The Star-Ledger

Where Children Are The Lead Detectors

N.J. Laws Don't Kick In Until After Blood Poisoning Reaches Dangerous Levels

The Star-Ledger — Friday, December 2, 2005

By RUSSELL BEN-ALI AND JUDY PEET
Star-Ledger Staff

Three-year-old Jaheim Washington and his sister, Lynnette, 5, have high enough levels of lead in their blood to get brain damage, but not quite high enough to get help.

The Washington children are among thousands of youngsters throughout New Jersey caught in a toxic trap: Because of underfunding and outdated guidelines, blood-poisoned children must meet a minimum level of toxicity before they are eligible for treatment and services.

"It doesn't make sense," said the children's mother, Annette Washington, 37, of East Orange, who has been trying to move into a lead-safe apartment for more than a year. "What are they (her children) supposed to do, just deteriorate? It's just crazy."

The debate over how high blood-lead levels in children have to rise before local health departments take action has a long history in New Jersey and around the nation.

In the case of the Washington children, for example, their blood-lead levels are high enough to concern their doctor, their health care provider and city health officials.

They are not high enough, however, to mandate relocation to a lead-safe apartment or force the landlord to make repairs, Washington said. For those services to kick in, she said she's been told by local and state health workers that she must wait until their blood-lead levels – which fluctuate between 12 and 15 micrograms per deciliter of blood – reach 20 micrograms.

That is at least twice the level at which many experts say neurological and physical damage can occur.

"It's definitely waiting until it's too late," Brian Gumm of the Washington-based advocacy group Alliance for Healthy Homes, said of the 20-microgram threshold. "Unfortunately, this is the way that most states approach this problem. They base it on children's lead levels instead of basing it on lead hazards."

Many of the regulations concerning lead treatment and abatement were promulgated at a time when scientists believed low levels of lead in the system were relatively benign. Recent studies show, however, that there is no such thing as safe blood-lead levels.

"The science is at a point now where we know kids can experience ... irreparable damage by what some scientists believe are relatively small amounts of exposure and lead levels," said Evelyn Liebman, program director for New Jersey Citizen Action. "To make someone wait until they reach this level of 20 (micrograms) is unconscionable."

Local officials say, however, that particularly in former factory states like New Jersey, with old housing stock, lead is so prevalent that their few precious resources must be spent on children with extremely high levels of lead poisoning.

"Mrs. Washington's situation is unfortunate, but we have assisted severely poisoned children (with levels of 53 micrograms or higher)," said Rochelle Evans, director of the East Orange Department of Health and Human Services. "Funding is limited."

Officials said the city of 70,000 has the budget for only one lead inspector and eight lead-safe properties, where families can temporarily live while their apartments are being decontaminated.

East Orange has 150 children with lead levels between 15 and 20 micrograms.

The federal Centers for Disease Control and Prevention sets the standards for lead poisoning. The CDC acknowledges that 10 micrograms per deciliter of blood is a matter of concern, but recommends investigation, monitoring and abatement only in cases where a child's blood level registers 20 micrograms or above.

Most states, including New Jersey, follow the 20-microgram standard set by the CDC. In New Jersey in 2003, more than 800 children had lead levels higher than 20 micrograms and 56 children had levels 45 or above.

Another 4,398 children had levels ranging between 10 and 19 micrograms and 167,702 children had lead levels below 10 micrograms. Advocates note recent studies that show intellectual impairments in children with blood-lead levels below 10.

Lead can pose health problems at any age but its potential to alter cell structure and chemistry of developing brains can devastate young children.

"What we would like to do is to stop the kids from ever getting above 10," said Steven Marcus of the University of Medicine and Dentistry of New Jersey, a nationally recognized expert on lead poison treatment.

"That would be the real gold standard – true prevention, not waiting until any kid has elevated lead level," Marcus said. "We have been for years using kids as lead detectors. If a kid gets lead poisoning, then we check the house. If it's got lead, we abate it."

But Marcus questioned the reality of lowering the state threshold to 10, and whether the state has the manpower to handle an enormous increase in monitoring.

In August, the state Department of Community Affairs announced a $50 million program to inspect and abate 850,000 houses and apartments over the next five years. It also provides funding for landlords unable to afford expensive abatement jobs and establishes one of the nation's first statewide registries of lead-safe housing.

The effort may come too late to benefit the Washingtons.

Jaheim and Lynnette first tested for elevated lead levels last year at the family's old apartment on Chestnut Street. Experts say that the longer the exposure, the higher the risk of brain damage. But with nowhere else to go, the family remained in the lead-laden apartment another six months, said Washington, a single mother of four who is studying for a high school diploma.

In late March the Washingtons finally moved another apartment after the landlord assured her the place was lead-safe. In September, however, a city inspection revealed that the new apartment was also lead-contaminated.

The city conducted the inspection, even though state law did not require it because the Washington children still have not topped 20 micrograms.

The East Orange inspector ordered the owner, Lazette Wilson of Teaneck, to abate nine areas of the house by Oct. 16, 2005, or risk a fine as high as $500 per day.

When contacted by telephone Wilson said she never received notification from the city. City officials disagreed, but added that Wilson asked for, and received, a 60-day extension to hire a certified lead abatement contractor.

In the meantime, the Washingtons are still in the lead-contaminated apartment, although the city said she stopped paying rent months before lead was discovered in the unit.

The East Orange Health and Human Services department said its workers continue to monitor the Washington children and are trying to find funds to help the family move.

But Washington said that, aside from a local councilwoman, she's found little help in the search for a lead-safe apartment.

"It's been hell," said Washington, describing how she's piled her belongings in one room to avoid contact with lead dust in others. "In the situation I'm in, I can't even have company."

Copyright 2005 The Star-Ledger

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