Times
online
Cover
Story
CONTENTS:
as our housing stock ages. The state is responding.
Sort of.
Staff Writer
In a perfect world, people would have no lead at all in their bodies. The heavy metal has no place in the food chain and is nothing but a detriment to the processes of life.
But the realities of environmental degradation are against us: Medical authorities maintain that, if tested, most of us would have at least traces of lead in our blood or tissues, the enduring legacy of leaded gasoline, lead in our water pipes, lead in our household paints, lead in the soils in which we work, play or garden.
Once ingested into the complex machinery and chemistry of animal metabolism, the element ties up oxygen's place on the hemoglobin molecule, inhibiting health and growth. It collects in soft tissues, bones and organs, permanently damaging these elegant structures and affecting their essential functions. Over time, it releases back into the bloodstream to carry on its insidious work. As with most toxins, those most at risk are very young children and the unborn infants of pregnant women.
The effects of lead poisoning are devastating - medically, emotionally and financially. At low levels, lead poisoning can cause headaches, hearing problems, lowered IQs, decreased attention spans, hyperactivity, impaired growth, reading and learning disabilities, hearing loss, insomnia and other problems. At very high levels, it can cause mental retardation, coma and death.
But lead accumulating to toxic levels is almost entirely avoidable, and as such, was identified in Maine's recent health survey as a preventable environmental health problem. Nearly all cases of childhood lead poisoning are attributable to the ingesting of chips and dust from pre-1978 paint in older homes.
ometimes, curious and tactile young children deliberately peel and eat the flaking paint; more often, they unwittingly breathe enough of the dust from battered surfaces like floors and window frames to make them sick. Regardless of the source, young children's developing bodies, especially their neurological and immune systems, can be affected for life.
Household paints no longer contain lead. Originally added to increase durability, it was banned outright in 1979. But more than half of Maine's housing stock was built pre-1960; and public spaces like schools, churches and community halls are also likely to contain the hazardous material.
While lead paint poisoning is widely considered a problem in poor, urban neighborhoods, many of the cases in Maine occur - often as a result of renovations to older homes - in middle-and upper-income families. Regardless of economic status, lead poisoning often happens to families who are otherwise vigilant in protecting the well-being of their children. The state says it's stepping up efforts to educate and support families living in older homes, but those whose lives have been changed by lead poisoning say it's not enough.
The countryside around West Lebanon is about as pretty as it gets here in rural New England. Tucked into a quiet corner near the southern border with New Hampshire, its winding roads and rolling hills hint at the nearness of the White Mountains without forsaking a comfortable sense of tradition and refinement. The village itself is centered on a five-corner intersection, where a gathering of handsome old clapboard homes creates a hospitable neighborhood, graced by a white hilltop church. The entire postcard village is on the National Register of Historic Places.
When Dean and Cindy Pratt found a house for sale in the village, they knew they were home. The place was perfect: spacious and gracious, with pine plank floors, loads of windows, and the added charm of built-in cupboards throughout. On a quiet corner lot with a little gardening space and a small barn, the house, built in 1890, fit their needs to a T.
The asking price was a little steep, but the young couple - he a bartender, she an office worker - had been living for three years with Dean's father in his log cabin in Berwick while they saved their down payment, and they were ready to talk turkey. After negotiating the price and working through the stack of paperwork required for their Farmers Home Administration loan, they moved in at the end of July in 1999.
Despite the routine form they signed when they bought the place, Cindy says, the whole issue of whether the house contained lead was brushed aside. "They told us there was lead in the house," she admits. "We asked a lot of questions. The realtor told us, 'You and I grew up in a lead paint house, and we're OK.' She treated it like it was no big deal. I thought she was someone we could trust."
In the helter-skelter way most of us settle into a new nest, the Pratts ran the vacuum cleaner around the empty rooms, stacked their everyday dishes on the worn shelves of the kitchen cabinets, and made plans to restore their distinctive house to its former elegance.
Their first project, just a few weeks after they had moved in, was to strip the layers of old paint off the wide boards of the upstairs hall floor. Dean says he used a chemical stripper first, because he didn't want to fill the house with the dust of sanding. During the time he worked on the floor with the chemical stripper, Cindy and the two kids - Dean, Jr., 2, and Tori, 4 - stayed away to avoid the fumes. When the floor was down to bare wood, except for the stubborn stripes of paint still stuck in the grain of the boards, Dean sanded with a rented drum sander. The afternoon he was finishing up, Cindy and the children moved back in.
"That night when I put them to bed," Cindy recalls, "They were terribly fussy and cranky, not like themselves at all. Somewhere in my mind, I knew they were lead-poisoned."
When Cindy brought the children to their pediatrician for a lead screening, young Dean's level was 28 mcg/dl (micrograms per deciliter of blood); Tori's was 17. The doctor advised the worried mother to keep the house dusted, watch the kids carefully and punch up their nutritional intake.
Because Dean's score was over 20, the state sent inspectors to the Pratt's house to test for lead. The inspectors used an X-ray device to see through the layers of paint in the old house; results were due in a couple of weeks, but did not come for nearly six. The inspectors returned weeks later to take a simple "swipe test," which measures lead dust on surfaces like windowsills and toys. "Wouldn't you think that would be the first thing they'd test?" Cindy asked.
On Oct. 10, Dean's lead level
was up to 64, and he was hospitalized for three days of intravenous
and oral treatment to draw the lead from his body and blood.
Doctors at Maine Medical Center told Cindy that, in accordance
with state regulations, she couldn't return to the home until
the lead problem was cleared up.
That day, the Pratts moved back in with Dean Sr.'s father. "We
walked out on Oct. 10. We came back to get some clothes. We stayed
with my dad from October [1999] until March [2000]," Dean
Sr. said.
The tests at the Pratt's house revealed extensive contamination, and the state told them to get an estimate for the abatement work needed to make the place safe to live in. The first bid was $31,460. A second came in at $41,150. After the DEP worked up design specifications for the project, though, the two contractors' bids jumped to $43,900 and $49,825, respectively.
The Pratts were in despair.
Their combined annual income was under $40,000, and they had
spent all the money they had on the down payment, financing the
house with a low-cost mortgage through the Farmers Home Administration.
"If you qualify for FHA," Cindy said, "it's obvious
you don't have much money."
The state, Cindy says, offered false assurances, promising to
help with the cost of the abatement. "They said, 'It's part
of Dean's medical treatment to get the house abated; we won't
abandon you,' " she recalled. Instead, the state dragged
its heels and, despite several visits from various agencies and
inspectors, no progress was made toward getting the Pratts back
into their home. They were about $7,000 over the income eligibility
limit for access to a state-administered HUD grant, and there
was no other help in sight.
In November, desperate and fed up with getting nowhere with the
state, Cindy Pratt testified at a November hearing before Senator
Susan Collins. Her predicament, she said, touched the senator.
"She said, 'This isn't right; we need to take care of this
family.'"
FHA, it turned out, was the answer. The federal program had required an inspection of the property prior to approving the loan; when inspectors made their report to the agency, they made no mention of lead. Just three problems were identified: The sellers were required to 1) replace some iffy shingles on the barn roof, 2) drill a well to replace the hand-dug one in the cellar, and 3) paint the peeling exterior of the house, before they would finance the Pratt's purchase.
Cindy Pratt is bitter. "We were sold a house with tons of hazards, and we didn't know anything about it," she said. "The barn roof could have caved in and the well could have dried up and we would have been better off than we were."
Because the FHA inspection failed to identify the lead issue, the agency took the hit. In March, they asked the Pratts to request a voluntary foreclosure on the property, and took ownership. FHA paid for the extensive abatement project; the cost swelled to about $57,000 before the job was done. At the end of the project, the Pratts moved back in; just last month, they closed on the property for the second time. As it was, they borrowed about $10,000 from Dean's father to replace all the doors and windows in the house, because the abatement design called for simply painting over the battered surfaces, a remedy Cindy and Dean both strongly opposed. Come spring, they'll be covering the soil around the perimeter of the house with a thick layer of mulch to keep the children away from the paint-contaminated ground.
Although Maine has had a nominal lead poison program in place for 10 years, critics like Cindy Pratt say the state isn't doing nearly enough to protect its citizens. Educational outreach needs to be stepped up. Medical screening for exposure should be routine and universal. More financial assistance should be available to support the expensive process of abatement, both to property owners who must make their housing units lead-safe, and to families who are displaced while their home is being abated. And perhaps most important, critics say, landlords and homeowners should be required by law to make their properties safe for new occupants - sooner rather than later.
Response from the state has been slow and, at times, defensive. A kind of Catch-22 mentality seems at work: More screening is likely to lead to more diagnoses, greater hardship on stricken families and property owners, and increased demand for limited state resources. But a triumvirate of state agencies, drawing on federal funds, is attempting to deal with the problem, and although the stepped-up program is shaky and asynchronous, it does appear to be moving in the right direction.
·Most of us, over
the course of a lifetime, have had enough contact with lead in
one form or another that it would show up in a blood test. Accordingly,
the Centers for Disease Control and Prevention accepts anything
under 10 mcg/dl as a normal finding. It considers 10 and up elevated
and has called for universal screening for all children. However,
it recognizes that the cost/benefit relationship is more meaningful
in high-risk populations.
But lead poisoning affects families from all areas and from all
economic and social backgrounds. In addition to victimizing the
poor, it often occurs when middle-class or well-off families
purchase older homes to renovate, unaware of the risks to their
children (or to pregnant women, another high-risk group). Many
of the diagnosed cases in Maine last year occurred in middle-income
families, most often in association with home renovations.
Despite this demographic spread, screening efforts in Maine at
this time are largely focused on children of low-income families.
Under federal guidelines, all children enrolled in Medicaid should
be screened at age 1, and again in their second year. But in
Maine, less than a quarter of this group is tested, according
to state records.
MaryAnn Amrich heads up the Childhood Lead Poisoning Prevention program at the state's Department of Health and Human Services, which tracks all lead screenings done in the state. Amrich says one goal of her program is to increase screening rates by raising family and physician awareness. To that end, the program has churned out a number of leaflets and informational packets for distribution through physicians' offices and other outlets.
Amrich is also collaborating with programs like Children Run Better Lead-Free, affiliated with the Barbara Bush Children's Hospital at Maine Medical Center in Portland. Funded through a two-year, $120,000 grant from the Mattina Proctor Foundation, program director Dr. Victoria Rogers says representatives will visit every children's health-care provider in the state within the next two years to emphasize the importance of educating and screening young clients. She's also speaking to daycare providers, because many children spend enough time in daycare to pick up a case of lead poisoning. In addition to reminding clinicians of their responsibilities under Medicaid guidelines, Rogers says her teaching efforts will focus on helping to identify the at-risk child - based on economic, social, nutritional and educational factors, as well as the all-important age of the home in which they live. The goal of Children Run Better Lead-Free is to double the screening rate of at-risk kids.
Amrich's program is also responsible for following up on diagnosed cases, and, in extreme circumstances like the Pratts, for removing families from their homes until abatement can be accomplished. Occasionally, if parents don't respond appropriately, she said, the department will refer a case to child protective services. "We do have the option to pursue an enforcement action," she said. "Medically, we are mandated reporters. If a family is endangering the health or life of a child, we will make a referral."
"People are afraid of the Department of Human Services," Cindy Pratt said. "The idea that the department is interested in your children is really frightening." This fear of losing custody is behind much of the reluctance to screen children more widely, Pratt maintains. Not only that, but a serious abatement project generates such financial and emotional difficulties for families that some physicians opt not to screen even high-risk cases for fear that a family will find itself displaced and without resources.
Amrich says her program is looking to soften its image while remaining active in protecting children from dangerous environments. Now, she said, in most situations, CLPP will work with families to keep them in their home while short-term safety measures, like painting over battered surfaces, are instituted. If the Pratt case came up today, she said, things would be different."Today the building would not be posted, and there would be no mandate to remediate," she said. "We can make suggestions and work with families to find assistance." Cindy Pratt says this looks good on paper, but interim measures are ineffectual and only serve to prolong a family's danger and discomfort. "Quick fixes are not the answer," she said. "When your children are poisoned, there is no quick fix."
The Department of Environmental Protection has its own lead-paint program, the Lead Hazard Prevention Program, headed by Carole Cifrino. Funding for the program comes in large part from the federal Environmental Protection Agency.
Cifrino says her program also looks to raise public awareness of lead hazards, but where Amrich's program targets physicians and parents, Cifrino's goes for contractors, renovators and home handymen. Cifrino said early efforts included placing informational brochures in paint stores and lumberyards. "People didn't even take notice," she said.
Now, she said, working together with Amrich's CLPP program, she has developed a series of print and television messages, although she says neither program, as yet, has the funds to buy air time or advertising space. Still she says, the department is committed to educational outreach for professional renovators and do-it-yourselfers alike.
Additionally, the DEP offers training for private abatement contractors and lead inspectors, and it is responsible for licensing and certifying these professionals. In a contentious move, it has also developed a "lead-smart" training program in an effort to expand the number of workers with qualifications in handling the ticklish task of making a lead paint home safe for children. This basic training consists of a one-day workshop. But full-blown "lead-safe" abatement contractors, who take a 40-hour course with annual updates, contest the value of this preparation.
When a lead paint home is professionally remediated, the scene looks like a combination of shots from Silkwood and ET. The empty house is posted and sometimes cordoned off to keep the public at bay. Rooms are sealed with heavy plastic and duct tape. Moon-suited workers scrape painted surfaces down to bare wood, sucking up the toxic chips with a specially filtered vacuum. If a painted surface cannot be scraped bare, then it must be replaced, enclosed or repainted. Contaminated soils surrounding the house must either be removed and replaced or covered over. All waste is disposed of in accordance with state and federal regulations.
Rick Sanborn, an abatement contractor in Portland, says the lead-smart program gives homeowners a false sense of security and encourages short-term, ineffective measures over comprehensive abatement. Sanborn, who was awarded the contract on the Pratt's home, said the state's one-day training promotes measures like painting over friction surfaces - like window frames - instead of scraping the old lead paint away completely or replacing the frame with new materials.
"[With lead-smart training] any guy with a hammer and saw can go out and do this work," Sanborn said. "And they won't be monitored. If they don't set the project up properly, a child can get poisoned. Rather than being a risk-based approach, it's just a dollar-based approach." Sanborn concedes that there is a role for lead-smart workers, but he wants to see the state limit their use. "They shouldn't let lead-smart contractors in if there's a pregnant woman in the house, children under 6, children with increased lead levels, or if it's a very extensive project," he said. Sanborn also takes issue with the state's requirements for certified lead inspectors and abatement designers. "There's way too much latitude," he said.
Landlords in Maine are required to provide lead-safe environments for tenants with small children. And homeowners, when they sell, must disclose whatever they know about lead in the house. With full-scale professional abatement running anywhere between a few thousand dollars to $40,000 or $50,000, many property owners are unable to afford remediation. And tenants and homeowners like the Pratts may find themselves looking for a place to stay while abatement is in process, sometimes a period of several weeks or even longer. Because a diagnosis of lead poisoning can trigger a mandated abatement, the cost, inconvenience and emotional upheaval of this period is, at least in part, what discourages clinicians and parents from seeking lead screening more routinely.
The Maine State Housing Authority has funds to help some low-income families. A two-year grant from the federal office of Housing and Urban Development, matched with state funds, has given MSHA a pot of about $3 million with which to assist homeowners with the cost of abatement. Roger Bondeson is the program manager for Energy and Housing Services at MSHA. He says families with incomes at or below 80 percent of the median income for the area where they live qualify for assistance. In Bangor, that means a family of four earning $32,650 qualifies; in Aroostook County the same family could make $30,100. If they moved to suburban York County, the cut-off would be $34,000. The most any family can expect from the MSHA grant is $15,000 plus a small relocation allowance. The Pratts, earning just upwards of $40,000, were ineligible for state aid in dealing with their $57,000 problem.
Landlords also qualify for MSHA aid; in fact, new HUD regulations require that all federally subsidized housing must address the lead-paint problem. Landlords must be renting to low-income tenants and are eligible to receive up to $10,000 per housing unit for up to five units. To make their dollars go further, they may use "lead-smart" contractors instead of "lead-safe" contractors, but only if the total rehab cost per unit is under $25,000 and there are no lead-poisoned children in the home.
The HUD grant was received in 1998; so far just four abatement projects have been completed. Bondeson, who's brand-new to his position, said "it's an infrastructure problem" that's slowed things down, but now that lead inspectors and abatement designers have been trained, and staff at the state's four Community Action Programs are up to speed in identifying and assisting potential grant recipients, things will happen much more quickly. He has 14 projects in process and 38 more approved and waiting for work. Bondeson says as the word gets out about the danger of lead and the availability of financial aid in dealing with it, the demand for assistance will rise sharply. He thinks that under current guidelines the state has enough money to handle the need through 2002, and he expects the feds will renew the grant after that. Still, in the large picture, Bondeson said: "We do not have the money we need to address this issue. With the federal dollars I have, I can only help low-income households. ... We really do not know the entire extent of this problem."
The three-pronged effort by the state is still flying well-below radar, and, impatient with what seems like bureaucratic ineptitude, some Mainers have taken things into their own hands. Notably, in Portland, Susan Thornfeldt has formed the non-profit education and outreach program, the Maine Lead Action Project. Herself the mother of a lead-poisoned child, Thornfeldt says the state's programs are too slow in spreading the word about the dangers of lead paint, too willing to accept minimal abatement efforts, too limited in their support and financial assistance, and too complacent in dealing with the needs of lead paint poisoning victims. For a problem that's been on the books for almost 30 years, she says, it's inconceivable that so little has been done. "Why does a tragedy like Cindy Pratt's or my own family have to happen." she asked. "It seems like [state officials] just say things to put you off. They tell you they're 'beefing up the program,' but that's just giving families a false sense of security. They have to realize they're public servants. They are responsible to the public and not to public relations."
Thornfeldt said she is proud to have won the support of Home Depot in developing a comprehensive brochure for home renovators, and she has persuaded Fleet Bank to offer a low-cost home equity loan program specifically to help middle-income homeowners with the high cost of lead abatement. She applauds the screening efforts of the Children Run Better Lead-Free program, but thinks mandated screening for all Maine children is the best course. She says the state is not offering prevention, but reaction, in dealing with the lead paint problem. "This is 100 percent preventable," she said. "People just need to know about it. People aren't going to poison their kids if they understand the danger."
It was Thornfeldt who brought Cindy Pratt to tell her story before Sen. Susan Collins' public hearing in November 1999. Reached at her Washington, D.C., office last week, Collins said her attention to the lead-paint problem intensified when friends, living in a handsome Victorian home in Bangor, discovered that their three children were lead-paint poisoned.
"This is too often viewed as a problem of the inner city," she said. "One of the most important things we can do is to alert people to be more cautious." Collins looks to the example set by the state of Rhode Island, which requires a lead screen along with standard childhood immunizations before any child can start public school. "Rhode Island pediatricians are very aggressive on this issue," Collins said. "Maine needs to be better educating its health care providers."
In a December 1999 letter to Gov. Angus King, Collins made several suggestions for improving Maine's lead screening, treatment and prevention services, based on Rhode Island's model. "I believe many of these strategies could be successful in Maine, and I would like your assessment of the feasibility of implementing better control and screening measures in our State," the letter ends. Although the governor apparently didn't specifically respond to Collins' suggestions, the current tri-agency effort was coordinated soon after.
Cindy Pratt said her family's experience has been grueling. While she blames the FHA inspector for failing to identify the lead problem in the first place, she is more incensed at the state for its insensitive and ineffectual handling of the case, and until things change substantially, she fears other families will face similar experiences. And she is still afraid for her own family - for the health of her children as they play and eat and sleep and grow in the high-ceilinged rooms of the pretty house on the corner in West Lebanon.
Little Dean and Tori's lead levels are down to acceptable numbers now - 12 and 7, respectively, at a September check-up - and to watch the energetic children in their home, you'd never suspect the fear, anger and guilt their parents are living with.
"These children are our proudest accomplishment; there's nothing in the world we wouldn't do for them," Cindy said. "We try to do all the right things: No one smokes in our house, we give them healthy food, we always buckle up in the car. But we ended up poisoning our own kids. The hardest part is, we'll never know for sure how they've been affected."
Meg Haskell can be reached
at:
mhaskell@mainetimes.com
For more information
on lead paint in Maine:
Maine Lead Action Project
Susan Thornfeldt, Director
(207) 775-5935
email: leadsafe@gwi.net
http://www.maineleadaction.org
The MLAP, a grassroots, nonprofit organization, provides information
and referrals to families and communities statewide.
Maine Department of Human Services
Childhood Lead Poisoning Prevention Program
(207) 287-4311
Maine Department of Environmental Protection
Lead Hazard Prevention Program
(800) 452-1942
Maine State Housing Authority
Lead Paint Removal Program
(800) 452-4668
or contact your closest Community Action Program:
Aroostook County Action Program (Presque Isle)
764-3721 or (800) 432-7881
Community Concepts, Inc. (South Paris)
743-7716
Penquis Community Action Program (Bangor)
973-3500 or (888) 424-0151
Washington-Hancock Community Agency (Milbridge)
546-7544
City of Portland
Healthy Homes Project
874-8943
City of Lewiston
Health Department
784-2926 ext. 208
City of Auburn
Lead Protection Program
786-2421