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5.19.2001
State to intervene in more
cases of lead poisoning
BY PETER
B. LORD
Journal Environment Writer
PROVIDENCE -- The state Department of Health announced
yesterday it will significantly expand its lead-poisoning intervention
program -- setting some of the toughest standards in the region and helping
more poisoned children in the process.
The new standards, which will mandate inspections of more housing units,
will allow the Health Department to intervene on behalf of an estimated
50 to 100 additional children each year, according to Al Cabral, chief
of the Health Department's lead-inspection program. Cabral concedes that
it's a rough estimate based on figures from last year and on variables
that can affect such relatively low blood-lead levels.
The department will provide the children's families with referrals for
treatment, monitor their health and pay contractors to inspect their apartments
or homes.
Since many lead-poisoning victims are the urban poor living in rental
housing, the financial impact of the inspections will be felt mainly by
landlords. It can cost $10,000 to eliminate lead-paint hazards in a house.
The intervention efforts aren't cheap. The Health Department pays private
contractors $675 per inspection, Cabral said. Some of that money is reimbursed
by Medicaid.
The department now intervenes when a child's blood-lead level is found
to be at 20 micrograms of lead per deciliter of blood -- 20 ug/dl -- or
above, which is considered to be significantly poisoned. Under the new
standards, which will take effect July 1, the "action level" will be lowered
to a level of 15 ug/dl or above. The department will act if a child maintains
that level during two tests conducted 90 days apart.
Health officials can only estimate how many additional children will benefit
from the increased intervention.
The new limits put Rhode Island ahead of its neighbors. Connecticut intervenes
for levels of 20 ug/dl and above. Massachusetts acts when blood-lead levels
are 25 ug/dl and above.
The department also plans to make available its list of homes where lead
inspections have taken place, and it recently expanded its efforts to
educate families living in housing where a child has been found to be
poisoned.
Health Department spokesman Robert J. Marshall described the expanded
services in a letter to the Childhood Lead Action Project, which was received
yesterday. The advocacy group held a demonstration at the Health Department
on Wednesday, demanding more efforts to reduce lead poisonings of children.
Marshall had met with the demonstrators and later with Health Department
Director Patricia Nolan and other top department officials to talk about
the complaints.
"Some of the stuff was already in the pipeline, so our people had been
listening to the group already," Marshall said. "Some of it was timing,
some was just a different way of communicating. Everyone's awareness was
heightened by" The Journal's six-part series on lead this week.
Elizabeth Colon, one of the organization's leaders, called the new health
initiatives a step in the right direction.
"At least having a response is a big change -- this is the first time
they have written back to us," Colon said. "I think the department is
finally beginning to take us seriously. It knows that we're not going
to back down, and we're going to keep pushing for this. Hopefully, more
positive things will happen."
Last year in Rhode Island, 32,313 children under age 6 were tested for
lead poisoning. Of those children, 2,804 had blood-lead levels of 10 ug/dl
or above, which prompted the Health Department to send prevention and
treatment information to their families.
But 455 of those children had levels of 20 ug/dl or above. Those cases
prompted immediate intervention by the Health Department.
The Health Department last changed the standard for inspections in 1998,
when it reduced the intervention threshold from 25 ug/dl to 20 ug/dl.
Health officials have resisted lowering the intervention level because
they said they haven't had the money to pay for more inspections. The
department applied for financing from the U.S. Centers for Disease Control
and Prevention to expand the program later this year.
Although that grant has not been approved, Cabral said he pushed -- and
succeeded -- in lowering the limits at the meeting on Wednesday. The department
can find the money somehow, he said.
Colon said she was happy the action level is being lowered, but she called
it "ridiculous" to require two tests for children who have blood-lead
levels at 15 ug/dl and above before the department acts.
"In that time, a child could jump from fifteen to fifty," she said.
But Marshall said the second test at that low level is recommended by
CDC guidelines.
Marshall told Colon that the department intends to put a list of closed
inspection cases on its Web site, but some "technical barriers" will delay
that for some time.
In the meantime, the department plans to create a link on its Web site,
sending people to a searchable database of closed inspection cases that
The Journal is carrying on its Web site http://projo.com/extra/lead/
as part of its series on lead poisoning.
Marshall said health officials were concerned when one of the parents
complained that she got a runaround when she called the department for
help. He concluded that one of the problems may have been that the department's
hot line holds only 15 telephone messages. He said he hoped to expand
the capacity of the department's answering machines.
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