Lead poisoning in Maryland drops to lowest recorded level, testing increases in first year of state initiative

Lead poisoning in Maryland drops to lowest recorded level, testing increases in first year of state initiative

Governor Larry Hogan proclaims Lead Poisoning Prevention Week in Maryland

Baltimore, MD (October 25, 2017) – Childhood lead poisoning cases in Maryland decreased last year to the lowest levels since data has been collected in connection with the state’s 1994 lead law, according to a 2016 Childhood Blood Lead Surveillance report released today by the Maryland Department of the Environment (MDE). Additionally, blood lead testing rates increased across Maryland in the first year of the state’s initiative to test all children at ages 1 and 2. MDE continues to work with the Department of Health (Health) and the Department of Housing and Community Development (DHCD), as well as local partners, to prevent childhood lead poisoning in Maryland.

For the first time, the report also tracks potential sources of lead exposure in reported cases of childhood lead poisoning and finds that many young children with elevated blood lead levels may have been exposed to lead from sources other than deteriorated lead-based paint.

The report follows Governor Larry Hogan’s announcement earlier this year that the U.S. Centers for Medicare and Medicaid Services approved an application by the Maryland Department of Health to launch a $7.2 million initiative to reduce lead poisoning and improve asthma, two conditions related to environmental conditions in housing. The Department of Health, in collaboration with the MDE and the DHCD, will implement the initiative. Governor Hogan also proclaimed this week as Lead Poisoning Prevention Week in Maryland.

Blood lead testing rates and a new initiative

Blood lead testing rates increased across the state in 2016. Maryland’s new initiative to test all children at ages 1 and 2, regardless of where they live, was announced by the Hogan administration in October 2015 in response to data showing that the state could improve its testing and identification of children with lead exposure.

Although the new Department of Health regulations for increased testing were in effect for only nine months in 2016, starting in March of that year, the 2016 Childhood Blood Lead Surveillance report shows that the number of children age 1 or 2 tested for blood lead in Maryland was 12.2 percent higher than the comparable average for the prior six years. Most counties experienced increases in testing rates, with the largest increases in Howard, Frederick and Carroll counties, each of which saw rates in 2016 increase by more than half. Harford, Queen Anne’s, and Calvert counties also saw increases from 25 to 50 percent.

The report attributes the increase in testing of young children to the universal blood lead testing initiative for 1- and 2-year-olds and to another Maryland Department of Health initiative to endorse Point of Care testing for lead, which allows healthcare providers to test children and provide results in the same office visit. This simplifies testing for parents and, in most cases, eliminates any further office visits or testing for lead.

Childhood lead poisoning cases and Maryland’s lead law

Even with the increase in blood lead testing, the report shows that the percentage of tested young children in Maryland with blood levels at or above the level that triggers action under state law decreased compared to the prior year. This is the lowest level since the beginning of such data collection in 1993.

Last year, less than 0.3 percent of Maryland children tested had an elevated blood lead level that equaled or exceeded the state law-defined elevated level of 10 micrograms per deciliter. The comparable figure for Baltimore City also decreased to the lowest levels since the beginning of data collection, to 1 percent. The report’s findings represent a decrease since 1993 of more than 98 percent in the number of young children reported to have lead poisoning. Much of the decline in blood lead levels is the result of implementation and enforcement of Maryland’s 1994 Reduction of Lead Risk in Housing Act.

The report also shows a decline in the percentage of tested children with blood lead levels below the state-law-defined elevated level, but still of concern based on guidance from the U.S. Centers for Disease Control and Prevention. The number of Maryland children identified with blood lead levels of 5-9 micrograms per deciliter decreased from 1,789 in 2015 to 1,729 in 2016. MDE and the Baltimore City Health Department coordinate to investigate pre-1978 rental units in the city where children with test results of 5-9 micrograms per deciliter live.

MDE serves as the coordinating agency for statewide efforts to eliminate childhood lead poisoning. In addition to the new lead testing plan, under the Hogan administration, Maryland has moved to protect more children from the health risks associated with lead paint poisoning by enforcing an expansion of the type of rental housing covered by the state’s lead law.

Tracking potential sources

In 2016, MDE began comprehensively tracking potential sources of childhood lead exposure. While exposure to lead paint hazards continues to affect children across Maryland, exposure from other sources has been observed, the report states.

For example, 20 of 35 confirmed cases in Prince George’s County were children of refugee families who had relocated to the United States and recently settled in that county, the report finds. Also, cosmetics, such as kohl, and spices purchased outside the United States were identified as potential health hazards during investigations of a significant number of cases across Maryland.

DHCD’s Lead Hazard Reduction Program

The Special Loans Program of the Maryland Department of Housing and Community Development continues to make a significant impact on the lead exposure from lead-based paint in pre-1978 housing stock statewide. The Lead Hazard Reduction Loan and Grant Program was established by the Maryland General Assembly in 1986 solely for the purpose to extend loans and grants to eligible individuals, child care centers, and sponsors to finance the lead hazard reduction of residential housing units. In Fiscal Year 2017, the program helped abate lead in 114 homes for $1,776,139. In addition, the department’s energy programs utilized abatement-related activities on 37 homes for $75,000.

Healthy Homes for Healthy Kids Lead Initiative gets approval

The U.S. Centers for Medicare and Medicaid Services approved an application by the Maryland Department of Health to launch a $4.17 million initiative to reduce lead poison conditions through the abatement of lead and other lead-related repairs in housing.

The initiative leverages federal funds available through the Maryland Children’s Health Program under the authority of a Health Services Initiative State Plan Amendment. The Healthy Homes for Healthy Kids Program will receive $4.17 million in funding, using a combination of $3.67 million in CHIP federal matching funds and $500,000 in State fiscal year 2018 funds. Eligibility requirements for the initiative are as follows: a child who has a lead test result of 5 mg/dl; 18 years or younger, lives in or visits in the home or apartment for 10 hours or more a week; and are currently eligible or enrolled in Medicaid or CHIP.

DHCD will administer the initiative through a network of nonprofits, local agencies, and contractors to help complete the projects. The local health boards and primary care physicians will assist in referring the impacted families to the program to get the much-needed repairs completed.

More information

Childhood lead poisoning is a completely preventable disease.

Exposure to lead is the most significant and widespread environmental hazard for children in Maryland. Children are at the greatest risk from birth to age 6 while their neurological systems are developing. Exposure to lead can cause long-term neurological damage that may be associated with learning and behavioral problems and with decreased intelligence.

Maryland’s lead law requires owners of pre-1978 rental dwelling units to register their properties and reduce the potential for children’s exposure to lead paint hazards by performing specific lead risk reduction treatments prior to each change in tenancy.

Under the Maryland lead law, the Department of the Environment: assures compliance with mandatory requirements for lead risk reduction in rental units built before 1978; maintains a statewide listing of registered and inspected units; and provides blood lead surveillance through a registry of test results of all children tested in Maryland. The lead program also: oversees case management follow-up by local health departments for children with elevated blood lead levels; certifies and enforces performance standards for inspectors and contractors conducting lead hazard reduction; and performs environmental investigations of lead poisoned children. The lead program provides oversight for community education to parents, tenants, rental property owners, home owners and health care providers to enhance their roles in lead poisoning prevention. Maryland works in partnership with the U.S. Environmental Protection Agency, Baltimore City and other local governments and non-profit organizations such as the Green & Healthy Homes Initiative to prevent childhood lead poisoning.

Quotes

“We are making progress in the battle against childhood lead poisoning in Maryland. The Maryland Department of the Environment is committed to reducing exposure to lead in newer rental homes now covered under Maryland’s lead law and to enforcing the law for older rental units, including those in Baltimore City. We will work closely with our partners, such as the Department of Health, the Department of Housing and Community Development, Baltimore City, the Green & Healthy Homes Initiative, and the U.S. EPA to eliminate this completely preventable disease.”

– Ben Grumbles, Secretary, Maryland Department of the Environment

“We are extremely pleased with the progress that the State’s health care providers, parents, and advocates have made over the last year in testing more children for lead, in conjunction with the Department of Health and the Department of Environment. Together with the State’s recently announced efforts to increase resources for lead abatement and environmental case management through Medicaid and the Children’s Health Insurance Program, the increased testing helps to fulfill the State’s commitment to reduce and eliminate childhood lead poisoning in Maryland.”

– Jinlene Chan, Acting Deputy Secretary for Public Health Services, Maryland Department of Health

“The Department of Housing and Community Development is proud to partner with the Department of the Environment and the Department of Health to support lead paint abatement in our state’s communities. Programs like the Lead Hazard Reduction Loan and Grant Program have been instrumental in the reduction of childhood lead poisoning cases and new initiatives like Healthy Homes for Healthy Kids will enable us to continue our positive progress to protect Maryland’s children from exposure to lead.”

– Matt Heckles, Assistant Secretary, Maryland Department of Housing and Community Development

Additional information

2016 Maryland Childhood Lead Registry Annual Surveillance Report

Graphic: Childhood blood lead surveillance statewide 1993-2016

Graphic: Childhood blood lead surveillance Baltimore City 1993-2016

Graphic: Change in 2016 Maryland blood testing rates by county

Lead Poisoning Prevention Week proclamation

Maryland Department of the Environment Lead Poisoning Prevention Program

Maryland lead law fact sheet

Maryland Department of Health

Maryland Department of Housing and Community Development

Baltimore City Health Department