Lead Poisoning: an Impending Threat to Public Health

In the 1970’s, the built environment in the United States was replete with lead, a neurotoxin that damages the brain and nervous system, and is particularly harmful to children. Reducing children’s exposure to lead has been a strong public health accomplishment over the past 20 years, but the presence of lead in the built environment, particularly in low-income communities and communities of color, remains a threat to public health. In January, we published a blog that describing how communities across the US have benefited from lead poisoning prevention programs that save lives as well as money: a CDC analysis shows that every dollar spent to reduce lead hazards shows a $17-$220 return on investment, for an overall savings of $181 billion to $269 billion. Yet, in recent years, the federal government has scaled back lead prevention, and it’s about to get worse.

Lead poisoning is a nationwide public health crisis, yet abatement funding will soon be cut.

The Washington Post reports that under the current presidential administration, the Environmental Protection Agency is proposing to cut lead abatement programs by $16.61 million. The programs to be cut include trainings on safe removal of lead-based paint, and public education about the dangers of lead. This is a crushing blow to public health, given that most states rely on federally funded lead paint removal programs, and an estimated 38 million U.S. homes still contain lead-based paint-- the largest culprit for lead exposure.

Lead poisoning is a problem that extends far beyond contaminated water in Flint, Michigan.

The way data on lead exposure is collected at the state level, rather than the neighborhood level, can make it difficult to pinpoint communities at greatest risk. Reuters examined neighborhood-level bloodwork disclosed by state health departments and the CDC, finding 3,000 areas (2,606 census tracks and 278 zip codes) with double the lead poisoning rates of Flint, MI. In this Reuters article, M.B. Pell and Joshua Schneyer offer an in-depth analysis of what it looks like to be deeply affected by lead poisoning in communities across the U.S.

Underserved communities, with old infrastructure, will be most adversely affected.

Legacy lead in crumbling paint, plumbing, industrial waste, and structures built before 1978, contributes to elevated lead levels in the blood (5 micrograms/deciliter). Any child with a higher level needs a public health intervention. Lead poisoning, which causes developmental delays in children, causes communities that have been left behind to fall even further behind.

Most states will be left in the lead dust.

Currently, 14 states train contractors on how to safely remove lead paint, while the other 36 rely on funding from the government. In this Reuters article, Dr. Luis Galup, a pathologist and the county health officer in South Bend, Indiana, where 31% of children tested between 2005 and 2015 had over six times Flint’s rate of lead levels in their blood, indicated that he is uncertain of the future now that funding may cease. “Filled with old dwellings, [South Bend] has one of the highest poverty rates in town. Dr. Luis Galup said funds to tackle the problem in South Bend have dwindled. ‘We are the lowest of the low in terms of public health funding,’ he said.”

The future of lead abatement programs is an open question.

Our public health system must address these newly identified lead poisoning enclaves, which have flown below the radar with little to no funding. The question is, with severe cuts to the public health budget at the federal level, where will lead abatement grants come from? “‘I hope this data spurs questions from the public to community leaders who can make changes,’ said epidemiologist Robert Walker, co-chair of the CDC’s Lead Content Work Group, which analyzes lead poisoning nationwide. ‘I would think that it would turn some heads.’”