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Conn. health experts propose lower childhood blood lead levels to trigger early intervention

lead_poisoning_connecticut_children.jpg
Tony Bacewicz
/
C-HIT

State leaders are looking to lower the childhood blood lead levels that would trigger parental notifications, educational outreach and interventions like home inspections.

Child advocates and public health experts say the change would align the state’s levels with updated federal recommendations and provide earlier intervention to more kids in Connecticut by identifying cases of lower lead exposure, as opposed to just cases of higher levels of lead poisoning.

“It’s been proven that there’s absolutely no safe amount of lead for a child and their developing brain to be exposed to,” said Dr. Jennifer Haile, a primary care physician at Connecticut Children’s. “At very low levels, children tend to remain asymptomatic, but the long-term effects are irreversible.”

Legislation proposed by Gov. Ned Lamont’s office would change the state’s threshold of action from 10 micrograms of lead per deciliter of blood, to 3.5 micrograms. The change would reflect the lower benchmark approved by the U.S. Centers for Disease Control and Prevention in October.

Lamont has proposed in his annual budget that $70 million of the state’s pandemic American Rescue Plan Act dollars be used for the expansion of lead education, case management, remediation and abatement cases.

“It is, to me, still unbelievable that there are children who experience lead toxicity in the state of Connecticut,” said Dr. Manisha Juthani, commissioner of the state Department of Public Health. “This is something we need to fix.”

A bill is before the General Assembly’s Public Health Committee, which heard testimony Monday during a virtual public hearing

State data shows that lead poisoning among young children has been on the decline for years. According to a 2017 DPH report, about 1,665 children under 6 years old had blood lead levels of 5 micrograms or higher, which under current state policy is considered lead poisoning.

It was a decrease of nearly 17% from the year before.

However, some families and children remain more at risk than others. Experts say lead exposure continues to exacerbate health disparities.

“In Connecticut, the communities of the highest number of lead cases are our urban centers and neighborhoods of high rates of poverty,” said Liany Arroyo, director of Hartford’s Department of Health and Human Services. “We know children of color are disproportionately affected by this issue.”

Juthani said data from 2020 show that non-Hispanic Black children under 6 years old were 2.6 times more likely to have lead poisoning than white children. Black-Hispanic and non-Hispanic Asian children of the same age were also twice as likely to have elevated lead levels.

Bill supporters say the new legislation would accelerate efforts to close these gaps.

The Connecticut bill proposes that all cases of children who test at 3.5 micrograms or higher be reported to state and local health authorities. Parents or guardians of children with elevated blood lead levels must be notified and be provided education and information about prevention methods.

By 2024, an elevated blood lead level of 5 micrograms or higher will trigger an on-site inspection by public health experts to help families identify sources of lead in their homes or living spaces, and make a plan to remove those sources.

At higher levels of lead poisoning, local health directors would order epidemiological investigations to find the causes of significant lead exposure and order remediation, which on average could cost upwards of $10,000.

Alice Rosenthal, senior staff attorney at the Center for Children’s Advocacy, said someone’s housing and financial situation often determines what families may or may not be able to do to prevent or eradicate lead exposure at home, especially without outside assistance.

“Many of these families I work with don’t have the ability to just simply move if their child has lead poisoning,” Rosenthal said. “They rely on their landlords to remediate the apartment so that they can keep their children safe.”

To help offset the potential costs related to lead exposure treatment and lead remediation, the legislation proposes expanding the state’s Medicaid program for low-income residents to cover some services.

The ARPA funding set aside in the governor’s budget would largely help municipalities take on additional lead poisoning surveillance and cases that are expected to result from the lower 3.5 microgram threshold.

Aisling McGuckin, director of health for the city of Waterbury, said the funds are needed. She has two staff members managing the city’s lead cases.

In fiscal year 2021, even with lead case referrals down overall because of the COVID-19 pandemic, McGuckin said the city would still have had more than 1,000 cases of lead poisoning that would have required an investigation and a follow-up under the newly proposed lead limits in the current bill.

“With current staffing levels, we would not have been able to manage this feat, necessary as it may have been,” she added.

The bill would need a majority vote of support to pass out of the Public Health Committee before going to the House and Senate for further consideration.

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