The pandemic, officials say, has led to a decrease in the number of lead tests conducted this year in Milwaukee, a major concern in a city whose Health Department has been criticized for its handling of the public health crisis.
Marivel Montejano, director of home environmental health for the City of Milwaukee Health Department, said comparing 2019 data to 2020 data through September shows a 39 percent decline in lead tests performed and a 27 percent decline in the number of children tested.
The reason for the drop: a coronavirus pandemic that has kept parents and children out of clinics for regular and follow-up visits and hindered the ability for health care and lead assessment workers to get into homes to conduct vital risk-reduction work.
The Centers for Disease Control and Prevention, or CDC, recommends interventions for any children with lead exposure levels of 5 micrograms per deciliter or higher to minimize the risk of lifelong health, learning and behavior problems.
Fueling more concerns are the rising number of children spending more time at home due to virtual schooling and other factors, and that older homes and buildings are primary sources of lead exposure.
Montejano said the pandemic forced changes in protocol “to ensure both the safety of staff going into families’ homes and the families themselves.”
Those changes included a pre-visit telephone screening for COVID-19 symptoms or possible exposure and referrals to local coronavirus testing sites.
Home visits, if necessary, are planned based on recommended COVID-19 timeframes, she said. During the pandemic, the city’s home environmental health division continued to respond to and investigate all cases in which lead levels were high, she added.
In extreme cases where children had blood levels of 20 micrograms per deciliter or higher, the families receive clinical case management services along with physical and neurological developmental screenings by public health nurse case managers. An environmental investigation by certified lead risk assessors is completed for the home in those cases, and education on how to minimize future exposure and a Healthy Homes Kit is provided, Montejano said.
Pandemic ‘threw everybody for a loop’
COVID-19 has also caused disruptions for the Sixteenth Street Community Health Centers’ Lead Outreach Program.
“When March and COVID presented itself, it put the whole lead program on hold in terms of doing home visits,” said Marcos De La Cruz, clinical director of the organization’s lead program. COVID-19 “threw everybody for a loop.”
Pre-pandemic, he said, outreach workers conducted door-to-door visits, in-home lead testing and lead abatement work in addition to follow-up lead testing and other services for children who tested with high exposure levels.
“Because there is no medication for children with elevated levels, the education provided to parents focuses on proper nutrition and removing risks,” De La Cruz said. “Not being able to see patients in person made things difficult.”
Although it was no longer able to conduct in-home visits, the clinic did follow up with children who tested with elevated levels of lead, and it conducted visual assessments of homes via Zoom when possible, he said.
The center was able to continue to conduct lead tests on children during their six-, 12- and 18-month checkups, and during their annual checkups for kids ages 2 to 5, so the staff was able to capture a big group of patients, he said.
Sixteenth Street has been working since September to bring a backlog of children who need retests or other services back to the clinic. A decision to resume in-home visits will be made once the positive rate of COVID-19 cases goes down.
“There’s nothing set in stone for the near future, but we’re ready when we are able to,” De La Cruz said.
The decrease in lead screenings is a major concern for U.S. Rep. Gwen Moore, a Milwaukee native. She said her office recently requested information on lead testing for the state.
“They confirmed that preliminary data indicated that tests for children under 6 were down, especially in the early part of this year,” Moore said.
Moore joined other members in Congress who sent a letter to Robert R. Redfield, director of the CDC, that requested additional federal funds and resources be allocated to address the COVID-19-related challenges to lead testing.
Locally, Ald. Martina Dimitrijevic authored a 2021 budget amendment to expand the SafeHomes Lead Abatement Initiative, which would increase lead abatement and lead hazard inspection capacity for the Milwaukee Health Department and the Department of Neighborhood Services.
The amendment, which is part of a larger omnibus package co-sponsored by several Common Council members, would increase funds for the program with $500,000 in Tax Incremental Financing resources. The money would be used to create a new lead abatement program that focuses on owner-occupied dwellings, according to a news release issued last week by Dimitrijevic.
“Sadly, a large number of properties across Milwaukee contain lead exposure threats from water and from surfaces that contain lead-based paints,” Dimitrijevic said.
The city is well behind its goal to replace 1,100 lead water lines at homes and businesses by the end of the year, and seven decades away from removing all public and private-owned lead water service lines.
Several groups have said that these lines, also known as “lead laterals,” are a primary source of childhood lead poisoning in Milwaukee. The city has contended that lead paint is the main source of lead poisoning in children and that the city’s water meets all federal safety guidelines.
According to the CDC, there is no safe level of exposure to lead, and exposure can cause behavior problems and learning disabilities in young children and also harm adults. A 2019 study by the University of Wisconsin-Milwaukee, which examined data on more than 89,000 people born in the city from 1989 to 2003, found that childhood lead exposure increased the risk of being a perpetrator or victim of gun violence.
How you can protect kids
In terms of what parents and others can do to protect their children from exposure to lead hazards, Montejano said they should look out for paint that is chipping, peeling or flaking around windows, porches, fences and garages.
Parents and guardians should always use soap and water when washing or cleaning hands, toys, bottles, pacifiers and other items.
Montejano urged residents to use NSF/ANSI 53 water filters, which are certified to remove lead, and to avoid products that are imported and may contain lead — such as cosmetics, candies, spices, cookware and medicines.
“Feeding children healthy foods that contain iron, calcium and vitamin C minimizes the absorption of lead in the body,” Montejano said. “Most importantly, have children tested for lead poisoning.”
For more information on lead testing in the City of Milwaukee or to receive a Healthy Homes Kit, you can call the Home Environmental Health Program at 414-286-2165.