BY: TIMNA AXEL AND ENRIQUE PEREZ
Lead, a soft and naturally occurring metal, is one of the best-studied toxic substances known to humans—it is especially harmful to the brain, kidneys, bone marrow, and other body systems of young children. Childhood lead poisoning has been dramatically reduced over the past few decades, as lead has been phased out from gasoline, food and beverage cans, house paint, and other common sources. In 1978, there were about 14.8 million poisoned children in the United States; by the early 1990s, that number had declined to 890,000 children. In Chicago, the rates of elevated blood levels in children have decreased from one in four to fewer than one in one hundred children tested.
Still, the Centers for Disease Control and Prevention in 2015 found close to 1,000 children in Cook County with elevated blood levels. Many more children likely go uncounted because their results fall under the CDC’s “reference level” of five micrograms of lead per deciliter of blood, but the reality is that any lead in the body can be dangerous.
Read on to follow two different paths to lead exposure that have been identified in the city, and how families and children are affected by the poison.
Paint in Homes
In 1978, the federal government banned the consumer use of lead-based paint, but more than 75 percent of houses and apartments in Chicago were built before 1970, according to the Metropolitan Agency for Planning, and the city itself estimates that a third of its housing stock has lead hazards in its paint or soil. Four to five times more children in Chicago are affected by lead poisoning in houses built before 1950 than in other cities, according to civil and environmental engineer Marc Edwards, who presented the information to the Centers for Disease Control and Prevention in 2010.
In most Chicago homes, deteriorating lead-based paint is the main issue as it chips and becomes dust, prominently gathering in areas like windows, porches, doors, and doorframes that are easily accessible to children. Paint dust was likely the culprit when Yasmine McCray was diagnosed with lead poisoning at two-and-a-half years old, says her mother Mary McCray. Yasmine had a blood lead level of eleven micrograms per deciliter, just above the level at which the Chicago Department of Public Health must be notified so that it can investigate possible lead hazards in the home.
Provisions are in place to make sure residents know about lead hazards when they move in: A lead disclosure form, which should be given whenever a residence is leased out or sold, should detail the location of the lead-based paint and the condition of the painted surfaces. Home buyers are also allowed ten days to conduct a paint inspection or risk assessment for lead-based paint hazards before they buy. But those regulations are hard to enforce, and often require buyers and renters to be discerning in a situation where they might not have much choice.
In the McCrays’ case, after Yasmine’s blood results came back, a CPDH inspector was sent to their home in Hyde Park. The inspector found old paint peeling on the walls, which were then scraped and repainted. Even so, the McCray family soon moved to Auburn Gresham. But the damage was already done: when McCray noticed that her daughter’s behavior had become overly hyper, a doctor drew the connection to lead exposure, she says.
Critics say that the city’s lead policies are reactive, not proactive. Inspections only take place if the owner or tenant requests them or if a child has high blood-lead levels and CPDH is alerted, as in the McCrays’ case. And children don’t get tested regularly for lead.
“The only two mandates for getting tested that I know of are: [Medicaid] has a mandate—I’m not sure how strictly it’s followed—and for entering the Chicago Public Schools system you’re supposed to have a blood lead test on file,” says Eric Potash, a lecturer at the University of Chicago’s Harris School of Public Policy. “But I also don’t know how rigorous that testing is. The big caveat with the CPS mandate is that most people don’t enter CPS until they’re five or six [years old] and then it’s way too late.”
The city has limited resources when it comes to lead inspection, says David Jacobs, an adjunct associate professor at the University of Illinois at Chicago School of Public Health.
“The Chicago Department of Public Health has ten [lead] inspectors, which is ridiculously low considering the number of units. It is estimated that there are 5,000 to 10,000 units with lead hazards in Chicago,” he says. A department spokesperson says it conducts between 800 and 1,000 home inspections every year.
Another factor is an ongoing change in public housing. As cities like Chicago have torn down housing projects and moved toward Section 8 vouchers over the past twenty-five years, low-income families have become more at risk. Public housing units were inspected regularly for lead due to federal oversight, but Section 8 housing is not held to the same standards, says Howard Ehrman, a doctor and environmental activist who was a former top official in the Department of Public Health.
With limited city resources, researchers are looking for ways to predict when and where children are at risk for lead poisoning, in order to concentrate efforts on the hardest-hit communities. Potash is working with graduate students to build a predictive model based on data, such as building inspections for lead hazards, locations where children have been poisoned by lead in the last twenty years, rates of renting and homeownership, and whether or not people in a neighborhood have health insurance.
Potash says his model can predict households that likely contain lead hazards and have children younger than one year old. They are now running a pilot outreach program, partnering with the CDPH, landlords, and other agencies (including integrating with electronic medical record systems) to alert at-risk households and provide inspection information and remediation services.
“The CDPH only has resources to help a couple thousand kids each year,” says Potash. “By using the model to target the resources, you dramatically improve the efficiency and effectiveness by something like three times that much. You could potentially help three times as many kids.”
Water in Parks
This October, Chicago Park District officials announced that all of its drinking fountains and sinks had been tested for lead. The results: at least one fixture in forty-four percent of the District’s parks had lead levels that matched or exceeded fifteen parts per billion, the action level set by the Environmental Protection Agency at which water systems are required to step up their corrosion control or replace pipes. Specifically, fourteen of 544 indoor fixtures and 445 of 1,891 outdoor fountains tested above this level and were immediately turned off.
While contaminated fountains were found in parks throughout the city, certain neighborhoods like Auburn Gresham, where every park contained fixtures with elevated lead levels, were especially hard-hit.
This was news to McCray, who moved away from her lead-contaminated Hyde Park home to Auburn Gresham, and whose kids had been playing on the jungle gym at Foster Park. Three of the park’s outdoor fountains had elevated lead levels, testing showed. At Mahalia Jackson Park, about 1.5 miles away, both drinking fountains had elevated levels of lead, with one testing at 361 parts per billion. Two other Auburn Gresham parks, Dawes Park and O’Hallaren Park, also had contaminated fixtures.
Yasmine’s pediatrician didn’t recommend any medical treatment for the lead in her blood, but she has been tested every year since her diagnosis. McCray says her lead level has decreased over time, and she is now ahead of her class at school. Still, she worries about her kids drinking lead-contaminated water at the parks: “What if they get lead from the sprinklers?” she says.
While most studies show that exposure to lead-contaminated water is not likely by itself to elevate blood lead levels in most adults, there is a danger to infants and pregnant women who may be using the water. Pregnant women especially are at “the most sensitive time” for lead poisoning from water, says Helen Binns, a pediatrician who directs the lead evaluation program at Lurie Children’s Hospital of Chicago.
Fountains that the Park District did not shut off may be dangerous even if they didn’t exceed the EPA’s “action level,” Binns says. She and other lead experts agree that the EPA level is meant to be an engineering marker, and that no level of lead is safe inside the human body. “The fifteen parts per billion of lead in water is not a health-based standard. We would prefer that it be two, or something really low,” Binns says.
There is no federal regulation requiring water testing for park facilities. Nevertheless, a few U.S. cities have conducted similar tests of parks and other public facilities, including Portland, OR, and Ithaca, NY, both announced around the same time this summer.
The Park District has not yet identified why so many of its water fixtures have elevated lead levels, and the situation could get worse in the winter when all fixtures are turned off—unused fixtures are more likely to have contaminated water, which is why health departments recommend people regularly flush their pipes. Still, city officials emphasize that the results show no system-wide contamination.
“If it were because of the water that was coming through the pipes themselves, we would expect all of the faucets within a school or a park to be affected,” says Dr. Julie Morita, commissioner of the Chicago Department of Public Health.
As of late November, Jessica Maxey-Faulkner, spokeswoman for the Park District, could not provide details about whether the district is working with Department of Public Health or Water Management officials to determine how to prevent future lead contamination at the water fountains. The Chicago Park District is still investigating the cause of the contaminated fountains, Maxey-Faulkner says.