Childhood Lead Poisoning / Environment Health Watch

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Graph of the decline in lead poisoning rates in Cleveland from 40% in 1996 to 8% in 2005.

Data from Cleveland Department of Public Health and the Cuyahoga County Board of Health

Lead Poisoning in Cleveland and Cuyahoga County - Dramatic Declines, Continuing Crisis

What is "Lead Poisoning"

The amount of lead in a child's blood is measured in micrograms of lead per tenth of a liter of blood (mcg/dl). In 1990, the Centers for Disease Control established a lead level of 10 mcg/dl or greater as the "level-of-concern" (now commonly considered "lead-poisoned"). The level of concern is the level at which CDC recommends public health actions be initiated. At the time, CDC did not define the threshold of 10 mcg/dl as "lead poisoning," acknowledging damage below 10 mcg/dl.

Recommendations of CDC's Advisory Committee on Childhood Lead Poisoning Prevention (11/2/2007) Interpreting and Managing Blood Lead Levels <10 µg/dL in Children and Reducing Childhood Exposures to Lead

As evidence of lead's damage at lower levels continued to accumulate, there have been increasing calls for CDC to lower the level of concern threshhold. See Lead's Damage Below Currently Accepted Levels, American Public Health Association and A Small Dose

Modified from A Small Dose

New "Level of Awareness" for Cleveland/Cuyahoga County

The four public health departments in Cuyahoga County (Cleveland Department of Public Health, Cuyahoga County Board of Health, Lakewood Department of Human Services and the Shaker Heights Health Department), based on research by the Medical Committee of the Greater Cleveland Lead Advisory Council, recommends a child blood-lead level of 5mcg/dl be used as a new level of awareness in the region, the level at which response should be initiated. See Lead Facts for Greater Cleveland Health Care Providers.

The new level of awareness at 5 mcg/dl recognizes that many more children than previously acknowledged are potentially hurt by lead - more than 40% of children tested in Cleveland in 2004 and more than 20% in the First Ring Suburbs.

The charts below indicate that while the percent of children at or above 10 mcg/dl dropped substantially between 2000 and 2004, the percent of children at or above 5 mcg/dl remained extraordinarily high.

Data from the Cuyahoga County Board of Health

Cleveland Childhood Lead Poisoning Rates - 2004-2006

Based on the CDC blood-lead level-of-concern (10 mcg/dl), 1,693 children in Cleveland were identified as lead-poisoned, 11% of those tested in 2004.

Based on the Cleveland/Cuyahoga County blood-lead level-of-awareness (5 mcg/dl), 6,517 children in Cleveland were identified as lead-poisoned, 42% of those tested in 2004.

Only 33% of children were tested, so most children hurt by lead are never identified. Of the 67% of children who were not tested, no doubt many were also lead-poisoned in 2004.

In 2005, 1,354 children in Cleveland (9% of the 15,106 tested) had blood-lead levels equal to or greater than 10 mcg/dl. In 2006, 1,069 children in Cleveland (8% of the 13,854 tested) had blood-lead levels equal to or greater than 10 mcg/dl. Data for children 5-9 mcg/dl is not yet available.

Cuyahoga County Childhood Lead Poisoning Rates - 2004-2006

Based on the CDC blood-lead level-of-concern (10 mcg/dl), in 2006, 1,306 children in the Cuyahoga County were identified as lead-poisoned, 6% of those tested.

Based on the Cleveland/Cuyahoga County blood-lead level-of-awareness (5 mcg/dl), 4,432 children in the Cuyahoga County were identified as lead-poisoned, 20% of those tested in 2006.

A problem for all of us

When so many children in a community are hurt by lead, it is not just a tragedy for the child and their family. Iit is a problem for all of us - poor school performance, unprepared workforce, crime and delinquency. See Putting Lead Poisoning on the Community Agenda.

How does Cleveland/Cuyahoga County rank in Ohio?

Chart from Cuyahoga County Board of Health

See Ohio City and County childhood lead poisoning rates.

How does Cleveland rank nationally? It is always at or near the top.

The chart below compares the cities with the largeste number of lead-poisoned children identified by testing (2003 data). Cleveland’s rate was the highest. Chicago had the most poisoned children.

Cleveland’s high rate makes sense, since it also at the top for poverty. Lead poisoning is primarily a disease of poverty.

National blood-lead level declines - Major public health victory

The decrease in children's average blood-lead levels 1976-1999 is a major public health victory.

How did this happen? Not by cleaning up the lead, but by eliminating the sources of lead – in paint, in gasoline and other products.

Now that the major sources are removed however, clean-up of exposure pathways – lead-contaminated dust and soil and failed lead-based paint - is needed. This is much more costly and difficult because it must be done one house at a time. So the rate of decline is sure to taper-off and likely to stall.

Strategy for childhood lead poisoning prevention

First an intense focus on children, pregnant women, housing and neighborhoods at highest risk.

Second an outreach and education effort to broadly integrate lead safety into all aspects of housing.

The strategy is not dependent on stand-alone lead hazard control in a huge number of homes which would be an impossibly expensive undertaking.

The goal is for lead safety awareness to become an ordinary part of everyday home repair, maintenance, renovation and cleaning.

"Test the home, not the child, and eliminate all non-essential uses of lead. The key is to require screening of high-risk, older housing units to identify lead hazards before a child is poisoned - before occupancy and after renovation or abatement." Dr. Bruce Lanphear, Cincinnati Children's Hospital Medical Center. See Preventing and Managing Lead Poisoning

More Information on Lead Poisoning

Other sites -

Alliance for Healthy Homes
National Center for Healthy Housing
Department of Housing and Urban Development
Environmental Protection Agency
ClevelandHealth.info
Cuyahoga County Board of Health
Cleveland Department of Public Health
Summary of lead poisoning research (pdf, 135pgs) from Child Health and the Environment by Donald T. Wigle [McLaughlin Centre for Population Health Risk Assessment]
National Library of Medicine - Lead and Environmental Health
More links

Flags representing the number of lead-poisoned children in Cleveland displayed for a Lead-Safe Living rally of the Greater Cleveland Lead Advisory Council (July 19, 2006).

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Updated 5/08