Policymakers must act on children and lead

It is widely assumed that children’s exposure to the toxic effects of lead in their environment is a thing of the past, at least in the developed world. In fact, as a new US report reveals, it remains a big problem for many American children: one that public policy needs to urgently address, according to this guest blog from Fadumo Abdi and colleagues.

Lead continues to be a problem for many of America’s children, despite marked successes of federal policies in reducing the use of lead in common products – for example, through regulations that phased out lead in gasoline between 1978 and 1996. Exposure comes from a variety of sources, especially from deteriorating lead-based paint in older buildings, lead in pipes that deliver drinking water to homes and schools, or residential proximity to airports used by planes that still run on leaded fuel. Exposure to lead can even come from food, candy, and other consumer products.

The neurological effects of lead exposure can be devastating. In children, it is associated with academic and behavioural struggles in school, as lead makes it more difficult to concentrate in class and increases the likelihood of diagnosis with learning disabilities. These deficits become risk factors for future negative outcomes – including delinquency, criminal behavior, substance use, and teen pregnancy – as exposed children enter adolescence and young adulthood.

Continued exposure

Some of these negative effects may be offset by high-quality programs provided in early and middle childhood, but the preferred solution by far is to prevent initial exposure to lead. But, while children’s blood lead levels declined dramatically following federal efforts from the 1970s onward, many children continue to be exposed to lead, particularly those from low-income and minority populations.

A new report from the Robert Wood Johnson Foundation and the Health Impact Project at the Pew Charitable Trusts–inspired by Flint and other impacted communities–represents a comprehensive, up-to-date analysis of the sources of lead exposure for children and how that exposure can be prevented. Child Trends and its partners, the Urban Institute and Altarum Institute, were part of the report’s quantitative analysis team, assessing the effects, costs, and benefits of various interventions to prevent lead exposure and support children who have been exposed.

The report provides federal, state, and local policymakers with evidence-based recommendations for dealing with lead hazards to prevent exposure among children. Recommendations with the potential to impact the most children include: reducing lead in drinking water in homes built before 1986, and in other places that children frequent, including child care settings and schools; removing lead paint hazards from housing built before 1960, especially in low-income housing, and in other places where children spend time; and increasing enforcement of the EPA’s renovation, repair, and painting rule to ensure that the appropriate safety measures are taken when work is done in a house with lead paint.

Blood testing

The report also recommends that policymakers respond on behalf of children who have already been exposed to lead by improving blood lead testing among children at high risk of exposure, and finding and remediating the sources of their exposure. It suggests that policy should ensure access to developmental and neuropsychological assessments and appropriate high-quality programs for children with elevated blood lead levels.

Addressing these various lead hazards could lead to millions (if not billions) of dollars in benefits via healthier, more successful future generations of children. And because lead disproportionately affects low-income and minority communities, policy – and decision-makers in these communities should be particularly mindful of the implications of these recommendations.

Unlike many of our country’s toughest public health issues, we know how to solve the lead problem. In fact, we have already successfully eliminated some of the sources of lead. Now it’s time to finish the job, and ensure that no child is put at risk of lead exposure again.

Fadumo M. Abdi, Vanessa Harbin Sacks, and Kristin Anderson Moore

Main Photo: jensmith826
Inset photo: Child Trends