Lead And Your Kids

When Helene and Bruce Tackling found their two-story house in New London, Conn., in December 1989, they called it "our Christmas miracle." It seemed perfect. On the very same street where Bruce grew up, it had two parks nearby, a big backyard and enough space so their 2-year-old, Jessica, and the baby on the way could have their own bedrooms. It needed some renovation, but Bruce was handy with a Spackle knife and the family moved in on March 1, 1990.

Bruce immediately went to work, scraping the old paint off the pantry and sanding the bathroom walls down to the original wood. The place was looking sharp. But within months of moving in, the children had become increasingly demanding and irritable. Nicholas, the new baby, wouldn't stop crying, his voice sometimes locking into a continual eerie scream, "like he wasn't even awake," says Helene. Doctors said it was colic, and nurses told her to feed him bananas and rice. Jessica kept complaining of stomachaches, but checkups found nothing wrong. One day Helene was cleaning out a filing cabinet when she found a pamphlet on lead poisoning, which she vaguely recalled as a disease kids used to get from chewing pencils. But the symptoms listed matched her children's behavior, so she called her pediatrician's office. The nurse said not to worry. "She's not eating paint chips, is she?" the nurse asked. Helene had never seen the kids eating paint chips, and she regularly vacuumed any peeling paint.

But this April, the Tacklings learned that much of what they and most Americans believed about lead poisoning was wrong. Tests showed both Jessica and Nicholas had lead poisoning. They probably got it not from eating paint chips but from fine paint dust-stirred up in part by the renovations Bruce did to make the house just like new and the vacuuming Helene did to make it pristine. Helene consoled herself by thinking they had caught it early enough so doctors could cure her kids. Doctors had to repeatedly tell the disbelieving mother the disturbing news: damage from regular exposure to lead is usually irreversible. It's too early to tell how the lead has affected them, but odds are, Jessica and Nicholas will not be quite as intelligent as they were born to be. "I'm living it every single day, every single day," says Helene. "I just think of this nightmare. I look at my children and wonder what I've taken away from them."

Lead poisoning? Most middle-class parents would have the same reaction as the Tacklings: denial and disbelief. Isn't lead poisoning something that happens only in the ghetto, where poor children eat flakes of paint? On the surface, the incredulity makes sense. The federal government did, after all, ban the use of lead-based paint in 1978, and phase out most lead in gasoline in the 1980s. Kids today on average ingest far less lead than their parents did-and they don't seem to have suffered an epidemic of lead poisoning. There shouldn't be a problem at all, let alone one affecting people in decent houses. Yet the fact is that lead poisoning is now being, called the nation's No. 1 environmental threat to children-not by Greenpeace or Ralph Nader, but by top officials of the Bush administration. To be sure, some liberals of late have excitedly spotted lead as a politically attractive "children's issue." But the new assessment of lead's dangers comes from scientists and public-health officials who have formed two conclusions: first, while government stopped new lead from being poured into the environment, it never actually dealt with the 3 million tons of old lead that line the walls and fixtures of 57 million private American homes. More important, in the past 10 years research has clearly demonstrated that even small doses of lead can slow development and make children less intelligent.

According to Joel Schwartz, a senior scientist at the Environmental Protection Agency, one out of nine children under age 6 has enough lead in his blood to place him in what scientists now consider the risky zone. U.S. Public Health Service estimates place the figure as high as one in six. In the inner city, approximately one out of two children falls in that range. The U.S. Centers for Disease Control will issue new guidelines in the next few months that contain a dramatic message for doctors and public-health officials: lead is a much more serious hazard than we thought, and families and the government should take action well before children show obvious symptoms. "Lead poisoning is entirely preventable, yet it is the most common and societally devastating environmental disease of young children," says Dr. Louis Sullivan, secretary of Health and Human Services.

In a nation that bans food colorings because they may harm one person in a million, the concept that one out of nine children is adversely affected by lead seems hard to believe. Is it possible that so many of our children are brain damaged? Obviously not. But several hundred thousand of them have absorbed enough lead to significantly slow their minds and alter their behavior. Roughly 2 million others have slightly elevated blood-lead levels without obvious symptoms or intellectual damage. The lead industry argues that scientists still have not proven that small doses of lead really damage kids. But they agree with public-health officials that parents can greatly reduce the risk of any harm by taking a few simple steps (page 46). Chief among them is changing the way they think about the paint on their walls.

The lead problem persists because lead paint persists. Paint manufacturers removed much of the lead from paint in the 1950s. But the failure of the government to address lead hazards in housing-and the unwillingness of interest groups to push them-has meant that most of the paint remains in the same houses that got coats 40 or more years ago. Seventy-five percent of all private housing built before 1980 has some lead paint, according to a 1990 report by the U.S. Department of Housing and Urban Development. Middle- and upper-income families are as likely to have lead paint in their homes as the poor, the report found, and homeowners were as likely to have it as renters. The mere presence of lead-based paint doesn't harm children, but HUD reported that 20 million of those leaded houses have too much lead dust or chippings-about 20 percent of the entire housing stock-and 3.8 million of those homes had children living in them.

Two of those children were 4-year-old Nicholas McFadden and his older sister Chrystal Files of Baltimore. Chrystal almost certainly got lead poisoning from living in a run-down apartment when she was 4 years old. Their mother, Stephanie Poole, found another apartment that, she says, looked safe: smooth walls, intact baseboards. But she didn't know to look for paint dust or tiny loose chips, which were plentiful on the windowsill in Nicholas's playroom. Within a year of moving in, Nicholas had severe lead poisoning.

Poole now has to observe the consequences. Last month she stood anxiously in the hallway at the Kennedy Institute in Baltimore, afraid to look in the room where Nicholas was undergoing a painful treatment called chelation, which uses injections to cleanse the blood of some lead. When Chrystal entered first grade last fall, Stephanie watched as the other kids whizzed through drills on vowels and consonants, while Chrystal gazed blankly out the window. She is far behind the other kids in spelling and math. "I'm hoping she's just slow," Stephanie says, tears welling, "and there's not something wrong with her."

Only in the past decade have researchers focused on how lead damages development, even when kids don't show obvious medical symptoms. In the 1970s, the CDC defined lead poisoning as occurring when a child had 30 micrograms of lead per deciliter of blood (30 jig/dl), the level at which problems like anemia, stomach ailments and noticeable learning troubles appear. But a 1979 study by Dr. Herbert Needleman, then a physician at Children's Hospital in Boston, found that asymptomatic working-class children in Chelsea and Somerville, Mass., who had higher lead residues in their teeth performed worse on IQ and development tests than those with less lead. A subsequent follow-up study showed that children with lead levels equal to 25 to 35 jig/dl were six times more likely to have reading disabilities and seven times more likely to drop out of high school.

The Needleman study was one of the first that tried to factor out other possible explanations such as family stimulation and parental IQ, and it triggered a wave of research on low-level effects of lead. A 1987 study of 249 mostly middle- and uppermiddle-income infants in the Boston area reported that those exposed to 10 to 25 ug/dl of lead in the womb lost four to six points on developmental tests measuring memory, learning and tasks like putting pegs into a board or naming parts of a doll. A 1987 study of 501 children in Edinburgh, Scotland, found that those with average blood levels of 11 ug/dl suffered similar intelligence losses, while another Scottish study reported that children with slightly elevated blood-lead levels were more likely to be considered hyperactive or aggressively antisocial by their teachers. Other studies have linked low-level exposure to hearing loss, slower reaction time, reduced attentiveness, delays in the age at which children first walk and problems with balance. In part because of these studies, the CDC in 1985 lowered the definition of lead poisoning to 25 ug/dl, where it remains. The CDC is planning to draw new warning lines below that number, advocating family or community action between 10 to 25 ug/dI. It has not yet decided what level should be labeled lead "poisoning...... The more we learn, the more toxic we find it to be," says James Mason, head of the U.S. Public Health Service.

While there is a strong consensus that lower levels of lead cause damage, there is no unanimity. Studies financed by the lead industry have found little damage at low levels, and one independently funded study found that early intelligence losses associated with lead may fade in later years. "You see tremendous inconsistencies among the results," says Rosalind Volpe, a consultant with the International Lead Zinc Research Organization, an industry-sponsored group. The key health statistic, according to Jeffrey Miller, spokesman for the Lead Industries Association, is that average blood levels have dropped dramatically in recent decades, from 17 Fig/dl in 1978 down to about 6 jig/dl now. "One might get the sense it's a billowing epidemic, when in fact the opposite is true," he says.

It's a fair point, which makes one wonder: if lead is so bad, why aren't half of today's adults suffering the effects of childhood lead poisoning? The answer is that many probably are, but couldn't possibly know it. "I guess we all might have been a little smarter than we turned out," says David Bellinger, a lead researcher at Harvard University. "It's hard to tell if someone goes from 140 IQ to 135."

The changing notion about how kids get poisoned is altering beliefs about who gets poisoned: if children can get lead poisoning without eating peeling paint, they can get it without living in dilapidated housing. The Children's Hospital in Boston reports that from 1987 to 1990, 40 percent of its infant-poisoning cases resulted from victims ingesting dust while the family, often well-to-do, renovated an old house. The daughter of a financial consultant and a management consultant became sick from renovations on an old farmhouse in Concord, Mass. Paul and Gerry Francoeur's 3-year-old daughter, Heather, seems to have gotten lead poisoning from playing in her sandbox, which apparently became contaminated with lead dust after her father sanded paint off the house's exterior.

The Francoeurs were lucky because they live in Massachusetts, the only state that requires mandatory testing of children for lead poisoning. Several states and cities have aggressive programs to screen innercity children for lead poisoning. But all those programs together in 1985-86 tested just 800,000 kids, about 4 percent of children under age 6. And pediatricians of middle-class kids test even less frequently than those of the poor.

It takes strikingly little lead to cause lead poisoning. A child can become severely lead poisoned (60-80 ug/dl) by eating one milligram of lead-paint dust-equivalent to about three granules of sugar-each day during childhood. To achieve blood-lead levels of 35 ug/dl, a child would have to eat just the equivalent of one granule of sugar a day. That's why a child can become ill merely by regularly touching a windowsill and then sucking his thumb. Why is lead so toxic? The body, in effect, mistakes it for calcium. The lead attaches to and disrupts enzymes essential to functioning of the brain and other cells. Because lead is an element, it never decomposes into another, more easily tolerated, substance. While it can be removed from the bloodstream through chelation, most of the lead that is absorbed into a child's brain, it's there, literally, forever.

Children are most likely to get lead poisoning between the ages of 6 months and 6 years, when lead dust from carpeting, toys or the floor is more likely to find its way into their mouths. (An adult can tolerate larger doses.) If exposed, developing fetuses are the most vulnerable of all. Sometimes mothers subject their children to lead by eating, drinking or breathing lead during pregnancy. Researchers are now examining theories that women store lead in their bones and years later may withdraw it, along with the calcium, during pregnancy and pass it on to their fetuses. Sandra Roseberry of Portsmouth, N.H., probably passed lead on to her daughter Julianne by stripping wallpaper during pregnancy. Julianne's blood-lead level went as high as 100 ug/dl.

Although a less serious culprit than paint, drinking water can raise blood levels, too. When Vice President Dan Quayle recently had his Washington mansion tested, he was disturbed by the levels of lead found in the water. The Environmental Protection Agency estimates that lead in water causes 10 to 20 percent of overall childhood lead exposure.

The new science about lead's effect on the brain may force policymakers to re-examine some social issues through a new prism. For example, if lead can cause aggressive behavior, learning disabilities and hyperactivity, might it not also be a contributing factor in poor educational performance among low-income blacks, who suffer the most lead poisoning? "The education community has not really understood the dimensions of this because we don't see kids falling over and dying of lead poisoning in the classroom, " says Bailus Walker, dean of the public-health school at the University of Oklahoma and former commissioner of public health in Massachusetts. "But there's a very large number of kids who find it difficult to do analytical work or [even] line up in the cafeteria because their brains are laden with lead."

It's not just the educational community that has ignored the problems of lead. Civilrights advocates, environmental lobbyists, even children's welfare advocates have until recently done almost nothing about lead. The inaction stems mostly from two contradictory beliefs: that the problem had been solved and that it is too big to solve (removing old paint would be a gargantuan task). Congress gave most of the responsibility for solving the lead-paint problem to the HUD in 1971. But HUD has done little about most private housing, and in government-assisted housing it has regulated only peeling paint, whether it has lead in it or not. Many localities still believe they only have to fix peeling paint up to five feet high on walls, ignoring both the laws of Congress and gravity. When trying to promote research about lead, HUD has had mixed results too. In 1975, for example, it paid the Johns-Manville Corp. to find a way of sealing off lead paint. Incredibly, Mansville suggested covering it with asbestos.

The failure for years of government and liberal advocates to focus on lead has been so stark that it begs an uncomfortable question: have attitudes about race and poverty affected people's willingness to take on this problem? Consider Wanda Johnson, a welfare mother from Baltimore with eight children-five of whom have suffered from lead poisoning. Psychological tests have shown her poisoned kids far behind their age group, yet their future teachers or bosses may not have expected much more anyway. "They're going to walk around with a 10-pound weight," says James Ruffin, a University of Maryland School of Law student who tried to force the Johnsons' landlord into making repairs. "But most people are just going to assume they're naturally slower and lazier."

New research and an awareness that lead hazards touch people like the Tacklings of New London, Conn., as well as the Johnsons have helped prod the government into stronger action in the past two years. After years of delay, EPA in May issued rules attempting to reduce lead in drinking water. HUD has, for the first time, asked for funds to de-lead private housing, and is writing rules on how to improve a house through small, practical steps without ripping it entirely apart. One bill being drafted in Congress by Rep. Henry Waxman would require house sellers to notify prospective buyers of lead paint. The most important governmental action will be CDC's new guidelines for doctors and public-health professionals. But CDC faces a dilemma: how to make people more aware of lead's hazards without creating a stampede of hysterical parents. Health departments and medical labs could not now handle a surge in demand for blood tests. And outside Massachusetts or Maryland, few contractors are actually qualified to test and remove lead.

Over the next few years, parents' concern will likely rise faster than the understanding of what they should or shouldn't do. When Baltimore began publicizing lead hazards in the early 1980s, about half the poisoning cases treated by the Kennedy Institute resulted from houses that had leaded paint improperly removed. Marc and Cathryn Perrone of Milwaukee actually consulted an engineer to find out how to get rid of old lead paint safely. They decided on a heat gun. After they'd stripped most of the paint, they learned that heat guns were very dangerous. When they tested their kids, their daughter Miranda, then 21 months old, had a 33 jig/dl reading.

Mark Rosenbaum, a lawyer in Los Angeles, had already renovated his 85-year-old house when he decided to have his 16-month-old daughter, Samara, tested. The tests revealed a blood level first of 8 ug/dl and then of 12 ug/dl. The family moved out right away. Tests of the house showed lead dust on the floors and carpets, but the Rosenbaums couldn't find a contractor in all Los Angeles who knew how to remove the lead-based paint. "You go to the Yellow Pages for lead abatement and you might as well be looking for krypton abatement," he says. They flew in a licensed professional from Massachusetts. The cost: $70,000.

The Rosenbaums' experience was harrowing, but it should be kept in perspective. Research has shown that if the exposure to low doses of lead is halted early, parents can make up for most potential learning deficits through good diet and extra stimulation. It's unlikely that paint dust will really alter Samara's life. And Rosenbaum is lucky in another way. As general counsel of the American Civil Liberties Union in California, he was able to vent his anger by helping sue California for not testing enough for lead poisoning. But most families won't take such dramatic steps, or, for that matter, test their own children. The problem for them isn't lack of money or legal expertise. They simply don't realize-or can't believe-that the dust on their windowsill might be quietly stealing part of their child's potential.

Seventy-four percent of all private housing built before 1980 contains some lead paint. ..CN.-***

Three million tons of old lead line the walls and fixtures of 57 million American homes. ..CN.-***

One of nine children under age 6 has enough lead in his blood to place him at risk. ..CN.-***



There are 3.8 million homes with peeling lead paint or lead dust inhabited by children under the age of 7. ..CN.-***

52% of these families have an annual income less than $30,000; 48% have incomes more than $30,000. ..CN.-***

Two thirds of the families with incomes less than $30,000 per year rent their homes. ..CN.-***

More than 75% of the families with incomes over $30,000 per year own their homes. ..L1.- SOURCE: DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

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