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Hazards of Lead

"'Silent Epidemic': Nearly 1 in 3 Kids Exposed To Damaging Levels of Lead"

By MARIA GODOY, July 29, 2020            
Children laying on several undressed mattresses

Lead exposure has been an issue for many years. Above: Women and children from lead-contaminated villages rest on mattresses during testing and treatment for lead poisoning in a ward at the Doctors Without Borders clinic in Anka, Nigeria, in 2010.

Shawn Baldwin/Bloomberg via Getty Images

How many children in the world have been exposed to dangerous levels of lead?

That's a pressing question that has had no definitive answer until now. About 1 in 3 children have been exposed to lead at levels shown to damage their health and cognitive development, according to a groundbreaking report that is the first to document the problem globally.

The report, produced by UNICEF in partnership with Pure Earth, a global nonprofit that tackles toxic pollution in poor communities, "is the first report of its kind and it's important," says Katarzyna Kordas, an environmental epidemiologist at the University of Buffalo who studies the effects of toxic metal exposures in children and was not involved in the study. Prior to this, she says, "there have actually been no studies to systematically and comprehensively estimate the extent of children's exposure to lead globally."

The new report finds that some 800 million children worldwide have blood lead levels at or above 5 micrograms per deciliter – a level considered cause for intervention by the Centers for Disease Control and Prevention. (There is no safe level of lead exposure in children.) Among other harms, lead exposure at that level has been linked to lasting decreases in cognition, including a 3-to-5 point drop in scores on intelligence tests, notes study co-author Nicholas Rees, a policy specialist at UNICEF working on climate, energy and the environment. He says it's "incredibly alarming" to realize that up to a third of the world's children could be facing such potential hits to IQ.

"We're talking about a massive problem that has ripple effects, obviously, for the kids, but for society at large," Rees says. "It's effectively limiting the potential of a third of the world's children." It could also limit the creative and economic output of whole societies, he says.

Indeed, Kordas says one of the strengths of the new report is that it highlights not only the health consequences of lead exposure but also the economic ones. The report cites one analysis that found that over the lifetime of affected people, childhood lead exposure could result in a loss of nearly $1 trillion in earnings in lower and middle-income countries in Africa, Asia, Latin America and the Caribbean. That kind of economic argument may help to add a sense of urgency in countries where combating childhood lead exposure has not been prioritized.

"I really hope that with the weight of support by UNICEF and Pure Earth, the problem of lead exposure and poisoning among children will receive the attention it deserves," Kordas says.

Lead exposure is particularly dangerous to children under 5, whose bodies absorb lead much more efficiently than adults and are at greatest risk of suffering lifelong physical and cognitive damage, the report notes. Childhood lead exposure has also been linked to aggression, hyperactivity and other behavioral problems, notes Joseph Graziano, a professor of environmental health sciences and pharmacology at Columbia University and an expert on lead poisoning in children.

"This has been a decades' long silent epidemic that has really deprived generations of children of their full capabilities and their full economic potential," Graziano says.

While exposure to elevated levels of lead continues to be a problem in parts of the U.S. like Flint, Mich., Graziano says "the Western world has taken it on head on." As the new report notes, blood lead levels in high-income countries have decreased dramatically since lead in gasoline and paint was phased out, but they remain "dangerously high" in lower and middle-income countries. Most of the children affected by lead exposure live in Africa and Asia, though many live in Central and South America and Eastern Europe, according to the report.

Globally, sources of lead exposure can often include ceramic serving dishes made with a lead-based glaze, which can lead to lead chips making their way into food. In some countries, including Georgia, India and Bangladesh, researchers have found that lead chromate is being added to some spices, particularly turmeric, to increase its weight and enhance its color.

Lead mining and lead water pipes are also major sources of exposure, as is the informal recycling and burning of e-waste.

But one of the biggest sources worldwide is the recycling of lead acid batteries from cars, trucks and other vehicles, which account for about 85% of the world's lead use, Rees says. While battery recycling can be done safely in countries with proper regulations and monitoring, an untold number of informal, unregulated and sometimes illegal recycling facilities have cropped up where workers extract lead and other metals from used batteries for resale.

"Sometimes [this happens] in people's backyards, sometimes in open areas where parts of the batteries are burned, and the lead can enter fumes, it can enter the soil and can enter surrounding water sources. That's where the risk becomes really, really high," Rees says. Sometimes, workers might unwittingly carry lead dust back home on their clothes, he says.

In many cases, he says, the people engaged in these activities – and the communities around them — are not aware of the risks.

That was the case in Kathgora, Bangladesh, a village of about 300 people about 9 miles outside of Dhaka, the capital city. In 2016, informal battery recycling operations opened in a bamboo jungle by the village. Residents started asking questions when they saw their livestock die after grazing on grasses contaminated by lead dust from the recycling operations. But they didn't realize their children were also affected, because symptoms of lead exposure in kids can be subtle at first, says Luftul Kabir, a researcher with Pure Earth who investigated the Kathgora site.

"They had no idea why children were not learning anymore and why they were so aggressive and things like that," says Maya Vandenant, chief of health for UNICEF Bangladesh. "The awareness among the community members is very, very low."

Kabir says the villagers eventually forced the recyclers to shut down. In 2017, a team from Pure Earth and the Bangladesh Department of Environment came in to carry out remediation, clearing out used battery parts and removing contaminated top soil. At the start of the project, testing of blood lead levels in 75 village children found an average of 21.3 micrograms per deciliter; 18 months later, those blood lead levels had dropped by 42% on average, according to Pure Earth.

But while improvements in blood lead levels is possible, reversing the damage already done by lead exposure isn't. That's why prevention is absolutely key, Kordas, Vandenant and Rees emphasize.

"I think the bottom line is we need to focus on reducing exposure in the first place because unfortunately, you can't undo the damage that lead causes to the brain and the body," Rees says.

Quoted from npr.org, August, 2020. Author Maria Godoy: Goats and Soda - Stories of Life in a Changing World

"Federal Watchdog Warns EPA Is Failing To Enforce Lead Paint Abatement Rules"


Millions of homes built before 1978 still contain lead-based paint. A report published Monday finds the Environmental Protection Agency is not adequately enforcing laws meant to protect children from lead-laden paint flakes and dust. Stew Milne/AP
Millions of homes built before 1978 still contain lead-based paint. A report published Monday finds the Environmental Protection 
Agency is not adequately enforcing laws to protect children from lead-based paint flakes and dust. Stew Milne/AP
Lead-based paint was extremely popular in the early and mid-20th century — used in an estimated 38 million homes across the U.S. before it was banned for residential use in 1978.

The risk didn't stop with the ban. Today, when older homes are renovated or repaired, contractors are required to take special precautions to avoid exposing residents to lead-laden dust and paint chips that are dangerous, especially to children and pregnant women. It's part of a broader set of environmental regulations meant to protect young people from lead exposure.

But an internal investigation by the federal watchdog for the Environmental Protection Agency finds that the EPA is not enforcing many of those requirements adequately.

The sweeping report by the EPA's Office of Inspector General says the agency does not have an "effective strategy" for enforcing rules that require contractors and other renovators to be trained and certified before they work on homes that have lead paint in them and that the agency is not keeping track of basic details that would help it know whether children are being exposed to lead-contaminated dust.

"It's fairly clear that at every turn, the agency is failing," says Erik Olson, senior strategic director for health and food at the Natural Resources Defense Council, an environmental advocacy group. "It's really disappointing. It's kind of heartbreaking, to see this kind of thing."

While rates of childhood lead poisoning have decreased since lead was banned from gasoline and household paint decades ago, tens of thousands of young children are still exposed to dangerous amounts of lead each year in the U.S., according to the Centers for Disease Control and Prevention.

Lead-containing dust from construction is one culprit.

The EPA is supposed to make sure that renovators follow these practices. But the new report finds that the EPA does not appear to know which buildings it is supposed to be regulating. According to the report, the EPA is not keeping track of construction projects that involve lead-based paint."Normal cleaning methods will not pick up all the dust in a work area. Sweeping is not enough," explains an EPA training document. "You need to use water, detergent and a HEPA vacuum to clean up dust effectively."

"The agency could not identify or estimate how many renovators or renovations were being conducted in each region," Sarah Davidson, an analyst from the Office of Inspector General, says in an explanatory podcast accompanying the report's release Monday.

The agency's most recent list of renovations is from 2010, the first year of the Obama administration, when about 320,000 construction firms did about 18 million projects that required lead paint control.

The report also found that the EPA hasn't been tracking other basic information about its enforcement of the lead paint rules, including how EPA employees in different parts of the country reach out to residents about risk from lead paint dust and keep track of the agency's own inspections of properties under construction.

The inspections that the agency did report does suggest that, on average, fewer than 1% of renovators in the U.S. who are working on homes with lead-based paint have been inspected over the past five years, although the number of inspections vary dramatically by region.

In the region that includes Texas and the four states bordering it, for example, the agency reported an average of just 18 lead-based paint inspections each year. A spokesperson for the agency declined to comment specifically on the inspection rates.

"If you're not out there inspecting, you can really have serious problems," says Olson. "To have so few inspections is sending a signal that it's OK not to be carrying out the law."

Monday's OIG report makes six recommendations to the EPA, including that the agency figure out which renovation firms are working on buildings that involve lead-based paint; that the EPA monitor childhood blood lead levels to make sure children are being protected; and that it comes up with specific goals to make sure the agency is enforcing lead rules.

In response, the EPA says it will accept two of the six recommendations — neither of which pertain to enforcement or inspections.

"EPA believes that current and planned implementation of the Lead-Based Paint Renovation, Repair and Painting Rule fulfills the [inspector general's] recommendations," an EPA spokesperson tells NPR in an email. "EPA details these specific actions, reports, and memorandum in response to the [inspector general's] recommendations. You can find them in full at the end of the [inspector general's] report."

"New Lead Exposure Standards Recommended by the Panel"

By MIKE STOBBE Jan. 5, 2012

                                                                                        Photo: Chitose Suzuki, Associated Press


For the first time in 20 years, a federal panel is urging the government to lower the threshold for lead poisoning in children.

If adopted, hundreds of thousands more children could be diagnosed with lead poisoning. Too much lead is harmful to developing brains and can mean a lower IQ.

Recent research convinced panel members that children could be harmed from lead levels in their blood that are lower than the current standard, officials at the Centers for Disease Control and Prevention said.

While the number of cases has been falling, health officials think as many as 250,000 children have the problem, many of those undiagnosed. The proposed change could take it to 450,000 cases.

Wednesday's vote by the Advisory Committee on Childhood Lead Poisoning Prevention would lower the definition of lead poisoning for young children from 10 micrograms of lead per deciliter of blood to 5 micrograms. The CDC has accepted all of the panel's recommendations in the past.

Lead - a metal that for years was common in paint and gasoline - can harm a child's brain, kidneys and other organs. High levels in the blood can cause coma, convulsions and death. Lower levels can reduce intelligence, impair hearing and behavior and cause other problems.

Usually, the victims are children living in old homes that are dilapidated or under renovation, who pick up paint chips or dust and put it in their mouths. Lead has been banned in paint since 1978. Children have also picked up lead poisoning from soil contaminated by old leaded gasoline, and from dust tracked in from industrial worksites.

Lead poisoning is detected through a blood test, often when kids are toddlers. Most cases are handled by seeking out and removing the lead source, and monitoring the children to make sure lead levels stay down. A special treatment to remove lead and other heavy metals is used for very high levels.

Quoted from SF GATE, HEALTH 2012. Author Mike Stobbe: http://www.sfgate.com/health/article/New-lead-exposure-standards-recommended-by-panel-2442470.php#photo-1997320

"Lead Poisoning Toll Revised to 1 in 38 Young Kids"

By MIKE STOBBE Apr. 4, 2013 

NEW YORK (AP) — More than half a million U.S. children are now believed to have lead poisoning, roughly twice the previous high estimate, health officials reported Thursday.

The increase is the result of the government last year lowering the threshold for lead poisoning, so now more children are considered at risk.

Too much lead can harm developing brains and can mean a lower IQ. Lead poisoning used to be a much larger concern in the United States, but has declined significantly as lead was removed from paint and gasoline and other sources.

The new number translates to about 1 in 38 young children. That estimate suggests a need for more testing and preventive measures, some experts said, but budget cuts last year eliminated federal grant funding for such programs.

Those cuts represent "an abandonment of children," said David Rosner, a Columbia University public health historian who writes books about lead poisoning.

"We've been acting like the problem was solved and this was a thing of the past," he added.

Lead can harm a child's brain, kidneys and other organs. High levels in the blood can cause coma, convulsions and death. Lower levels can reduce intelligence, impair hearing and behavior and cause other problems.

Most cases of lead poisoning are handled by tracking and removing the lead source, and monitoring the children to make sure lead levels stay down. A special treatment to remove lead and other heavy metals is used only for extremely high levels.

Often, children who get lead poisoning live in old homes that are dilapidated or under renovation. They pick up paint chips or dust and put it in their mouth. Other sources include soil contaminated by old leaded gasoline, dust from industrial worksites and tainted drinking water

Lead has been banned in household paint since 1978 and was gone from gasoline by the late 1980s.

After lowering the standard, the Centers for Disease Control and Prevention went back and looked at old blood tests from 1,653 children under 6 to determine how many would have lead poisoning under the new definition.

About 3 percent of them — or about 50 kids — had blood lead levels higher than the new threshold of 5 micrograms of lead per deciliter of blood. Using that result, CDC officials calculated that an estimated 535,000 young children have lead poisoning.

A year ago, when the threshold was 10 micrograms, experts estimated that somewhere between 77,000 and 255,000 young kids had high levels of lead.

These estimates have focused on children younger than 6, who have been considered most at risk of neurological problems due to lead.

Overall, the new CDC study found lead counts were higher on average in children who were poor or African-American, said the CDC's Mary Jean Brown, an author of the study.

Those kids are more likely to live in old housing or in neighborhoods with greater exposure to lead, she added.

The good news: Even with the lower threshold, lead poisoning appears to still be declining. Years ago, some local health departments began tracking the number of kids with blood levels at 5 or greater, and they say those numbers have been dropping steadily.

However, it's likely that many children with lead poisoning have not been diagnosed. In the CDC study, elevated lead levels were discovered for a third of the children only when they were tested by researchers.

"When you look for it, you find it," Columbia's Rosner said.

Once lead poisoning is diagnosed, doctors often refer parents to local health departments to get their homes checked out to try to find the source of the problem. But as demand for investigations grows, there's less money to pay for them. Congress last year cut CDC lead program's budget from about $29 million to $2 million. That ended CDC grants to local health departments for their programs.

Detroit's lead program was all but eliminated because of the federal cut and state and local funding problems, said Bob Scott of Michigan's lead poisoning prevention program.

Other places are struggling to keep up with lead work at the same time they are cutting staff. The Cleveland area has been aggressive about lead poisoning prevention but the loss of CDC funding hurt those efforts.

For example, Cuyahoga County — which includes Cleveland — saw its staff for blood testing of children and public education drop from 2 1/2 positions to 1.

"It's unsustainable," said Terry Allan, the county's health commissioner.

Quoted from Associated Press News, 2013. Author Mike Stobbe: http://bigstory.ap.org/article/lead-poisoning-toll-revised-1-38-young-kids

"Studies Link Childhood Lead Exposure, Violent Crime"

By Michael Hawthorne

Exposed to lead

City inspector Paul Diaz talks to a 2-year-old whose blood was found to contain lead at four times the federal standard. Increasingly, researchers are finding lead poisoning at a young age is linked to permanent changes in the human brain that may increase criminality. 

 (Antonio Perez, Chicago Tribune)

After growing up poor in a predominantly African-American neighborhood of Cincinnati, the young adults had reached their early 20s. One by one, they passed through an MRI machine that displayed their brains in sharp, cross-sectioned images.

For those who had been exposed to lead as toddlers, even in small amounts, the scans revealed changes that were subtle, permanent and devastating.

The toxic metal had robbed them of gray matter in the parts of the brain that enable people to pay attention, regulate emotions and control impulses. Lead also had scrambled the production of white matter that transmits signals between different parts of the brain, largely by mimicking calcium, an element that plays a critical role in brain development.

Scars left by lead have had significant consequences for the study participants and their communities. As children, they struggled in school more than those who had not been exposed. As teens, they committed crimes more frequently, University of Cincinnati researchers reported.

"What we found — and continue to find — is that lead sowed the seeds of their future," said Kim Dietrich, a neuropsychologist who has been following the group of nearly 300 people since they were born in the late 1970s. "It isn't conducive to behavior we associate with normal development, making smart decisions and success."

People have known for centuries that lead is poisonous, and removing it from gasoline and paint has dramatically reduced exposure for American children.

Lead paint poisons poor kids, city spends less on cleanup

But a growing body of research is making it clear that the toxic legacy of lead has far more wide-ranging effects than previously known. Lingering dust from paint and deposits from old vehicle emissions continue to harm thousands of children in older industrial cities like Cincinnati and Chicago.

Once an obscure academic specialty, lead poisoning is gaining new appreciation from economists, criminologists and education experts as researchers document how early exposure harms children in ways that don't become apparent until years later. The damage ends up costing taxpayers in the form of increased spending on health care, special education and law enforcement.

Last month, a Tribune investigation found that lead hazards are festering in the same parts of Chicago that have given the city a national reputation for violence and academic failure. In impoverished, crime-ridden neighborhoods like Austin, Englewood and Lawndale, more than 80 percent of the children tested in 1995 had dangerous lead levels.

Tribune Graphics

Today those kids are in their early to mid-20s, when criminal behavior peaks.

As evidence mounts of the links between lead poisoning, poor school performance and crime, some scientists are starting to focus on lead pollution as a key factor in Chicago's violence.

"People in neighborhoods like Englewood have faced multiple assaults over different periods of time — job losses, segregation, housing discrimination," said Robert J. Sampson, a Harvard University researcher who has been studying Chicago for more than two decades. "Yet through all of that there is this persistent lead poisoning. It creates a social context where kids are at a clear disadvantage."

Sampson recently added lead data to his existing research on poverty, education and crime in Englewood and other neighborhoods. The results, he said, were shocking. A map of lead poisoning rates among children younger than 6 in 1995, for instance, looks very similar to a map of aggravated assault rates in 2012, when those kids were 17 to 22 years old.

"It's not something I appreciated before," Sampson said. "But when I see the astounding levels of lead poisoning in these communities, it makes complete sense that it is part of the cycle of deprivation."

Politicians and policymakers have yet to catch up to this line of thinking, seemingly regarding lead pollution as a problem solved long ago. During the past five years, federal and state officials have sharply cut funding to screen kids, inspect properties and eliminate lead hazards.

With less money directed at the problem, children ages 5 and younger continue to be harmed at rates up to six times the Chicago average in corners of predominantly African-American neighborhoods on the South and West sides, according to the Tribune's analysis of city records.

One researcher working in Chicago, Anne Evens, recently published a study that draws a sharper focus on how lead is still ravaging the city years after it faded as a local and national issue.

A former chief of lead poisoning prevention at the Chicago Department of Public Health, Evens obtained the lead tests of more than 58,000 children born in the city from 1994 to 1998 and compared the results with how they performed on standardized tests in third grade.

Her peer-reviewed study, published in April in the scientific journal Environmental Health, found that exposure to lead during early childhood significantly increased the chance that a student would fail reading and math tests, even when controlling for other factors such as poverty, race, birth weight and the mother's education level.

The scope of what Evens found is staggering: At three-quarters of Chicago Public Schools, the average lead level of third-graders exceeded a standard established by the Centers for Disease Control and Prevention in each year from 2003 to 2006.

Why is third grade so important? That's when children begin to use reading to learn other subjects, and studies show students who fail to master reading skills during such a critical year are more likely to fall behind in later grades and drop out of high school. Dropouts are significantly more likely to end up in jail than to get a diploma.

Some teachers and reading specialists know that kids exposed to lead as toddlers are more likely to act out, have trouble staying on task and struggle to work well with classmates. Yet it doesn't come up in the debate about how to improve schools.

"I used to think that lead was only a problem years ago for kids who had eaten a bunch of paint chips," said Karl Androes, co-founder of Reading In Motion, a nonprofit that trains CPS teachers to improve reading skills in kindergarten and first grade through music and drama. "That's also why we've had trouble getting the (education) foundations or the principals to pay attention to it."

"But we're talking about our kids now," Androes said. "And there just isn't enough attention being paid to how lead affects the classroom."

Even modest reductions in lead exposure can make a difference.

Jessica Wolpaw Reyes, an economist at Amherst College, studied what happened during the 1990s when Massachusetts embarked on an effort to eliminate lead paint hazards in homes with young children. She found the $5 million-a-year program helped reduce the number of students who performed poorly on standardized tests by 1 to 2 percentage points, with most of the benefits seen among children from low-income communities.

While that might not sound like much of an improvement, Reyes said, it was equivalent to what the state could have expected if it had closed the income gap between poor and middle-income communities by 22 percent.

"There is a lot of research showing if you can intervene early with children, it costs relatively little but makes a huge difference," Reyes said. "Yet that's a hard sell to policymakers. It's tough to get people to spend money on things that aren't going to yield benefits for another 15 or 20 years."

Multiple studies have concluded that steps taken to reduce lead exposure already have saved money, with the value of removing the toxic metal from gasoline estimated in thebillions or trillions of dollars. Some, including Reyes, argue that stopping the constant flow of lead into the environment is a major reason why crime rates dropped sharply nationwide during the 1990s.

In a 2007 paper, Reyes traced how the 1970 Clean Air Act kicked off the decline in the use of leaded gasoline. The rate of decline varied widely among states and tracked almost perfectly with state-by-state drops in violent crime rates about 20 years later.

Similar studies have been conducted by Rick Nevin, a consultant to the U.S. Department of Housing and Urban Development, and Tulane University researcher Howard Mielke, whose earlier work helped lay the foundation for the phaseout of leaded gasoline.

They concluded that steps taken to reduce childhood lead exposure were a major factor — if not the biggest factor — in preventing people from committing violent crimes in their early 20s.

"This is a no-brainer for the public health community, which is very familiar with what lead does to the human brain," said Reyes. "But until recently, police chiefs and the criminology community in general have been very skeptical."

At a recent City Club of Chicago breakfast, a moderator said he was "going on a limb" in asking Chicago police Superintendent Garry McCarthy about the connection between lead exposure and violent crime. Audience members reacted with laughter.

"Yeah, I kind of study this stuff," said McCarthy. "I don't know."

The moderator quickly moved on to another subject. McCarthy declined to comment for this story.

One of the most compelling Chicago-related studies explored the lead-crime connection at the city level. Mielke, along with colleague Sammy Zahran, compared leaded gasoline emissions with aggravated assault rates in Chicago and five other cities and found a good fit in each one.

Both trends look like an upside-down "U." Emissions from leaded gasoline started increasing in the 1950s, peaked in the early '70s and then steadily declined. Aggravated assault rates rose, peaked and fell on a similar curve, only about 20 years later.

As these studies have percolated beyond scientific journals, the biggest dispute appears to be on how much of an impact the decline of lead had on crime rates. Other experts credit changes such as falling unemployment rates, more police on the streets, higher rates of incarceration and a shift away from the use of crack cocaine.

University of Chicago economist Steven Levitt, co-author of the best-seller "Freakonomics," cited the legalization of abortion as a big part of the crime drop. Fewer unwanted babies, he has argued, meant fewer violent young men decades later.

"The vast majority of people still dismiss lead as anything of any consequence," said Bruce Lanphear, a researcher at Simon Fraser University in Vancouver who conducted some of the first research on health effects at low doses. "It's almost impossible to separate out the underlying reasons for these problems, but lead certainly is one of things that triggers urban decay."

The link between childhood lead exposure and violent behavior is well-established, both in animal research and human studies like the one in Cincinnati. Small doses can reduce IQ and essentially cause parts of the brain to short out, in particular, the areas responsible for controlling aggression.

Given the scale of lead hazards in Chicago, advocates say political leaders are overlooking a cost-effective way to help improve schools and reduce crime.
"Of all the problems that affect kids in these neighborhoods, lead is the easiest to solve," said Evens, who now heads Elevate Energy, a nonprofit that addresses lead issues while making homes more energy-efficient. "But there just isn't the political will to do something about it."
Chicago Tribune's Jeremy Gorner contributed.


Twitter @scribeguy

Quoted from Chicago Tribune, 2015. Author Michael Hawthorne:

Copyright © 2015, Chicago Tribune

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