26 July 2010

Lead-Poisoned Kids left Untreated in Detroit

The Detroit Free Press

Sue Hill, whose son Christian Matthews, now 20 months, had a lead level in May of 18 micrograms per deciliter of blood -- too low for the city to inspect her home under guidelines established in March. Within a couple of weeks, Christian's lead level shot up to above 33, which could lead to permanent developmental problems. (PATRICIA BECK/Detroit Free Press) 

Detroit's anti-lead program -- beset with alleged shakedowns and bogus treatments, missing files, incompetence and mismanagement -- was upended last year after such scorching claims were reported in state and federal investigations.Among the sweeping reforms was a new standard, announced in March, setting sharp boundaries for what could be done for stricken kids based on the level of lead in their blood. Instead of starting nursing care at 10 micrograms per deciliter the new threshold was set at 20, creating a huge care gap for more than three-quarters of Detroit's lead-poisoned children care, critics said.

In an effort to gain control of the troubled program, critics say, decisions were made with an eye more toward efficiency than children's health.

So children such as Christian Matthews were turned down for treatment and suffered lasting damage.

The city's March standards focused too narrowly on a small percentage of children with the highest exposure and left "over 80% of all lead-poisoned children in Detroit ineligible for services," said Mary Morrow, director of the Wayne County Prosecutor's Office's lead enforcement advocacy division.

Just three months later, the standard was rolled back to 10 micrograms per deciliter after the opposition by the Prosecutor's Office.

William Ridella, deputy director of the city's Department of Health and Wellness Promotion, said the decision to again give the wider array of services to children with lower lead levels was based on a review of resources and input from other agencies in the anti-lead fight.

He said no one was "ignoring those kids" with lower lead levels, but now the wider array of services "will be focused on all kids all the time."

Too late for some lead-poisoned kids

When tests showed Christian had a lead level of 18 micrograms per deciliter of blood in May, his mother, Sue Hill, turned to the City of Detroit for help.

"But they said they couldn't come out at that level," Hill, 40, said of her call to the city's Department of Health and Wellness Promotion.

Within a couple of weeks, Christian's lead level shot up above 33 -- a dangerous level that could lead to permanent developmental problems -- and city inspectors and health workers rushed to assist Hill and her 19-month-old son.

But by then, the damage was done. Once a person is poisoned with lead, there is no cure.

The frightening scenario played out in a three-month window when the city's anti-lead leaders said that the all-out response for direct intervention would go to kids with lead levels of 20 and above -- Christian's reading fell 2 points short.

Today, though, Hill wouldn't have to wait.

On June 17, after weeks of wrangling with the Wayne County Prosecutor's Office -- and inquiry by the Free Press -- the city' health department scrapped the controversial treatment standards that some experts said shortchanged kids such as Christian.

Now, nursing care, parental education, home inspections and other services once again will go to children with lead levels of 10 micrograms per deciliter of blood, said William Ridella, the city's deputy health director.

Under the short-lived March protocols, families with children who had levels of 10-14 got only advice and information by mail. And kids with lead levels of 15-19 weren't seen by nurses unless the levels stayed elevated for a month or more -- delaying intervention, experts said.

Dr. Bruce Lanphear, a leading expert on lead poisoning who did pioneering research in Cincinnati, said officials "are missing a tremendous opportunity to help kids" when they don't start more intensive treatment at lower levels.

Now at Simon Fraser University in Vancouver, British Columbia, Lanphear said that "10 is now the recommended level of concern."

And treating lower levels is cost effective, Lanphear said. Every $1 spent on affected kids at an early age saves $17 to $220 over a lifetime in educational and medical costs.

Worried about the damage already done to her son, Hill said she didn't realize the danger lead-laden dust -- not just larger lead paint chips -- presented.

"When I learned how real serious it is, I broke down and cried," Hill said. "They should have been yelling like they did with H1N1" about the dangers, she said of public health officials.

No child should have to wait like Christian for help, said Mary Morrow, director of the Prosecutor's Office's lead enforcement advocacy division that enforces local and state anti-lead laws.

"We are pleased that the (Detroit health department) has decided to reinstate services to all lead-poisoned children and are cautiously optimistic that this policy will result in a reduction in the number of Detroit children who suffer this devastating disease," she said.

No safe level

With its large stock of older homes with lead paint and environmental contamination from decades of heavy industry, Detroit is among America's most lead-afflicted cities.

Lyke Thompson, director of Wayne State University's Center for Urban Studies, said 5,000 Detroit addresses have been identified by Michigan home inspectors where two or more children have had elevated lead levels in their blood. Some of those addresses are occupied and may represent an ongoing risk.

Another 10,000 addresses have been identified where at least one child had an elevated lead level, Thompson said.

Lead poisoning is dangerous to all, but it is especially devastating to young children, experts said. There is no safe level.

Even at low levels, lead can cause brain and neurological damage and can harm hearing and kidney functions, lead experts said. Increasingly, lead exposure is linked to speech, learning and behavior problems. Very high levels can cause seizures and death.

Lead permanently injures hundreds of Detroit kids every year. And even after lead levels drop, the damage of the exposure remains.

But Detroit's fight was hampered by a stunning array of problems laid bare in two inspections last year.

The Michigan Department of Community Health said Detroit's health department "was not capable of delivering the lead program to city residents." The review found that staff was poorly trained and supervisors were inattentive or failed to provide basic oversight.

A federal Centers for Disease Control and Prevention audit last fall found "a very serious lack of performance and coordination" and that "the extreme deficiencies noted are serious and represent an egregious act."

Additionally, federal agents were investigating corruption allegations. In May, Donald M. Patterson, a city lead inspector, was indicted on federal charges of bribery, wire fraud and making false statements.

Patterson is awaiting trial on charges that he got payments for bogus remediation treatments of a lead-contaminated property where a child was found with a lead level of 156 -- a reading that astonished local officials.

Going too far

After the two blistering reports, the city refocused and redesigned its program -- such as taking the responsibility of home inspections from the health department and transferring it to the Buildings and Safety Engineering Department -- to secure private and government funding. And it hired Ronald Levi to help attack the lead problem.

Levi did not have medical or public health experience, but he brought a sharp business background honed over more than 20 years at IBM, including program management.

The Kresge Foundation, which provides hundreds of thousands of dollars for lead-fighting measures, wanted the leader in the lead fight to have a direct line to the mayor's office. Although Levi is now in the health department, the foundation said it has been assured that the fight is under the eye of Kirk Lewis, Mayor Dave Bing's group executive for corporate and civic affairs, and who was the boss at Bing's former auto parts firm.

Under Levi, new treatment protocols were put in place in March, with resources focused on the most severe cases. The protocols were a sharp departure from previous standards for treatment that had children with lead levels of 10 eligible for nursing care.

Morrow, the prosecutor, said that major reforms were needed to address incompetence and possible corruption, but the March protocols went too far in the wrong direction and were endangering rather than helping children with lower levels of lead poisoning.

"Why revamp the program if 80% of the kids are being abandoned?" she said.

According to 2009 Detroit health department reports, 832 children younger than 6 had lead levels of 10 or higher. Of those, only 153 had readings above 20, which would have triggered intervention.

WSU's Thompson agreed that the dangers of low-level exposure are becoming more apparent.

Treatment, he said, can seem costly.

"But the cost of doing nothing is something we can't afford," he said.

1 comment:

benchbug said...

This article contains a lot of factual errors and omissions. The Wayne County Prosecutor is playing politics with poisoned kids. See the Spirit of Detroit blog and sign this petition to fix Detroit's lead poisoning prevention program.