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Kids in high-risk areas not being tested for lead poisoning

Early prevention key to protecting children, experts say.

Thousands of infants and toddlers across Ohio aren’t getting tested for lead poisoning even though they are at high risk or are living in unsafe homes, an I-Team analysis found.

Less than one-third of the 232,670 children under age 3 living in the 324 ZIP codes identified as having an increased risk of lead poisoning were tested in 2010, according to data obtained by the Ohio Department of Health and census data.

State law requires that they be tested at age 1 and 2.

Early prevention and detection are key to protecting children from severe problems, said John Belt, who administers the lead program for ODH.

“Lead poisoning, although it disproportionately affects low-income children, really passes through all income areas,” he said. “Anyone living in an older home with deferred maintenance runs the risk of their children being poisoned.

“Once a child is lead-poisoned, the neurological damage is permanent.”

But across Ohio, only about 155,000 children have been tested for lead each year since 2010, according to ODH data. Of those, more than 10,000 each year, on average, are found to have what the federal government considers to be elevated blood lead levels. And an average of more than 1,700 children each year have blood lead levels requiring intervention by public health officials.

All of these children face potentially irreversible cognitive damage in what Belt called “the biggest preventable childhood health issue in the United States.

“We’re probably testing a little over half of the children that should be tested,” he said.

Education is key

Many parents are unaware of the risks from lead poisoning — as well as the law regarding testing, according to health officials.

Federal budget cuts cost the state $1.3 million that was used to educate parents and pediatricians about testing requirements, Belt said. This money was passed along to local governments, which often doubled or tripled its impact with matching funds.

“What we’ve found is if we’re not out there every day educating the professionals and lay persons, and that’s parents, grandparents … (if) that information is not placed in front of them, they’re not aware,” he said.

Twenty six ZIP codes that are all or partially in Montgomery County are deemed high risk for lead poisoning, meaning all children ages 1 and 2 should be tested. These ZIP codes contained 17,626 children under age 3 in the 2010 census. But only 4,229 children under age 3 in those ZIP codes were tested that year.

In 13 Montgomery County ZIP codes, less than a quarter of children under age 3 were tested in 2010. In the 45005 ZIP code, which includes Carlisle and Franklin and extends into Butler and Warren counties, 13 percent of those children were tested.

Federal law requires lead testing at ages 1 and 2 for all children on Medicaid — regardless of where they live — and children who meet other criteria, such as regularly visiting homes built before 1950 or homes built before 1978 that are being remodeled.

Blood lead levels are measured in terms of micrograms per deciliter. If a child has a level above 10, state or local health officials conduct a lead risk assessment. Medical case managers then provide education and referrals to community resources.

If a lead risk is found in a home, the property owner is given 90 days to fix the problem by hiring a professional lead abatement contractor. Options include removing the painted area, removing the paint or properly covering it. Health officials can grant an extension for up to a year.

If the problem isn’t addressed, a “Not to Occupy” order can be issued, declaring the home unsafe.

Progress made

Health officials say these rules, put in place over the past decade, and other regulations have had a dramatic impact. In 1999, roughly 8.7 percent of children tested under age 6 had elevated blood lead levels, compared to around 1 percent today.

“We are still seeing a lot of lead poisoning, not the same frequency as we did 20 to 30 years ago, so the incidents of lead poisoning has markedly decreased over the years because of reductions and strict regulations of the possible sources of lead,” including food, gasoline, cosmetics, toys and paint, said Dr. Maria Nanagas, director of the Lead Poisoning Clinic at Dayton Children’s Hospital.

While Ohio health officials intervene at a blood level of 10, Nanagas and the U.S. Centers for Disease Control and Prevention stress that there is no safe level of lead in a child’s blood. The CDC identifies any child who tests at more than 5 micrograms per deciliter as having elevated blood lead level.

Mary Jean Brown, chief of the CDC’s lead poisoning prevention branch, noted that a blood level as low as 2 has been linked to lowered academic performance and behavioral issues.

In 2012, the most recent year of data available from ODH, there were 209 children in Montgomery County and 18 in Greene County diagnosed with levels between 5 and 9 micrograms per deciliter. There were 7,482 statewide.

“We want to move the whole population, the whole distribution, to the left, away from five,” Brown said.

Staff writer Ken McCall contributed to this report

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