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Childhood Lead Poisoning brochures and booklets

Graph of the decline in lead poisoning rates in Cleveland from 40% in 1996 to 6% in 2007.

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

Too Many Kids Have Too Much Lead
And It’s Everybody’s Problem

  • In Cleveland, East Cleveland, and Cuyahoga County, too many kids have too much lead and it is everybody’s problem. Of children tested in 2007, 16% in the entire County, 22% in Cleveland and 24% in East Cleveland had levels of lead that could diminish their life-chances.
  • Lead poisoning is a tragedy for the child and their family. When rates are this high, it is tragedy for the entire community. It is everybody’s problem. If you are worried about school performance, worry about lead. If you are worried about crime, worry about lead. If you are worried about workforce readiness, worry about lead. more
  • Most of the costs – for the children, for their families and for the community – cannot be calculated. But for some interventions and outcomes associated with childhood lead poisoning, we can make reasonable estimates of the dollar cost. We looked at the lifetime costs for the 6500 children tested in 2004 with elevated blood-lead levels. A new Economic Policy Institute study also researches the costs and benefits of lead hazard control, concluding there are significant returns to investing in early action controlling lead.

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.
  • As evidence of lead's damage at lower levels continues to accumulate, there are 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 and Lead Testing Requirements and Medical Management Recommendations Chart.
  • The new level of awareness at 5 mcg/dl recognizes that many more children than previously acknowledged are potentially hurt by lead - more than 22% of children tested in Cleveland in 2006 and more than 24% in the East Cleveland.

Cleveland and Cuyahoga County Childhood Lead Poisoning Rates - 2008 (children under 6 years of age)

  • Based on the CDC blood-lead level-of-concern (10 mcg/dl), 6.3% (956 children) in Cleveland were identified as lead-poisoned
  • Based on the Cleveland/Cuyahoga County blood-lead level-of-awareness (5 mcg/dl), 21.7% (3,298 children) in Cleveland were identified as lead-poisoned,
  • Of the 25,351 children in Cuyahoga County that were tested in 2008, 16.2% (3,951 children) were tested at levels of 5 mcg/dl and above.
  • Of the 25,351 children in Cuyahoga County that were tested in 2008, 4.8% (1,174 children) were tested at levels of 10 mcg/dl and above.
  • Lead poisoning and increased blood lead levels have permanent affects on the well-being and health of a child, regardless of the current blood lead level.
  • Prevalence history of Cleveland including charts and maps dating back to 1995.

Cuyahoga County Childhood Lead Poisoning Rates - 2004-2008 (PDF of chart)

 Cuyahoga County, Ohio
 
Year Screened
 Total Children Screened (0-72 months) 
 Number of Children with BLL 5 or greater µg/dl** 
 Percent of Children with BLL 5 or greater µg/dl** 
Cleveland
2008
     15,168
         3,298
22%
Cleveland
2007
     14,987
         3,322
22%
Cleveland
2006
     13,809
         3,532
26%
Cleveland
2005
     15,048
         4,319
29%
Cleveland
2004
     15,477
         6,517
42%
Cleveland Heights
2008
           718
               84
12%
Cleveland Heights
2007
           926
            109
12%
Cleveland Heights
2006
           817
            115
14%
Cleveland Heights
2005
           757
            112
15%
Cleveland Heights
2004
           751
            165
22%
East Cleveland
2008
           529
            170
32%
East Cleveland
2007
           651
            158
24%
East Cleveland
2006
           683
            216
32%
East Cleveland
2005
           726
            277
38%
East Cleveland
2004
           790
            359
45%
Euclid
2008
           879
               57
6%
Euclid
2007
           892
               48
5%
Euclid
2006
           754
               66
9%
Euclid
2005
           706
               70
10%
Euclid
2004
           718
            126
18%
Lakewood
2008
           796
               74
9%
Lakewood
2007
           964
               99
10%
Lakewood
2006
           809
            122
15%
Lakewood
2005
           751
            129
17%
Lakewood
2004
           703
            130
18%
Cuyahoga County
2008
     24,351
         3,951
16%
Cuyahoga County
2007
     25,228
         4,070
16%
Cuyahoga County
2006
     22,323
         4,432
20%
Cuyahoga County
2005
     23,099
         5,288
23%
Cuyahoga County
2004
     23,157
         7,999
35%
Source: Data analyzed by Epidemiology and Surveillance Services at The Cuyahoga County Board of Health. Revised 4/14/2009 and 4/12/2010. Original data obtained through the Ohio Department of Health's Childhood Lead Poisoning Prevention Program. 
   * Data from the Ohio Department of Health and Cuyahoga County Board of Health, only cities with 500 or more children tested are included. 
   **5 µg/dl or greater is the level of awareness set by the health departments in Cuyahoga County in 2007    based on  evidence  that lead is potentially damaging to children at levels below 10 µg/dl.    

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

Childhood lead exposure and uptake in teeth in the Cleveland area during the era of leaded gasoline
(Science of the Total Environment, 2010)
By Norman Robbins, Ahong-Fa Zhang, Jiayang Sun, Michael E. Ketterer, James A. Lalumandier, Richard A. Shulze


Environmental Research Journal Article
Longevity of the effectiveness of interim soil lead hazard control measures and influencing factors.
By C. Scott Clark, Paul A. Succop, William Menrath, Sandy M. Roda, Stuart Greenberg, Mia Buchwald-Gelles, Hongying Peng (submitted June 2009). Full article available at http://www.sciencedirect.com/

Article Abstract:
A 7-year follow-up was conducted to determine factors associated with the longevity of interim soil lead hazard control measures that had been applied to housing in the Cleveland OH area. The approach involved (1) visual determination of the treatment integrity, (2) collection of information regarding 14 factors that may contribute to longevity of treatment integrity and (3) collection of one composite soil sample from treated areas with visual failure at each house and another composite sample from areas without visual failure. For the 200 houses studied, an average of 4 different soil areas were treated. For 96% of these areas, the treatments used were: (1) re-seeding, (2) mulch/wood chips and (3) gravel. Of a total of 191,034 ft2 of treated soil areas observed, less than one-third, i.e. 59,900 ft2 (31.3%) exhibited visual failure at the time of follow-up. Hazard control method and the presence/absence of shade were the only factors found to significantly affect visual failure rates. Of the three most commonly used control measures, the lowest visual failure rate was for re-seeding, 29.1% after a mean of 7.3 years; for non-shaded areas, which had been re-seeded, the failure rate was 22.2% compared to 35.7% for shaded areas. At 116 of the 193 houses (60%) that had both visually failed and visually non-failed treated soil areas, the geometric mean soil lead concentration was higher in the failed areas (p=0.003). The actual difference was only 13% with most levels equal to or exceeding 400 ppm. However, when compared to the US EPA limit for bare soil in other residential areas (1200 ppm) the percent equal to or exceeding the limit was much higher in the visually failed areas, 33.1%, than in areas where such failure was not observed, 22.0%.

 

Lead Data Analysis Report
Analysis of Lead Hazard Control Data, Disclosure, Risk Assessment and Clearance Data, Prevalence, and Multiple Poisoning Cases
Prepared by EHW for the Cleveland Department of Public Health

  • Risk Assessment
    Large percentages of homes had lead hazards – 46% floor, 61% sill, 76% well, 49% soil.
  • Clearance Testing
    Based on clearance testing, 98% of housing units met standards by the final clearnace test
  • Landlord Lead Hazard Disclosure to Tenants
    83% of landlords did not disclose lead hazards information to tenants as required by law, based on tenant surveys.

 

The Ad Council Lead Poisoning Prevention Campaign has made a conservative estimate that over one million children are affected by lead paint poisoning today.  Over 38 million American homes have potential lead poisoning hazards.  Increased blood lead levels can lead to brain damage, nervous system damage, behavioral disorders, slowed growth, hearing problems, aggressive behavior, hyperactivity and learning problems.  Visit http://leadfreekids.org/ for more information on the campaign and for more information on lead poisoning.

Back to School Media Campaign-Cleveland Lead Awareness Commercial

More Information on Lead Poisoning

Other sites and articles-


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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