Child Lead Poisoning: A Public Health Problem Out Of The Public Eye

Jul 20, 2015

Shaghaf Mohammed has seen too much in her 11 years. Her family fled Iraq in 2013. And when they left, they never could have guessed the battle they’d face in their new home in Manchester. Shaghaf’s four-year-old sister, Aleel, is sick with lead poisoning.

"When she gets sick, she always cry, she always hug me," Shaghaf explains, describing Aleel. "She feels very scared. She always don’t eat. We had her one time, one week she didn’t eat, she didn’t drink."

  Aleel also doesn’t speak because she’s autistic.

New Hampshire Public Radio recently reported on the health hazard posed by lead contamination in a luxury apartment complex in Manchester. Tenants there decided to sue, claiming their landlord, Brady-Sullivan properties, downplayed the risk to their health. The EPA is now forcing the landlord to clean up the building.

The Brady Sullivan case shines a spotlight on child lead poisoning: a public health problem mostly out of the public eye.

Policy out of sync with science

Within two months of moving into this apartment, Aleel’s blood lead level was high enough for her to be considered poisoned. The likely source? Lead paint. Once he learned about Aleel's problem, the landlord did paint over much of the old paint in the apartment. But the girls’ mother, Bushra Naseef, shows me the front stairwell which is still flaked with chipping lead paint.

As we’re talking, four-year-old Aleel walks into the stairwell and puts her mouth right on the chipping banister.

We do not force anyone to remediate lead in an apartment until after a child has been poisoned. So it is like our children are the canary in the coal mine - you know, the caged bird. - Kate Kirkwood, lead abatement contractor

In 2013, the year this family immigrated to the U.S., more than 1,000 children in New Hampshire were poisoned by lead. But the actual number is almost certainly higher because the state only screened 16.5 percent of kids that year.

The rate of child lead keeps going down. As of 2013, it was about six times lower than five years earlier. And a law passed this year pushes the state to screen more children, and provides more protection for families at risk of lead exposure.

Related: New Hampshire Lags In Testing Kids For Lead

But at the same time, even with this new law, people like Kate Kirkwood, a lead abatement contractor, say New Hampshire’s policy falls short of addressing the problem.

"We don’t force anyone to remediate lead in an apartment until after a child has been poisoned. So it’s like our children are the canary in the coal mine – you know, the caged bird," says Kirkwood.

New Hampshire forces a landlord to remediate when a child has a blood lead level of ten micrograms per deciliter. Aleel’s level has been at 9.5 for two years. Her older sister Shaghaf’s is just over 5. Both girls are considered poisoned by the Centers for Disease Control and Prevention. CDC also acknowledges there is no safe exposure level for children.

Kirkwood has tried to help Bushra Naseef’s family find another apartment they can afford without lead hazards – no luck so far.

"She really has no protection at this point at all," says Kirkwood, "and it’s partly because the child’s lead level never reached ten. Even though CDC  has been telling us for years now that children have significant health effects, including decreased IQ, at 5 micrograms per deciliter, New Hampshire’s level of action is 10."

A widespread problem

The problem is by no means limited to refugees.

New Hampshire’s housing stock is old: 62 percent of homes here were built before 1978, the year the federal government began cracking down on lead paint. More old houses means more likelihood kids are exposed to lead – a neurotoxin that can have permanent health and behavioral impacts on young children.

"So the state has identified more than half of New Hampshire communities as being at high risk for lead poisoning, and their recommendation is that all one and two year olds in those high-risk communities be tested for lead," says Tom Irwin with the Conservation Law Foundation, which has lobbied for tougher lead laws in New Hampshire. "Unfortunately according to the most recent statistics, only 40 percent of those kids actually were tested."

Any small town that you drive through on a summer day, you are going to see somebody with a ladder against an old 200-year-old house scraping paint - no plastic down, no containment to keep that lead dust in. And that is the culture here in New England for 100 years. - Beverly Drouin, lead expert with the Department of Health and Human Services

The new state law may change this. It aims to bring New Hampshire’s screening rates in line with our neighbors, which test far more children. It also requires healthcare providers to educate parents when a child is identified as being poisoned.

Still, even with the new law, Massachusetts, Vermont and Maine require landlords to fix lead hazards much sooner than New Hampshire does.

And even where the state does have authority to force renovations, enforcement can lag. Budget cuts under Governor John Lynch reduced the number of New Hampshire lead inspectors from four to just one. And that one job sat vacant for parts of 2012 and 2013. During those years, New Hampshire only ordered remediation when a child’s blood lead level hit 15 – three times higher than what the CDC calls poisoning.

Beverly Drouin runs the state’s lead office. She says she’d like to have resources to help more families. And she says – for the most part – the public just doesn’t understand how serious this problem is.

"Any small town that you drive through on a summer day," says Drouin, "you’re going to see somebody with a ladder against an old 200-year-old house scraping paint – no plastic down, no containment to keep that lead dust in. And that is the culture here in New England for 100 years."

There’s a new federal rule at play here too. The Renovation, Repair and Painting Program became law in 2010. It requires contractors and landlords all over the country to take an eight-hour class on how to do this work, and how to clean up the mess they make. Kate Kirkwood teaches these classes.

"Day after day," she says, "I have people coming into our classes grumbling about this stupid new rule that they have to listen to and figure out and comply with now, and by the time we get to the first break at 10 o’clock in the morning, I’ve had contractors come up to me in tears. ‘You know, I think I might have poisoned my own kids and my grandchildren. I had no idea this was such a big problem.’ "

Compliance with the federal training requirements is low. No one has an exact number, but Kirkwood estimates around 80 percent of New Hampshire’s landlords and contractors don’t have the federal training.

Frustrated victims

When he was three months old, Frank Donovan had an elevated blood lead level of one microgram per deciliter. The CDC says there is no known safe level of exposure for children under six years old.
Credit William Donovan

None of this sits well with the victims of lead contamination. William Donovan’s infant son had an elevated blood lead level earlier this year from a Nashua apartment.

"What really frustrated us the most was the fact that families that didn’t do anything wrong, there was no laws to protect us" says Donovan, "because we could have been homeless, which we ended up becoming homeless for a little bit. But the laws didn’t have our back."

Donovan says when his landlord found out about the baby’s lead level, he evicted the family. Evictions like this are now illegal under the new state law. The new law also establishes a commission to examine what else the state should do to prevent childhood lead poisoning.