Today we begin our series on childhood lead poisoning and how the state is responding to it.
This heavy metal can be disastrous to a child's health - a fact that has been known since the early 1900's. By 1909, France, Belgium and Austria had banned the use of lead paint inside homes.
Such paint is not the only source of the metal, but today, it is the most widespread.
America also banned lead paint - in 1978. But almost three decades later, New Hampshire still confronts about 250 cases of lead poisoning each year.
New Hampshire Public Radio's Amy Quinton has our first report.
She looks at the one group that has been hit hardest by lead poisoning - newly arrived refugees from Africa.
(sound of children playing)
Somali refugee Juma Ali Muya’s five young children are busy playing in their room in an apartment in downtown Manchester.
"My name is Halima and I’m 13, my name is Arbay and I’m 9 years old, My name is Ajayib and I’m seven years old, my name Hamadi and I’m two, my name Amina and I’m six years old..." (laughing)
The littlest one, Hamadi, is actually three.
Speaking to them in Mushunguli, Juma Muya tries to get them to calm down.
(natural sound)
As Muya begins to talk about this small three bedroom apartment on Wilson street, roaches crawl along the walls behind him.
There’s also lead paint in this apartment.
Speaking through a translator, Muya says if he could afford to, he would move.
"If have enough deposit for new apartment I would move, besides I don’t know where to go how should I know if I move the place that I’m moving to is safe for the children, that apartment have no lead paint"
Muya’s has good reason to worry about lead.
Two years ago, doctors found elevated lead levels in all five of his children.
The apartment they’re in now is where health officials moved them to escape an even more dangerous apartment in downtown Manchester.
For all of the children except one, their lead levels eventually dropped.
But for Ajayib -- who was five years old at the time – the effects have been devastating.
Her levels reached 63 micrograms per deciliter.
She suffered permanent brain damage and is now in special education.
Her father says she is violent at times.
"She doesn’t sleep well at night, she all the time beats her brother, Hamadi, she grabs him and then throws him on the floor, she fights with teachers and has a lot of problems in the home."
African refugees are a tiny fraction of the Manchester population, but they account for a full third of the lead poisoning cases in the city.
Sue Gagnon, with Manchester’s Public Health Department, says that’s because their malnourished bodies soak up lead like sponges.
“We have seen several children who enter the United States most of them with iron deficiency, if they present iron deficiency anemia they are more prone to lead exposure, the body tends to absorb more leadâ€
Lead poisoning has taken such a toll on Muya’s family, he thinks they might have been better off staying in their refugee camp in Kenya.
"We run away from war, civil war, chaos, that’s why we came here, but now, I talk to myself and say I would prefer to stay there because at least in Africa I had healthy children."
The idea that a refugee camp could have been a better choice than an apartment in Manchester might sound shocking, but to people who follow lead poisoning, what’s truly outrageous is that lead paint continues to damage children’s brains three decades after it was banned in America.
"I don’t know why it’s taken so long, maybe there’s not been the voice of these children as loudly as it could be..."
State Public Health Director Mary Ann Cooney says on average, 250 children a year are lead-poisoned across the state.
The cumulative impact is much larger.
According to federal surveys, more than 10-thousand children in New Hampshire have had dangerous levels of lead in their blood at some point.
In 2000, the state discovered that it might have a bigger problem with lead than it thought.
"Much of the interest frankly, much of it arose when we had a death of a child the only death in the country was here in this state, that can’t be ignored when you consider that it’s a totally preventable condition"
It may be preventable, but the cost can be high.
Cooney says the fundamental problem is the number of old homes.
Statewide 75 percent of homes built prior to 1978 have lead-based paint.
Map outlining the spread of lead poisoning and lead hazard cases across New Hampshire. (Courtesy Department of Health and Human Services) See a full-size version of the map
If any of that flakes, or if lead dust is stirred up in a doorway or window, a child can become poisoned.
Even for families that can afford to renovate, problems can emerge.
Phil Alexakos is an environmental health supervisor with Manchester’s Public Health Department.
Almost one out of every three children poisoned statewide lived in homes that had recently undergone renovations.
"Old Victorian homes that are being refurbished and renovated by their parents, or a do-it yourself project, there’s tragic stories about people poisoning their own children, that does occur, it’s a multi-faceted problem."
But most of the lead paint problem is found in lower income housing.
In Manchester alone, an estimated three-quarters of the city’s housing stock has lead paint.
Lawyer Stephen Hyde represents many smaller property owners in the state and sits on the Governors Lead Paint Task Force.
He says many property owners simply can’t afford to remove the lead themselves.
“In many cases they have a couple of buildings that do very well, and the profits from those buildings allow them to carry buildings that don’t do well, where they’re not making any money. So for the landlords to be saddled with 14-thousand dollars or whatever the number is per unit in abatement would be financial ruin for them.â€
Stiff opposition over the cost of abatement – and whose responsibility it is to pay for it, has stymied efforts to beef up New Hampshire’s lead poisoning laws.
Currently, they aren’t at national standards.
The Centers for Disease Control and Prevention considers a child lead poisoned if their blood lead level reaches 10 micrograms per deciliter.
In New Hampshire the standard is twice that before the state will intervene.
Attorney Christine LaValley, with New Hampshire Legal Assistance, says in effect, the state is using children as lead detectors.
"The state statute doesn’t kick in until a child’s poisoned so we’re using children as canaries in coalmines basically, because nothing can be done, no abatement action can be forced on the landlord unless a child has been poisoned and poisoned at 20 BLL’s which is significantly high."
The Governor’s Lead Task Force has recommended strengthening New Hampshire’s laws – starting adopting the federal guidelines.
But Public Health Director Mary Ann Cooney says it will be difficult.
"With the numbers of units that are potentially out there we know it would take us a long time with the current staff that we have in order to really do the amount of either inspection or going in and responding to a lead poisoned child at a lower level"
Cooney says changing the law would likely require an additional five state staffers, at taxpayer’s expense.
That is likely to meet resistance from lawmakers in a tight budget year.
And then there are the landlords.
They point to the millions of dollars they’ve spent voluntarily to deal with lead.
And they oppose any tightening of the law.
For NHPR News, I’m Amy Quinton.
I am so glad to see someone covering this story. It's a tragedy, because lead poisoning is very preventable. It's not true that the only choice we have is to impose a cost of thousands of dollars on landlords or do nothing. In fact, if landlords spent much less than that to keep apartments in good condition, and if they did an adequate job of informing residents of how they can protect themselves, a lot of prevention would be accomplished. In addition, if the programs that assist refugees concentrated on getting these particularly vulnerable children into safer apartments - if they had enough money to pay the premium for them - it would make a big difference. If there were programs to ensure these children had diets that got iron and calcium into them, so they didn't absorb lead like a sponge, that would make a difference. If the housing department actively enforced paint conditions, that would make a difference. If the courts recognized that a failure to keep paint in good condition could be a life-threatening matter, that would make a big difference. Now those are five things that would make a big difference - and there are more like them. For example, no one should ever sand or disturb old paint without containing the dusts. And windows and door frames and stairs with lead should be the first things to be replaced - that's not as costly as doing lead removal throughout. And not one of these things is imposing several thousands of dollars of costs on each landlord. So the landlords should cease opposing the movement in the state to deal actively with this tragic problem and understand that they need to be part of the solution. Otherwise in the end they will face much greater costs from having put off acting.
The history of child lead poisoning in the U.S. is a tragic one. The producers of lead and lead paint were well aware that their product was severely injuring and killing large numbers of young children as least as far back as the 1920s. Medical journal articles reporting that children were being poisoned by lead paint in their homes began appearing the in U.S. in 1914. After that, article after article described how children - lead-poisoned from window sills, porch railings, cribs, toys and other painted surfaces in the home - were hospitalized suffering from severe stomach cramps, paralysis, blindness, and convulsions; and many died. Even the lead industry's own medical consultant expressed his concern.
Many cities and one state, Rhode Island, have sued the lead paint producers to help recover the costs of dealing with this public health tragedy. Many more cities and states should do so.
For more information, see www.sueleadindustry.homestead.com