[Senate Hearing 107-802]
[From the U.S. Government Publishing Office]
S. Hrg. 107-802
LEAD-BASED PAINT POISONING:
STATE AND LOCAL RESPONSES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HOUSING AND TRANSPORTATION
of the
COMMITTEE ON
BANKING,HOUSING,AND URBAN AFFAIRS
UNITED STATES SENATE
ONE HUNDRED SEVENTH CONGRESS
FIRST SESSION
ON
ENSURING THAT CHILDREN WITH DANGEROUS LEVELS OF LEAD IN THEIR BLOOD ARE
IDENTIFIED AND RECEIVE CARE AS EARLY AS POSSIBLE, AND TO INTRODUCE
PROGRAMS TO PROPERLY SCREEN AND TREAT CHILDREN FOR LEAD POISONING
__________
NOVEMBER 13, 2001
__________
Printed for the use of the Committee on Banking, Housing, and Urban
Affairs
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COMMITTEE ON BANKING, HOUSING, AND URBAN AFFAIRS
PAUL S. SARBANES, Maryland, Chairman
CHRISTOPHER J. DODD, Connecticut PHIL GRAMM, Texas
TIM JOHNSON, South Dakota RICHARD C. SHELBY, Alabama
JACK REED, Rhode Island ROBERT F. BENNETT, Utah
CHARLES E. SCHUMER, New York WAYNE ALLARD, Colorado
EVAN BAYH, Indiana MICHAEL B. ENZI, Wyoming
ZELL MILLER, Georgia CHUCK HAGEL, Nebraska
THOMAS R. CARPER, Delaware RICK SANTORUM, Pennsylvania
DEBBIE STABENOW, Michigan JIM BUNNING, Kentucky
JON S. CORZINE, New Jersey MIKE CRAPO, Idaho
DANIEL K. AKAKA, Hawaii JOHN ENSIGN, Nevada
Steven B. Harris, Staff Director and Chief Counsel
Wayne A. Abernathy, Republican Staff Director
Jennifer Fogel-Bublick, Counsel
Mark Calabria, Republican Economist
Sherry Little, Republican Legislative Assistant
Joseph R. Kolinski, Chief Clerk and Computer Systems Administrator
George E. Whittle, Editor
______
Subcommittee on Housing and Transportation
JACK REED, Rhode Island, Chairman
WAYNE ALLARD, Colorado, Ranking Member
THOMAS R. CARPER, Delaware RICK SANTORUM, Pennsylvania
DEBBIE STABENOW, Michigan JOHN ENSIGN, Nevada
JON S. CORZINE, New Jersey RICHARD C. SHELBY, Alabama
CHRISTOPHER J. DODD, Connecticut MICHAEL B. ENZI, Wyoming
CHARLES E. SCHUMER, New York CHUCK HAGEL, Nebraska
DANIEL K. AKAKA, Hawaii
Kara Stein, Staff Director
Tewana Wilkerson, Republican Staff Director
(ii)
?
C O N T E N T S
----------
TUESDAY, NOVEMBER 13, 2001
Page
Opening statement of Senator Reed................................ 1
Opening statements, comments, or prepared statements of:
Senator Allard............................................... 3
Senator Sarbanes............................................. 4
Senator Dodd................................................. 9
Senator Carper............................................... 29
Prepared statement....................................... 32
WITNESSES
Susan Thornfeldt, Director, Maine Lead Action Project............ 5
Prepared statement........................................... 33
Supplemental material................................... 35
Bruce Lanphear, MD, MPH, Associate, Professor of Pediatrics,
Children's Hospital Medical Center, Cincinnati, Ohio........... 8
Prepared statement........................................... 48
Charts submitted......................................... 53
Nick Farr, Executive Director, National Center for Lead-Safe
Housing........................................................ 10
Prepared statement........................................... 71
Sheldon Whitehouse, Attorney General for the State of Rhode
Island......................................................... 17
Prepared statement........................................... 73
Richard A. Fatur, Environmental Protection Specialist, Colorado
Department of Public Health and the Environment................ 21
Prepared statement........................................... 76
Chart submitted.......................................... 79
Sue Heller, Project Administrator of the Manchester Lead
Abatement Project, Manchester, Connecticut..................... 23
Prepared statement........................................... 80
(iii)
LEAD-BASED PAINT POISONING:
STATE AND LOCAL RESPONSES
----------
TUESDAY, NOVEMBER 13, 2001
U.S. Senate,
Committee on Banking, Housing, and Urban Affairs,
Subcommittee on Housing and Transportation,
Washington, DC.
The Subcommittee met at 2:35 p.m., in room SD-538 of the
Dirksen Senate Office Building, Senator Jack Reed (Chairman of
the Subcommittee) presiding.
OPENING STATEMENT OF SENATOR JACK REED
Senator Reed. Let me call this Subcommittee hearing to
order and welcome all of you and my colleague, the Ranking
Member, Senator Allard of Colorado.
Today, we are looking forward to a hearing on the lead-
based paint poisoning issue, in particular, State and local
responses.
Recently, in my home newspaper, the Providence Journal in
Rhode Island, Peter Lord did a series of columns and stories
that illustrated the seriousness of this problem, and
particularly, its
effect on children. I hope that today, listening to local
authorities, we can get a better sense and perspective on this
issue, and particularly, again, its impact on children.
Despite significant progress in the fight against childhood
lead poisoning, lead-based paint remains the most serious
environmental hazard for children in the United States. In my
own State of Rhode Island, both our General Assembly and our
Governor's administration have identified lead paint as the
number one environmental health issue facing Rhode Island's
children.
According to the Center for Disease Control and Prevention,
nearly one million preschool children living in the United
States have blood lead levels high enough to impair their
ability to think, concentrate and learn.
Unfortunately, except for severely poisoned children, there
is no medical treatment for the disease. Even then, treatment
may only reduce the level of lead present in the body, and not
reverse the harm already caused.
The only way effectively to prevent lead poisoning is to
remove the source of exposure. After eliminating lead from
gasoline, dietary sources, such as beverage cans, and paint in
1978, the primary cause of childhood lead poisoning today is
exposure to lead-based paint applied to residential properties
prior to 1978, when the paint was banned.
More specifically, it is the ingestion of lead-contaminated
surface dust from chipping or peeling paint, friction from
opening or closing windows, and lead paint disturbed during
remodeling and repainting projects. This lead dust gets onto
children's hands and toys, poisoning them while they engage in
normal play activities, such as putting hands, toys and other
objects into their mouth.
Thus, despite the fact that lead paint has not been sold
for residential use in more than 20 years, it continues to
cause serious health problems in children. Lead paint placed on
walls decades ago has not been removed, but instead, covered up
by layers of other paint.
The layering effect means that children today are still at
risk for exposure to lead paint that may have been applied to
the homes decades ago. In addition, national health data
indicate that low-
income children are eight times more likely to be lead-poisoned
than children from well-to-do families, and African-American
children are at five times higher risk than white children.
As a result, I have introduced two bills along with my
colleague, Senator Torricelli, that are intended to improve our
ability to detect and treat children at high risk of lead
poisoning, as well as
expand our network of Federal program sites where children at
increased risk for lead poisoning can be screened.
The Early Childhood Lead Poisoning Prevention Act requires
WIC and Head Start Early Start programs with children under age
three to assess whether a child participant has been screened
for lead and provide and track referrals for any child who has
not been appropriately screened.
The Children's Lead Screening Accountability For Early
Intervention Act, or the Children's Lead Safe Act, would
require Medicaid contractors to comply with existing
requirements to provide screening, treatment and any necessary
follow-up services for Medicaid-eligible children who test
positive for lead poisoning.
In addition, I and a number of my colleagues have been
pushing the Administration and Congress to dramatically
increase fund-
ing for HUD's Office of Lead Hazard Control. It is our hope
that
for fiscal year 2002, the Administration will make lead
poisoning
a priority and allocate at least $250 million for that much-
needed
and dramatically-underfunded lead hazard control grant program
at HUD.
However, today's hearing will focus on the nature and
extent of lead-based paint poisoning, what percentage of our
Nation's housing stock is hazardous, and initiatives being
undertaken by local and State governments to deal with this
problem.
This hearing is only the first in a series on lead-based
paint poisoning. It is my hope that these hearings will help
shine a light on this terrible problem, energize the Federal
Government into playing a greater role, and improve local,
State, and Federal cooperation in the process. More needs to be
done. No child should have to live with the consequences of
this preventable disease.
We will hear from two panels of witnesses. The first panel
will consist of: Susan Thornfeldt, Director of the Maine Lead
Action Project; Bruce Lanphear, Associate Professor of
Pediatrics, Children's Hospital Medical Center, Cincinnati,
Ohio; and Nick Farr, Executive Director, National Center for
Lead-Safe Housing.
On our second panel, we will hear from three local and
State officials about their efforts to solve the lead-based
paint problem in their localities.
We will be asking all the witnesses to discuss, one, the
nature and extent of lead-based paint poisoning in their
communities; two, the past and present approaches they have
been involved in to eliminate lead-based paint poisoning; and
three, what more needs to be done to make our Nation's housing
lead-safe.
But before I call the witnesses forward, let me recognize
the Ranking Member, Senator Allard of Colorado.
Senator Allard.
STATEMENT OF SENATOR WAYNE ALLARD
Senator Allard. Thank you, Mr. Chairman.
I would just like to thank you for holding this hearing on
the hazards of lead-based paint in residential housing.
Fortunately, Colorado is not at the top of the heap on this
one. As I understand, your State of Rhode Island is. We have
about a 3 or 4 percent incident that occurs in children, which
ranks us just past the median.
Although we have a relatively low percentage compared to
other States, and especially Rhode Island and some other places
here on the East Coast, this is still one of those issues that
we are happy to be doing something about. This is an issue of
great concern in my State, even though we have that low
percentage. It will continue to be until significant lead-based
hazards are under control.
I am looking forward to a constructive hearing that focuses
on reducing the risk to children of lead-based paint in
housing.
According to the Centers for Disease Control and
Prevention, childhood lead poisoning is the most common
environmental disease of young children. Even low levels of
lead contamination have been linked to the impairment of mental
development and muscle control, hearing and emotional
development.
Research has shown that the most common source of lead
exposure for children today is lead paint in older housing and
the contaminated dust and soil that it generates. We have come
a long way in reducing the hazard to children from lead. Blood
lead levels in children have dropped dramatically since the
1950's. But this does not mean we have conquered the problem.
The Department of Housing and Urban Development estimates
that three-quarters of pre-1980 housing units contain some
lead-based paint. This paint becomes hazardous when it is not
properly maintained, when children come into contact with chips
of paint and the dust it creates.
We are here today to hear about how lead-based paint
hazards affect exposed children and how State and local
governments are controlling this problem in their housing
stock. A lot of local governments have implemented programs and
solutions that focus on abatement of flaking or decaying paint,
training for homeowners and painters during remodeling
projects, blood testing and awareness campaigns, and incentives
for landlords to better maintain their property.
Colorado, for example, issued regulations to address lead-
based paint hazards in pre-1978 housing and child-occupied
facilities.
The Department of Public Health regulates risk assessment,
inspection, and the control or elimination of hazards in its
targeted housing. The Department also dedicates about half of
its effort to outreach and education of Colorado residents and
property owners on identifying and controlling lead hazards.
Efforts like these
deserve our support and immediate implementation.
I would like to thank all of our witnesses for being here
today and I look forward to hearing from all of you on how we
can best address this problem at the Federal level. I would
like to extend a special welcome to Richard Fatur with the
Colorado Department of Public Health and the Environment. I am
glad you are here to share with us Colorado's progress in
addressing this issue.
Again, I would like to thank my colleague for holding this
hearing and I look forward to working with him on this matter.
Senator Reed. Thank you very much, Senator Allard.
We have been joined by the Chairman of the Full Committee,
Senator Sarbanes. Senator, would you like to make an opening
statement?
STATEMENT OF SENATOR PAUL S. SARBANES
Senator Sarbanes. Mr. Chairman, I want to thank you for
holding this hearing on lead-based paint poisoning. This is
clearly a very important topic. Over a million children across
the country experience lead poisoning.
We have a serious problem in my own State, particularly in
Baltimore City, which ranks tenth amongst counties and cities
with high lead hazards.
Minority and low-income children are disproportionately
affected by this serious condition and it is really a solvable
problem.
Mr. Chairman, I want to commend you for the panel that you
have assembled here today to try to ensure that our children
live in lead-safe housing. We will be hearing about actions
taken at the State and local level to address lead hazards in a
number of communities. Obviously, there is a role for the
Federal Government to play as well and I look forward to
working with you and Senator Allard in that endeavor.
We have put in a number of programs in Maryland to try to
address these issues such as the Maryland Lead Screening
Program, to help raise awareness about lead hazards. In 1996,
the Maryland legislature passed legislation requiring landlords
to maintain their housing units so that the housing remains
safe. It requires them to take steps to reduce lead hazards
already existing. As always, when you enact legislation, you
also have a follow-on enforcement problem and we need to be
paying attention to that.
One of your witnesses, Nick Farr, Executive Director of the
National Center for Lead-Safe Housing, which is a nonprofit
organization based in our State, is to be commended for their
work with respect to providing safe housing for children.
Mr. Chairman, although I will not be able to stay for the
whole hearing, I will stay and give support as long as I can.
Senator Reed. Thank you very much, Senator Sarbanes.
Senator Allard. Mr. Chairman.
Senator Reed. Senator Allard.
Senator Allard. I would just like to ask your indulgence
and the indulgence from those on the panel. At 3 p.m., I have a
mark-up of a piece of legislation in another committee. In
other words, we are adopting amendments and what not, and I
will have to dismiss myself. I apologize that I will not be
here for the full hearing.
Thank you, Mr. Chairman.
Senator Reed. Thank you, Senator.
Let me recognize and introduce the first panel.
Susan Thornfeldt is the mother of two children poisoned by
lead. She is the founder and Executive Director of the Maine
Lead Action Project in Portland, Maine. She also serves on the
board of the Alliance to End Childhood Lead Poisoning.
Dr. Bruce Lanphear is Associate Professor of Pediatrics and
Director of the Children's Environmental Health Center at the
Children's Hospital Medical Center and the University of
Cincinnati,
in Cincinnati, Ohio. He is also Deputy Editor of Public Health
Reports--the journal of the U.S. Public Health Service--and was
recently appointed as a member of the expert advisory board on
Children's Health and the Environment in North America. He con-
ducts research in environmental health and is a widely-
recognized
expert in residential factors linked with lead exposure,
asthma,
and injuries.
Nick Farr is the Executive Director of the National Center
for Lead-Safe Housing. Mr. Farr has previously served as Vice
President of the Enterprise Foundation, Executive Vice
President of the North American Mortgage Company, Executive
Director of the California Housing Finance Agency, General
Deputy Assistant
Secretary for Community Planning and Development at HUD, Pro-
fessor of Law at the NYU Law Center, and Director of the Model
Cities Administration.
Now before you all begin, I would first like to thank you
for your written testimony, which has been shared with Members
of the Subcommittee, and I would ask you to stick to the 5
minute time limit, if you could. We have the full text of your
testimony and that is now part of the record.
Ms. Thornfeldt.
STATEMENT OF SUSAN THORNFELDT
DIRECTOR, MAINE LEAD ACTION PROJECT
Ms. Thornfeldt. Thank you.
Good afternoon and I want to thank you for your efforts to
highlight lead poisoning and for giving me the opportunity to
share our family's story. I am the mother of a little boy named
Sam, who was poisoned by lead. As Senator Reed has noted, I am
the Director of the Maine Lead Action Project and I also serve
on the Board of the Alliance To End Childhood Lead Poisoning.
Lead poisoning entered our lives soon after we purchased
our 170-year-old home. It is a late 19th Century colonial,
nestled in
a nice residential, coastal neighborhood in Portland, Maine. My
husband and I chose an older home, like many of us do, for its
charm, beautifully detailed woodwork, and its stately
graciousness.
As eager, first-time homeowners, we soon began our much-needed
renovations.
What we did not know, until our child became inexplicably
ill, was that our home contained lead. We were unaware of the
dangers, and the serious, permanent health effects lead could
have on our children.
I first became acquainted with the topic of lead poisoning
in an article from a very popular parenting book; as a first-
time mother and voracious reader, I absorbed every bit of
information about child development. I came across a half page
devoted to childhood lead poisoning, which in a nutshell,
explained the rapid rate a child's brain grows from birth to
age 6 and the irreparable, cognitive damage lead could do to
children. I did not have to read another word. At my urging, my
son's pediatrician did a lead screen on Sammy and delivered the
news that, he indeed had elevated blood lead levels. He was
screened much more frequently from 6 months to 2 years old, his
levels climbing higher with each visit. This came as a total
surprise to my husband and me because we were now religiously
cleaning and washing Sam's hands and toys much more often. This
was, quite honestly, the only preventative advice we had
received.
I am sure many other parents of lead-poisoned children have
heard their own public health department imply, ``Go home, feed
your children better, watch them more carefully, clean your
house, and by the way . . . good luck.'' Though it may not be
said outright, this is the message that is clearly being
delivered. Why are we, as parents, made to feel that we are
somehow responsible for the poisoning of our children? Does
childhood lead poisoning end with the distribution of brightly
colored brochures, frequent hand washings, and ABC's of good
nutrition? These are the Band-Aids covering up a much bigger
problem--toxic paint lurking in our country's housing.
Sadly, Sam was diagnosed with lead poisoning soon after his
second birthday. As a parent, it is heartbreaking knowing that
the home you provided for your child was slowly poisoning him
everyday. There is no deeper feeling of sadness, frustration,
and
helplessness.
In order to avoid poisoning Sam once again, and endangering
our daughter, Alexandra, who had just started crawling, we
chose to move out while lead abatement was performed on our
home. I cannot emphasize enough the challenge of coping with
the enormous stress of caring for a sick child, relocating, and
dealing with the
financial burden--at times it was unbearable. Looking back, I
am not quite sure how we pulled it off. But I now have to
believe the worst is behind us, and Sammy will have a happy
childhood, and normal, productive school years. But for many
children, lead poisoning prevents them from succeeding in
school or in life.
Though many other stories may begin much differently than
mine--maybe in an apartment in Chicago, on a farm in rural
Louisiana or in a home on the West Coast--many of them share a
common theme: Our children served as the lead detectors
alerting
us to the hazards of living in a home contaminated with lead-
based paint. If there is one thing that I have learned from my
experiences, it is that the system set up to protect our
children from lead poisoning is, sadly, reactionary.
Screening children for lead in their blood is important to
finding and treating sick children. But allowing children to
serve as lead detectors is no solution to the environmental
disease of lead poisoning--it is an immoral approach. In fact,
health departments' preoccupation with screening children often
obscures the need for and deflects resources from finding and
fixing hazardous houses.
We can make sure that what happened to my children does not
happen to other children. But, to do so, we have to confront
the reality of lead poisoning--this is a disease that a healthy
child catches from a house.
There is only one real way to protect children from lead
poisoning--and that is to prevent and control hazards in
children's homes. We need to find the homes with lead-based
paint hazards and control those hazards before a child is
needlessly exposed.
As our family's experience proves, educating parents about
hand-washing, and nutrition and hygiene will not solve this
problem. Children do not need to be told to eat their
vegetables and wash their hands--they need homes that are safe
from lead-based paint hazards. What is politely called ``parent
education'' really amounts to passing the buck. Of course,
nutrition, hygiene, and housekeeping are beneficial, but the
fact that my home was dangerous--and millions of homes across
the country are still dangerous today to children, not because
of any lapse in parenting, but because the lead paint industry
cared more about making money than safety. Despite the
overwhelming evidence of the danger of its product and the
availability of safer alternatives, the lead paint
manufacturers knowingly marketed a poisonous product for
decades.
To add insult to the injury they caused, the paint industry
is a big proponent of ``parent education.'' Benjamin Moore
congratulates itself on helping communities hold ``fun and
educational'' events about lead poisoning for families. Well, I
want Benjamin Moore to know that lead poisoning is no fun.
Children and families have paid the price for the
industry's misconduct. Taxpayers have paid the price for the
industry's misconduct--hundreds of millions of local, State,
and Federal dollars. As a parent and taxpayer, I am tired of
paying. I want to know when the companies that caused this
problem are going to help pay for solving this problem.
We as a country can protect children from lead poisoning.
We know what to do, what solutions work. We have set the
national goal of ending this disease by 2010. But solutions
cost money. It is time for the lead industry to pay its fair
share. And it is time that everyone--communities, Government,
and industry--do the job right to eliminate lead poisoning once
and for all.
Thank you.
Senator Reed. Thank you very much, Ms. Thornfeldt.
Dr. Lanphear.
STATEMENT OF BRUCE P. LANPHEAR, MD, MPH
ASSOCIATE PROFESSOR OF PEDIATRICS
CHILDREN'S HOSPITAL MEDICAL CENTER
CINCINNATI, OHIO
Dr. Lanphear. I would like to thank you all for the
opportunity to share some of the research and thoughts on
primary prevention of lead poisoning.
Lead poisoning, like other diseases, has evolved through
three stages--recognition of an acute disease, elucidating the
disease spectrum and mechanisms of exposure, and finally,
prevention and control of exposure.
What is unique about lead poisoning, or contrasted with
some other diseases, is that its evolution was hampered or
obstructed at each stage by industry efforts.
Despite the dramatic declines that we have seen in
children's blood lead levels over the past two decades,
subclinical lead toxicity remains a major public health
problem. In many parts of the country, it remains epidemic,
particularly in older cities, in the northeast, the midwest,
the southeast, but even in special communities or smelter
communities in Colorado and others in the west.
It is a systemic toxicant associated with numerous adverse
conditions and diseases in humans. The cognitive deficits that
we so often think about are just the tip of the iceberg.
There is no magic medical bullet or therapy. The evidence
has come out suggesting that the adverse consequences of lead
exposure are persistent and irreversible.
It is a major environmental justice problem particularly
affecting children of color and leading to disparities in
school problems and evidence now suggests delinquency.
It has been long known that lead is a systemic toxicant. In
the 1970's, it was estimated that a one-microgram per deciliter
reduction in blood lead levels in adults would lead to 635,000
fewer persons in the United States with higher blood pressure,
3,200 fewer heart attacks every year, 1,300 fewer strokes every
year, 3,300 fewer deaths every year. There is also increasing
and compelling information that lead is neurotoxic at blood
lead levels less than 10 micrograms per deciliter.
Children, for example, who have a blood lead level of 10
micro-
grams per deciliter, have been shown to have a 15 point deficit
linked to lead exposure. We can find evidence down below 5
micrograms per deciliter. So the million children that have
been discussed today should be multiplied many-fold. It is
millions and millions of children.
Moreover, there appears to be greater decrements in reading
and intelligence at lower blood lead levels. So, for example,
across a range of blood lead levels. In our Rochester cohort,
we found about a 5.7 reduction in IQ scores for each 10
microgram per deciliter. But when we limited that to children
with blood lead levels less than 10, there was an 11 point drop
for the initial 10 micrograms per deciliter.
These effects are not subtle. Indeed, what they suggest is
that the vast majority of children who suffer from the adverse
consequences of lead exposure never attain blood lead levels
greater than 10 micrograms per deciliter. But this should not
surprise us.
Contemporary children, despite the rather dramatic decline,
still have increased blood lead levels 10 to 100 times that of
pre-
industrial humans.
There is also increasing evidence that lead is linked with
behavioral problems and delinquency. Indeed, there is some
suggestion, and the science is bearing this out, that the
dramatic increase in crime in the last century may be due not
simply to social decay, but, rather, widespread exposure to a
potent neurotoxicant. Well, what do we do about this?
As we have already heard, in the past, most of our response
has been reactionary. We have relied on children as biological
indicators of substandard housing. Unfortunately, this does not
work if the adverse effects of lead exposure are persistent and
irreversible.
What type of steps should we take?
First, as many cities and States have done, we can begin to
identify before a child is unduly exposed neighborhoods and
housing that contain lead hazards. We can conduct targeted
screening of housing with wipe tests, what I think virtually
every advocate and public official would recognize as the
single most important tool.
In this case, screening children becomes a safety net. It
does not become our primary effort to prevent childhood lead
exposure.
While there is considerable evidence that lead abatement
and other kinds of lead hazard controls are effective for
children at higher blood lead levels, blood leads of 25 to 30
micrograms, there is still some uncertainty about their
effectiveness at lower blood lead levels and that work needs to
be done.
Finally, lead hazards are just one of many residential
hazards that children suffer from today. Sixty percent of all
fatal injuries in children occur in housing. Over 50 percent of
nonfatal injuries occur in housing. Over 40 percent of doctor-
diagnosed asthma can be attributed to housing exposures.
Until we begin to address residential hazards like lead
poisoning and others in a more comprehensive way, we won't
address the dramatic social disparities that we see, nor will
we protect children's health.
And so, I would suggest that there needs to be a National
Institute for Safe Housing to address lead poisoning and other
residential hazards, because until then, until effective
standards for the domestic environment are devised, it is
likely that children will continue to be employed as biological
indicators of substandard housing.
Thank you.
Senator Reed. Thank you, Dr. Lanphear.
Before I recognize Mr. Farr, we have been joined by Senator
Dodd. Senator, would you like to make an opening comment?
STATEMENT OF SENATOR CHRISTOPHER J. DODD
Senator Dodd. Mr. Chairman, thank you for holding this very
worthwhile hearing. I want to thank our witnesses, and I
appreciated the chance to hear Dr. Lanphear. I could not agree
with you more about your analysis and the potential harm, or
the known harms caused by lead paint and the very real
connections based on some very strong scientific evidence of
behavioral problems that are linked to potential lead paint
issues.
I think this is very helpful and I think the idea of having
a broader perspective on it is really tremendously
constructive.
I spent a day in my State last winter on asthma and housing
issues. Connecticut has one of the highest rates of it, even
though we have a very affluent State and it is directly related
to the increased number of children that have asthma, directly
relates to poor areas in my State.
There is no question but the condition of housing and the
explosion of asthma in children is linked.
Mr. Chairman, I am going to apologize in advance about not
being able to stay. Sue Heller is one witness you are going to
hear from, and I suspect that every one of the people at the
table know about Sue.
First of all, she is from Rhode Island. She has a Rhode
Island background, from Brown University.
Senator Reed. That explains it.
[Laughter.]
Senator Dodd. Well, you are the Chairman. I was going to
say that. Of course, I was going to say that.
But you did not keep a hold of her because she is in
Connecticut now, and has done a terrific job in Manchester and
really has a wonderful national reputation for her work in the
lead paint area and the lead-based paint poisoning issues.
Again, you will hear from her. You will know what I am
talking about. We have had the wonderful pleasure of working
with her for a long time. She has made a huge difference, and
the people she works with in a community, an example nationally
of what can happen when local government, private-sector
people, contractors and others, all are working on the same
page to deal with a problem of this magnitude and prove that 6
percent of the kids were affected by it, poor kids, as much as
10 percent. Those are pretty high numbers, in a relatively
affluent community in my State. But Sue's leadership on this
has been tremendous and she will be a very valuable
contribution to the information that we will be collecting
today.
I apologize to her in advance for not being here, but I get
to hear Sue all the time, so I know how you feel about this.
And again,
Mr. Chairman, I thank you for holding this hearing.
Senator Reed. Thank you, Senator. Thank you very much.
Mr. Farr.
STATEMENT OF NICK FARR, EXECUTIVE DIRECTOR
NATIONAL CENTER FOR LEAD-SAFE HOUSING
Mr. Farr. I am the Executive Director of the National
Center for Lead-Safe Housing. We are a national research
organization. We have evaluated the local lead hazard control
programs in about
30 places, including Rhode Island, Manchester, Connecticut, and
Baltimore, Maryland. We are pretty familiar with what is going
on locally.
Mr. Chairman, you said in the beginning, and Dr. Lanphear
certainly reinforced it, that the only moral and effective way
to deal with childhood lead poisoning is to prevent children
from being exposed to lead in the first place. It does no good,
or it does very little good, to get them after they are already
lead-poisoned. So the issue that I want to talk about is the
extent of the housing problem in America where children are
exposed.
As has been indicated, most children with elevated blood
lead levels are exposed to lead because they live in older,
poorly-maintained housing containing lead-based paint, which
means virtually all housing built before 1960, and much housing
built after that.
According to the recently completed HUD national survey of
lead and allergens in housing, some 38 million homes in the
United States have lead-based paint somewhere in the building.
Over 25 million homes have significant lead-based paint
hazards.
Lead-based paint hazards include flaking or peeling lead-
based paint, lead-based paint on friction or impact surfaces,
such as windows and doors, lead-based paint on chewable
surfaces, such as window sills, which children can reach, and,
most importantly,
excessive levels of lead in dust on floors or window sills and
lead-
contaminated soil.
The greatest risk of lead poisoning occurs in older housing
units that contain lead hazards that either are or will be
occupied by low-income families with children under the age of
six.
Almost 14 million housing units are occupied by low-income
families. While only 1.6 million homes with lead-based hazards
are presently occupied by low-income families with children
under six, it must be recognized that most low-income families
move frequently, particularly those living in rental housing
that are most likely to be in poor condition due to lack of
maintenance. So it is fair to estimate that the number of lead-
hazardous housing units in which low-income families with young
children now live or are likely to live in the near future,
could well exceed 3 or 4 million houses. And those numbers are
based on the present standards of the hazard of lead in
household dust.
If Dr. Lanphear is correct that lead at much lower levels
than the present standard actually constitutes a hazard, and
our research reinforces his position on this, then the number
of hazardous houses in the country would be many, many more
times than I have just indicated.
So, we are talking about many millions of housing units.
The Congress in 1992 adopted Title X of the Housing and
Community Development Act of 1992 and it established the
present framework for the Nation's effort to end childhood lead
poisoning. Title X importantly shifted the emphasis from
waiting until a child is poisoned to trying to deal with lead
hazards up front and preventing children from being poisoned in
the first place.
Two of the important things that it did was: First, to
direct HUD to adopt regulations governing its large Community
Development Block Grant, HOME, and other rehabilitation
programs to require that reasonable steps be made in those
Federally-assisted housing to make houses lead-safe; and,
second, Congress established the Lead Hazard Control Grant
Program to fund lead hazard control work in privately-owned,
low-income housing. And privately-owned, low-income housing is
where the problem really exists.
Since 1990, the number of housing units with lead-based
paint has been reduced and these reductions can be expected to
continue. But the percentage of housing units with deteriorated
lead-based paint has actually increased slightly from 19 to 22
percent, reflecting the continuing aging of housing and the too
commonly inadequate maintenance of housing occupied by low-
income families.
As a direct result of Title X, as many as 1\1/2\ million
older, Federally-assisted housing may be made lead-safe through
HUD-funded rehabilitation over the next 10 years, if the
contractors follow lead-safe work practices and do not cause
more harm than they do good. And city and State recipients of
HUD's lead-hazard control grants are controlling lead hazards
in over 7,000 of the most at-risk housing units every year.
The cost of lead hazard control treatments obviously varies
from one housing unit to another, depending on the size and
condition of the unit, the type of unit, and the lead hazard
control strategy selected. It ranges from about $2,000 a
housing unit up to $9,000 or $10,000 a unit for deteriorated
housing with substantial lead hazards.
HUD estimates that the incremental cost--that is, above
regular rehabilitation costs--range from about $2,500 for a
house that is in not too bad a condition, to $9,000 for
abatement of hazards in housing in poor condition.
As a practical matter, neither market forces nor the
present Federal programs are dealing with the most badly
contaminated housing where the children are most at risk of
becoming poisoned. These are housing units in which two or
three or more children become lead-poisoned over the years as a
succession of families move in and out of that housing.
For example, we have a map which was developed by Brown
University of the housing in Providence where at least two,
sometimes three, sometimes four kids have been poisoned over
the last 5 years. So it is a persistent problem.
Thus, while progress is being made, at the present rate, it
will take at least several generations to make all housing
lead-safe for our Nation's children. The Nation will miss the
goal cited by Ms. Thornfeldt by the Department of Health and
Human Services of eliminating childhood lead-poisoning by 2010.
We are going to miss that by a mile.
So here is my prescription of what can be done, to
complement what Dr. Lanphear said. First of all, we should make
sure that the new HUD lead regulation is fully implemented.
That deals with housing which is Federally-assisted.
Second, EPA should enact regulations to establish lead-safe
renovation and maintenance practices as the national norm, as
Title X almost 10 years ago directed the EPA to do.
Third, rehabilitation of older inner-city housing should be
a national priority. Mostly, we are talking about using HUD
block grant and HOME funds for that purpose.
Fourth, we should expand environmental testing, as
distinguished from testing of children, of older properties in
at-risk neighborhoods so we know where the work should be done.
Fifth, we should demolish obsolete and uneconomic
properties and provide safe replacement housing for the
families that live in those properties.
And finally, we should make certain that no housing like
the housing in Providence which I referred to, poisons children
once, twice, three or four times.
As a practical matter, HUD's Lead Hazard Control Grant
Program is the only realistic source of financing at this time
for controlling hazards in the older, low-rent, poorly-
maintained housing where children are most at risk.
Private owners are unwilling or unable to make those
housing units lead-safe because the cost of lead-hazard control
could never be recouped by the property owners. In some cases,
the cost even exceeds the market value of the housing. Cities
have other needs and priorities for HUD's Community Development
Block Grant and HOME funds and may be reluctant to condemn
units in the already dwindling stock of affordable housing for
fear of increasing homelessness.
For better or for worse, Federal funding, mostly for HUD's
Lead Hazard Control Grant Program, is the only realistic way at
the present time to deal with the worst housing where children
are most likely to be poisoned.
In conclusion, childhood lead poisoning will only end when
the Nation changes its priorities and recognizes childhood lead
poison-
ing as an epidemic that must be broadly addressed.
For starters, Congress should sharply increase
appropriations for lead hazard control now. At present, the
only effective program is HUD's Lead Hazard Control Grant
Program. The Center estimates that the annual appropriations
for that program must be increased to $400 or $500 million a
year if we are to prevent children from being poisoned in
generation after generation, and to prevent children who are
now failing from school to lead productive lives.
Thank you.
Senator Reed. Thank you very much, Mr. Farr.
Thank you all for your testimony today.
Let me begin with Ms. Thornfeldt.
You have a unique perspective as a mother of a child who
has been poisoned by exposure to lead. Can you describe
essentially the impact it has had on your son and your family?
And by the way, how is he doing?
Ms. Thornfeldt. Sammy is now 6 years old and he just
started kindergarten in September. So, he has been into the
formal school system for about 2 months now. We are not quite
sure how well he is going to do. We have high hopes for him and
we are going to do the best we can with what we can do.
It has impacted our family greatly. As I noted in my
testimony, the enormous stress of dealing with a sick child,
the relocation issues, the lead abatement, and the financial
strain on our family, we are still recovering from, and this
was 4 years ago. So the toll has definitely been stressful.
Senator Reed. And in your work with your colleagues in
Maine, you see this in many different perspectives. I think
that your home was an older home that you renovated.
Ms. Thornfeldt. Yes.
Senator Reed. But as Mr. Farr and Dr. Lanphear spoke, there
are many lower-income rental units that, are not renovations.
It just exists that way. Do you find that in Maine?
Ms. Thornfeldt. No, we do not. Maine has the highest
homeownership rate in the Nation, and we are very proud of
that. So 60 percent of all of the childhood lead poisonings in
our State are as a result from homeowners renovating and
poisoning their own children. In some sort of way, the guilt is
pretty tough on parents to actually go ahead and move forward
with those renovations and ending up poisoning a child
yourself.
Senator Reed. Thank you.
Now, Dr. Lanphear, in your testimony, you indicated that if
we could spend about $450 million, as Mr. Farr suggested, that
we could save about $1.5 billion, or let me say, a considerable
multiple. How would we save this? Could you outline it?
Mr. Lanphear. Well, that is actually a low estimate because
it does not account for other potential hazards or outcomes
from lead exposure, such as delinquency, such as tooth decay
and oral health problems, such as cardiovascular disease.
Most of the cost/benefit analyses that have been done so
far have really focused on cognitive deficits as their major
outcome.
Moreover, they focused on an estimate from children who
only 20 years ago had blood levels that were higher. And as I
pointed out, the decrement in reading or in IQ for children at
lower blood levels is much greater.
And so, the lower estimate that was used in previous cost/
benefit analysis will underestimate any benefit that will come
from this. So it is cost beneficial.
Senator Reed. The scientific information about the impact
of low levels of lead exposure, what effect should that have on
our screening and our treatment approaches?
Dr. Lanphear. Well, I think the first thing is, as you have
heard from across the panel here, that it really should push us
to be focusing on identifying the hazards in housing before a
child is unduly exposed. That could happen at the time that
somebody buys a home. Certainly after any renovation, a dust
wipe could be used. It could be as a part of any Federal
subsidy for housing part of a requirement, or for Medicaid-
eligible children.
And so, unless we change the trigger for action from a
child to the source, in this case, housing, we are never really
going to shift to prevent undue lead exposure in the first
place. That has to be the key to shifting our efforts.
But I would also point out right now that the EPA standard
for residential lead hazards is not adequate to protect
children. I think another aspect, and this is in the written
testimony, that that needs to be looked at carefully because it
provides an illusion of safety to families who are doing the
renovation work.
Senator Reed. Now, you seem to suggest in your testimony,
Dr. Lanphear, that we are just responding to children that have
very overt symptoms of high levels of lead. But, yet, the
damage is done and perhaps even not really noticed at much
lower levels of lead. Is that a fair statement? I do not want
to be imprecise.
Dr. Lanphear. I would not say most of the children, until
you have blood lead levels of 50 or 60, there is no obvious
symptoms. But, rather, you have to look at hundreds of children
compared to one another before you see it in many cases,
although you clearly will have mothers tell you, before a child
was exposed, they were a nice, docile, friendly kid. They are
exposed and all of a sudden, they have temper tantrums,
behavior problems. And of course, this happens all around the
time of the terrible 2's. So it is very difficult to tease
apart lead as a neurotoxin versus a developing child.
At lower levels, it is more subtle and you can only see it
when you look at populations of children.
Senator Reed. But you notice in those lower levels, though,
significant losses in cognitive processes.
Dr. Lanphear. That is right. In reading, in math, certainly
in intelligence. Some people have estimated that for every one
IQ point lost, a child's lifetime earnings will be reduced by
about $12,000. So that is where some of the cost/benefit comes
in.
Senator Reed. Thank you, Doctor.
Mr. Farr, in your testimony, you said that the HUD Lead
Hazard Control Program is the only funding available,
effectively. Do you believe that, in addition to increasing
funding, we have to introduce new Federal programs, or would
our best approach simply be to fund robustly at the $450
million level, the existing program?
Mr. Farr. Well, right now, I would think that would be the
most effective way to move. I mentioned some other things in my
testimony and in my written statement that I think would make a
difference as well. I would just add sort of in answer to one
of your questions to Dr. Lanphear.
Senator Reed. Yes.
Mr. Farr. In Maryland, the statute which Senator Sarbanes
referred to requires all owners of rental property built before
1950, whenever the property turns over, which is frequently
with that kind of housing, to take certain steps to reduce lead
hazards. I happen to have drafted those steps, so I think they
are pretty good.
It could use a little better enforcement, frankly, if the
law is going to be truly effective. But we also, as you
probably know, have helped draft and have pushed for
introduction of a similar statute in the State of Rhode Island,
and it almost passed last time, but it didn't quite.
There are things that local governments can do with
encouragement from hearings like this to require owners,
particularly of older rental property, to take certain cost-
effective steps--we are not asking them to spend hundreds of
thousands of dollars--which will make the houses considerably
safer.
And the research we have done, some of it with Dr.
Lanphear, indicates that what we call interim control
treatments, which can be done in the $2,500 to $5,000 range,
are effective in bringing the levels of lead and dust down and
keeping them down over a period of time.
And in Rhode Island, we found that you could bring dust
lead levels on floors down to 10 micrograms per square foot or
below; and they stayed that way for 3 years, without undue
expenditures. That kind of local effort would make a lot of
difference, and you do not need a lot of Federal money to
accomplish that.
The reality is the owners of the really bad housing are
going to pay no attention to a law like that because they
cannot get their money back. So, they just abandon the houses,
which you do not need very much, either, in creating
homelessness. For the worst housing, where the children are
most at risk, I think the best shot is to increase the
appropriation to that program.
Senator Reed. It seems that, running throughout all your
testimony, is this notion of getting away from simply screening
children and then treating them individually. But taking, right
or wrong, a more public health approach, which is identifying
the source of the contagion, which is the worst offenders. You
mentioned and you have identified a house in Providence that
had several successive families----
Mr. Farr. A whole series of houses, hundreds of houses.
Senator Reed. And that by identifying those houses, direct
Federal/State resources to remediation and then work your way
down the list of the worst- to next-worse, all the way down. Is
that being done? Are you seeing that?
Mr. Farr. It is being done in some places. It is what we
call targeting, and it is being done. And certainly, the HUD
program strongly encourages people to do that. It is a
competitive program and you only get money if you are focusing
where the need is.
In Rhode Island, for example, the city of Providence has
floated some bonds for a variety of rehabilitation projects and
it has earmarked some of that money for lead hazard control,
which is
another good example of what a State and local government can
do to supplement the Federal program. Not every State cares
about this as much as Rhode Island does.
Senator Reed. Well, one of our goals is to make every State
care about this as much as Rhode Island.
Dr. Lanphear, do you have a comment about a new paradigm
when it comes to looking at the way we deal with the issue of
lead exposure?
Dr. Lanphear. Yes. I think you hit it as a public health
approach rather than this reactionary approach. Going back to
this idea of how we think about housing, residential hazards
are analogous to occupational hazards of 30 years ago.
We just started to recognize occupational hazards and
provide an infrastructure to protect the worker. We have
virtually nothing in place to protect where children work, if
you will, in the home environment. And where people have the
means to provide for their children, and they know how and are
given the information, then they can do that.
There are a lot of situations, whether it is a homeowner
trying to renovate, or it is families who live in rental
property that they cannot control, where their children
confront hazards every day. It is a neglected public health
problem.
To the extent that we can begin to think about housing as a
public health effort, come out with an institute, if you will,
that could oversee other agencies' efforts to protect children
in housing, review the scientific evidence and come out with
recommendations for standards that State and local agencies
could adopt, I think we would go a long way to protect
children. And without that, we are not going to go a long way
in protecting children's health.
Senator Reed. Thank you, Dr. Lanphear.
Ms. Thornfeldt, finally, you have been very active in
Maine. Are there any local initiatives that you feel are
particularly worthwhile that we could emulate across the
country?
Ms. Thornfeldt. Well, Maine is not as progressive as Rhode
Island or Massachusetts at this point right now. The State just
got its first HUD grant 3 years ago and the city of Portland
just had their second HUD grant renewed. So, we are making
strides. Hopefully, there will be a bill in the next
legislative session to address universal screening in the State
of Maine. We are taking those steps to move forward.
But you posed the question to Mr. Farr and Dr. Lanphear.
I think when children and families have paid the price for lead
poisoning for all these decades, and now we are talking about
taxpayers still pulling the toll here of funding HUD for their
lead hazard control program, and I think we are all mindful of
the concept of polluter pays. And I think we need to start
thinking about steps to holding the lead paint manufacturers to
fixing some of our older housing stock here.
Senator Reed. Thank you very much.
Thank you all for your testimony very much.
I would like to now call forward the second panel, if they
could please take their places.
[Pause.]
Let me now introduce the second panel. The first witness on
the panel is Attorney General Sheldon Whitehouse from my own
State of Rhode Island. Elected in 1998, Sheldon has focused his
efforts on health care, environmental enforcement, crime
prevention, and punishing armed criminals. Sheldon previously
served as U.S. Attorney for Rhode Island. Before that, his
career in Government included positions as Director of Business
Regulation and Executive Counsel and Policy Director to
Governor Bruce Sundland.
Next, we are joined by Mr. Rick Fatur. Currently, Mr. Fatur
is developing Colorado's lead-based paint program for the
Colorado Department of Public Health and the Environment. He
started the Colorado Lead Coalition and has worked in the
environmental field for over 25 years as a chemist,
environmental consultant, and instructor for asbestos and lead-
based paint classes.
Finally, we are joined by Sue Heller, who has previously
been introduced by Senator Dodd, with the highest praise. She
currently administers the Manchester Lead Abatement Project in
Manchester, Connecticut, supervising abatement of over 110
dwelling units from outreach through construction of these
units. Other experiences include directing the $225 million New
York City Community Development Block Grant and managing
public-private sector projects for the mayor's office.
And we look forward to all of your testimony. We will begin
with Attorney General Whitehouse.
Mr. Whitehouse, welcome.
STATEMENT OF SHELDON WHITEHOUSE
ATTORNEY GENERAL FOR THE STATE OF RHODE ISLAND
Mr. Whitehouse. Thank you, Mr. Chairman. It is very nice to
see you here.
Rhode Island, as you know, has a serious lead paint
problem. And I will begin my testimony by describing the
insidious nature of lead paint poisoning, which provides no
particular telltales, creates no symptoms ordinarily, and is
therefore a particularly dangerous and difficult poison to
locate, particularly in an environment in which there has been
substantial misleading discussion about the nature of lead
poisoning, suggesting that you have to eat lead paint like
potato chips in order to be poisoned.
Families are often not sufficiently enough on the alert to
know that their children are being lead-poisoned. And it is
certainly not a low-income problem entirely. People who are of
some considerable affluence and who take pride in the
maintenance of their homes, particularly during renovation
periods, can find that their own children have been lead-
poisoned.
The Conservation Law Foundation of Massachusetts had
identified Rhode Island as the lead poison capital of the
United States and both our Democratic general assembly and our
Republican governors administration have identified lead as the
number-one environmental health issue facing Rhode Island's
children.
The rate of lead poisoning of our children in Rhode Island
is 2\1/2\ times the rest of the United States. In Providence,
it is 4 times higher than the rest of the United States. We
test the blood of every child entering kindergarten for lead
poisoning. Every year, on average, more than 2,000 kids
reporting to kindergarten have elevated blood levels.
Against this backdrop of a very real and insidious public
health
calamity, Rhode Island has been active at the municipal, State
and Federal levels.
At the municipal level, the bulk of the response has
occurred in the city of Providence, our capital city. The
city's primary focus is on providing lead safe, healthy
housing, and public education to its residents. Through an
experienced lead abatement team, through HUD and National Safe
Houses Corporation grants, and through close enforcement
coordination with my office and the Department of Health, along
with aggressive public outreach to children, parents, schools,
families, realtors, homeowners, elevated blood levels in
Providence's children have dropped from 38 percent of those
entering Providence kindergartens in 1998, to 25 percent of
kindergartners today.
At the Federal level, we have pursued Federal grants
through HUD and other agencies and worked with Federal
officials, primarily HUD, EPA, and the U.S. Attorneys Office.
Federal polit-
ical leaders such as yourself have shown considerable interest
and
vision.
At the State level, we are addressing lead-poison through a
variety of agencies and means. Our Department of Health
conducts the blood testing program I have described. In the
year 2000, 32,313 children under the age of 6 were tested in
Rhode Island. Two
thousand eight hundred four of those children had elevated lead
levels in their blood. The Department of Health follows up on
each case where the child's blood level is 20 milligrams per
deciliter or higher, with home inspections and case management.
Our Department of Human Services provides funding and care
for low-income residents who experience lead poisoning and
require medical treatment. Rhode Island became the first and
only State to receive permission from the Healthcare Financing
Administration to use Medicaid funds for replacing or repairing
windows in homes of lead-poisoned children if landlords or
tenants satisfied the
eligibility requirements.
My department, the Department of Attorney General, is
involved primarily on the enforcement side. When we become
aware that a residence contains dangerous levels of lead,
usually by a referral from the Department of Health, we take
action to require owners and landlords to abate the lead.
Landlords are not always willing, so we have repeatedly taken
them to court and obtained orders, contempt judgments, and
civil penalties to enforce their obligation to abate. For
instance, in one case, a judge's contempt order required the
landlord to pay civil penalties, find and fund alternative
housing for the tenants, and to immediately abate the lead
hazards or face raised fines. We have successfully completed 20
such lawsuits. We have approximately 200 cases in the office in
process right now, and roughly 100 homes and apartments,
including the exterior and the soil that surrounds them, have
successfully been abated or are in the process of abatement.
Moreover, the Department of Health reports that they find
an entirely new level of cooperation and compliance from
landlords when they are given the initial notification now that
word is out in the landlord community of our enforcement
strategy.
We have referred cases for prosecution to the Department of
Justice, HUD, and the EPA to enforce the Federal requirements
that landlords and sellers disclose lead hazards to buyers and
tenants. We hope that the Federal Government will take a more
active role in prosecuting these cases in the future.
In addition to recognizing the efforts of municipal,
Federal, and State government, I should take a moment to
commend the community organizations that are so active in Rhode
Island in this area: Health & Education Leadership for
Providence, the Help Lead Safe Center, the Childhood Lead
Action Project, Greater Elmwood Neighborhood Services, various
neighborhood and church organizations, Head Start, the VNA, and
many nonprofit housing groups.
Blood, toil, tears and sweat were Winston Churchill's
exemplars of effort. In Rhode Island, the blood is given by
infants and small children who must be regularly tested, and in
some cases, hospitalized, to have their blood chelated. The
tears are shed by family members who discover, often too late,
and often despite very reasonable levels of maintenance of
their homes, that their child has become lead-poisoned. The
toil and sweat comes from the men and women of these community
organizations who every day administer to the many needs of
families facing these uncertainties.
Everyone in Rhode Island is working to clean up the lead
paint mess. Municipal government and thus, municipal taxpayers,
are pitching in. State government through many agencies, and
thus, State taxpayers, are pitching in. Federal efforts have
been made through HUD, the EPA, and the Department of Justice.
Volunteers and staff of community organizations are pitching
in. Families, of course, bear a terrible share of the burden--
the lead poisoning of their children, the worry and woe of
mothers and fathers, the displacement of families from their
homes, even the minor trauma of holding your child as painful
and frightening procedures are performed to test for lead
poisoning or to chelate lead out of your child's blood. Even
landlords and homeowners are pitching in, cleaning up lead
paint that may have been put on years before they ever bought
the home.
Mr. Chairman, there is, only one group not pitching in. And
that is the lead pigment companies who sold this toxic material
for decades, profited from it, lied about it, and are now
trying to evade even the most microscopic share of
responsibility for cleaning up the mess they helped to create.
After determining that the pigment companies were prepared
to do essentially nothing about this problem, I filed a lawsuit
to determine what the fair share of responsibility of these
companies is, and to get the companies to contribute that fair
share to the remedy of this problem.
The lawsuit was filed on October 12, 1999. The State of
Rhode Island is represented by myself and by my office, by a
highly regarded law firm which represented the State with great
success
in litigation that you will remember well, arising out of Rhode
Island's 1991 bank failures, and by a national firm which has
the depth to withstand the inevitable blizzard of paper
occasioned by large-scale civil litigation. As Attorney
General, I am directly involved in this case, guide its
strategy, and successfully argued the case for the State
against the motions to dismiss.
Our allegations fall into three groups. There are equitable
counts. There is a statutory count under a Rhode Island State
consumer protection statute. And there are a number of
traditional tort counts which bear on the properties owned or
maintained by Rhode Island in its proprietary capacity. For
example, the public nuisance count would enable the Rhode
Island Superior Court within its equitable jurisdiction to
impose a reasonable order allowing more rapid and complete
abatement of lead paint that the State presently has resources
to accomplish.
As the Rhode Island General Assembly has noted, ``Rhode
Island presently does not have the public nor the private
resources to handle the total problem.''
I should point out that a public nuisance lawsuit, when
brought by a responsible public official to vindicate a public
harm, is not an ordinary piece of litigation. Its primary
purpose is not to resolve a dispute between contending private
parties, but rather to protect the public health, safety and
welfare. A public nuisance lawsuit is, in some measure, an
exercise of the police power of the State.
What remedy do we seek that will relieve Rhode Island
children of the hazard of lead paint poisoning? Ideally, all
lead paint needs to be removed from residences where children
may be exposed. With limited resources, we believe the first
priorities are: one, to remove lead from friction surfaces such
as doors and windows; two, to assure that repairs and
maintenance are done in a way that does not expose residents to
lead dust; and three, to encapsulate lead surfaces, since it is
lead's inherent, intrinsic nature to chalk and form poisonous
dust.
I will conclude my remarks by observing that I am just a
small State Attorney General, and this lawsuit has provided me
my first experience of national level spin. I will not bore you
here with the description of the various characterizations of
this lawsuit, characterizations of my motivations, or
characterizations of the facts of lead paint poisoning. Suffice
it to say that we wish as quickly as possible to bring this
case forward, so that we can present the State's case and the
defendants can present theirs, and a decision can be made not
on rhetoric, not on spin, but on evidence and facts. We look
for the outcome of that process to be a fair and sensible order
requiring the defendants to contribute in a fair and sensible
way to the clean-up of the mess they made.
If Rhode Island is to be considered the lead paint capitol
of the United States, Mr. Chairman, let us also seek to be the
capitol of lead paint solutions.
Thank you very much.
Senator Reed. Thank you very much, Mr. Whitehouse, for your
testimony, also for your leadership.
Now let me call on Mr. Fatur.
Mr. Fatur.
STATEMENT OF RICHARD A. FATUR
ENVIRONMENTAL PROTECTION SPECIALIST
COLORADO DEPARTMENT OF PUBLIC HEALTH
AND THE ENVIRONMENT
Mr. Fatur. Good afternoon, Chairman Reed, and Members of
the Subcommittee. My name is Rick Fatur, and I am an
Environmental Protection Specialist with the Colorado
Department of Public Health and the Environment's Lead-Based
Paint Program. I have been asked to testify before your
Subcommittee on Colorado's Lead-Based Paint Program.
First, I want to thank you for inviting me to this
discussion on State and local lead-based paint programs. I
would like to start by giving you a summary and an overview of
our State program.
I would say that Colorado is an example of a State with an
average childhood lead poisoning problem. We have found that 3
to 4 percent of the children tested have elevated blood lead
levels, which is close to the national average. We have
identified pockets or areas where 15 to 20 percent of the
children have elevated blood lead levels, but we do not seem to
have the same problem that some States have where certain
cities or areas may have up to 50 percent of the children with
elevated blood lead levels.
The only current Colorado State lead-based paint regulation
covers the abatement of lead-based paint. Colorado's lead-based
paint regulation for abatement is nearly identical in content
to the
Federal EPA lead-based paint regulation for abatement, with a
few minor differences.
The current regulation covers the following items. There
are requirements for conducting lead-based paint inspections,
risk assessments, and then also abatement projects. In
addition, abatement projects have requirements for notification
and also submitting a protection plan. They need to be
conducted by certified abatement firms using certified workers
and supervisors, and are inspected by the State to ensure that
proper work method are being used. We also have a compliance
section so enforcement actions may be taken for noted
violations. We require certification of abatement firms,
workers, supervisors, designers, inspectors and risk assessors.
And we approve training providers and audit the classes to
assure proper content.
Overall, the State regulation is working well. Inspections,
risk assessments, and abatements are presently all voluntary
activities. I believe lead poisoning could be further reduced
if triggers could be introduced requiring these activities be
conducted under certain circumstances.
I would now like to address some of the positive aspects of
our program.
We are showing an increase in abatement activities/
projects, which shows that people are becoming more aware of
the problem.
We are also showing an increase in the number of abatement
firms, and all personal certifications.
Working ``lead-safe,'' by containing and controlling lead
hazards, is becoming a more common-place practice in Colorado.
Since inspections, risk assessments and abatements are
volun-
tary activities, a major part of the program is outreach and
education. We developed a Colorado Lead Coalition to help us
with these activities and are seeing very good results from its
work. Incidentally, the EPA recently honored our Colorado Lead
Coalition with an Environmental Achievement Award on October
30.
The members of the coalition include: The Colorado
Department of Public Health and the Environment; the
Environmental Protection Agency; the Colorado Department of
Housing; the Denver Environmental Health; the Denver Housing
and Neighborhood Development; the Northeast Denver Housing
Center; the Denver Water Board; and the Agency for Toxic
Substances and Disease Registry.
The new coalition members that will be joining this year
include OSHA, HUD, and the El Paso County Health Department.
The Colorado program for testing children is working well
and we continue to see an increase in the number of children
being tested. We have begun the process of revising our State
regulation to mirror the new EPA regulatory requirements issued
in January 2001.
Finally, I would like to discuss some of the problems we
have seen, not only within our State, but also nationally.
By far the majority of projects are being done for the
purpose of renovation and remodeling, not for abatement.
Abatement is the elimination lead-based paint hazards and must
be conducted in accordance with existing regulations. HUD
requires some training to control lead-based paint hazards
during HUD's renovation and remodeling projects, but the vast
majority of renovation or remodeling projects are still being
done by untrained persons without any control measures.
Again, I believe lead poisoning could be further reduced if
triggers could be introduced requiring inspections before
renovation and remodeling is permitted, and requiring that risk
assessments and abatement be conducted under certain
circumstances.
The EPA needs to promulgate their other regulations as
quickly as possible to close the present loopholes. These
include the regulations covering--renovation and remodeling and
buildings, bridges and structures.
One of the most significant problems involving lead-based
paint is the lack of funding or financial assistance available
for abatement or lead-safe renovation and remodeling.
Although there seems to be enough funding for training,
outreach, education and even free training classes, almost no
money exists to help the underprivileged families who have
lead-poisoned children and have an urgent need for interim
controls or abatement to correct lead-based paint hazards in
their homes. We should think of ways to focus more immediate
attention on this issue.
We will all need to work together to resolve some of these
problems in order to reach our Nation's goal of eliminating
childhood lead poisoning by the year 2010.
Thank you very much, and I would be glad to respond to any
questions you may have. I have also included a rough diagram of
the current lead-based paint regulations and how they affect
each other, and I would be glad to discuss the diagram if
anyone has any questions.
Senator Reed. Thank you very much for your testimony. My
pronunciation I think is different than your pronunciation.
Mr. Fatur. It is close.
[Laughter.]
Senator Reed. Anytime there is an A, I have a problem. So
how is your name pronounced?
Mr. Fatur. ``Fa-ture.''
Senator Reed. Fatur. Well, thank you very much, Mr. Fatur,
for your testimony and also for your years of effort in this
area.
Mr. Fatur. You are welcome.
Senator Reed. Thank you so much.
Ms. Heller.
STATEMENT OF SUE HELLER
PROJECT ADMINISTRATOR OF THE
MANCHESTER LEAD ABATEMENT PROJECT
MANCHESTER, CONNECTICUT
Ms. Heller. I am Sue Heller. I am administrator of LAP, the
Manchester, Connecticut Lead Abatement Project.
Thanks to those who direct their own energies and staff
work
toward lead solutions.
Senator Jack Reed holds the first lead-based paint hearing
in 10 years, yet another milestone in his quest to end lead
poisoning in our time. What better place to be than in a
hearing where rank is accorded to Senator Allard of Leadville.
We are all from Leadville today.
Connecticut's lead muse is Senator Christopher Dodd, a
champion of children, housing and Medicaid. Senator Joseph
Lieberman and our Representative John Larson provide
Connecticut with knowledgeable and substantive support.
As a HUD grantee, we appreciate the insightful, effective
leadership of David Jacobs. Today, when thoughtful people are
preoccupied with national values, security, and other
imponderables, it is a comfort to be able to talk about a
preventable, soluble problem--childhood lead poisoning.
Over a million Connecticut household units were built
before 1978. Five hundred thousand have some lead paint risks
and 65,000 suffer real hazards. Children are not adequately
screened
or tested for blood lead levels, despite pediatric advice and
the
Medicaid Band-Aid.
Connecticut landlords are obligated to abate when a
resident child is poisoned at 20 micrograms per deciliter. No
regulation or resource compels correction when a child has a
mild elevation.
Poor cash flow in low-income housing and ignorance of
effective lead practices deter owner response. Blood lead
levels lower than 10, formerly thought safe, seem to be
damaging. Poisoning thought irreversible, though, thankfully,
is treatable. So prevention, which costs less than abatement,
is the cost-effective strategy of choice.
Our State responds to the prevailing lead problems of old
housing, ignorance of lead safety, insufficient screening, and
a shortage of resources. Training is delivered in lead safety
and licensure.
Some jurisdictions have won Federal lead money, but very
leaded areas in the State have unsuccessfully competed for
scarce grants. The courts aggressively enforce lead orders.
Hartford instituted a postal cancellation message and a stamp
to command resources and attention recently.
Screening is increasing in some larger cities and the State
has two regional treatment centers, each with lead-safe houses.
Manchester, Connecticut, uses its 368 HUD-funded units to
pilot innovations and to build local capacity. In moving toward
prevention, we have invoked four levels of intervention--
lowering average costs in the process from $11,500 to $7,250
per unit. We have developed an economic sector of the
construction industry devoted to lead and delivered customized
training for thousands. LAP has used lead funds to trigger
homeownership for 14 low-income, first-time homeowner-
occupants, meeting local community development and housing
affordability objectives as abatement money is combined with
local rehab.
Senator Dodd recently jump-started a Manchester initiative,
Lead Action for Medicaid Primary Prevention (LAMPP). The
Senator responded to the opportunity to maximize potential
development of Medicaid youngsters by investing in affordable
housing.
LAMPP will remediate housing where mildly elevated Medicaid
youngsters live. Managed care health providers will refer cases
for preventive, cost-effective measures: window repair or
replacement, paint stabilization, and grass seeding.
A State-funded pilot at $200,000 a year for 2 years will be
matched by funds from lead and housing programs, bonding,
Medicaid, private dollars, and if we are persuasive, Federal
funds.
LAP has won a national best practice award and a local
customer service award for its production, cost effectiveness,
prevention, and creativity. But those things are not enough.
What needs to be done? More funds are necessary for
prevention to deal proactively with children at risk, while not
yet poisoned, and to continue to react to poisoned kids.
Money should be directed at prepoison efforts, like nursery
preparation or turn-over strategies, where owners can see the
pay-off of low-cost, preemptive measures applied between
tenants.
We must screen more, but use the data dynamically to guide
remediation, focusing on Medicaid youngsters who are
disproportionately at risk.
The Federal Medicaid mandate can be a functional and
financial lever. We have to demythologize lead costs and
liability by demonstrating low-cost, lead-safe skills. Best
practices, new equipment, relocation techniques, and technical
assistance to remodelers. We have to encourage those who can
afford to remediate themselves.
Programs like ours can only remediate at present an
infinitesimal percent of the real needs. In Manchester, it is 3
percent. With
additional dollars, we can satisfy the real demand for assisted
abatement and prevention. Early prevention can preclude life-
long neurologic impairment of kids, deter costly treatment of
poisoned children and their households, and reduce expensive
special education and behavioral intervention necessary once a
child is poisoned.
We need more funding for a well-managed strategy to ensure
quick implementation of compound benefits--healthier children,
sounder housing, and improved neighborhoods.
Senator Reed. Thank you Ms. Heller, for your testimony.
Thank you all for your excellent testimony.
Let me begin with Ms. Heller, if I could.
Dr. Lanphear testified with great conviction, at least to
this person, that the standard is probably too high in terms of
assessing the true damage to children. If we were to adopt a
lower standard, what impact would that have from your
perspective locally on screening remediation, other than the
obvious that it will cost more money. Can you flesh out some of
the impacts?
Ms. Heller. I think more sensitive prenatal work--the
nursery preparation, attention by public health professionals,
and of course, more money for these programs to demonstrate how
things can be done to people who cannot afford to do them, as
well as to people who can.
Senator Reed. And you indicated that in your testimony,
with your leadership, and Senator Dodd and others, you have
begun to coordinate better the medical establishment and the
housing establishment for remediation. You might elaborate on
what you have done, but also, an indication if that is common
throughout the country or something very rare?
Ms. Heller. It is fairly rare. We have been very fortunate.
Manchester is an extremely well run community, and while
not so affluent, its effective administrative infrastructure
masks some of the problems. I think if we could export that
spirit of cooperation between health and housing authorities,
it would be an extremely valuable tool to use around the
country.
We have done it through mutual respect, and it is hard to
say what else--lots of work, mutual respect.
Senator Reed. Good.
Mr. Fatur, in Colorado, have you been able to link together
the housing authorities and health care providers in terms of
remediation of the problems in treating the children?
Mr. Fatur. We have to some extent. The main work that we
have tried to do is through outreach, through our lead
coalition and getting other people involved, and doing outreach
activities for different groups, which include health care
providers. It is an area where you just need everybody to work
together and everybody's support and everyone to get on the
same page.
Senator Reed. Are your health care professionals and the
community leaders also talking about lowering the standard for
the threshold?
Mr. Fatur. There is talk about that. But in Colorado, we
pretty much are adopting the EPA's regulations as they come out
and trying to be not more strict or stringent than they are,
even though it might merit it in this case. We really probably
would not be able to in Colorado, I do not think, unless EPA or
HUD or the rest of the agencies set their standards lower than
we could in Colorado if we were to adopt those standards.
Senator Reed. You have an interesting perspective. You are
there in the locality, working at the State level with
communities. Are there any techniques or programs that you find
particularly useful that you think should be copied across the
country?
Mr. Fatur. Well, I believe the main thing that we have done
there is we found that communication really is the key because
a lot of it focuses on outreach and education. One of the main
things that we have done in Colorado is develop our lead
coalition. And you can see that we have a variety of housing
environmental agencies, et cetera, there.
We meet once or twice a month for planning activities for
the National Child Lead Poisoning Prevention Week. We assist
each other with the programs and outreach. We try to focus our
outreach activities so that not everybody is focusing on the
schools. We can spread it out. We get together and combine and
do presentations for different organizations and try to come to
an agreement on the different regulations because they may not
exactly mirror each other. We try to get the local health
departments involved. We have Denver environmental health and
El Paso County.
One of the main things that we have done is we are now
going to be partnering with the National Coalition for Lead-
Safe Kids, which is a national coalition, and we are going to
try to bring some of their expertise that they have nationally
into Colorado to also help us there. I think they are a great
organization and they can help anyone who is trying to develop
a coalition in their own State.
Senator Reed. Just one question for both Mr. Fatur and Ms.
Heller.
I was struck by Mr. Farr's comment that in my own capital
city of Providence, they were able to identify one unit that in
a series exposed several different children. Do you have that
kind of housing data in Colorado that you could identify the
units that consistently seem to be a problem? And similarly, in
Connecticut?
Mr. Fatur. Not to a great extent. If we have a home that we
know we have done a project in and we know there is a lead
hazard, then we can start tracking the families that go through
there. But, in general, it is not really adequate to do that.
Senator Reed. And I would presume also that a treating
physician probably would not have access to a database like
that, so that when a child walked in, it does not even register
that this child is coming from a location that another child
might have come in weeks or months before.
Mr. Fatur. Right. Well, one thing that we are really
working on and it fits in with what you are talking about, is
we had a guest speaker in our coalition meetings from the EPA
environmental
justice department or section. They are working with us to do
some GIS mapping for all the areas in Colorado so we can try to
establish that type of information and target areas and even in
homes where we know that there is a problem and try to track
those homes.
So, we are working on that now jointly with the EPA
environmental justice department.
Senator Reed. Ms. Heller, can you comment from your
perspective in Connecticut?
Ms. Heller. In Connecticut, I would say that it does
happen. In Manchester, it is very unlikely to happen because we
have a highly aggressive coordinated code enforcement team. And
that team includes health and housing, as well as code
officials. I would say that that is one way that we attack the
issue and it is one way that you can join the various
disciplines involved in it, along with the availability of the
Federal money.
Our lead grant has been very inducive to cooperation
because housing and health authorities realize that using the
money is going to solve health problems, health code issues,
building code issues, and help affordable housing, along with
school programs where health and housing are issues. I would
say that we have a fairly coordinated effort.
Senator Reed. All right.
Mr. Whitehouse, let me commend you for your leadership on
these issues and the aggressive way that you have tried to use
your enforcement authorities.
And I think one of the issues that came up in the other
panel is that we have a lot of statutes on the books, but until
they are enforced, they are just on the books. They are not
helping kids.
You indicated in your testimony that you have brought about
20 lawsuits against landlords who allowed their properties to
fall into disrepair. This is a relatively low number given the
number of properties. Can you comment upon your constraints,
and also, given your engagement with other attorney generals
around the country, the issues that face them in terms of
prioritizing and pursuing these types of actions?
Mr. Whitehouse. When we are bringing enforcement actions,
we are following up on really two initiatives to locate the
cases.
One is to follow up on the Department of Health's
identification of
individual children as already lead-poisoned, and we have a
mechanism in place where we have worked out the health care
confidentiality problems and we can get access to that
information and address the landlords whose houses are
responsible for that particular poisoning.
As earlier speakers have said, that sort of thing requires
children to being the canaries in the mine, to being the
biological indicators, I think Dr. Lanphear said. And that is a
very unfortunate way to deal with the public health problem.
Another way that we are doing this is with what we call the
Nuisance Task Force, which brings together code enforcement,
the police departments, and a variety of local officials with
our office to highlight what we think are dangerous or
offending places.
And it may be that they are offensive primarily for the
number of police visits to them more than lead immediately. But
you then highlight the major properties and that gives you an
opportunity to go out and pursue them. Unlike a murder or a
robbery, you do not always have a victim complaining of the
offense. You have to be able to go out and find the situations.
Most attorney generals' offices are not set up with a lead
investigative capability. And so, to some extent, we are
required either to develop that as we have done and to work
with other agencies in order to get that in.
The 20 cases are cases that have actually gone to trial. We
have a process, once we are notified by the Department of
Health, or once we identify a nuisance property, of bringing in
the landlord for a little frank discussion. And very often, we
find that the frank discussion solves the problem right away
and we then enter into a consent agreement that will solve it,
or send them back to the Department of Health for compliance
with the existing Department of Health abatement program.
So, to a degree, that 20 represents not all that we have
done, but, rather, the top of the pyramid, and below that are
the collateral effects of people who did not get that far with
us, or indeed, who never need to come to us because the word
was out that we were taking this seriously and that landlords
would be pursued until the problem was solved.
Senator Reed. Now, you also indicated in your testimony,
Mr. Whitehouse, that you have made referrals to Federal
authorities--EPA, HUD, and to the Federal Attorney's Office.
Can you comment upon their capacity, not just Rhode Island,
but, again, from your perspective across the country, to follow
up on some of these suits?
Mr. Whitehouse. The capacity is obviously not great. They
have done at least one lawsuit at the U.S. Attorney's Office
that I am aware of. It is a very busy office with a lot of
major matters. And in the wake of the events of September 11,
and Attorney General Ashcroft's desire to focus the Department
of Justice more aggressively on antiterrorism activities, that
leave less rather than more for lead paint enforcement.
I think that the primary enforcement will remain at the
State level and at the municipal level.
Senator Reed. To what extent, could Federal resources and
programmatic support help this issue, from your perspective?
Mr. Whitehouse. I think programmatic support would be very
valuable. The Federal statutes primarily address the question
of notice provided at the time of transfer of a property and
whether or not adequate notice under the Federal law was
provided.
It has penalties for failure to provide notice, but it is
not--unlike nuisance law, which was an ancient common-law
doctrine that allows you to get right into that house and to
order it cleaned up, the Federal statute more polices the
notification rather than the actual public harm that is taking
place from lead paint poisoning.
I think the primary focus will remain at the State level,
and to the extent that resources could come to departments like
mine that are active in this, or would become active if they
had resources, I think that would be a wise investment.
Senator Reed. Thank you very much.
We have been joined by Senator Carper. Senator, if you
would like to make a statement and ask questions, please go
ahead.
STATEMENT OF SENATOR THOMAS R. CARPER
Senator Carper. Mr. Chairman, thank you very much, and to
our witnesses, welcome. It is nice to have somebody here from a
smaller State than Delaware.
[Laughter.]
There is only one State smaller than ours, but you have
more people.
[Laughter.]
We are delighted you all are here and we thank you very
much for your testimony.
Senator Reed. The question is, do we have more lead? That
is the question.
[Laughter.]
Senator Carper. In Delaware we have tried--and if you will
excuse this--we have tried to get the lead out. Senator, when
you and I served together in the House of Representatives, Joe
Biden and I worked, along with the people who ran public
housing in the State of Delaware, an effort to try to eradicate
lead paint from our public housing. We did not get it all, but
I think we have a whole lot of it eliminated.
At the time, the Administration here in Washington was
saying that we should become proactive with respect to lead
paint in public housing, especially when kids got sick. And we
said, no, that is too late, and what we ought to do is
proactive and try to get started on the job before kids became
sick and had elevated levels of lead in their blood.
I have a couple of questions, if I could, and maybe I could
start with you, Ms. Heller.
I am sorry I missed your testimony. I was called out of the
room. Could you just take maybe 60 seconds and share with me a
point or two that you would want me to take away from your
comments?
Ms. Heller. We need more money for prevention, as you
yourself said, and to demonstrate preventive activities, things
like lower cost lead abatement, projects that focus on
Medicaid, children who are at risk, and projects that help
families to prepare nurseries or help them to do work on their
houses, lead-safely.
Senator Carper. Fine. Do you lead the Connecticut Lead
Abatement Project? Is that correct?
Ms. Heller. Excuse me?
Senator Carper. The Connecticut Lead Abatement Project.
Ms. Heller. Manchester Connecticut Lead Abatement Project.
Senator Carper. All right. Fair enough. I understand that
you may have some involvement in the private sector in that
initiative. And I would just ask, how has the involvement, if
there is some of the private sector, in your group's endeavors,
how has it impacted the ability of the project to fight lead
enforcement?
Ms. Heller. That is a really good question because I think
involving the private sector is one of the keys. Most
particularly, to gaining the hearts and minds of people and
developing a constituency to actually think of lead as a very
important issue.
We do work on customizing training for very many population
groups in order to capture their hearts and minds. And I think,
as in most of these things, if you first listen and hear the
real concerns of the constituencies, you can customize training
and programs to meet their needs. So, I would have to say that
is it.
Senator Carper. Fine. Thank you.
Is it Mr. Fatur?
Mr. Fatur. Fatur.
Senator Carper. Do people ever mispronounce your name?
Senator Reed. Constantly.
[Laughter.]
Senator Carper. I will try not to butcher it too badly. I
get called all kinds of things as well.
Mr. Fatur. All right. Well, it is unusual if someone gets
it right the first time.
Senator Carper. I was trying to when you pronounced it.
If I could walk out of here with only one or two points
that you have made in your testimony, what would those be?
Mr. Fatur. Well, to kind of summarize, the program in
Colorado is working really well. We have developed a lead
coalition that I talked about where all the different agencies
get together, housing and Federal agencies and health
departments and that, to try to get on the same page for
solving this problem.
We do have some problems that we have encountered in the
State and those I will just run through briefly again.
One is that most of the projects are being done for the
purpose of renovation and remodeling and not abatement.
Abatement requires that control methods are being used.
Renovation and remodeling in HUD's projects requires control
methods. But if it is not a HUD project and it is not
abatement, 99 percent of the projects are being done without
any type of controls. We would like to see that cleared up. The
EPA could come out with regulations quicker for the renovation
and remodeling sector, would be one solution.
The other solution is we could introduce triggers into our
abatement regulation that would require some of these
activities before renovation and remodeling, such as
inspections, risk assessments, some control type of abatement
measures.
And the third is, we have had a real problem in Colorado as
far as getting funding for actual abatement work. The HUD lead
control hazard grants are really good and really great, but we
have only been able to get one in Colorado. And if you are
outside the Denver area, there is virtually no help for these
people.
Senator Carper. Good. Thank you very much.
General Whitehouse? How do you like being a General?
[Laughter.]
Mr. Whitehouse. As I tell General Sentrotio, who is head of
the Rhode Island National Guard, when he calls me General, the
General in attorney general is the general in general store,
not the General in General Patton.
[Laughter.]
But attorneys general love to be called General, and so
there
we are.
Senator Carper. Lieutenant Governors also like to be called
Governor, too.
[Laughter.]
Mr. Whitehouse. Not lieutenant, I know.
[Laughter.]
If I had two points to make, the first would be that lead
is a particularly insidious and misunderstood poison, in that
it does not show any immediate effect to children, and in that
the popular wisdom that you have to be poor and allowing your
children to eat lead paint chips the size of potato chips in
order for them to suffer, are wrong. In fact, it is dangerous
in microscopic levels.
Second, in order to resolve it, I think a lot of different
groups and agencies need to be working together. In Rhode
Island, many are working together. The one that is absent from
the table is the lead pigment companies. And in the absence of
their having proposed a meaningful role for themselves in this
debate, I think it is en-
cumbent upon us to find judges who will do that for them.
Senator Carper. Okay. I presume that the industry that you
refer to is not going to be testifying today?
Senator Reed. We are having a series of hearings, Senator.
This is the first about local and State responses. I am sure
they will have an opportunity to testify.
Senator Carper. Good. Refresh my memory. I do not recall.
How long has it been since lead paint was outlawed?
Senator Reed. In 1978.
Senator Carper. It has been a while. All right. I think you
noted in your testimony that Rhode Island has pursued Federal
grants through HUD and maybe other agencies as well. I was just
wondering, how has your State used those grants? You may have
touched on this and I just missed it. Which programs, in your
view, if any of those programs, have proven effective?
Mr. Whitehouse. The Federal grants have primarily gone into
the city of Providence, which runs a variety of abatement and
education programs. I do not work for the city of Providence
and I could not tell you the details about how those are
working.
I do know that the support that the HUD grants help to give
to the community organizations that are so active on this
question is very valuable. But I would consider it a piece of a
larger partnership. The community, through community
organizations, is really pulling an awful lot of its own
weight.
Senator Carper. Thanks again.
Mr. Chairman, thanks for letting me jump in here with some
comments and some questions.
And to our witnesses, thanks for joining us today.
Senator Reed. Thank you, Senator Carper.
Thank you, ladies and gentlemen, for your excellent
testimony. And as I indicated, this is the first in what I
assume will be several hearings. This is a critical issue. It
is the number one pediatric health issue in the country and it
is something that we can do that is absolutely preventable. And
shame on us if we do not.
Thank you very much.
The hearing is adjourned.
[Whereupon, at 4:15 p.m., the hearing was adjourned.]
[Prepared statements supplied for the record follow:]
PREPARED STATEMENT OF SENATOR THOMAS R. CARPER
Mr. Chairman, thank you for holding this hearing on such an
important issue. I would like to commend you for your leadership in
seeking to eradicate childhood lead poisoning in the United States. I
was pleased to cosponsor your resolution,
S. Res. 166, designating October 21-27 as ``National Childhood Lead
Poisoning Prevention Week.''
My interest in this issue dates back to my days serving in the
House of Representatives. When children living in public housing began
to get sick in the 1980's, tests revealed high lead blood levels,
indicating lead-based paint as the cause. I worked with Senator Joe
Biden to ensure that the Department of Housing and Urban Development
pursue preventative, rather than remedial, actions concerning lead-
based paint in public housing. HUD preferred a ``health'' approach,
requiring lead removal only after illness or high lead blood levels had
already occurred, while Senator Biden and I advocated a ``housing''
approach, which called for preventative action in all public housing
regardless of age of inhabitants or signs of illness.
With nearly one million children affected, childhood lead poisoning
continues
to pose a very serious environmental hazard to America's children.
Childhood lead
poisoning is a national health, education, and environmental problem,
that dis-
proportionately affects low-income and minority families and the cities
with older
housing stock.
The good news is that childhood lead poisoning is preventable. As
the Department of Housing and Urban Development and the Environmental
Protection Agency have recognized, the presence of lead-based paint
does not present a risk to children. Hazards result when lead-based
paint has been allowed to deteriorate, typically by landlords who do
not maintain their properties. Childhood lead poisoning can be
prevented if housing, especially houses built before 1950, undergoes
maintenance and repairs to make them ``lead-safe,'' at-risk children
are tested, and families and others are educated about preventing
childhood lead poisoning.
With high-level leadership, adequate Federal funding for HUD, and
other lead hazard remediation programs, and attention at the State and
local level, this problem can be solved. In Delaware we applied for and
received a $2.7 million grant to increase blood screenings and
aggressively target problem housing stock. Starting in New Castle
county and moving south, we hope to eradicate lead hazards in Delaware
homes within 5 years. Mr. Chairman, I support your efforts to increase
funding for the lead abatement.
The solution to lead-based paint hazards is practical, primary
action now. The way to reduce the hazards is to educate families with
young children about the risks, to identify and treat children who have
already been exposed to unhealthful levels of lead, and to require
property owners to make their properties lead-safe. We need to support
State and local government efforts by increasing the profile of the
issue and increasing Federal funding of the HUD Lead Hazard Control
Programs. And finally, we need Presidential leadership to prioritize
and publicize this clearly preventable disease.
I am less certain that litigation is a solution. Former
manufactures sold lead paint decades ago when it was lawful. The
Federal Government required that lead-based paint be used in Federal
buildings, including Federally-funded housing. States and cities
followed the Federal Government lead and also required the use of lead
paint in their housing codes.
Lead-based residential paint has not been sold for decades, and was
banned for residential use by the Federal Government in 1978. Lawsuits
or the threat of suits cannot be used to change marketing practices or
force stronger warning labels to prevent future exposure to a harmful
product, as was the situation with tobacco,
because this product is no longer being manufactured. Our primary goal
now is to
fix the existing problem, and I am not sure litigation is the most
effective way
to do that.
Mr. Chairman, to solve this problem we need White House leadership
and co-
operative partnerships with industry, cities, and community-based
organizations.
Thank you again for holding this hearing. I look forward to the
witnesses' testimony today. Their testimony describing State and local
solutions to the problem of lead-based paint poisoning, as well as the
views of Duke University Professor of Law Walter Dellinger, will be
useful as this Subcommittee considers how the Federal Government should
respond to this problem. Mr. Chairman, thank you again for holding this
hearing; I look forward to working with you to eliminate childhood lead
poisoning.
PREPARED STATEMENT OF SUSAN THORNFELDT
Director, Maine Lead Action Project
November 13, 2001
Good morning. Thank you for your efforts to highlight lead
poisoning and for
giving me the opportunity to share our family's story. I am the mother
of a little
boy named Sam, who was poisoned by lead. I am the Director of the Maine
Lead
Action Project and I also serve on the Board of the Alliance To End
Childhood Lead Poisoning.
Lead poisoning entered our lives soon after we purchased our 170-
year-old home. It is a late 19th Century colonial, nestled in a nice
residential, coastal neighborhood in Portland, Maine. My husband and I
chose an older home, like many of us do, for its charm, beautifully
detailed woodwork, and its stately graciousness. As eager, first-time
homeowners, we soon began our much-needed renovations.
What we did not know, until our child became inexplicably ill, was
that our home contained lead. We were unaware of the dangers, and the
serious, permanent health effects lead could have on our children.
I first became acquainted with the topic of lead poisoning in an
article from a very popular parenting book; as a first time mother and
voracious reader, I absorbed every bit of information about child
development. I came across a half page devoted to childhood lead
poisoning, which in a nutshell, explained the rapid rate a child's
brain grows from birth to age 6 and the irreparable, cognitive damage
lead could do to children. I did not have to read another word, at my
urging my son's pediatrician did a lead screen on Sammy and delivered
the news that, he indeed had elevated blood lead levels. He was
screened much more frequently from 6 months to 2 years old; his levels
climbing higher with each visit. This came as a total surprise to my
husband and me, because we were now religiously cleaning AND washing
Sam's hands and toys much more often. This was quite honestly, the only
preventative advice we had received.
I am sure many other parents of lead-poisoned children have heard
their own public health department imply, ``Go home, feed your child
better, watch him more carefully, clean your house, and by the way . .
. good luck!'' Though it may not be said outright, this is the message
that is clearly being delivered. Why are we,
as parents, made to feel that we are somehow responsible for the
poisoning of our
children? Does childhood lead poisoning end with the distribution of
brightly
colored brochures, frequent hand washings, and ABC's of good nutrition?
These are the Band-Aids covering up a much bigger problem--toxic paint
lurking in our country's housing.
Sadly, Sam was diagnosed with lead poisoning soon after his second
birthday. As a parent, it is heartbreaking knowing that the home you
provided for your child was slowly poisoning him everyday. There is no
deeper feeling of sadness, frustration and helplessness.
In order to avoid poisoning Sam once again, and endangering our
daughter, Alexandra, who had just started crawling, we chose to move
out while lead abatement was performed on our home. I cannot emphasize
enough the challenge of coping with the stress of caring for a sick
child, relocating, and dealing with the financial burden--at times it
was unbearable. Looking back, I am not quite sure how we pulled it off.
I now have to believe the worst is behind us, and Sammy will have a
happy childhood, and normal, productive school years. But for many
children, lead poisoning prevents them from succeeding in school or in
life.
Though many other stories may begin much differently than mine--
maybe in
an apartment in Chicago, on a farm in rural Louisiana or in a home on
the
West Coast--many of them share a common theme: Our children served as
the lead
detectors alerting us to the hazards of living in a home contaminated
with lead-
based paint.
If there is one thing that I have learned from my experiences is
that the system set up to protect our children from lead poisoning . .
. is, sadly, reactionary.
Screening children for lead in their blood is important to finding
and treating sick children. But allowing children to serve as lead-
detectors is no solution to the environmental disease of lead
poisoning--it is an immoral approach. In fact, health departments'
preoccupation with screening children often obscures the need for and
deflects resources from finding and fixing hazardous houses.
We can make sure that what happened to my children does not happen
to other children. But, to do so, we have to confront the reality of
lead poisoning--this is a disease that a child catches from a house.
There is only one real way to protect children from lead
poisoning--and that is to prevent and control hazards in children's
homes. We need to find the homes with lead-based paint hazards and
control those hazards before a child is exposed.
And, as our family's experience proves, educating parents about
hand washing, and nutrition and hygiene will not solve this problem.
Children do not need to be told to eat their vegetables and wash their
hands--they need homes that are safe from lead hazards. What is
politely called ``parent education'' really amounts to passing the
buck. Of course, nutrition, hygiene, and housekeeping are beneficial
but the fact is that my home was dangerous--and millions of homes
across the country are still today dangerous to children, not because
of any lapse in parenting, but because the lead industry cared more
about making money than safety. Despite the overwhelming evidence of
the danger of its product and the availability of safer alternatives,
the lead paint manufacturers knowingly marketed a poisonous product for
decades.
To add insult to the injury they caused, the paint industry is a
big proponent of ``parent education.'' Benjamin Moore congratulates
itself on helping communities hold ``fun and educational'' events about
lead poisoning for families. Well, I want Benjamin Moore to know that
lead poisoning is no fun.
Children and families have paid the price for the industry's
misconduct. Taxpayers have paid the price for the industry's
misconduct--hundreds of millions of local, State, and Federal dollars.
As a parent and a taxpayer, I am tired of paying. I want to know when
the companies that caused this problem are going to help pay for
solving this problem.
We as a country can protect children from lead poisoning. We know
what to do, what solutions work. We have set the national goal of
ending this disease by 2010. But solutions cost money. It is time for
the lead industry to pay its fair share. And it is time that everyone--
communities, Government, and industry--do the job right to eliminate
lead poisoning once and for all.
PREPARED STATEMENT OF BRUCE P. LANPHEAR, MD, MPH
Associate Professor of Pediatrics, Children's Hospital Medical Center
Cincinnati, Ohio
November 13, 2001
I am an employee of Children's Hospital Medical Center of
Cincinnati, Ohio. I am acting on behalf of the children of the United
States.
A Rationale and Strategy for the Primary Prevention of
Subclinical Lead Toxicity
Subclinical lead toxicity, defined as a blood lead level of 10 g/
dL or higher, was estimated to affect 1 in every 20 children in the
United States. [1] The prepon-
derance of experimental and human studies demonstrate serious
deleterious and
irreversible effects of low-level lead exposure on brain function, such
as lowered
intelligence and diminished school performance, especially from
exposures that occur in early life. [2] Collectively, the results of
these studies argue that efforts to prevent neurocognitive impairment
associated with lead exposure should emphasize primary prevention--the
elimination of residential lead hazards before a child is
unduly exposed. This contrasts, paradoxically, with current practices
and policies
that rely almost exclusively on secondary prevention efforts--attempts
to reduce a
child's exposure to residential lead hazards only after a child has
been unduly exposed. Despite an abundance of recommendations about how
to prevent children's exposure to residential lead hazards, there is a
paucity of data demonstrating the safety or benefits of these
recommended controls for children with blood lead levels below 25 g/
dL. [3]
Although the mechanisms by which lead causes its toxic effects
remain unknown, substantial progress has been made in reducing
widespread lead exposure. During the past two decades, average blood
lead levels in U.S. children have fallen by over 90 percent, due
largely to the elimination of lead from gasoline, dietary sources (for
example, lead-soldered canned foods and beverages), and residential
lead-based paint. [3, 5] It is estimated that 890,000 (4.4 percent)
preschool children in the United States have a blood lead of 10 g/dL
or higher. [1]. But in some cities, especially in the northeastern and
midwestern United States, over 35 percent of preschool children have
blood lead levels exceeding 10 g/dL from exposure to residential lead
hazards. [6]
Prior to 1970, lead poisoning was defined by blood lead greater
than 60 g/dL, a level often associated with acute symptomatic
disease--including abdominal colic, frank anemia, encephalopathy or
death. Since then, the threshold for defining elevated blood lead
levels has gradually been reduced. In 1991, CDC reduced the threshold
even further, to 10 g/dL. [4] These ongoing reductions in the
acceptable levels of children's blood lead were the result of evidence
indicating that blood lead levels as low as 10 g/dL were associated
with adverse effects in children, such as lowered intelligence, hearing
deficits and growth retardation. [2]
Although blood lead concentrations below 10 g/dL are often
considered typical or ``normal'' for children, contemporary levels of
childhood lead exposure remain exceedingly high compared with that of
pre-industrial humans. [7] Indeed, there is increasing evidence that
lead-associated cognitive deficits occur at blood lead lower than 5 g/
dL. [8] Collectively, the results of existing research argue for a
reduction in blood lead levels that are considered ``acceptable''--from
10 g/dL to 5 g/dL or lower. They also argue for a shift toward the
primary prevention of childhood lead exposure, which contrasts sharply
with current efforts that rely almost exclusively on case management of
children with elevated blood lead levels. [3]
From Screening Children to Housing
Universal screening of children for elevated blood lead levels in
the United States is controversial. Elevations in children's blood lead
level are unevenly distributed in the U.S. population--varying by
child's age, poverty level, race, and condition and age of housing. [1,
6] Due to the focal distribution of lead exposure, few children are
identified as having an elevated blood lead level in some communities.
Thus, some pediatricians and public health officials are hesitant or
vigorously oppose universal screening. There is no question, however,
that because lead exposure is
cumulative and its detrimental effects irreversible, [9] any strategy
that is limited
to screening children after an exposure has occurred is flawed. [3]
Thus, there continues to be a need to refine screening strategies
to target and identify children with undue lead exposure. [10] But it
is more critical to develop a strategy and expand our efforts to
identify and eliminate residential lead hazards before children are
unduly exposed.
Residential Sources of Lead Exposure
Paint is the major source of childhood lead poisoning in the United
States. Children with blood lead above 55 g/dL are more likely to have
paint chips observable on abdominal radiographs and the majority of
preschool children with blood lead over 25 g/dL are reported to put
paint chips in their mouths. [11] In contrast, house dust contaminated
with lead from deteriorated paint and soil is the prim-
ary source of lead ingestion for children with blood lead between 10
g/dL and 25
g/dL. [12] Over 95 percent of U.S. children who have elevations in
blood lead fall
within this range. [1]
Residential Standards: Key to Prevention
Under Section 403 of Title X, the U.S. Congress mandated the
Environmental Protection Agency (EPA) to promulgate health-based lead
standards and post-abatement clearance testing for house dust and
residential soil. Standards are necessary for screening high-risk
housing to identify lead hazards prior to occupancy and before a child
is unduly exposed. Residential standards are also critical to identify
and eliminate lead hazards for children who already have elevated blood
lead levels; major sources of lead will be neglected if dust and soil
testing are not routinely done. Finally, standards serve as a benchmark
to compare the effectiveness and
duration of various lead hazard controls. But if standards remain
voluntary, they
will not be used nor will they protect children from undue lead
exposure.
EPA defines their level of statutory concern as between 1 percent
to 5 percent probability of a child having a blood lead level in excess
of 10 g/dL. Scientists have estimated, from epidemiologic data, that 5
percent of children will have a blood lead level *10 g/dL at a floor
lead level of 5 g/ft\2\--a value almost 10 times lower than the
proposed EPA floor standard. [13] At a floor standard of 50 g/ft\2\,
20 percent of children are estimated to have a blood lead level *10 g/
dL. [13] Children who are exposed to floor dust lead levels *25 g/
ft\2\ are at 8 times higher risk of hav-
ing blood lead levels *10 g/dL compared with those exposed to levels
below 2.5
g/ft\2\. [13] Thus, the floor standard promulgated by EPA is
inconsistent with their
definition of blood lead levels that ``pose a threat'' and does not
adequately protect children.
Hazards of Lead Hazard Controls
Lead poisoning is often regarded as a preventable disease. In
practice, however, the safety and benefits of measures intended to
control or reduce residential lead hazards are uncertain. Interventions
to prevent or control childhood lead exposure (called lead hazard
controls) have far too often been shown to result in an increase in
children's blood lead levels. [14] There is some evidence that lead
hazard controls, including paint deleading or abatement and
stabilization of painted surfaces, can reduce lead exposure for
children who have blood lead levels *30 g/dL. [15] In contrast, it is
uncertain if lead hazard controls are safe or beneficial for children
who have lower blood lead levels. Indeed, paint abatement has been
shown to cause a rise in children's blood lead levels. [16] Presumably,
this rise in blood lead levels is due to lead contamination from
removal or scraping of leaded paint. [17] It is
likely that lead hazards caused by lead hazard controls or renovation
can be elimi-
nated by promulgating effective health-based dust standards and
requiring that clearance tests are conducted after any renovation or
abatement is complete. But clearance tests or residential lead
standards must be empirically derived and protect children from undue
lead exposure, as measured by blood lead levels.
The costs to prevent childhood lead poisoning from residential
hazards are very substantial. It has been estimated, for example, that
the first year cost to reduce residential lead hazards in Federally-
owned or Federally-assisted housing is $458 million. HUD has estimated
the overall benefit, defined as increase in lifetime earnings of
children who are protected from the detrimental effects of lead
exposure, was $1.538 billion--a net benefit of $1.08 billion. [18] This
estimate does not, however, include recent findings indicating that the
drop in IQ is greater for each 1 g/dL increase in blood lead at levels
below 10 g/dL. [19] Nor does it include other anticipated benefits,
such as reductions in cardiovascular disease, tooth decay and
delinquent behaviors. [20]
Other Residential Hazards
Lead poisoning in childhood is only one of several indicators of
our failure to protect children from residential hazards. Children's
health is a function of their home environment. If residential hazards
were eliminated, morbidity and mortality among children in the United
States would decline dramatically. Moreover, many of the
racial and socioeconomic disparities in children's health would be
reduced.
Injuries, including falls, ingestion, and burn injuries, are the
major causes of morbidity and mortality in children. Over 50 percent of
fatal and nonfatal injuries in childhood occur in children's homes.
[21] Environmental tobacco smoke competes with injuries as the leading
cause of disease in U.S. children. [22] Over 43 percent of U.S.
children are exposed to environmental tobacco smoke in their homes,
leading to a dramatic excess of asthma and respiratory illness. [23]
Asthma, the most common chronic disease of childhood, is intimately
linked to residential exposures of indoor allergens and pollutants.
[23-24] Indeed, it has been estimated that over 40 percent of doctor-
diagnosed asthma in children under 16 years is attributable to
residential exposures. [23-24] In the past 2 decades, asthma rates
doubled in U.S. children. [25] Finally, a number of agents encountered
in housing, including pesticides, have been linked to detrimental
effects in children. [26] Thus, it is clear that residential hazards
are critical determinants of children's health.
Childhood exposures to residential hazards are antecedents for
diseases in adulthood. The detrimental effects of low-level lead
exposure on intelligence are irreversible and dramatically reduce
opportunities and increase racial inequality. [2, 20] Lead poisoning is
also associated with cardiovascular disease, premature live births,
delinquent behaviors, and an increased mortality from all causes. [27]
Similarly, exposures to indoor allergens during early childhood are
critical for the development of asthma and the consequences of
childhood asthma persist throughout life. [28] Racial and socioeconomic
disparities in environmentally induced diseases, already apparent in
childhood, are pronounced. [1, 6, 13, 29] Collectively, these data
indicate that to protect children from the major causes of morbidity
and mortality, it is critical to develop health policy focusing on the
control of residential hazards. Many of the strategies and tools that
are necessary to protect children from undue lead exposure are relevant
to other residential hazards.
A Strategy for the Primary Prevention of Lead Poisoning
A comprehensive strategy for the primary prevention of childhood
lead poisoning should include several components.
Empirically-Based Residential Lead Standards
Promulgation of empirically-derived, health-based residential lead
standards are essential. The lead dust standards would be used to
screen housing before a child is unduly exposed, and after lead hazard
controls or renovation. [8] These standards must be empirically-derived
and they must be enforced. Voluntary ``standards'' are unlikely to
protect the majority of children from undue lead exposure.
Screening housing units by using dust samples should be
incorporated into housing codes. Dust sampling should be required prior
to approval of Federal subsidizes for housing. Exceptions could be made
for housing units that have been shown to be free of lead-based paint.
Screening could be targeted to rental housing because the majority of
children who have blood lead levels of 10 g/dL or higher reside in
rental housing.
Studies to assess the ability of individuals who have taken 1 day
training programs to accurately measure lead-contaminated house dust
are needed. Ongoing
research is testing the ability of families to conduct dust sampling
for lead. These
research projects are essential to make what is generally regarded as
the single most important tool to identify housing units that contain
lead hazards (for example, dust wipe samples) more widely available.
Strategy to Identify and Target Residential Lead Hazards
National, State, and community surveys of housing need to be
conducted to identify and prioritize the elimination of residential
lead hazards. There should be plans for the identification and
remediation of lead-contaminated housing. There should also be plans
for the gradual elimination of lead hazards during renovation or
demolition of older housing.
Studies to Prove Lead Hazard Controls Protect Children
Once residential hazards are identified, it is essential to have
safe and effective methods to eliminate them. Although there is good
evidence that lead abatement or lead hazard controls are effective in
reducing exposure for children who have blood lead levels over 25 g/
dL, there is limited evidence that existing lead hazard controls are
safe or efficacious for children with blood lead levels below 25 g/dL.
Evidence of their safety and efficacy must initially rely on children's
blood lead
levels. Thereafter, dust lead levels and other environmental measures
could be used to evaluate various lead hazard controls. Lead hazard
controls need to be assessed in trials that are experimental in design
or, at a minimum, include a control group to account for potential
confounding variables, such as seasonal variation and the typical
decline in children's blood lead levels as they mature.
An expert committee convened by the National Academy of Sciences
should be asked to critically examine what is known about the safety
and efficacy of existing lead hazard controls. Specific components of
lead hazard controls, such as wet versus dry scraping to remove leaded
paint, should be tested. Too often, we have relied on expert opinion
about what is safe or effective. These methods can and should be tested
in randomized trials. Lower cost interventions should be compared with
full abatement in controlled trials.
Various strategies that are ultimately shown to be safe and
effective in preventing lead exposure should be allowed. Owners or
landlords can then make larger investments for longer term benefits
(full abatement) and smaller investments that require ongoing
maintenance (lower cost lead hazard controls). This will provide
flexibility for housing units with lower and higher value.
Scientific Advisory Committee to HUD
A Scientific Advisory Committee should be established to advise the
Director of the Office of Lead Hazard Control and Healthy Home
Initiative in the U.S. Department of Housing and Urban Development.
This Committee would advise the Director about research that is
necessary to protect children from residential lead hazards, including
lead poisoning, asthma, and residential injuries.
Funds to conduct research to improve our understanding of and
control efforts for residential hazards (asthma, injuries and lead
exposure) should be expanded. These funds should specifically target
housing factors related to residentially-induced diseases and be
designated to the Centers for Disease Control and U.S. Department of
Housing and Urban Development. These funds should be no less than $100
million annually.
Establish National Institute for Safe Housing
A national institute for the study and control of housing-related
morbidity and mortality in children is needed. This institute should
conduct research to understand and control residentially-induced
diseases in children. It should maintain surveillance for
residentially-induced diseases. It should assess the science underlying
standards or recommendations for residential hazards from the CDC, EPA
or HUD. It should coordinate efforts of these and other agencies to
ensure that vital public health research is conducted.
The research conducted by this institute should adhere to the
principle that passive controls (for example, efforts that do not
require modifying individuals' behaviors) are the most effective ways
to eliminate residentially-induced diseases. For too long, we have
simply passed out brochures or told mothers to ``clean their houses
better'' to reduce their child's risk of lead poisoning. Educational
efforts or dust control are inadequate unless lead-based paint is made
inaccessible.
This institute should have funds to conduct research and to make
awards to universities, public health and housing agencies, and other
entities for the purpose of understanding and controlling
residentially-induced diseases in children.
Summary
The current lead poisoning prevention strategy largely ignores
existing scientific evidence indicating that our efforts should
emphasize primary prevention. Most
Federal agencies involved in lead poisoning prevention acknowledge that
primary
prevention is preferable, yet our efforts continue to focus on
screening children for
elevated blood lead levels and controlling lead hazards only after a
child has
been unduly exposed. It is time to establish a scientifically-based
strategy to elimi-
nate subclinical lead toxicity by controlling residential lead hazards;
it is within
our grasp.
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23. Pirkle JL, et al. JAMA 1996 Apr 24; 275(16):1233-1240. Gergen
PJ, et al. Pediatrics 1998 Feb 1; 101(2):E8. Chilmonczyk BA, et al. New
Engl J Med 1993; 328:1665-1669. Lanphear BP, et al. Pediatrics 2001;
017:505-511.
24. Platt-Mills TAE, et al. J Allergy Clin Immunol 1995; 96:435-
440. Pope AMR, et al. Indoor Allergens--Assessing and controlling
adverse health effects. 1993,
National Academy Press, Washington, D.C. Taylor W, et al. Pediatrics
1992;
90:657-662.
25. Gergen PJ, et al. JAMA 1990; 264:1688-1692. Weiss KB, et al.
Ann Rev Publ Health 1993; 14:491-513.
26. Daniels JL, et al. Environ Health Perspect 1997; 105:1068-1077.
Montana E, et al. Pediatrics 1997 Jan 1; 99(1):E5.
27. McDonald JA et al. Arch Environ Health 1996; 51:116-121.
Schwartz J. Environ Res 1994; 66:105-124. Needleman HL, et al. JAMA
1996; 275:363-369 National Research Council. Measuring lead exposure in
infants, children, and other sensitive populations. National Academy
Press, 1993.
28. Strachan DP, et al. BMJ 1996; 312:1195-1199.
29. Gold DR, et al. Am Rev Respir Dis 1993; 148:10-18.
PREPARED STATEMENT OF NICK FARR
Executive Director
National Center For Lead-Safe Housing
November 13, 2001
Nick Farr is the Executive Director of the National Center for
Lead-Safe Housing, a Maryland nonprofit corporation. The Center's
mission is to help sharply reduce childhood lead poisoning while
preserving the Nation's stock of affordable housing. It developed the
Department of Housing and Urban Development's Guidelines for the
Evaluation and Control of Lead-Based Paint Hazards in Housing and is
evaluating the cost and effectiveness of the lead hazard control
strategies of State and local recipients of HUD's lead hazard control
grants. The Center has carried out a number of research projects in
lead hazard control and provided training and technical assistance to
cities and nonprofit organizations in developing and carrying out lead
hazard control programs.
Childhood Lead Poisoning
Childhood lead poisoning is still the number one environmental
disease of children. According to estimates of the Centers for Disease
Control and Prevention
almost 900,000 children have lead in their blood at or above 10
micrograms per
deciliter, the official level of concern. These children are likely to
suffer from a lowering of their IQ's and their attention spans, leading
to poor school performance,
reduced job related capacity and increased adolescent delinquency.
Recent research suggests that blood lead levels well below 10
micrograms per deciliter are also asso-
ciated with these problems. So the number of children in harms way
could be in
the millions. Since African-American children are five times as likely
to be poisoned
than white children, childhood lead poisoning is also a major
environmental justice
problem.
The vast majority of children who have elevated blood lead levels
became ill by ingesting lead from deteriorated paint in household dust
or contaminated soil in normal play activities. Young children play on
floors, at windows or in their yards. Their hands and toys become
contaminated from lead in dust on the floor, windowsills and window
wells and in bare soil. They put their hands and toys in their mouths
and ingest tiny but dangerous amounts of lead. Some of that lead lodges
in their brains and central nervous system disrupting normal
neurological development and causing the IQ and attention span
decrements described above.
Once the lead has affected the brain and central nervous system,
the damage is permanent and irreversible. Medical treatment can reduce
the amount of lead in children's blood at high levels, but recent
research has confirmed that this medical treatment does not reverse
past brain damage. Therefore, the only moral and effective way to deal
with childhood lead poisoning is to prevent children from being
exposed to lead in the first place.
Lead Hazards in Housing
Most children with elevated blood lead levels are exposed to lead
because they live in older, poorly maintained housing containing lead-
based paint. Other children are exposed when their older homes are
renovated or remodeled and the contractors fail to follow lead safe
work practices to control, contain and clean up lead contaminated dust
generated whenever lead-based painted surfaces are disturbed.
According to the recently completed HUD National Survey of Lead and
Allergens in Housing, some 38 million homes in the United States have
lead-based paint somewhere in the building. Over 25 million homes have
significant lead-based paint hazards. Lead-based paint hazards include:
Flaking or peeling lead-based paint.
Lead-based paint on friction or impact surfaces, such as
windows and doors.
Lead-based paint on chewable surfaces, such as window sills.
Excessive levels of lead in dust on floors or window sills.
Lead contaminated soil.
Housing in which all paint is intact is not hazardous. As long as
the house is well maintained and as long as renovators and maintenance
workers follow lead lead-safe work practices whenever they disturb
lead-based paint, housing with intact paint will continue to be safe.
EPA and HUD have developed lead-safe work practices training and HUD is
subsidizing provision of that training. This approach of educating
property owners and contractors on how to avoid creating lead hazards
should be strongly supported to prevent the further increase in the
number of housing units with lead hazards.
The greatest risk of lead poisoning occurs in older housing units
that contain lead hazards and that either will be or are currently
occupied by low-income families with children under 6. Almost 14
million housing units are occupied by low-income families. While only
1.6 million homes with lead-based paint hazards are presently occupied
by low-income families with a child under 6, most low-income families
move frequently, particularly those living in rental housing units,
that are most likely to be in poor condition due to lack of
maintenance. So it is fair to estimate that the number of hazardous
housing units in which low-income families with young children now live
or are likely to live in the near future could well exceed 3 million.
Controlling Lead Hazards
In Title X of the Housing and Community Development Act of 1992,
the Congress established the framework for the Nation's effort to end
childhood lead poisoning. Title X recognized that lead-based paint
hazards could be safely controlled by treatment strategies short of
full removal, thereby reducing costs. Subsequent research shows that
this position was correct. The Center's evaluation of HUD's lead hazard
control grant program shows that children's blood lead levels decline
by 26 percent and dust lead levels decline by 66 percent in homes
treated with modern methods.
Title X also shifted the emphasis from waiting until a child was
found to have an elevated blood lead level before dealing with lead
hazards to controlling lead hazards up front and preventing children
from being lead poisoned in the first place. It directed HUD to require
cost-effective lead hazard control treatments in Federally-owned and
assisted housing. HUD's new lead regulation implements that statutory
requirement. Cities, counties, and States should carry out those
requirements without further delay; and HUD should enforce them
scrupulously. Title X also established the lead hazard control grant
program to fund lead work in privately-owned, low-income housing.
Since 1990, the number of housing units with lead-based paint
hazards has been reduced and these reductions can be expected to
continue. Some of this reduction results from market forces. Tens of
thousands of the most contaminated housing are demolished every year.
Some contaminated housing is remodeled in gentrifying neighborhoods. On
the other hand, the percentage of housing units with deteriorated lead-
based paint actually increased slightly, from 19 percent in 1990 to 22
percent in 1998, reflecting the continuing aging of housing and too
commonly inadequate maintenance of housing occupied by low-income
families.
As a direct result of Title X, as many as 1.4 million older,
Federally-assisted housing units may be made lead safe through HUD
funded rehabilitation over the next 10 years if contractors follow
lead-safe work practices. City and State recipients of HUD's lead
hazard control grants are controlling lead hazards in over 7,000 of the
most at-risk housing units lead-safe every year. Many of those units
were occupied by families with lead poisoned children. Many more units
may be made lead-safe as a result of public education efforts as
consumers come to demand lead-safety from painters and contractors.
Cost of Lead Hazard Control
The cost of lead hazard control treatments per housing unit treated
under the HUD Lead Hazard Control Grant Program varies depending on the
size and condition of the unit, the type of unit and the hazard control
strategy selected, ranging from $2,000 for housing units in sound
condition and with moderate lead hazards to $10,000 or more for
deteriorated housing with substantial hazards. In many cases, HUD's
grantees combine lead hazard control work with other rehabilitation
activities. It is difficult to separate lead hazard control costs from
rehabilitation costs, because the same activities, such as window
replacement, serve both purposes. HUD estimates that the incremental
costs for interim control lead hazard work average about $2,500 and
$9,000 for abatement of hazards. From the property owner's point of
view, however, the costs are frequently $5,000 to $10,000.
As a practical matter, neither market forces nor Federal programs
are dealing with the most badly contaminated housing where children are
most at risk of becoming poisoning. This housing is largely located in
deteriorating inner-city neighborhoods where little or no private funds
are being invested. Controlling the lead-based hazards in those units
is so expensive that recipients of HUD grants avoid them so that they
can treat more housing units with their limited grants. Housing in this
condition is being abandoned every year; and some properties are being
demolished with HUD block grant funds. But too many of these high-risk
housing
continue to be rented to low-income families who have little or no
choice. These
are the housing units in which two or three or more children become
lead poisoned
over the years as a succession of families with young children move in
and out.
Thus, while progress is being made, at the present rate it will
take at least several generations to make all housing safe for the
Nation's children. The Nation will miss the goal of a lead-safe America
in 2010 by a wide margin. There are a number of steps that can be taken
to accelerate meeting that national goal, including:
Full implementation of HUD's lead regulation.
Establishing lead-safe renovation and maintenance as the
national norm.
Making rehabilitation of older, inner-city housing a national
priority.
Expanding environmental testing of older properties in at-risk
neighborhoods.
Demolition of obsolete and uneconomic properties and providing
safe replacement housing.
Making certain that no housing unit poisons children twice.
But as a practical matter, HUD's Lead Hazard Control Grant Program
is the only realistic source of financing at this time for controlling
lead hazards in the older, low-rent, poorly-maintained housing where
children are most at risk. Private owners are unable or unwilling to
make those housing units lead safe, because the costs of lead hazard
control could never be recouped. In some cases it even exceeds the
market value of the housing. Cities have other needs and priorities for
HUD's Community Development Block Grant and HOME funds and may be
reluctant to condemn units in the already dwindling stock of affordable
housing for fear of increasing homelessness.
Conclusion
Childhood lead poisoning will end only when the Nation changes its
priorities and recognizes childhood lead poisoning as an epidemic that
must be broadly addressed. For starters, Congress should sharply
increase appropriations for lead hazard control now. At present, the
only effective program that can address the core of the problem is
HUD's Lead Hazard Control Grant Program. The Center estimates that the
annual appropriation for the program must be increased to $400 or $500
million if we are to prevent poisoning of generation after generation
of young children who are likely to fail in school and lead
unproductive lives.
----------
PREPARED STATEMENT OF SHELDON WHITEHOUSE
Attorney General for the State of Rhode Island
November 13, 2001
Mr. Chairman and Members of the Subcommittee on Housing and
Transportation.
Rhode Island has a serious lead paint problem. Lead poisoning is an
insidious condition, because it ordinarily shows no immediate symptoms.
The brain and nervous system damage lead causes is gradual, and has no
physical telltales that might warn a parent. The widely spread legend
that a child has to eat lead paint chips like potato chips to be lead
poisoned is false, but has misled many families to underestimate the
hazard for their children, particularly infants.
The Conservation Law Foundation of Massachusetts described us as
``The Lead Poison Capitol of the United States.'' \1\ Our Democratic
General Assembly and our Republican Governor's Administration have both
identified lead paint as the number one environmental health issue
facing Rhode Island children.\2\ The rate of lead poisoned children is
two and a half times higher in Rhode Island than in the rest of the
United States. In Providence, our capitol, the rate of lead poisoned
children is four times higher than the rest of the United States.\3\ We
test the blood of every child entering kindergarten for lead poisoning.
Every year, more than 2,000 kids
reporting to kindergarten have elevated lead in their blood.\4\
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\1\ Providence Journal-Bulletin, May 18, 1998, at B.4.
\2\ R.I. Gen. Laws Sec. 23-24.6-3; Governor's Advisory Council on
Health, First Annual Report 1999 at 18.
\3\ Providence Journal-Bulletin, May 13, 2001, at A.1.
\4\ 1998 through 2001 Rhode Island's KIDS COUNT Factbooks. In 1998,
3,010 kindergartners had elevated blood lead levels. In 1999, 2,327
kindergartners had elevated blood lead levels. In 2000, 1,873
kindergartners had elevated blood lead levels and in 2001, 1,713
kindergartners had elevated blood lead levels. These figures are based
on the Center for Disease Control's finding that any blood lead level
exceeding 10 mg/dL is elevated.
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Against this backdrop of a real public health calamity, Rhode
Island has been
active at the municipal, State, and Federal levels.
Municipal Response
The bulk of our lead poisoning occurs in older urban areas, and
most of our older houses are located in our capitol city, Providence.
Providence has been active in attacking lead paint.
The city's primary focus is on providing lead safe, healthy
housing, and public education to its residents. Through an experienced
lead abatement team, $5 million in HUD and National Safe Houses
Corporation grants, close enforcement coordination with my office and
the Department of Health, and aggressive public outreach to children,
parents, schools, and even realtors, elevated blood lead levels in
Providence's children have dropped from 38 percent of those entering
Providence's kindergartens in 1998 to 25 percent of kindergartners
today.\5\ The city has further allocated $800,000 to help eligible
owners make their properties safe.\6\ Only a few weeks ago, Providence
announced that another $4 million from the Neighborhood Improvement
Bond will be used to shore up city housing stock and that the city has
applied for another $3 million HUD grant.\7\
---------------------------------------------------------------------------
\5\ Id.
\6\ Providence Journal-Bulletin, October 24, 2001, at C.1.
\7\ Id.
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The Federal Effort
We have pursued Federal grants through HUD and other agencies and
worked with Federal officials, primarily at HUD, EPA, and the U.S.
Attorney's Office.
Federal political leaders such as Senator Reed have shown considerable
interest and vision.
The State of Rhode Island
The State of Rhode Island is addressing its lead paint public
health hazard through a variety of agencies and means. Our Department
of Health conducts the blood testing program I have described. In the
year 2000, 32,313 children under the age of 6 were tested in Rhode
Island; 2,804 (8.7 percent) of those children had elevated lead levels
in their blood.\8\ The Health Department follows up on each case where
the child's blood lead level is 20 mg/dL or higher, with home
inspections and case management.
---------------------------------------------------------------------------
\8\ Department of Health, Office of Occupational and Radiological
Health & Division of Family Health statistics.
---------------------------------------------------------------------------
Our Department of Human Services provides funding and care for low-
income residents who experience lead poisoning and require medical
treatment. Through referral to community-based service providers, Human
Services, with Medicaid funds, pays for the screening of low-income
children. In 1998, Rhode Island became the first and only State to
receive permission from the Healthcare Financing Administration to use
Medicaid funds for replacing or repairing windows in homes of lead-
poisoned children if landlords or tenants satisfy eligibility
requirements.\9\ Since window repair and replacement is not normally a
reimbursable item by Medicaid, this confirms the Federal Government's
view that the lead paint health problem in Rhode Island is particularly
acute.
---------------------------------------------------------------------------
\9\ Providence Journal-Bulletin, December 11, 1998 at B.1.
---------------------------------------------------------------------------
The Department of Attorney General is involved primarily on the
enforcement side. When we become aware that a residence contains
dangerous levels of lead, usually by referral from the Department of
Health, we take action to require owners and landlords to abate the
lead. Landlords are not always willing, so we have repeatedly taken
them to court and obtained orders, contempt judgments, and civil
penalties to enforce their obligation to abate.\10\ We have
successfully completed 20 lawsuits. We have approximately 200 cases in
the office in process right now, and roughly 100 homes and apartments
(including the exterior and the soil that surrounds them) have
successfully been abated or are in the process of abatement. We have
referred cases for prosecution to DOJ, HUD, and EPA to enforce the
Federal requirements \11\ that landlords and sellers disclose lead
hazards to buyers and tenants. We hope that the Federal Government will
take a more active role in prosecuting these cases in the future.
---------------------------------------------------------------------------
\10\ For example, in Whitehouse v. Piscopio, (KC 00-96), a Superior
Court judge found a landlord in contempt after judgment had been
entered against him and he was ordered to abate the lead hazards
immediately. The judge's contempt order required the landlord to pay
civil
penalties, find and fund alternate housing for the tenants, and to
immediately abate the lead
hazards or face stiffer fines.
\11\ 42 U.S.C. Sec. 4851 et seq.; 15 U.S.C. Sec. 2615 (a).
---------------------------------------------------------------------------
In addition to recognizing the efforts of municipal, Federal and
State government, I should take a moment to commend the community
organizations that are so active in Rhode Island in this area: Health &
Education Leadership for Providence, the Help Lead Safe Center, the
Childhood Lead Action Project, Greater Elmwood Neighborhood Services,
various neighborhood and church organizations, Head Start, the VNA, and
many nonprofit housing groups.
Blood, toil, tears, and sweat were Winston Churchill's exemplars of
effort. In Rhode Island, the blood is given by infants and small
children who must be regularly tested, and in some cases have their
blood chelated. The tears are shed by family members who discover,
often too late, and often despite very reasonable levels of maintenance
of their homes, that their child has become lead poisoned. The toil and
sweat come from the men and women of these community organizations who
every day administer to the many needs of families facing these
uncertainties.
Everyone in Rhode Island is working to clean up the lead paint
mess. Municipal government, and thus municipal taxpayers, are pitching
in. State government through many agencies, and thus State taxpayers,
are pitching in. Federal efforts have been made through HUD, the EPA,
and the Department of Justice. Volunteers and staff of community
organizations are pitching in. Families, of course, bear a terrible
share of the burden: the lead poisoning of their children, the worry
and woe of mothers and fathers, the displacement of families from their
homes, even the minor trauma of holding your child as painful and
frightening procedures are performed to test for lead poisoning or to
chelate lead out of the child's blood. Landlords and homeowners are
pitching in, cleaning up lead paint that may have been put on years
before they bought the home. There is only one group not pitching in:
the lead pigment companies who sold this toxic material for decades,
profited from it, lied about it, and are now trying to evade even the
most microscopic share of
responsibility for cleaning up the mess they created.
After determining that the pigment companies were prepared to do
essentially nothing about this problem,\12\ I filed a lawsuit, to
determine what the fair share of responsibility of these companies is--
I know it is more than zero--and to get the companies to contribute
that fair share to the remedy of this problem.
---------------------------------------------------------------------------
\12\ The effort most touted by the pigment companies is
ClearCorps--a program of ``lead abatement,'' which consists of deep
cleaning. Although the effort of deep cleaning by ClearCorps is a
positive development, the pigment manufacturers really only have
minimal involvement and investment in the project, as it is primarily
staffed by Americorps volunteers paid for by U.S. taxpayers. ClearCorps
has performed deep cleaning in 122 units in Rhode Island.
---------------------------------------------------------------------------
The lawsuit was filed on October 12, 1999. The defendants are The
Lead Industries Association, Inc., American Cyanamid Company, Atlantic
Richfield Company, E. I. DuPont de Nemours & Company, The O'Brien
Corporation, Conagra Grocery Products Company, The Glidden Company, NL
Industries, Inc., SCM Chemicals
and The Sherwin-Williams Company. The State of Rhode Island is
represented by
myself and my office, by a highly regarded Rhode Island law firm which
represented the State with great success in litigation arising out of
Rhode Island's 1991 bank failures, and by a national firm which has the
depth to withstand the inevitable blizzard of paper. As Attorney
General, I am directly involved in this case, guide its strategy, and
successfully argued the case for the State against the motions to
dismiss.
Our allegations fall into three groups. There are equitable counts;
there is a statutory count under a Rhode Island State consumer
protection statute; and there are a number of traditional tort counts
which bear on the properties owned or maintained by the State of Rhode
Island in its proprietary capacity.\13\ For example, the public
nuisance count would enable the Rhode Island Superior Court within its
equitable jurisdiction to impose a reasonable order allowing more rapid
and complete abatement of lead paint than the State presently has
resources to accomplish. As the Rhode Island General Assembly has
noted: ``Rhode Island presently does not have the public nor the
private resources to handle the total problem.'' \14\
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\13\ The equitable counts I am prosecuting in the State's sovereign
capacity to obtain injunctive, equitable and other relief necessary to
abate present harms and to protect the future health and well-being of
Rhode Island's children. Public nuisance is in this category of claims.
The statutory count alleges violation of the R.I. Deceptive Trade
Practices Act, R.I. Gen. Laws Sec. 6-13.1, and is brought pursuant to
the authority vested in my office by the General Assembly by that
statute and pursuant to my authority to prosecute offenses and other
legal or equitable processes. R.I. Gen. Laws Sec. Sec. 42-9-4-42-9-5.
The tort counts I am pursuing for the State in a proprietary
capacity include strict liability, negligence, negligent
misrepresentations and omissions, and fraudulent misrepresentations and
omissions.
I also seek damages from the defendants with counts of civil
conspiracy, unjust enrichment, and indemnity.
\14\ R.I. Gen. Laws Sec. 23-24-6-2.
---------------------------------------------------------------------------
I should point out that a public nuisance lawsuit, when brought by
a responsible public official to vindicate a public harm, is not an
ordinary piece of litigation. Its primary purpose is not to resolve a
dispute between contending private parties, but rather to protect the
public health, safety and welfare. A public nuisance lawsuit is, in
some measure, an exercise of the police power of the State.
Public nuisance law in Rhode Island and in most jurisdictions in
this country requires first, that there must be a public nuisance. That
means there must be a harm either to a public right or to a sufficient
number of members of the public as to implicate a public interest,\15\
and the harm must be serious and not merely trivial or annoying. This
has been defined as an unreasonable interference that arises when
``persons have suffered harm or are threatened with harm that they
ought not
have to bear.'' \16\ Second, it must be determined who is responsible
for the public
nuisance. The standard of responsibility is whether the defendant has
created or
maintained the public nuisance or contributed to or participated in the
creation or
maintenance of the public nuisance.\17\ Finally, if a public nuisance
is proven to be
a defendant's responsibility, the judge then has the authority to enter
a reason-
able order, consistent with the nature of the nuisance and with
considerations
of due process, as well as common sense and efficiency, for the
protection of the
public health.
---------------------------------------------------------------------------
\15\ Hydro-Manufacturing, Inc. v. Kayser-Roth Corp., 640 A.2d 950,
959 (R.I. 1994).
\16\ Wood v. Picillo, 443 A.2d 1244, 1247 (R.I. 1982).
\17\ U.S. v. Hooker Chemical and Plastics, 748 F.Supp 67 (W.D. N.Y.
1990).
---------------------------------------------------------------------------
What remedy do we seek that will relieve Rhode Island children of
the hazard of lead paint poisoning? Ideally, all lead paint needs to be
removed from residences where children may be exposed. With limited
resources, the first priorities are
(1) to remove lead from friction surfaces such as doors and windows,
(2) to assure that repairs and maintenance are done in a way that does
not expose residents to lead dust, and (3) to encapsulate lead
surfaces, since it is lead's nature to chalk and form poisonous dust.
I will conclude my remarks by observing that I am just a small
State Attorney General, and this lawsuit has provided me my first
experience of national level spin. I will not bore you here with a
description of the various characterizations of this lawsuit,
characterizations of my motivations or characterizations of the facts
of lead paint poisoning. It will suffice to say that we wish as quickly
as possible to bring this case forward, so that we can present the
State's case and the defendants can present theirs, and a decision can
be made not on rhetoric or spin but on evidence and facts. One way or
the other, our case will stand or fall on its factual and legal merit.
We look for the outcome of that process to be a fair and sensible order
requiring the defendants to contribute in a fair and sensible way to
the clean up of the mess they made.
If Rhode Island is to be considered the lead paint capitol of the
United States, then let it as well be considered the capitol of lead
paint solutions--solutions to a silent public health menace to our
children and to children throughout the United States.
----------
PREPARED STATEMENT OF RICHARD A. FATUR
Environmental Protection Specialist
Colorado Department of Public Health
and the Environment
November 13, 2001
Good morning, Chairman Reed, Senator Allard, and Members of the
Subcom-
mittee. My name is Rick Fatur, and I am an Environmental Protection
Specialist with the Colorado Department of Public Health and the
Environment's Lead-Based Paint Program. This morning, I have been asked
to testify before your Subcom-
mittee on Colorado's Lead-Based Paint Program.
First, I want to thank you for inviting me to this discussion on
State and local lead-based paint programs.
I would like to start by giving you a summary and overview of our
State program.
I would say that Colorado is an example of a State with an
average childhood lead poisoning problem. We have found that 3-4
percent of the children tested have elevated blood lead levels,
which is close to the national average. We have identified pockets
or areas where 15-20 percent of the children have elevated blood
lead levels. But we do not seem to have the problem some States
have where certain cities or areas may have up 50 percent of the
children with elevated blood lead levels.
The only current Colorado State lead-based paint (LBP)
regulation covers the abatement of lead-based paint.
Colorado's LBP regulation for abatement is nearly identical in
content to the Federal EPA LBP regulation for abatement, with just
a few minor differences.
The current regulation covers the following items.
1. There are requirements for conducting:
LBP Inspections
LBP Risk Assessments
Abatement Projects
2. In addition, Abatement Projects:
Have requirements for Notification
Need to be conducted by certified abatement firms using
certified workers and
supervisors
Are inspected by the State to ensure that proper work methods
are being used
3. Compliance:
Enforcement actions may be taken for noted violations
4. We require certification of:
Abatement Firms
Workers, Supervisors, Designers, Inspectors and Risk Assessors
5. We approve Training Providers:
Classes are audited to ensure proper course content
Overall the State regulation is working well. Inspections,
risk assessments, and abatements are presently all voluntary
activities. I believe lead poisoning could be further reduced if
triggers could be introduced requiring these activities be
conducted under certain circumstances.
I would now like to address some of the positive aspects of our
program.
We are showing an increase in abatement activities/projects,
which shows that people are becoming more aware of the problem.
We are also showing an increase in the number of abatement
firms, and all personal certifications.
Working ``lead-safe,'' by containing and controlling lead
hazards, is becoming more a common practice.
Since inspections, risk assessments, and abatements are
voluntary actions, a major part of the program is outreach and
education. We developed a Colorado Lead Coalition to help us with
these activities and are seeing very good results from its work.
Incidentally, the EPA honored our Colorado Lead Coalition with an
Environmental Achievement Award on October 30. Members of the
Coalition include:
Colorado Department of Public Health and Environment
Environmental Protection Agency
Colorado Department of Housing
Denver Environmental Health
Denver Housing and Neighborhood Development
Northeast Denver Housing Center
Denver Water Board
Agency for Toxic Substances and Disease Registry
New Coalition members for this next year will include:
OSHA
HUD
El Paso County Health Department
The Colorado program for testing children is working well and
we continue to see an increase in the number of children being
tested.
We have begun the process of revising our State regulation to
mirror the new EPA regulatory requirements issued in January 2001.
Finally, I would also like to discuss some of the problems we have
seen, not only
within our State, but also nationally.
By far the majority of projects are being done for the purpose
of renovation and remodeling, not abatement. Abatement is the
elimination of lead-based paint hazards and must be conducted in
accordance with existing regulations. HUD requires some training to
control lead-based paint hazards during HUD renova-
tion and remodeling projects, but the vast majority of renovation
and remodeling projects are still being done by untrained persons
without any control measures.
Again, I believe that lead poisoning could be further reduced
if triggers could be in-
troduced requiring inspections before renovation and remodeling is
permitted,
and requiring that risk assessments and abatement be conducted
under certain
circumstances.
The EPA needs to promulgate their other regulations as quickly
as possible to close the present loopholes. These include the
regulations covering:
1. Renovation and Remodeling
2. Buildings, Bridges, and Structures
One of the most significant problems involving lead-based
paint is the lack of funding or financial assistance available for
abatement or lead-safe renovation and remodeling. Although there
seems to be enough funding for training, outreach, education, and
even free training classes, almost no money exists to help the
underprivileged families who have lead poisoned children and have
an urgent need for interim controls or abatement to correct lead-
based paint hazards in their homes. We should think of ways to
focus more immediate attention on this issue.
We will all need to work together to resolve some of these problems
in order to reach our Nation's goal of eliminating childhood lead
poisoning by the year 2010.
Thank you very much and I would be glad to respond to any questions
you may have. I have also included a rough diagram of LBP regulations
and how they affect each other. I would be glad to discuss the diagram
if anyone has any questions.
PREPARED STATEMENT OF SUE HELLER
Project Administrator of the
Manchester Lead Abatement Project
Manchester, Connecticut
November 13, 2001
I am Sue Heller and I run the Manchester, Connecticut Lead
Abatement Project (LAP). Thank you for inviting me to talk about lead.
I am proud to be here in the presence of so many lead gurus who have
directed their own energies and staff work toward lead solutions.
Senator Reed has scheduled the first lead hearing in 10 years,
another milestone in his quest to end childhood lead poisoning in real
time. Senator Reed has a proud lead legacy in bills, allocations, the
Medicaid mandate and the national designation of Lead Week. What better
place to be, in a hearing where rank is accorded to Senator Wayne
Allard, who represents Leadville. Today, we are all from Leadville.
Connecticut's lead muse is Senator Christopher Dodd, a long-time
champion of children, housing and Medicaid. Senator Joseph Lieberman
provides Connecticut with ongoing knowledgeable, substantive support to
the lead issue and to projects. Our Representative John Larson actively
seeks out and disseminates successful lead measures through his
district.
Manchester, as a HUD grantee is lucky to have the insightful
effective leadership of David Jacobs the Director of HUD's Office of
Healthy Homes and Lead Hazard complemented by valuable counsel from
Ellis Goldman and Stan Galik.
Special thanks to Nick Faar, at the National Center for Healthy
Housing and Don Ryan of the Alliance to End Childhood Lead Poisoning
who are constant mentors.
The town of Manchester's sound administrative infrastructure has
benefited LAP through leadership from Mayor Stephen Cassano, longtime
Health Director Ronald Kraatz, and Town Managers Richard Sartor and
Steven Werbner among others. There has been nonpartisan support from
the legislature (kudos to Representatives David Blackwell and Jack
Thompson), with help from the Governor's office, and officials from the
State Departments of Public Health and Economic and Community
Development. On a day when thoughtful people around the world are
preoccupied with national values, security and other imponderables, it
is a comfort to be able to talk about a preventable soluble problem--
childhood lead poisoning.
Connecticut Issues
Visitors come to Connecticut to tour historic old homes. The
strength of Connecticut's housing market is dependent on old and
attractive housing, 1,113,000 housing units were built before 1980 and
462,000 built before 1950. It is estimated that nearly 500,000 carry
some lead risk, 65,000 have real hazards.
Lead safe work practices are not universally used by Connecticut
construction workers or remodelers who work on older housing, which
have more weather beaten wooden construction and wrap-around porches,
than in other sections of the country. Whether remodelers call what
they do lead work or not, lead is involved in construction or repair of
old houses; the danger is that construction can create dust and risk,
in the absence of lead-safe practices. And workers in some industries
bring lead dust home from work on clothes or shoes particularly
hazardous if they hug their children when they come home from work
before they shower and change clothes.
While blood lead screening is increasing in the large cities, not
enough testing is done and too few children are screened or tested at
appropriate intervals. Smaller jurisdictions do less testing so
children who have low lead levels without obvious symptoms are often
not identified. Medicaid children are frequently not tested
despite a Federal Medicaid mandate.
In 1999 alone, 2,017 Connecticut children (under 6 years of age)
were found to have blood lead levels over 10 g/dL, a recognized level
of concern and 460 over 20 g/dL, the level that usually defines
poisoning. There are many additional children with elevations who were
tested in other years or have never been tested at all.
Many of the State's 228,000 children under 6 years old and
particularly the 31,399 in poverty or those Medicaid-eligible are
vulnerable to lead poisoning, because they move frequently from one
substandard house to another.
While State regulation obligates landlords to correct home
environmental conditions when a child is poisoned at a blood lead level
over 20 mg/dL, insufficient cash flow in low-income housing deters
compliance. There are few if any financial resources to remediate
housing conditions for mildly poisoned youngsters, who are not covered
by regulation. Recent studies indicate that children are more
vulnerable to lower and lower levels of lead even under 10 mg/dL, once
thought to be the upper limit of safe exposure and that poisoning is
likely to be irreversible (fortunately treatable). Therefore,
prevention--primary and secondary--offers the only real solution to
childhood lead poisoning.
Certainly it is cheaper for both the private and public sectors to
maintain existing housing stock by treating a unit preventively for
lead at $2,500 to $5,000 a unit, than to abate at $10,000 or to replace
at over $100,000, a unit.
State Approaches
Connecticut responds to the prevailing lead problems of old
housing, ignorance of lead safety, insufficient screening and a
shortage of resources.
The Health Department delivers lead information to the public
through training, and widely disseminated literature and videos.
Manchester has piloted many training measures for the State: lead-safe
practices needed to meet 1012-13 regulation, CEU licensure in day care
real estate brokerage and construction contracting. The New England
Lead Coordinating Committee's Keep It Clean Campaign, which promotes
lead safe work practices, was born in Manchester, Connecticut, and
spread quickly through the State, and region, training personnel in
paint and hardware stores to help customers to address lead hazards
effectively.
Some jurisdictions have succeeded in winning lead grants but some
of the most leaded areas have been unsuccessful at competing for scarce
Federal lead funding. (Bridgeport has the highest number of lead cases
in the State.)
Connecticut has built a local network to deal with lead using
municipal health departments and doing quarterly in-service education.
The court system has been proactive in enforcing laws. Hartford, has
begun to use post office resources to generate attention and resources
from stamps and cancellation messages. Hartford has also an interactive
reading program for beginning readers based on lead. Connecticut has
studied blood lead screening data comparing State-wide data with
Medicaid data, which points to the need for remediation in Medicaid
households. There are two successful lead-safe houses to serve the
State for relocation. They are frequently full; the lead-safe houses
themselves require added resources to maintain their own code-compliant
lead safe conditions.
Manchester Approaches
Manchester has used the 325 dwellings abated with HUD's lead money
as laboratory cases to pilot innovations. We have moved closer to
prevention by invoking four different levels of lead intervention,
reducing average unit costs for abatement to less than $8,000 from the
$11,500 it cost us in 1997 (in a range of $1,000 to $12,000 now).
(Around the State costs are generally much higher, but will probably
drop with experience). LAP generates local economic development by
identifying and launching business opportunities presented by lead to
local construction contractors, workers and suppliers. We have
developed a local economic sector of the construction industry devoted
to lead along with customized training for thousands of participants
from various population groups, thereby building local capacity to deal
with lead in many quarters.
Certified job training and placement has aided hundreds of
construction workers, many underemployed or unemployed. We have used
lead funds to trigger home ownership for 14 low-income, first-time
homebuyers affecting about 30 households. Manchester has been able to
meet town community development and housing affordability objectives as
we spend HUD's abatement money. We combine community
development block grant funds (CDBG) and other dollars and policies to
effect comprehensive, integrated rehabilitation in a single scope of
work to carry out town community investment objectives.
LAP developed a lead insurance pool, which induced construction
contractors to engage in abatement. Because of our excellent experience
rating, the insurance industry extended coverage to more contractors
and lowered annual premiums to an affordable $6,000-$8,000 from $18,000
to $24,000 it charged earlier.
We continually export our local experience to other communities,
the region and the State. LAP won a National Best Practices Award and a
local Customer Service Award, LAP was cited for cost-effectiveness,
education, prevention capacity building and creativity. But this is not
sufficient to fulfill our mission to make Manchester a lead-safe
community. Dollars are needed to complete our work and institute more
preventive measures earlier to target needy households, before a child
is poisoned.
LAMPP
Manchester recently spearheaded LAMPP, Lead Action for Medicaid
Primary Prevention, which was jump-started by Senator Dodd early in its
development less than 2 years ago. The Senator responded to the
opportunity to ensure the maximum
potential for Medicaid children who are more vulnerable to lead risks
and other compromising conditions. The exposure given through Senator
Dodd's interest expedited LAMPP's development and encouraged
participation.
LAMPP will rehabilitate lead hazards in residential units that
house Medicaid youngsters around the State. Children under 6 years of
age with mild elevations of blood lead will be referred by Medicaid's
Managed Care health providers so that their homes can be treated with
preventive, low-cost, cost-effective lead treatment measures. Window
repair or replacement, paint stabilization and grass seeding will be
complemented by home environmental assessments and education for
parents and landlords. The State just allocated $200,000 a year for a 2
year pilot. Local contributions will come from existing lead and
housing programs, private participation, State bonding, Medicaid,
Medicaid providers, hospitals, etc. and, if we are properly persuasive,
from the Federal Government. LAMPP is operated by the Connecticut
Children's Medical Center.
LAMPP was spawned by State lead entities under auspices of the Get
the Lead Out Coalition, public and private sector health and housing
entities collaborating with property owners, hospitals, nonprofits,
public agencies and legislators from both sides of the aisle. LAMPP is
modeled after Manchester's LAP, itself a collaborative effort. LAMPP
will address lead poisoning which disproportionately affects Medicaid
recipients--poor youngsters who live in older housing.
LAMPP Benefits
Improve health of Medicaid children--who are most at risk.
Invest in affordable housing and home environmental conditions
thereby aiding occupants, owners and neighborhood residents.
Pilot for Medicaid as an approach to meet the letter and
spirit of its Federal Medicaid mandate.
Based on what we have learned, what must be done to solve lead
poisoning?
Devote more funds to deal with children at risk who are not
poisoned, continu-
ing to react to those already poisoned. Prevention measures in
needy households
cost less.
Judicious management can shorten the solution period and broaden
the impact of expenditures permitting economy and cost-effectiveness,
simultaneously promot-
ing economic development and housing improvement.
Increase blood lead screening and use the data dynamically to
guide remediation. Pinpoint Medicaid youngsters who are
disproportionately at risk and for whom the Federal Medicaid
mandate can provide a functional and financial lever.
Target money to vulnerable but not yet poisoned youngsters at
an early age. LAP's early action alternatives are directed at lead-
safety for newborns encouraging nursery preparation and prenatal
education for parents. LAP is partnering with a target neighborhood
elementary school to formulate a curriculum to educate children,
their parents, and teachers .
Lower costs as we gain more knowledge from best practices,
research, and equipment.
Economic incentives must be identified to encourage repair as
opposed to replacement, because routine repair can be cheaper.
Demonstrate to owners how a turnover strategy, to treat units,
between tenants, preemptively quickly and cost-effectively, can pay
off.
Demythologize lead treatment: its costs and its liabilities,
by demonstrating cost-effective remediation.
Listen to affected constituencies to respond to concerns by
parents, landlords, construction contractors, real estate market
participants, and health providers.
Convey information customized on a need to know basis to
attract audiences.
Increase outreach and marketing to broaden the constituency
for lead.
Find private sector partners so lead safety can evolve from an
iffy supposition for them into an ongoing sound investment
maintenance strategy recognized by the real estate market.
Upgrade rehabilitation skills--teaching remodelers about lead
safe practices and expedite remediation with help in relocation,
etc. Offer technical aid widely, encouraging those who can afford
to remediate themselves.
Programs like ours can only remediate an infinitesimal (3 percent)
of the real needs. With additional dollars wisely used and carefully
targeted we can satisfy the necessary demand for assisted remediation.
(LAP has only been able to abate 368 units out of 680 applicant units
of the estimated 13,250 dwelling units in need in the target area.)
Early prevention can deter the lifelong neurologic impairment of kids,
preclude even more costly treatment of poisoned children and their
households and stem the need for expensive special education and
behavioral intervention necessary once a child is poisoned. Well
managed, the strategy can be implemented in a few years with compound
benefits: healthier children, sounder housing, and improved
neighborhoods.