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Health Department Turns Focus To Lead Poisoning

Older houses to be tested as part of study

Apr 20, 2003 | Pensacola News Journal The Escambia County Health Department is set to begin a study to determine how many residents in Escambia and Santa Rosa counties live in houses contaminated with lead, a highly toxic substance that may be making them sick.

The Health Department will visit the homes of children diagnosed with lead poisoning over the last five years and will conduct random tests on houses built before lead-based paint was outlawed in 1978. The most common cause of lead poisoning is from ingesting peeling and chipping lead-based paints or lead dust in older houses.

Health officials estimate there are nearly 130,000 such houses in Escambia/ Santa Rosa. They plan to test 100 houses this year and maybe many more depending on how much money is available.

The effort is part of a much broader, congressionally funded environmental health study designed to determine whether toxic pollution is making people sick in Escambia and Santa Rosa counties.

Lead is a toxic metal that severely stunts intellectual development and is linked to a wide range of behavioral problems. Exposure, particularly among children younger than 6 years old whose brains are developing rapidly, can be permanent.

The purpose of the Health Department study:

Determine whether children previously diagnosed with lead poisoning still have elevated lead levels in their blood.

"We`re going to go back and look at as many of these children as we can," said Dr. John Lanza, director of the Escambia Health Department. "First we want to recheck their lead levels, especially if living in the same residence. Then we`ll ask permission to go in and check for lead."

Find the source of lead exposure.

The goal is to establish an accurate estimate of how many Escambia/Santa Rosa houses have lead in them and should be considered hazards.

If a large number fails the lead tests, Lanza plans to ask elected leaders in both counties to enact laws requiring lead tests be conducted in older houses at the time they are sold.

Lanza, a pediatrician, suspects the same lead-contaminated houses could be exposing generation after generation of children to lead.

"We`ve had over 500 cases of elevated lead levels since 1993 but have looked at very few of those for the actual source of the lead," he said.

The answers could shine a light on a very serious health problem that affects an estimated 434,000 children nationwide. The World Health Organization estimates as many as 18 million children in developing countries have suffered permanent brain damage because of lead poisoning.

Those most at risk in the United States are the poor and minorities, who typically are exposed to lead-based paint in older, deteriorating houses where dust and paint chips easily are ingested.

Roughly 24 million houses and apartments nationwide should be considered "significant lead-based paint hazards" according to an October study by the U.S. Department of Housing and Urban Development.

The only way to eliminate that hazard is to keep children away from the lead.

National health experts praise the Escambia Health Department study, which is the first attempt locally and perhaps in Florida to locate the main sources of contamination in a given region. The experts said they are particularly intrigued by the idea of legislation requiring lead tests in older houses.

Such a move, they said, is a bold step to help prevent childhood lead exposure.

"I think a study like this is what more health departments should be doing," said Dr. Philip Landrigan, a pediatrician and chairman of the department of community and preventive medicine at New York`s Mount Sinai School of Medicine. "It`s the kind of thing that more health departments would like to do but typically do not have the funds."

The Escambia Health Department can afford it only because it`s getting a portion of the nearly $2 million in congressional funding to study toxic pollution and its effect on health in Escambia and Santa Rosa counties.

Estimated cost of the lead study: $44,465.

That`s a small price to pay if it can help prevent children from coming into contact with lead, said Dr. John Rosen, a pediatrician and director of environmental sciences at Albert Einstein College of Medicine in New York.

"It`s obvious that childhood lead poisoning is an absolutely preventable disease," he said. "But a bigger emphasis must be placed on inspecting and characterizing housing before children even get there."

The lead problem

The national Centers for Disease Control and Prevention has termed lead poisoning "one of the most common pediatric health problems" in the country.

The number of lead poisoning cases in Escambia/Santa Rosa has been decreasing steadily.

In 1998, 88 children were diagnosed with lead poisoning in Escambia. In 2002, only four had lead poisoning a 95 percent drop. Lead poisoning cases dropped 50 percent in Santa Rosa during that same period.

Lanza believes the decline mostly reflects the fact that more older homes are disappearing and testing is not as prevalent.

"I think we need to do a better job of testing children," said Pam Meyer, an epidemiologist in the CDC`s lead poisoning prevention branch in Atlanta. "Many family physicians don`t screen because they don`t know if a child lives in an older home. But they can ask some questions, and we encourage it."

It`s difficult to estimate the severity of the area`s lead poisoning problem, Lanza said, "because clearly the numbers are decreasing."

But he and others note with concern that recent research shows blood lead concentrations considered safe have very serious health effects, including reduced IQ and hearing loss.

"There is no demonstrated safe concentration of lead in blood," the U.S. Environmental Protection Agency reported in a February study of pollution and children`s health.

That means potentially hundreds of local children are harmed by lead exposure every year but are not receiving treatment because they have not been diagnosed with lead poisoning.

Federal health experts are reviewing whether to lower the threshold, which is 10 micrograms of lead per deciliter of blood.

Lanza said they should.

"We may be fooling ourselves into thinking there`s not as much of a problem with lead now because we`re not seeing as many cases of 10 or greater," he said. "But if the health effect is really a lot lower than 10, then we`re fooling ourselves in thinking that the problem is going away."

Raising concerns
Health officials expect to find older houses with lead.

That suspicion is supported by lead testing conducted by the City of Pensacola`s Housing Department.

The city in the last two years has tested roughly 150 houses participating in the federally subsidized rental assistance program. Each house was built prior to the federal ban on lead-based paint, and each had at least one resident 6 years old or younger.

The results to date: 40 percent failed the lead test.

"I`m not sure we`re going to see much difference," Lanza said of the Health Department study.

The Florida Department of Health in July recommended that Escambia and two other counties "warrant additional attention to childhood lead poisoning," in large part because of "the numbers of older housing units."

The health effects of lead poisoning have not received a great deal of attention locally.

One exception: The Escambia Health Department two years ago studied the possible link between lead poisoning and children`s performance on state standardized education tests.

The results raised concerns.

More than one in every four school-aged children diagnosed with lead poisoning between 1993-99 in Escambia County attended one of nine schools that failed the Florida Comprehensive Assessment Test, or FCAT, in 1999.

"Clearly, more students with elevated lead levels are attending the lower-performing schools than the higher-performing schools," the study concluded.

Despite this, nothing more was done. The Health Department and the Escambia County School District conducted no follow-up tests.

"We`ve never had any money to do follow-ups," Lanza said.

How the program will work
The Health Department now has the money to do further research.

The day-to-day operation of the Health Department study has been assigned to Steve Metzler, an environmental supervisor at the Health Department and a federally certified lead risk assessor.

"I would like to be rolling on the environmental assessments and investigations" soon, Metzler said.

The Health Department has hired Lori Stansbury, a certified lead inspector, to do the field samples.

The biggest obstacle, Metzler said, will be locating the children diagnosed with lead poisoning in the last five years.

Some may have moved to other neighborhoods, while others may have left the city or state.

In either case, health experts still want to visit the house or apartment where the lead-poisoned child lived at the time he or she tested positive.

Reason: If the house is a lead hazard, it will continue to impact future residents who live there.

"That`s especially important in the event that there is a mother about to bring another child into the house," Stansbury said.

The tests are entirely voluntary. But Metzler said most parents probably will welcome the follow-up blood tests and lead inspection.

"Here we are, we`re offering them an opportunity to at least rule out their home" as the source of the lead, he said. "It may not be the environment, but at least we can rule it out."

Environmental health projects for Escambia and Santa Rosa counties.

Here are the University of West Florida`s first seven projects for what is proposed to be a five-year environmental health study. The seven projects will be funded with $1.7 million approved by Congress in 2001 and an additional $225,000 approved this year.

Construction of a Northwest Florida environmental bibliography: Designed as a central database of reports, studies and other documentation
involving toxic pollution and environmental health in Northwest Florida. One goal: identifying gaps in data where insufficient study has occurred. Links to information to be placed on a Web site.

Cost: $93,832

Air quality studies, pilot survey: Seeks to identify what pollutants are in the air and determine the level of exposure of residents to each pollutant. Goal is to determine the contaminants of greatest concern, then focus in-depth study on these.

Cost: $300,000

Pollution effects on Bayou Texar sediment, water quality: Although Bayou Texar`s problems are well-documented, this study would focus on the effects on the bayou from two large plumes of underground toxins from the Escambia Treating Co.
and Agrico Chemical Co. Superfund sites. Work would include identifying the exact paths of the plumes and their toxins` potential exposure to humans and marine life.

Cost: $170,889

Assessing fisheries as vectors for toxic materials in the environment to humans: Will test fish and shellfish in most of Escambia and Santa Rosa counties` major waterways for mercury, dioxin and other chemical residue in their tissue. The goal is to determine health effects of pollutants in the water. If tests confirm harmful heavy metals and other toxins are bio- accumulating in marine life, more in-depth studies will follow on water and sediment quality to determine the potential effect on humans.

Cost: $305,160

Assessing impact of environmental hazard exposure on the health

status of geographically defined populations in Escambia and Santa Rosa counties:

Will determine whether there is evidence that toxic pollution is contributing to some serious local health problems, such as high cancer mortality and incidence rates, birth defects and infant mortality. The study will attempt to locate specific areas where pollution is contributing directly to health problems.

Cost: $199,445

Clinical toxicology and public health evaluation of communities near

Superfund sites in the Palafox Redevelopment Area:

Objective is to conduct very detailed health assessments of former residents near the Escambia Treating and Agrico hazardous waste sites in central Pensacola. An Escambia County Health Department clinic already has been screening former residents near both sites for problems associated with exposure to toxic chemicals. But this study, to be led by University of South Florida environmental health experts, would involve detailed blood work to find residues of dioxin, pentachlorophenol (PCP) and arsenic that might be affecting former residents` health years after they moved.

Cost: $328,607

Screening young children for potential exposure to environmental lead contamination in Escambia/Santa Rosa: Designed to identify sources of harmful lead exposure to children. Study will be directed by Dr. John Lanza, director of the Escambia County Health Department, and Dr. E.W. Sutton, director of the Santa Rosa County Health Department.

Cost: $44,465

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