By: Jennifer Haile, MD, and Chris Corcoran
One year ago, we first heard the phrase “shelter in place.” No one knew the effects this would have on our children, and we still don’t. One thing we did know was that children were going to be staying in their homes more, which put them at a different type of risk – lead poisoning.
Decreased Screening for Lead Poisoning
According to U.S. Census data, more than 71% of Connecticut’s housing was built before 1978, which was when lead paint was banned. More than 30% of our housing was built before 1950, which puts these homes at an even higher risk of deterioration. The most common source of lead exposure is paint and the invisible dust it creates. There is no safe lead level. Lead at any level causes irreversible neurologic damage to the developing brain, which can lead to developmental delays for toddlers, learning deficits and attention problems for school-age children, and other concerns that linger throughout the lifespan.
Over this last year, not only were children possibly exposed to lead more due to spending more time in their homes, many were not receiving routine health care, including lead screening.
The state of Connecticut mandates that providers screen children for lead poisoning twice prior to 36 months of age. It is not surprising that lead screening rates dropped dramatically in the early months of COVID-19. The Centers for Disease Control and Prevention (CDC) estimates that in the early phase of the pandemic, more than 10,000 children with elevated lead levels were missed due to decreased screening and increased exposure. Pediatricians and parents need to work together to get children screened and identify potential hazards in the home.
Intervening to Treat Lead Poisoning
Connecticut Children’s Lead Treatment Center has worked hard over the last year to adjust to the new hurdles COVID-19 has thrown at us. We have begun offering video visits to all patients with lead levels of 5 micrograms per deciliter and above, which is the level that the CDC recommends case management. Compliance with video and telephone appointments, as well as blood lead testing have been good and our patients appreciate the real time assistance.
Through video, we are able to see areas of concern in the home. Based on what we see during the visit, we can suggest families adopt temporizing measures such as keeping windows closed, moving furniture to block concerning areas, or avoiding porches or entryways where lead paint may be present. However, once we identify a child with an elevated blood lead level, these temporizing measures might not be sufficient to ensure the lead level does not increase, which is where a referral to Connecticut Children’s Healthy Homes Program (Healthy Homes) comes in.
Preventing Lead Poisoning
Healthy Homes is dedicated to eradicating childhood lead poisoning by making homes lead safe and healthy for families across Connecticut. Healthy Homes is just one of the 15 programs working under the guidance of Connecticut Children’s Office for Community Child Health, and the program has been supported by Connecticut Children’s since its inception in 2003. If a child in the Lead Treatment Center is identified with an elevated lead level, providers in the Lead Treatment Center send a referral to Healthy Homes. Upon receiving the referral, Healthy Homes team members do their utmost to encourage the property owner to apply to the program to help reduce the likelihood of that child’s lead level rising, and to prevent other children living in the property from also falling victim to this insidious illness.
Healthy Homes staff are trained to educate property owners about the benefits of the program for existing and future tenants. Healthy Homes works with qualified property owners to inspect their property, whether it is a single-family residence or a 30-unit rental property. Healthy Homes collaborates with the property owner to manage the process from the bid procurement, to hiring and overseeing contractors doing the work, to the final inspection when our certified lead-based paint hazard consultants determine if the unit(s) are lead safe. As a result, children living in that home are protected from future exposure to lead paint contamination, and any children residing in that same housing in the future will also be protected.
Striving for a Lead-Free Future
Connecticut Children’s is uniquely poised to help reduce childhood lead poisoning, despite the COVID-19 pandemic. Like the Lead Treatment Center, Healthy Homes updated our protocols and procedures to safely inspect homes and help occupants stay safe and healthy throughout the entire process.
However, the first step in identifying childhood lead poisoning is proper screening.
It is crucial for pediatricians to identify children that have missed their required lead screenings during the pandemic and get them tested. Connecticut Children’s Lead Treatment Center and Connecticut Children’s Healthy Homes Program are ready to help families navigate ways to prevent lead poisoning and create lead safe housing for the children of Connecticut.
Jennifer Haile, MD, is a primary care pediatrician at Connecticut Children’s and serves as director of Connecticut Children’s Lead Treatment Center.
Chris Corcoran is the interim manager of Connecticut Children’s Healthy Homes Program.