The state will direct most of its efforts — and most of $30 million in federal money — toward its cities, whose children have borne the brunt of this epidemic. In announcing the allocation recently, Gov. Ned Lamont pointed to lead’s “catastrophic” effects on children’s health and development, noting that lead poisoning is “a problem that impacts most deeply minority and disadvantaged communities of our state.”
Nearly half of the 1,024 children reported as lead poisoned in 2020 lived in New Haven, Bridgeport, Waterbury, Hartford, or other cities, according to state Department of Public Health numbers.
DPH Photo.
“The money is necessary to address a problem that is a wrong of the past,” said Manisha Juthani, MD, commissioner of the state Department of Public Health. “We need to do better in the state of Connecticut.”
The more enduring thrust of the state’s new actions, however, is the strengthening of its outdated lead laws, starting in 2023. The changes will increase early interventions by:
• Gradually lowering the blood lead levels that trigger parental notifications.
• Lowering the blood lead counts requiring home inspections.
• Requiring more frequent testing of children who live in areas where lead exposure is more common.
Under current law, parental notifications aren’t required unless a child’s blood lead level is 5 micrograms per deciliter or higher. Starting Jan. 1, 2023, the trigger for parental notifications will be 3.5 micrograms, the standard adopted by the American Academy of Pediatrics and the U.S. Centers for Disease Control and Prevention. If the state had used the CDC’s new measurement of 3.5 micrograms in 2020, the number of Connecticut children considered lead poisoned would triple to 3,000.
More significantly, perhaps, is that by Jan. 1, 2025, investigations into where and how a child has been poisoned will drop from the current trigger of 20 micrograms per deciliter to 5 micrograms per deciliter.
‘It’s A Start’
The $30 million for lead poisoning relief is from the state’s share of the 2021 American Rescue Plan Act (ARPA), the Biden administration’s COVID-19-relief legislation.
Department of Public Health Commissioner Manisha Juthani, MD, said the funds will be spent largely on remediating housing found to be the source of a child’s poisoning.
Abating a single home or apartment can cost between $12,000 and $15,000, Juthani said, adding that the ARPA money will remediate more than 1,500 housing units.
“It’s a start,” she said. “This may not remove the problem altogether, but the hope is that we can make a … dent.”
“We’re going to continue to explore funding opportunities that may be federal, that may be with other partners,” Juthani said. “This is always going to be an ongoing priority.”
DPH Photo
Lori Mathieu, DPH public health section chief, discusses the state’s lead abatement plans with Commissioner Juthani.
The federal government approved a bipartisan infrastructure measure in 2021, allocating $3 billion over the next five years to cover the costs of replacing lead-lined water pipes throughout the country.
Connecticut and the other states are conducting inventories to identify pipes that need to be replaced. “Right now, we have about 18,000 on a list of possible lead service lines,” said Lori Mathieu, DPH public health section chief.
Leaded water pipes cause about 20% of all lead poisoning cases in the state; nearly every other case is linked to leaded paint.
Lead Paint In Housing
Until it was banned in 1978, for more than a half-century, lead was added to house paint to boost its durability. Even painted over, it remains on the walls of older apartment buildings and homes. As the paint inevitably deteriorates, leaded chips and paint dust can be ingested by crawling babies and toddlers who, during this peak period of brain development, typically explore their new worlds using hand-to-mouth activities.
Once in the bloodstream, the heavy metal can cause permanent cognitive problems, including a measurable loss in IQ points, hearing loss, developmental delays, learning disabilities and hyperactivity.
For years, Connecticut law lagged behind the scientific findings that ever-smaller amounts of lead can cause irreversible harm to young children.
In testimony before the Public Health Committee in March, doctor after doctor described the dire and discriminatory landscape of lead poisoning.
“As a pediatrician who cares for children with lead toxicity, I have seen firsthand the devastating and long-term health effects that lead poisoning has on the physical and mental health of young children, in particular those under the age of 6.”
— Erin Nozetz, MD, chair of the New Haven Lead Task Force
“Right now, in Connecticut,” Nozetz said, “the risk of a child being poisoned and the response to that poisoning depends on the town that the child lives in. We also know that children from underrepresented minority populations are disproportionately affected by lead toxicity. I don’t know about you, but this infuriates me.”
Waterbury’s Efforts
Connecticut cities have some of the oldest housing in the country. Larger cities may each have well over 10,000 housing units built before lead paint was outlawed.
Waterbury has more than 14,500 such units, and the city consistently has some of the highest numbers of lead-poisoned children in the state, state DPH reports show.
The Brass City reported 81 lead-poisoned children under 6 in 2020, which is certainly an undercount because of the pandemic, said Public Health Director Aisling McGuckin. In 2018, the year before COVID-19 hit, Waterbury reported twice as many lead-poisoned children.
“Waterbury is predominantly a renter city,” McGuckin said. Healthy Homes, the federal program created to eliminate housing-related environmental hazards, has done a lot of work in the city, she said. But much work remains, as well as challenges, she said.
“Landlords can be hard to contact” if an apartment unit or home needs lead remediation, McGuckin said, so “families don’t have a lot of control.”
And there are the logistics involved in the numbers of children and families needing help.
In testimony urging passage of the lead legislation, McGuckin wrote, “Currently in Waterbury, we have two staff managing the lead case management work. In FY 2021, we had over 1,000 cases that under the proposed blood lead level limits would have provoked an investigation and follow-up.”
A Modernized System
New Haven was embroiled in a class-action lawsuit for over two years after the city quietly changed its criteria for investigating lead-poisoned children. Two top health officials, including the department’s director, left. Last summer, a state judge agreed with the New Haven Legal Assistance Association, which had brought the lawsuit, that New Haven was in the wrong.
When the new mayor, Justin Elicker, hired Bridgeport’s public health director to fix the embattled health department, Maritza Bond said she would involve a broad spectrum of the community in her efforts, including lawyers from New Haven Legal Assistance.
“We’re in an excellent position,” Bond said. “We’ve modernized systems. We have a lead dashboard. We’re tracking cases, updating them daily.” The department’s website contains maps highlighting areas with high numbers of lead cases.
The lead program is almost fully staffed. “In two years, we’ve gone from two inspectors to five, and we’re hiring for a sixth,” said Bond, who is running for secretary of the state.
And New Haven is inspecting the homes of lead-poisoned children whose blood lead levels are 5 micrograms per deciliter or higher. The state won’t require that until 2024.
To view the 2018 and 2019 childhood lead reports go here.
Scroll below to read the 2020 childhood lead poisoning report.
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Open in new tab A child whose blood test shows 5 micrograms of lead per deciliter or higher is considered poisoned. The 2015 numbers show 98 new cases of children with lead levels of 20 micrograms or higher, four times the threshold number and a 32 percent jump from 2014.
“We cannot, with any certainty, explain why this is the case,” said Krista M. Veneziano, coordinator of the Connecticut Department of Public Health’s (DPH’s) Lead, Radon, and Healthy Homes Program, about the disproportionately larger numbers of higher toxicity.
Exposure to lead can damage cognitive ability, including a measurable and irreversible loss in IQ points. It can also be linked to speech and developmental delays, hyperactivity, hearing loss and behavioral problems, though these may not show up until years later.
Babies and toddlers are the most likely victims of lead paint poisoning and are especially vulnerable to its effects during these vital developmental years. With their hand-to-mouth exploring, they are more liable to ingest flaking paint chips, which taste sweet, or leaded paint dust, created by doors and windows in older housing opening and shutting, grinding down the paint. Soil near the base of older, dilapidated buildings is also frequently contaminated.
These numbers from the DPH are just an estimate because of under-testing. Although state law requires all children to be tested twice, a year apart, before they turn 3, only 55 percent of 1- and 2-year-olds had both screenings in 2015.
Connecticut is not alone in deficient screening and, in fact, does better than many states. A national study of 1- to 5-year-olds published May 2 in “Pediatrics,” an American Academy of Pediatrics journal, concluded that “undertesting of blood lead levels by pediatric care providers appears to be endemic in many states.”
The state started testing children for lead poisoning in 2002. In more recent years, as knowledge of the continuing impact of the neurotoxin and of the importance of testing have widened, children with elevated blood lead levels have been reported in nearly every town and city.
But the highest numbers of poisoned children are always in the four largest, poorer and minority-dominant cities—Bridgeport, New Haven, Hartford and Waterbury. Hence, black children under 6 were twice as likely to be lead poisoned as white or Asian children in 2015, and Hispanic children were 1.6 times as likely to be poisoned as non-Hispanic children.
More than 75,000 children under 6 were screened in 2015, with New Haven reporting 196 new cases of children with lead levels at or greater than 5 micrograms. Waterbury reported 186 cases; Bridgeport, 179; and Hartford, 113.
Combined, children in these cities comprise close to half of all the new cases of poisonings in 2015.
Dr. Patricia Garcia, co-director of the Regional Lead Treatment Clinic at Connecticut Children’s Primary Care Center in Hartford, said the clinic’s current caseload is 179 children, who generally come from the from the top half of the state. Lead patients from Fairfield and New Haven counties are more likely to seek treatment at the lead clinic at Yale New Haven Children’s Hospital.
And although there are a fair number of children from the city, Garcia said, “If you live in Connecticut, you are at risk for lead.
“Our housing stock is old, we’re from New England, it’s part of our heritage. … [This] means every child is at risk, and it doesn’t matter what socioeconomic class you come from.”
Since 2014, when Flint, Mich., changed its water source and poisoned thousands of its residents, awareness has grown nationwide that lead remains an unresolved problem.
Connecticut’s lead problems, as in most New England states, are linked more to lead paint, which wasn’t banned nationally until 1978. Nearly 60 percent of the state’s housing stock was built before 1970, and percentages in the cities can be higher.
More than 75 percent of New Haven, Bridgeport and Hartford’s housing stock is pre-1960, with the three cities generally swapping positions at the top of the state’s lead-plagued municipalities.
DPH numbers show that among 135 dwelling units investigated and reported in 2015, 84 percent had lead-based paint hazards, 59 percent had a lead dust hazard, and 34 percent showed lead in the surrounding soil.
The lead numbers will be fleshed out when the DPH issues its full 2015 lead surveillance report in the next few months.
The total number of Connecticut children 6 and under with lead poisoning in 2015 was 2,156, which includes children still being treated from previous years. This is about 130 fewer than in 2014.
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“We cannot kick the can down the road and hope the problem goes away. It will not,” DeLauro, a Democrat who represents the 3rd Congressional District, said at a press conference at the New Haven Health Department.
U.S. Rep. Rosa DeLauro
In a May 7 story, C-HIT reported that figures from the state Department of Public Health show that tens of thousands of children are being regularly exposed to lead paint and lead dust – and that tens of thousands of children are not being properly tested for exposure to the toxin.
Damage caused by lead, which can include cognitive, hearing and neurological deficits, among others, is irreversible.
The congresswomen’s legislation — the Healthy Homes Tax Credit Act — would give a $5,000 tax credit to homeowners for lead paint and dust abatement, as well as for asbestos and radon, and remove lead-lined plumbing. The bill is a companion to one introduced earlier this year by U. S. Sen. Chris Murphy of Connecticut.
DeLauro and Esty, the latter who represents the 5th Congressional District, pointed out Monday that hundreds of thousands of homes across the state were built before the federal government banned lead paint in 1978.
The walls and ceilings of older homes were often just painted over, which doesn’t prevent the undercover of toxic paint from eventually chipping off and falling onto the floor; even more dangerous is lead-paint dust, created when windows and doors are opened and shut over the years, grinding down the paint to dust, which can be easily ingested or absorbed by crawling babies and toddlers.
Because of the age of the state’s housing stock, the federal government considers Connecticut to have one of the highest lead-poisoning risks in the country.
Although children who live in older, poorer urban areas are most at risk for lead poisoning, DPH numbers show that children have been exposed in West Hartford, East Hartford, New Britain, Stratford, Hamden, Middletown, and many other communities statewide.
The crisis in Flint, Mich., has shone a light on lead-poisoning linked to water, DeLauro said.
DeLauro added, “No community should ever endure what Flint has endured. Every single person in this country deserves to come home to a place where they feel secure, where they do not worry about their health being at risk, where they do not feel afraid.”
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