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:
- 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.
- Assuming the child is screened (not necessarily a safe assumption), the child is found to have lead in his or her blood.
- 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.
- 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.