...lead has been identified as causing a range of health effects in children, from behavioral problems and learning disabilities to seizures and death...

About 17 percent of the children living in the United States under 18 years of age have a developmental, learning or behavioral disability (endnote 1).  When a learning disability goes untreated, children lose self-esteem and often suffer serious consequences as a result.  The National Center for Learning Disabilities reports that in 1999, more than 75,000 school age Kentuckians (ages 6 to 21) were served under the Individuals with Disability Education Act.  One particular disability that has received much attention in recent years is attention deficit disorder which now affects 3 to 6 percent of our school children.

These disabilities are caused by a complex interplay of genetic, environmental and social factors.  Evidence reviewed by the National Academy of Sciences indicates that toxic chemicals contribute to these problems.  In most instances, the cause of a disability is not known.  However, research has linked certain environmental toxins to learning and behavioral disorders in children.  For example, lead has been identified as causing a range of health effects in children, from behavioral problems and learning disabilities to seizures and death.  Children and the developing fetus are more vulnerable to the effects of lead than adults.  There is currently no demonstrated safe concentration of lead in the blood, and adverse health effects can occur at low concentrations (below 10 micrograms/deciliter), according to the U.S. Environmental Protection Agency.

In the past, ambient concentrations of lead from leaded gasoline were a major contributor to blood lead levels in children.  Today, elevated blood lead levels are due mostly to ingestion of contaminated dust, paint and soil.  Soil and dust that are contaminated with lead are important sources of exposure because children play outside, and very small children frequently put their hands in their mouths. Deterioration of lead-based paint can generate contaminated dust and soil, and past emissions of lead in gasoline that subsequently were deposited in the soil also contribute to lead-contaminated soil and house dust.  Children also may be exposed to lead through drinking water contaminated by pipes and fixtures containing lead.  Lead exposure to children over the next 10 years is estimated to cost the nation $22 billion in forgone earnings (endnote 2).

Lead Testing In Kentucky

State efforts to identify children at risk from lead poisoning through blood lead testing have been in place in Kentucky since 1992.  Local health departments have performed 308,294 blood tests on children for lead during the past decade.  The state also conducts programs for lead poisoning prevention.  Since 1996 the number of children tested by local health departments for lead has declined significantly, from 42,250 screenings to 19,438 screenings in 2002.

The Kentucky Lead Poisoning Prevention Program recently committed to increasing screening rates by 20 percent through outreach and education activities in at-risk areas.  Building coalitions at the local level and developing primary prevention strategies will also play a major role in achieving this goal.  State efforts are also underway to develop a Kentucky Blood Lead Surveillance (KBLS) System, performance measures to assess progress and an advisory committee to develop a screening plan based on surveillance data.  Until this plan has been implemented, Kentucky will continue to recommend universal blood lead testing of all children at 1 and 2 years of age and screening of all children between 6 months and 6 years of age with a verbal lead risk assessment.

Since 1996 the number of children tested by local health departments for lead has declined significantly, from 42,250 screenings to 19,438 screenings in 2002.

Childhood Blood Lead Levels in Kentucky

The good news is that average blood lead levels in children 5 years old have declined 85 percent since 1976 in the United States (endnote 3).  The decline in average blood lead levels is due largely to the national phase out of lead in gasoline between 1973 and 1995.  The reduction in blood lead levels is also attributed to the banning of lead from paint and plumbing supplies.  However, an estimated 1 million pre-schoolers still have elevated blood lead levels that can lead to brain damage, learning disabilities and lifelong dysfunction (endnote 4).

In Kentucky, 19,438 tests were undertaken to determine blood lead levels in children in 2002.  Local health departments detected unsafe blood lead levels (above 10 micrograms/deciliter) in 4.9 percent of the tests, which was well above the national average of 2.2 percent (endnote 5).  However, this higher state rate may reflect more concentrated testing in high risk areas, according to state health officials.  It should also be noted that blood lead levels in Kentucky have declined from the previous years when the percentage of children with blood levels of concern (10-19 micrograms/deciliter) ranged from 13 to 16 percent.

An estimated 38 million homes in the U.S., or 40 percent, have lead-based paint, according to the U.S. Department of Housing and Urban Development.  In Kentucky, an estimated 700,000 housing units may contain lead-based paint hazards with 455,000 having significant lead-based paint hazards (endnote 6). Of those with significant lead-based paint hazards, 22,762 homes house low-income families with children aged less than 6 years – the age group most susceptible to lead poisoning.

Local health departments detected unsafe blood lead levels (above 10 micrograms/deciliter) in 4.9 percent of the tests, which was well above the national average of 2.2 percent (endnote 4).

Lead and lead compounds are also released to the environment during the manufacturing process.  In Kentucky more than 1 million pounds of lead and lead compounds were released to the environment.  The level of lead-contaminated soils in Kentucky is unknown.  However, several waste, industrial and even public housing sites containing lead-contaminated soils have posed public health threats.  For example, a 1998 federal study detected lead, cadmium and arsenic in soil samples collected from residential yards near Rubbertown—an industrial area in Louisville (endnote 7). Arsenic and cadmium are two other metals that can pose health risks to fetuses and children.

In 2001, high levels of lead contamination were detected in Junction City, Ky., in the Burke Street residential area.  The property and streets are contaminated with lead that was leaching from lead-acid battery casings derived from the recycling and recovery of lead from car and light industry batteries.  The EPA excavated more than 6,000 tons of soil from the site at a cost of $1 million.  In Jefferson County, a jury recently awarded a 12-year-old boy $3.5 million after finding that the Housing Authority of Louisville failed to adequately remedy lead-contaminated soil, which contributed to the boy’s developmental delays.  The boy’s family lived in public housing where lead paint was flaking off onto the ground.  The lawsuit contended that the boy was contaminated by lead dust in the soil where he played.  The plaintiffs argued that Housing Authority officials knew the lead-based paint had contaminated the soil but tried to hide the risk from residents.  The Housing Authority said it worked to correct the lead problems, and that the boy’s condition could not be traced to lead poisoning (endnote 8).

Some Helpful Web Sites

CDC Childhood Lead Poisoning Prevention - The Advisory Committee on Childhood Lead Poisoning Prevention has released recommendations for case management of children with elevated blood lead levels. 

EPA Lead in Paint, Dust and Soil - Information on all aspects of the federal lead poisoning prevention program. 

Kentucky Department for Public Health Lead Program - Administration of state laws and regulations on lead abatement.

Department of Housing and Urban Development - Federal programs to address lead and other pollution problems affecting children.

Endnotes