As LNP | LancasterOnline’s Nicole C. Brambila reported in late June, physicians at Lancaster County’s only pediatric unit had treated two children under age 3 in Lancaster County in recent weeks for severe lead poisoning. One of the children had a blood lead level of 52 micrograms of lead per deciliter of blood; the other child’s level was 112 micrograms of lead per deciliter of blood, Brambila reported. While no level of lead is considered safe, the Centers for Disease Control and Prevention has identified 5 micrograms of lead per deciliter as a “level of concern.” A physician said one of the children with severe lead poisoning had normal levels just seven months ago.
A lot of things have fallen to the wayside during the long, strange months since COVID-19 first disrupted our lives.
Perhaps you are — like us — just now catching up on medical and dental appointments and laboratory tests that you put off during the pandemic shutdown.
We cannot emphasize enough how important it is to make sure you’re up to date on routine medical care.
This is essential for children, too, and not just because they need to be immunized against vaccine-preventable diseases.
As LNP | LancasterOnline’s Brambila reported, county physicians are worried that, given that so few children are tested for lead, and so many parents skipped routine checkups because of the pandemic, more children may be at risk of lead poisoning.
“You can’t do a lead screening by telemedicine,” said Dr. Frances Gross, chair of Penn Medicine Lancaster General Hospital’s pediatric unit.
Joyce Ravinskas, program manager for the UPMC Pinnacle Lead Poisoning Prevention and Education Program, said she has seen a 35% increase for investigation referrals.
“This is definitely attributed to COVID,” said Ravinskas. “Right now we’re seeing a lot more cases coming in because children are starting to come back for their wellness checks and they’re being tested for lead.”
Sadly, because of COVID-19 school closures, children likely spent more time in their homes last year than ever before.
In Lancaster city and Columbia, landlords are required to certify that properties built before 1978 are lead-safe or lead-free before they can rent them to families with young children. But there’s no such countywide ordinance.
And, as the recent cases of lead poisoning in two Lancaster County children under 3 — babies, really — illustrate, much more needs to be done to address this issue.
Gross, who has practiced in Lancaster County for more than 30 years, could not recall the last time a child in Lancaster County was diagnosed with lead levels as elevated as those two children.
As Brambila reported, lead poisoning “can be detected with a simple blood test, but only about 20% of Pennsylvania children are tested each year.”
The consequences of lead poisoning can be terrible and lifelong — the damage is irreversible.
According to the CDC, exposure to lead can “seriously harm a child’s health and cause well-documented adverse effects,” such as damage to the brain and nervous system, slowed growth and development, learning disabilities and behavior problems, and hearing and speech problems.
A 2017 Princeton University and Brown University study found that early lead exposure in boys raised the probability of incarceration by 27% to 74%. These problems spell higher costs for school systems and county governments — and heartbreak for families.
As Gross put it, “The only treatment for lead poisoning is prevention.”
But it can be difficult for health care providers to assess the scope of the problem because data reported by the state tends to lag. As Harriet Okatch, assistant professor of biology and public health at Franklin & Marshall College, noted in a spring discussion, state data not only isn’t timely, but it’s basic and aggregated, so it can’t be used to identify where precisely children are being exposed to lead.
As we’ve written, a county public health department that could tackle lead exposure in children effectively, with real-time data, could save children’s futures — and taxpayer money in the long run.
But Lancaster County lacks such a department.
So it’s up to physicians and advocacy groups — and the media — to raise awareness about the need to test children for lead exposure.
The toxic source
Most lead poisoning comes from exposure to lead-based paint — a substance that is frequently found in older houses.
A report published in May by an organization called Fight Crime: Invest in Kids noted that Pennsylvania “didn’t ban this type of paint for residential use until 1978, and Pennsylvania ranks fifth in the country for old housing, with 70 percent of residential units having been built prior to 1980.”
As Brambila reported, roughly half of Lancaster County homes were built before 1978, according to the Pennsylvania Department of Health.
In this commonwealth, according to the Fight Crime: Invest in Kids report, lead poisoning occurs in Black children at nearly five times the rate of white children, and Hispanic children experience lead poisoning at twice the rate of white children.
As Brett Sholtis of WITF reported last week, Fight Crime: Invest in Kids is made up of police chiefs, district attorneys and sheriffs seeking to prevent children from ending up in the criminal justice system.
That group and other advocates for children want to see federal coronavirus relief money used in Pennsylvania to address lead poisoning in children.
Gross of LGH took part in a recent virtual news conference with the Lead-Free Promise Project, a coalition pushing for funds from the American Rescue Plan to be used to remediate lead-laden homes.
We agree that this would be an excellent use of that money — unfortunately, the Republican-led Legislature has put billions of it in savings, instead of using it to help Pennsylvanians now.
As Brambila reported, state Rep. Michael Sturla, D-Lancaster, introduced a bill earlier this year that would require a housing inspector to conduct lead testing on housing units built before 1978; the results would have to be made publicly available. “Right now we don’t even know where the places are,” Sturla told LNP | LancasterOnline’s Brambila. “We’re using children as canaries in the coal mine to identify where there are high levels of lead. That to me is barbaric.”
It is indeed barbaric.
The Pennsylvania Legislature can help to address this problem, though we cannot count on its help anytime soon. The state House and Senate aren’t slated to reconvene until late September.
We’ll remind them of this issue when they get back to work.
In the meantime, parents can take the imperative preventive measure of talking to their children’s pediatricians about lead testing — without further delay.