9 Replies Latest reply on Feb 13, 2012 1:10 PM by randalleraymond

    Blood Lead Poisoning, Student Achievement and Environmental Health

      For some time now I have been involved in research that examines the impact of elevated blood lead levels on student achievement. This falls into a category of problems that are related to the impact of environmental health on student achievement and school success. I think it is critical that this area of investigation be given more attention. In many cases these environmental health issues are generational in that the parents of the students affected were also affected by these environmental factors as were their parents. Until more attention is given to these issues large numbers of high poverty, urban students will continue to be left behind while we close schools due to poor performance. Our research shows very clearly, with high significance, that the higher an individual's blood lead level between birth and 5 years of age the lower they score on all education assessment tests as they grow. Unless we begin to address these conditions through more intensive early childhood education programs these students will continue to struggle and potentially drop out of the education system.

      This is a landmark study of great significance. This project resulted from collaboration between the City of Detroit Department of Health and Wellness Promotion (DHWP) and the Detroit Public Schools Office of Research, Evaluation, Assessment and Accountability. It took 18 months to work out a memorandum of understanding that allowed us to take all of the venous blood lead testing data for individuals living in the City of Detroit from DHWP, 169,301 records, and match that data with a Detroit Public Schools (DPS) student database. The data is from 1992-2008 so it is longitudinal. We were able to identify over 45,000 currently enrolled DPS students in the blood lead testing database. You will find a more information at:

       

      http://proceedings.esri.com/library/userconf/health10/docs/gis_collaboration.pdf

       

      Most large cities with Health Departments have this type of data available as they are required to keep the records. The key to better understanding is the development of the memorandum of understanding that makes it possible to combine the data from the schools and health department so a better understanding of the educational impact can be explored. I believe that this is one of the greatest educational achievement problems that exists in eastern US urban centers of high poverty. More than 25% of the current school population of DPS had elevated blood lead levels (EBLLs) between birth and 5 years old. When the data is examined by school enrollment, DPS has over 40 schools where the more than 35% of the school population had EBLLs. Under no child left behind, declining enrollment and the financial conditions in DPS schools have been closed because they do not make AYP when a high percentage of the population performs poorly due to past environmental health related issues.

        • Re: Blood Lead Poisoning, Student Achievement and Environmental Health
          tdiener
          Your post demonstrates how valuable data and GIS is to assessing student acheivement. A few questions: Can lead blood levels be reduced?  Can the negative effects of lead be reversed? and Are students with high lead levels eligible for remediation?
            • Re: Blood Lead Poisoning, Student Achievement and Environmental Health

              Hi Tom, thanks for your reply to this post. In answer to your questions: When an individual is identified with elevated blood lead levels (EBLLs) they are treated to reduce the blood lead levels. However, children between birth and 3 years old are at the greatest risk for permanent damage depending on the length  and level of exposure to the EBLLs. This data analysis clearly shows that students identified as "special education" eligible have significantly higher EBLLs than those students not identified as "special education". The problem is that many students who have experienced EBLLs do not get identified as "special education" and the results clearly show that they are significantly negatively impacted in their ability to perform on the state standardized testing. This research would suggest that when these children are first identified with EBLLs then educational remediation should begin immediately. In this way it might be possible to reverse some of the damage that has occurred. If we continue to do what is happening today then these result clearly show that many children will not be able to perform at acceptable levels as they grow older and move through the education system.

            • Re: Blood Lead Poisoning, Student Achievement and Environmental Health
              erroth

              Randall,

               

              You mention that more early childhood intervention is essential; what preventive measures are being taken to minimize lead poisining in the first place?

                • Re: Blood Lead Poisoning, Student Achievement and Environmental Health

                  Hi Eric

                   

                  Thanks for this question. In general, children become the "canaries in the mine" when it comes to the prevention of lead poisoning. It is not until a child living in a lead dangerous area is found to have an EBLL that something is done to reduce the risk of exposure. This generally happens one house/housing unit at a time. If you look at the maps included in the presentation it is very clear that in the City of Detroit there are areas where the risk of exposure to high lead levels is very great. Whole areas need to be remediated but it is difficult to get large scale remediation happening. This is an issue in neighborhoods in many cities in the US as a result of industrial pollution. This is why I am posting this information. It is an effort to bring to the attention of more individuals the serious long term effects of EBLLs and the impact on student achievement in hopes that more people will be willing to explore these problems in their communities and come to the rescue of the children that are being impacted. It has long been suspected (known) that EBLLs hurt the learning potential of children. However, due to confidentiality of the data maintained by health departments and the Centers for Disease Control and Prevention few studies have been accomplished that so clearly show this long term negative impact on children in our schools today. Until more people truly understand how serious this problem is little will be done and the children will continue to be the "canaries in the mine".

                    • Re: Blood Lead Poisoning, Student Achievement and Environmental Health
                      erroth

                      What would you recommend educators to do for their community regarding lead poisining in children?

                        • Re: Blood Lead Poisoning, Student Achievement and Environmental Health

                          Educators need to be aware that issues with EBLLs and other related environmental health impacts can significantly limit a child's ability to learn. They need to become proactive for their students and develop collaborations with the local public health agencies. Public health agencies are required to keep records on these types of issues in the communities. Educators need to meet with these agencies to become informed about how many children in their communities are being impacted. There needs to be a greater emphasis on developing educational remediation programs for the children as soon as the conditions are identified. New educational strategies need to be develop. There is some work happening that leverages various technology tools to help the students but this work is not taking place in a large scale fashion. Once a child is identified with EBLLs there should be an effort to develop an individual learning plan for that child. If we continue the current practice the long term results are very predictable. Until we try new educational approaches for these students it will not be possible to know if the current results can be altered.

                    • Re: Blood Lead Poisoning, Student Achievement and Environmental Health
                      Bonnie Feather

                      This topic would seem to be an ideal one for students to learn about through a Project.  Are you involving any of the students in the DPS in learning more about the topic?  Their final deliverable could be a very interesting video, publication, or other way of educating others, especially children and educators, about the dangers.

                       

                      ~Bonnie

                       

                      PS

                      You will cringe when I tell you in truth that when I was young, my father built a shed in our back yard.  He used corrugated tin for the roof, and attached it with roofing nails, which in those days had been dipped into lead to create a malleable head which was meant to cover the nail hole with a large cap to keep out water. The caps were about 2 mm thick and about 12 mm in diameter.

                       

                      Almost daily I would climb up onto the fence and reach over the roof to pull these soft lead caps off a couple of nails.  Are you with me?  Do you know what I did with them?  I chewed them.  I loved the way the lead felt as I chewed. We lived in this house for 3 years, and I did this until all of the nails I could reach were de-cap-itated.

                       

                      I believe either:

                      1. I could have been much smarter than I am today, or
                      2. I was exceedingly fortunate to have no discernible effects.
                        • Re: Blood Lead Poisoning, Student Achievement and Environmental Health

                          HI Bonnie, thanks for your comment. I did have group of students win a national award, Seiko Environmental Youth Challenge, for working on issues related to the dangers of blood lead poisoning. However, this particularly study was not a part of that effort due to a plethora of issues with the confidential nature of the data being used. 

                           

                          Your story about the shed is very interesting. The greatest impact of EBLLs on  brain development occur between birth and 3 years of age. This a time in development when a blood brain barrier is still developing in humans. During this period lead can leach out of the brain related blood capillaries into the brain. This is what causes the damage to learning. While there are other detrimental effects for older children to EBLLs they do not seem to have such a significant impact on learning potential. Kids do the darnest things!

                            • Re: Blood Lead Poisoning, Student Achievement and Environmental Health

                              I thought the information below was important to add to this discussion. I hope some of you will read it and contribute.

                               

                              One of Congress's Most Damaging (and Racist) Budget Cuts That Flew Under the Radar
                              The fund for lead-poisoning prevention was almost entirely eliminated. And here's why this is such a big deal.

                               

                              http://www.alternet.org/health/154005?page=entire

                               

                              AlterNet  By Peter Montague and Maria B. Pellerano

                              One of Congress's Most Damaging (and Racist) Budget Cuts That Flew Under the Radar

                              The fund for lead-poisoning prevention was almost entirely eliminated. And here's why this is such a big deal.

                              February 7, 2012  | 

                              For Christmas this year, Congress gave the nation's urban children a gift that will keep on giving -- a 94 percent cut in funds for lead-poisoning prevention. Once a child is poisoned by toxic lead, permanent brain damage reduces I.Q., lowers grades in school, and diminishes self-control. This, in turn, can lead to frustration, a sense of failure, impulsiveness, aggression, and, for some, potentially even violence, crime, and prison. Lead is a soft, grey metal with many practical uses, from bathroom pipes to bullets. Unfortunately, it is highly toxic to humans. Despite eons of knowledge about the toxicity of lead, during most of the 20th century Congress allowed the paint and gasoline industries to lace their products with millions of tons of the stuff, which of course ended up in the environment where much of it still remains available to poison unsuspecting children. Urban neighborhoods are full of lead today, in soil and in paint flaking off old buildings. Low-income families are hardest hit because they tend to live in old buildings poorly maintained.

                              With a peculiar mix of frugality and cruelty, Congress's $1 trillion spending bill for 2012 shrank a small ($30 million per year) federal lead-poisoning-prevention program to a minuscule $2 million annual effort, a 94 percent cut. And it's no surprise to anyone that the children harmed by this grinch move are mostly city kids, which means they're mostly African-American and Hispanic. The nation's medical establishment has been reporting excessive lead in urban children (75 percent of them of color) since 1952 -- so we have 59 years of studies, all showing the same thing. Therefore, in this rare instance, Congress relied on the best available science and knew exactly what it was doing. It was saddling hundreds of thousands of urban children with persistent cognitive damage and elevated blood pressure for life.

                              Less than 2 weeks after Congress delivered its toxic Christmas gift, a federal Advisory Committee on Lead Poisoning Prevention recommended that the official standard for declaring a child poisoned by lead should be cut in half. The Advisory Committee on Childhood Lead Poisoning Prevention of the Centers for Disease Control and Prevention (ACCLPP) issued its report Jan. 4, recommending that the official definition of "elevated blood lead levels" should be reduced by half, from its present 10 units to 5. The definition of a unit is very geeky -- one microgram of lead in one deciliter of blood, written ug/dL. A microgram is a millionth of a gram and there are 28 grams in an ounce. A deciliter is a tenth of a liter and a liter is about a quart.

                              Even as it was recommending a standard of 5, the ACCLPP committee emphasized that even 5 is not safe. In its report, the Committee repeated several times that the only safe level of lead in a child's blood is zero. The main effect of lead is to impair cognition, which is usually measured (after age 5) by an I.Q. test. Many studies confirm that any amount of lead reduces a child's I.Q. to some degree. (For more confirmation on this see the following studies: Binns, 2007; Bellinger, 2008b; Canfield, 2003; CDC 2004; Chiodo, 2004; Needleman, 2004; Rogan, 2003; Schwartz, 1994.)

                              The body of a healthy 2-year-old contains about 10 deciliters of blood -- in plain English, one liter (Russell, 1949). At 5 micrograms per deciliter, that child would carry a total of 50 micrograms of lead in his or her blood. Fifty micrograms is a speck. If you took one adult aspirin tablet and crushed it into 8000 equal pieces, one piece would weigh 50 micrograms. So, yes, lead is a potent poison. Such "low" levels of lead are harmful because, as the human body evolved, there just wasn't much lead in the environment, so we never evolved ways to detoxify or eliminate it from our bodies quickly. Based on careful analysis of ancient bones, several studies have shown that the average lead in the blood of pre-industrial humans was 0.016 ug/dL (Flegal, 1992). Therefore, U.S. children with 5 ug/dL in their blood have 300 times as much lead as pre-industrial humans. So "low" levels of lead, like the recommended 5 ug/dL, aren't really low at all, in an evolutionary or biological sense.

                              Medical researchers have a pretty clear idea how much lead causes how much brain damage. The ACCLPP report says that a blood-lead level of four ug/dL will reduce a child's I.Q. by two to five points, with a best estimate of 3.7 points. Reliable studies have shown that blood-lead of even two ug/dL will reduce a child's I.Q. by about three points. (Canfield, 2003; Lanphear, 2005)

                              In 2007, the New York Times ran a front-page story describing what it means for a group of children to lose just three I.Q. points: "Three points on an I.Q. test may not sound like much," the Times said. "But experts say it can be a tipping point for some people -- the difference between a high B average and a low A, for instance. That, in turn, can have a cumulative effect that could mean the difference between admission to an elite private liberal-arts college and a less exclusive public one."

                              Of course the Times did not mention it, but for some children the loss of three I.Q. points could equally well mean the difference between a high D average and a low C, with a cumulative effect that could mean the difference between staying in school and dropping out. We also know that 10 percent of young men of color who drop out of high school end up in prison or in juvenile detention (Sum, 2009). So three I.Q. points could mean the difference between freedom and prison.

                              Importantly, loss of I.Q. hurts low-I.Q. people more than it hurts high-I.Q. people. The average I.Q. is 100, and by definition half of all people have below-average I.Q.s. If your I.Q. is 130 and you lose 3 points, you're losing about 2 percent of your total capacity. If your I.Q. is 80 and you lose 3 points, you're losing about 4 percent of your capacity. So toxic lead disproportionately damages those who can least afford to lose brain power.

                              Some health officials justify the status quo by pointing out that there used to be a lot more toxic lead in people's blood than there is today, and it's true. Thirty years ago, the median blood lead level in pre-schoolers of all races was 15 ug/dL and 88 percent of U.S. children had more than 10 ug/dL. The estimated average I.Q. loss in those generations is 9.2 points. They are our leaders today, which may help explain why we're in the shape we're in. Unfortunately, reducing the median lead level from 15 to the present 1.9 (chiefly by phasing out lead in gasoline) did not produce a proportionate rise in I.Q. Kids today have a median I.Q. roughly 5 points higher than kids in the 1970s. The reasons for this are complicated but basically there's a greater loss of I.Q. as lead rises from 1 to 10 ug/dL compared to the loss that occurs above 10 ug/dL.

                              The ACCLPP estimates that 450,000 U.S. children currently have 5 ug/dL or more lead in their blood. As we've seen, Congress has allocated a total of $2 million in 2012 to help these children, which means each child can get $4.45 worth of services. A simple pin-prick blood test can cost $10.00, and removing or encapsulating lead in a home costs $7000 on average.

                              In the U.S., there are currently 4 million homes contaminated with lead-based paint with young children living in them. If the entire $2 million lead-poison-prevention budget for 2012 were spent removing or encapsulating lead in homes, only 285 of the 4 million homes could be cleaned in a year. To clean all 4 million homes would cost $28 billion. But, as we'll see, the financial return on such an investment would be immediate and large.

                              And it's not like this problem has sneaked up on us. The paint industry openly acknowledged in the 1890s that lead-based paint was dangerous; in 1897 at least one company, Aspinall's, was advertising proudly that its paint "is NOT made with lead and is non poisonous." The poisoning of children by dust from lead-based paint was first reported in medical literature in 1904. Lead-based paint was banned for interior use in Australia and most of Europe during the 1920s. The U.S. delayed another 50 years, banning it in 1978. Furthermore, just as Europe was phasing out lead-based paint in the 1920s, the U.S. oil industry introduced toxic lead into gasoline in 1925 (Hernberg, 2000; Silbergeld, 1997). The tailpipes of automobiles then spewed a fine dust of toxic lead -- some 30 million tons of it -- from sea to shining sea for the next 70 years, until Congress finally phased it out slowly between 1973 and 1995. The soil in most U.S. cities today is still laced with toxic automotive lead, which kids still track into their homes. (Urban gardeners beware -- get your soil tested for lead.)

                              The problem of urban children poisoned by lead-based paint was first acknowledged by U.S. public health doctors in the 1930s. The City of Baltimore began routine surveillance of lead in children in 1931, finding black children poisoned seven times as often as white children (Hicks, 1970). Reports of large numbers of children poisoned by lead-based paint appeared in medical literature in the 1950s (Williams, 1952; Montague, 1992). Those early reports all emphasized that lead was mainly a danger to poor, African-American children living in urban slums. For a society blinded by 350 years of white privilege in law and custom, a silent epidemic of poisoning affecting mainly low-income black families had no political meaning. To judge by Congress's action in 2011, it still doesn't.

                              The failure to solve the problem of toxic lead seems particularly odd because billions of dollars each year could be gained by eliminating lead from housing. A 2005 policy statement from the American Academy of Pediatrics reviewed several cost-benefit analyses, all showing that eliminating lead from housing would save billions each year because I.Q. translates into earning power which, in turn, translates into tax revenues.

                              Here are some numbers from the Academy's 2005 statement. There are 4 million homes in the U.S. needing lead removal or encapsulation. At $7000 to clean an average home, eliminating the lead paint problem would require a one-time investment of $28 billion. The savings would be $43 billion in the first year and each year thereafter because children with higher I.Q.s tend to get more schooling and then jobs with higher pay. So lead remediation would pay for itself in less than one year and would then save tens of billions each year thereafter (Grosse, 2002; Gould, 2009). An investment of $28 billion is less than the U.S. has spent every six months in Iraq for the past 8 years.

                              Other recent studies make the same point, but you get the idea -- there's a huge amount of money to be saved by ceasing to poison our children (Gould, 2009).

                              To state the reverse: We are forgoing billions of dollars in income and taxes each year in order to keep our urban children poisoned. This is an astonishing use of scarce resources, to put it mildly. How can we possibly explain such a bizarre national policy?

                              It must be that, for the U.S. Congress, some things are more important than money.

                              Congress passed a law in 1971 mandating removal of lead-based paint from housing. The federal government then dragged its feet and bungled the task for 20 years. In 1990, Dr. Herbert Needleman, a well-known lead expert, told the New York Times that, "The Government's record in dealing with this problem is one of absolute dereliction" (Schmidt, 1990). In 2012, the situation is even worse. Why?

                              Could it be that many politicians of the past 35 years, both Republican and Democrat, have found it advantageous to keep inner-city kids behind the 8-ball by diminishing their I.Q.s early in life, making them less successful in school, plus making them more impulsive, aggressive, and potentially violent, thus more likely to end up in prison? (Needleman, 2002; Wilkinson, 2003; Montague, 1997; Masters, 1997; Nevin, 2006) From that perspective, exposing urban children to toxic lead could be seen as part of a well-established pattern -- a school-to-prison pipeline, aided by a war on drugs that targets people of color and a private prison industry that kicks back money into election campaigns to promote public policies that keep the jails overflowing. Mass incarceration of blacks in particular has created a legal opportunity to once again discriminate against them in jobs, housing, voting, jury duty, public assistance, educational opportunity, small business loans, and more -- in sum, the "New Jim Crow." We hope this is not the case, but the historical facts speak for themselves. 

                              Peter Montague is a historian and journalist whose work has appeared in Counterpunch, Huffington Post, the Nation and many other publications. He has co-authored two books on toxic heavy metals.

                              Maria B. Pellerano, M.A., M.B.A., M.P.H. is the Research Administrator for the Department of Family Medicine and Community Health's Research Division, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey. From 1990 to 2004, Ms. Pellerano provided technical assistance on toxic substances and human health to community-based environmental groups.