Thirty years ago, public health officials across the country sought to ban lead-based paints, a major cause of lead poisoning in children.
Today, the children who were once at risk for this hazard have become parents. But despite widespread public attention and millions of dollars in prevention efforts, lead poisoning remains a problem in houses that predate the 1978 ban on lead paint.
“Just about every house built before 1978 likely has lead in it,” said Tom Lata, community-development coordinator for the city of Columbia. “Some to a much greater degree than others.”
According to the Missouri Department of Health and Senior Services, 12 children in Boone County — 1 percent of those tested — had unsafe levels of lead in their blood in 2003. In St. Louis, 1,624 children — 14 percent of those tested — had unsafe levels of lead in their blood. An unsafe level of lead in the blood is defined as more than 10 micrograms per deciliter of blood. The only way to determine the presence of unsafe lead levels is by blood testing.
Those numbers, though, don’t necessarily reflect the extent of the problem.
In Missouri, mandatory lead testing is limited to children who live in counties deemed by the state health department to be at a high risk for lead poisoning. Sixty-four of Missouri’s 114 counties are deemed totally or partially at high risk.
Counties are labeled total high-risk if they fall under any of three factors: at least 22 percent of houses are built before 1950, when lead-content in paint was highest; at least 12 percent of children tested have unsafe lead levels in their blood; or there is a history of lead mining or lead processing in the county. Counties are labeled partial high-risk areas if only a portion of the county meets those criteria.
Children in high-risk areas are required to have annual blood tests until the age of six, regardless of their family’s income level. Children whose parents receive Medicaid are tested when they turn 1 and 2, no matter where they live.
Under those standards, neither Boone County nor neighboring Cole and Callaway counties require annual blood tests for non-Medicaid children. The remaining five counties that border Boone — Audrain, Cooper, Howard, Randolph and Moniteau — fall into the high-risk category and require annual blood tests.
Individuals who work to reduce lead poisoning in children acknowledge that the problem may never be fully eliminated, especially since the definitions of “elimination” vary from state to state.
“Elimination for Missouri is that we don’t have a prevalence rate that’s any higher than the national average,” said Susan Thomas, coordinator of the Childhood Lead Poisoning Prevention Program for the state health department.
Nationally, 2.2 percent of children have unsafe levels of lead in their blood, Thomas said. In Missouri, the rate is 4 percent.
As the national rate decreases, Thomas said the state has set a target of 2010 for getting the state average below the national threshold.
North of Columbia in Randolph County, lead poisoning in children is one of the local health department’s top priorities, said Marilyn Humphrey, a nurse who previously oversaw the Randolph reduction effort.
Randolph County reported 15 children with unsafe levels of lead in their blood in 2003. Those children and their families were targeted for educational and outreach services, Humphrey said.
“We would go to their home, and we would run various tests through the home and see if we could find out where it’s coming from,” Humphrey said.
In Columbia, a program through the federal Department of Housing and Urban Development offers low-income homeowners low-interest loans to conduct repairs on their homes. Lata said that 13 homes in the city received such loans last year. Roughly half of the homes selected for the emergency repair loans require lead removal.
But for homeowners faced with an assortment of emergency repairs, lead removal isn’t always the top priority, Lata said. Sometimes more visible problems such as a broken furnace or a leaky roof must be repaired first.
“We do what we can with the budget we have,” he said. Columbia’s annual share of the loan program is usually $250,000, Lata said.
The program currently serves people living in determined “eligibility areas” within the city, Lata said. Those who live outside the eligible areas, but who are in need of lead abatement or other emergency repairs, must sign up on a waiting list. The city is working on a new method to assess loan applications that will allow people living outside the eligible areas to receive assistance, he said.
Because of the limited money available for lead removal, other repair procedures are used that reduce the risk of lead — but these don’t fully eliminate the hazard.
Instead of stripping lead paint, the toxin may be covered with a special chemical sealant. Or, rather than removing lead-painted siding, it may be covered with plastic and coated with a layer of vinyl siding.
Compared to urban areas such as St. Louis, where the scope of the problem is far greater, Columbia’s share of the pie is relatively limited, Lata said.
“The fact of the matter is in Columbia the incidence of lead poisoning in children is much lower than in St. Louis,” he said. “Those are the areas that get that money.”
For the past two weeks, the city of Columbia held lead abatement training sessions to show local construction workers how to properly remove lead hazards from older homes.
The training was offered by The Pharos Group, a St. Louis company. The course was taught by Steve Singler, who specializes in hazardous materials response for the St. Louis Fire Department.
Singler, who has offered lead-abatement training throughout Missouri since 1996, credited city employees in Columbia for their management of the lead program.
“Most of the programs are managed very sloppily,” he said. “Columbia is one of the best-organized programs I’ve seen.”
Singler said that other lead-poisoning programs spend too much money on administration, research or testing for lead poisoning rather than for removal of lead hazards.
“It doesn’t help solve the problem,” he said, “It just identifies the scope of it.”
The actual lead-removal procedure is often not the most expensive part of the process, Singler said. Instead, contractors must also pay for training, insurance and disposal of the removed lead.
For a typical home, the cost can range from a few hundred dollars to tens of thousands. Singler said it all depends on how much work needs to be done on the house, since no two homes are alike.