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SCHENECTADY COUNTY
Lead screening of children inadequate
BY MICHAEL LAMENDOLA Gazette Reporter

   A statewide public health program requiring Schenectady and other counties to identify infants poisoned by lead is missing too many cases, local officials said.
   Part of the problem is that some doctors don’t test children at the appropriate age and neither the state Department of Health nor local public health departments can force physicians to perform screenings, officials said. In other cases, parents refuse to participate in screenings.
   “There are barriers and they are signifi - cant,” said Claudia Hutton, spokeswoman for the state Department of Health.
   Health officials say identifying and tracking children poisoned by lead before age 6 is important because lead can damage the brain and other vital organs during this cognitive stage, causing developmental problems later in life. Initial screenings are supposed to be done at ages 1 and 2.
   Schenectady County Public Health Services is charged by the state with monitoring children with high lead levels, but it cannot take action to help them until they are identified through the screenings.
   “It’s frustrating not being able to take action until it’s too late,” said Stephanie Scuderi, registered nurse and administrator of the county public health services’ prevention and patient services.
MAKING HEADWAY
   County officials said they have three initiatives in place to help them take a more proactive approach in locating and tracking local children exposed to lead.
   According to county public health statistics, physicians have screened approximately 60 percent of the 10,000 children born in Schenectady County since 1996. The statistics are current to 2001, the most recent data available.
   Glynnis Hunt, county public health education coordinator, said Schenectady County’s efforts are better than those of surrounding counties. She could not provide regional statistics, saying the information was confidential.
   An audit by the Office of the State Comptroller, released June 14, said flaws in the statewide program resulted in a failure to screen 133,477 children for lead poisoning out of a population of 380,933.
   Schenectady’s statistics show that 50 percent of 1-year-olds received their fi rst test for lead poisoning by age 16 months. Another 10 percent received their first test by age 2. Children should be tested twice by age 2, however.
   An audit by the Office of the State Comptroller, released June 14, found similar results statewide. The audit said flaws in the statewide program resulted in a failure to screen 133,477 children for lead poisoning out of a population of 380,933.
   Hutton said the program “has made great strides over the last five years. We have doubled the number of new testings and have also raised by half the number of people getting retested. Our program is doing well on many fronts.”
LOCAL PROBLEM
   Dr. Kevin Karpowicz, a pediatrician with Hometown Health, estimates Schenectady County has between 92 and 100 children with lead poisoning, but physician screenings have only identified half that number. He said approximately 2.5 per hundred children tested positive with early lead poisoning, based on approximately 1,000 births annually.
   “Fifty-four were identified through screening, and another 50 out there do not know they have it,” Karpowicz said. “They are scattered throughout the city in older houses.” The figure applies to 2005 screenings.
   Attorney Peter Danziger, who specializes in civil lawsuits involving lead poisoning of children, said “Schenectady has one of the highest incidences of lead poisoning in upstate New York.”
   The statewide directive from the health commissioner took effect in 1993 and seeks to eliminate childhood lead poisoning in upstate New York by 2010. The directive requires all health care providers to test all children for blood lead levels at age 1 and again at age 2. In addition, health care providers are also required to evaluate all children 6 months to 6 years of age for risk of lead exposure each year as part of routine care. The plan also provides resources to reduce lead exposure in the environment.
   Many factors contribute to the low screening numbers. Scuderi said well-baby care appointments routinely drop off after the child reaches age 18 months. And Hutton said parents do not often follow through on testing.
   “What happens a lot in lead screening is physicians cannot draw the blood sample in office. They refer the parent to a lab with the child. Oftentimes, the parent does not follow through or thinks, ‘There is no lead in my house. I’m not going to do this,’ ” she said.
   Danziger said, “There is a lack of awareness of how serious the problem is. Everybody has heard the word lead; it is not a scary word. If it was rat poison, everyone would be jumping up to clean it up.”
RELUCTANT PARENTS
   The State Health Department said blood from finger sticks, the most common method to sample blood in the physician’s office, can easily become contaminated. The department recommends confi rming any blood lead results done this way by repeating the test with a sample drawn from a vein.
   Parents often do not want to take the time away from work and other duties and are afraid to expose a young child to a test involving drawing blood through a vein, Karpowicz said.
   Also, the test often carries a fee, usually around $50, which some parents cannot afford because they have little or no insurance, he said.
   “We have children who are uninsured. They have to pay for the lab work and can’t afford it. It’s not always easy for people to go to a lab for venipuncture,” Karpowicz said.
   Scuderi said Schenectady has a large transient population that includes children with no insurance. “When they hit the local health care system, that is the first time someone will give them an application” for the state’s Child Health Plus or Medicaid. Both insurances cover lead screening fees.
   Karpowicz is trying to increase the number of screenings by purchasing two blood-testing machines at $1,500 each. He would charge $10 per test. He is looking for grants to buy the machines.
   “We are looking for a new lead testing machine that can do accurate testing through a finger stick. We can get results then and there. To have the results then and there would be a significant advance in providing provide care,” Karpowicz said. “Doctors don’t want to burden parents, and parents don’t want to go through. A simple test is the way to go to overcome those
barriers.”
   Physicians must report children who test positive for lead poisoning to county heath officials. At 10 micrograms per deciliter of lead, the county will contact parents, conduct education and send follow-up letters to ensure that the levels are going down. In cases involving 20 micrograms or higher per deciliter of lead, the county steps in to conduct a home inspection and ensures that the lead is removed.
   The county is monitoring 35 children with lead levels between 10-14 micograms; 14 between 15-19 micograms; and 11 with 20 or more micograms, but less than 40.
   The county will monitor children and work with their parents until the lead level decreases. State law says counties must monitor children up to age 6, but Schenectady County will maintain services until the child’s lead level declines or is stabilized, Scuderi said.
TREATMENT
   The general treatment for lead poisoning is through diet, education and elimination of the lead in the environment, she said. Lead levels will eventually decline if there is no further exposure. A chemical treatment is used on children whose blood contains 40 or 50 micrograms per deciliter.
   “We get one to two per year,” Scuderi said.
   Many experts consider a level of 20 too high for the first level of county action.
   “It should be lower. It is important for people to be aware of where it is coming from. A level of anything over five is considered a potential for causing issues,” Karpowicz said.
   Danziger, who is forming a Capital Region Coalition Against Lead Poisoning, said the state Assembly approved a bill that would require counties to conduct lead inspections in homes where children test with 10 micrograms or more. “It would affect thousands and thousands of children,” he said.
   The Senate has not passed its version yet, he said.
SOURCES OF
CONTAMINATION
   Most children are exposed to lead poisoning by consuming leadbased paint chips and dust through hand-to-mouth activities. Some absorb it by eating lead-tainted dirt or by playing with toys coated with lead-based paint. The changeover to unleaded gas is credited with a significant decrease in lead contamination to the environment.
   “Lead is a neurotoxin; it damages the brain,” Karpowicz said. “We don’t know how many have the problem. We are more aware of it now.”
   Lead used to be a primary ingredient in wall paint used in houses; it was banned in 1978. Nonetheless, lead-based paint coats many homes in Schenectady.
   The county is targeting these homes through the state-funded Healthy Neighborhoods Program, now in its third year. Under the program, county officials visit residents who volunteer for an inspection and offer them education and free equipment to keep lead away from their children.
   In three years, county nurses have visited 800 homes in Hamilton Hill, Vale, lower Union Street and Rotterdam. The state grant is for $100,000.
   “The areas are primarily lowincome, but there are [lead] issues with houses in the GE Plot,” where pre-1950 houses exist, Scuderi said.
   The second initiative involves the city and county working together. The city recently obtained a federal grant of $1.4 million to be distributed over three years.
   Under this program, the city will provide lead-free paint for homes containing lead paint at no cost to the owner or occupant. The house has to contain children younger than 6 to qualify. The program will target 200 homes.  

  
  
  

This has been going on since 1978....30 years!! It should be up to the homeowner/landlord to purchase and paint if there is still lead paint. I find it so hard to believe that in 30 years, not a one of these houses have ever been re-painted?

If the dwelling is rental, than the landlord shoud have 'X' amount of days/weeks to get the place repainted at 'his/her' expense. If it is a homeowner, than they should be responsible as well. OH, there is that word again...'responsible'. If the government keeps going in and paying for these things, with our tax dollar, than surely people will have no need to be responsible for themselves. I mean come on, it's been 30years for God's sake!!!!!

The Egyptians used to paint their bodies with lead......and we call them brilliant.......