What do a rock star and a refugee have in common?

They both had sons poisoned by lead dust in Maine. They are very different cases but represent the majority of lead poisoning in children and they both should never happen.

One is caused by renovations and one is caused by low-income subsidized rental housing. Both are infuriating and entirely preventable. The Health Impact Project released an assessment of childhood lead exposure health costs in August. The team of experts completed a cost benefit analysis for the lead remediation for all children born in 2018. The economic modeling proves the government cost savings from preventing lead poisoning.

I don’t know Jon Fishman from the band Phish or his son who was exposed to lead dust. They don’t need the federal money I manage to address the lead paint that poisoned their son, but Jon has spoken publicly about his family’s experience with lead dust in a 200-year-old Maine farmhouse. Fishman told the Huffington Post in 2015 that he suspected the lead dust was created by stripping the floors during a renovation or cleaning the house without a HEPA filter. His wife runs an organic farm. While they were limiting their exposure to chemicals in food, their family was exposed to a neurotoxin in their own home.

The second family rents a two-bedroom apartment and I suspect relies on food stamps to eat. The building was built around 1900. I met them because their building now has a legal order to abate the lead hazards. The poisoned child also has a developmental disability. This little boy has existing health and speech problems. He lives with a single mother with no income, no car and very limited English skills. This little boy also has pica so he eats substances that aren’t food.  You can’t see lead dust but housing authorities and local codes don’t require lead inspections so multiple officials approved funding for that home for this family based on varied visual inspections despite the obvious risk factors. You can’t see lead dust but we continue to rely on visual inspections for many local housing inspections. Every painted surface in the apartment now has child-sized teeth marks. Much of the paint has been chewed down to bare wood. Thankfully the majority of the paint was lead free or the poisoning could have been life threatening.

Lead paint was banned for use on residential homes in 1978 so how did these two children both end up poisoned in 2017?

 

We still have lead paint in an estimated 37.1 million homes in America.

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Regular wear and tear of windows and doors create lead dust. Many repairs and renovations impact the old layers of paint too. Lead dust is easily transferred to the blood stream by hand to mouth contact. The Fishman’s probably received a ‘lead disclosure’ pamphlet when they bought their house in Maine. This is the only legal requirement.  If you’re lucky a bank or insurance company might require a lead inspection. The contractor who renovated the Fishman’s farmhouse was required by federal law to have an EPA lead safe certification. This requires an 8-hour class for renovators who work in residential buildings built before 1978. The contractor either didn’t have certification or didn’t follow the lead safe work practices and so left poisonous dust in the home.

There is no EPA office or staff in the State of Maine to enforce compliance. The Health Impact Project team calculated that full enforcement of lead-safe renovation rules would protect about 211,000 children born in 2018 and provide future benefits of $4.5 billion, or about $3.10 per dollar spent.  As long as the EPA doesn’t have the resources to consistently and sufficiently enforce the law, the existing regulations will never compete with massive DIY market to create awareness around the need for trained and licenses contractors to keep kids safe from lead paint. In 2015 the DIY/home improvement North American market turned over more than $320 billion. The Lead Risk Reduction program (the prevention program) was eliminated in the EPA’s 2018 budget and their enforcement capability is chronically underfunded. Our policies and budgets continue to target children after they are poisoned. We are using American children as canaries in coal mines.

The second case of childhood lead poisoning involves renters. There is seven people in a two-bed apartment. Their rent is paid for by a local statutory body. This should require some sort of housing inspection but the standards are inconsistent.  A housing authority has also inspected the that building as there are other tenants with a Section 8 voucher. There are no local, state or federal protections for renters until AFTER a child has lead in their blood. I am the last in a long line of public officials, housing inspectors, social workers who walked through that building and I am there too late. I think it’s unacceptable in 2017 that any type of housing inspection would not assess the health implication of placing a vulnerable child with a pica diagnosis there. There are case workers advocating for this family and communicating on the mother’s behalf so there was ample opportunity for collaboration between social workers, housing officials and the property owner.

We have known for decades how poisonous lead is for people and that children under six are at a particular risk for poisoning. The statistics are scary: 535,000 children between 1 and 5 are diagnosed with blood lead levels of 5 ug/dl or higher each year. 37.1 million homes in the US contain lead paint and 23.2 million contain obvious lead hazards. Children who are lead poisoned are estimated to lose two IQ points for each 10 ug/dl rise and the first 1 to 10 ug/dl is associated with a loss of six IQ points. The societal and financial costs to American families and communities are astronomical. Eliminating lead from pipes, houses and schools will save the federal government about $19 billion and state governments about $10 billion for children born in 2018 alone.

The U.S. has made progress in reducing the number of lead poisoned children but these two cases of lead poisoning in Maine highlight the gaps and failures of our legislation to protect our most vulnerable citizens. The only vaccine for lead poisoning is to reduce the lead hazards in your child’s home and environment.

My advice to parents is to insist on a lead inspection before buying a house that includes soil and water. Factor the removal of hazards into your purchase price. Low-income renters and buyers often don’t have negotiating power so that is where local governments need to reform their housing and building codes to address potential health hazards, through code enforcement and permitting. The sons of rock stars and refugees should both be safe from heavy metal poisoning in their homes and we can not wait for the federal government to protect them.

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