivers and children about lead and how to prevent exposure.
Communities can educate the public through brochures and incorporate the information into school curriculums. The material should consider literacy levels, spoken languages, and modes of dissemination.
This education response should target other significant stakeholders including landlords and owners of day care centers where young children spend a significant portion of their day. For landlords, this could result in remedial action to ensure lead-safe properties.
Contributing further, the lack of political attention paid to lead poisoning has resulted in limited action to address the condition. Unlike other diseases with overt symptoms that cannot be ignored such as fever, lead poisoning usually presents itself in the form of restlessness, lower IQ, and abdominal pains.
Caregivers are less likely to devote time to the management of these symptoms, especially if they have to juggle these healthcare demands with competing work commitments and economic hardships. Lead-poisoning symptoms are placed low on the priority list.
It is therefore advisable to include early testing of blood lead levels in routine child-care visits. If detected early, the child can be removed from the source or the source can be removed from the environment to prevent the development of symptoms and their cumulative effects.
Our research in Lancaster also revealed that living in rental homes is a risk factor for lead poisoning.
Renters are usually limited in the changes they can make to a home and in Lancaster, where there is a shortage of rental units, renters are more likely to rent a house with lead-based paint and are less likely to complain to the landlords.
In situations such as this, policies can be enacted to protect children, and, in fact, Lancaster recently enacted the Lead poisoning prevention and lead hazard control ordinance. The law requires landlords to make homes lead-safe before renting to families with children.
Several steps can be taken at different levels to address lead poisoning. At an individual level, caregivers, educators and landlords should educate themselves about lead poisoning. Several online materials available in different languages exist online.
Families also should speak to their pediatricians and have their children tested; current guidelines recommend testing at the ages of one and two years.
Finally, municipalities should formulate enforceable ordinances, such as that in Lancaster, to create a second layer of prevention.
The nationwide ban in 1978 drastically decreased lead poisoning rates, but it requires a multifaceted approach by local stakeholders to get us across the finish line and ultimately remove the harmful metal from our children’s environments.
Harriet Okatch is assistant professor of biology and public health at Franklin & Marshall College in Lancaster, Pa.