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Public Radio's Environmental News Magazine (follow us on Google News)

States Fail to Test for Lead

Air Date: Week of

Children who have high levels of lead in their blood can often be treated to prevent severe neurological and behavioral problems. But it's estimated that hundreds of thousands of U.S. children are poisoned by lead each year without ever being diagnosed. Deirdre Kennedy reports from Oakland, CA.


CURWOOD: It's Living on Earth. I'm Steve Curwood. For years the public health profession has stressed early detection and treatment of diseases such as prostate and breast cancer. But when it comes to what the federal government says is the number one environmental health threat for children, there is little prevention and screening. The threat is lead poisoning, which damages brain development and is linked to juvenile delinquency and learning disabilities. But researchers say hundreds of thousands of children are poisoned by lead each year without ever being diagnosed. From Oakland, California, Deirdre Kennedy has our story.

(A baby laughs)

KENNEDY: A children's hospital in Oakland, California. Angela and David Jackson -- their mother asked that their real names not be used -- run and tousle in the hallway like a pair of puppies. The two- and three-year-old brother and sister look like any bright, affectionate toddler. But these children are suffering from lead poisoning.

RYDELL: Hey, how have you been?

WOMAN: All right.

RYDELL: Don't look too sick to me.

KENNEDY: Jim Rydell is a nurse practitioner who's been working with the family to make sure the children's lead levels come down and stay down.

RYDELL: These were really serious lead levels, and if they were maintained at this level, it's possible that they would develop more significant neurological signs, such as possible seizures and things of that nature.

KENNEDY: Both children were hospitalized twice for lead poisoning. On this day they're at the hospital for a follow-up visit. Rydell explains to their mother about other possible symptoms of lead poisoning, such as hearing loss and hyperactivity.

RYDELL: Have you been concerned about their hearing at all, or...?

WOMAN: (laughs) They don't listen to me.

RYDELL: They don't, huh? Tell me about their activity. Are you concerned about their activity at all, like being too much, too little?

WOMAN: Too much.

RYDELL: Too much?

WOMAN: Too much.

RYDELL: As compared to other kids that you know?

WOMAN: Too much.

RYDELL: Too much, really? Okay.

KENNEDY: Angela and David came to Rydell's attention only after their GP found that David was severely anemic. It was then that his pediatrician tested him for lead poisoning. When David's lead levels turned out to be extremely high, 12 times the accepted danger level, doctors sent both children to the hospital. The children are now getting drugs to flush the lead out of their bodies, but nurse practitioner Jim Rydell warns their mother that more damage could still show up later.

RYDELL: Lead can cause problems that we can't always notice, that we don't see. They're very subtle, what we call like silent problems or developmental problems that, you know, we don't see right up front. But when you go to look at how they're performing, like in kindergarten or school, sometimes we see they're having some developmental delays. And if we can pick those up now and start intervening, giving them some help, and get the lead out of the house, then hopefully we'll avoid any, you know, real school problems later on and stuff.

KENNEDY: Those problems can also include juvenile delinquency. In a University of Pittsburgh study, Dr. Herbert Needleman found that young male juvenile delinquents were twice as likely to have high bone lead levels than young men without convictions. Angela and David were lucky that their lead poisoning was caught early. The longer lead exposure lasts, the more neurological damage can occur. Once it's diagnosed, the effects of lead poisoning can be mitigated by getting rid of the lead hazard and giving the children early educational assistance. But more than 200,000 other children in California will likely suffer the long-term effect of lead poisoning without ever being diagnosed, according to a new report by the Environmental Working Group. It found that since 1992, a mere four percent of the state's lead-poisoned children were ever tested. One of the study's authors, Bill Walker, says that many people mistakenly think that since lead has been taken out of gasoline and paint, that it isn't really a problem any more.

WALKER: As lead levels in children's blood have declined, that's been a very great thing. As a result of people thinking that the problem had been solved, there has been a lot less diligence by the medical community, by the regulatory community, in trying to search out those children who are still affected.

KENNEDY: Poor children are at highest risk for lead poisoning because they're more likely to live in dilapidated housing where there's old lead paint. And children who suffer from malnutrition absorb lead much faster. A 1989 federal law requires that states provide screening for all low-income children under age six, or reimburse HMOs and private doctors for the tests. But federal investigators say most states are flouting that law. And without enforcement or monitoring, testing is simply not happening, says Neil Gendel, who heads San Francisco's Healthy Child Project.

GENDEL: If the doctor doesn't believe that a kid should be tested, often the kid's not tested. And if you leave it to the parents to demand that doctors have their kids tested, well, you know that most parents are not going to be able to deal with doctors and be able to do that, and especially poorer parents.

KENNEDY: Gendel believes that doctors and parents are also reluctant to put young children through a painful blood test.

WOMAN: Okay, baby, quick owie. One, two, three, yeow!

(A child screams, cries)

WOMAN: That's it. No more owie. No more owie. I'm sorry, sweetheart. I know, that was rude, huh?

KENNEDY: The most important time to screen children is at 12 months and again at two years, when toddlers are most likely to ingest lead dust from the ground or on window sills. Doctor Susan Cummins heads California's Childhood Lead Poisoning Prevention Program. She agrees that the state has fallen behind with its screening, but says her department simply hasn't had the funding to enforce existing guidelines and laws.

CUMMINS: We've done all the easy stuff. We've done all the regulatory activities that are needed to take lead out of paint, gasoline, other consumer products. What we're doing now is dealing with the tail end of the problem, the most difficult problems that are the hardest to solve. And that includes the children, who are the most marginalized societally, and finding them and caring for them requires a lot of intensive effort.

KENNEDY: In recent years states like New York and Massachusetts have spearheaded efforts to tackle childhood lead poisoning. But several other states, like Washington, California, Montana, and Alabama have come in for major criticism from children's advocates. Washington officials say they don't believe it's worth spending money on lead testing, because lead poisoning isn't really a big problem in the Pacific Northwest. But with more and more medical evidence pointing to long-term social problems from lead poisoning, it's an effort that state governments can't afford to economize on, says the Environmental Working Group's Bill Walker.

WALKER: We are talking about expenditures of a lot of money to try and attack it. But there have been study after study that shows that we would get that money back and lots more in terms of not only improved earning power of these kids, but money that society doesn't have to spend on special education, doesn't have to spend on health care, and doesn't have to spend on juvenile justice programs.

KENNEDY: The Environmental Working Group's report has apparently prompted California lawmakers to back up laws with more funding. They're currently considering adding $2 million to the health department's budget to make sure that cities and communities are screening each and every child in California for lead poisoning.

RYDELL: Say aah. Show her how we did it. Aah...

CHILD: Aah...

RYDELL: Good. Can you do that for me?

CHILD: Aah...

RYDELL: (Laughs) Okay. Do it real quick and then you can go home soon, okay? Perfect. Say aah...

KENNEDY: Children's advocates are hoping that more kids like David and Angela will be diagnosed early, so that health workers can intervene to stop their lead exposure and help them grow up as healthy as possible.

RYDELL: Okay, you look pretty good. We'd never know there was anything wrong, huh.

(Child says something unintelligible)


KENNEDY: For Living on Earth, I'm Deirdre Kennedy in Oakland, California.

RYDELL: Is he being silly?


RYDELL: He's a silly guy, huh? (Angela laughs) I'd say both of you are silly, huh? Both of you are silly, okay.



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