Lead Law Moving Forward in New Hampshire Legislature

May 21, 2015 by  | Bio |  Leave a Comment

MBTA-spotlight

Photo credit: Ecophotography

While many of us believe childhood lead poisoning is a thing of the past, the sad truth is that it’s not. In fact, every year, more than 1,000 New Hampshire children are poisoned by lead, with deteriorating lead-based paints the primary cause. The impacts of lead poisoning can be devastating and lifelong. Children can suffer a loss of IQ, behavioral difficulties, and organ and nerve damage. While the problem is statewide and affects all communities and people of all walks of life, many of the children impacted come from families that are already struggling, including low-income families living in substandard housing.

It doesn’t have to be this way. A bipartisan bill, SB 135, is making its way through the New Hampshire legislature that would protect children in our state.

The bill has already passed the New Hampshire House and Senate with strong support, with potential negotiations regarding amendments taking place between the two legislative bodies before being sent to Governor Hassan for her consideration. If the bill passes the legislature and Governor Hassan signs it into law, children across New Hampshire will benefit.

SB 135 is common-sense legislation. With better education, enhanced screening to make sure New Hampshire kids don’t fall through the cracks, and improved maintenance standards for rental properties, we can prevent lead poisoning and all its tragic costs. The lead poisoning prevention bill would put us on a clear path to achieving these important goals and keeping New Hampshire children safe.

More in-depth information on addressing lead poisoning in New Hampshire can be found in the following blog posts:

A Healthy Approach to Lawn Care

Apr 2, 2015 by  | Bio |  1 Comment »

Is the organic approach to lawn care and the movement against the use of chemical pesticides becoming mainstream? That seemed to be the case recently when more than 100 folks attended two events – one in York, Maine, and the second next door in Ogunquit – hosted by Scott Eldredge, owner of Eldredge Lumber and Hardware. Jay Feldman, director of Beyond Pesticides, and Chip Osborne of Osborne Organics, provided homeowners and turf professionals sound reasons to reconsider approaches to caring for lawns and gardens.

Scott Eldredge has been concerned for some time that chemical pesticides and synthetic fertilizers are not good choices for building healthy soils and assuring clean water. These concerns were confirmed by the speakers. The bottom line is that chemical pesticides and synthetic fertilizers don’t address what’s needed for a vibrant lawn or garden: healthy soils. Rather, they merely address the symptoms of unhealthy soils. While multi-step fertilizer applications and herbicides and pesticides do nothing for the long-term health of the soil (they only set up the homeowner for buying more of the same product – a sales treadmill), a system-based approach using organics gets to the root issue of healthy soils that contain plenty of organic material, lots of microbes, at the optimum pH level. This is the level where vibrant lawns and productive gardens really begin.

Ogunquit forum advocating organic alternatives

A recent forum in Ogunquit, Maine, educated homeowners about healthy, organic approaches to lawn care.

In 2014, the Town of Ogunquit became just the second community in the U.S. to enact a pesticide ordinance that covers both public and private property. In all but seven states, towns are actually pre-empted from adopting a pesticide ordinance by state statute. While New Hampshire is one of the states where communities aren’t allowed to pass a pesticide ordinance, towns here are permitted to adopt fertilizer use regulations, which New Castle and Franklin have done.

The incorrect application or overuse of lawn and garden care products compromises the health of our waters, and the Great Bay watershed is no exception. Through stormwater, tons of nitrogen are harming the fragile ecosystem of Great Bay. The side effects of herbicides, fungicides, and pesticides – even at low levels – have consequences that are not yet fully understood. Reducing their use – out of abundant caution – is a very smart move.

Scott Eldredge has already pulled some commonly sold pesticides and herbicides from his shelves at two store locations. He just refuses to sell them. It’s encouraging to see decisions based on the health of land and water and not a business’s bottom line.

In Exeter, Another Vote for Clean Water

Mar 20, 2015 by  | Bio |  Leave a Comment

By a wide margin, the citizens of Exeter, New Hampshire, recently rejected a move to reduce the size of wetland buffers in their community. As I discussed in a recent blog, buffers are an important tool for protecting both the health of our wetlands and water quality. Considering the significant challenges facing our Great Bay estuary, reducing these types of protections would have been taking us in the wrong direction.

Fortunately, a group of residents, Exeter Citizens for Responsible Growth, successfully campaigned over the last few weeks to convince voters that an ordinance change promoted by the planning board, selectmen, and the economic development office – all to accommodate new development on the Epping Road Corridor – lacked transparency and adequate public review. Kudos to the citizen’s group, and to the Exeter Conservation Committee, which advised against the proposed ordinance change.

Exeter citizens influencing the vote on March 10.

Exeter citizens stand up for clean water on March 10.

As Great Bay–Piscataqua Waterkeeper, I find it heartening to see local residents once again standing up for clean water. It was a pleasure working with local citizens and the Conservation Commission, and I’m grateful to members of our Clean Water Advocates for Great Bay group who worked with me to support the Exeter group’s effort to educate the public and to urge voters to safeguard existing wetland protections.

Buffers are essential to protecting the many valuable functions of our wetlands, such as flood control, wildlife habitat, and filtering out pollutants from runoff. Given Exeter’s pending need to comply with the EPA’s town-wide, nitrogen-control plan – part of the town’s final permit for its sewage treatment plant – a move to minimize buffers now is the opposite of what is needed to control and decrease nutrient pollution.

While the effort to reduce wetland buffer protections in Exeter is almost certain to continue, last week’s outcome is another example of what a small group of concerned citizens can accomplish, and another sign that people on the Seacoast care about clean water. Congratulations to them!

Rainbow Smelt Declining in Great Bay

Mar 16, 2015 by  | Bio |  Leave a Comment

Are we losing yet another piece of our Great Bay ecosystem? After two winter seasons of declines in rainbow smelt, most recreational fishermen would likely say “yes.” The smelt run seems to be going the way of the Great Bay oyster – downward.

Every winter, ice fishermen haul their shacks onto the rivers feeding Great Bay to await the return of rainbow smelt, catching this local delicacy through the ice on hooks baited with sea worms. Their only concern is whether or not there will be enough ice. This year there has been plenty of ice, but for the second year in a row, there are few smelt.

Fishermen wonder where the rainbow smelt have gone. Early reports for this season have been so dismal that most fishermen have not even bothered to pull their shacks on to the ice. Only a few very optimistic anglers set up on the Squamscott River in Stratham. The local bait shop isn’t even carrying sea worms this year – not wanting to get stuck with the inventory. No one, not even the New Hampshire Fish and Game Department, has a definitive answer as to why the number of smelt returning is so low.

Smelt shacks on the Squamscott River

Smelt shacks on the Squamscott River

Adult rainbow smelt typically overwinter in estuaries and bays and then spawn in early spring in pool and riffle areas above or in the head-of-tide areas of coastal streams and rivers. Juvenile smelt remain in the estuary, bay, or sheltered coastal areas through the summer, and sometimes through late fall. They stay closer to shore generally unless they need to go in search of cold waters during warm months. Their relatively small size – six to eight inches – precludes them from being netted at sea.

The geographic range of rainbow smelt has been constricting for the last few decades, no longer extending south to the Chesapeake. Is the problem ocean temperature? Are smelt abandoning Great Bay for northern waters? Maybe, but even in Maine, smelt numbers have reportedly declined by 50%. Climate change may be a factor. Temperature, dissolved oxygen, pH, turbidity, total nitrogen and phosphorus, and periphyton are also all suspected of playing a role in spawning success.

While we may not have too much immediate influence over the big picture at sea, we do have control locally—especially with water quality in the spawning grounds of Great Bay. The future of the iconic smelt run in the Great Bay estuary is yet another reason to reduce pollution and restore the health of our waters.

A Firsthand Account of the Ravages of Lead Poisoning

Feb 18, 2015 by  | Bio |  Leave a Comment

On February 17, New Hampshire’s Senate Health & Human Services Committee held a public hearing on SB 135, a bill designed to better protect New Hampshire kids from the continuing threat of lead poisoning. The Committee heard strong support for SB 135 from a broad range of interests. Joan Valk, a Family Support Specialist at Child Family Services, was the last person to testify. Because her firsthand observations of the problem of lead poisoning make such a compelling case for addressing the problem of childhood lead poisoning, I thought I’d share them here in full:

According to the Centers for Disease Control, “No safe blood lead level in children has been identified,” and “lead exposure can affect nearly every system in the body.” In my 14 years as a home visitor in Merrimack County, most often in and around the Franklin area, I have seen many children who suffer the effects of lead poisoning. These children all have learning delays, speech delays, and behavioral issues. They need Early Supports and Services before they get to public school and Individualized Education Plans once they get into school.

Services that they typically get are special education hours, including help with math and reading, physical therapy, occupational therapy, and behavioral therapy. Many require a one-on-one aide to help them through the school day. Parents have to try to handle all of the appointments with medical providers, specialists, school meetings, and counselors, and somehow manage their children’s symptoms at home, dealing with behaviors that even experienced parents are at a loss of how to handle. These parents try to cope with impulsive behaviors including biting, hitting, kicking, head banging, and throwing toys and furniture. Once the children are three years old, there is a waiting list for in-home services through area agencies, so parents are left to deal with these behaviors with little or no support.

Although lead poisoning can occur in any socio-economic status, most of the families I serve are very low income, and do not have many options or alternatives to where they are living. Parents then have to deal with the guilt that, in trying to provide a home for their children, they have inadvertently contributed to their condition. I have gone into homes with cracked and peeling paint on walls, ceilings, and window sills, with parents who don’t even own a vacuum, who know that there is lead in their house, but feel like they can’t do anything about it. Or they don’t understand how harmful it can be to their children. Some parents mistakenly think that, because they were raised in a home and they are fine, that their children will be fine, too.

Parents are afraid to ask their landlord to do anything for fear that they will be kicked out of their apartments and be homeless. They are afraid to call the code enforcer. Many landlords refuse to address the issues, or address them by replacing windows or painting over the lead paint, but they don’t do it correctly and the situation becomes even more harmful for the child. Some of my clients believe that the landlord has said there is no lead paint in the home when the landlord has actually said that he/she has no knowledge of lead paint in the housing, so the parents think their children are safe when they may not be. And even if they move out, another family with children moves in and the cycle is repeated over and over again, with the children of our New Hampshire families paying the price, and New Hampshire and our schools footing the bill.

See more posts in our series about childhood lead poisoning.

 

Childhood Lead Poisoning: A Preventable Disease

Feb 18, 2015 by  | Bio |  Leave a Comment

In my last blog – the second in a series about childhood lead poisoning – I discussed the fact that not nearly enough kids in New Hampshire are being tested for lead in their blood. As discussed, screening is essential for determining if a child has been poisoned and, if he or she has been, for taking action to avoid further exposure.

But what about preventing lead exposure in the first place?

Not surprisingly, that’s a major recommendation of the Centers for Disease Control (CDC). In 2012, after affirming that no level of lead exposure is safe, and that even low levels of lead can have irreversible health impacts, the CDC determined that “primary prevention” must be pursued as an essential strategy. This means preventing exposures from happening in the first place, as opposed to managing exposures only after a child has been poisoned.

In its 2008 report, the New Hampshire Lead Study Commission adopted the following as one of its guiding principles: “New Hampshire must emphasize prevention before children get poisoned and focus on improving and maintaining safe, healthy homes. Lead poisoning is a preventable disease. The Commission reinforced that every effort must be made to focus on improving the lead safe status of New Hampshire’s housing stock. Everyone must be committed to supporting maintenance and making all homes safe and healthy so that children do not have to be exposed to lead in the first place.”

Unfortunately, even though lead poisoning is a preventable disease, New Hampshire’s lead program is largely reactive and not built on a primary-prevention approach. Here’s a typical scenario for how the current programs works:

  1. A young child is unknowingly exposed to a lead hazard – typically as a result of deteriorating lead-based paint, leading to the ingestion of lead dust from normal hand-to-mouth behavior.
  2. Assuming the child is screened (not necessarily a safe assumption), the child is found to have lead in his or her blood.
  3. If the child’s blood lead level is high enough to trigger action under New Hampshire’s lead law (10 micrograms per deciliter), the state’s Healthy Homes & Lead Prevention Program (HHLPP) opens an investigation.
  4. If the child lives in a rented dwelling, HHLPP may inspect the dwelling and, if lead hazards are found, must issue a lead hazard reduction order to the landlord, requiring the hazards to be addressed.

So, what’s wrong with this picture? We’re basically allowing kids to become poisoned first, and then requiring lead hazards to be addressed.

To prevent lead poisonings, it’s critical that lead-painted surfaces be properly maintained and not allowed to deteriorate. That’s one of the goals of SB 135, a bill pending in the NH Senate. SB 135 would establish a task force – composed of a broad range of interests – to determine the feasibility of developing an Essential Maintenance Practices program for pre-1978 rental housing and child-care facilities. Such a program could play a critical role in preventing the problem of deferred maintenance, which leads to lead hazards (such as loose and flaking paint and lead dust), which in turn leads to kids becoming poisoned and property owners facing liability.

This aspect of SB 135 is an important step in preventing New Hampshire kids from being poisoned by lead. In my next post, I’ll discuss another important aspect of SB 135 aimed at preventing lead hazards: a provision to help prevent unsafe renovation and painting practices that can result in kids being poisoned.

Screening Kids for Lead Poisoning – Why New Hampshire Needs to do Better (Spoiler alert: only 39% of high-risk NH children are being tested)

Feb 12, 2015 by  | Bio |  Leave a Comment

In my most recent blog – the first in a series about childhood lead poisoning – I provided an overview of the challenge: that even though we know there is no safe level of lead exposure for kids and that even low levels of lead can cause irreversible, lifelong harm to our children, we are not doing a good enough job preventing what is, in fact, a very preventable problem. I also discussed the scope of the problem – that childhood lead poisoning affects communities across New Hampshire (and New England), with significant health and economic impacts.

Universal & Targeted Screening

A critical tool in addressing the problem of childhood lead poisoning is screening – testing kids to determine whether they have lead in their blood. Based on factors such as the percentage of the population under six years of age, the percentage of kids living in poverty, and the percentage of older housing stock, the NH Department of Health and Human Services – the agency that addresses lead problems through its Healthy Homes and Lead Prevention Program – has categorized each of New Hampshire’s 234 municipalities as either high-risk “universal” communities, or as “target” communities. The current approach to screening depends on the category.

More than half of New Hampshire’s cities and towns are classified as high-risk, “universal” communities, meaning all kids in these communities should be tested for lead at the age of one and two. Older children who have moved into a high-risk, “universal” community also should be tested. In the remaining cities and towns – so-called “target” communities – physicians are to use a questionnaire to determine each child’s risk and whether to conduct a blood test.

Do you live in a high-risk, “universal” testing community? To find out, take a look at Table 2 (page 9) of New Hampshire’s Screening and Management Guidelines.

So, How Are We Doing?

Some communities are doing quite well in testing their kids for lead poisoning. In Berlin – one of the state’s eight highest-risk communities – effectively all one-year-olds, and 86 percent of two-year-olds, were tested in 2013. Of those 203 kids tested, 65 (32 percent) had elevated blood lead levels.

More generally, however, New Hampshire’s screening rates are far below the state’s recommendations. Applying its guidelines, the state’s Healthy Homes and Lead Prevention program estimates that 23,554 one- and two-year-olds should have been tested in 2013. But how many actually were?

Only 10,830.

In other words, of all the kids with the highest risk of being exposed to lead, only 39 percent were tested.

Why is this a problem?

Properly screening kids – especially those at high risk – is essential for two reasons. First, it’s critical for the health of kids who have been exposed to lead. If a child is found to be poisoned, steps can and must be taken to educate the child’s parents and to eliminate lead hazards to prevent the child’s blood lead level from increasing further.

Second, by not diagnosing kids who have been poisoned, we’re working off data that understates the scale of the problem. In my prior blog, I mentioned that in 2013 alone, there were more than 1,000 new cases of lead poisoning in New Hampshire. That number derives from New Hampshire’s statewide screening data. Because that data fails to account for nearly 13,000 kids who should have been tested, but were not, it’s fair to assume that the actual number of lead-poisonings in New Hampshire is higher.

What’s the solution?
New Hampshire’s low screening rates likely stem from an inaccurate assumption – that childhood lead poisoning is no longer an issue. Whether it’s parents declining to have their children tested, or members of the medical community attending to other health issues (or a combination of both factors), we must do better. That’s why SB 135, legislation currently pending in the New Hampshire Senate is so important. The bill (see section 6 in particular) would establish a lead screening commission to ensure New Hampshire improves its screening rates and, in the process, protects more kids from the harm of lead poisoning.

In my next blog, I’ll discuss another important element of SB 135 – actions designed to prevent children from becoming poisoned by lead in the first place.

Childhood Lead Poisoning: A Persistent Problem, Solutions Needed

Feb 10, 2015 by  | Bio |  Leave a Comment

 Alex via photopin (license)

We must do a better job in New Hampshire and across New England of protecting our children from the devastating impacts of childhood lead poisoning.
Photo: Alex via photopin (license)

For years, we’ve all known that lead is a dangerous toxin that can result in serious health problems. As a result, we’ve seen lead removed from our gasoline, and we’ve seen it removed from our paint. But unfortunately, the problem of lead poisoning – particularly in children – has not gone away. While lead-based paints were banned in 1978, much of our housing stock in New England – including in New Hampshire, where I live and work – is old enough to contain lead paint. And when that lead paint either deteriorates, or is disturbed, the health of our kids is put at risk.

CLF’s work to protect New England’s children from the devastating impacts of lead poisoning dates back decades, when we played a key role in policies and laws to prevent childhood lead poisoning in Massachusetts. We’re now addressing the problem in New Hampshire, where we’re working closely with a diverse group of stakeholders – public health officials, children’s advocates, property owners and lead professionals, to name a few – to put an end to childhood lead poisoning.

In this blog – the first in a series – I briefly describe the nature and extent of childhood lead poisoning, with a focus on New Hampshire. In upcoming blog posts, I’ll drill down on some of the specific challenges we face, and needed solutions.

No safe level; long-term consequences

In 2012, the Centers for Disease Control concluded that there is no safe level of lead exposure for children, and that even low blood lead levels – levels much lower than traditionally considered “elevated” – can lead to IQ deficits, attention-related behaviors, and poor academic achievement. The harm caused by lead can be irreversible, effectively robbing kids of their full potential. Although thankfully rare, high lead exposures, especially among vulnerable populations, can have fatal consequences. Sadly, in the year 2000, New Hampshire experienced the nation’s most recent fatality caused by lead poisoning – the death of a two-year-old Sudanese girl in Manchester, in the year 2000.

A shared risk

Childhood lead poisoning disproportionately affects children in low-income families living in aging, substandard housing. Children with nutritional deficiencies, such as New Americans who have come from challenging circumstances abroad, are even more vulnerable. In New Hampshire, the Department of Health and Human Services has identified – on the basis of housing age, poverty levels, and surveillance data – eight highest-risk communities: Berlin, Claremont, Franklin, Laconia, Manchester, Nashua, Newport, and Rochester.

But the problem extends far beyond these communities. Based on the prevalence of aging housing stock and other factors, 57 percent of all New Hampshire municipalities have been designated as high-risk “universal screening” communities, meaning that all children in those cities and towns should be tested for lead (as I’ll discuss in a future blog, far from 100 percent of children in those communities are actually tested). And, of course, even beyond New Hampshire’s universal screening communities, wherever pre-1978 buildings containing lead-based paint are present, the risk remains.

The high cost of childhood lead poisoning

In 2013 alone, more than 1,000 new cases of lead poisoning were documented in New Hampshire – a number that’s far too high, considering the cumulative impact of more than 1,000 new cases each year, and considering the long-term consequences that can result from lead exposure.

In addition to the potentially life-changing effects of lead poisoning for poisoned children and their families, the larger economic impacts are significant as well. In a July 2014 report, the NH Division of Public Health Services conservatively estimated that the 2013 cohort of New Hampshire 5-year-olds will experience a lifetime earnings loss of $240 million as a result of lead-related IQ loss. It also estimated annual costs associated with special education ($209,000), medical treatment ($178,000), and crime linked to exposure to lead ($8.9 million). As the report states: “Reducing lead exposure yields economic benefits by avoiding health care and special education costs and by preventing reductions in intelligence, academic achievement, future productivity, and violent crime behavior.”

There are solutions

As noted above, as a nation we’ve already taken significant steps to reduce lead poisoning. But there’s more to be done. From increasing the number of kids screened for lead poisoning, to policies that prevent poisonings from happening in the first place (a strong recommendation of the Centers for Disease Control), we must do a better job in New Hampshire and elsewhere in the region to protect our children’s health and future. In my next blog, I’ll discuss the challenge of screening more children, to ensure we better identify and protect kids who have been exposed to lead.

This blog is the first in a series about childhood lead poisoning. Read the entire series here.

Clean Water Advocates are Onboard for the Great Bay Estuary

Jan 30, 2015 by  | Bio |  Leave a Comment

Last year, in our ongoing work to engage the public in our efforts to protect the Great Bay estuary, we established a network of local residents who care about water – Clean Water Advocates for Great Bay. Since that time, members of the Clean Water Advocates group have helped ensure the success of an important local vote in Exeter (that approved funding to move the town toward an upgraded sewage treatment plant). They’ve also been adding their voices to promote needed solutions for the health of the estuary.

I’m pleased to say that the Clean Water Advocates group continues to grow. Twenty-five enthusiastic folks turned out in Portsmouth last week to hear recent updates on the numerous sewage treatment plants – including Peirce Island –and stormwater pollution issues in and around Great Bay and the Piscataqua River.

The group was updated on the most significant of the 18 sewage plants in the Great Bay watershed — progress being made, plans for upgrades, and the dilemma of delay with some. With ecosystem loss pronounced and ongoing, achieving higher levels of sewage treatment for the estuary in the near future is absolutely essential.

The Clean Water Advocates were presented with a list of potential projects and initiatives that are intended to keep public attention focused on Great Bay. Those ideas will only prove successful with their help – and with the help of others who care about the future of Great Bay, the Piscataqua River, and all the waters that are part of the estuary.

The conversation was a two-way street, with members of the group providing numerous suggestions that might prove to engage and educate the public. Something for everyone. Contact me if you’d like to get involved!