Part one of four

Childhood lead poisoning: It’s the problem that everyone thinks has gone away.

But everyone is wrong.

Lead poisoning was the headline-grabbing public health controversy of the 1970s and ’80s, but later got pushed to the back pages by fresher issues, like the industrial chemical called BPA used in toys or the flame retardants in children’s clothing.

But while politicians and the media took up newer topics about toxic health hazards, lead from the paint in older homes was still poisoning tens of thousands of children, especially in states like Maine, which has the sixth-oldest housing stock in the country.

The problem was so serious that in 1991 the Maine Legislature passed a law promising to eradicate childhood lead poisoning by 2010.

While some progress was made following passage of that law, five years after the deadline, thousands of Maine children are still being poisoned by licking surfaces covered with lead paint dust, licking their hands and fingers after touching lead dust or inhaling the lead dust floating in the air around their homes.

The Maine Center for Public Interest Reporting spent six months investigating the problem by examining state and national data, and interviewing the top experts in the field, public health officials, landlords and tenants. The findings include:

• Lead is still the top health hazard for children, according to Dr. David Bellinger, a Harvard environmental epidemiologist and pediatric neuropsychologist who is one of the nation’s leading experts on childhood lead poisoning.

• The most likely victim of lead poisoning in Maine is a poor child, because the poor live in older, cheaper rental housing for which there is no financial incentive for landlords to remove the layers of lead paint. Lewiston and Auburn have three times the rate of childhood lead poisoning – often among Somali immigrants – as the rest of the state.

• The primary way officials discover unsafe levels of lead in a home is to use poisoned children as red flags, indicating that there’s a problem. Doctors or health officials report a poisoned child, and then property owners have to clean up the lead after the child has been exposed.

• Experts know how to solve the problem – by removing lead paint from homes or maintaining it so that it does not chip, peel or break down – but public officials have instead chosen a cheaper, stopgap approach that means lead poisoning will be around indefinitely.

‘A HUGE PROBLEM’

No one knows for sure how many Maine children have been poisoned by lead. That’s because only about 50 percent of 1- to 2-year-olds statewide, and only 27 percent of 2- to 3-year-olds, were systematically tested during 2009-13, the most recent years for which data are available. Those age groups are considered to be the most vulnerable because of frequent “hand-to-mouth activity and a higher absorption of any lead that they take into their bodies,” Dr. Dora Mills, who was Maine’s director of public health from 1996 to 2011, told a legislative committee in 2005.

Available data show that in 1997, for example, 400 children under 6 were newly identified as suffering from lead poisoning. From 2003-13, the average number of children newly identified with lead poisoning was 130, with 79 children in 2013, the most recent year for which data is available.

Two factors suggest the number could be larger.

One is that the level of lead in the blood considered high enough by the state to be classified as poisonous has changed, following standards adopted by the national Centers for Disease Control and Prevention. Until this year, the level at which a Maine child was considered lead-poisoned was 10 or more micrograms per deciliter of lead in blood. In June, the Legislature changed the danger level to five micrograms. With that lower threshold, hundreds more children per year in Maine will be diagnosed with lead poisoning. And even that number may fail to capture cases of genuine lead poisoning, because medical experts say any level is dangerous.

The second factor that suggests a larger problem is the number of children living in housing units the state says pose a lead paint hazard: nearly 30,000 kids under 6 live in housing built before 1950, which has the highest probability of being lead-contaminated. Even if just one percent have lead poisoning, that’s 300 kids; three percent is 900 children.

Mills, a pediatrician and former state public health director who is now vice president for clinical affairs at the University of New England in Biddeford, put it bluntly: There is “a huge lead problem in the state.”

Mills also criticized the state’s habit of having exposed children lead public health officials to buildings with lead paint problems.

“It’s a sick part of the system we have, waiting for children to be poisoned, then identifying the homes,” she said.

YOUR BRAIN ON LEAD

One fact about lead poisoning that is well-established is what it does to the human brain after it gets into the bloodstream: “It will scramble up the way the brain works.”

Those are the words of Bellinger, the Harvard epidemiologist.

The lead, he explains, interferes with neurotransmitters, the chemicals that pass information between brain cells.

Lead “introduces noise” to that system, “makes cells fire when they shouldn’t and inhibits cells when they should be firing,” Bellinger said.

All that means a child with lead poisoning could have impulse control problems, inability to delay gratification, an increased chance of failing in school and of getting arrested, he said.

In the 1970s, the federal government banned lead from gasoline and residential paint. In 1995, the ban was extended to lead solder in food cans.

The resulting decline in Americans’ exposure to lead has been hailed as one of the great public health victories of the 20th Century.

“Over the past three decades, blood lead levels of children and adults have plummeted as a result of bans on lead in gasoline, paint, and solder used in canned foods,” wrote physician and lead researcher Dr. Bruce Lanphear in 2007.

But as Lanphear notes in his essay, “The Conquest of Lead Poisoning: A Pyrrhic Victory,” the lead didn’t go away, and the victory was only partial. While the federal government had moved to protect children from a destructive toxin, those actions only took care of new sources of exposure to the toxic metal.

Banning lead from paint, food cans and gas did nothing to get rid of the leaded paint that remained on the walls of buildings built before 1978. It did nothing to get rid of the lead-laden soil next to heavily trafficked roads. And it did nothing to get rid of the lead-saturated soil next to old buildings whose paint had chipped off and fallen onto the ground.

It did create a false sense of safety about lead.

In part, lead’s enduring threat reflects that scientists now understand that it can disrupt brain functioning at much lower levels than was thought in the 1970s. So the acutely toxic cases of lead poisoning that lead to death are rarely, if ever, seen anymore.

And because the heyday of anti-lead poisoning advocacy occurred in the 1970s, “it’s a sort of quiet childhood threat that nobody really thinks about any more,” said former Maine legislator and public health foundation executive Lisa Miller. Miller did lead testing on children in Portland in the 1980s.

Yet the lead that remains in and around homes is poisoning children at much lower levels than previously understood.

For example: With a blood level of just 5 micrograms per deciliter, a lead-poisoned child is 30 percent more likely to fail third grade reading and math tests and more likely to be non-proficient in math, science, and reading, according to studies of tens of thousands of children in Chicago and Detroit.

“Other things get a lot more attention these days – bisphenol and brominated flame retardants – but there’s no question that lead is worse than we thought back in the ’70s,” said Harvard’s Bellinger.

But childhood lead poisoning is a preventable problem. If all the deteriorating lead paint that poisons children were cleaned up, children wouldn’t get poisoned.

“We know how to prevent lead poisoning; we just haven’t done it,” said Bellinger. “It’s fairly simple – this is not a complex technical problem. Just get rid of all the lead paint in the country.”

The Maine Center for Public Interest Reporting is a nonpartisan, non-profit news service based in Augusta. Email: [email protected] Web: www.pinetreewatchdog.org. The research and writing of this story was supported by a grant from the Emanuel and Pauline A. Lerner Foundation.