Though incidences of lead poisoning have declined greatly among children in Baltimore and Maryland in the past two decades, they have not decreased as readily among youngsters who live in homes not covered by the state's lead paint law.
More than half the Maryland youngsters found last year with elevated levels of lead in their blood lived in owner-occupied homes or rental units built since 1950, according to a new report by the state Department of the Environment.
Statewide, more than 500 children age 6 and younger were poisoned by lead last year, the report said. Most of those cases, 347, were in Baltimore — long the state's leader in lead poisoning because of the age and dilapidated condition of much of the city's housing.
Government officials and health advocates gathered Friday outside a recently treated East Baltimore rowhouse to celebrate the gains made against the long-standing childhood health scourge, but also to draw attention to new efforts to reach more families living in unregulated homes that likely contain toxic lead-based paint.
"This is 100 percent preventable, and it's really not hard, not difficult to prevent lead poisoning in children," said Maryland first lady Katie Curran O'Malley, who joined local, state and federal officials at the news conference.
Even minute amounts of lead can harm young children's brains and their nervous systems, reducing their IQ and causing learning and behavioral problems that can last a lifetime. Lead-based paint was widely used in homes before safety concerns eventually prompted it to be banned for residential use. Baltimore did so in 1950, with the rest of the state and nation following suit in 1978.
However, the hazardous paint remains on walls, windows and molding of thousands of older homes in the city and state. Usually painted or papered over, it gets ground into dust and flakes when windows or doors are opened and closed, or when paint is disturbed. Though the dust is often invisible, young children can ingest enough to be harmful just by putting unwashed fingers to their mouths.
The percentage of children tested in Maryland found to have lead poisoning has declined nearly 98 percent since the state's lead risk reduction law was passed in 1994. That law required owners of rental units built before 1950 to register with the state and fix them up to reduce risks of young tenants picking up lead paint dust.
Officials credited the law and its more rigorous enforcement over the past decade with the sharp decline in poisoning cases. Dr. Madeleine Shea, the city's deputy health commissioner, noted that the number of poisoned children in Baltimore had dropped 26 percent from 2008 to 2009. Last year, less than 2 percent of city children tested were found to have elevated levels of the toxic metal in their blood — down from one in three nearly two decades ago.
Despite the sharp decline, officials and advocates remain concerned about the risks in owner-occupied homes or in rental dwellings built since 1950, neither of which is covered by the law.
"While we celebrate our achievements, we must remain vigilant," Shea said. "Thousands of Baltimore homes still have lead hazards."
Deirdre Young Randall did something about hers. The 51-year-old state health department employee wanted to be sure her two grandsons — 3-year-old Tyler and 8-month-old Peyton — did not get lead poisoning, as her two grown daughters did when they were younger.
When testing found lead dust in her 74-year-old rowhouse, Randall had the windows replaced and the floor treated through a "healthy homes" initiative of the Coalition to End Childhood Lead Poisoning, a Baltimore-based nonprofit.
Since the late 1990s, crews have abated lead paint in more than 2,200 homes, most of them in the city, said Ruth Ann Norton, the coalition's executive director. The bulk of the costs is covered by about $4 million in grants the group has received, but owners are required to put up some money, based on their income. Randall said she paid nearly $600 for the work, which Norton said cost about $4,000 overall.
"For $4,000 in investment, we have saved another child from costing us $723,000," Norton said, referring to an estimate by researchers of the lifetime earnings lost by each child with lead poisoning.
Despite the declines in lead poisoning, Norton warned that it won't be eliminated this year — a national goal set by the federal government — or for years to come, without greater efforts.
The Environmental Protection Agency issued a regulation in April requiring contractors to take precautions against spreading lead-paint dust when renovating, repairing or painting homes, schools and day care facilities built before 1978.
Any contractor doing such work is supposed to be certified by the EPA as having been trained in lead-safe practices. But the federal agency has held off enforcing the requirement until October after industry groups complained there had not been time to get enough contractors the required training.
About 1,500 contractors are certified in Maryland, with more expected in the coming year, said Abraham Ferdas of the agency's Mid-Atlantic office.
While that should help, Norton said, lead paint will remain in many homes, and could become a hazard if not maintained properly.
Her group pushed unsuccessfully this year for legislation that would have required testing for lead dust each time a rental unit turns over, even if it has been treated to reduce lead risks. She said testing ought to be required for owner-occupied homes as well whenever they change hands.
"People can argue that this is remarkably great progress, and it is," she said. But unless more is done, "We will always struggle with having [poisoning] cases every year."