Flint is a warning, but we must do more locally as well
February 19, 2016 12:00 AM
By Karen Hacker
With the advent of the Flint, Mich., public health crisis, lead poisoning has once again become a front-page news story. Although blood lead levels in U.S. children have been dramatically reduced over the past 40 years, lead poisoning still occurs.
Today, the presence of lead continues to put Pennsylvania’s and Allegheny County’s children at risk — but lead in the water, as in Flint, is not the chief concern. The major source of lead poisoning in Allegheny County is the presence of lead in paint used in older dilapidated housing.
Lead paint that flakes off and household dust contaminated with lead account for up to 70 percent of elevated lead levels in U.S. children. Since young children tend to put things in their mouths, they are at risk for lead exposure from lead paint chips and dust found in houses built before 1978.
Even low levels of lead in blood have been shown to affect IQ, ability to pay attention, academic achievement and criminal behavior. And the effects of lead exposure cannot be corrected.
Here in Pennsylvania, we have two major problems.
First, blood screening for lead is not mandated in our state as it is in several other states. That needs to change. All children should be tested between the ages of 9 and 12 months and again at 24 months. While we in the Allegheny Health Department have promoted screening and it is covered by insurance, doctors may defer based on their perception of the problem or the location where the family lives. In addition, although a child has received a prescription for a blood lead test, it may require an extra trip to the lab, which means it sometimes doesn’t happen. Mandatory screenings would help solve those issues.
Second, the Centers for Disease Control and Prevention recently changed its recommendations regarding lead levels. It now suggests that physicians follow any child with a lead level of 5 micrograms per deciliter or more to determine if the level is rising or falling. However, since 2012 the CDC resources available for states and counties to follow and remediate lead problems have been severely reduced. This hampers our ability to fully implement new recommendations.
As a result of funding limitations, the Allegheny County Health Department can do an environmental intervention only for children who have persistent blood lead levels of at least 15 msg/dl. Even this level of intervention is at risk as the focus of federal Healthy-Homes funding shifts from lead to injury prevention. There must be a continued commitment to funding these efforts to ensure that our children are protected.
As the story in Flint unfolds, we can bemoan the lack of foresight that led to such problems and express our outrage. Here at home, lead is a problem we can prevent with appropriate remediation and education, and the required resources. Nationally, public health funding has been declining for years while new and old issues continue to emerge. This has been the case for lead screening and remediation.
As the news of Flint is fresh on our minds, we need to advocate for more federal funding to support lead screening and remediation nationally and in our Pennsylvania communities that are most at risk.
Karen Hacker, a physician, is director of the Allegheny County Health Department.
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