Flint water crisis triggers debate over lead poisoning of children across US

Depending on who you ask, the water crisis in Flint, Michigan, is either a reminder of the progress made against lead poisoning, or a sign more needs to be done. After nearly four decades of federal lead regulations, the issue is back in the headlines.

Almost four decades after lead was federally regulated out of paint and gasoline, it’s not often lead poisoning makes the national news. But in Flint there are areas where more than half of the children have levels of lead in their blood above 5 micrograms per deciliter (µg/dL) - and the issue of lead exposure is gaining prominence again.

There is no safe blood lead level. However, in 2012 the Centers for Disease Control and Prevention (CDC) officially recognized 5 μg/dL as the standard for lead poisoning. Levels as low as 2 μg/dL are known to lower IQ, according to the CDC, while slightly higher levels in children put them at risk of developing ADHD and other learning disabilities. There is no reversing the effects of having too much lead in the blood.

Running with the headline “America's lead poisoning problem isn't just in Flint. It’s everywhere,” Vox reported on the top 10 cities or counties in the country with the highest recorded levels of lead in children’s blood, taking the opportunity to provide geographical and socio-economic context.

At USA Today, an op-ed titled “Flint lead crisis getting a tad overdone” includes in the subheading, “we are winning the war on lead poisoning,” taking the opportunity to provide historical context.

Both approaches come with good intentions, raising awareness of the issue and how to deal with it. There is good news and there is bad news when it comes to lead poisoning, especially in the case of children.

Starting with the bad news, figures by the CDC from 2014 show 10 cities or counties with 10 percent or more of tested children exhibiting lead poisoning, meaning 5 or more μg/dL, micrograms per deciliter of blood. The top spot went to Houston County, Alabama, which tested 12 children and found seven had been dangerously exposed. 

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Filling out the rest of the top 10 was one more Alabama county, four Louisiana parishes, and a county in each of Kentucky, Indiana, Oklahoma, and West Virginia. In Claiborne Parish, LA, of the children tested,  40 percent tested positive for lead poisoning. In Dallas County, AL, a slightly lower 36.8 percent of children tested did as well. Next was Caddo Parish with 28.6 percent, and Ouachita Parish with 20 percent - the latter of which tied Tyler County, WV. 

The bottom four were Campbell County, KY, with 15.6 percent, Jefferson Parish with 14.3 percent, Grant County, OK, showing 14.8 percent, and finally Dubois County, IN, with 10.3 percent of children tested being labeled as ‘lead poisoned.’ 

Many of these areas are in the South and have poorer populations. In Houston County, there are over 100,000 residents, and the average income is $40,000, a little less than the state average, Vox reported. 

The city of Flint’s rate of lead poisoning could, perversely, be considered a hope or dream for the other top 10. Flint officials recently estimated 4 percent of the 8,000 children there have a level of 5 μg/dL or higher. Some of the worst areas in Flint found 10.6 percent of kids in that category, still faring better than nine of the top 10 cities and counties nationwide.

That doesn’t mean there isn’t a problem in Flint, or even in other parts of the country with better rates. The CDC estimates that nearly half a million children between 1 and 5 years old have lead poisoning. But that estimate could be unreliable, considering half of all counties didn’t report any blood lead level data in 2014. Around 44 percent of counties that did report showed zero cases of lead poisoning.

Eleven states -- Alaska, Arkansas, Hawaii, Idaho, Montana, Nebraska, North Dakota, South Carolina, South Dakota, Utah, and Wyoming -- haven’t sent the CDC any data at all on the matter. Reporting to the CDC is not mandatory.

Now, the good news. Forty years ago, the Environmental Protection Agency found that the average child younger than 5 years of age had a blood lead level of 15 μg/dL, meaning the reality has shifted wildly toward a clean bill of health as far as lead in the blood goes. Kids back then were much, much more likely to be exposed to lead by picking up paint chips or dirt around the house. 

By the early 1990s, National Health and Nutrition Examination Surveys showed the rate of 10 μg/dL lead poisoning cases in children aged 1-5 had dropped to 4.4 percent - a fall of more than 73 percent from surveys in the 1970s.

The two most recent presidential administrations have continued to take action on lead regulations. The Bush administration strengthened air and water rules in 2007 and 2008, and the Obama administration put further restrictions on plumbing supplies.

What happens next could well be bigger if the debate on lead poisoning continues to grow.