PUBLIC-HEALTH advocates and landlords differ heatedly on most issues concerning lead poisoning, but they agree on one thing: The current prevention system doesn't work.
Government efforts to protect tenants from lead-based household paint have been "an unmitigated absolute failure," says Ira C. Cooke, lobbyist for the Property Owners Association of Baltimore, an organization of the city's larger landlords.
Health advocates don't go that far, but they do say that local and state governments lack the money and political will to deal with the problem.
"I don't think the city or the state, or anybody, is really committed to preventing lead poisoning," says Ellen K. Silbergeld, a University of Maryland toxicologist who chairs the state advisory council on lead poisoning.
James Keck, former lead-poisoning-prevention coordinator for the city, agrees.
"I go around the country and people say, 'Yeah, I understand Baltimore is way out in front on this issue,' " says Keck, who is now a consultant on lead-abatement training. "I say, 'If we're way out in front, I pity the rest of the country.' "
The Evening Sun has found that the problem of lead poisoning produces a vicious circle of "Catch 22s" that government cannot seem to break. It goes like this:
Children are poisoned, their homes are deemed unsafe, their families often evicted. Then, because no one wants to foot the bill for abatement or find new homes for the tenants, the cycle begins again -- sometimes in the same house.
"We've got to stop using children as lead detectors," says Kim Turner, coordinator of Parents Against Lead, a group of Baltimore families whose children have been poisoned.
Health advocates say government officials are as ineffective at responding to lead poisoning as they are at preventing its occurrence in the first place.
Consider the following:
* Only a fraction of those Maryland children most at risk of lead poisoning are tested, despite medical experts' recommendations that all young children be screened.
* Local and state agencies check a home for lead paint only after a poisoning, meaning that a child may already have suffered permanent brain damage.
* In Baltimore, home of most of the state's lead-poisoning cases, fewer than half of the homes where poisonings occurred in the past four years have had their lead paint removed or covered over, as required by city regulations.
Instead, many lead-laced homes have been boarded up and abandoned, worsening the city's severe shortage of low-income housing. Others are occupied months or years later, still exposing young children to poisonous paint dust.
PROBLEMS HAVE PERSISTED
These problems are not new. Many were outlined in a state health department report to the General Assembly in 1984 that urged a campaign to virtually wipe out lead poisoning in Maryland by 1995. After seven years, the goal seems as elusive as ever, however. Some of the report's recommendations have been followed, but the more sweeping proposals -- such as mandatory screening of all young children -- have not.
"I think our hope that we might be able to eliminate this as a problem in the near future is . . . going to be very difficult to realize," says Dr. Katherine Farrell, who helped write the 1984 report and now works in Anne Arundel County's health department.
In recent years, city and state efforts to combat lead poisoning have been handicapped by a lack of funds and by the reluctance of government officials to act boldly. But it was not always so; Baltimore's health commissioner banned the use of lead paint in homes in 1951, 26 years before the federal Consumer Products Safety Commission enacted a similar ban nationwide.
In 1986, the city adopted tough regulations designed to make de-leading less dangerous and more effective, after Johns Hopkins medical researchers demonstrated that many Baltimore children were being re-poisoned by inadequate removal of lead paint using traditional methods. The state followed suit in 1987 with similar rules governing lead abatement projects elsewhere in Maryland.
But Baltimore landlords complain now that the regulations actually have compounded the problem, by making abatement so expensive that few owners attempt it. The costs of abatement have soared, from about $800 per home a decade ago to more than $10,000 for many dwellings today.
LANDLORDS SEEK RELIEF
As health officials push for an all-out fight against lead poisoning, the city's landlords have launched a counterattack, seeking relief at City Hall and in Annapolis from "draconian" abatement requirements and from hundreds of lawsuits filed by tenants with poisoned children. Claiming they too are victims of lead poisoning, landlords are staging what one called a "silent riot," selling off their houses or evicting tenants and letting the homes sit vacant rather than comply with orders to get the lead out.
"For the first time ever, the responsible landlords are boarding up their houses," contends Cooke, the lobbyist. "They're not willing to take the lead out because they can't afford to do it under these regulations."
Health advocates question Cooke's claim, but the landlords' complaints have had an effect. Mayor Kurt L. Schmoke rejected recommendations of his own task force for new state laws combating lead poisoning and ordered the panel to focus instead on finding cheaper ways of de-leading homes. And Gov. William Donald Schaefer this year short-circuited lead-related legislation in the General Assembly -- including three bills sought by landlords and one that would have required stepped-up lead screening in Maryland -- by promising to undertake another study of the problem.
"The problem doesn't need to be studied anymore," says Saul Kerpelman, a lawyer who has filed hundreds of lawsuits on behalf of lead-poisoned children. "The problem needs to be solved."
Fewer than 10 percent of Maryland's young children who are at risk of lead poisoning are being screened. In Baltimore, where many children visit public health clinics for their medical care, about 24 percent of the at-risk youngsters are tested. A bill was introduced during this year's General Assembly that would have required screening of all Maryland children, but state officials opposed it, saying it would cost $6 million a year.
SCREENING IS FAVORED
This year, the U.S. Centers for Disease Control plans to recommend that all children under six be screened for lead poisoning, according to a draft document provided to The Evening Sun. The federal health agency also intends to lower the poisoning threshold by 60 percent.
The CDC move could cause a 10-fold increase in the number of children considered lead poisoned. Such an increase would overwhelm state and local agencies already struggling to deal with seriously poisoned children. For example, the workload could quadruple at the state health department laboratory that now analyzes the bulk of lead-screening tests done on Maryland children. The lab, which now handles 59,000 lead tests and nearly 13,000 paint and dust samples yearly, simply could not handle such an increase, says the lab's director, J. Mehsen Joseph.
The increased workload also could swamp the small force of local and state inspectors who check homes for lead hazards now. The City Health Department has six inspectors who checked out 300 homes last year, while the Maryland Department of the Environment has only three to cover the rest of the state.
Once a lead-poisoning case is identified through blood tests, local health departments are supposed to see that the child gets prompt medical attention. They also must inspect the sick child's home or call in the state, since most counties lack the X-ray devices needed to detect lead paint. But some poisoning cases fall through the cracks. Tenants move, or are not home when the inspector comes.
SOME INSPECTIONS FAIL
And some inspections are botched. It took 10 months and two inspections for the city to order the lead out of Thomasena Hester's rented home at 2139 W. Lexington St. after her grandson was found last May to be poisoned. The first inspector visited last spring and told her the house was "full of lead," Hester says. But a lead-paint violation notice was not issued until March of this year, after a second check of her house last fall by a different inspector.
Hester, meanwhile, says she has been ordered by her landlord, Nock Realty, to get out by June 1.
Jerome Wise, an employee of Nock Realty, acknowledged serving Hester with an eviction notice, but he would not explain why. "If your child were living in a house with lead, and he was poisoned, would you want him to continue living there?" he asked.
Hester says she has been looking, but has been unable so far to find a suitable home for her family. "Some places are worse than what I've got," she says. "Frankly, I don't know where to go."
When lead paint is found in a home, the City Health Department cites the owner and orders the paint removed or covered over within 30 days -- a deadline that rarely is met.
DEADLINES NOT MET
In fact, most homes where children are poisoned are not de-leaded months or even years after the deadline. Less than half, or 429, of the 1,046 lead-abatement orders issued by the City Health Department since July 1987 have been obeyed, according to department records obtained by The Evening Sun. One-third of the houses cited in 1987 and 1988 still have not been de-leaded.
Getting property owners to comply with abatement orders is one of his biggest problems, says Michael Wojtowycz, director of the health department's lead-poisoning prevention program.
Many homes cited for lead paint are vacated, boarded up and abandoned, officials say, but no one knows for sure just how many. Landlords contend that 1,000 homes in Baltimore have been abandoned in the past year alone because of the city's lead-abatement regulations. But city housing spokesman William Toohey says the number of vacant properties has grown only about half that much in the past five years, and housing officials do not know how many were abandoned because of lead-abatement orders.
In about 10 percent of lead-poisoning cases, the home is sold after being cited for lead paint, forcing city officials to start the enforcement process all over again for that property.
In such cases, city health inspectors must act like detectives, tracking property owners through a maze of management firms, mail drops and holding companies. Letters come back unopened, and phone calls go unanswered. Sometimes, only the threat of court action gets an owner to call. Meanwhile, unabated homes sometimes are re-rented to new, unsuspecting tenants.
Despite such hard cases, city officials rarely prosecute property owners for failure to remove lead. "It's like a policeman who can go around handing out warnings, but no tickets," complains Turner, of Parents Against Lead.
Enforcement is particularly difficult with homeowners, who figure 20 to 25 percent of city poisoning cases, Wojtowycz says. The city is reluctant to take homeowners to court, since many cannot bear the costs of de-leading their property.
RED TAPE A PROBLEM
Even when landlords or homeowners do cooperate, red tape brings agonizing delays. The state Department of Housing and Community Development has a $650,000-a-year fund -- down from $1 million two years ago -- to help abate lead in Maryland homes. But obtaining money can take six months to a year from the time a property owner applies until work begins.
The number of homes rendered safe through the state program is relatively small. In the past five years, the housing agency has issued 113 loans or grants totaling $2.2 million to remove or cover lead paint in just 192 homes statewide. Yet, at least 500 children are seriously poisoned every year in Maryland.
When abatements finally do occur, the tenants must move out for their own protection from the lead dust that might be raised. Such relocations often last a month or more. But there is no pool of lead-safe housing, and landlords are not required to help tenants relocate.
As a result, some tenants have been forced to stay for months in crowded quarters with family or friends. One West Baltimore mother, Wanda Johnson, has been living since last July with her eight children in a two-bedroom unit at an East Baltimore motel operated by Volunteers of America as a homeless shelter and halfway house.
The family moved from its rented home on Hollins Street in west Baltimore because the landlord had promised a housing court judge he would abate. The landlord, James Lefko, who lives in West Virginia, has since decided to turn the home over to Johnson rather than de-lead it, according to Clinton Bamberger, a University of Maryland law professor whose students represented her.
As difficult as it is to get action in Baltimore, state environmental officials say it can be even harder elsewhere in Maryland. Some suburban and rural county health departments do not regard lead-poisoning prevention as a high priority, so when cases crop up, response is slow, says Patricia McLaine, lead-poisoning prevention coordinator for the state Department of the Environment.
In jurisdictions outside the city, state and local officials lack the clear legal power to force property owners to clean up lead paint. Without that authority, "we're really hamstrung," says McLaine.
As it is now, state regulations direct how to remove or cover lead paint in homes, but do not specify any deadline for completing the work. Another hole in the regulations: Lead-testing and abatement companies are not certified or licensed. About 100 home-improvement and painting contractors have had workers trained in state-approved courses, but State officials say the quality of work done varies, and lead-abatement regulations often are violated.
The state paid $500,000 in 1987, for instance, to help de-lead a Prince George's County apartment complex, only to find out later that the earlier surveys were erroneous and the apartments never had lead paint to begin with. Lead testing procedures have since been tightened, state officials say.
Overshadowing all the other problems, however, is the pricetag for prevention and the dispute over who should pay it.
"The real answer here is money," state Sen. John Pica Jr., D-City, said this year during a legislative hearing on two landlord-relief bills he sponsored. "But no one wants to give up the money. Instead, we continue to kick the problem back and forth, and these children are suffering."
NEXT: The outlook for solutions.