Childhood Lead Exposure:  Societal Impacts and Exposure Prevention
25
August

By Adem Lewis / in , , /


>>>HELLO.
THIS IS PETER ASHLEY WITH HUD’S OFFICE OF LEAD HAZARD CONTROL
AND HEALTHY HOMES AND I’D LIKE TO WELCOME YOU TO THE THIRD IN
OUR SERIES OF FIX HEALTHY HOMES SEMINARS FOR THIS FISCAL YEAR.
TODAY, WE’RE GOING TO BE TALKING ABOUT CHILDHOOD LEAD EXPOSURE,
SOME OF THE IMPACTS OF LEAD EXPOSURE, AND IMPORTANTLY, MAYBE
MORE IMPORTANTLY, WHAT CAN BE DONE TO PREVENT LEAD EXPOSURE
AND WHAT CAN BE DONE ONCE A CHILD IS EXPOSED TO LEAD TO
MITIGATE THE EFFECTS. WE HAVE VERY EXPERIENCED
SPEAKERS WITH US TODAY. MANY YEARS OF WORK IN THIS
FIELD, AND WE REALLY APPRECIATE THEIR TIME AND EFFORT TO BE HERE
WITH US. WE HAVE�– I WANT TO RECOGNIZE
LISA CRIST FROM EAP’S OFFICE OF GROUNDWATER�– EPA’S OFFICE OF
GROUNDWATER AND DRINKING WATER WHO JOINED OUR PANEL TODAY, KIND
OF A LAST MINUTE. WE THOUGHT THAT BECAUSE OF THE
ATTENTION THAT LEAD AND DRINKING WATER HAS GOTTEN WITH THE FLINT
SITUATION, THAT IT WOULD BE IMPORTANT TO HEAR ABOUT WHAT EPA
IS DOING IN THIS AREA. SO BEFORE WE GET STARTED, I JUST
WANTED TO GO OVER A LITTLE BIT OF BACKGROUND ON THIS TOPIC.
THE SLIDE IN FRONT OF YOU SUMMARIZES SOME DATA FROM OUR
2006 AMERICAN HEALTHY HOMES SURVEY, AND IT JUST ILLUSTRATES
THE EXTENT OF HOMES IN THE U.S. THAT HAVE LEAD-BASED PAINT, SO
THAT’S 37�MILLION AS OF 2006. THIS NUMBER DECREASES OVER TIME
WITH DEMOLITION AND GUT REHAB, BUT IT’S STILL A VERY LARGE
NUMBER. NUMBER OF HOMES WITH AT LEAST
ONE LEAD-BASED PAINT HAZARD IS ABOUT 23�MILLION, SO A HAZARD
COULD BE PEELING OR CHIPPING LEAD-BASED PAINT, HIGH LEVELS OF
LEAD IN SOIL, OR HIGH LEVELS OF LEAD IN DUST.
THIS TABLE ALSO INDICATES REALLY THE AUDIENCE THAT IS THE BIGGEST
CONCERN FOR LEAD EXPOSURE. THAT’S CHILDREN UNDER THE AGE OF
6 AND THE SURVEY GAVE US THIS ESTIMATE OF 3.6�MILLION HOMES
WITH ONE OR MORE LEAD HAZARDS AND A CHILD UNDER 6.
IN THE LOWEST ROW, IT IS THE TARGET AUDIENCE OF OUR LEAD
PROGRAM HERE AT HUD, IT’S HOUSEHOLDS WITH YOUNG CHILDREN
THAT ARE LOW INCOME. SO THAT’S ABOUT ONE�MILLION.
NEXT, PLEASE. THIS SLIDE IS JUST A BRIEF
OVERVIEW OF HUD’S LEAD HAZARD CONTROL PROGRAM.
WE’VE BEEN IN EXISTENCE SINCE 1993.
WE GIVE GRANTS TO LOCAL GOVERNMENTS AND STATE
GOVERNMENTS TO ADDRESS LEAD-BASED PAINT HAZARDS IN
LOW-INCOME HOUSING. WE’VE, OVER THE YEARS, GIVEN
OUT, I THINK, OVER $1.5�BILLION IN FUNDS.
THEY SUPPORT NOT JUST DIRECT INTERVENTION, BUT EDUCATION AND
OUTREACH AND THE DEVELOPMENT OF THE INDUSTRY-TRAINED RISK
ASSESSORS AND INSPECTORS AS WELL.
SO COMBINED WITH OUR ENFORCEMENT OF LEAD REGULATIONS, WE ESTIMATE
THAT WE’VE MADE OVER THE YEARS ABOUT 420,000 HOUSING UNITS IN
THE U.S. LEAD SAFE. CURRENT AWARDS TO OUR GRANTEES
WHO ARE IN THE FIELD NOW ARE ABOUT A LITTLE OVER
$400�MILLION. BUT WE’VE MADE GREAT PROGRESS.
THIS SLIDE IS A LITTLE BIT DATED, BUT IT GIVES YOU THE
SENSE THAT I WANT TO CONVEY OF THE DOWNWARD TREND IN BLOOD LEAD
LEVELS, SO THIS SLIDE SHOWS THE PERCENTAGE OF CHILDREN ABOVE THE
PREVIOUS BENCHMARK OF TEN MICROGRAMS PER DECILITER, SO
THAT WAS THE BENCHMARK OF INDICATING WHAT ELEVATED BLOOD
LEVEL IS. IT WAS USED TO�– A LOT OF
PEOPLE DESIGNATED IT AS THE LEVEL OF LEAD POISONING AND
HIGHER. IT’S A BIT OF A CONTROVERSIAL
TERM. MAYBE WE’LL TALK MORE ABOUT THAT
TODAY. BUT IT SHOWS THE DECLINE FROM
1988 TO 2002, AND IMPORTANTLY, YOU CAN SEE FROM THE FIGURES
THAT THERE ARE DISPARITIES IN LEAD POISONING.
AFRICAN AMERICAN CHILDREN HAVE THE HIGHEST EXPOSURES OVER THE
YEARS. THIS IS STILL THE CASE, BUT WE
STILL SEE THIS DOWNWARD TREND AND WE SEE THIS REDUCTION IN
DISPARITIES IN EXPOSURE AS WELL. SO IF I HAD ANOTHER FIGURE THAT
WENT OUT UNTIL 2016, YOU’D STILL SEE THESE DECLINES IN BLOOD LEAD
LEVELS, WHICH IS GREAT. EARLY ON, AND I THINK RICK, ONE
OF OUR SPEAKERS WILL TALK ABOUT THIS, THERE WERE VERY WIDESPREAD
EXPOSURE FROM LEAD IN GASOLINE AND ONCE LEAD WAS TAKEN OUT OF
GAZ LIEN, IT BECAME�– GASOLINE, IT BECAME MORE OF A CONCERN ON
LEAD EXPOSURES FROM HOUSING, SOIL DUST AND POINT.
THIS SLIDE JUST SHOWS ANOTHER ASPECT OF OUR CURRENT CHALLENGE,
AND THAT’S THE REDUCTION IN THE LEVEL AT WHICH CHILDREN ARE
CONSIDERED TO HAVE ELEVATED BLOOD LEAD LEVELS.
THE TERM POISONING IS USED SOMETIMES, I BELIEVE,
INAPPROPRIATELY, BUT IN 2012, CDC CHANGED FROM THE BENCHMARK
OF TEN MICROGRAMS PER DESLY LITER THAT I JUST MENTIONED TO
WHAT WE CALL NOW A REFERENCE VALUE OF FIVE MICROGRAMS PER
DECILITER OF LEAD IN THE BLOOD OF CHILDREN.
AS AN INDICATOR OF CHILDREN THAT HAVE HIGHER EXPOSURES THAN THE
REST OF THE POPULATION. IT’S BASED ON A 97-POINT
DISTRIBUTION IN NATIONAL BLOOD LEAD LEVELS FOR CHILDREN.
IT’S FROM FOUR YEARS OF DATA FROM THE NHAIN SURVEY.
THEY’RE REEVALUATING FOUR MORE YEARS RIGHT NOW.
THAT’S WHY I HAVE THE QUESTION MARK NEXT TO 2016.
IT’S LIKELY THAT THIS LEVEL WILL GO DOWN FROM 5 TO A LOWER LEVEL.
YOU SEE IN THE PAPER RECENTLY WITH FLINT, FOR EXAMPLE, THE
WORD LEAD POISONING IS USED IN REFERENCE TO THE VALUE OF 5 AND
ABOVE. THAT’S NOT REALLY MEANT TO BE
USED THAT WAY. IT’S AN INDICATOR OF CHILDREN
THAT HAVE HIGHER LEVELS, RELATIVELY HIGHER LEVELS OF LEAD
THAN OTHER CHILDREN. THERE’S A CONTINUUM OF EFFECTS.
THERE’S NO LEVEL OF LEAD IN CHILDREN’S BLOOD WHERE THEY�–
WE HAVEN’T SEEN AN ADVERSE EFFECT.
THAT’S THE MAIN REASON THAT EPA WENT TO THIS REFERENCE VALUE,
BUT IT MAKES FOR A CHALLENGING ENVIRONMENT FOR HOUSING PROGRAMS
WHEN YOU’RE KIND OF KEYING OFF CHILDREN WITH BLOOD LEAD
TESTING, AT WHICH LEVEL DO YOU INTERVENE, SO MAYBE WE CAN TALK
A LITTLE BIT ABOUT THAT IN OUR Q&A.
SO IF YOU HAVE QUESTIONS DURING THE SEMINAR, PLEASE SEND THEM TO
THIS MAILBOX, [email protected], AND
WE’LL TRY TO GET THEM ANSWERED. GIVE YOU A SECOND TO WRITE THAT
DOWN. OKAY, I’D NOW LIKE TO INTRODUCE
OUR FIRST SPEAKER AND THAT IS RICK NEVIN.
HE’S A SENIOR ECONOMIST WITH ICF INTERNATIONAL.
HE WAS THE PRINCIPAL AUTHOR OF THE ECONOMIC ANALYSIS OF HUD’S
1999 LEAD SAFE HOUSING RULE. THIS IS THE REGULATION THAT
GOVERNS�– THAT TRIES TO PREVENT OR CREATE LEAD-SAFE HOUSING IN
FEDERALLY ASSISTED HOUSING, SO THAT’S PUBLIC AND OTHER ASSISTED
HOUSING. AND HE CONTRIBUTED TO THE
FEDERAL STRATEGY FOR ELIMINATING CHILDHOOD LEAD POISONING.
HE IS ALSO A CO-AUTHOR OF SEVERAL PEER-REVIEWED STUDIES
ABOUT HOW LEAD-SAFE WINDOW REPLACEMENT CAN ELIMINATE LEAD
PAINT HAZARDS AND THE AUTHOR OF TWO STUDIES OF LEAD EXPOSURE
INTACTS ON IMPORTANT SOCIETAL TRENDS, INCLUDING CHANGES IN IQ,
SCHOLASTIC ACHIEVEMENT AND VIOLENT CRIME.
RICK?>>FROM OVER HERE OR�–
>>IF YOU COULD COME UP HERE, THAT WOULD BE GREAT.
>>THANK YOU. WE CAN GO TO THE FIRST SLIDE.
I’M GOING TO START WITH A QUICK OVERVIEW OF KNOWN LEAD EXPOSURE
IMPACTS. LEAD IS A NEUROTOXIN AND
CHILDREN ARE ESPECIALLY VULNERABLE DURING THE FIRST
YEARS OF LIFE WHEN THE BRAIN IS IN A CRITICAL STAGE OF
DEVELOPMENT. INDIVIDUAL OUTCOMES ARE GOING TO
VARY WITH THE SEVERITY OF LEAD POISONING AND WITH VARIATIONS IN
BIOLOGICAL SENSITIVITY, RESULTING IN POPULATION IMPACTS
THAT OVERLAP LIKE VENN DIAGRAMS. LOWER LEVELS OF LEAD EXPOSURE
ASSOCIATED WITH IQ LOSSES, LOWER EDUCATION ATTAINMENT AND
ACHIEVEMENT, AND MORE IMPULSIVE AND DELINQUENT BEHAVIOR DURING
ADOLESCENCE. MORE SEVERE LEAD POISONING IS
ASSOCIATED WITH LARGER IQ LOSSES, INCREASED RISK OF MENTAL
RETARDATION, MORE SEVERE EDUCATION LIMITATIONS, AND
GREATER RISKS OF VIOLENT OFFENDING.
NOW, MY RESEARCH SHOWS A POPULATION, LEAD EXPOSURE TRENDS
HAVE AFFECTED NATIONAL TRENDS IN EDUCATION AND BEHAVIOR.
MY 2000 STUDY FOUND THAT LEAD EXPOSURE TRENDS EXPLAINED MOST
OF THE VARIATION IN THE USA HOMICIDE RATE FROM 1900 TO 1998.
AND USA VIOLENT CRIME RATES FROM 1960 TO ’98 AND UNWED TEEN
PREGNANCY RATES FROM THE 1950s THROUGH 1996.
MY 2007 STUDY SHOWED THE SAME STRONG RELATIONSHIP BETWEEN
PRESCHOOL BLOOD LEAD TRENDS IN BURGLARY AND ROBBERY RATES IN
THE USA, CANADA, BRITAIN, AUSTRALIA, AND OTHER NATIONS,
AND MY 2009 STUDY SHOWED THAT BLOOD LEAD TRENDS ALSO EXPLAINED
TRENDS IN PUBLIC SCHOOL PREVALENCE OF MENTAL RETARD
INDICATION OR MR FROM 1948 TO 2001.
AND YES, I KNOW THAT NR IS NOW CALLED�– MR IS NOW CALLED
INTELLECT CAL DISABILITY BUT I’M GOING TO USE THE MR TERM TODAY
TO BE CONSISTENT WITH MY EARLIER STUDY THAT I’LL BE CITING.
GO TO THE NEXT ONE. NOW, THE TIME PRECEDENT
INDICATOR OF CAUSATION REQUIRES THAT THE SUSPECTED CAUSE PRECEDE
THE EFFECT. MY STUDY FINDINGS RELATE
SOCIETAL TRENDS IN LEAD EXPOSURE WITH LEAD EXPOSURE, WITH BEST
FIT TIME LAGS THAT REFLECT AN ANALYSIS OF WIDE ARRAY OF TIME
LAGS. THE BEST IF IT WAS THE 21-YEAR
TIME LAG FOR USA HOMICIDE, 23 YEARS FOR VIOLENT CRIME AND
ROBBERY TRENDS, 18 YEARS FOR BURGLARIES, AND ALL OF THESE
LAGS, IT’S IMPORTANT TO NOTE, ARE CONSISTENT WITH LEAD INDUCED
NEUROBEHAVIORAL DAMAGE IN THE FIRST YEARS OF LIFE AFFECTING
PEAK PROPERTY CRIME OFFENDING THAT OCCURRED IN THE LATE TEENS
AND PEAK VIOLENT CRIME OFFENDING THAT OCCURS IN THE EARLY 20s.
THE BEST FIT LAGS FOR UNWED PREGNANCY FOR 15 YEARS FOR GIRLS
UNDER AGE 15, 17 YEARS FOR AGES 15 TO 17, 20 YEARS FOR GIRLS
AGES 18 AND 19, AND THE BEST FIT FOR MR PREVALENCE WAS 12 YEARS
FOR STUDENTS AGES 6 TO 18, SO AGAIN, HAVING TESTED MANY
DIFFERENT TIME LAGS, THE BEST IF IT WAS CONSISTENTLY ASSOCIATED
WITH NEURAL IMPACTS IN THE FIRST YEAR OF LIFE.
NOW, THE MOST COMMON PATHWAY AFFECTING CHILDREN IS LEAD IN
HOUSE DUST. IT’S INGESTED VIA NORMAL HAND TO
MOUTH ACTIVITY AS CHILDREN LEARN TO CRAWL, ABSORBED INTO THE
BLOODSTREAM AND CARRIED TO THE DEVELOPING BRAIN.
HEAVILY LEADED 1900 PAINT DETERIORATED BY CHALKING,
CAUSING SEVERE LEAD DUST HAZARDS AND AIR FALLOUT FROM LEADED
GASOLINE SETTLED AS LEAD IN DUST.
THE USE IN LEAD IN GASOLINE FELL AFTER THE IT WAS TAKEN OUT OF
GAS AND THE BAN ON LEADED PAINT, BUT IT IS STILL POISONING
CHILDREN TODAY. WE NOW KNOW THE AMOUNT OF LEAD
IN DUST THAT IS INVISIBLE TO THE NAKED EYE IS ENOUGH TO CAUSE
NEURAL DEVELOPMENTAL DAMAGE. NOW, THE STRONGEST INDICATOR FOR
A CAUSAL THEORY IS GENERALLY ACCEPTED TO BE WHEN IT IS
REVEALED AS A RESULT OF AN ACTION TAKEN TO PREVENT THE
SUSPECTED CAUSE OF DISEASE AND LATER TRENDS SHOW EXPERIMENTAL
EVIDENCE OF CAUSE AND EFFECT. IN OTHER WORDS, THE ULTIMATE
TEST OF A CAUSAL THEORY IS WHETHER IT HAS PREDICTIVE POWER.
DOES REMOVING THE SUSPECTED CAUSE HAVE THE EXPECTED EFFECT
IN THE REAL WORLD? AND THAT’S REALLY WHAT I’M GOING
TO BE FOCUSING ON FOR THE REST OF THIS PRESENTATION.
MY 2000 STUDY TRACKED USA HOMICIDE RATES FROM 1900 TO
1998, FOLLOWING THE RISE AND FALL OF USA PER CAPITA USE OF
LEAD IN PAINT AND GASOLINE WITH A 21-YEAR TIME LAG.
THE HOMICIDE RATE HAS FALLEN 52% FROM 1991 TO 2014, BUT THAT
INCLUDES IMPORTANTLY A 26% DECLINE FROM 1998 TO 2014.
AND ON THIS GRAPH, JUST TO BE CLEAR, THE BLACK DIAMOND TREND
SHOWS PER CAPITA LEAD USE FROM 1879 TO 1987 AS REPORTED IN MY
2000 STUDY. THE RED TRIANGLE TREND SHOWS THE
1900 TO 1998 HOMICIDE TREND REFLECTED IN THAT ANALYSIS,
MAPPING FOR LEAD EXPOSURE TRENDS WITH A 21-YEAR LAG, AND THE
GREEN CIRCLE TREND SHOWS THE EXPERIMENTAL EVIDENCE OF ONGOING
DECLINES IN THE HOMICIDE RATE. WE’RE USING THAT COLOR SCHEME
REPEATEDLY. MY 2000 STUDY ALSO FOUND THAT
LEAD EXPOSURE SPENDS EXPLAIN 90% OF USA VIOLENT CRIME RATE
VARIATION FROM 1960 TO 1998. THE VIOLENT CRIME RATE HAS
FALLEN ANOTHER 36% FROM 1998 THROUGH 2014.
THE BLACK DIAMOND IN THIS TREND SHOWS AVERAGE PRESCHOOL BLOOD
LEAD SINCE THE 1930s AND THE RED TRIANGLE SHOWS THE VIOLENT CRIME
RATE THROUGH 1998 WITH A 23-YEAR TIME LAG FOLLOWING THE BLOOD
LEAD TRENDS. THE GREEN CIRCLE AGAIN SHOWS THE
EXPERIMENTAL EVIDENCE OF ONGOING DECLINE IN THE VIOLENT CRIME
RATE. NOW, VIOLENT CRIME DECLINED
SINCE 1991 HAS NOT BEEN AS STEEP AS THE 1975 TO 1985 FALL IN LEAD
EXPOSURE BECAUSE THE VIOLENT CRIME WE’VE SEEN FOR AGES BEING
OLDER HAS ACTUALLY INCREASED 24% SINCE 1991.
THIS REFLECTS ONGOING CRIME EFFECTS OF BIRTH YEARS WHEN LEAD
EXPOSURE WAS STILL RISING. BY CONTRAST, THE JUVENILE
VIOLENT CRIME ARREST RATE FELL 65% FROM 1991 TO 2014 AND THE
JUVENILE PROPERTY CRIME ARREST RATE FELL BY 73% OVER THOSE
YEARS. AND WE SAW THE MIRROR IMAGE OF
THIS TREND IN THE 1960s WHEN JUVENILE AERS RATES SURGED�–
ARREST RATES SURGED BECAUSE THE YOUNGEST AGE GROUPS ARE THE
FIRST TO SHOW THE EFFECTS OF BOTH RISING AND DECLINING
POPULATION LEAD EXPOSURE. WITH SHIFT IN ARREST RATE HAS
PRODUCED WHAT I THINK IS A VERY UNDERREPORTED SHIFT IN
INCARCERATION RATES. MY 2009 STUDY HIGHLIGHTED THIS
TREND USING DATA THROUGH 2006 AND I’M SHOWING YOU HERE THAT
THIS TREND IS NOW CONTINUED THROUGH 2014.
FROM 2001 TO 2014, MALE INCARCERATION RATES FELL 62% FOR
AGES 18 TO 19, 38% FOR AGES 20 TO 24, AND 27% FOR AGES 25 TO
29, BUT ROSE 31% FOR AGES 40 TO 44 AND 82% FOR AGES 45 TO 54.
AGAIN, WE’RE STILL SEEING THE IMPACTS OF BIRTH YEARS WHEN LEAD
EXPOSURE WAS RISING. MY 2000 STUDY ADDED ABORTION
RATES BY AGE FROM AGI WITH UNWED BIRTH RATES FOR THE NEXT YEAR TO
ESTIMATE UNWED PREGNANCY RATES BY YEAR OF CONCEPTION.
AGI SENT ME A LETTER AT THE TIME THAT STUDY WAS PUBLISHED THAT
WAS FOLLOW LIGHT BUT SKEPTICAL�– FOLLOW LIGHT BUT
SKEPTIC�– POLITE BUT SPECTACLE WITH THE CAUSE AND EFFECT
THEORY. CONSIDERING THE CAUSAL REGARDING
MARRIAGE, IT SEEMS HIGHLY UNLIKELY THAT THE RATES WILL
MR.�MET. FROM 1996 TO 2013, THE
PRESENTING NASA RATE FOR GIRLS UNDER�– PREGNANCY RATE FOR
GIRLS UNDER AGE 15 FELL BY 72%. THE AGE 15 TO 17 UNWED PREGNANCY
RATE FELL 66%. THE NEXT SLIDE SHOWS THAT THE
AGE 18 AND 19 UNWED PREGNANCY RATE FELL 48%.
THE DECLINE IN UNWED TEEN PREGNANCY REFLECTS LARGE
DECLINES IN ABORTION AND UNWED BIRTH RATES FOR WOMEN IN THEIR
20s, BUT THE DECLINE IS MOSTLY DUE TO DECLINING ABORTION RATES.
UNWED BIRTH RATES HAVE INCREASED SINCE THE 1990s FOR WOMEN OVER
25 AND THE ABORTION RATES INCREASED FOR WOMEN OVER 40.
THESE IS THE SAME SHIFT IN NUMBERS, REFLECTING THE ONGOING
EFFECTS OF YEARS WHEN LEAD EXPOSURE WAS STILL RISING.
RETURNING TO CRIME, MY 2007 STUDY FOUND THAT 78% OF BURGLARY
RATE VARIATION THROUGH 2002 IN CANADA, BRITAIN, AUSTRALIA, WAS
EXPLAINED BY PRESCHOOL BLOOD LEAD TRENDS.
THE BURGLARY RATES FELL MORE THAN 50% FROM 2002 THROUGH 2014
IN BRITAIN, TRACKING THE EARLIER BLOOD LEAD TRENDS I REPORTED.
IT ALSO FELL BY MORE THAN 50% IN AUSTRALIA.
NEXT SLIDE. AND IT ALSO FELL BY MORE THAN
50% IN CANADA. NEXT SLIDE.
IN THE CASE OF ROBBERY, I FOUND IN MY 2007 STUDY THAT 71% TO 89%
OF ROBBERY RATE VARIATION THROUGH 2002 IN THE USA, CANADA,
BRIT TAUN AND AUSTRALIA WAS EXPLAINED BY FRIENDS IN PUBLIC
SCHOOL�– TRENDS IN PUBLIC SCHOOL BLOOD LEAD.
THERE WAS A 30% DECLINE FROM 2002 THROUGH 2014.
YOU CAN SEE CANADA, THEIR ROBBERY RATE FELL 50% FROM ’91
THROUGH 2014, INCLUDING A 39% SINCE 2002, 39% DECLINE.
AND FROM 2002 TO 2014, THE ROBBERY RATE FELL BY ABOUT 60%
IN AUSTRALIA, ON THE NEXT SLIDE, AND ALSO FELL BY ABOUT 60% IN
BRITAIN. IT’S JUST REMARKABLY CONSISTENT
HOW ACCURATE THE FORECASTS HAVE BEEN BASED ON EARLIER BLOOD LEAD
TRENDS. NOW, THERE IS AN ESTABLISHED
DOSE-RESPONSE RELATIONSHIP BETWEEN PRESCHOOL BLOOD LEAD AND
IQ LATER IN LIFE. BLOOD LEAD OF 10 LOWERS IQ ABOUT
7�1/2 POINTS. BLOOD LEAD OF 60 CAN LOWER IQ BY
ALMOST 20 POINTS AND OTHER RESEARCH SEVERELY LINKED BLOOD
LEAD POISONING WITH INCREASED RISK OF MR.
ADDED TO EXPOSURE OF CITY AIR AND LEAD PAINT HAZARDS OF SLUM
HOUSING MADE THE POISONING SEVERE IN THE 1960s WHEN
OFFICIALS REPORTED THERE WERE A LARGE NUMBER OF COMATOSE AND
CONVULSING CHILDREN IN BLOOD LEAD POISONING IN INNER CITY
HOPS. THE 1982 NATIONAL RESEARCH
COUNCIL REPORTED THAT 75 TO 80% OF ALL MR STUDENTS IN THE 1970s
HAD IQ ABOVE 55 AND MOST OF THESE MILD CASES WERE OF UNKNOWN
CAUSE WITH A VERY HIGH PREVALENCE AMONG CHILDREN LIVING
IN URBAN SLUMS. GO TO THE LAST SLIDE.
MY 2009 STUDY SHOWED BLOOD LEAD TRENDS EXPLAINED 65% OF THE
VARIATION IN MR PREVALENCE FROM 1948 TO 2001, TRACKING BLOOD
LEAD TRENDS WITH A 12-YEAR LAG. PREVALENCE IN 2012 WAS 0.87%,
THE LOWEST SINCE 1959. YOU CAN SEE PREVALENCE WAS 1 TOY
2 TO 1.3% FROM 1991 TO 2004, BUT THAT WAS WHEN SCHOOLS SWITCHED
FROM THE 1974�WISC-R TO THE III, WITH THE LATTER BASED ON THE
NUMBER OF CHILDREN BORN AS LEAD EXPOSURE WAS DECLINING, SO THE
BELL CURVE, WHICH WAS BASICALLY THE IQ GRADED ON THE CURVE HAD
LESS LEAD EXPOSURE FOR THE ENTIRE POPULATION.
OTHER RESEARCH HAS SHOWN THAT STUDENTS WITH MILD MR HAVE
WISC-III SCORES ABOUT 5�1/2 POINTS HIGHER THAN THE WISC-R
SCORES, SO THIS MEANS THE DECLINE IN MR PLENTY OF LENS
UNDERSTATES THE�– PREVALENCE UNDERSTATES THE CHILDREN WITH
IMPAIRED ABILITY BECAUSE NEW TESTS RESULTS IN HIGHER
FUNCTIONING STUDENTS BEING DIAGNOSED WITH MR.
THANK YOU.>>THANK YOU VERY MUCH, RICK.
THIS IS VERY INTERESTING AND INSIGHTFUL DATA.
DO YOU HAVE ANY QUESTIONS FOR RICK FROM THE AUDIENCE OR ANY IN
OUR MAILBOX? OKAY, YOU FOLKS WHO ARE TUNED IN
VIA THE WEBCAST, DON’T FORGET TO SUBMIT QUESTIONS TO THE MAILBOX.
I HAVE ONE QUESTION FOR YOU, RICK.
HAS THERE BEEN ANY COST-BENEFIT ANALYSIS OF PREVENTING LEAD
EXPOSURE BASED ON THE�– SOME OF THE OUTCOMES THAT YOU’VE
HIGHLIGHTED, IN PARTICULAR CRIME?
>>WE REALLY HAVEN’T TRIED TO CAPTURE THE BENEFIT WITH CRIME.
WE STILL HAVE SO MUCH GOOD NEWS AHEAD OF US BECAUSE BLOOD LEAD
LEVELS HAVE CONTINUED TO DECLINE, SO YOU’D HAVE TO
ESTIMATE WHAT THE CRIME WOULD BE STARTING ABOUT 20 YEARS FROM
NOW, BUT JONATHAN I BELIEVE IS GOING TO BE TALKING ABOUT WINDOW
REPLACEMENT STRATEGY EARLIER AND THERE HAS BEEN EXTENSIVE WORK
THAT’S BEEN PEER-REVIEWED AND PUBLISHED SHOWING ENORMOUS NET
BENEFITS FROM A LEAD-SAFE WINDOW REPLACEMENT STRATEGY BASED JUST
ON THE IMPACT THAT LEAD IS KNOWN TO HAVE ON EDUCATION OUTCOMES
AND LIFETIME EARNINGS ASSOCIATED WITH IQ.
>>THANK YOU. AND THEN ONE OTHER QUESTION.
I THOUGHT I NOTICED IN SOME OF YOUR FIGURES, YOU HAD PRESCHOOL
BLOOD LEAD LEVELS AVERAGE FOR U.S. CHILDREN THAT WENT BACK
FARTHER THAN I THOUGHT WE HAD DATA FOR.
HOW FAR BACK DO WE HAVE DATA FOR PHYSICAL BLOOD LEAD?
>>WHAT I DID WITH MY 2007 STUDY IS THAT IN EVERY NATION I LOOKED
AT, I WAS ABLE TO FIND REPRESENTATIVE BLOOD LEAD SURVEY
DATA FOR AT LEAST ONE YEAR AND IN SOME CASES FOR A FEW.
AND THERE HAVE BEEN OTHER STUDIES THAT I CITED THAT SHOWED
THAT THE CORRELATION BETWEEN LEAD USE IN GASOLINE AND
PRESCHOOL BLOOD LEAD WAS WELL ABOVE 90%, LIKE 95%, DURING THE
YEARS THAT GASOLINE LEAD WAS BEING USED IN EVERY COUNTRY.
THAT WASN’T BECAUSE OTHER RISKS WEREN’T SIGNIFICANT, BUT FOR
EXAMPLE, THE RISK OF LEAD PAINT EXPOSURE JUST CHANGED AT A
GRAISHLLY SLOW RATE WITH�– GLACIALLY SLOW RATE WITH CHANGES
IN THE HOUSING STOCK DURING THE DECADES THAT LEAD IN GASOLINE
WAS USED, SO WHAT I WAS ABLE TO DO IS EXTRAPOLATE THE BLOOD LEAD
TRENDS BASED ON THE COMBINATION OF BLOOD LEAD SURVEY DATA FROM
EACH COUNTRY AND THE PER CAPITA LEAD EMISSIONS IN EACH COUNTRY
AND I’M HAPPY TO SAY THERE’S BEEN ANOTHER STUDY SINCE THEN
THAT AT LEAST IN THE USA CONFIRM VERY WELL THE SHAPE OF THE CURVE
ARE FOR THE USA BLOOD LEAD TRENDS BASED ON ANALYSIS OF
TOOTH LEAD ENAMEL FOR INDIVIDUALS BORN FROM THE 1930s
THROUGH THE 19 MAIN TIS. — 1990s.
>>THANK YOU VERY MUCH. IS IT SAFE TO SAY THAT ALL OF US
ON STAGE WERE LEAD POISONED BASED ON THE CURRENT REFERENCE
VALUE OF 5 IF YOU USE THAT TERM?>>I THINK YOU MADE A GOOD POINT
EARLIER. IT’S DIFFICULT TO COMMUNICATE
TWO EQUALLY IMPORTANT MESSAGES. WE STILL HAVE A SERIOUS PROBLEM.
THERE’S NO EVIDENCE THAT A BLOOD LEAD LEVEL OF 2 IS SAFE AND HAS
ZERO IMPACTS. JUST THE OPPOSITE.
IT DOES HAVE IMPACT, SO AT A PUBLIC HEALTH LEVEL, THIS IS
STILL AN URGENT PROBLEM AND GLEED TO ADDRESS IT AS�– NEED
TO ADDRESS IT AS SUCH, BUT I DON’T WANT TO SCARE THE LIVING
HELL OUT OF INDIVIDUAL PARENTS WHO HAVE A CHILD WITH A BLOOD
LEAD LEVEL A LITTLE BIT ABOVE 5 BECAUSE IN THE LATE 1970s, MORE
THAN 90% OF CHILDREN HAD BLOOD LEAD LEVELS ABOVE 5.
>>THANK YOU. YES, THAT PUTS IT IN
PERSPECTIVE. THANKS, RICK.
OKAY, I’D LIKE TO NOW INTRODUCE OUR NEXT SPEAKER, AND THIS IS
DR.�PAT McLANE. PAT HAS WORKED WITH PUBLIC
HEALTH PROGRAMS AT THE LOCAL, STATE AND NATIONAL LEVELS FOR
MORE THAN 30 YEARS. SHE IS AN ASSISTANT PROFESSOR AT
THE UNIVERSITY OF MARYLAND SCHOOL OF NURSING AND SERVES AS
DIRECTOR OF THE COMMUNITY PUBLIC HEALTH NURSING SPECIALTY WHERE
HER RESEARCH HAS FOCUSED ON ISSUES OF CHILDHOOD LEAD
POISONING AND CHILDHOOD ASTHMA. PAT PREVIOUSLY WORKED FOR THE
NATIONAL CENTER FOR LEAD-SAFE HOUSING, THE PREDECESSOR TO
JONATHAN’S ORGANIZATION, CALLED NOW THE NATIONAL CENTER FOR
HEALTHY HOUSING. DURING WHICH TIME SHE OFTEN
WORKED CLOSELY WITH OUR OFFICE HERE AT HUD.
PAT CURRENTLY CHAIRS THE MARYLAND LEAD POISONING
PREVENTION COMMISSION.>>THANK YOU, PETER.
AND I’M GOING TO TALK TODAY ABOUT THE RELATIONSHIP BETWEEN
LEAD EXPOSURE AND EDUCATION, ANOTHER OUTCOME OF INTEREST
CERTAINLY TO SOCIETY AS WELL AS TO PARENTS AND PEOPLE WHO ARE
WORKING ON HOUSING INTERVENTIONS AS WELL.
SO�– NEXT SLIDE. IN TERMS OF BACKGROUND, THESE
ARE VERY SIMILAR TO THE INFORMATION THAT RICK PRESENTED.
THE KINDS OF EFFECTS THAT WE’VE SEEN IN TERMS OF NEUROCOGNITIVE
EFFECTS INCLUDE DECREASES IN IQ. PROBABLY, THOUGH, NOT THE
OUTCOME WE SHOULD BE MOST CONCERNED ABOUT.
CHANGES IN WORKING MEMORY ARE REALLY KEY TO BEING ABLE TO
DECODE LANGUAGE AND LEARN TO READ, AND IT’S BEEN SUGGESTED
THAT THESE SCHOOL PERFORMANCE MEASURES ARE REALLY AMONG THE
MOST MEANINGFUL MEASURES, PARTICULARLY FOR SOCIETY AT
LARGE, AND THE GRADE LEVEL TEST SCORES, READING READINESS IN
KINDERGARTEN, AND MATH AND READING SCORES ARE REALLY
IMPORTANT MEASURES IN TERMS OF SEEING WHAT WILL HAPPEN WITH
CHILDREN, MAKING SURE CHILDREN CAN COMPLETE THEIR EDUCATION,
ETCETERA. AND IN ADDITION TO THE EFFECTS
ON SCHOOL PERFORMANCE, WE HAVE EFFECTS ON ATTENTIONAL
DYSFUNCTION, AGGRESSION, DELINQUENCY, AND AS RICK
MENTIONED BEFORE, EARLY DEFICITS MAY PERSIST AND THERE’S NO
THRESHOLD OF LEAD EXPOSURE BELOW WHICH WE DON’T GET AN IMPACT, SO
NO LEAD LEVEL IS SAFE, AND WE WANT TO REDUCE EXPOSURE AS MUCH
AS POSSIBLE. SO IN TERMS OF THE ASSOCIATION
BETWEEN IQ SCORES AND BLOOD LEAD LEVELS, THIS DATA IS VERY OLD.
THESE STUDIES GO BACK TO 1981, AND YOU CAN SEE ACROSS DIFFERENT
POPULATIONS THE DECREASE IN IQ SCORES AND RELATIONSHIP WITH
INCREASING BLOOD LEAD LEVELS. SO THE HIGHER THE BLOOD LEAD
LEVEL, THE LOWER THE IQ SCORE, AND THE DIFFERENCES IN THESE
CURVES HERE ARE BECAUSE OF THE POPULATION THAT WAS BEING
STUDIED WAS DIFFERENT. THIS ALONE, AND SO WE SEE THIS
LOSS OF IQ, WHICH WE THINK IS IMPORTANT, BUT THIS ALONE ISN’T
THE FULL STORY BECAUSE THE LOSS OF IQ AND LOSING IQ FOR A
POPULATION MEANS THAT WE’RE REALLY SHIFTING THE MEDIAN OF
THE POPULATION IQ SO THAT WE’RE ON THE ONE SIDE CUTTING OFF
CHILDREN WHO MIGHT HAVE BEEN GENIUSES WITH VERY, VERY HIGH IQ
SCORES, AND ON THE OTHER SIDE, WE’RE SIGNIFICANTLY INCREASING
THE NUMBER OF CHILDREN WHO HAVE VERY LOW IQ SCORES, WOULD BE
CONSIDERED IMPAIRED, VERY LOW END OF NORMAL WHO ARE LESS ABLE
TO CONTRIBUTE TO SOCIETY AND WHO NEED ADDITIONAL SERVICES.
YOU’VE SEEN THIS BEFORE. PETER ASHLEY SHOWED THIS GRAPH
SHOWING THE DECREASE OVER TIME AND THE DECREASE IN DISPARITIES,
BUT I WANT YOU TO TAKE A LOOK AT THE 1988 TO 1991 ON THE FAR LEFT
SIDE WHERE THE AVERAGE PERCENTAGE OF AFRICAN AMERICAN
CHILDREN IN THIS COUNTRY�– THIS IS U.S. DATA�– 18% OF AFRICAN
AMERICAN CHILDREN HAD BLOOD LEADS OVER 10 AND I WANT YOU TO
THINK ABOUT THAT NUMBER BECAUSE I’M GOING TO PRESENT MORE RECENT
DATA TO SUGGEST THAT ALTHOUGH THESE�– THE NATIONAL
DISTRIBUTION�– THE NATIONAL PREVALENCE OF HIGHER BLOOD LEADS
IS IMPROVING, WE STILL HAVE A REALLY DIFFERENT PICTURE IN
INNER CITIES IN OUR COUNTRY, AND WE NEED TO PAY ATTENTION TO THAT
BECAUSE THE NATIONAL PICTURE IS NOT THE PICTURE WE SEE IN URBAN
AREAS. SO I’M GOING TO WALK THROUGH A
FEW STUDIES AND THEN I’M GOING TO TALK TO YOU ABOUT A
METHODOLOGY THAT WE USE TO TAKE A LOOK AT EDUCATIONAL LEVELS AND
BLOOD LEAD LEVELS, WHICH I THINK MIGHT BE AN IMPORTANT
METHODOLOGY TO USE IN THE FUTURE FOR�– ESPECIALLY TO SEE WHAT’S
GOING ON WITH POPULATIONS. SO THIS WAS ONE OF THE FIRST
STUDIES DONE IN THE LATE�– IN THE EARLIER ’90s LOOKING AT
LOW-LEVEL EXPOSURE AND YOU CAN SEE WITH THE LOWEST BLOOD LEADS
BEING BELOW 5, THE DIFFERENCE IN IQ.
SO AS THE BLOOD LEAD GOES UP FROM 0 TO 4.9 AND ABOVE 15, WE
SEE A DROP OF ABOUT 12IQ POINTS AND THIS WAS ONE OF THE FIRST
STUDIES THAT WAS ABLE TO LOOK AT LOWER BLOOD LEAD LEVELS.
ANOTHER STUDY USING THE NHANS DATA OF 1988 TO 1994.
THIS IS NATIONAL POPULATION DATA FOR THE WHOLE UNITED STATES
POPULATION, SHOWED THAT BLOOD LEAD LEVELS BELOW 5 HAD AN
IMPACT ON STANDARDIZED TEST RESULTS AND YOU CAN SEE HERE AT
BLOOD LEADS�– AND THESE WERE CURRENT.
MOST OF THE STUDIES WE’RE LOOKING AT LOOK AT BLOOD LEAD IN
EARLY CHILDHOOD, BUT YOU CAN SEE THAT THE LOWER THE CURRENT BLOOD
LEAD LEVELS, THE HIGHER THE ADJUSTED TEST RESULTS, SO�– AND
OUR HIGHEST BLOOD LEAD LEVEL HERE IS OVER 3 AND WE CAN SEE
FAIRLY IMPORTANT DECREASE IN THE TEST SCORES FROM 95.8 AT THE
LOWEST BLOOD LEAD LEVEL TO 91 FOR MATH, AND FOR READ, ALMOST
95 TO A LITTLE ABOVE 88, SO VERY SIGNIFICANT DIFFERENCES IN TEST
SCORES. THIS IS ONE THE FIRST LOOK AT
THE STANDARDIZED TESTS. THIS STUDY WAS PUBLISHED IN 2007
BY MIRANDA AND HER COLLEAGUES STUDYING BLACK AND WHITE
ENGLISH-SPEAKING CHILDREN IN NORTH CAROLINA, AND WHAT THEY
FOUND WAS THAT THE DECREASES IN SCORES WERE STEEPER AT THE LOWER
LEVEL OF BLOOD LEADS, SO BETWEEN BLOOD LEAD OF 1 OR 2 AND 6,
WE’RE LOSING MOST OF THE DECLINE IN READING SCORES.
WE ALSO FOUND THAT THE DECREASES IN SCORES WERE ASSOCIATED WITH
BLOOD LEADS AS LOW AS 2 MICROGRAMS PER DECILITER.
THEY DID�– THIS GROUP DID ANOTHER LARGER STUDY WITH 58,000
CHILDREN, FINDING THAT LEAD HAS LARGER EFFECT FOR CHILDREN WHOSE
END OF GRADE READING SCORES ARE LOW.
SO THE�– AND THAT WILL CONTINUE ACROSS TIME, AND THAT BLACKS HAD
HIGHER BLOOD LEADS THAN WHITE AND THE EFFECT ON SCORES, ON
THEIR READING AND MATH SCORES, WERE LARGER FOR BLACK CHILDREN
THAN FOR WHITE CHILDREN. NOW, THIS STUDY DESIGN HAS BEEN
USED IN MANY RECENT STUDIES. I’M GOING TO SHOW YOU SOME MORE
RESULTS BECAUSE WE KNOW MORE ABOUT THE RELATIONSHIP BETWEEN
LEAD AND EDUCATIONAL OUTCOMES. WE TYPICALLY USE GRADE COHORTS
OF PUBLIC SCHOOL CHILDREN, AND THE GRADE LEVEL TESTING THAT’S
DONE AT REGULAR INTERVALS. RESEARCHERS HAVE LOOKED AT CITY
INFORMATION, COUNTY AND STATE LEVEL DATA.
WE HAD DIFFERENT POPULATIONS BEING STUDIED IN ALL OF THESE
STUDIES. THEY DIFFER BY RACE, ETHNICITY,
LANGUAGE, SOME ARE URBAN AND AT HIGHER RISK.
SO THERE’S A LOT OF VARIATION IN THIS�– IN THE POPULATION.
THE BLOOD LEAD EXPOSURE MEASUREMENTS TYPICALLY DONE IN
EARLY CHILDHOOD, AT AGES 1 AND 2, ALTHOUGH THE STATE AND LOCAL
REQUIREMENTS DIFFER. SOME JURISDICTIONS ARE TESTING
CHILDREN EVERY YEAR THROUGH AGE 5.
WE HAVE A WIDE DIFFERENCE, THOUGH, IN THE SCREEN
PENETRATION RATES, THE NUMBER OF CHILDREN’S WHO ARE ACTUALLY
TESTED RANGES FROM 10 TO 90%, AND MOST OF THE DATA IS
MAINTAINED BY STATE LEAD REGISTRIES WITH ALL THE DATA
BEING REPORTED FROM LABORATORIES.
THE OUTCOME ASSESSMENTS THAT WE’RE LOOKING AT IN THESE
EDUCATIONAL STUDIES ARE THE STANDARDIZED TESTS, READING
READINESS, READING AND MATH, AND THE TIMES WHEN CHILDREN ARE
TYPICALLY TESTED ARE AT THE BEGINNING AND END OF
KINDERGARTEN, THIRD GRADE, FOURTH GRADE, AND OTHER GRADES
THEY’RE TESTED AS WELL. WE CITIZENSHIP LOOK AT MEASURES
THAT�– TYPICALLY LOOK AT NURSE THAT INCLUDE TOTAL SCORES AND
WHETHER OR NOT THEY ACHIEVE A BENCHMARK.
IN EDUCATION, IF YOU ACHIEVE A BENCH MARK, THAT MIGHT MEAN
YOU’RE READY TO GO ON TO FIRST GRADE OR READY TO ADVANCE OR YOU
STAYED BEHIND, SO BENCHMARK IS A REAL IMPORTANT MEASURE.
THIS KIND OF STUDY GIVES US A LONGITUDINAL LOOK AT THE EFFECTS
OF BLOOD LEAD IN EARLY AGE AND THE EDUCATIONAL EFFECTS LATER
ON. AS YOU CAN SEE, THIS IS FROM MY
RESEARCH, BUT YOU CAN SEE CHILD AT BIRTH AND THEN THEY’RE TESTED
HERE FOUR TIMES, 1, 2, 3, AND 4 YEARS OLD, AND THEN THEY GET
INTO SCHOOL, INTO KINDERGARTEN, AND THEY HAVE TESTS FOR
KINDERGARTEN READING READINESS ON EITHER SIDE OF THEIR SCHOOL.
SO WE ACTUALLY END UP GETTING A REALLY GOOD PICTURE
LONGITUDINALLY OF WHAT GOES ON WITH INDIVIDUAL CHILDREN AND WE
DO THIS BY LINKING DATA FROM SCHOOL ENROLLMENT, WHICH HAS
RACE, ETHNICITY, AGE, LANGUAGE, SES MEASURE WHICH IS FOR US
WHETHER THE CHILDREN ARE PARTICIPATING IN SCHOOL LUNCH
PROGRAM. THE EDUCATIONAL OUTCOME MEASURE,
WHICH IN MY CASE WAS THE PALS-K MEASURE FOR READING READINESS,
AND THEN WE HAVE HEALTH DEPARTMENT BLOOD LEAD DATA, AND
THESE DATA ARE LINKED INTO A LINKED DATA SET AND THE
IDENTIFIERS ARE STRIPPED. THE UNIQUE IDENTIFIERS THAT
COULD IDENTIFY WHETHER THERE WAS A PERSON, THEY’RE LINKED AT THE
INDIVIDUAL LIFL, BUT THE IDENTIFIERS ARE STRIPPED BEFORE
THE DATA IS ANALYZED, GIVING US THE OPPORTUNITY TO REALLY LOOK
AT THESE UNIQUE CONNECTIONS, SO IT’S A VERY INNOVATIVE KIND OF
DESIGN AND I THINK SOMETHING THAT CAN BE USED EVEN IN SOME OF
THE HOUSING STUDIES AND PROVIDENCE PLAN IN RHODE ISLAND
DID THE WORK FOR ME. I KNOW THEY’VE BEEN LOOKING AT
SOME OUTCOMES FOR HOUSING AS WELL.
WHAT ARE THE FINDINGS? WHAT DO WE KNOW NOW?
WE HAVE FINDINGS FOR BLOOD LEADS UNDER, EQUAL TO AND LESS THAN 3
SHOWING DECREASED END OF GRADE TEST SCORES.
AT LEVEL OF 4, INCREASED LIKELIHOOD OF LEARNING
DISABILITY, POOR PERFORMANCE ON TESTS.
AGAIN, LOOK AT THE SIZE. WE HAVE 57,000 CHILDREN IN NORTH
CAROLINA, WE HAVE 35,000 CHILDREN IN CONNECTICUT.
WHEN WE START LOOKING AT 5 MICROGRAMS PER DECILITER, 30%
MORE LIKELY TO FAIL THIRD GRADE READING AND MATH TESTS.
48,000 CHILDREN HERE IN CHICAGO. MORE LIKELY TO BE NOT PROFICIENT
IN SCIENCE, MATH AND READING, 21,000 CHILDREN IN DETROIT.
AND THEN AT THE 5 TO 9 LEVEL, SCORING 4.5 POINTS LOWER ON
READING READINESS, 3,400 CHILDREN IN RHODE ISLAND.
WHEN WE LOOK AT 10 AND ABOVE, AGAIN SCORING HERE 10.1 POINTS
LOWER ON READING READINESS FOR 3400 CHILDREN IN RHODE ISLAND
AND BETWEEN 10 AND 19, SIGNIFICANTLY LOWER ACADEMIC
PERFORMANCE ON MORE THAN 3,000 CHILDREN IN MILWAUKEE.
AT THE HIGHER LEVEL, WE HAVE A STUDY, THIS IS ON THE IMPACT OF
279 CHILDREN WHO HAD BLOOD LEADS OF 25 AND OVER, LEVELS WE DON’T
SEE THAT FREQUENTLY ANYMORE. THIS WAS DONE IN OHIO, FINDING
THAT THESE CHILDREN, THESE 279 CHILDREN ALONE HAD A COST OF
HALF A MILLION DOLLARS PER YEAR FOR SPECIAL EDUCATION AND
JUVENILE JUSTICE COSTS, THAT’S BEING PAID ONGOING.
SO CHILDREN WHO ARE EXPOSED EARLY ON CARRY THAT EXPOSURE AND
THE BURDEN OF THAT EXPOSURE ON THROUGH EDUCATION AND IT’S
REALLY IMPORTANT THAT WE UNDERSTAND, IT’S NOT JUST THE
TIME THAT WE TEST THEM THAT WE’RE CONCERNED ABOUT, BUT THEIR
WHOLE PROJECTION IN TERMS OF THEIR LIFE PROJECTION.
NOW, READING AND READING READINESS ARE VERY IMPORTANT
MEASURES TO OUR SOCIETY. IF YOU DON’T KNOW HOW TO READ,
YOU’RE IN BIG TROUBLE. AND 25% OF CHILDREN ARE ENTERING
KINDERGARTEN IN OUR COUNTRY NOT READY TO READ.
AND THIS READINESS PREDICTS A LOT OF LATER OUTCOMES.
WE ALSO KNOW THAT EARLY EDUCATIONAL INTERVENTION IS MORE
EFFECTIVE. 80% EFFECTIVE IF THE
INTERVENTION OCCURS BEFORE THIRD GRADE, BUT ONLY 10 TO 15% IF
IT’S AFTER FIFTH GRADE. SO THIS IS VERY IMPORTANT.
WE ALSO KNOW THE COSTS FOR REPEATING A GRADE OR FOR SPECIAL
ED ARE ONE AND A HALF TO THREE TIMES HIGHER THAN COSTS WE MIGHT
PAY FOR PRE-KINDERGARTEN OR PRESCHOOL.
REALIZING IS NOT�– IS ASSOCIATED WITH MANY ISSUES AND
MANY FACTORS. THESE ARE SOME OF THEM.
BUT LEAD IS CERTAINLY ONE OF THEM AS WELL.
AND SO IT’S REALLY IMPORTANT THAT WE UNDERSTAND THAT ALL
THESE FACTORS WILL AFFECT READING AND A STUDENT’S ABILITY
TO PERFORM WELL IN SCHOOL. NOW, I WANTED TO TALK A LITTLE
BIT ABOUT THE STUDIES FROM THE�– THE FINDINGS FROM OUR
STUDY AND WE SHOWED YOU THE 4.5 AND THE 10.1 POINTS LOWER ON
THESE FALL ENTRY SCORES BASED ON LEAD LEVELS, BUT THIS WAS ALMOST
THE SAME AS OUR FINDINGS FOR WHAT THE DIFFERENCE IN SCORE
WERE DUE TO OUR MEASURE OF SCS, WHICH WAS A REDUCED LUNCH AND
FREE LUNCH COMPARED TO CHILDREN WHO DIDN’T HAVE THIS CATEGORY.
SO CHILDREN WHO ARE COMING FROM POOR BACKGROUNDS AND ARE LEAD
EXPOSED HAVE THIS DOUBLE BURDEN OF BOTH OF THESE DECREASES IN
SCORE. AND AGAIN, THIS IS WHAT WE FOUND
IN LOOKING AT INDIVIDUAL BLOOD LEAD LEVELS, THE HIGHEST DROP IN
SCORE WAS EIGHT POINTS THAT OCCURRED BELOW A BLOOD LEAD
LEVEL OF 6, INDICATING THAT THESE LOWER BLOOD LEAD LEVELS
ARE REALLY THE PLACES WHERE WE’RE SEEING AN EFFECT ON
CHILDREN’S ABILITIES IN SCHOOL. NOW, I TALKED ABOUT THE
BENCHMARK AND THE IMPORTANCE OF THE BENCHMARK.
WHAT THIS SHOWS IS THAT CHILDREN WHO HAD A BLOOD LEAD OF 5 TO 9
WERE 21% MORE LIKELY TO FAIL THAT BENCHMARK TEST WHEN THEY
ENTER KINDERGARTEN AND IF THEY HAD HAD A 10 OR ABOVE, 56% WERE
MORE LIKELY TO FAIL THAT BENCHMARK TEST, WHICH MEANS THAT
THEY HAVE TO HAVE SPECIAL ATTENTION, SPECIAL PROGRAMS IN
KINDERGARTEN TO HOPE THAT THEY WILL THEN BE ABLE TO PASS OUT OF
KINDERGARTEN. SO IT’S A REAL BURDEN ON THE
SCHOOL SYSTEM TO HAVE THIS BIG INCREASE IN CHILDREN WHO NEED
EXTRA EDUCATIONAL ATTENTION. NOW, I MENTIONED THE ISSUE OF
PREVALENCE AND THE PREVALENCE OF BLOOD LEADS, AND IN THE STUDY
THAT WE DID IN RHODE ISLAND, THE CHILDREN WERE IN KINDERGARTEN
BETWEEN 2004 AND 2005 SCHOOL YEAR AND 2006-2007 SCHOOL YEAR,
SO THEIR BLOOD LEADS WERE MEASURED IN 1999 TO 2004, WHICH
IS THAT LAST SECTION ON THE SLIDE THAT WE SAW EARLIER.
THE PREVALENCE, HOWEVER, OF BLOOD LEADS WITHIN THE
KINDERGARTEN STUDENTS IN PROVIDENCE WAS 20%.
ONE IN FIVE CHILDREN IN THE PROVIDENCE PUBLIC SCHOOLS DURING
THIS PERIOD HAD HAD BLOOD LEAD OVER 10 COMPARED TO THE NHANS
DATA FOR THAT PERIOD WHERE IT’S 1.4% OF CHILDREN IN THAT AREA.
I THINK IT’S A VERY IMPORTANT FINDING AND I THINK WE NEED TO
REALLY PAY ATTENTION TO THE DIFFERENCES THAT WE’RE SEEING
ACROSS THE COUNTRY, PARTICULARLY IN URBAN AREAS.
SO THE LEAD AND EDUCATION CONNECTION IS VERY CLEAR.
THE FINDINGS ARE VERY CONSISTENT.
IN ADDITION, CHILDREN WHO HAVE LEAD EXPOSURE ARE NOT ALWAYS
IDENTIFIED OR TRACKED IN SCHOOL SETTINGS.
IT MAY BE REASONABLE TO SHARE CONFIDENTIAL MEDICAL INFORMATION
WITH SCHOOLS IF CHILDREN ARE GOING TO BE PROVIDED WITH
INTERVENTION. FOR INSTANCE, IF CHILDREN WERE
PROVIDED WITH ACCESS TO PRE-KINDERGARTEN, IF THEY HAD
ONE OF THOSE ELEVATED BLOOD LEAD LEVELS AND I’M THINKING HERE OF
0 TO 5, 5 TO 9. SO�– BUT IF WE’RE NOT GOING TO
DO ANYTHING ABOUT THE INFORMATION, IF WE’RE NOT GOING
TO PROVIDE THEM STAKE TO SERVICES�– ACCESS TO SERVICES
WHICH WOULD BE DESIRABLE, THEN WE HAVE A PROBLEM WHERE THIS
INFORMATION COULD LEAD TO LABELING OF CHILDREN WITHIN THE
EDUCATIONAL SYSTEM. SO THERE’S MUCH MORE NEEDS TO BE
DONE. IN FACT, WE REALLY DON’T HAVE A
GOOD PICTURE OF WHETHER THE EDUCATIONAL NEEDS OF
LEAD-POISONED CHILDREN ARE BEING MET IN SCHOOLS NOW.
AND THAT IS A PROBLEM. IN TERMS OF WHAT WE KNOW ABOUT
LEAD AND EDUCATIONAL PROGRAMS, WE DON’T HAVE A LOT OF DIRECT
INFORMATION. SO�– BUT WE DO KNOW THAT
ENRICHED AND NURTURING ENVIRONMENTS FOR ANIMALS AND
HUMANS ARE VERY SIMILAR. SO OUR KNOWLEDGE GAPS, WE DON’T
KNOW WHICH PROGRAMS WORK AND WE DON’T KNOW, REALLY, WHAT KINDS
OF PROGRAMS WOULD BE BEST. HOWEVER, LET ME JUST SKIP TO THE
END�– OOPS. WE DO KNOW THAT LEAD EXPOSURE IS
CONTRIBUTING TO DISPARITIES AND MANY DISPARITIES, WE KNOW
THERE’S NO SAFE LEVEL. WE KNOW THESE DATA LINKAGES
WOULD REALLY BENEFIT PUBLIC SCHOOLS AND PUBLIC HEALTH.
WE NEED TO ADVOCATE FOR RESOURCES ARE AND APPROACHES
THAT WORK, AND WE NEED TO ENSURE THAT IN THE FUTURE, ALL CHILDREN
THAT HAD ELEVATED BLOOD LEAD LEVELS RECEIVE THE EDUCATIONAL
SERVICES THEY NEED AND THIS IS GOING TO SET THE STAGE FOR
BETTER OUTCOMES IN THE FUTURE.>>THANK YOU VERY MUCH, PAT.
WE HAVE TIME FOR A COUPLE OF QUESTIONS.
ANYBODY IN OUR AUDIENCE? FOR THOSE ON THE WEBCAST, WE
DON’T HAVE A LARGE AUDIENCE HERE.
BEAUTIFUL DAY IN D.C. I THINK A LOT OF PEOPLE ARE
OUTSIDE ENJOYING IT. ANYBODY EMAILING ANY QUESTIONS?
I HAVE ONE, PAT. I GUESS WE LACK RESEARCH ON WHAT
INTERVENTIONS WOULD BE MOST EFFECTIVE TO OVERCOME DEFICITS
OF LOWER LEVEL LEAD EXPOSURE, BUT WHAT DO WE KNOW?
I THINK THERE’S BEEN SOME ANIMAL RESEARCH ON THIS AND I GUESS
RESEARCH ON CHILDREN WITH OTHER DEFICIT, NOT MAYBE LEAD�–
CAUSED BY LEAD.>>YES.
YES, THANKS, PETER. YES, I THINK WE DO KNOW QUITE A
BIT ABOUT OTHER SOURCES OF DEFICIT AND THAT KIND OF
STRUCTURED PROGRAMS. WE HAVE DATA FROM EARLY
EDUCATION AND CLEARLY EARLY EDUCATION IS MAKING A BIG
DIFFERENCE IN OUTCOMES FOR CHILDREN, ECONOMIC ANALYSIS
INDICATES THREE TO SEVEN DOLLARS SAVINGS FOR EVERY DOLLAR THAT WE
SPEND. THEN RESEARCH WITH CHILDREN WHO
HAVE AUTISM AND DEVELOPMENTAL DISORDERS HAVE DOCUMENTED
SIGNIFICANT IMPROVEMENTS THERE, BUT�– AND WE KNOW FROM THESE
OTHER STUDIES THAT THE ENRICHED NURTURING ENVIRONMENTAL IS
REALLY IMPORTANT, BOTH FOR ANIMALS AND FOR HUMANS, AND THAT
EXPOSURE TO BOOKS, MATERIALS, PARENTS, NURTURING
RELATIONSHIPS, DECREASED STRESS, SCHOOL INTERVENTIONS FOR POOR
READERS AND THE IMPORTANCE OF INTERVENTIONS CONTINUING
THROUGHOUT THE YEAR ACROSS, THESE ARE VERY IMPORTANT
FINDINGS WITH REGARD TO EDUCATION AND THE KINDS OF
THINGS THAT WILL WORK. WE DO NEED TO FUND STUDIES TO
LOOK AT THE EXTENT TO WHICH PARTICULAR PROGRAMS MAKE A
DIFFERENCE. IT MAY VERY WELL BE THAT
CHILDREN WITH LEAD EXPOSURE, THAT THEY’RE GOING TO NEED A
MORE INDIVIDUALIZED APPROACH IN TERMS OF THEIR EDUCATION, BUT IF
WE IDENTIFY KIDS AND THEN DON’T PROVIDE THEM WITH SERVICES SO
THEY CAN EXCEL IN SCHOOL, THEN WE’RE GOING TO HAVE MANY MORE
PROBLEMS ON THE OTHER END, AND THERE’S A NEED FOR�– THERE’S A
NEED FOR RESEARCH, THERE’S A NEED FOR RESOURCES JUST IN TERMS
OF CHILDREN GETTING INDIVIDUALIZED NEEDS MET AND I
THINK, FOR INSTANCE, IF WE WERE TO MAKE SURE ALL THESE CHILDREN
HAD PRESCHOOL PROGRAMS AND ACCESS TO PRESCHOOL PROGRAMS
WOULD DO A LOT TO GETTING THEM READY FOR SCHOOL AND MOVING THE
DIAL IN THAT RECORD. — IN THAT REGARD.
>>THANKS VERY MUCH, PAT. OKAY, ANY QUESTIONS IN OUR
MAILBOX? OKAY, LET’S MOVE ON THEN.
OUR NEXT SPEAKER TODAY IS JONATHAN WILSON.
JONATHAN HAS WORKED AT THE NATIONAL CENTER FOR HEALTHY
HOUSING FOR 22 YEARS AND CURRENTLY SERVES AS DIRECTOR OF
RESEARCH. DURING HIS TENURE, HE HAS SERVED
AS A PROGRAM MANAGER FOR RESEARCH, TECHNICAL ASSISTANCE,
AND POLICY WORK. HE HELPED COORDINATE THE
EVALUATION OF THE HUD LEAD HAZARD CONTROL GRANT PROGRAM,
THE LARGEST AND MOST EXTENSIVE STUDY OF LEAD HAZARD CONTROL IN
HOUSING EVER UNDERTAKEN IN THE U.S.
HE ALSO LED RESEARCH ASSESSING EFA’S LEAD RISK ASSESSMENT
PROTOCOLS AND THE EFFECTS OF WINDOW AND PORCH INTERVENTIONS
ON LEAD EXPOSURE AND HE HAS AUTHORED OVER 25 PEER-REVIEWED
RESEARCH MANUSCRIPTS ON LEAD AND OTHER RESIDENTIAL HEALTH
HAZARDS. JONATHAN, WELCOME.
>>THANK YOU, PETER. I REALLY PRECIOUS THE
OPPORTUNITY TO BE HERE�– APPRECIATE THE OPPORTUNITY TO BE
HERE TODAY. I’M GOING TO BE TALKING ABOUT
THE HOMES AND WHAT WE KNOW ABOUT ADDRESSING HAZARDS IN THE HOME.
AND WE NEED TO START WITH THE BASIC PREMISE.
LEAD POISONING OR ELEVATED LEAD LEVELS OF CHILDREN ARE 100%
PREVENTABLE. WE TOOK THE LEAD OUT OF THE
GROUND. WE PUT IT IN OUR HOMES.
WE PUT IT IN OUR GASOLINE, WE PUT IT IN OUR COMMUNITIES, AND
THAT’S WHY KIDS ARE GETTING SICK TODAY.
WHAT WE NEED TO DO IS TO TAKE IT OUT OR TO PREVENT IT FROM
BEING�– FROM CHILDREN BEING EXPOSED FROM THOSE SOURCES.
WE CAN DO IT. IT WILL TAKE SOME EFFORT, BUT WE
CAN DO IT. THE PROBLEM IS NOT THAT HARD IN
ONE LEVEL. WE KNOW WHERE THE LEAD IS IN
MOST PLACES AND IF WE ADDRESS IT PROPERLY, THEN CHILDREN ARE
GOING TO BE SAFE. IT’S A PART OF WILL POWER, IT’S
A PART OF RESOURCES TO MAKE THIS HAPPEN.
SO WHAT IS PREVENTION IN THIS CASE?
LOOKING AT THIS SLIDE, YOU SEE DATA FROM THE NATIONAL
EVALUATION FROM 1995 AND 1996. AND THE DATA BEING PRESENTED IS
DATA THAT CONTROLS FOR HOUSING CONDITIONS AND LOOKS AT BLOOD
LEAD LEVELS OF CHILDREN WHO ARE BEING ENROLLED INTO THE STUDY.
AND WHAT WE’RE SEEING IS, ON THE LEFT-HAND SIDE OF THE SCREEN,
THAT WE DON’T KNOW WHAT’S REALLY GOING ON WITH THE CHILDREN
BEFORE AGE 9 BECAUSE WE’RE NOT TESTING THEM AT THAT POINT.
TESTING IS STARTING WHEN THEY’RE SUPPOSED TO BE GOING FOR THE
ONE-YEAR CHECKUP AND SOME OF THEM GET THEM EARLY AND SO IN
THIS EVALUATION, WE SAW THAT FOR A STANDARD HOME THAT HAD A DUST
LEAD LEVEL ON THE FLOORS OF ABOUT 20 MICROGRAMS
PER-SQUARE-FOOT, THAT WE SEE IN THIS HOME, A CHILD IN THIS STUDY
WOULD HAVE, AT THAT TIME, WITH OTHER EXPOSURES GOING ON IN
THEIR LIFE, START OFF A LITTLE BIT BELOW 7 MICRO GRAMS PER
DECILITER AS FAR AS THEIR BLOOD LEAD LEVEL AND THEN WOULD
PROGRESS UP TO, ON AVERAGE, OVER 9 AT AROUND AGE 2, AND THEN
WOULD START DECLINING AGAIN AND LEVELING OFF AROUND AGE 5 OR 6.
AND WE SEE THIS TREND THAT’S ALSO BEEN SHOWN IN EPA’S STUDY
IN MILWAUKEE, SOMETHING SIMILAR. AND THE POINT OF THIS IS, ONE,
CHILDREN DEVELOP DIFFERENTLY AND THERE ARE DIFFERENT STAGES OF
DEVELOPMENT ALONG THE WAY, SO AT NINE MONTHS, MY CHILD’S DAYCARE
CENTER CALLS THIS THE AGE WHERE THEY’RE NOT YETTED TO LERS, BUT
THEY’RE START�– TODDLERS, BUT THEY’RE STARTING TO CRAWL AROUND
AND GET EX-POTIONED TO THINGS AND THEN THEY’RE PULLING
THEMSELVES UP AND STARTING TO GET EXPOSED TO THE LEAD ON WIN
ZOE STILLS AND STARTING TO INGEST IT THAT WAY.
THEY’RE ALSO DEVELOPING THEIR BODIES AND PROCESSING MORE LEAD
THAT’S COMING INTO THEIR SYSTEM. SO WE’RE SEEING THIS INCREASE
THROUGH THE AGE 2 AND THEN AT THAT POINT, THERE’S DIFFERENT
EXPOSURES GOING ON AND IT’S STARTING TO DROP DOWN.
WHY IS THIS IMPORTANT? WE TALKED ABOUT PREVENTION.
IF WE GO AFTER THE KIDS WHEN THEY HAVE A BLOOD LEAD AT A
CERTAIN LEVEL, THEY MAY BE NEARING THE TOP OF THEIR POINTS.
THERE WILL BE CONTINUED EXPOSURE, BUT WE NEED TO STOP IT
EARLY ON, AND THIS DOTTED LINE PART OF IT, OR BEFORE, WE NEED
TO BE GETTING INTO HOMES AND PREVENTING THE KIDS FROM BEING
EXPOSED IN THE FIRST PLACE. SO HOW DO WE DO THIS?
WE NEED TO UNDERSTAND THE SOURCES.
THERE ARE MANY SOURCES OUT THERE.
WE’VE HEARD A LOT ABOUT FLINT AND WATER AND WE KNOW THERE ARE
SOURCES FROM PARENTAL WORK AND HOBBIES, AND CHILDREN MAY BE
EXPOSED TO MANY OTHER THINGS, INCLUDING OUTDOORS EXPOSURES,
WHETHER IT’S DEMOLITION OF A PROPERTY DOWN THE STREET,
WHETHER IT’S SOMEBODY PAINTING THEIR HOUSE AND SAND LASTING IT,
WHICH�– SAND BLASTING IT, WHICH THEY SHOULDN’T BE DOING.
WHETHER THERE’S OLD GASOLINE LEAD NOW SITTING IN THE SOIL IN
THE PARK ACROSS THE STREET. ALL THESE ARE SOURCES, BUT WE
KNOW FROM REPEATED STUDIES THAT THE NUMBER ONE SOURCE IS
LEAD-BASED PAINT IN THE HOME AND WHAT HAPPENS TO THAT PAINS AS IT
DETERIORATE�– PAINT AS IT DETERIORATES, BREAKS DOWN AND
GOES INTO THE DUST IN THE HOME AND THE SOIL OUTSIDE THE HOME.
JUST TO SET THE FRAMEWORK HEAR, WE TALKED ABOUT LEAD-BASED PAINT
OR WHEN I TALK ABOUT LEAD-BASED PAINT, WE’RE TALKING ABOUT THE
FEDERAL STANDARD OF ONE MILLIGRAM PER MILL METERS
SQUARED. I KNOW THERE’S CERTAIN STATES
THAT HAVE A DIFFERENT DEFINITION, BUT THAT’S WHAT
WE’RE TALKING ABOUT PRESENTING DATA HERE.
FOR THE FLOOR AND SILL DUST LEVELS, WE HAVE TWO STARRED
STANDARDS RIGHT NOW�– HAZARD STANDARDS RIGHT NOW THAT EPA PUT
OUT. WE ALSO HAVE CLEARANCE LEVELS.
THOSE ARE HAVING ONE SAMPLE WITHIN A HOME THAT’S ABOVE THE
40, 250, OR 400 ON WINDOWS. FOR SOILS, A PLAY AREA WITH 400
PARTS PER�MILLION OF LEAD WHERE A CHILD IS LIKELY TO PLAY OR
SOMEWHERE IN THE REST OF THE YARD, 1200 PARTS PER�MILLION,
AND THIS IS WITH THEIR BARE AREAS, SO SOMETHING THAT’S
EXPOSED TO THE CHILD. AND THEN WE HEAR A LOT ABOUT
WATER LEAD, WHICH IS AT 15 PARTS PER�BILLION.
SO WE TALK ABOUT LEAD-BASED PAINT, RICK ALREADY PRESENTED
THAT BLUE LINE THAT WE’RE SEEING, THE LEAD�– WHITE LEAD
GOING INTO HOUSE PAINT AND HOW IT DECLINED FROM PEAKS FROM
AROUND 1915 TO COMING DOWN TO ZERO AT 1978.
BUT WHAT REMAINS IS WHAT’S IN OUR HOMES TODAY, AND THE ORANGE
AND GREEN LINES SHOW DATA FROM THE AMERICAN HOUSING SURVEY
WHICH WAS LAST DONE IN 2005-2006, AND THE PERCENTAGE OF
HOMES THAT HAVE LEAD-BASED PAINT AND LEAD-BASED PAINT HAZARDS, SO
WE SEE IN THE PRE-1940 HOUSING WHEN MOST OF THE LEAD WAS GOING
INTO THAT’S HOMES, WE SEE 85% OF THE HOMES HAVE LEAD-BASED PAINT.
WHEN WE GET INTO THE 1940s AND ’50s, IT DROPS DOWN TO
TWO-THIRDS OF OUR HOMES HAVE LEAD-BASED PAINT AND THEN INTO
THE 1960s, 1978, 25% OF OUR HOMES AND THAT NUMBER MAY BE
EVEN LOWER THAT’S DAYS. WE’RE LOOKING FORWARD TO HUD
COMING�– HAVING ANOTHER SURVEY IN THE NEXT COUPLE OF YEARS THAT
WILL TAKE A LOOK AT THIS AND SEE WHERE WE ARE.
THIS IS A COMPLEX SLIDE, SO LET ME SIMPLIFY IT.
I CAN TALK ABOUT THIS FOR A LOT OF TIME, BUT THEN WE’D HAVE ALL
THE PEOPLE ON THE WEBINAR DROP OFF AND WE CAN’T AFFORD TO LOSE
ANYBODY IN THE ROOM, LET’S BE HONEST.
THIS IS DATA FROM THE FREE-1940s�– PRE-1940s, THE
SURVEY THAT CAME BEFORE THE 2005 SURVEY, AND WE CAN SEE A FEW
TRENDS. ONE, THE BLUE LINES ON THE RIGHT
SIDE, THIS IS EXTERIOR COMPONENTS WITHIN A BUILDING,
AND WE SEE THE LINE, THE PERCENTAGE OF COMPONENTS THAT
HAVE LEAD-BASED PAINT, AND SO ONE THING TO TAKE AWAY IS
THEY’RE HIGHER THAN THE GREEN LINE, SO WHAT’S GOING ON INSIDE
THE HOUSE. IT’S MORE LIKELY WE’LL FIND
LEAD-BASED PAINT ON THE OUTSIDE AS ON THE INSIDE.
THE OTHER THING TO LOOK AT IS THE PURPLE NUMBERS.
THIS IS THE MEAN LEAD LOADINGS WITHIN THESE HOMES, AND WE CAN
SEE HIGH LEVELS ON WINDOWS ON THE OUTSIDE AND ON THE INSIDE.
IT DOESN’T MEAN WE SHOULD ONLY WORK ON WINDOWS.
BUT IT DOES MEAN IT’S A REAL OPPORTUNITY POINT TO ADDRESS
THESE HIGH LEVELS OF LEAD THAT ARE ON BOTH THE EXTERIOR AND
INTERIOR OF OUR HOMES. WE SEE THE SAME TREND LINE IF WE
LOOK AT THE 1940s, 1960s, OR POST-1960s, BUT THESE BARS GET
LOWER AND LOWER WITH EACH ONE OF THE TRENDS.
AND HOW DOES THE TREND RELATE TO DUST?
WE SEE THAT WE’VE GOT BLUE AND ORANGE.
IN THIS CASE, THE BLUE BEING MEAN DUST LEAD LEVELS ON ALL
FLOORS, AND THEN THE ORANGE IS FLOORS WITH A CHILD UNDER AGE 6.
THIS IS INTERESTING DATA. I’M NOT SURE WHAT IT MASON
TOTALLY, BUT WE�– MEANS TOTALLY, BUT WE SEE WITH THE
TREND WHERE PAINT IN THE HOME, WE’RE SEEING THE DUST LEAD
LEVELS MIMIC THAT TREND. HIGHER LEVELS IN THE PRE-1940s
AND, IN FACT, IN THE 1940 HOMES THAT HAD CHILDREN UNDER 6,
THEY’RE EVEN HIGHER IN THESE HOMES.
SO WE’RE, YOU KNOW�– WE NEED TO THINK ABOUT THAT AND DO
SOMETHING ABOUT THIS PROBLEM WITHIN OUR HOUSING STOCK.
THIS IS A COMPLICATED SLIDE, BUT THIS IS REALLY PROBABLY THE MOST
IMPORTANT ONE I’M GOING TO PRESENT.
AND THE REASON WHY IS THIS IS A SIMPLE PROBLEM.
WE NEED TO DO SOMETHING ABOUT THE LEAD IN OUR HOMES, BUT IT’S
NOT SOMETHING THAT CAN BE A SIMPLE ANSWER.
IT’S NOT SOMETHING WE CAN SAY, IF WE ONLY FIX THE FLOOR DUST,
WE HAVE IT SOLVED. IT’S ONLY IF WE PICK THE SOIL,
WE’LL HAVE IT�– FIX THE SOIL, WE’LL IT SOLVED.
IF WE JUST REPLACE THE WINDOWS, WE’LL HAVE IT SOLVED.
NONE OF THOSE INDIVIDUAL AFROEMPS WILL SOLVE THE�–
APPROACHES WILL SOLVE THE PROBLEM BECAUSE YOU CAN SEE ALL
THE ARROWS THAT END UP AT BLOOD LEAD.
WE KNOW FROM THE STUDIES THAT HAVE BEEN DONE, THAT THE MOST
PREDICTIVE DIRECT SOURCE FOR YOUNG CHILDREN IS THE FLOOR DUST
LEVEL AND IS MOUTHING BEHAVIOR. THAT CHILDREN EXPOSED MOST
DIRECTLY WITH THE FLOORS IN THEIR HOMES, THEY PUT THEIR
HANDS ON IT, THEY INGEST IT INTO THEIR MOUTHS, AND THAT’S HOW
THEY ARE LARGELY EXPOSED. FOR A SEGMENT OF CHILDREN, THEY
HAVE MOUTHING BEHAVIOR THAT MAKES THEM BE INTERESTED IN
GOING TO WINDOWS AND PUTTING THEIR MOUTHS ON THEM AND GETTING
DIRECT INGESTION FROM THE WINDOW, BUT�– AND BECAUSE OF
THAT, WE CAN SEE IN SOME STUDIES A PATHWAY FOR WINDOW SILLS TO
BLOOD LEAD. BUT IF WE’RE GOING TO SOLVE THE
PROBLEM, WE NEED TO STOP ALL THESE ARROWS AND SO WE HAVE TO
THINK ABOUT WHAT IS THE SOLUTION TO IT.
TALKING ABOUT WINDOWS FOR A MOMENT, WE DID A STUDY�– I GOT
TO GIVE CREDIT TO PETER. HE DIDN’T PAY ME TO DO THIS, BUT
JUST TO SAY THAT ALL THE STUDIES I’M TALKING ABOUT IN THIS WERE
ALL FUNDED BY HUD AND THE OFFICE OF HEALTHY HOMES.
THEY’RE THE BALL GAME HERE AS FAR AS LEAD STUDIES, AND WE NEED
TO APPLAUD THEM FOR THEIR WORK, BUT THE STUDY THAT WE HAD AN
OPPORTUNITY TO WORK ON LOOKED AT THE DIFFERENCE BETWEEN IMPACT
AND WINDOWS SO WHEN WE OPEN UP AND SHUT WINDOWS, THERE’S OFTEN
RUBBING AND THE QUESTION IS DOES THAT ABRASION CREATE DUST LEAD
AND THE ANSWER IS IT DOES IN TWO WAYS.
ONE IS IT DIRECTLY CREATES DUST LEAD AND THE OTHER IS THAT IT
CAUSES FAINT TO CHIP AND THAT�– PAINT TO CHIP AND THAT THEN GOES
INTO THE DUST. WHEN WE LOOKED AT HOPES OR
WINDOWS THAT DID NOT HAVE RUBBING OR BINDING OR HAVE THE
PAINT INTACT, THERE WAS NO SIGNIFICANT ASSOCIATION WITH THE
WINDOW DUST. BUT WHEN IT WAS A BREAKDOWN IN
THAT PAINT BECAUSE OF RUBBING OR BINDING OR SOMETHING ELSE, THEN
WE SEE AN INCREASE IN DUST LEAD LEVELS IN THE WINDOWS, WHICH
EVENTUALLY GETS TO THE FLOORS, WHICH EVENTUALLY IS GETTING INTO
THE CHILDREN. ITS ALSO IMPORTANT TO HAVE
SMOOTH AND CLEANABLE SURFACES, AND WE FOUND IF A SILL WAS
NEITHER SMOOTH SMOOTH NOR CLEANABLE, THAT THE DUST LEAD
LEVELS WERE 60% HIGHER THAN WINDOWS WITH SMOOTH AND
CLEANABLE SURFACES. WE TALKED ABOUT THE EPA
STANDARDIZE OF 40 AND WE’VE DONE�– STANDARD OF 40 AND WE’VE
DONE ANALYSES THAT SHOW THAT WE REALLY NEED TO BE GETTING AT
LEAST TO 10 ON FLOORS AND 100 ON SILLS.
IF WE GOT TO THAT LEVEL, WE KNOW THAT LESS THAN 5% OF CHILDREN
LIVING IN THESE HOMES WOULD HAVE A BLOOD LEAD OVER 10.
RIGHT NOW THE CURRENT STANDARD, THE PROJECTIONS ARE THAT THIS IS
ACTUALLY CLOSER TO 12% THAT WOULD BE EXPOSED OR WOULD HAVE
THE LEVELS ABOVE 10 AND THAT’S NOT EVEN TALKING ABOUT THE NEW
REFERENCE LEVEL. SO I TEND TO TALK ABOUT 10 AS
SOMETHING THAT WE SHOULD BE AIMING FOR, AND 10 THAT WE
SHOULD BE CONSIDERING THE EFFECTS OF.
THIS IS LOONG AT THE EFFECTS OF CERTAIN�– LOOKING AT THE
EFFECTS OF CERTAIN CHARACTERISTICS OF THE BLOOD ON
A FLOOR LEAD LEVEL ABOVE 10. THIS IS FROM THE AMERICAN
HOUSING SURVEY AND THEY FOUND THAT IF YOU HAD DETERIORATED
LEAD-BASED PAINT ABOVE THE DE�MINIMUS LEVEL OF HUD, THAT
THERE WOULD BE 3% OF HOMES THAT HAD THIS THAT, IN THOSE HOMES,
YOU WOULD BE 14 TIMES MORE LIKELY TO HAVE A FLOOR DUST LEAD
LEVEL ABOVE 10 THAN IF YOU HAD A HOME THAT DID NOT HAVE ANY
LEAD-BASED PAINT. YOU’RE TALKING ABOUT ANYWHERE IN
THE HOME, THAT’S 14% OF HOMES BACK IN 2005, YOU’RE NINE TIMES
MORE LIKELY TO HAVE A DUST LEAD LEVEL ABOVE 10 THAN IN A HOME
WITHOUT LEAD-BASED PAINT, AND IF YOU HAD ANY LEAD-BASED PAINT
REGARDLESS OF DETERIORATION, THAT’S 35% OF HOMES, YOU’RE SIX
TIMES MORE LIKELY TO HAVE A FLOOR DUST LEAD LEVEL ABOVE 10.
SO THE FIRST ATTACK IS TO ADDRESS THE DETERIORATED, BADLY
DETERIORATED PAINT IN THE HOME, BUT ON THE LONG HAUL, WE NEED TO
GET RID OF THE LEAD-BASED PAINT ALTOGETHER.
THAT HAS TO BE THE MESSAGE. LOOKING AT SOIL LEAD�– AND THIS
IS NOT COMPARED TO HOMES WITHOUT LEAD-BASED PAINT, BUT COMPARING
SOIL HOMES TO HOMES WITHOUT SOIL LEAD HAZARDS, THEY’RE MORE TIMES
MORE LIKELY TO HAVE FLOOR DUST LEAD LEVELS ABOVE 10.
SO WHAT ARE THE SOLUTIONS? AT A MINIMUM, WE HAVE TO TAKE
CARE OF THE DETERIORATED PAINT. WE HAVE TO MAKE IT ALL INTACT.
THIS IS NOT JUST INTERIOR, BUT EXTERIOR.
WE HAVE TO REMOVE THE PAINT FROM BINDING SURFACES OR AT LEAST,
YOU KNOW, RIGHT ALONG THOSE SURFACES, SO WE’RE NOT CREATING
THE HAZARD THAT WAY. YOU HAVE TO CREATE SMOOTH AND
CLEANABLE SURFACES SO THAT ONCE WE SOLVE THESE PROBLEMS, WE CAN
CONTINUE TO CLEAN THEM. I’M GOING TO SHOW YOU A SLIDE ON
HOW WE CAN CONTINUE TO IMPROVE THE ENVIRONMENT ONCE WE’VE
ATTACKED THE FLOORS. WE NEED TO USE LEAD-SAFE
PRACTICES AND CERTIFIED CONTRACTORS IN CERTAIN
SITUATIONS SO THAT THE WORK IS DONE PROPERLY AND THE DUST IS
PROPERLY REMOVED. WE SHOULD TEST AFTER WORK.
AND WE SHOULD ALWAYS CONSIDER INVESTING IN THE NEXT STEP WHERE
WE DON’T HAVE LEAD-BASED PAINT AT ALL BEING EXPOSED TO
CHILDREN. SO A COUPLE MORE AND GETTING
DOWN A LITTLE BIT FURTHER INTO THE WEEDS, LOOK AT WINDOWS, AND
RICK ALLUDED TO THIS. THE QUESTION HAS COME UP OFTEN,
WHAT IF WE REALLY FOCUSED ON WINDOWS.
WOULD IT MAKE A BIG DIFFERENCE? WE HAD THE OPPORTUNITY TO GO
BACK 12 YEARS AFTER THE ORIGINAL EVALUATION OF LEAD IN HOMES AND
ANSWER THAT QUESTION, AND WE COMPARED HOMES THAT HAD ALL
WINDOWS REPLACED WITH THOSE THAT HAD NON-REPLACEMENT, AND
NON-REFLAMES WAS A MIXTURE�– REPLACEMENT WAS A MIXTURE OF
THINGS. WE DIDN’T DICK STATE WHAT PEOPLE
WERE�– DICTATE WHAT PEOPLE WERE DOING IN THEIR HOMES.
10% WITH A LITTLE OF WINDOW REPLACEMENT.
45% DID SOMETHING TO THE PAINT ON THE WINDOWS THAT WAS
SIGNIFICANT, SUCH AS REMOVING THE PAINT BY STRIPPING, BY
REMOVING PARTIAL SASH REPLACEMENT IN SOME CASES, OR AT
LEAST BY DOING JAM LINERS, OR TROUGH COVERS, SOMETHING THAT
PREVENTS EXPOSURE TO THE PAINT. 43% DID PAINT STABILIZATION,
MAKING SURE THERE WAS NO MORE LOOSE PAINT, AND 2%, THE PAINT
WAS ALREADY INTACT IN THE FIRST PLACE.
THIS IS A LOT OF DATA ON THE SLIDE.
THIS IS FOR THE PEOPLE THAT LIKE NUMBERS.
THE NEXT SLIDE IS FOR PEOPLE THAT LIKE GRAPHS, AND WHAT WE
SEE THAT IS IF WE LOOK AT THE TOP LINE, AGAIN, THE AVERAGE
LEVEL IN THE STUDY WAS ABOUT 20 MICROGRAMS PER SQUARE FOOT.
BEFOREHAND ON FLOORS, IT WAS ON AVERAGE ABOVE 200, AND THAT FOR
FLOORS, THAT WE SEE WE GOT IT DOWN AT LEAST HALF AND IT STAYED
THAT WAY BECAUSE WE STOPPED THE SOURCES AND THEN PEOPLE WERE
ABLE TO CLEAN AND ACTUALLY CONTINUE TO GET IT LOWER AND
LOWER AND LOWER UNTIL 12 YEARS LATER, THE LEVELS WERE BELOW 3.
ON SILLS, WE SEE A JUMP UP. WE SEE AN EXPOSURE PATTERN
BECAUSE DUST AND WINDOWS IS NOT JUST INSIDE OF THE HOUSE, BUT
FROM BEING BLOWN IN FROM THE OUTSIDE OF THE HOUSE.
SO WE SEE A JUMP UP AT SIX MONTHS, BUT THEN IT STABILIZES
AND STARTS GOING BACK DOWN. AGAIN, WE CREATE CLEANABLE
SURFACES WHERE PEOPLE CONTINUE TO CLEAN, SO IT FALLS DOWN ON
AVERAGE BELOW 50. IN THOSE IT GRAPHICALLY NATOED
OUT AND WE SEE�– SMOOTHED OUT AND WE SEE A DIFFERENCE BETWEEN
THE REPLACEMENT LINE, THE BOTTOM LINE, AND THE NON-REPLACEMENT
LINE, WHICH IS THE TOP LINE. SO WE SHOWED THAT THERE WAS
SIGNIFICANT CHANGES IN BOTH GROUPS.
WE SAW THAT VARIOUS STRATEGY IN BOTH GROUPS.
HOWEVER W THE WINDOW REPLACEMENT GROUP, WE SEE DUST LEAD LEVELS
ARE 41% LOWER ON FLOORS, 51% LOWER ON SILLS.
WINDOW REPLACEMENT IS A MUCH MORE EFFECTIVE STRATEGY.
WE ALSO RECOGNIZE THAT THERE ARE OTHER FACTORS GOING ON THAT
INFLUENCE WHAT WAS GOING ON, INCLUDING EXTERIOR DUST,
NEIGHBORHOOD POINT SOURCES, THE BUILDING CONDITION, ESPECIALLY
ON THE OUTSIDE, AND OTHER SITE EFFECTS THAT WE DON’T REALLY
UNDERSTAND BUT WE DO KNOW THAT A PLACE LIKE SCLIG HAS HIGHER
DUST�– CHICAGO HAD HIGHER DUST LEAD LEVEL THAN A PLACE LIKE
VERMONT, SO WE NEED TO CONSIDER THAT AS WE MOVE FORWARD.
THERE’S A LOT OF INFORMATION ON THIS, BUT REALLY WHAT I WAS
TALKING ABOUT, WHAT RICK WAS SAYING, IS THAT THERE ARE
FINANCIAL BENEFITS BEYOND JUST LEAD PAINT.
IT INCLUDES ENERGY EFFICIENCY, IT INCLUDES PROPERTY VALUE, IT
IMPROVES KEEPING KIDS OUT OF SPECIAL EDUCATION IN THE FUTURE,
AND SO BOTH OF THESE STRATEGIES ARE EFFECTIVE, BUT IF WE THINK
ABOUT IT LONG TERM, WE REALLY SHOULD BE THINKING ABOUT HOW THE
PUBLIC AND PRIVATE SECTOR CAN INCENTIVIZE FOLKS TO DO MORE
WINDOW REPLACEMENT AND GET THIS PROBLEM OUT OF OUR HOMES IN THE
LONG RUN. NOW I’M GOING TO THE END OF MY
TIME, BUT I WANTED TO EMPHASIZE THE SECOND PART, WHICH IS IN
MILWAUKEE, THEY HAD A GREAT PROGRAM BACK AROUND 2000 THAT
FOCUSED ON WINDOWS AND DEALING WITH WINDOWS.
AND IT WORKED PRETTY WELL, BUT IT DIDN’T WORK AS WELL AS THEY
THOUGHT, AND THE MANAGER OF THAT PROGRAM, AMY MURPHY, A REAL
LEADER IN THIS COUNTRY ON LEAD, TRIED TO LOOK AT IT AND SAID YOU
KNOW WHAT’S HAPPENING? WE TOLD THE PROPERTY OWNERS TO
DEAL WITH THE LEAD ON THE OUTSIDE OF THE PROPERTY.
WE DIDN’T REALLY HAVE THE ENFORCEMENT TO MAKE A CHANGE,
AND SO PORCHES WERE SUPPOSED TO BE FIXED, BUT THEY WERE NOT
BEING FIXED. PORCHES ARE A MAJOR SOURCE,
ESPECIALLY IN A LOT OF NORTHEASTERN COMMUNITIES WHERE
THEY HAVE BIG PORCHES, AND SO WE DID A STUDY IN ROCHESTER AND
LOOKED AT THE EFFECTS OF DUST LEAD UP THERE.
WE FOUND THAT ON PORCHES, THE AVERAGE DUST LEAD LEVEL BEFORE
WORK WAS DONE WAS 68, SO WE’RE TRYING TO GET OUR FLOORS INSIDE
AT LEAST BELOW 40 AND I WOULD SAY WE SHOULD GET THEM BELOW 10
AND WE HAVE THIS SOURCE RIGHT OUTSIDE THE DOOR THAT’S 68.
WE HAVE A PROBLEM HERE BECAUSE THAT DUST IS GOING TO COME
INSIDE. WE KNOW FROM OUR STUDIES THAT
THE INTERIOR FLOOR DUST IS ACTUALLY HALF OF THE FLOOR DUST
IMMEDIATELY INSIDE THE FRONT DOOR.
SO DUST IS COMING IN FROM THE OUTSIDE THAT’S CONTAMINATING OUR
HOUSES. SO WHAT DO WE NEED TO DO ABOUT
THIS? THEY DID A STRATEGY WHERE IN
MOST OF THEIR PROPERTIES, THEY EITHER REPLACE THE FLOORING, THE
DECKING OF THE PORCHES, A HIGHLY EFFECTIVE APPROACH.
THEY REDUCED THE DUST LEAD LEVELS BY MORE THAN HALF AND IT
STAYED DOWN. IT ACTUALLY DECLINEZ EVEN
FURTHER ONE YEAR — DECLINED EVEN FURTHER ONE YEAR LATER.
THEY DID PAINT STABILIZATION AND THAT WILL VERY WELL, IT
DECLINED, AND IT CONTINUED TO DECLINE, ALTHOUGH NOT
SIGNIFICANTLY FROM POST WORK TO ONE YEAR, BUT WHEN THEY DID DO
ANYTHING, THE LEAD LEVELS WENT UP BECAUSE THE CONTRACTORS WERE
STILL WORKING ON THE INSIDE OF THE HOUSE AND THEY HAD NO
INCENTIVE, NO REQUIREMENT TO TEST AFTER THEY WERE DONE, SO WE
SEE THE DUST LEAD LEVELS SIGNIFICANTLY GOING UP AFTER THE
WORK WAS DONE. NOW, FORTUNATELY, JUST THROUGH
CLEANING AND BLOCKING EVERYTHING ELSE, DUST LEAD LEVELS DID GO
BACK DOWN, ALTHOUGH THEY WERE STILL HIGHER, ALTHOUGH IN THE
SIGNIFICANTLY THAN BEFORE BASELINE, SO THEY JUST�– SO
WHAT DO WE KNOW? THIS IS AN INTERESTING SLIDE,
BUT IT JUST SAYS WHERE THE SIGNIFICANCE IN THESE DIFFERENT
APPROACHES. TO ABOVE 10, WE SHOULD BE DOING
SOMETHING MORE THAN NOTHING. ABOVE A BASELINE LEVEL OF 130
MICROGRAMS PER SQUARE FOOT ON THE FLOOR, WE SEE A SIGNIFICANT
DIFFERENCE BETWEEN REPLACEMENT AND STABILIZATION.
BUT THE REAL TAKE-HOME MESSAGE IS THAT PORCHES ARE AN IMPORTANT
SOURCE. WE NEED TO DO SOMETHING BECAUSE
IT AFFECTS THE INSIDE OF THE HOUSE AND WE NEED TO THINK ABOUT
HOW WE CAN ADDRESS THIS. AND THE WAY WE DO THIS IS WE
NEED TO SET CLEARANCE STANDARDS. WE NEED TO IDENTIFY A RISK
STANDARD FOR PORCHES. WE CURRENTLY KNOW THAT 40 IS
FEASIBLE AND WE CAN DO THIS EFFECTIVELY BY MOVING FORWARD.
AND IF WE DO ALL THESE THINGS, WE CAN SEE THE CURVE GO DOWN.
WE CAN DO IT BEFOREHAND, AND SEE THAT LEVEL THAT WE SAW EARLY ON
DROP DOWN WHERE WE’RE NOT GETTING KIDS UP TO 5 IN THE
FIRST PLACE. THANK YOU SO MUCH.
>>THANK YOU VERY MUCH, JONATHAN.
DO WE HAVE ANY QUESTIONS? FROM THE AUDIENCE FOR JONATHAN?
NO? ANYTHING�– OH, WE DO.
PLEASE.>>WE HAVE A COUPLE OF QUESTIONS
FROM THE AUDIENCE. THE FIRST ONE IS PRETTY MUCH FOR
RICK AND PAT. WILL THERE BE LONGITUDINAL
STUDIES WHICH LOOK AT THE LINK BETWEEN ELEVATED LEAD LEVELS IN
CHILDHOOD AND COGNITIVE CHANGES LATER IN LIFE?
>>I DON’T HAVE ANY INFORMATION ON THAT, BUT I’VE OFTEN WONDERED
ABOUT THAT. WHAT’S GOING TO HAPPEN WHEN
PARTICULARLY PEOPLE WHO HAVE HAVE BEEN SEVERELY POISONED, NOT
JUST ABOUT ALZHEIMER’S, BUT WITH ANYTHING RELATED TO THE BRAIN,
STROKES LATER IN LIFE, FOR EXAMPLE.
BUT I’M NOT AWARE OF RESEARCH BEING DONE ON THAT.
>>NOT MY AREA OF EXPERTISE, BUT I BELIEVE THERE HAVE BEEN
STUDIES LOOKING AT AGING EFFECTS LATER IN LIFE AND THAT CERTAINLY
SUGGESTS AND WE DO KNOW THAT VERY LOW LEVELS OF LEAD ARE
ASSOCIATED WITH OTHER ADULT HEALTH EFFECTS.
SO I THINK THIS IS A BIG PROBLEM AND ONE THAT WE’RE GOING TO
CONTINUE TO SEE PROBLEMS AS PEOPLE AGE THAT ARE ASSOCIATED
WITH THESE MUCH EARLIER EXPOSURE TO LEAD.
>>WE HAVE A SECOND QUESTION. THIS ONE IS AIMED AT PAT.
IS IT LIKELY THAT A NURSE HOME VISITING PROGRAM, PRENATAL AND
POSTNATAL, FOR LOW INCOME HOUSEHOLDS COULD BE COST
EFFECTIVE ON THE BASIS OF IDENTIFYING ANY HOME LEAD
HAZARDS AND COUNSELING ABOUT LEAD SAFE PRACTICES?
>>WELL, THIS IS VERY NEAR AND DEAR TO MY HEART.
ACTUALLY, THERE HAS BEEN A STUDY DONE IN RHODE ISLAND, MARY D.
BROWN AND I AND OTHERS WERE INVOLVED IN THAT STUDY.
WHAT WE FOUND WAS THAT WE WERE ABLE TO REDUCE THE DUST LEAD
LOADING IN THE HOME. WE CERTAINLY WERE ABLE TO
IMPROVE PEOPLE’S ABILITY, KNOWLEDGE ABOUT LEAD, BUT WE DID
NOT SHOW A DECREASE IN BLOOD LEAD LEVEL.
THAT BEING SAID, THIS KIND OF INTERVENTION HAS NOT BEEN
STUDIED SINCE THAT TIME THAT I’M AWARE OF.
I CERTAINLY THINK IT WOULD BE LEVEL TO PARENTS, BUT I FEEL THE
BOTTOM LINE IS, THE HAZARDS IN THE HOME AND WE NEED TO MAKE
SURE WE’RE TAKING STEPS TO ADDRESS THE HAZARDS IN THE HOME
SO THAT LEAD HAZARD CONTROL WORK, LEAD HAZARD REDUCTION WORK
ARE VERY IMPORTANT. WE’VE ALSO SHOWN THAT STRATEGIES
THAT ASSIST PEOPLE IN MOVING TO SAFER HOUSING HELPED WHERE THAT
SAFER HOUSING HAS LOWER DUST LEAD LEVELS THAN DOES RESULT IN
A DECREASE IN BLOOD LEAD LEVELS, SO I THINK WE FLAED TO THINK
OF�– NEED TO THINK OF THINGS THAT REALLY CHANGE THE
ENVIRONMENT IN THE HOME OR HELP PEOPLE MOVE TO A SAFE HOME
ENVIRONMENT, AND ONE OTHER STRATEGY THAT HAS BEEN TRIED
WITH REGARDS TO THAT, ALTHOUGH I’M NOT AWARE OF A SCIENTIFIC
EVALUATION, IS LOOKING AT THE�– GIVING PEOPLE SECTION�8
VOUCHERS. WE HAVE A SECTION 8 VOUCHER
PROGRAM IN MARYLAND THAT WE’VE BEEN ABLE TO USE FOR FAMILIES
WITH LEAD POISONED CHILDREN, AND THIS HAS REALLY RESULTED IN
FAMILIES STAYING IN LEAD SAFE HOUSING FOR THE LONG-TERM.
THE PROBLEM WHEN YOU MOVE THE CHILD INTO LEAD-SAFE HOUSING, IS
UNLESS THEY STAY IN THAT HOUSING, THEN THEY’RE GOING TO
BE BACK IN A SITUATION WHERE THEY WILL BE FURTHER EXPOSED.
SO WE NAED TO FIND WAY�– NEED TO FIND WAYS TO GET CHILDREN
INTO SAFE HOUSING AND KEEP THEM IN SAFE HOUSING, PARTICULARLY
DURING THIS TIME PERIOD UNDER 6 YEARS OF AGE.
>>THANK YOU, PAT. I HAVE ONE QUESTION FOR
JONATHAN. IF YOU WERE KING, JONATHAN, AND
YOU COULD REQUIRE TO US MAKE CHANGES IN OUR LEAD HAZARD
CONTROL PROGRAM REQUIREMENTS TO OUR GRANTEES TO BE MORE
EFFECTIVE, I GUESS YOU COULD SAY, IN REDUCING LEAD EXPOSURES,
WHAT WOULD YOUR NEW REQUIREMENTS BE?
IN A NUTSHELL.>>YOU DIDN’T PREP ME FOR THAT
ONE. YOU KNOW, I’M GOING TO MAKE A
PLUG FOR ACTUALLY HEALTHY HOMES RATING SYSTEM.
I THINK THAT SOMETIMES WE AS ORGANIZATIONS GETTING INTO
RHYTHM THAT WE THINK WE’VE GOT THE PROBLEM SOLVED.
YOU KNOW, WE’VE GOT A SYSTEM OF�– WHETHER TREATING WINDOWS
SOME WAY OR WE’RE GOING TO TREAT SOIL OR WE’RE NOT GOING TO TREAT
SOIL, AND THE RATING SYSTEM, JUST FOR THOSE WHO ARE NOT
FAMILIAR, IT LISTS 28, 29 SECTORS AND SAY THAT YOU NEED TO
GO IN AND THINK ABOUT EACH ONE OF THESE AND WHETHER YOU MAY
HAVE A PROBLEM WITH THEM. DO YOU HAVE ELECTRICAL ISSUES,
DO YOU HAVE A FALL ISSUE FROM A LIE WINDOW, AND IT SEEMS TO�–
HIGH WINDOW AND IT SEEMS TO ME THAT SOME SORT OF RATING SYSTEM
UP FRONT THAT WOULD SAY, YOU KNOW, I REALLY DID THINK ABOUT
WHETHER I’M GOING TO TREAT SOIL OR NOT, I’M REALLY GOING TO
THINK ABOUT WHETHER I TREAT THE PORCHES OR NOT.
DOCUMENTING THAT COULD BE VERY EFFECTIVE BECAUSE I’M NOT SURE,
I’VE HEARD RUMORS SOMETIMES, THAT SOMETIMES SOIL IS NOT
ADDRESSED AS MUCH, THAT OUTSIDE OF BUILDINGS ARE NOT ALWAYS
ADDRESSED AS MUCH, AND, YOU KNOW, I THINK THAT YOU’RE IN A
POSITION WHERE YOU DON’T REALLY KNOW AND IF YOU COULD HAVE SOME
SORT OF DOCUMENT THAT, YOU KNOW, SIMPLIFIES SORT OF THE REPORT
THAT’S SUPPOSED TO BE DONE ON THOSE THREE UNITS THAT COULD
THOUGH YOU WHAT THEY’RE DOING, THAT COULD BE HELPFUL.
>>THANKS. WE DO HAVE A NEW GRANT
MANAGEMENT SYSTEM WHERE THE GRANTEES REPORT ON WHAT THEY’VE
DONE, SO I THINK WE DO HAVE THE DATA THAT WOULD ALLOW US TO LOOK
AT THAT, BUT IN TERMS OF LEAD, LEAD HAZARDS BASED ON YOUR
PRESENTATION, IT DOES SEEM LIKE�– AND WE ARE WORKING ON
PROBABLY A POLICY MEMO TO REDUCE THE DUST LEAD CLEARANCE
STANDARDS FOR OUR GRANTEES AND NOT WAIT FOR EPA AND THEIR
PURVIEW TO CREATE THE DUST LEAD STANDARDS AND THE REGULATORY
PROCESS IS VERY LONG, SO WE’LL PROBABLY COME UP WITH THE
GUIDANCE THAT WILL REQUIRE OUR GRANTEES TO USE THE REDUCED LEAD
DUST STANDARDS AND I THINK WE SHOULDN’T FORGET ABOUT THE
PORCHES AS WELL, SO THANK YOU. AND THE FINAL SPEAKER TODAY, SO
HANG IN THERE, FOLKS, WE’RE ALMOST DONE, IS LISA CRIST FROM
THE U.S. ENVIRONMENTAL PROTECTION AGENCY.
LISA IS WITH THE EPA’S OFFICE OF GROUND WATER AND DRINKING WATER.
SHE’S GOING TO TALK A LITTLE BIT ABOUT WHAT THEY DO TO PROTECT
THE PUBLIC FROM BEING EXPOSED TO LEAD IN WATER.
THANKS, LISA.>>SO THANK YOU VERY MUCH FOR
INVITING FLEE TO COME TALK TO�– ME TO COME TALK TO YOU TODAY
ABOUT THE NATIONAL PRIMARY DRINKING WATER RULES FOR LEAD
AND COPPER. I’M GOING TO TALK A LITTLE BIT
ABOUT WHAT THE CURRENT RULE REQUIREMENTS ARE, SPEND MAYBE A
MOMENT TALKING ABOUT THE CHALLENGES THAT THE CITY OF
FLINT, MICHIGAN, IS FACING WITH THEIR LEAD CONTAMINATION OF
THEIR DRINKING WATER, AND THEN WE RECENTLY GOT RECOMMENDATIONS
FROM OUR NATIONAL DRINKING WATER ADVISORY COUNCIL ON HOW WE CAN
REVISE THE LEAD AND COPPER RULING BASED ON A LOT OF
STAKEHOLDER INPUT. I WANT TO TALK A LITTLE BIT
ABOUT THAT WITH YOU TODAY. SO THE LEAD AND COPPER RULE
UNDER THE SAFE DRINKING WATER ACT, EPA IS AUTHORIZED TO SET
PUBLIC HEALTH GOALS FOR CONTAMINANTS IN DRINKING WATER
AS WELL AS ENFORCEABLE STANDARDS, SO IT’S IMPORTANT TO
NOTE THAT THE LEAD AND COPPER RULE IS ACTUALLY A TREATMENT
TECHNIQUE RULE. SO MOST OF OUR REGULATIONS
TYPICALLY HAVE A PUBLIC HEALTH GOAL AND STHREN A MAXIMUM�–
THEN A MAXIMUM LEVEL OR STANDARD THAT A SYSTEM CAN’T EXCEED FOR A
PARTICULAR CONTAMINANT. A TREATMENT TECHNIQUE RULE
DEFINES A SET OF ACTIONS THAT A SYSTEM NEEDS TO TAKE TO MAKE
SURE THEY’RE REDUCING LEAD. THEY NEED TO MINIMIZE LEAD AND
COPPER IN THE DRINKING WATER THROUGH A NUMBER OF DIFFERENT
ACTIONS. THE MAIN ONE IS REALLY REDUCING
THE CORROSIVITY OF THE WATER ITSELF AS IT TRAVELS THROUGH
LEAD-BEARING MATERIALS, EITHER IN PREMISE PLUMBING OR LEAD
SERVICE LINES, CORROSIVE WATER CAN DISSOLVE THAT LEAD AND
THAT’S HOW YOU GET THE LEAD IN THE DRINKING WATER.
SO ONE OF THE KEY COMPONENTS OF THE TREATMENT TECH NANI
COLORETTI IS TO MAKE SURE — TECHNIQUE IS TO MAKE SURE THAT
THE WATER IS MINIMALLY CORROSIVE AS POSSIBLE AND WHEN THOSE
ACTIONS ARE NOT ENOUGH, WE REQUIRE THAT THE PUBLIC WATER
SYSTEMS ACTUALLY REMOVE LEAD SERVICE LINES.
I THINK JONATHAN MADE A GREAT POINT, WE NEED TO GET RID OF THE
SOURCES OF LEAD AND LEAD SERVICE LINES IS PROBABLY ONE OF THE
BIGGEST SOURCES OF LEAD IN DRINKING WATER.
SO THE CURRENT RULE, AS I MENTIONED, WE HAVE A MAXIMUM
CONTAMINANT LEVEL GOAL, SO THIS IS A LEVEL THAT WE KNOW THAT
THERE’S NO ANTICIPATED OR EXPECTED PUBLIC HEALTH EFFECTS,
AND AS PAT SAID, YOU KNOW, THERE’S NO SAFE LEVEL OF LEAD.
SO WE’VE SET OUR GOAL AT ZERO. WE THEN SET OUR ACTION LEVEL OR
OUR STANDARD AT A LEVEL THAT’S AS CLOSE TO OUR GOAL AS FEESABLE
AND WE NEED TO TAKE INTO ACCOUNT, YOU KNOW, HOW LOW
ANALYTICAL METHODS ARE ABLE TO QUANTIFY LEVELS IN DRINKING
WATER AND WE ALSO NEED TO LOOK AT WHAT ARE THE CURRENT TOOLS TO
REDUCE THAT CORROSIVITY, WHAT CONTROL TREEMS OPTIONS ARE�–
TREATMENT OPTIONS ARE AVAILABLE. SO WE’VE SET AN ACTION LEVEL
RATHER THAN AN MCL AND THAT’S 15 PARTS PER�BILLION.
THERE IS NOT A HEALTH-BASED NUMBER OR A LEVEL THAT BELOW OR
ABOVE MEANS IT’S OKAY OR NOT OKAY OR SAFE OR NOT SAFE.
IT IS BASED ON FEASIBILITY AND EXCEEDING THAT ACTION LEVEL
ACTUALLY TRIGGERS ADDITIONAL THINGS THAT THE SYSTEM NEEDS TO
DO. EXCEEDANCE OF THE ACTION LEVEL,
ISN’T A VIOLATION, BUT FAILURE TO DO THE ADDITIONAL ACTIONS IS.
SO NEXT. SO THE WAY THAT A SYSTEM
MEASURES WHETHER THEY’VE EXCEEDED THE ACTION LEVEL,
THEY’RE REQUIRED TO COLLECT SAMS AT CUSTOMERS�– SAMPLES AT
CUSTOMERS, AND THEY NEED TO GO TO THE HIGHEST RISK SITES SO
THEY’RE LOOKING AT WORST POSSIBLE CASES.
THOSE SITES ARE HOMES SERVED WITH LEAD SERVICE LINE OR WE
KNOW THEY HAD COPPER PIPING WITH LEAD SOLDER BEFORE IT WAS BANNED
IN THE EARLIER ’80s. THAT’S WHERE THEY WANT TO TARGET
THE TAP SAMPLING. THEY COLLECT THE DATA AND LOOK
AT THE 90th PERCENTILE TAP LEVELS AND IF THAT RESULT IS
GREATER THAN OUR 15 PARTS PER�BILLION ACTION LEVEL,
THEY’RE THEN REQUIRED TO TAKE A NUMBER OF STEPS.
FIRST THING THEY WANT TO LOOK AT IS WHAT KIND OF QUALITY OF WATER
IS GOING THROUGH THEIR SYSTEM. IS IT CORROSIVE, WHAT’S THE pH
LIKE, WHAT’S THE ALKALINITY LIKE, DO THEY HAVE A LOT OF
DISSOLVED SOLIDS, OTHER FACTORS. LOOKING AT WATER QUALITY
PARAMETERS AND FIGURING OUT WHAT’S BEST FOR THAT SYSTEM.
THEY DO NEED TO INSTALL OR LOOK AT CORROSION CONTROL TREATMENT
AND WHAT’S REQUIRED IS TO ADD SOME KIND OF INHIBITOR.
IT MAY BE A MATTER OF CONTROLLING pH AND OTHER
FACTORS. ALTHOUGH LEAD IS TYPICALLY NOT
FOUND IN SOURCES OF DRINKING WATER, LAKES, RIVERS, THAT TYPE
OF THING, WE STILL ASK THAT THEY TAKE A LOOK AND IF LEAD HAPPENS
TO BE IN THEIR SOURCE WATER, DO TREATMENT TO REMOIFT BEFORE
THEY’RE BRINGING IT INTO THE DISTRIBUTION SYSTEM.
THEY’RE REQUIRED TO CONDUCT PUBLIC EDUCATION VERY SHORTLY
AFTER THEY REALIZE THEY’VE HAD AN ACTION LEVEL EXCEEDENCE.
THE INFORMATION GUESS TO ALL CUSTOMERS, IT TALKS ABOUT THE
HEALTH EFFECTS OF LEAD AND ACTIONS THEY CAN TAKE, THINGS
LIKE FLUSHING TAPS BEFORE THEY DRINK OR PERHAPS USING A FILTER
OR OTHER MEASURES. AND THEN FINALLY, AS I
MENTIONED, THE LEAD SERVICE LINE REPLACEMENT IS A VERY IMPORTANT
COMPONENT. THE RULE REQUIRES THAT SYSTEMS
REPLACE OR REMOVE 7% OF THEIR LINES ANNUALLY UNTIL THEY HAVE
THE LEAD LEVELS BACK UNDER CONTROL.
NOW, ONE THING I DID WANT TO NOTE AS WELL IS WHEN WE
ORIGINALLY PROMULGATED THE LEAD AND COPPER RULE IN THE EARLIER
’90s, WE REQUIRED THAT ALL LARGE UTILITIES, SO THOSE ARE DEFINED
AS ANY SYSTEM THAT SERVES MORE THAN 50,000 PERSONS, ALL OF THEM
HAD TO INSTALL CORROSION CONTROL TREATMENT AND MAINTAIN OPTIMAL
WATER QUALITY PARAMETERS. FOR SYSTEMS THAT SERVE LESS THAN
50,000 PEOPLE, IF THEY HAVE ACTION LEVEL EXCEEDENCES, THEN
THEY’RE REQUIRED TO INSTALL THE TREATMENT.
I WANT TO TALK ABOUT THE CHALLENGES THAT FLINT IS FACING
RIGHT NOW AND WHAT LED TO WHERE THEY ARE.
THEY WERE FOR MANY, MANY YEARS PURCHASING TREATED WATER FROM
DETROIT AND DETROIT WATER HAD A CORROSION INHIBITOR THAT THEY
WERE ADDING TO IT. IN APRIL OF 2014, AN EMERGENCY
CITY MANAGER DECIDED THAT THEY WOULD MOVE OFF THE DETROIT
RIVER�– OR EXCUSE ME, OFF THE DETROIT WATER SUPPLY AND START
USING THE FLINT RIVER AS THEIR WATER SUPPLY.
THAT THEY HAD NO CORROSION CONTROL TREATMENT IN PLACE
EITHER TO TREAT THAT FLINT WATER.
SO THEY CONDUCTED A COUPLE OF ROUNDS OF THAT TAP SAMPLING
MONITORING I DESCRIBED AND ALTHOUGH THEY’RE 90th PERCENTILE
DIDN’T EXCEED OUR LEVELS, THE TREND SHOWED THE LEVELS WERE
GOING UP. FLRP A NUMBER OF THINGS THAT
WERE�– THERE WERE A NUMBER OF THINGS THAT WERE IDENTIFIED AS
POTENTIAL ISSUES WITH THE WAY THEY COLLECTED THE SAMPLES,
WHICH MAY HAVE UNDERESTIMATED OR MISREPRESENTED WHAT WAS REALLY
HAPPENING WITH THE LEAD IN DRINKING WATER.
ONE OF THE THINGS IS THEY DID NOT CONDUCT ALL OF THAT TAP
SAMPLING APT THE HIGHEST RISK�– AT THE HIGHEST RISK SITES THAT
THEY’RE REQUIRED TO, SO THE ONES WITH LEAD SERVICE LINES AND
OTHER FACTORS. THERE WERE QUESTIONS ABOUT HOW
THE RESULTS WERE HANDLED, WHETHER OR NOT PROPER
INVALIDATIONS OF SAMPLES TOOK PLACE.
AND THEN ONE OF THE INSTRUCTIONS THAT THEY WERE PROVIDING TO
RESIDENTS WAS TO DO PRESTAGNATION FLUSHING AND WHAT
THAT MEANS IS UNDER THE REGULATION, WE REQUIRED THAT THE
TAP SAMPLES ARE COLLECTED AFTER THE WATER HAS SAT IN PREMISES
PLUMBING AND THOSE SERVICE LINES FOR SIX HOURS.
WE WANT TO MAKE SURE WE REALLY UNDERSTAND WHAT’S LEECHING OUT
BY HAVING THE WATER SITTING IN THOSE AREAS WHERE YOU WOULD
TYPICALLY SEE LEAD. THEY INCLUDED AN INSTRUCTION TO
CUSTOMERS TELLING THEM TO FLUSH, YOU KNOW, OPEN ALL THEIR TAPS,
FLUSH THE WATER BEFORE THEY STARTED THAT STAGNATION PERIOD
AND THERE’S BEEN SOME CONCERN THAT PERHAPS THAT ALSO MAYBE
UNDERESTIMATED THE LEAD THAT WAS REALLY COMING OUT AT THE TAP.
SO OTHER CHALLENGES, RESEARCHERS AT THE HURLEY MEDICAL CENTER
STARTED LOOKING AT BLOOD LEAD LEVELS OF CHILDREN IN THE
COUNTY, BOTH BEFORE WHEN THEY WERE ON THE DETROIT WATER AND
THEN WHEN THEY MADE THE SWITCH TO A NEW WATER SOURCE, THE FLINT
RIVER, AND WHAT THEY FOUND IS THE INCIDENCE OF CHILDREN WITH
BLOOD LEAD LEVELS ABOVE THE CDC REFERENCE LEVEL OF 5 MICROGRAMS
PER DECILITER HAD INCREASED SIGNIFICANTLY.
AND I THINK THAT REALLY BROUGHT THE ATTENTION OF THE FULL
FEDERAL FORCE AT THAT POINT. SO SOME OF THE THINGS THAT THE
CITY AND THE STATE ARE DOING TO REMEDY THE SITUATION IS THEY ARE
PROVIDING BOTTLED WATER TO THEIR CITIZENS.
THEY PROVIDED FILTERS AND THEY’VE HAD PROFESSIONAL
PLUMBERS COME IN AND INSTALL FILTERS SO THAT THAT WATER IS
BEING FILTERED AND THEY’RE NOT GETTING THE LEAD EXPOSURE AND
THEY’RE GOING TO REPLACE ALL OF THEIR LEAD SERVICE LINES.
THEY’RE GOING TO GO ABOVE THE 7% ANNUALLY THAT’S REQUIRED BY THE
LAW AND JUST REMOVE THOSE SOURCES OF LEAD.
SO TO HELP OUT, EPA ESTABLISHED A TASK FORCE AND IT’S MADE UP OF
FOLKS BOTH HERE AT HEADQUARTERS AND WITHIN OUR REGION FIVE
OFFICE, WHICH IS WHERE MICHIGAN IS LOCATED, AND THEY’RE DOING A
NUMBER OF THINGS TO HELP THE MICHIGAN DEPARTMENT OF
ENVIRONMENTAL QUALITY AND THE CITY OF FLINT AS THEY MOVE
FORWARD. SO THEY PROVIDED RECOMMENDATIONS
ON HOW BEST TO TAKE SAMPLES IN SCHOOLS.
THEY PROVIDED RECOMMENDATIONS ON LOOKING AT HOW THEY’RE DOING THE
RESIDENTIAL TAP SAMPLING TO MAKE SURE THEY’RE REALLY GETTING THE
MOST ACCURATE AND BEST POSSIBLE RESULTS FROM THAT SAMPLING.
OF COURSE, THEY’RE DOING A LOT OF WORK WITH HELPING ADVISE THEM
ON CORROSION CONTROL TREATMENT AND HOW TO MOVE FORWARD WITH
THAT. THE CITY IS CONTEMPLATING
ANOTHER SWITCH TO A DIFFERENT SOURCE OF WATER IN A COUPLE MORE
YEARS, AND SO BEING PREPARED, THINKING ABOUT WHAT THEY’RE
GOING TO NEED TO BE IN A GOOD POSITION TO CONTROL CORROSION IN
THAT WATER AS WELL AS WHAT THEY’RE USING NOW FOR A SOURCE.
NEXT SLIDE. SO I WANT TO TALK A LITTLE BIT
ABOUT THE RECOMMENDATION OR ONE IN PARTICULAR WE GOT FROM OUR
NATIONAL DRINKING WATER ADVISORY COUNCIL.
SO WE’VE BEEN WORKING WITH THEM FOR ABOUT A YEAR AND A HALF WITH
A WIDE VARYING GROUP OF STAKEHOLDERS TO GET INPUT, AND
YOU KNOW, ONE OF THEIR KEY RECOMMENDATIONS WAS TO CREATE A
PROACTIVE LEAD SERVICE LINE REPLACEMENT PROGRAM.
SO RATHER THAN WAIT UNTIL YOU HAVE AN EXCEEDENCE AND THEN
START RAMPING UP A PROGRAM, JUST HAVE IT BE AN ONGOING WITH A
GOAL OF REMOVING ALL THE LEAD SERVICE LINES.
WE ESTIMATE, BASED ON SOME RESEARCH DONE BY THE AMERICAN
WATER WORKS ASSOCIATION, THAT THERE’S ABOUT TEN�MILLION LEAD
SERVICE LINES IN THE UNITED STATES TODAY.
THIS IS SOME DATA FROM THE LATE ’80s, AND ALTHOUGH WE KNOW THAT
THERE’S BEEN SOME LEAD SERVICE LINE REMOVALS, A LOT OF THEM
HAVE BEEN PARTIALS, NOT FULL LEAD SERVICE LINES, SO WE’RE
PROBABLY STILL LOOKING AT ABOUT TEN�MILLION LINES THAT NEED TO
BE REMOVED. AND OUR REGULATIONS, WE CAN
SPECIFY THAT A WATER SYSTEM MUST REMOVE LEAD SERVICE LINES, BUT
FOR THE PORTION OF THE LINE THAT THEY DON’T OWN, WE CANNOT
REQUIRE THAT THEY PAY FOR THAT PORTION.
THEY CAN OFFER TO THE CUSTOMER TO COORDINATE AND REMOVE THE
LINE AT THE CUSTOMER’S COST, WHICH HAS BEEN A CONTRIBUTING
FACTOR TO WHY THERE’S SO MANY PARTIAL LEAD SERVICE LINES
REPLACEMENTS. SOME UTILITIES, HOWEVER, ARE NOT
ALLOWED TO SPEND PUBLIC FUNDS ON PRIVATE LAND AND SOMETIMES
THERE’S ACCESS ISSUES TO BEING ABLE TO GET ON A HOMEOWNERS
PROPERTY TO REMOVE THEIR PART OF THE LINE.
SO I JUST WANTED TO POINT OUT A COUPLE OF QUOTES FROM THE ACTUAL
REPORT FROM�– WE GOT FROM OUR ADVISORY COUNCIL, AND YOU KNOW,
ONE OF THE THINGS THAT THEY ACKNOWLEDGED IS THAT CREATIVE
FINANCIAL MECHANISMS ALSO WILL BE NEEDED TO ACHIEVE THIS GOAL
OF REMOVING ALL LINES FOR ALL INDIVIDUALS, POTENTIALLY EXPOSED
TO LEAD, REGARDLESS OF RACE, ETHICITY OR INCOME, LEAVING A
LEAD SERVICE LINE IN PLACE BECAUSE A LOW INCOME RESIDENT
DOES NOT HAVE THE MEANS TO PAY RAISES SERIOUS QUESTIONS OF
DISPARATE IMPACTS AND ENVIRONMENTAL JUSTICE AND ONE OF
THEIR SUGGESTIONS IN THE REPORT IS THAT WE NEED SOME SUPPORTING
ACTIONS OVER AND ABOVE WHAT CAN BE DONE UNDER THE SAFE DRINKING
WATER ACT AND LOOKING TO SOME FEDERAL PARTNERS TO HELP WITH
THIS. SO SOME OF THE NEXT STEPS, AND I
THOUGHT WHERE THIS GROUP IN PARTICULAR AND HUD HEALTHY HOMES
MIGHT BE A GREAT PARTNER FOR US IS THINKING ABOUT HOW WE CAN
FIND SOME FUNDING MECHANISMS FOR THAT’S LOW INCOME FOLKS THAT
WANT TO REPLACE THEIR PART OF THE LINE, BUT AREN’T ABLE TO.
ALSO THINKING A LITTLE BIT ABOUT HOW RAISE AWARENESS�– WE CAN
RAISE AWARENESS ABOUT LEAD BEING A SOURCE�– EXCUSE ME, DRINKING
WATER BEING A SOURCE OF LEAD EXPOSURE AND WHEN YOU’RE
THINKING ABOUT LEAD PAINT AND OTHER EXPOSURES, ALSO THINKING
ABOUT THE LEAD IN DRINKING WATER AS A CONTRIBUTING FACTOR.
AND THEN WITH ALL OF THE DIFFERENT HEALTHY HOMES
INITIATIVES AND THINGS THAT YOU’RE DOING, MAYBE THINK ABOUT
HOW WE CAN NOT ONLY EDUCATE HOMEOWNERS, BUT MAYBE IT’S PART
OF LOOKING AT HEALTHY HOMES MORE HOLISTICALLY AND LEAD ISSUES AND
CONSIDERING DRINKING WATER AND POTENTIAL LEAD SERVICE LINES AS
A CONTRIBUTING FACTOR. SO THAT’S ALL I HAD.
I GUESS I CAN TAKE QUESTIONS OR TURN IT BACK OVER TO PETER.
>>DO WE HAVE ONE FOR LISA?>>WE DO HAVE ONE FOR LISA.
THE QUESTION WAS�– AND IT HAD A COMMENT TO BEGIN WITH.
WITH THE FLINT ISSUES, OUR AREA RESIDENTS ARE ENCOURAGED TO TEST
FOR COPPER AS WELL AS LEAD. THIS IS FOR PERSONAL
INFORMATION, NOT THE PUBLIC WATER SUPPLY.
IT WOULD BE GOOD IF THE EPA WOULD PUT OUT THEIR LITERATURE
FOR THE END USER REGARDLESS OF SUP PLAY TO PRIVATE�– SUPPLY TO
PRIVATE HOMEOWNERS AND THE QUESTION IS IS THE COPPER TEST
REALLY RECOMMENDED OR IS IT PART OF A LEAD AND COPPER?
>>THAT’S A GREAT QUESTION. AND IT IS THE LEAD AND COPPER
RULE. LEAD TENDS TO GET ALL OF THE
ATTENTION AND PARTICULAR IN FLINT.
WE DO HAVE A STANDARD FOR COPPER.
OUR GOAL IS 1.3 MILLIGRAMS PER LITER AND OUR ACTION LEVEL IS
ACTUALLY SET AT THE SAME PLACE. THE HEALTH EFFECTS FOR COPPER
TYPICALLY WILL BE NAUSEA, UPSET STOMACH.
IT’S NOT QUITE AS SEVERE AS YOU WOULD EXPECT TO SEE WITH LEAD.
FOLKS WITH WILSON’S DISEASE MAY HAVE MORE DIFFICULTY PROCESSING
COPPER. IT’S PROBABLY, FOR MOST
HOMEOWNERS WHO ARE INTERESTED IN UNDERSTANDING THEIR WATER
QUALITY, IT MAY BE SOMETHING THEY WOULD BE INTERESTED IN
SEEING. TYPICALLY IF YOU HAVE A COPPER
PROBLEM, YOU’LL HAVE TASTE AND ODOR ISSUES BEFORE YOU REACH
THAT ACTION LEVEL, SO YOU USUALLY WILL KNOW IF IT’S A
PROBLEM.>>THANK YOU VERY MUCH, LISA.
I DO HAVE ONE QUESTION. SO WHEN WERE THE LEAD SERVICE
LINES USED? OR I GUESS MORE SPECIFICALLY,
WHEN DID WE STOP USING LEAD SERVICE LINES?
I’M EXPECTING THAT THEY’RE IN THE OLDER HOMES WHERE THE
RESIDENTS WILL BE EXPOSED, MORE LIKELY TO BE EXPOSED TO LEAD
PAINT HAZARDS AND THEN LEAD IN WATER AS WELL.
>>I THINK YOU GOT THAT ABOUT RIGHT.
IT WAS VERY COMMONLY USED IN THE POST WORLD WAR II ERA AND I
THINK IN THE ’70s, A LOT OF LOCALITIES AND MUNICIPALITIES
QUIT USING IT. IT WASN’T UNTIL 1982 THAT IT WAS
ACTUALLY�– EXCUSE ME, 1986 THAT IT WAS ACTUALLY BANNED.
THE SAFE DRINKING WATER ACT WAS AMENDED AND THERE WAS A NEW
DEFINITION OF WHAT COULD BE CONSIDERED LEAD-FREE, AND SO 8%
AT THAT TIME WAS WHAT WAS CONSIDERED LEAD-FREE, BUT I
THINK THE PRACTICE PROBABLY WAS DISCONTINUED BEFORE THE ACTUAL
BAN. BUT TYPICALLY, WE LOOK AT OLDER
HOUSING STOCK IS WHERE YOU WOULD EXPECT TO SEE THAT.
>>AND YOU SAID POST WORLD WAR II.
WHAT ABOUT THE OLDER STOCK PRE-1940?
>>PROBABLY AS WELL.>>OKAY.
>>I THINK IT WAS�– YES.>>SO JUST TO BE CLEAR, OUR LEAD
HAZARD CONTROL GRANT FUNDING CANNOT BE USED TO REPLACE
SERVICE LINES. THEY CAN CERTAINLY TEST FOR LEAD
UNDER THOSE GRANTS AND THEY CAN REPLACE SOME OF THE FIXTURES IN
THE HOME FOR EXAMPLE, BUT WE NEED TO FIND OTHER SOURCES FOR
THE SERVICE LINES. ANYWAY, I’D LIKE TO THANK OUR
SPEAKERS TODAY. SORRY THAT WE DIDN’T HAVE MORE
OF�– A LARGER IN-PERSON AUDIENCE, BUT I THINK WE HAD A
GOOD AUDIENCE VIEWING THE WEBCAST AND WE WILL DO BETTER TO
GET AN IN-PERSON AUDIENCE, A LARGER AUDIENCE IN THE FUTURE,
BUT AGAIN, THANK YOU VERY MUCH FOR BEING HERE, TAKING THE TIME
FOR YOUR PRESENTATIONS AND IT’S A VERY IMPORTANT ISSUE AND WE AT
HUD LOOK FORWARD TO WORKING WITH YOU ALL ON THE ISSUE.
SO THANKS VERY MUCH. CAPTIONING PROVIDED BY
CAPTION ASSOCIATES, LLC www.captionassociates.com
>>WE HAVE ONE MORE QUESTION?>>THERE WAS ONE FINAL QUESTION.
THIS WAS FOR RICK. IT ASKS, DOES THE DATA ABOUT THE
DECLINE IN UNWED PREGNANCIES CORRELATE WITH THE BLOOD LEVEL
CONTROLS AND THE USE OF CONTRACEPTION SUCH AS PLAN B?
>>NO, IT DOESN’T CONTROL FOR THAT, BUT WE’RE LOOKING AT A
TREND THAT GOES BACK FROM THE 1950s, SO I THINK THAT WOULD
REALLY BE STATISTICAL NOISE IN THE OVERALL TREND RELATIONSHIP.
>>OKAY. THAT’S IT.
WE’RE WRAPPING UP NOW. THANK YOU.


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