March 18, 2016

Lewiston Sun Journal

By Scott Thistle

AUGUSTA — In a letter to lawmakers this week, the director of the Maine Center for Disease Control said his agency would not move quickly to implement lower blood-lead standards.


CDC Director Ken Albert said the state would pursue a months-long process to implement the new standards, which will trigger interventions for children who test positive for lead in their blood when it reaches a concentration of 5 micrograms per decilitre. The state’s current trigger for intervention is 10 micrograms or higher.


The law change, which had broad bipartisan support and was funded in the state’s current two-year budget, is based on the most current medical science and federal Centers for Disease Control guidance. The U.S. CDC repeatedly notes there is no safe blood-lead level.


The neurological damage that results from prolonged exposure can be irreversible and includes lost intelligence, attention deficit and hyperactivity disorders and behavioral impairments that can limit a child’s ability to learn or even participate in school.


Maine CDC officials have said they are poised to issue a rule for the new lead standards but have not yet done so. The rule would have to go through a public hearing, following a 30-day notice. Officials would allow additional time after the hearing for written comments to be submitted before the rules could be enacted.


Advocates for the new standard say the state should move immediately to implement it using an emergency rule-making process that does not require a public hearing. And while emergency rules can only be in place for 90 days, advocates said, it would allow the Maine CDC to get started quickly on identifying children and communities affected by lead poisoning.


The 2015 law change also provides additional staff for the Maine CDC to help with implementing the change and to begin collecting new data. The lower levels are expected to identify an estimated 553 more children in the state with lead poisoning, according to a Maine CDC memo sent to a coalition that was organized to work at lowering the standard.


Lawmakers who backed the bill, especially those from Androscoggin County, where lead poisoning rates in children under the age of 6 are more than double the statewide average, said the lack of urgency from the Maine CDC on the issue of lead poisoning is troubling.


“The administration has had nearly nine months to prepare for these changes,” Sen. Nate Libby, D-Lewiston, said. “They’ve had nine months to develop and promulgate rulemaking; nine months to prepare for hiring additional CDC staff; nine months to develop (requests for proposals) for contractors. Without a public outcry about the administration dragging its feet, I can’t see the law being implemented before another nine or 12 months passes.”


Libby, along with Sen. Amy Volk, R-Scarborough, wrote to Maine Department of Health and Human Services Commissioner Mary Mayhew back in September 2015 imploring her to have the state’s CDC move quickly on the matter.


“Children are suffering from lead poisoning right now,” Libby and Volk wrote. “We have the legal authority and the resources to address it. We just need to clear the red tape and get it done.”


Lawmakers and experts on lead poisoning say time matters because the longer a child is exposed to lead, the greater the neurological damage, including effects that are irreversible.


But Maine CDC officials said there is no emerging public health crisis around lead poisoning in the state. They have also said the new standard is such a significant change and will have such a wide-ranging impact that careful consideration of implementing rules to adopt the new standard are important.


“Maine is not Flint, Mich., and there is no public health crisis due to elevated lead blood levels in Maine,” John Martins, a spokesman for the Maine CDC wrote in an email message to the Sun Journal. “There has not been a massive increase of elevated blood lead in our children or a failure of our public health system to respond and take action when required. In fact, we’re seeing a decrease in the number of children with elevated blood levels.”


Martins said the implication Maine DHHS and state’s CDC were not concerned about lead poisoning or that they were not focused on the issue was unfair and untrue.


“We are committed to moving this new law forward and addressing issues related to elevated blood lead because of its impact on child development,” Martins wrote. “We continue to monitor recommendations, guidance, research and the latest scientific studies to ensure that Maine children’s exposure to lead is minimized.”


In his letter to lawmakers, Albert noted that identifying additional children under the lower standard would trigger an increased volume of home inspections and likely more abatement orders for landlords and homeowners.


“We believe that a rule that constitutes a significant expansion of existing regulations must move through the public hearing process and that public comment must be allowed to inform the final rule,” Albert wrote to lawmakers on March 14.


Albert also wrote that the CDC was “in the process of obtaining approval to fill state positions that are necessary to implement and sustain the new standard.”


Those new employees would ultimately have to be approved by Republican Gov. Paul LePage’s office. But CDC officials would not say whether LePage had signed off on those new positions.


Rep. Peggy Rotundo, D-Lewiston, said she could not understand why the agency meant to protect the public’s health was not trying to move more quickly on the matter.


“Why would we not want to be doing everything that is reasonable and in our power to reduce the amount of lead in our environment to protect our children and grandchildren?” Rotundo asked. “There is science behind the federal government’s standards. These standards were endorsed by strong bipartisan support in the Legislature. It is time for the DHHS commissioner to stop dragging her feet and start to act responsibly on behalf of Maine’s children.”


Greg Payne, the director of the Maine Affordable Housing Coalition, also expressed dismay over the delay.


“The fact is that hundreds of Maine children are currently being exposed to damaging levels of toxic lead, and the harm that it is causing is irreversible, tragic, and incredibly costly to our state,” Payne said. “Maine’s Legislature stepped up to pass a law and allocate funds to protect these kids, and yet more than eight months later, state officials still haven’t even approved the regulations or staff required to implement that law. Their callousness in the face of such preventable harm is shocking and inexcusable.”


The Maine CDC’s inaction on the lower lead standards was also drawing criticism from national advocates on the issue of lead poisoning.


“By not moving on this rulemaking, they are knowingly leaving kids in a situation where they are literally having their brains damaged,” Ruth Ann Norton, the president and CEO of the Green and Healthy Homes Initiative, a Washington, D.C.-based coalition that was organized to end child lead poisoning in the U.S.


“What the science tells us is levels as low as 2, between 2 and 7 (micrograms per deciliter) have some of the most aggressive cognitive impacts on young children,” Norton said. “By not acting on this, the state is knowingly sticking its head in the sand and not taking action to basically protect kids from a very dangerous neurotoxin.”

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