In 2009, Marisa Nadeau and her young children moved into an apartment connected to the 200-year-old Hallowell home owned by Nadeau’s parents. The parents were renovating the rest of the old Federal house, but were meticulous about the work so Nadeau’s children wouldn’t be exposed to toxic dust from the centuries of lead paint on the walls.
“They cleaned up really good,” said Nadeau, even using a special lead-blocking paint over the old paint.
“But even still, any little sanding you do, it tracked right in, on peoples’ shoes, tools, whatever was brought through” the building, exposing her two boys to lead dust. They were diagnosed with lead poisoning after testing by a pediatrician who recognized that living in such an old house posed a special risk to the kids.
“It was stressful, that’s for sure, trying to get answers,” she recalled. “Do we need to do something with the boys, do they need to go to the hospital?”
They didn’t need to go to the hospital, but the apartment needed cleaning by specialists to remove the lead. The cleaners had to wear head-to-toe protective gear, which made Nadeau worry that much more.
“Seeing them with all that stuff — we’re exposing our kids to this without anything on,” she said.
After the cleanup, her children’s lead levels went down. Knowing her two boys would no longer be exposed to lead, she thought, “Okay, now that it’s taken care of we were kind of like, okay, now we’re fine.”
Then she gave birth to her third child, another boy. And that child, too, ended up with elevated levels of lead in his blood.
“I was like, ‘Oh great, do we have to go through this all over again?’” said Nadeau. “Luckily at that time, we were moving so when we checked this (new) house and it came back negative, it was kind of relieving.”
She had her youngest child’s lead levels checked again. Those levels are “fine,” Nadeau said.
But the earlier lead poisonings shadow the family. While lead levels can be brought back to normal in children who have been poisoned, doctors say that the toxic legacy of lead remains.
“Lead is highly toxic, especially to young children. It can harm a child’s brain, kidneys, bone marrow, and other body systems,” according to the national Centers for Disease Control. Lead poisoning afflicts children in many destructive ways: reduced intelligence, hyperactivity, speech delays, reading problems and aggressive behavior.
Nadeau’s youngest son has attention deficit hyperactivity disorder, or ADHD.
“It could very well have been a result” of lead poisoning, said Nadeau. “Our oldest, James, has autism. Whether that’s related to that or not, I don’t know.”
The Nadeau family’s experience is far from unique.
From 2003 through 2013, 1,512 Maine children, from newborns to 5 year olds, were diagnosed with lead poisoning. Starting this year, the number of lead-poisoned children will rise by hundreds more cases annually, as the state lowers the blood lead level that triggers a diagnosis.
What’s being done to solve the problem?
For years, the state’s main approach to battling lead poisoning has been what some consider unethical — find poisoned children and then clean up the source of their poisoning.
Like many other states with limited funding for lead poisoning eradication, the state has mounted a public health program to educate the public and test and diagnose the children most likely to suffer from lead poisoning. That program, run by a committed group of scientists and public health specialists within the Maine Center for Disease Control, or CDC, is funded by a 25-cent fee on the sale of every gallon of paint, with additional funding from the federal government and state general fund.
Once they obtain a diagnosis, if the child’s lead level is above 15 micrograms per deciliter, public health officials inspect the home. If it is contaminated, they try to get the family out of the home. Then, the state works with property owners — usually landlords — to fix the problem, which can sometimes end up a bitterly contested and drawn-out process. Limited funding has meant that the state’s efforts have focused on identifying children after they have been poisoned — living evidence of a housing unit with deteriorated lead paint that needs fixing.
The CDC has conducted a determined campaign to identify lead-poisoned children and get their homes cleaned up, but it’s increasingly clear to staff there that they can’t eradicate lead poisoning — as the state promised to do by 2010 — on their own.
“Since we still have hundreds of newly identified children each year with blood lead levels above the new [federal] CDC reference level, as a society, we are clearly not doing enough,” said Dr. Andrew Smith, the toxicologist who oversees the state’s childhood lead poisoning prevention program.
“We’ve been doing our thing for a while and it would be nice to see more happening with code enforcement and a joint collaborative effort to get more being done before a child is exposed to lead,” Smith said.
Once the CDC identifies a home that is contaminated with lead paint, there isn’t necessarily enough money to pay for cleaning it up. The money used to de-lead housing in Maine comes primarily from the federal government, which gave Maine $22.4 million between 1998 and 2014. That money cleaned up only 1900 units. The state estimates that there are 276,574 units in the state that are contaminated with lead and could potentially poison children.
Smith said the progress made so far is nevertheless significant, despite not achieving the goal of eradicating childhood lead poisoning by 2010.
“In 1997, we identified more than 400 children with blood lead levels of 10 (micrograms of lead per deciliter of blood) or higher. For 2014, we identified just under 80,” he said.
Three facts temper that good news:
• Not all Maine children are screened for lead poisoning, so there are children with lead poisoning that the state has not identified. According to state figures, around 80 per cent of Maine children in the urban areas, where there’s a high risk for lead poisoning, are screened for lead by age three. But 60 percent of Maine’s childhood lead poisoning takes place in rural areas, where the screening percentages are as low as the mid-40s.
• The state has been using 15 micrograms of lead per deciliter of blood as the level at which a child is designated “lead poisoned,” although in some cases a level of 10-14 micrograms will also be considered poisoned. The federal Centers for Disease Control says that level should be 5, but there is no safe level of lead in a child’s blood. That means the number of children who are poisoned by lead is greater than the state has recognized up until now.
• Until recently, the state conducted lead inspections in rental units where lead-poisoned children lived and, if lead was found, ordered cleanup or abatement of the lead hazard typically when children had lead levels of 15 or above. This year, the legislature lowered the level at which a state intervention will occur, from 15 micrograms to five. But the hundreds of newly diagnosed cases will still run into an old problem: “Bringing the level down to five,” said Smith, “will result in many more dwelling units under orders to remove environmental lead hazards. This in turn will quickly exhaust” the government funding.
And despite an increase in funding by the legislature to the Maine CDC for staff to handle the extra cases, that money runs out in two years.
This isn’t a new problem for Maine. In 2009, a report commissioned by legislators warned that there wasn’t enough money to solve the childhood lead poisoning problem.
“We confront a daunting challenge of a legacy of decades of using paint containing high amounts of lead,” wrote the report’s authors.
The report said that the “greatest impediment” to cleaning up Maine’s housing units that are contaminated with lead paint was the lack of money. That meant a relatively minor number of units per year would get cleaned up.
“Current resources will allow Maine to continue to make roughly 100 additional dwelling units lead-safe each year,” the report stated.
The legislature did nothing in response to the report’s recommendations to increase funding for, or expand, lead-poisoning prevention efforts.
Cost of special education
“The problem with lead is that no one’s aware of it until it hits home,” said Kevin Leonard, who does lead paint testing and abatement for the social service agency Community Concepts in Lewiston.
“Then it becomes scary,” said Leonard’s colleague, Sandy Albert. “It’s poison, it is, it’s hard to say that word. But it is a poisonous thing that’s in the environment.”
The effects of lead poisoning on Maine’s children can be counted in dollars. University of Maine Professor Mary E. Davis’ study on the economic effects of lead poisoning on children born in 2008 concluded that as a group, they would earn “nearly $240 million less (in 2008 dollars) throughout their lifetime as a result of the cognitive and neurological deficits related to lead.”
Special education costs for lead-poisoned children in Maine have not been analyzed, but one frequently cited national study pegs the annual amount to provide special education to each lead-poisoned child at $16,800.
It’s those kinds of numbers that have convinced Glenn Cummings, a former speaker of the Maine House of Representatives and now head of the University of Southern Maine, that the state has its priorities wrong. Cummings’ young son was diagnosed with lead poisoning in 1998.
“We’re going to pay for it one way or another,” he said. “The absence of some kind of comprehensive leadership to go after this does not exempt us from paying the price.”
Years after the date at which there were to be no more lead-poisoned children in Maine, there still are many. And that means hundreds of children per year are condemned to a lifetime of less — less intelligence, less education, less earning power.
It boils down to a lack of money, said Dr. Mills, the state’s former public health director.
“We’ve known for years that we needed a lot more funding,” said Mills.
And the lack of financial commitment to solve the problem means children have been damaged.
Ruth Ann Norton is the president and CEO of Green and Healthy Homes, the country’s largest anti-lead advocacy group, which has just opened an office in Lewiston.
She said, “With very little ingestion (of lead) you change the pathway for where a child will go and you move that path a little bit more toward school dropout, reading disabilities, lower IQ, the juvenile justice system — and away from opportunity, health and productivity.”
The research and writing of this story was supported by a grant from the Emanuel and Pauline A. Lerner Foundation. This is part two of a four-part series.