LEAD: EXAMPLE

OF THE JOB AHEAD

Inner City Children
Suffer Most

profile of exposure and uptake by race and social class-probably more so than any of the other major pollutants to which the general population is exposed. Lead also differs from most pollutants in another, more positive respect: In the last two decades, we've made the greatest progress in reducing overall lead exposure. Still, while exposures have been reduced overall, minority and lower income children retain a higher risk of elevated blood lead levels, a disparity that has been in evidence for decades.

In the Second National Health and Nutrition Examination Survey (NHANES II), conducted between 1976 and 1980, the average blood lead level for children aged 6 and under was found to be 16 micrograms of lead per deciliter of blood (μg/dl)-which is the most commonly used standard

measure of blood lead concentrations. For black children, however, the average blood lead level was 21 μg/dl; for children in the lowest fifth of family income, 20 μg/dl. Blood lead levels were notably elevated for children living in inner city areas. Poor black children in the inner city had an average blood lead level of 23 μg/dl.

To put this latter figure in perspective, consider that the Centers for Disease Control recommended in the 1980s that any child with a blood lead level of 25 μg/dl or higher be given a full-day test to determine whether hospitalization was needed. An even more dramatic comparison: Recently, a child with a blood lead level of 144 μg/dl died from massive brain damage. In other words, poor black children in inner city neighborhoods in the 1970s had average blood lead concentrations amounting to over 15 percent of a potentially fatal dose. For no other toxic substance in modern times has the average exposure for a large group been so close to the fatal dose.

Fortunately, a great deal of progress has been made in reducing blood lead levels in the United States, due in no small part to restrictions on lead in gasoline. More than half of the average blood lead level in U.S. children in the 1970s was attributable to lead in gasoline emissions. When unleaded gasoline was introduced and the

amount of lead limited in leaded gasoline, those emissions declined dramatically. Lead in gasoline today is less than half a percent of what it was at its maximum, and it will be banned entirely in 1996.

Other actions to reduce lead exposures have also had a significant impact, and continued improvements are expected. For example, the Food and Drug Administration (FDA) has taken steps to substantially reduce the use of lead solder in canned food,

formerly a significant source of lead exposure. At present, average blood lead level in American children is estimated to be under 6 μg/dl, considerably lower than found in NHANES II.

In addition, EPA recently issued rules requiring water suppliers to make their water less corrosive. Lead contaminates drinking water when the water corrodes the materials of the public water system and the plumbing within the home; also when lead is leached from the lead solder used to join copper pipes, from lead pipes and connections, and from faucets and other plumbing fixtures. Therefore, reducing the corrosivity of the water is expected to significantly reduce lead levels in drinking water.

To date, the overall improvement has been dramatic in that blood lead levels in every age, race, sex, and income category have decreased throughout the country. Ironically, however, the general decline appears to have increased the disparity in blood lead levels by race and social class. While income and especially race have always been important variables of exposure, we expect that the continuing decline in the blood lead levels in the general population

Lead Free Kids photo.

will make race and income even better indicators now than previously of the likelihood of elevated blood lead levels.

The obvious question is, Why? Gasoline, of course, was a lead exposure source that affected the entire population. Most of the lead particles emitted from car tail pipes are quite small, and their distribution across urban areas is relatively uniform. Everyone breathes the air, and everyone benefitted when lead was curtailed in gasoline. Similarly, most of the population benefitted when the use of lead solder in canned food was eliminated.

In contrast, exposure to lead paint, a major remaining exposure pathway, is much less uniform. Housing built before 1950 is most likely to contain paint with high concentrations of lead. After 1950, the lead content of paint declined substantially, and the use of lead paint for houses was banned in the 1970s. Survey data from the U.S. Department of Housing and Urban Development (HUD) indicate that 90 percent of housing built before 1940 contains some lead paint, as does 62 percent of housing built between 1960 and 1979. The survey assumes that virtually no housing built after 1980

contains lead paint.

Furthermore, older houses tend to have paint with higher lead concentrations: 75 percent of the pre-1940 housing had paint lead at concentrations higher than 2 mg/cm2 (double the level commonly defined as indicating the presence of lead paint), compared to only 18 percent of houses built between 1960 and 1979. Therefore, the presence of lead paint and the concentration of lead in the paint-varies widely from house to house.

But the mere presence of lead paint or even the concentration of lead in the paint does not tell the whole story. For one thing, the condition of the paint is critical. Lead paint that is well covered with non-lead paint, and in good condition, results in much lower lead exposures than exposed paint in poor condition. Everyone knows about children being poisoned by eating lead paint chips. But that's not really common. In fact, most cases of lead paint poisoning seem to occur from the ingestion of common household dust that has been contaminated with lead. The normal hand-to-mouth activity of small children results in their ingesting enough contaminated dust to raise their blood lead levels and even to poison them.

In homes with lead paint in deteriorated condition, the concentrations of lead in the dust are likely to be high. Adults as well as children are exposed to dust-dust that settles on plates and glasses, dust that contaminates carpets and furnishings, dust that we breathe, etc. More dust can mean higher lead exposures. Simply put, for the same presence of lead paint on the wall, the degree of risk presented can vary widely depending on how much exposure there is how deteriorated the paint is, how much lead infiltrates. the house dust, how much dust is present, and what the activity patterns

are for children and other family members.

For all these reasons, exposure to lead from paint, unlike lead from gasoline, is highly variable. Some houses have lead paint; some don't. Some buildings have lead paint in poor condition. The more dilapidated the housing, the higher the lead exposures are likely to be. Housing condition is largely a function of income.

Lead-contaminated soil is another source of exposure, but again the degree of potential exposure is highly variable. Decades of lead emissions from gasoline now contaminate urban soils, along with some deposition from other sources of lead. In older residential areas, more than a century's use of lead in exterior house paint has raised soil lead levels.

Soil contaminated by lead can be a significant exposure source, especially for children. And once more, the exposure of poor and minority children is likely to be higher, both because lower income and minority groups are more heavily concentrated in older urban areas and because their yards are more likely to have exposed soil--in other words, less likely to have ground cover, lawn furniture, swing sets, or other barriers to the soil. So, again, even for the same contamination level in the soil, lower income children are likely to have higher actual exposures. Of course, higher lead levels in soils and more exposed soil also increase the

likelihood of introducing lead into interior house dust, another pathway for lead exposure.

There are still other lead exposure sources that disproportionately affect lower income and minority groups. One is occupational exposure. Several surveys suggest that both groups are heavily represented in jobs at risk of having high occupational lead exposures. These occupations include construction, primary and secondary

For no other toxic substance

in modern times has the average exposure for a large group been so close to the fatal dose.

smelting, automobile repair, welding, and salvage work. Occupational exposures in adults are often linked with elevated lead levels in other family members, especially children. Unfortunately, occupationally exposed workers have not shown the same overall decrease in blood lead levels that has been seen in the general population over the past 15 years.

Certain consumer products also represent exposure sources that are likely to affect specific ethnic groups. Several studies have indicated that some traditional medicines, cosmetics, and foods from a range of cultures can contain high levels of lead. These goods, along with ethnic and handmade potteries that leach high lead levels, can all be sources of increased lead exposure and even toxicity. Brass and especially bronze are used for cooking and eating utensils in several cultures; both alloys can contain and leach high levels of lead.

It is important to note that while FDA has been successful in working with the U.S. food processing industry to eliminate the use of lead solder in cans produced domestically, imported cans are not currently regulated in this way. Some ethnic groups consume significant quantities of imported canned foods, and they are at risk of higher lead exposure from this source. These last points raise a difficult issue. Children or adults may have elevated blood lead levels both because of higher environmental exposures and because of behavior patterns that increase intake. The use of certain traditional remedies or canned foods with lead is one such behavior pattern. The degree of hand-to-mouth activity or the frequency of hand washing can modulate exposures. Many other factors can also affect a child's exposure to and uptake of lead from the environment, including nutritional status, eating habits, adult-to-child

ratio, etc. To be fully effective, successful intervention programs must target behavior as well as the physical environment.

Because of the factors discussed in this article, we expect that blood lead levels have probably fallen by a smaller than average percentage in poor inner city neighborhoods and among certain ethnic racial groups. Equity considerations are a major concern with lead exposure, in part because such exposure is associated with increased risk of compromised cognitive development and abilities and resulting substandard school performance. The inequity of imposing such a burden on children of lower socio-economic status and/or children from disadvantaged ethnic or racial groups is obvious: It compounds their burden by leaving them with fewer skills to overcome the disadvantages that face them.

By design, EPA regulations and programs have thus far aimed primarily to reduce the general population's exposure to lead. The Centers for Disease Control and other federal agencies are now developing a nationwide strategy to address lead paint exposure, which is currently the most important exposure source. This strategy specifically targets lead exposures predominantly affecting children who are already disadvantaged.

EPA is participating in the development and implementation of the strategy in several ways: by helping to design training programs for lead paint abatement workers, by conducting research on innovative approaches that can reduce the cost of lead paint abatement, and by providing technical assistance to CDC and HUD in designing their programs. If fully implemented, these initiatives should reduce the disparity in lead exposures among the U.S. population.

and remain, in short, environmental dumping grounds. Will the dominant culture, which has not been known to redistribute natural resources to the benefit of minority groups, relinquish its control of such resources? Will the dominant culture clean up minority communities? Will it redirect the nation's vast resources in a massive environmental reclamation program in minority communities? Will it embrace minority cultures as its own and thoroughly integrate itself into these communities? History provides no precedent for such occurrences. Therefore, minority communities will have to take the initiative to eliminate environmental pollution by whatever means necessary.

Some 20 years ago, comedian and nutritionist Dick Gregory noted that "America is insecure . . . . Americans will permit the continuation of a polluted system which makes billions of dollars through reckless pollution." Jazz musician Miles Davis addressed environmental issues in his autobiography: "[P]ollution is everywhere. Polluted lakes, oceans, rivers; polluted ground, trees, fish everything. I mean they're just ... so greedy. I'm talking about whites who are doing this... [to] the ozone layer."

What can minority communities do to reclaim their environmental destiny? Ultimately, minority communities have one of two choices for cleaning up their environments: (1) replace the dominant culture; or (2) clean up their own environments. The first choice is probably not practical or possible. The second choice is imminently practical and definitely possible. In fact, minority communities must lead the way in cleaning up their own communities. To the extent that the dominant culture is willing or able to assist, so much the better. However, minority communities cannot afford to wait for the dominant culture to "get environmental religion," so to speak. What will this minority

environmental clean-up campaign look like? Minority communities need to implement an all-out effort,

comparable to but larger than the civil

rights movement of the 1960s, to clean up the air, water, food, land, toxic wastes, and toxic behavior. In addition to cleaning up the neighborhood, this effort will provide development, employment, and economic power within minority communities.

Many urban minority communities are located in areas that are consistently in violation of the Clean Air Act. Asthma is killing African Americans in unprecedented numbers. Black males in urban areas are five times as likely to die from asthma as whites in the same settings. Minorities must eliminate ground-level ozone and otherwise clean the air in their communities. Lead poisoning is causing tragic disabilities among minority children: The sources of this lead contamination must be removed. Minorities must clean up polluted drinking water in their communities in both urban and rural areas. They must clean up the land and neutralize toxic waste sites. Minority communities must alter their food consumption patterns to improve health. Toxic behavior-drug killings, addictive drug use, and crime-must be significantly reduced.

Minorities do not own the refineries or chemical facilities that have

The author is pictured at the

Anacostia River in Washington,

DC.

produced the pollution dumped in their backyards. Since they do not have a vested interest in these companies, minority communities are in a unique position to lead the nation toward implementation of appropriate energy and manufacturing

technologies. There is an opportunity to play a leadership role in fostering a nonpolluting, innovative, competitive economic renaissance.

Environmental justice will be attained as minority communities rid themselves of pollution problems. Environmental racism will become irrelevant as environmental solutions are adopted and maintained by minority communities that are now disproportionately polluted.

There really isn't an alternative. The very health and existence of some of these communities are on the line. The time has come to seize the environmental initiative and clean up minority communities by whatever means necessary. The stories that follow provide some examples of what can be achieved when community groups take the initiative on behalf of their own environment.

(McDonald is President of the Center for Environment, Commerce, and Energy in Washington, DC.)