THE ROLE OF GOVERNANCE IN MITIGATING LEAD RISKS

Early identification of children at risk for lead exposure has the potential to decrease neurologic damage and behavioral disorders for many living in impoverished, substandard urban communities both globally and in the U.S. Increasing the number of children with regular access to blood lead screenings, residential exposure assessments, and lead hazard control strategies could substantially reduce the number of children that are currently above the U.S. Centers for Disease Control and Prevention (CDC) reference standard of blood lead levels (≥ 5 µg/dL).

Governance needs to identify important gaps in the current strategies that allow Elevated Blood Lead Levels (EBLLs) to remain constant at approximately 3% nationally with respect to the CDC reference standard. Testing, a topic we have heard so much about during the ongoing pandemic has also remained constant for EBLL during the past ten years at a disappointing rate of below 20% for children 6 years old or younger. Without an ambitious testing program, risk characterization remains difficult to comprehensively assess. Governance must evaluate aging infrastructure in terms of poorly kept residential housing, especially rental properties, that often turn over without any inspections to determine the presence and conditions of lead-painted surfaces. In addition, failure to replace lead service lines (LSL) represents a potential risk of contaminating drinking water, as we recently observed in the Flint, Michigan community.

Though COVID-19 currently challenges all levels of governance to do more with rapidly shrinking resources, we cannot fail to recognize that lead is a neurotoxin that permanently and severely damages children. When vaccines become available to help stem the devastation of the COVID pandemic, governance cannot relax and claim a job well done while hundreds of thousands of children face a future that could be impaired with the age-old problem of childhood lead poisoning.