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Gaps in Lead Screening Policies Across States Put Our Children at Risk

Elevated lead exposure in a significant number of US children is going undetected, says report.

Also see: Poisoning the Well: The US’s Unsafe Drinking Water Outrage

Until a few weeks ago, I’d not considered the problem of lead contamination as something I should worry about personally. This, despite the fact that I live in a house built in the 1930s with old doors and windows with lead paint. We replaced those a few years ago and the renovations were done in keeping with US Environmental Protection Agency guidelines. So that, I thought, was the end of it. Lead in the water supply, which I’d researched when the Flint, Michigan crisis began became public, wasn’t much of an issue in the California Bay Area.

But then, just as 2016 drew to a close, I read the Reuters investigation that found almost 3,000 communities across the United States with lead contamination worse than Flint. The investigation, based on a review of public health data from 21 populous states, found that many of these lead hotspots are receiving little attention or funding for clean ups or health screening. Soon after, on January 9, I came across another report, this time by Safer Chemicals, Healthy Families (SCHF), a coalition of 450 health and environmental groups, which pointed out that there is no uniform nationwide policy for screening children for lead contamination across the country.

Lead is a well-known toxin that can have serious health impacts, particularly on the development of the brain and nervous system. Its impact on children is associated with problems that are extremely costly to society, including learning disabilities, socialization issues, and violent behavior. Lead residue is ubiquitous in our environment, especially in urban areas. While the metal has been banned from household paint and gasoline for some time, there are numerous remaining sources of exposure, including paint in older housing, water service lines and plumbing, contaminated soil, and several continuing commercial uses.

“The highest risk areas are where you have a confluence of old housing and low income residents who may not have the resources to maintain the property so you end up with deteriorated lead-based paint and bare soil, which can also then create lead dust that children are exposed to,” says Dale Hagen, housing services manager with Alameda County’s Healthy Homes Department. (The Reuters investigation found that children in Oakland’s Fruitvale neighborhood could have a higher lead exposure rate than in Flint.)

Now, here’s the thing I didn’t know about — lead particles from leaded gasoline, which was phased out more than 30 years ago, still linger in the soil and air around us.

Howard Milke, one of this country’s leading lead researchers whose work helped phase out lead from gasoline in the 1970s and ’80s, says this old lead in the soil, that gets kicked up in the air by the wind and traffic, especially during the dry summer and fall months, continues to be one of the main sources of contamination in communities across the country.

“Soil lead doesn’t get due attention,” he told me over the phone from New Orleans. “One of the gaps in our thinking about the environment is that we have a Clean Air Act and a Clean Water Act but we don’t have a Clean Soil Act. So we have very little attention being paid to the idea that soil might be part of the exposure sources that would contribute to rising blood lead levels of the children.” Milke also pointed out that private properties, especially rentals, had the highest lead levels.

Given that I live in a neighborhood that’s chock-a-block with old houses, right next to a key traffic thoroughfare, and I have a sizeable backyard where I grow vegetables, raise chicken, and where my 21-month-old son likes to muck around — this information has me particularly worried.

Both the EPA and the Centers for Disease Control categorically state that there is really no safe level of lead in a child’s blood. Very young children, between ages 1 and 2, are particularly vulnerable, even at low levels of exposure, because their bodies absorb 4 to 5 times as much lead as adults from a given source. Which is why it’s important to screen their blood for lead.

But while there is a federal requirement that all children enrolled in Medicaid be routinely screened for lead, the Safer Chemicals Healthy Families report found that, apart from the Medicaid requirement, lead-screening policies for children differed widely from state to state. It’s key findings were:

  • 10 states plus Washington DC require universal testing, generally for children at ages 1 and 2;
  • 8 states require targeted testing of known or potentially high risk areas;
  • 27 states only provide recommendations; and
  • 5 states have no requirements or recommendations on their websites.

The report further found that no state is 100 percent compliant with federal Medicaid requirements or general state policies that require testing children at the critically important ages of 1 and 2. Also, states have differing policies about what blood lead levels (measured in micrograms per deciliter or μg/dL) are safe. Some go by 5 μg/dL, while others go by 10 μg/dL, though studies have show that levels even lower than 10 μg/dL can impair a child’s IQ.

This patchy network of blood lead screening policies, the report says, misses a significant number of children with elevated lead levels during the critical window when intervention could prevent long-term damage.

“Part of what drove us do the report was we didn’t have a good sense of how many states were testing and how frequently,” says Liz Hitchcock, legislative director of SCHF, which is calling on states to move to universal, mandatory lead screening for children aged 1 to 2. Regular testing is critical for identifying very young children with elevated levels early enough that intervention can prevent or mitigate long-term developmental damage, she says.

Jen Dickman, author of the SCHF report, told me that one of the main goals of testing is that “it also helps you identify and remediate the sources of poisoning as well.”

Of course, universal testing would require legislation and funding at the federal level — an uncertain proposition in the current political climate. But Hitchcock remains hopeful. “I think it’s a heavy lift but not impossible,” she says.

Greater public awareness would certainly help in this regard. As Hagen pointed out to me:

“Like you, most people think the lead issue has been resolved. One of the gaps that we have is the broader awareness. People think, oh the lead is out of the gasoline, it’s not in the paint anymore therefore the problem should go away. So that’s a big challenge for us to make people aware that this is still a significant issue.”

I’m getting my soil and my son tested for lead as soon as possible. Meanwhile, I’m sticking to raised beds with potting soil and compost for my veggie garden.

Here are a couple of places you can learn more about lead contamination and remediation:

The EPA’s lead webpage,

The Lead Lab Project, a nonprofit initiative founded by Milke that’s dedicated to helping communities with lead contamination in children’s play areas.

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