Lead paint proves to be the real problem in Washington

Lead in the water at Tacoma schools has parents across the state wringing their hands with worry. “Could that be us?”

Although the Tacoma situation is scary, lead-contaminated water is not the number one source of lead exposure for children. In King County, for example, it’s through lead paint or lead-contaminated dust.

So how do kids get exposed? There are many reasons, but it’s often from older homes, where lead paint was slathered inside and out for decades. It wasn’t made illegal until 1978.

Listen: “Why doesn’t Washington state test more kids on lead exposure?” on the Ron and Don show, April 29

Fifty-six percent of the homes in King County were built before then. Across the state, more than 60 percent of the homes were built before 1978.

Washington has received criticism from some health advocates across the country about how it keeps kids protected from lead.

In many East Coast states, health care providers are more proactive about testing and screening kids for levels of lead in the blood. In Connecticut, all children must be tested twice before they turn 3 years old.

Chris Corcoran, the program manager of the Healthy Homes Program with Connecticut Children’s Medical Center, is among those who believe it’s vital to do blood draw tests on all children.

“In order to become an effective prevention program or to support the work of our public health prevention efforts, we need to know where the kids are that have the elevated lead levels,” Corcoran said.

In Washington, you could have a baby and never hear about lead paint concerns from your health care providers, even if you live in an old home. That wasn’t the case for Kristin Rogers and her family.

Rogers wasn’t expecting to move last year. But she received lab test results for her 7-year-old daughter, Lyra, with big implications.

“She had elevated lead in her blood which meant that at some point in the last few months she had ingested lead somewhere,” Rogers said.

They moved from an old house in Seattle to a new construction in Bothell.

“My daughter is on the autism spectrum and she is not very verbal,” Rogers explained. She was exposed for about a year at age 6, starting when they moved into their previous house.

Lyra, like infants and toddlers, has a tendency to chew on things, even things like windowsills. She had been routinely chewing on a wall and on paint chips that were falling off of an old door.

“For most kids, lead-contaminated dust gets on a toy and they put it in their mouth. You do that often enough and it becomes a problem,” Rogers said. “But for her, she was actually putting the paint in her mouth because it’s sweet. Lead paint has a sweet taste to it, so that’s part of why kids eat it.”

Of course, it seems obvious now: paint chips. But Kristin and her husband didn’t realize those chips had dangerous levels of lead.

They will never know just what kind of damage it might have caused their daughter. It might not be much. But it’s hard to tell with lead.

There aren’t obvious symptoms and the problems, if severe enough, can cause permanent damage, like slowed growth and developmental delays.

Kristin beat herself up about it for awhile.

“There were a few months where it was that talk in your head about: could I have done that differently? Or, why didn’t I know?” she said.

As Rogers looks back, she wonders why more pediatricians don’t talk to parents about lead. And if testing were universal, she thinks, families would have a raised awareness about lead.

So why not mandate testing?

Elisabeth Long, lead epidemiologist at the state Department of Health, says Washington has historically low testing rates. But that doesn’t mean universal screening is the answer.

“Less than 4 percent of our children under six years old are tested. We would love to have more data but that test is invasive,” she said. “We would never want to do some screening just for the fact of increasing our surveillance system.

“What we want to do is what is in the best interest of the child’s health and that is to find the kids that are at the highest risk and screen them.”

States which do universal testing for lead usually do so at 12 and 24 months old, and drawing blood off of a child that young can be an ordeal. A venous blood draw isn’t the only way to do it, but it’s the most accurate way.

Many providers use a finger-prick test first. If the level is high, they then move to a blood draw from a vein.

But the finger-prick test itself is controversial in the health community. Some argue that it has problems.

When Long talks about risk assessment protocol in Washington, she’s saying that doctors and nurses should talk with parents and figure out if their child could be at risk. They should ask questions like: “when was your home built?”

This approach is the recommendation in the latest guidelines from the Washington State Department of Health, published in November 2015. That didn’t change from the last time the guidelines were updated, in 2008.

What is new is a two-page sheet of instructions on what those risk factors are, which makes it easier for providers to identify the potential exposure.

Now, it’s important to get that message out to doctors and make sure they know about the new guidelines, but the Department of Health doesn’t have an official method to do that.

Because paint is one of many ways people can be exposed to lead and is one of many potential contaminants in the home, the Department of Health website has a helpful and thorough map listing the risk factors by location all across the state, along with many more tips.

Most of all, health care advocates like Elisabeth Long stress that it’s important not to get irrationally concerned about lead exposure. It’s good to be aware and take appropriate steps to mitigate risk, but don’t panic.

Rogers says so, too, though she still wishes information was more prolific.

“If you don’t have a kid who is actively seeking paint chips, the threshold for danger is way different. You know, keep the sills painted so that things aren’t flaking off,” she said. “There are things that are pretty easy fixes but you’ve got to know to do it and a lot of people don’t.”

Tips for those who live in homes built before 1978

• Talk with your child’s doctor about exposure, so you can decide if you want your child tested. If your doctor needs information, guide him/her to the DOH lead risk assessment mentioned above.

• Take care of peeling paint, but not by scraping, as lead dust can then get into the air. Instead, paint over it to lock in the old lead paint.

• Clean with a wet cloth so dust can’t get out.

• Wash your hands often.

• Take your shoes off at the door.

• Planning a bigger renovation like a wall tear-down? Get an expert. Make sure you hire someone who is certified to deal with lead paint.

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