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.

 

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!

Getting Out on Great Bay Estuary

May 13, 2014 by  | Bio |  Leave a Comment

key-west-skiff12578Our Great Bay-Piscataqua Waterkeeper program has made terrific progress in protecting our amazing Great Bay estuary, and we’re making real progress toward our immediate goal of acquiring and launching a Waterkeeper vessel!

If you haven’t already heard, we’re in the midst of a campaign to raise $25,000 by June 1, to enable us to purchase, outfit and operate a boat. A watercraft will be an essential tool for protecting Great Bay, the Piscataqua River, and all the waters comprising our estuary. It will allow me, as Waterkeeper, to be the “eyes and ears” of the estuary, and to identify and help end illegal pollution.

A boat also will be a powerful platform for educating the public and decision-makers alike about the incredible value of the estuary, and the solutions to safeguarding its future.

We’ve identified the perfect boat to serve these needs – a 19-foot, center-console Key West with a clean-running four-stroke engine. Our friends at Port Harbor Marine in Kittery, Maine, are holding the boat for us until June 1. A craft is critical to advancing our mission to protect Great Bay, the Piscataqua River, and the estuary as a whole.

So I hope you’ll consider helping us, today, by making a contribution to our Great Bay Boat campaign. (When you do, please suggest a name for the boat!)

Thanks for helping us work for clean water!

 

 

Great News for Great Bay

Mar 18, 2014 by  | Bio |  Leave a Comment

Great news from Exeter, New Hampshire: On Tuesday, the 11, 78% of registered voters said “Yes” to funding the first steps in building a new sewage treatment plant – one that will replace the current, outdated plant that discharges into the Squamscott River, which flows into Great Bay. The $5 million bond issue for planning and engineering required 60% approval. Clearly, Exeter voters see the need to move forward with a new sewage treatment plant that will help bring relief to the nitrogen-plagued Great Bay estuary. This vote is huge for clean water.

Exeter, like neighboring Newmarket (whose residents voted overwhelmingly to fund a major upgrade to its sewage treatment plant), has a final permit from the EPA that regulates nitrogen discharges from the plant and requires that the town develop and institute a plan to reduce nitrogen pollution from stormwater. Excessive nutrients in the estuary have a direct and indirect negative effect on a very complex ecosystem. Nitrogen coming from sewage treatment plants and polluted stormwater can be reduced if we have the will to do so. The folks in Exeter obviously have the will to do just that.

A recently formed group of clean water advocates undertook some initiatives prior to the vote to help gain a positive outcome. I applaud their willingness to step up to the plate, do a little work, and help achieve a great result for the Squamscott River and Great Bay. Committed citizen activists always make a difference.

Not only did Exeter residents approve funding towards a new sewage treatment plant, they also voted to remove a centuries-old head-of-tide dam on the Squamscott/Exeter River. The Great Dam has contributed to several environmental concerns: it blocks anadromous fish passage, lowers dissolved oxygen content in the water behind the dam, and worsens upriver flooding. Removal of this dam will create only the second free-flowing river into Great Bay. You can read Exeter resident David O’Hearn’s blog post on this vote titled “Great Dam removal x 2”. David was recently featured in CLF’s “Faces of Great Bay”.

Faces of Great Bay: David O’Hearn

Feb 27, 2014 by  | Bio |  Leave a Comment

David-O'Hearn

David O’Hearn is a Bayman in New Hampshire’s Great Bay.

David O’Hearn is not easy to reach. If you want to sit down and talk, you need to catch him at work or during a blizzard. Otherwise, he is out doing something on Great Bay. That something does not include talking on a cell phone. David loves to clam, do a little trapping, harvest oysters, fish for stripers, catch a few smelts, and trap some lobsters. He always did and always will. He is a Bayman.

David grew up on the Squamscott River and still lives near it. The river and the bay attracted him like a magnet. He was enamored with the mysteries of the river and where it went. Great Bay was a whole new universe begging to be explored. He did things in boats as a youth that would appall any parent if they found out. Older, experienced baymen schooled him in fishing, shellfishing, and lobstering. He is married to the Bay, and has never contemplated divorce.

So what’s changed over the decades? In the early 1970s, the exposed mudflats along the Squamscott would stink from pollution that probably came from the already defunct textile mills in Exeter. The smell now is what you would expect. Wildlife along the river is much more prolific.

Water temperature and unusually large rain events, affecting salinity, really alter conditions in the Bay. “I did not catch even one lobster for an entire month after the Mother’s Day flood in 2006,” David says. “Nor did I trap any in Great Bay proper during the prolonged heat waves of the last two summers.” David sees green crabs when the water is warm, red crabs when the temperature is lower, and now even blue crabs at the mouth of the Bellamy. The invasive green crabs have been around for quite a while, but the blue crabs are new and may be a response to warming waters. “The striper fishing has been up and down and there used to be a lot more, and bigger, fish,” says David. He seldom sees any filter feeding pogies (menhaden) anymore.

Tides and rain affect water clarity. More sediment is in suspension. The extent of eelgrass has diminished. The last couple of years, David has seen a very significant increase in algae blooms and nuisance seaweeds. Pulling his lobster buoys becomes a real chore because the rope is fouled by a mass of plant growth like never before. “I am forced to pull a knife to cut the growth from the line while trying to operate my boat at the same time,” he says.

Though David is prone to voting “no” on most bond issues in Exeter, he is supporting the one this March to approve funds that will allow the town to move ahead with their new sewage treatment plant. “That new plant will reduce nitrogen that is currently wreaking havoc with Great Bay,” he says. David also supports the removal of the Great Dam in Exeter in order to maximize fish passage.

There is no question that David loves Great Bay. My sense is that he will pass on to others what he has learned from those who came before. David, and folks like him, is one reason that Great Bay needs and deserves whatever work is necessary to protect and improve it. Learn more about David and his love of Great Bay.

Our Faces of Great Bay series profiles people who live near and love the Great Bay Estuary, and who are working to protect it for today and future generations.

They’re Still Number 1: PSNH’s Merrimack Station Leads the State Again in Toxic Chemical Releases

Feb 20, 2014 by  | Bio |  1 Comment »

It’s clear to anyone paying attention to air pollution trends in New Hampshire that PSNH’s coal plants are a huge health and environmental liability for the state. And according to EPA data released last week, PSNH’s coal fleet continues to lead the state in toxic chemical releases: Merrimack Station in Bow remained New Hampshire’s number one toxic polluter in 2012, and Schiller Station in Portsmouth was number four.

Toxic-Chemical-Releases

“Merrimack-Station” by PSNH on flickr is licensed under CC by-nd 2.0

That these largely coal-burning facilities (one of Schiller Station’s units burns wood) are still the biggest releasers of toxic chemicals in the state is even more sobering given that the capacity factors (the ratio of utilization of a unit compared to its potential) for PSNH’s coal units hit their lowest levels ever in 2012:

I’ll say it again: a coal plant running at less than 1/3 capacity (the Merrimack units together ran at 32.23% in 2012) still releases more toxic chemicals than any other facility of any type in New Hampshire. 2012 was also the first full year that the $420 million scrubber was operational at the plant.

While Schiller Station dropped from second place in 2011 to fourth place in 2012 in toxic chemical releases, it’s a good bet that Schiller will be back in the number 2 spot when the 2013 numbers are released next year. Why? Though they’re still very low, the capacity factor for Schiller’s coal units nearly doubled between 2012 and 2013 (from 12.54% to 22.95%).

The bottom line: Even with a $420 million pollution control project online and rock-bottom capacity factors, PSNH’s coal-burning units are the state’s worst and fourth-worst toxic chemical releasers. The Public Utilities Commission and New Hampshire Legislature should keep this in mind as they discuss the future of PSNH’s electricity generating assets.

Toxic-Chemical-Releases

Source: ISO-NE and EPA Air Markets data

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