During Elizabeth McDade’s time as program manager for the Coalition to Prevent Lead Poisoning, she encountered many examples of lead unexpectedly entering peoples’ bodies. A few have stuck with her.
A father’s beard, covered in dust from his construction job, passed lead into his young daughter. An immigrant family saw elevated blood lead levels from goods they imported from India for religious services.
“The Monroe County Department of Health, they are relentless,” recalls McDade, who now is program director with the Rochester Energy Efficiency and Weatherization Climate Fund. “That’s how good they are. They can figure out where the hazard is with something that obscure.”
Thanks to the advocacy and educational efforts CPLP started in the early 2000s, instances of lead poisoning have decreased across the area, as evidenced by childhood lead blood level tests. In 2014, a study found that rates of lead poisoning decreased 2.4 times faster in Monroe County compared to all other counties from 1997 to 2011.
Even with those superior results, potential danger remains in Monroe County primarily due to lead-based paint used on the area’s old housing stock.
“We now know that there’s really no safe level of lead in the blood and we strive to have zero. But it’s pretty likely you will have some,” says Claire Henrie, CPLP program director.
The adoption of stricter testing thresholds, on the other hand, is more of a recent development. The federal Centers for Disease Control and Prevention in 2012 adopted stricter testing thresholds, setting a danger limit at 5 micrograms of lead per deciliter of blood; at that level, case management, including home testing and lead education or even abatement programs, is necessary. (Five mg/dL is equivalent to one grain of sugar dropped in 3.3 gallons of liquid.)
The new number halved the previous limit of 10 mg/dL, which means more children fall within an “elevated blood lead” level.
Monroe County adopted that same threshold in 2019, but factors, including the COVID-19 pandemic, impeded the full impact of this change. Geographic areas not traditionally associated with lead poisoning could now fall within those limits.
This development, along with new regulations at the city level, which include wipe testing of open porches at rental properties, signify improvement in treating lead poisoning, but expand the need for services.
“A kid who has a 5 now, would not have been considered elevated, 20 to 25 years ago,” Henrie says. “That in itself could be looked at as a type of progress.”
Lead dangers
While lead contamination through aging water pipes can often be at the center of mainstream conversations, the main focus for CPLP is hazards created through paint dust.
Lead was widely used in paint for durability and moisture resistance until the federal government banned it in 1978. Old housing stock, common in many parts of Monroe County, is more likely to have lead paint interiors and exteriors.
Even behind layers of new paint, it can present a danger, especially around areas of high usage or high friction. CPLP says monitoring and cleaning those areas is important to lessen the danger and potential for lead poisoning.
“Lead is an element, it doesn’t go anywhere; we just stopped adding it to things,” says McDade. “If you’re opening and closing wooden windows, you can see where it’s worn away and there’s three to four layers of paint or the raw wood itself. That’s how we get lead poisoning; it’s from friction surfaces.”
Any contractor doing a renovation, repair or painting project in a pre-1978 home that disturbs lead-based paint needs lead-safe certification, an Environmental Protection Agency requirement since 2010. Monroe County offers free RRP training sessions, although spots are limited.
Pregnant women can pass on lead poisoning to their unborn children if they breathe in or swallow lead particles.
“I have heard tragic stories about women getting the baby room ready, not being aware of RRP procedures, and unfortunately, in that act, poisoning their unborn baby,” Henrie says.
Young children often ingest lead particles by putting toys or objects in their mouths or crawling on the ground where it gathers. Lead is sweet to taste, further compounding that issue.
New York law requires testing of children at age 1 and 2 for blood lead poisoning. Tested children with EBL levels at or above 5 mg/dL are provided case management and educational outreach by Monroe County.
In cases with high amounts of blood lead detected, a health care provider might give treatment with a chelating agent or whole-bowel irrigation, which can get rid of the lead. Most common are house visits that can be used to detect lead hazards for removal from a child’s environment. Many times, avoidance is the best tactic.
“For example, if it turns out that one of your bedrooms is ‘hot,’ the test is picking up a lot from there, and you can’t afford to renovate it, then don’t have that be the kid’s bedroom,” McDade says.
“The level in the blood should go down if they’re not being exposed to it,” says Henrie. “But even if they’re not at an elevated range now, it doesn’t mean there won’t be changes and consequences to their body.”
As a toxin, lead affects the brain, heart, bones, and kidneys. It is particularly damaging to young children under age 6, whose bodies are still developing, and aging or pregnant individuals, who lose or require greater calcium levels, which can mobilize lead from where it has settled in the bones back to the bloodstream.
Adults can suffer from high blood pressure, kidney problems and reproductive issues if they are poisoned by lead. Children who are affected can have behavioral problems, hyperactivity, hearing problems, growth delays and lowered IQ.
“It’s this cradle-to-grave problem, which is virtually invisible and people assume we got rid of in 1978,” McDade says. “Some people look at it and say, ‘I turned out fine and I grew up during that time.’ Which is to say, ‘Well I did too and I wonder what I’d do with those extra IQ points back.’”
CPLP’s history
Established in 2000, CPLP is an interdisciplinary, intersectional group that formed and has persisted, in large part, due to luck and circumstance.
A year prior to its inception, Ralph Spezio, principal at School No. 17, happened to overhear school nurses discussing lead poison levels in students. He soon learned that 41 percent of his students had EBL levels.
This realization was reinforced by a study at that same time that found 98 percent of the homes in the surrounding neighborhood had lead hazards. A 2002 report further found that children in high-risk areas in Rochester had over four times the state rate of lead poisoning.
Spezio, who had connections to county health officials, doctors, educators, and community leaders, helped form the coalition, which worked hard to keep local stakeholders involved. CPLP bylaws call for at least 30 percent of the coalition’s board of directors to be representative of the “most highly affected communities.”
CPLP still maintains strong connections to community organizations, including those specifically dealing with lead poisoning. Among them is the Western New York Lead Poisoning Resource Center, which serves nine counties in the Finger Lakes region.
The CPLP’s day-long Community Lead Summit event in 2004 was part public education and part policy advocacy. Although the coalition avoided (and continues to avoid) assigning blame to a single party, the summit was publicized enough that it resulted in commitments from several political officials.
“The huge achievement of the coalition was that we had county health and city inspectors working together,” McDade says. “The coalition wasn’t throwing anyone under the bus, but they were pointing out the facts and gathering people together in a way that they had to respond.”
“And I think one of the keys to this work is that we say thank you,” she adds. “Over the years working together, we’ve developed a trust. We’ll hold people accountable, but it’s not about making someone look bad or searching for that scapegoat, it’s about helping to prevent lead poisoning in our kids and families.”
Although there was pushback from landlords resulting in a compromise measure, a new city ordinance passed unanimously by City Council in 2005 requiring lead hazard inspections as part of the existing certificate of occupancy process for rental housing in 2005. At the county level, lead hazards were added to the “move-in, move-out” inspection for public assistance housing around the same time.
Other local developments CPLP considers wins for its advocacy includes the creation of the Lead Safe Monroe County Plan, the Rochester City School District’s adoption of a Lead Safe Schools Policy, the Monroe County Department of Health lowering of environmental investigation to 8 mcg/dL, increasing one- and two-unit structures’ inspection rates, and 29 municipalities assessing their lead paint safety regulations.
The latest data
Like the rest of the northeast region of the United States, Monroe County’s housing stock is old. According to the most recent census data, 57.4 percent of its houses were built before 1970 (when New York banned lead based paint) and 70 percent were built before 1978 (when the federal government followed suit).
Areas with high proportions of houses built before 1970 include the city of Rochester (particularly the southeast, with a rate of 87 percent), the towns of East Rochester (82 percent), Irondequoit (80 percent), Brighton (64 percent) and the village of Fairport (71 percent). Proportions of pre-1978 built houses are even higher.
Other locations that stick out among places with otherwise low rates include portions of Greece and Gates that are closest to the city, parts of Henrietta, and the village of Brockport.
With the standard of 10 mg/dL, EBL levels were an urban problem. Data from the state Department of Health indicates that from 2000 to 2020, children from city of Rochester ZIP codes were the only ones to have EBL levels. They were most commonly found in Northeastern Rochester, which also has greater rates of poverty and older housing stock.
However, with the standard changed to 5 mcg/dl, EBL levels also have been recorded in Gates and Greece ZIP codes as well as several in East Rochester and the western part of Brighton.
Overall, state data shows, Monroe County’s EBL levels are among the lowest in New York, with Oneida, Albany, and Erie County being comparative populations that were among the highest.
Monroe County has been tracking its own blood lead testing results since 2009, according to Department of Health records. While its location tracking is less robust than the state Department of Health, it is quicker to release, with the latest data being available for 2022.
The two datasets largely tell the same story when it comes to geography; city ZIP codes in the Monroe County data, which were previously labeled as “high risk,” comprise the majority of all EBL level cases.
The numerical differences that do exist paint a somewhat darker picture when looking at county data, however. State data shows that from 2008 to 2020, the proportion of tested children with an EBL over 10 mcg/dL has fallen from 2.13 percent to less than 1 percent.
County data, on the other hand, shows that the same category fell to less than a percentage point, but that was in 2014. It has since slightly risen from its typical levels to 2.07 percent of tested children in 2022. County officials have said there is anecdotal evidence this rising trend has continued into 2023, although they do not define it as a “spike” yet. The COVID pandemic and recalls of certain testing machines were also cited as further factors clouding the picture.
It is a similar case with tested children with an EBL between 5 and 10 mcg/dL. State data shows a drop of 7 percent (from 9.16 to 2.12 percent of all cases), while county data shows a drop of about 2 percentage points (from 5.06 to 3.98 percent).
Testing rates for EBL remained consistent even during the pandemic, Monroe County numbers show. Post-pandemic, 2021 showed a slight decrease in tracked categories, but 2022 had a noticeable increase in EBL levels for tested children.
“During the pandemic, people were stuck at home and finally did that (house) project they’ve been putting off,” Henrie says, recalling her own recent home window project.
“Were they all aware of RRP procedure? Were they making sure to keep children and at-risk adults away from the project site? Was that even possible if it was at home? Were they wearing respiratory protection?” she continues. “All those questions come with that do-it-yourself phase people went through.”
Whether any rise in EBL levels is connected to DIY home improvement projects or if it will continue is unclear.
Compared with other counties, Monroe is well positioned in tracking its situation. Officials from Erie County, for example, brought up worries about state data being miscounted in a 2016 story by the Investigative Post. After convening the Buffalo and Erie County Lead Safe Task Force in 2018, they have released their own testing updates in annual reports. Onondaga County has also reported their testing results on a specific webpage beginning in 2023.
Upcoming developments
Although in comparatively good shape, area advocates and their allies are not finished improving lead prevention methods.
For example, state Assemblyman Jon Rivera was a featured speaker at CPLP’s Annual Breakfast, held earlier today. Since being elected in 2022, he has made lead paint one of his primary issues, most recently helping to pass the Lead-Based Paint Right to Know Act in the Assembly this May. The bill is supported by CPLP and co-sponsored by local Assemblyman Harry Bronson. (It is currently in committee at the state Senate level where Samra Brouk and Jeremy Cooney are co-sponsors.)
The bill would require owners of residential real estate property built before 1978 to test for the presence of lead-based paint before they sell the residence and to disclose the results to buyers prior to closure of the sale. It would also require those tests to be shared for use in a statewise lead-in-housing registry.
“This bill will equip homeowners and renters with the knowledge they need to make decisions with their family’s health and safety in mind,” said Rivera, who represents the Buffalo area, when it passed in the Assembly.
At the local level, $310,000 in funding for the city’s Childhood Lead Poisoning Prevention program was unanimously approved by the County Legislature in February, ensuring that lead testing in affected family homes would continue.
Rochester City Council took another step forward in June, voting unanimously to align the city’s Municipal Code with state, EPA and HUD regulations. This includes an additional dust wipe test for open porches on rental properties, a measure CPLP has advocated for many years.
“Porches can contain a whole lot of lead. The paint on them actually sometimes has more lead in it than regular paint. And we know many Rochester children play on porches,” Henrie said at a City Council meeting.
Lead clearance levels set by the EPA (the limit for what is considered a dangerous amount), have also changed for certain key areas such as floors, window sills, and wells. For example, window sills were set at a level of 250 micrograms of lead per square foot of surface area (ug/ft2) in 2001. Two decades later, the standard is now at 100 ug/ft2.
This lower threshold, similar to the decrease in limits for EBL levels, represents how well efforts by advocates for preventing lead poisoning have succeeded. While it also raises the amount and level of required services, CPLP is confident and encouraged by the progress it has made.
The work is still not complete, though.
“We have made tremendous, tremendous strides in preventing lead poisoning of children in this community,” says Henrie. “But there are still children being harmed by lead.”
Jacob Schermerhorn is a Rochester Beacon contributing writer and data journalist. The Beacon welcomes comments and letters from readers who adhere to our comment policy including use of their full, real name. Submissions to the Letters page should be sent to [email protected].