Intro 101A

1
Preventing Childhood Lead Poisoning in NYC
Jessica Leighton, Ph.D., M.P.H. Assistant
Commissioner New York City Department of Health
and Mental Hygiene June 7, 2004
2
Discussion Points

• Data on childhood lead poisoning in NYC
• Health effects of lead poisoning
• Control of lead-based paint hazards
• Important laws on lead poisoning
• Roles of HPD and DOHMH regarding lead poisoning
  prevention

3
Dramatic Decline in Childhood Lead Poisoning

• Children with blood lead levels 10 mcg/dL or
  greater
• 21,575 in 1995
• 4,876 in 2002
• Children with blood lead levels 60 mcg/dL or
  greater
• 2,649 in 1970
• 8 in 2002
• Goal Eliminate childhood lead poisoning

4
Health Effects of Lead Poisoning

• Even low levels of lead exposure can cause
• Decreased intelligence
• Behavioral problems
• Learning problems
• Most children today do not have observable
  symptoms
• Higher blood lead levels can cause more serious
  health problems.

5
Young Children are at Greatest Risk

• The current applicable age under Local Law 1 is
  children less than 7 years. The Law gives the
  Board of Health after 2005 the authority to
  change that age to less than 6 years.

6
Neighborhoods at Greatest Risk
7
Lead-based paint is the leading source of
childhood lead poisoning.

• 66 of children with lead poisoning have peeling
  lead-based paint in their homes
• Unsafe renovation work can cause lead poisoning
• Other sources include lead-glazed pottery,
  imported foods and spices, cosmetics and
  traditional medicines, hobbies and jobs and
  exposures in other countries.

8
How are children exposed to lead-based paint?

• Lead dust from normal hand-to-mouth behavior
• Eating paint chips

9
Preventing Childhood Lead Poisoning

• Waiting for a child to become lead poisoned is
  too late.
• Reducing environmental sources of lead is key.
• Steps must be taken to control lead-based paint
  hazards.
• Hazard identification
• Housing maintenance
• Safe work practices
• Cleaning and dust testing

10
Steps to Control Lead-based Paint HazardsHazard
Identification

• Identify apartments with young children
• Conduct follow-up inspections

11
Steps to Control Lead-based Paint
HazardsHousing Maintenance

• Perform repairs to address lead hazards based on
  annual inspections
• Perform repairs on turnover

12
Steps to Control Lead-based Paint HazardsSafe
Work Practices

• It is illegal to dry scrape or dry sand in any
  dwelling, day care center or school in NYC.
• Wet methods should be used.

13
Steps to Control Lead-based Paint HazardsSafe
Work Practices

• Use safe methods
• Use trained workers
• Cover furniture and floors
• Contain area
• Keep tenants out of work area

14
Steps to Control Lead-based Paint
HazardsCleaning and Dust Testing

• Remove lead dust before and after work is
  performed.
• Perform dust testing to confirm that cleaning has
  been adequate and the areas is safe for
  reoccupancy

15
Agency Roles in Lead Poisoning Prevention

• DOHMH Roles
• Educate the public, medical providers, community
  organizations and housing personnel about lead
  poisoning prevention.
• Promote blood lead screening of young children.
• Conduct environmental investigation and provide
  case coordination for lead poisoned children.
• HPD Roles
• Focus on lead-based paint hazards in multiple
  dwellings before childrens blood lead levels
  become elevated.

16
Key Federal Laws on Lead Poisoning Prevention

• EPA regulations (40 CFR Part 745)
• Notification
• Training, certification and work practices for
  abatement
• HUD regulations (24 CFR Part 35)
• Requirements for federally funded housing

17
Key NYC Laws on Lead Poisoning Prevention

• NYC Administrative Code (Articles 14 and 17)
• Housing maintenance
• Daycare maintenance
• Safe work practices
• NYC Health Code (Sections 173.13, 173.14, 173.15)
• Lead poisoned children
• Safe work practices

18
Local Law 1 Enforcement

• Local Law 1 is primarily enforced by HPD.

19
Local Law 1 Select DOHMH Responsibilities

• For lead poisoned children, lowers level at which
  DOHMH must conduct investigation to 15 mcg/dL or
  greater
• Respond to complaints of unsafe work practices
• Develop pamphlets on hazards of lead paint and
  procedures to correct hazards

20
Local Law 1 Select DOHMH Responsibilities

• Receive notifications from landlords about
  tenants not responding to owner inquiry
• Receive notifications of all work to be performed
  in a dwelling unit with a child lt7 years old or
  in a common area
• that disturbs gt100 square feet per room
• replaces 2 or more windows in a dwelling unit

21
Health Code Amendments

• Available on DOHMH website at
• http//www.nyc.gov/html/doh/html/public/notice/not
  ice.html
• Comments in writing by June 23, 2004
• Hearing on June 23, 2004

22
Conclusions

• Lead poisoning is still an important problem in
  NYC.
• Addressing lead based paint problems in housing
  is still the most important way to prevent
  childhood lead poisoning.
• Many laws address lead poisoning prevention
• The new Local Law 1 changes the way repairs and
  renovation is done in NYC housing
• Collaboration to eliminate childhood lead
  poisoning