Lead paint: Money for testing absent in York

(York) — For years, the York City Health Bureau tested hundreds of children around the city for lead exposure — an ongoing threat because so much of the city’s housing stock was built before 1978, when lead-based paints were often used in homes.

In 2013, about one-third of the tests the bureau did showed a child had an elevated blood lead level. The health bureau could then work with families to limit ongoing exposure that could make a child seriously ill and could potentially cause brain damage.

But the funding for that program was cut in 2013, and that testing stopped. The state said it’s working on getting funding to pay for lead blood testing. But there’s no guarantee.

Some children are still tested for lead exposure by their family doctor, but that testing is less consistent and less frequent than when the bureau did its own testing, too, said Dr. Matthew Howie, medical director for the York City Bureau of Health.

“Just because the policy changed and the funding has changed, it doesn’t change the problem underneath,” Howie said.

The scope of the lead problem

A lead in the water crisis in Flint, Michigan, brought lead poisoning into the national conversation. About three weeks ago, Vox.com reported that people in many cities, including York, have higher blood lead levels than people in Flint.

Barbara Kovacs, director of York City Bureau of Health, said York’s issue is related to lead paint, not water.

Mike Shanabrook, emergency planner for the city of York, said there are more than 12,000 buildings in York built before 1978 that have at least a partial residential use, which means it’s possible those buildings have lead paint in them.

Dust from lead paint, even in very small amounts, can lead to elevated blood lead levels. There is no safe blood lead level in children, according to the Centers for Disease Control and Prevention.

In 2014, 12.4 percent of the 1,612 children in York had blood lead levels of 5 micrograms per deciliter or greater, according to the state department of health. That’s the level the CDC says is much higher than most children’s levels.

A child with a blood lead level of more than 5 should be rechecked every six months until the age of three, and their parents should receive education about lead exposure and prevention, according to York’s health bureau. When a child has a very high blood lead level, such as 70 and above, that’s considered a medical emergency.

Children often show no immediate symptoms of lead exposure, said Marilou Yingling, coordinator of the York health bureau’s Lead and Healthy Homes Program, so exposure often goes unnoticed.

“So mom’s not going to see spots and take them to the doctor and say, ‘Oh, they need a lead test, they had a lead problem,’” Yingling said.

The problem might also get little attention because “we think it’s a poor, inner-city problem,” Yingling said. “But it doesn’t end there. They are the children who are most affected, but it doesn’t end there.”

There is old housing stock outside the city, she said, and people remodeling their older homes can unknowingly disturb lead paint, throwing lead dust into the air.

Lead is also found in soil and even in some toys and toy jewelry, especially toys imported from other countries, according to the CDC. And lead’s toxicity doesn’t diminish over time.

Young children, especially those under the age of six, who are exposed to lead are at risk of long-term effects of lead poisoning. That’s in part because they’re still developing. According to the CDC, exposure to lead can seriously harm a child’s health, causing damage to the brain and nervous system, and slowed growth and development.

What happened to the funding?

Pennsylvania doesn’t receive funding from the CDC for “lead poisoning prevention programmatic activities,” according to the CDC’s website.

The CDC didn’t respond to requests for an interview.

Howie said the funding cuts came around the time of the federal government sequester.

Congress “all but eliminated federal funding to prevent lead poisoning in 2012,” according to a USA Today article from Sept. 18, 2013. The CDC’s lead budget was cut by more than 90 percent, according to the article.

Howie said he doesn’t know why the CDC cut lead funding. The effects of lead at the time of exposure are often subtle, he said, which might have factored into the decision. Long term, lead exposure can cause myriad problems, Howie said, but they’re “very difficult things to quantify and trail back to an exposure in childhood.”

Fallout from loss of funding

Nearly three years after Yingling stopped testing children’s blood in York, she said she still gets calls about testing, lead questions and concerns from residents.

“We would literally go out into the neighborhoods of York city and knock on the doors to test the kids at random,” Yingling said.

Yingling still gets sent to city residences for lead issues, doing “risk assessment if a child is found to have a high lead level” during a routine checkup at their family doctor, said Kovacs. The bureau does receive some funding for that purpose, but it’s not able to do any of its own blood testing.

“When we get a report, we will go out and we will talk with the family,” Kovacs said. “It’s not like we’re ignoring the lead problem, but it’s (now) a reactive approach rather than preventative.”

The bureau last did random blood testing on children in the city in 2013, when about 2,000 tests were done. Those screenings found elevated blood lead levels nearly one-third of the time, Yingling said.

“Now the screening has been passed to the primary medical provider,” Howie said. That means screening is likely being done more inconsistently, he said.

Children covered by Medicaid get screened for elevated blood lead levels between the ages of one and two. But not all children in Pennsylvania are screened.

“In Pennsylvania, we don’t have a mandate for universal health screening right now,” said Dr. Loren Robinson, the deputy secretary for Health Promotion and Diseases Prevention. Robinson oversees four bureaus at the state health department, including the Lead and Healthy Homes program.

Robinson said cities and counties could use money from the Maternal and Child Health Program to do some screening.

But Kovacs said she can’t see where spending money from the Maternal and Child Health Program on screening is allowed. “If it’s in the state’s priorities, I don’t see it anywhere,” Kovacs said.

Looking ahead

Robinson said the state health department is looking at “any and every avenue to secure federal funds” for lead programs.

She said the crisis in Michigan might be enough to get the state to support funding. She expects that lead screening will likely be easier to get funding for than lead abatement, or removing lead from housing, which is more costly.

Robinson said universal testing for elevated levels of lead in children’s blood is possible, but would require legislation.

Jeff Sheridan, spokesman for Gov. Tom Wolf, said in an emailed statement that the governor’s Office of Policy and Planning “is reviewing draft legislation supported by the Department of Health, that would mandate a test for every child at 12 months and 24 months.”

He did not provide details.

Bob Reilly, a spokesman for U.S. Rep. Scott Perry, R-York County, said a spending bill signed into law in December increased funding for the CDC’s Healthy Homes and Lead Poisoning Prevention program by $1.5 million, up to $17 million, which is the highest level since 2012.

“We’re not aware why the York City Health Bureau’s funding was cut in 2013,” Reilly said by email Tuesday, adding that Perry’s office hadn’t heard about it until a reporter told them.

Reilly said Perry agrees that lead paint poses health risks, and his office would “be glad to assist the City of York in any way we can to help address the problem.”

Kovacs said the bureau did not apply for the grant funding to which Reilly was referring since, as she understands it, that funding is “primarily focused on housing and remediating the housing stock.This is not within the Health Bureau’s purview to do this kind of rehab work on houses.”

Howie, the bureau’s medical director, said the problem will continue as long as people live in buildings built before 1978. “You manage a lead problem,” he said. “You don’t eliminate a lead problem.”

And that problem needs funding to be managed well, he said.

He said he’s not an alarmist, and he’s not going to say that some child is going to die because of lead exposure tomorrow since the bureau doesn’t do random testing anymore. But he said he guarantees fewer children are being tested now, and they’re still being exposed to lead.

“The take-home message, I would say, when you have a chronic situation, it takes a chronic and persistent program to address it,” Howie said. “This is a management issue and we need the tools to manage it.”

Ways to reduce lead exposure, risk

Parents of children who live in homes built before 1978 should talk with their doctors about having their children tested for lead.

Marilou Yingling, coordinator of the York health bureau’s Lead and Healthy Homes Program, said people can have their home tested for lead, and even have work done to remove the lead. That work must be done by a licensed professional, and it can be expensive.

Some simple, inexpensive ways to limit the risk of lead paint in your home without removing the paint include doing regular wet cleanings, like mopping and wiping down windowsills with a wet rag.

Limiting children’s exposure to lead, especially young children under the age of six, is particularly important. But it can be difficult when children are teething, as they tend to put their fingers and toys in their mouths. Yingling recommends frequently washing your children’s toys, pacifiers and other items that they touch. She also recommends washing children’s hands and faces before they eat.

More information on lead exposure and tips to prevent exposure are available on the Centers for Disease Control and Prevention’s website. 

A move to escape lead

Shawn Robinson, 42, moved his family from their home on North Belvidere Street to Towson, Md., about five years ago. Robinson said concerns over lead paint were one factor in his decision to move.

His family didn’t have air-conditioning and would leave the windows open in the summertime. But when Robinson learned that lead dust from the chipping paint could come inside, he shut his windows. He had his children tested for lead — no one had an elevated level — and the landlord had the exterior of the house painted.

But, Robinson said, he was afraid the paint would chip again. So the family moved.

Robinson said there was a lack of manpower in the York City Health Bureau in 2007. He was frustrated to hear that the entire lead prevention program had lost funding in 2013.

“Why would they not provide the resources and manpower?” Robinson said.

This article is part of a content-sharing partnership between York Daily Record and WITF.