While lead in the tap water in Flint, Michigan, caused national outrage, many older cities, including St. Louis, have battled a more severe threat from lead for decades.
St. Louis Post-Dispatch reports that at least 3,300 kids in St. Louis have toxic levels of lead in their blood, which can lead to decreased intelligence, learning disabilities, stunted growth and other health problems. The problem isn’t in the tap water; it’s in old houses with lead-contaminated paint.
“I hate lead because there’s nothing good about it,” said Dr. Andrew White, professor of pediatrics at Washington University. “Its effects are essentially irreversible and devastating.”
In Flint, pediatricians raised red flags when the percentage of children testing high for lead went from 2 percent to 4 percent after the city switched the source of its tap water, causing lead in pipes to leach into the water.
Now the high blood lead levels in Flint have dropped back to 2 percent of the children tested, or 38 children with high levels, according to the Michigan Department of Health and Human Services.
In St. Louis, 9.2 percent, or 1,123 children tested in 2014, had a lead level above 5 micrograms per deciliter of blood, the federal threshold for intervention. There is no safe level of lead in the body. State records show an additional 2,189 children in the city have lead levels between 3 and 5, which can cause developmental delays and a permanent drop in IQ.
In several neighborhoods, more than 20 percent of kids have high lead levels, including Gravois Park, Fairground and Kingsway East. Children 6 and younger in St. Louis make up 14 percent of all the kids tested for lead in the state, but 40 percent of those with high levels.
“In some sense, the sensationalism of Flint has overshadowed the larger problem of most older inner cities,” White said. “This is a perfect time to refocus the efforts on St. Louis. Circumstances like Flint, while they are attention-grabbing and newsworthy, shouldn’t detract from the ongoing similar environmental challenges that we have here that may actually be more severe.”
Other cities with old housing stock struggle with the same problem. Nearly 14 percent of young children tested in Cleveland have high lead levels in their blood. In Chicago, the rate is 9.3 percent, and in Detroit, 8 percent. The U.S. and Missouri average is 4 percent. St. Louis County’s rate is 2.6 percent.
Almost 90 percent of the housing stock in St. Louis was built before 1978, when lead paint was banned. Even if homes are repainted, the threat from lead cannot be eliminated. Disturbing walls and windows can dislodge paint chips and dust, which can be ingested or inhaled by children. While lead is dangerous at any age, the developing brains and nervous systems in children are most at risk from the toxic metal.
Caden Anderson, 4, tested at a blood lead level above 20 micrograms last year. The high level triggered visits from a public health nurse for retesting, and his level has since gone down.
Caden’s grandmother, Anquanetta Williams, said her son also had lead poisoning as a child growing up in the city. Their home in north St. Louis is being repainted inside and out through the city’s Lead Safe Work Project. Williams said she is aware of the hazards from lead because of her work in a child care center.
“I think it’s a good program. They’re sure willing to help you out,” Williams said. “I don’t want him to get sick.”
Lead poisoning reached epidemic levels nationwide in the 1970s when gasoline and paint still contained lead. By the late 1990s, there was a big push to clean up the residual lead in houses and soil.
In 2003, St. Louis Mayor Francis Slay vowed to eradicate lead poisoning by 2010 through increased testing and remediation projects. The city hired a consultant from the Coalition to End Childhood Poisoning in Baltimore, and the efforts were successful.
In the 1990s, about one in four St. Louis children had lead poisoning. By 2011, the rate dropped to one in 50. But the improvements have slowed.
In 2012, the U.S. Centers for Disease Control and Prevention lowered the definition for potential lead poisoning from 10 micrograms of lead per deciliter of blood to 5 after scientists showed that children can suffer harm from even low-level concentrations of lead. Suddenly, 10 percent of city children met the definition. The change came at the same time federal money was cut for lead cleanup programs.
In 2004, the city had received $9 million in grants, mostly from the U.S. Department of Housing and Urban Development. An additional $7 million came in 2006 and again in 2008. In 2011, the grant was reduced to $3 million. The city was last awarded a $2.5 million HUD grant in 2014 to last for three years.
Another setback came in 2007 when the Missouri Supreme Court ruled that the city of St. Louis was not entitled to damages from the makers of lead paint. The city had sued Benjamin Moore & Co., Sherwin-Williams and other paint manufacturers to seek money for cleaning up lead paint in old homes.
Several other anti-lead efforts in St. Louis have ended. The St. Louis Lead Prevention Coalition disbanded in 2014. Health and Environmental Justice St. Louis, a nonprofit group that produced public service announcements called “Get the Lead Out,” hasn’t existed since 2003. The Missouri Foundation for Health last awarded a lead removal grant in 2004, which funded the Lead Safe St. Louis campaign through 2007 with $1.4 million.
The Lead Safe St. Louis campaign met its goals of coordinating the health department and building division to test kids and fix up their homes when necessary, according to Maggie Crane, the city’s communications director.
After eliminating one lead-related position in the last five years, the city has 28 full-time employees working on lead projects. The city now diverts some funds from building permit fees toward lead remediation projects, generating $2 million last year.
“The city has seen an 88 percent decrease in kids with elevated lead levels in their blood,” Crane said. “Continuing to reduce lead poisoning in our children continues – the child testing, home testing, and home remediation are still robust activities.”
State law requires annual testing of all children ages 6 and younger in St. Louis, but only about half get tested each year.
Testing is also mandatory in six ZIP codes in St. Louis County with older housing stock, including areas of Ladue, Clayton, Richmond Heights, Maplewood, Brentwood and Kinloch. In Jefferson County, children in Herculaneum are required to be tested because of contamination from a lead smelter.
Day cares are supposed to require confirmation of testing prior to enrollment, but the rule is rarely enforced.
Lead poisoning can be difficult to diagnose, which is why the annual screenings are necessary. When a child has a lead level of 5 micrograms, it’s a signal for further action.
“We’re not saying your child is poisoned or that’s a toxic level, but that is an alert that they’re being exposed somehow and we need to figure that out to prevent a chronic exposure,” said Julie Weber, director of the Missouri Poison Center at Cardinal Glennon Children’s Medical Center. The poison center receives about 60 to 70 calls a year regarding lead exposure.
Perhaps most discouraging for public health advocates was the end of the Heavy Metal Project that tested the homes of pregnant women in St. Louis for lead hazards and fixed them before the babies were born. The project’s results were published in a 2012 issue of the American Journal of Obstetrics and Gynecology, which showed success in preventing lead poisoning in infants.
“We did show that if you can identify moms who live in houses with lead hazards, you can sweep the house clean before the baby gets home and remove lead hazards and create a safe environment,” said Dr. Gilad Gross, one of the study’s authors and now a professor of obstetrics and gynecology at St. Louis University.
Another of the study’s authors, Dr. Daniel Berg, said without the prenatal prevention programs it is virtually impossible to eliminate lead poisoning.
“The issue is old housing stock and poverty,” said Berg, who now works at Family Care Health Centers.
St. Louis Children’s Hospital treats dozens of children every year for lead poisoning. One child last summer almost died with a blood lead level over 100 after he ate paint chips, Dr. White said. Lead poisoning at levels above 45 micrograms is treated with drugs that bind to the lead to help the body expel it. But the lead can be absorbed by the bones and continue to leach into the body for years.
Roger Lewis, director of the Environmental Health Research Laboratory at St. Louis University, oversees studies on lead exposure and its potential links to crime, violence and risky behaviors.
“I think someday we’ll find out that lead has been a bigger problem than we could ever imagine in terms of socio-behavioral problems along with intellectual deficits we already know about,” he said.
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