RESIDENTIAL
LEAD ABATEMENT
EXECUTIVE
SUMMARY
December, 1999
EXECUTIVE SUMMARY
The harmful effects of lead hazards on children have been recognized for many years. Since lead was banned in paint, gasoline, and food cans in the late 1970s, legislation at both the federal and state level has been aimed at pre-1978 housing as the major cause of lead poisoning among children. Childhood exposure to lead usually occurs in two ways:
· deteriorated paint (and resulting dust) in poorly maintained housing; and
·
repainting and remodeling projects that disturb leaded paint
without appropriate safeguards to control, contain, and clean up lead dust.
All homes built prior to 1978 are
considered to be potential sources of exposure to lead-based paint, however
housing built before 1950 generally contains the highest amount of lead-based
paint, since paint used at that time had a high lead content.
In Connecticut, 35 percent of the state's total housing units were built
prior to 1950.
The Legislative Program Review and
Investigations Committee voted to conduct a study of Residential Lead Abatement
in March 1999. The study examined
Connecticut's law, regulations, and programs for screening children for elevated
blood lead levels, as well as programs that provide financial assistance to
property owners to abate hazardous lead from their properties.
Under Connecticut law, property
owners are liable for abatement of defective interior and exterior surfaces that
contains toxic levels of lead and are in a residential dwelling where children
under the age of six reside. The
regulations do not require a child be diagnosed with an elevated blood lead
level in order for them to be applicable. However,
if a child has been identified with an elevated blood lead level, more extensive
abatement of lead hazards is mandated.
The Connecticut Department of
Public Health operates the Childhood Lead Poisoning Prevention Program, which
oversees prevention and regulatory activities.
The Department of Economic and Community Development administers federal
and state financial programs that provide loans and grants to property owners
for lead abatement activities. At
the local level, 108 health departments/districts are responsible for conducting
epidemiological investigations once a child is identified with a blood lead
level of 20 micrograms (mcg) per deciliter (dL) of blood or greater.
In addition, the local code enforcement agencies conduct environmental
inspections, issue abatement orders to property owners if lead hazards are
present, and ensure compliance with the order through re-inspection or referral
to the courts.
Connecticut currently recommends,
but does not mandate, all children between the ages of one and six be screened
for lead poisoning. Studies based
on national data have shown the risk for lead exposure remains
disproportionately high for some groups. Age,
income level, race/ethnicity, and age of housing are key factors in determining
children's risk for lead poisoning.
The Department of Public Health
recommends universal lead screening tests be performed on all children under the
age of six. But
screening data shows that only 20 percent had a valid screen for lead
poisoning during 1998.
Of those, 4.6 percent had blood lead levels equal to or greater than 10
mcg/dL (and 1.1 percent at or above 20 mcg/dL ).
Further, the vast majority of children with high blood lead levels are
concentrated in five of Connecticut’s largest cities.
Bridgeport, Hartford, New Haven, Stamford, and Waterbury accounted for 72
percent of children statewide with blood lead levels equal to or greater than 10
mcg/dL and 76 percent with levels at or more than 20 mcg/dL.
These cities, have the greatest number of children younger than age six,
high poverty rates, and a large portion of their housing stock was built prior
to 1950.
By statute, local health
departments/districts are required to submit lead inspection and abatement
activity to the Department of Public Health.
However, the committee found problems with the way these inspection data
are tracked, with numbers carried over from year to year.
The committee also found a low percentage of abatement orders are
actually completed. There were
1,200 orders outstanding throughout 1998, and only 275 were completed (23
percent)
As would be expected, given the
geographic location of children with elevated blood lead levels, the greatest
inspection and abatement activity is reported by six of the states largest local
health departments (Bridgeport, Hartford, New Britain, New Haven, Norwalk, and
Waterbury). The six departments
carried out 829 inspections (92 percent of the 903 total statewide inspections).
Finally, 228 abatements (83 percent of statewide total) were reported
completed.
The Connecticut General Assembly
created the Hazardous Materials Program in 1987.
The program is administered by DECD and operates as a consumer-oriented
loan/grant program for property owners who have been issued orders by local
health departments to abate lead or remove asbestos from residential dwelling
units. As of June 30, 1999, lead had been abated from 722 residential housing
units with total costs of $11,231,547, and an average cost-per-unit of $15,556.
An additional $2.5 million in state funding was allocated to the program
in June 1999.
The committee found the major
emphasis of Connecticut's lead program is on identifying children who have high
blood lead levels, requiring local health departments inspect the child's
residence and, if lead hazards are found, order the property owner to abate the
lead. The effect of this focus is
that thousands of property owners face considerable financial risk if a child
under the age of six has a blood lead level that requires an environmental
inspection of the residential unit. This
policy has not been particularly successful in Connecticut, especially when the
high number of lead abatement orders issued to property owners are compared to
the low number of actual abatements occurring.
The
committee believes the cornerstone of the state's policy should be the
prevention of lead poisoning and recommended a number of strategies for
increasing prevention activities so fewer children will be exposed to lead
hazards. These include:
· more widely distribute educational information on how to minimize or avoid exposure to lead hazards;
· establish a targeted lead screening program so children most at risk for elevated blood lead levels are identified early, provided with educational information, and interventions can be taken; and
·
establish voluntary essential maintenance practice guidelines for
rental properties to control and eliminate lead hazards, and provide tax credits
for property owners that implement the guidelines.
The
committee found the department’s information systems are fragmented and
contain too many discrepancies to support adequate program management.
A successful regulatory program must be supported by a comprehensive
database. To accomplish this, the
committee recommended the department establish a single database for the
program. The committee also found the Department of Public Health needs to
coordinate its information systems and ensure the validity of the data.
The department must also strengthen its oversight of local health
departments' enforcement of abatement orders and ensure epidemiological
investigations to identify lead sources are being performed.
A major policy issue at both the federal and state level is how to protect children from lead hazards. Although increasing prevention should reduce the number of children with elevated blood lead levels, the committee found strong and clear regulatory action is still needed when prevention efforts are unsuccessful and a child has a high blood lead level. Local health departments must have the authority to order property owners to manage and abate lead hazards to ensure children under the age of six are protected from continued exposure.
The department began a revision of its lead regulations in
1996. Achieving consensus has been
difficult, and the new regulations have yet to be adopted.
The program review committee believes several regulatory changes are
necessary to more clearly define the program.
These changes, however, must be undertaken in conjunction with
improvements in data collection and analysis, as recommended above.
Recommendations
1.
The Department of Public Health establish an Internet web site providing
online access to its Childhood Lead Poisoning Prevention Program.
At a minimum, the web site should contain Connecticut’s lead laws and
regulations, general information about ways to protect children from lead
hazards, information on financial assistance programs available to property
owners to manage and/or abate lead hazards, statistics on screening and
incidence rates, and how to request further information.
In addition, the department could use the site to gather information on
the impact of lead poisoning on the citizens of the state.
2.
C.G.S. §19a-110(d) be amended to require local health departments or
districts that receive a report of a child under the age of six with a blood
lead level equal to or greater than 10 mcg/dL to provide the owner(s) of the
property with educational materials on how to reduce lead hazards in housing.
The Department of Public Health shall develop and furnish the educational
materials to be provided.
3.
The commissioner of public health define in regulation the terms
“elevated blood lead level” and “lead-poisoning,” in conjunction with
recognized professional medical groups and the Centers for Disease Control, and
the responses required in accordance with guidelines issued by the Centers for
Disease Control.
C.G.S. §19a-111
shall be amended to require an epidemiological investigation for a confirmed
concentration of lead in whole blood equal to or greater than 20 mcg/dL for a
single test or 15-19 mcg/dL on two tests taken at least three months apart.
4.
The Department of Public Health adopt CDC’s interim policy
recommendation until the department establishes a permanent statewide health
plan for lead screening. DPH shall
follow the steps recommended by CDC to develop the state plan.
The plan shall include:
· data demonstrating the appropriateness of dividing the state into targeted screening areas;