July 2, 2017
By Charles Eichacker
‘Hundreds of kids are getting addressed now, instead of waiting until they get super-poisoned,’ says Greg Payne, director of the Maine Affordable Housing Coalition.
About a dozen years ago, a doctor told Greg Payne that his infant daughter had lead in her blood.
It was a rough awakening for Payne, who was then living in an 1860s farmhouse in Massachusetts. No amount of lead is considered safe, particularly for young children, but his daughter had 9 micrograms per deciliter in her blood – almost double the limit now advised by federal health authorities.
Payne removed his daughter Georgianna from the home, and inspectors traced the lead to a recent renovation. The family had knocked out an old window, unwittingly disturbing an old layer of lead paint and spreading its dust around the room.
“We knew to remove her from the home and have a firm come in, and not come back until there was no lead risk,” said Payne, who’s now the director of the Maine Affordable Housing Coalition. “Because the doctor alerted us, we got her out, and she’s doing great. She didn’t stew in that environment for months and years.”
New standards implemented in September have shown Augusta, Hallowell and Gardiner to be hot spots for lead poisoning among children up to 3 years old – ages when children are most vulnerable because their brains are developing and they’re more likely to crawl on floors that are covered in lead dust and stick their fingers in their mouths.
Across the state, those three cities had some of the highest rates of child lead poisoning under the new guidelines, according to data from 2011 to 2015 that’s available on the website of the Maine Center for Disease Control and Prevention, or Maine CDC.
To help address the problem, the state has provided grant funding to a local health group, Healthy Communities of the Capital Area, to educate families and property owners in the Augusta and Gardiner areas about the risks of lead exposure, strategies for preventing it and resources available to them.
There has been a surge of Maine children who are considered to have elevated lead levels under new guidelines that were adopted by the Legislature in 2015 – based on federal recommendations – and implemented last September.
The new guidelines lowered the amount of lead that a child needs to have in his or her body to qualify for an intervention by state health officials. The new standard is 5 micrograms of lead per deciliter of blood, down from the old standard of 15.
During the first eight months of the new standard, 203 Maine kids qualified for home inspections to determine the source of their lead poisoning, a more than four-fold increase from the 47 who would have qualified under the old standard, said Andrew Smith, the state toxicologist.
That change has earned praise from some advocates and health care providers.
“That’s a very good public health improvement,” Payne said. “We’re looking at hundreds and hundreds of kids who, under the old way of addressing this, were left in toxic apartments. These hundreds of kids are getting addressed now, instead of waiting until they get super-poisoned and their blood level is at 15.”
Of the 1,043 children under age 3 who were tested in Augusta, an estimated 6.1 percent had levels above the new limit – the 16th highest rate in Maine. And both Gardiner and Hallowell ranked in the top 10, with at least 8 percent of tested kids having elevated rates.
The reason for those high rates has to do with Maine’s housing stock, which is the sixth oldest in the nation, according to the Maine CDC. Nearly a third of Maine homes were built before 1950, when paint still held large concentrations of lead. As that paint breaks down and turns into dust, more than 100 Maine children are poisoned with it every year.
With enough exposure, those children can suffer learning disabilities, behavioral problems, hearing damage, language delays and reduced intelligence, the Maine CDC indicates on its website. In more serious cases, they can have seizures and attention disorders.
Lead poisoning rates have been declining across the state and nation over the last few decades, as substances such as lead paint and leaded gasoline have been eradicated. But it’s still a risk, as the poisoning of the Flint, Michigan, water supply showed three years ago.
“We know that (lead) can cause harm,” said Stephen Meister, a doctor in the Augusta area who recently became president of the Maine Chapter of the American Academy of Pediatrics. “The growing brain is actively making connections between nerves, and it causes damage to those nerves and to the child’s brain.”
Other, less common sources of lead include old water pipes, painted furniture and the clothing of people who work on industrial sites. Meister described one case in Maine, in which a father’s job involved sandblasting lead paint from bridges and his child was exposed to lead when he left his work clothes in the baby’s car seat.
For years, health officials have trained their lead poisoning prevention efforts on larger cities such as Portland, Lewiston-Auburn and Sanford, Smith said.
Those efforts have been particularly productive in Lewiston-Auburn, where the rate of kids under 2 years old tested for lead rose from 47.3 percent in 2008 to 77 percent in 2012. During the same period, testing stayed about flat across the state, and dropped in Portland and Sanford.
But because of the new state guidelines and the light they’ve cast on lower Kennebec County, the Maine CDC recently deemed Augusta one of five high-risk areas for lead poisoning. The others are Portland, Lewiston-Auburn, Bangor and Biddeford.
Last week, Healthy Communities held a forum in Augusta on lead poisoning to kick off the five-year project.
Health groups agree on the importance of testing children for lead exposure, both for their health and the state interventions that a positive test can unlock.
Among other things, once a child is shown to have lead poisoning, the state can fine landlords who don’t abate a family’s rental property. The state also offers resources to landlords who want to address the lead in their properties.
But advocates also criticize the de facto approach of waiting for kids – often from poor or minority families who can’t afford to buy their own homes – to have elevated rates before the state steps in.
“Maine is criticized for this, but almost every state takes this approach, which is strictly reactionary,” said Gail Carlson, an assistant professor of environmental studies at Colby College in Waterville. “It’s so expensive to rehab properties or mandate remediation by landlords, so we’re stuck waiting to get results on kids who are already lead poisoned … That’s an awful tradeoff.”
Some states, like Massachusetts and Vermont, require all children to be tested for lead poisoning, and Payne said he would like to see a similar law considered in Maine. His daughter was originally tested for lead exposure because of Massachusetts’ requirement.
But Smith, the state toxicologist, referred to Aroostook and Washington counties, where more than three-quarters of children under 2 years old have been tested in recent years, but fewer than 3 percent had high lead levels, according to Maine CDC data.
“We don’t find a lot of lead poisoning there, so is that an effective use of health care resources?” Smith said. “It’s easy to say ‘We should all do this,’ but is that the most cost-effective approach, versus getting providers to do risk assessments, which is the current model, where you identify hazards and decide to test?”
State and federal rules require that all children who receive their health insurance through MaineCare – the state’s version of Medicaid – be tested for lead poisoning at the ages of 1 and 2, but some providers don’t follow that requirement, Smith said.
Maine CDC officials are working with those providers to better understand what resources the state will provide to children shown to have elevated lead levels, Smith said. They’re also trying to work with municipalities to create local testing and prevention programs.