Lead Poisoning Threatens Milwaukee Children

Milwaukee's children suffer from a rate of lead paint poisoning that is more than six times the national average. Elevated levels of lead can result in retardation, behavioral and physical problems that will forever shrink a child's chances throughout life.

Why is Milwaukee's problem so severe? What can parents and health care providers do about it?

According to Margaret Layde, MD, Medical College of Wisconsin Assistant Professor of Pediatrics, the age and condition of Milwaukee's housing stock is the primary problem. "The rate of lead poisoning is improving, but we're still faced with the problem that more than 50% of our housing goes back before 1950," she states. "When rental housing isn't well taken care of, we see a lot more lead poisoning." Dr. Layde practices at the Downtown Health Center, which is affiliated with the Medical College and Children's Hospital of Wisconsin.

Active Involvement Needed
Given Milwaukee's housing stock, parents need to take "a very pro-active approach" in getting their toddlers tested for lead poisoning and eliminating hazards in the home, Dr. Layde emphasizes.

As Dr. Layde explains, the hazard to children typically results from lead dust or chips loosened by the opening and closing of windows that had been painted with lead-based paint, or from rehab work that penetrates lead-painted surfaces and thus spreads particles.

"Lead is a danger to the developing brains of toddlers," says Dr. Layde. "Just as their brains are growing, they start to put things in their mouths. They may play with toys coated with lead dust, and then put the toys in their mouths. Or they might look out the window, put their hands on the windowsill which has lots of lead dust and chips, and then suck their thumb."

Nationally, 1.6% of children under age 6 show signs of elevated lead in their bloodstreams, which can trigger learning disabilities, chronic behavioral problems, a variety of physical symptoms, and profoundly reduced chances for a normal life.

In Milwaukee, Six Times National Rate
Especially alarming for Wisconsin residents is Milwaukee's 9.8% rate of lead poisoning among kids, more than six times the national average, based on Milwaukee Health Department studies for 2004 (the last year for which final figures were available. Preliminary data for 2005 shows a welcome drop to 8.5%). Further, the Health Department finds an additional 2,300 cases per year.

In nearby Racine, the rate of lead poisoning was 5.7% in 2004, more than triple the national average.

These figures are deeply worrying to parents of young children, health care providers, and health officials alike. Parents must aggressively monitor their toddlers' health, she stresses. "In toddlers, no symptoms are visible. You can't wait until the symptoms have developed, or harm will have already taken place. Parents should be pro-active in insisting on lead testing even if their doctors don't initially mention it. "

Testing Especially Crucial for Children on Medicaid
Lead testing is absolutely essential for central-city toddlers, who most commonly face the risks of living in older housing that had been painted with layer after layer of lead-based paint. The US finally banned the use of these paints in 1978. (While secret paint-company memos as early as 1904 admitted that lead-based paint was "poisonous" to both paint workers and children inhabiting lead-painted homes, the US industry successfully resisted an outright ban until 74 years later.)

Families eligible for Medicaid should insist that their children up to age 6 be tested. "Here at Children's Hospital, we test every child on Medicaid three times in the first three years of life," Dr. Layde notes.

We check blood lead levels (BLL) on children 4 to 6 years of age who haven't been previously tested or who have other risk factors, like siblings or playmates who have elevated BLL or children who move into older housing.

Of course, lead poisoning affects families of any financial status, so all youngsters should be tested. "We've seen big remodeling jobs in fashionable neighborhoods unleash lead dust and cause elevated levels of lead in toddlers' bloodstreams. Kids may visit a home or attend a day-care center where there are lead hazards, so all toddlers should be tested," says Dr. Layde.

Parental Responsibilities
Parents need to actively insure that their toddlers are healthy and that potentially hazardous conditions around the home are eliminated. Among the most crucial steps suggested by Dr. Layde:

• Make sure that your doctor checks for lead poisoning. Blood drawn to check for anemia can also be used to test for lead poisoning.
• Wash your child's hands frequently, particularly before meals.
• When cleaning around windows, use safe techniques. "The use of vacuum cleaners actually spreads the dangerous lead dust around, so wet-mopping is a much better technique to use," Dr. Layde points out.
• Supply your toddler with the right foods. The right choices can help to counter and reduce some of the lead in toddlers' bloodstreams. It is especially important to include foods high in protein (milk, cheese, and yogurt) and iron (lean beef, chicken, turkey, and green leafy vegetables.) Foods high in fat should be avoided, as they hold the lead in toddlers' bodies.

City and State Efforts
Along with the efforts of parents to vigilantly check their child's health, city and state health officials are proceeding with aggressive programs to eliminate hazardous housing conditions through a program of "primary prevention," says Dr. Layde, who serves on the Wisconsin Lead Poisoning Elimination Committee. The aim of the program is to eliminate childhood lead poisoning by 2010 through actions including the training of landlords, painters, and contractors to use proper procedures in ridding homes of lead paint problem areas.

Lead paint poisoning has become a prominent issue in recent months. The city of Milwaukee has filed a lawsuit against lead paint manufacturers to recover about $85 million of the costs of clearing Milwaukee's homes of lead paint dangers, with a trial expected by late 2006 or early 2007. In early March, the state of Rhode Island was awarded as much as $3 billion in the first such successful lawsuit in the nation against the lead paint industry.

Additional helpful information can be found on the City of Milwaukee's Childhood Lead Poisoning Prevention Program website.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.