North Carolina Childhood Lead Poisoning Prevention Program

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North Carolina Childhood Lead Poisoning
Prevention Program
Division of Environmental Health
Lead poisoning can be prevented.
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Lead-based Paint

• Paint manufactures used to put lead pigments in
  paint because the pigments make the paint last
  longer, dry faster and cling to surfaces better.
  
• Paint that is disturbed or that is breaking down
  with age can contaminate dust and soil.
• Lead is highly toxic. Exposure to it can be
  dangerous, especially for young children.

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Child Exposure

• Children are poisoned because they eat lead dust
  that has gotten on their hands, toys, pacifier,
  etc. Damage to the childs health is usually
  done before symptoms show.
• Children who may be exposed to lead hazards
  should be tested for elevated blood lead levels.

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CDC Guidelines

• Targeted Screening of 12 and 24 month old
  children.
• N.C. - mandatory screening for recipients of
  Medicaid, WIC, and HealthChoice.
• Blood lead analysis provided at no charge through
  the State Laboratory.

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Blood Lead Levels

• A blood test tells you what a childs recent
  exposure to lead has been. Lead in blood is
  measured in micrograms of lead per deciliter of
  blood (ug/dL).
• 0 5 10 15 20 25 30 35 40
• low risk moderate risk high risk urgent
  risk
• A level above 10 is of concern.

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N.C. Surveillance Data

• In 1999
• More than 105,000 kids tested.
• 625 confirmed 10 ug/dL or greater
• (50 of EBL children were never retested).
• 80 confirmed lead poisoning.

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Health EffectsA lead-poisoned child usually
seems healthy.

• Exposure to low levels of lead can permanently
  affect children. In low levels lead can cause
• Nervous system and kidney damage.
• Learning disabilities, attention deficit
  disorder, and decreased intelligence.
• Speech, language, and behavior problems.
• Decreased muscle and bone growth.
• Hearing damage.

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Societal Cost

• Lifetime cost of a moderately poisoned child
  40,000 - 60,000.
• Reduction in lifetime earnings, medical and
  special education cost.
• Does not include reduced family time, anxiety in
  caring for a lead-poisoned child, decreased
  stature and hearing ability, increase juvenile
  delinquency and crime, and hypertension later in
  life.

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Adult Exposure

• Inhalation/Ingestion
• Long term health risks
• high blood pressure
• reproductive problems
• anemia
• kidney failure
• memory and concentration problems
• muscle and joint pain

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Family Exposure

• Lead can be dangerous to workers and their
  families if the worker brings equipment and
  clothing home from the job site.
• Vehicles and homes can be contaminated with
  lead-based paint and dust if safe work practices
  are not followed.

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Global Action

• Countries that either banned the use of lead
  paint or severely restricted childrens contact
  with it
• France 1840s Spain 1931
• Germany 1870s Yugoslavia 1931
• Australia 1920 Cuba 1931
• Great Britain 1926 USA 1978

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Affected Housing

• According to HUD estimates
• 64 million homes have LBP.
• 20 million homes with deteriorated LBP likely to
  cause exposure.
• 890,000 children with elevated blood lead levels.

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Hazard?

• Is all lead-based paint a hazard?
• The mere presence of lead paint does not mean
  there is a hazard.
• Lead-based paint that is intact and covered with
  several layers of non-lead paint is not a health
  risk if it is maintained.

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Equipment

• HEPA filter-equipped vacuum cleaner
• Properly fitted respirator
• Protective clothes
• Heavy duty polyethylene plastic sheeting
• Duct tape
• Wet-sanding sponges/paper
• Spray bottles
• Detergent

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Safe Work Practices

• Control access to the work area
• Cover the work area with plastic
• Cover the ground with plastic
• Shut off HVAC
• No eating, drinking, smoking in work area
• Protect occupant and belongings
• Mist painted surfaces before disturbing

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Safe Work Practices contd

• Wet sweep
• Perform specialized cleaning when project is
  completed.
• Change clothes and shoes before leaving work
  area.
• Wash work clothes separately from family laundry.
• Dispose of wash water down a toilet.

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Exterior Work

• Cover the ground with 6 mil plastic sheeting.
• Move play equipment at least 20 away from the
  work area.
• Close all windows and doors.
• Daily site cleanup

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Unsafe Work Practices

• Stripping paint on-site with methylene
  chloride-based solutions.
• Torch or flame burning
• Heating paint with a heat gun above 1100 degrees
  Fahrenheit.
• Uncontrolled abrasive blasting, or uncontrolled
  waterblasting.

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Specialized Cleaning

• Using a HEPA equipped vacuum cleaner, vacuum from
  the cleanest areas to the dirtiest areas. Work
  from the top of the room toward the bottom,
  cleaning, door frames, chair rails, window sills
  and troughs, shelves, counters, baseboards and
  floors.

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Specialized Cleaning contd

• Wet Cleaning
• Detergent solution and two buckets
• Work from the cleanest to the dirtiest areas.
• Change Rinse water at least once per room.
• Change mop heads after each unit/house.
• Flush dirty water down the toilet.

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Preventive Maintenance Program

• In 1997 the North Carolina General Assembly
  adopted the Childhood Lead Exposure Control Act
  establishing a voluntary preventive maintenance
  program (PMP).

• The PMP is designed to to reduce childhood lead
  exposure in pre-1978 rental housing.
• The PMP is primary prevention!

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Who is Eligible to Participate?

• Participation Is Voluntary.
• Owners of pre-1978 residential rental property
  are eligible to participate.
• Owners of property identified as a potential
  source of childhood lead poisoning are also
  eligible to participate.

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Who cannot Participate?

• Child occupied facilities such as child care
  centers and schools.

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Benefits Of Participation

• Protect children from exposure to lead-based
  paint and lead-contaminated dust.
• Liability relief from lead poisoning related
  lawsuits.
• Property Marketing.

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Maintenance Standard Activities

• Repair and repaint interior areas of
  deteriorated paint.
• Adjust doors and windows to minimize friction.
• Make interior surfaces smooth and cleanable.
• Cap window troughs with vinyl or aluminum.
• Pre-1950s property must also
• repair and repaint exterior areas
• cover bare soil within 3 ft. of the foundation.

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Maintenance Standard Activities (contd)

• Use safe work practices to prevent the spread of
  lead dust.
• Protect occupants belongings.
• Use specialized cleaning to remove residual lead
  dust.
• Provide occupant information.
• Undergo annual monitoring.

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Maintenance Staff

• Maintenance staff should have proper training and
  a clear understanding of lead-based paint
  hazards, safe work practices, occupant
  protection, and dust cleanup methods.

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Questions?

• Claudia Rumfelt-Wright
• Preventive Maintenance Program Coordinator
• Division of Environmental Health
• 1632 Mail Service Center
• Raleigh, NC 27699-1632
• Tel. [phone]
• Fax [phone]