Because of an editing error, an article in Sunday's Carroll County edition incorrectly identified a family member who received outpatient treatment for childhood lead poisoning through Baltimore's Kennedy Krieger Institute. David Williams, 4, Taneytown, completed a course of treatment as an outpatient.
* The Sun regrets the error.
In November 1994, Jane and David Williams bought a 26-room Taneytown mansion with dreams of restoring the historic property and raising their children there. But they have put the project on hold since learning last summer that lead paint dust has poisoned their two young sons.
The Williamses say that dealing with the devastating news of their sons' illnesses has been made more difficult by overzealous doctors who forced them to move from their contaminated home and warned that their children might be turned over to state foster care if they refused.
Doctors from Baltimore's Kennedy Krieger Institute and state environmental officials say they sympathize with the family's plight but that they have a legal obligation to see that the children are in a lead-free environment.
"The house is a toxic-waste site," said Dr. Michael Johnston, medical director at Kennedy Krieger, a national leader in researching and treating childhood lead poisoning.
"The kids may look fine, but their brains can be injured in ways that will affect them for their entire lives," he said.
The couple said the doctors have shown no concern for the financial hardships the family faces as a result of having to move from their home. The Williamses spent a month in a Westminster motel and bought a $22,000 mobile home so that they can live on their property while they work to rid their house of lead. The family is staying with friends until the trailer is ready for occupancy.
"We put our life savings in this house, and now we're told we can't live here," Mrs. Williams said. "Am I supposed to walk away from a $100,000 investment?"
The doctors and the Williamses have different perceptions of the dilemma, but they agree that there are no easy solutions.
Lead in the blood
The couple discovered in August that their sons had been poisoned when 4-year-old David's blood was screened for a Head Start pre-kindergarten program. Tests showed that 3-year-old Jeremiah also had been poisoned. Mr. Williams had toxic levels of lead in his blood, and Mrs. Williams had more than normal.
Early blood tests showed that David had 43 micrograms of lead per 1,000 deciliters of blood, and Jeremiah was tested at 47 micrograms, Mrs. Williams said.
The federal Centers for Disease Control's "level of concern" begins at 10 micrograms of lead per deciliter of blood, and at 20 micrograms state health officials are required to intervene.
The main source of childhood lead poisoning is peeling paint. Exposure to the toxic metal in children under 6 can cause lasting learning disabilities and behavioral problems. Dr. Johnston said children are most vulnerable to brain damage from lead poisoning at age 3, the age of the Williams' younger son.
A medical study released this month found that boys with high levels of lead in their bones were more likely to engage in vandalism, shoplifting and other activities associated with juvenile delinquency.
Although most child lead poisoning cases in the state are in Baltimore, the problem often goes undetected in suburban and rural areas because of less frequent lead screenings. Fifty percent of young children in Baltimore are screened for lead, hTC compared with 7 percent outside the city, state environmental officials said.
Restoration of old homes accounts for many of the rural and suburban cases of lead poisoning. And people are often reluctant to accept the fact that their dream home is an environmental hazard.
"Nobody can believe that their lovely old home is contaminated," said Susan Guyaux, head of the state Department of the Environment's environmental lead division.
The Williams children were first treated at Kennedy Krieger's lead safe house, where they stayed for 28 days in September. After their release, the boys' blood lead levels decreased to the high teens, but a few weeks after returning to their Taneytown home, the levels had risen into the 30s, Mrs. Williams said.
The children's blood levels fluctuated over the next two months, and by the end of December they had returned to dangerously high levels -- 40 to 50 micrograms of lead per deciliter of blood.
A frustrating situation
Jeremiah has since been admitted twice to Kennedy Krieger for additional treatment, and his father has completed a course of treatment as an outpatient.
After treating the children for a second time, doctors at Kennedy Krieger refused to release them to their parents until the family moved to a lead-free environment, informing the Williamses that Carroll County child protective service workers might be asked to intervene if the boys returned to the Taneytown home.
As a result, the Williams family moved in mid-January to Westminster's Comfort Inn, where they stayed for a month.
Mrs. Williams said the doctors went beyond the bounds of their authority by refusing to release the boys into her care unless certain conditions were met.
"It's nice to have everyone telling you what you can and can't do with your children and your property," Mrs. Williams said. "I feel like I'm in Communist Russia instead of the United States."
Dr. Johnston said he understands Mrs. Williams' frustration but that the institute's first concern is the health of the children. He said the Williamses apparently couldn't keep the boys confined to a five-room area of their home from which lead had been removed by a team from Kennedy Krieger.
"If a parent is taking a child back to a toxic site, it's up to us as doctors to prevent that," Dr. Johnston said. "We're trying to save their brains."
In a lead-poisoning case in which the contaminated dwelling is occupied by owners rather than renters, health officials generally try to teach parents about lead's effect on a child's development and the importance of safe lead-removal techniques. In rare cases, health officials may bring in social service workers if a child's continued exposure to lead is considered to constitute negligence.
The Williamses say they have done their best to protect their sons' health, and they fault Kennedy Krieger for not doing more to help them.
"Kennedy Krieger just let us drop through the cracks because we're not a low-income family -- or at least we weren't when this started," said Mrs. Williams. She and her husband operate a business that installs hardwood floors.
Dr. Johnston disagreed, saying Kennedy Krieger paid for a contractor specializing in lead paint abatement and inspection to assess the Williams' home to determine the best method of lead removal. The institute also sent a team to clean the rooms of the house that the family was living in with phosphate soaps and a high-efficiency vacuum cleaner.
In addition, Dr. Johnston said, Kennedy Krieger has offered to contribute $1,200 toward the purchase of the mobile home and $200 toward the Williams' $1,900 motel bill.
Mrs. Williams said the cleaning by Kennedy Krieger's crew was inadequate and that the consultant provided inaccurate information on lead abatement. She also said she wasn't satisfied with the institute's financial assistance to the family.
Dr. Johnston said social workers at Kennedy Krieger worked to find public funding to help the Williamses pay for lead-abatement costs but that their income was too high to qualify for assistance.
"My sense was that our team expended hours and hours on this and tried to make it happen," he said.
The Williamses installed the mobile home on their property last ,, week, after the County Commissioners granted an exception to the county's zoning laws to allow the arrangement for a year. The family can't move in, however, until plumbing and electrical work have been completed and inspected by the county.
A monumental task
The Williamses plan to do most of the lead-abatement work themselves. They estimate that the project could cost more than $100,000.
The size of their home makes it a monumental task and one that state environmental officials warn could be extremely hazardous not done properly.
"With older homes, once you do it wrong, you may never be able to get the lead [levels] down again," Ms. Guyaux said.
Dr. Johnston is optimistic about the children's chances for recovery if further exposure to lead paint is avoided.
"We hope that the treatment, which has pulled a lot of lead out of their bodies, has changed the course somewhat," he said.
"I'm optimistic that they've been promptly and well treated and that they will do well."