Lead cases on the rise; Montclair Health Department monitoring children
By Jaimie Julia Winters
When childhood lead poisoning became a priority statewide in 2018, Montclair health officials took action in their own backyard.
The number of Montclair children with reported high levels of lead rose from 11 in 2017 to 16 in 2018, with lead paint being the leading culprit, said Susan Porteuse, Montclair’s health director and health officer.
She attributes some of the rise to the reduction in the allowable blood lead levels in children, from 10 micrograms per deciliter to 5 in 2018.
Montclair had been awarded a $183,853 State Department of Health grant spanning 18 months, from January 2018 to June 2019. It helped fund the department’s efforts in lead screening, nurse case management and environmental investigations.
“The grant allowed us to purchase two state-of-the-art lead analyzers, one for painted surfaces and one for product testing, purchase supplies and equipment for the program, print outreach materials, allow for required training of staff and hire/offset staff salaries,” said Portuese.
CASES OF LEAD
In 2018, the department managed 31 cases in total throughout the towns that share services with Montclair — including Nutley (10 cases), Verona (four) and Cedar Grove (one). There were 16 cases in Montclair proper.
That compared to 22 cases from 2017, including 11 from Montclair, nine from Nutley and two from Verona.
Children are required to be tested for lead at ages 1 and 2, typically being screened in their pediatrician’s office. If an elevated lead level is detected, the physician is required to report it to the local health department. Some parents also have their children tested due to concerns with lead exposure through paint or water in older homes, said Portuese.
It can take several months, or longer, for blood lead levels to come down to an acceptable level, and for environmental abatement to be completed, so cases remain open until that happens. The child continues to be seen and treated by his or her pediatrician during this process. Of the 31 cases in 2018, 16 have been closed out, while 11 cases remain open.
Once a child with elevated blood lead levels is identified, Montclair Health Department nurses visit the family for case management. They follow the child’s medical care, and make recommendations regarding proper nutrition, which is important in helping bring lead levels down.
They also survey the parents to determine possible sources of lead exposure, and maintain contact with the parents until the blood lead levels have reached acceptable levels.
“At prescribed blood lead levels, our Registered Environmental Health Specialists also conduct an inspection of the home with a lead analyzer to determine the source of exposure,” Portuese said. “If it is paint in the home, the owner must hire a certified lead abatement contractor to remove chipping and peeling paint that has been identified to contain lead. Other potential sources of exposure are removed from the home.”
MORE TESTING NEEDED
The number of children getting tested, however, remains low in Montclair, with the state reporting that 34 percent of Montclair’s children were tested in 2016 and 35.4 percent tested in 2017.
“We are currently working on a contract with a local provider to conduct lead screening in our health department and community settings to increase screening rates,” said Portuese.
The department plans on applying for another grant through the state in March.
WHERE LEAD COMES FROM
Lead paint is the main source of lead exposure in children. Older homes were often painted using lead-based paint, which was banned in the 1970s. If the paint is not maintained properly, or owners try to do renovations in their home without taking precautions to properly control paint dust and debris, children can be exposed to chipping, peeling or paint dust, she said.
“It is ingested or inhaled and gets into their bloodstream, causing lead poisoning,” said Portuese.
Other sources of lead include imported pottery or toys, spices, cosmetics and in some hobby items, like stained glass and fishing sinkers.
Old lead pipes, used as laterals between the house and main water lines, or lead solder once used to seal pipe connections, can also contaminate drinking water. Homeowners are advised to get their water tested, and to use filters and to flush the line by running the faucet for several minutes, she said.