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IN THIS ISSUE:
Congress has finally completed appropriations
for FY2003. Operating under tight budget caps, Congress sharply
curtailed overall domestic spending, including affordable
housing programs. At the same time, Congress increased HUD’s
lead safety funds from $110 million last year to $175 million.
This includes a new $50 million pot of funds for grants of
at least $2 million for the areas with the worst lead abatement
needs. HUD will identify these areas based on specified need
and risk factors. Presumably, this program will run in parallel
with HUD’s existing lead hazard control grants, although
it requires a different local match, and an exclusive focus
on rental housing. Congress level funded healthy homes grants
at $10 million and increased Operation LEAP from $6.5 million
to $10 million. (For details, see www.house.gov/rules/omni10.pdf.)
Congress essentially level funded EPA and CDC lead poisoning
prevention programs.
Many cities and states are pursuing effective
ways to prevent and control lead-based paint hazards before
a child is exposed. Every jurisdiction stands to benefit from
the lessons learned by others through universal access to
a broad set of innovative and promising primary prevention
tools and strategies. To help accelerate action to make U.S.
housing safe for children and their families, the Alliance
is developing Building Blocks for Primary Prevention: Protecting
Children from Lead-Based Paint Hazards under a contract to
CDC.
Building Blocks will provide concise descriptions of 50-100
strategies that merit consideration by all who have a role
in reducing lead and other environmental health hazards in
housing. The featured strategies will span the spectrum of
primary prevention and, wherever possible, be illustrated
by actual examples to provide programs and policy makers nationwide
easy access to information about innovative and promising
strategies.
The Alliance is currently identifying innovative strategies, both proven
and promising, to highlight as individual building blocks. To propose
a nomination, please send a brief description of the potential building
block including contact information to Laura Fudala (lfudala@afhh.org).
Only a few paragraphs are needed for initial summaries of potential building
blocks. Alliance staff will follow up to research and develop the description
of the strategies during the next few months. For a detailed description
of Building Blocks, visit www.afhh.org/aboutus/aboutus_projects_buildingblocks.htm.
On January 31, CDC released the Second National Report on
Human Exposure to Environmental Chemicals, including lead.
The report, available online at www.cdc.gov/exposurereport/
presents exposure information for 116 environmental chemicals
measured in blood and urine specimens from a sample of people
who represent the US population for the years 1999 and 2000.
Samples were collected from some 2,500 participants in CDC's
National Health and Nutrition Examination Survey (NHANES)
– an ongoing national health survey of the U.S. population.
The report covers heavy metals (e.g., lead, mercury, uranium),
organophosphate pesticide metabolites, dioxins, and cotinine
(a marker of exposure to tobacco smoke). Based on these 1999-2000
data, CDC estimates that 2.2% of children aged 1-5 (434,000
children) have blood lead levels greater than or equal to
10 µg/dL, while the geometric mean blood lead level
for this group is 2.23 µg/dL. Both these values reflect
declines since the 1991-1994 NHANES estimates of 4.4% (890,000
children) and 2.7 µg/dL, respectively. The number of
children was too small to make estimates of population subgroups,
and hence does not illuminate disparities by income or race.
For all age groups, the report estimates higher geometric
mean blood lead levels for Black and Hispanic persons than
for Whites. The data on lead levels is available at www.cdc.gov/exposurereport/metals/pdf/lead.pdf.
A new Ohio law signed by Governor Taft in January overhauls the state’s
lead law. All rental property, day care, or educational facilities constructed
before 1950 must be maintained using Essential Maintenance Practices (EMPs).
Persons who perform EMPs are required to complete an approved training
program. If the owners of such properties wish to also perform standard
treatments and clearance, their properties shall be presumed not to be
the source of poisoning of a child with an elevated blood lead (although
this presumption is rebuttable by clear and convincing evidence). The
law also establishes licensing for clearance technicians who can perform
clearance examinations in connection with activities other than abatement.
The bill signed into law can be found at www.legislature.state.oh.us/bills.cfm?ID=124_HB_248.
For more information on the bill, contact Marcheta Gillam, Senior Attorney,
at Legal Aid Society of Cincinnati at 513-241-9400 or mgillam@lascinti.org.
On February 5, HUD announced grants totaling $6.5 million
under its Operation LEAP program, a new initiative to leverage
private sector resources for lead poisoning prevention. The
Alliance is pleased that our collaborative project to leverage
the lead-based paint disclosure law for action in high-risk
housing was selected for funding. Our project partners include
two State agencies, five local health departments, and ten
community-based organizations across the country. HUD also
selected the following other organizations for Operation LEAP
funding: the National Center for Healthy Housing (Columbia,
MD), National Safety Council (Washington, DC), Neighborhood
Improvement Development Corporation (Milwaukee, WI), Greater
Detroit Area Health Council, Access Agency, Inc. (Willimantic,
CT) and the Energy Programs Consortium (Washington, DC). Visit
HUD’s website at www.hud.gov/news/release.cfm?content=pr03-013.cfm
for more information.
CDC recently released a notice of funding availability for FY 2003 childhood
lead poisoning prevention grants. CDC plans to award $31 million to approximately
40 grantees to include states, territories, and five cities (New York,
Chicago, Detroit, Los Angeles County, and Philadelphia) with a high number
of children with elevated blood lead levels. Grants will support development
of targeted screening plans, surveillance programs, and case management
of children with elevated blood lead levels. The announcement also makes
some significant changes to CDC’s grant program. Consistent with
the federal strategy to end lead poisoning by 2010, CDC grantees must
develop an action plan to eliminate childhood lead poisoning in their
state or jurisdiction, with the help of a workgroup or advisory committee.
Grantees must also conduct targeted primary prevention activities to high-risk
children and families. The application deadline is March 24.
The Community Environmental Health Resource Center (CEHRC),
a project of the Alliance developed in collaboration with
local advocates, has developed several Spanish-language materials
for advocates conducting hazard assessments in high-risk housing.
These hazard assessment materials are available in the "En
Español" section of the CEHRC website (www.cehrc.org)
and include the Visual Survey Report, Sampling Results Report,
Floor Plan and Site Plan. Translation into Spanish is ongoing
and new materials will be posted as they become available.
A federal district court judge recently issued a decision
that severely criticized the state of Idaho for failing to
provide required screening and treatment services to children
served by Medicaid. The state was also criticized for failing
to comply with Medicaid’s outreach requirements that
are intended to inform families about available screening
and treatment programs. According to press reports, U.S. District
Court Magistrate Judge Mikel Williams listed 10 areas where
the state is violating mandatory Medicaid provisions for testing
and treating children with elevated blood lead levels. The
decision comes out of a class-action suit filed by attorney
Robert Huntley in 2000. For more information on this and similar
Medicaid cases, check www.healthlaw.org
where such legal developments are regularly posted.
As part of a settlement agreement, Healthcare USA of Missouri
will spend $1,131,000 beyond its contractual agreement to
conduct lead screenings for St. Louis area children enrolled
in Medicaid. The settlement resolves a lawsuit filed in November
1999 against the HMO for failing to screen young children
enrolled in the state’s Medicaid program. Medicaid requires
that children receive lead screenings at ages 12 and 24 months.
The HMO tested only a small fraction of eligible 1- and 2-year-old
children. A similar suit filed in 1999 against Prudential
Health Care Plan is still pending. For more information on
the settlement, visit www.ago.state.mo.us/newsrls/2002/121902.htm.
The February 17 issue of Newsweek carries an article on efforts underway
by governments to hold the lead industry accountable for marketing lead-based
paint despite knowledge of its dangers to human health. The article, “Getting
the Lead Out: Lawsuits in Rhode Island and elsewhere aim to make paint
companies pay to clean up their poison past,” highlights the fall
2002 trial in Rhode Island and presents both sides of the debate on the
extent to which the industry sought to allay public concern through an
intense public relations campaign in the 1920’s when the dangers
of lead began to receive broad attention in the US. A mother’s experience
in Rhode Island exhibits the horror many families face in older homes
where children are poisoned by lead dust from peeling or flaking paint.
The Detroit Free Press recently published a week-long series
on lead poisoning in Michigan. The series, available online
at www.freep.com/lead/,
highlights the high number of lead-poisoned children in Detroit
and shortcomings in hazard remediation policies and enforcement
of housing ordinances. One article in the series discusses
a lead smelter that operated in a low-income Detroit community
for two decades.
Recently published studies have linked lead exposure to
a wide range of human health problems, including delinquency
in youths, premature death, and kidney damage. “Bone
Lead Levels in Adjudicated Delinquents – A Case Control
Study” published in the Nov.-Dec. 2002 issue of Neurotoxicology
and Teratology (Vol. 24, Issue 6) by Herbert L Needleman et
al. compared the bone lead levels of 196 youths aged 12-18
who were arrested and adjudicated as delinquent by the Juvenile
Court of Allegheny Co. PA, and 146 nondelinquent controls
from Pittsburgh high schools. The delinquent youths had significantly
higher bone lead concentrations than the nondelinquent youths
– 11 parts per million (ppm) compared to 1.5 ppm in
the control group. The abstract is available at www.elsevier.nl/locate/neutera.
In “Blood Lead Levels and Mortality” in the Nov. 25, 2002
issue of Archives of Internal Medicine researchers, Mark Lustberg and
Ellen Silbergeld, analyzed mortality follow-up data from NHANES II, and
concluded that individuals with blood lead levels of 20 to 29 µg/dl
in 1976 to 1980 (which comprised 15% of the US population at that time)
experienced a 46% higher rate of death from 1976 through 1992.
A research study involving 200 patients with chronic kidney
insufficiency was published in the Jan. 23, 2003 issue of
the New England Journal of Medicine ("Environmental Lead
Exposure and Progression of Chronic Renal Diseases in Patients
without Diabetes” by Ja-Liang Lin et al.). The researchers
concluded that “low-level environmental lead exposure
may accelerate progressive renal insufficiency in patients
without diabetes who have chronic renal disease. Repeated
chelation therapy may improve renal function and slow the
progression of renal insufficiency.” The abstract is
available at http://content.nejm.org/cgi/content/short/348/4/277.
An Environmental Health Perspectives article authored by
Lih-Ming Yiin, et al. assessed the effectiveness of standard
vacuum cleaners for cleaning lead-contaminated house dust
with those containing HEPA-filters. Researchers found no statistically-significant
difference between the two cleaners in the lead loading reduction
in 127 New Jersey Homes. Sampling data showed a significant
(54.7%) reduction in lead loading on soiled carpets with both
types of vacuum cleaners. The study also found lead loadings
to be similar on carpets and upholstery, indicating that soiled
upholstery may also be a significant risk factor. The abstract
is available online at http://ehpnet1.niehs.nih.gov/docs/2002/110p1233-1237yiin/abstract.html.
“Lead-Based Paint Health Risk Assessment in Dependent
Children Living in Military Housing,” in the September/October
2002 (Vol. 117, 446-452) issue of Public Health Reports concluded
that children living in on-site military housing were less
likely to be exposed to lead hazards, when compared with children
in the general population. Researchers, Davis M. Stroop, Kim
N. Dietrich, Allen Hunt, Lawrence Suddendorf, and Mark Giangiacomo,
compared the geometric mean blood lead level of 1,992 military
children (1.5 µg/dL) with data from NHANES III, Phase
1 for children in the general population (2.8 µg/dL).
The prevalence rate for military children with blood lead
levels above 10 µg/dL was 1.6%, compared with 4.5% for
the general population. The abstract for this article is available
online at http://phr.oupjournals.org/cgi/content/abstract/117/5/446.
Dr. Evelyn A. Mauss, environmental activist, died recently
at age 87. Dr. Mauss worked as a Science Consultant to the
Natural Resources Defense Council (NRDC) for many years, helping
to advance global lead poisoning prevention. She was also
an Associate Dean and Adjunct Professor of Physiology at New
York University. Mauss’s life-long advocacy inspired
advocates in New York, across the US, and around the world.
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