California lags in testing toddlers for lead exposure

A third of young California children at risk for lead poisoning are not being tested despite state and federal laws that require it, according to a new study—a problem at least partly addressed by legislation now on the governor’s desk.

Researchers using data from the state Department of Public Health found that 160,000 children 1 and 2 years old who needed testing never received it. That’s a 34 percent failure rate, the study says.

“Our most vulnerable kids, the ones that are the most lead-poisoned, are not getting tested,” said Susan Little, who led the study for the Environmental Working Group, an advocacy organization that crossed the state’s testing reports with census figures. “The state is failing its mandate.”

The Department of Public Health oversees the Lead Poisoning and Prevention Program and typically contracts with counties to run testing, educational and prevention programs. The data used for the study are from 2013, the latest the state has.

A department spokesman did not answer questions about the study, saying officials needed more time to review and respond to them.

The study estimates that San Luis Obispo County is failing to test 64 percent of its at-risk 1- and 2-year-olds.

“We take lead poisoning prevention seriously and are looking into this report,” said a statement from the county’s Department of Public Health. “We have concerns about the methodology as it relates to S.L.O. County.”

Several other counties were contacted for comment but did not respond.

Lead is a neurotoxin that can cause brain damage and developmental and learning disabilities. The federal Centers for Disease Control has determined there is no safe level of the metal in the body. The issue has been the subject of headlines since the Flint, Michigan, water crisis was revealed in 2015. Reports last year by Reuters identified dozens of “hot” zip codes in California—areas where large numbers of children tested positive for lead—shown by 2012 data.

The state defines children most at risk for lead poisoning as those on Medi-Cal, California’s healthcare system for the needy, and other public assistance programs.  Youngsters in lower-income families potentially have higher exposure to old homes with chipped and peeling lead paint or may be most likely to live in areas with lead contamination in the soil or water.

The state and federal governments require that these toddlers be tested when they are 12 and 24 months old. In 2013, an estimated 469,000 children statewide were supposed to be tested, according to the study.

Almost all California counties failed to meet the mandate, the study found. Only one, San Francisco, showed that it tested more children than required. Mendocino County ranked worst, failing to test 87 percent of required children.

More than half of the target children in 16 counties were not tested, and in larger counties like Los Angeles, Fresno and Santa Barbara 30 percent to 48 percent went untested.

“It’s the department’s responsibility to ensure the counties are carrying out the contract and the goals,” Little said. “They haven’t been doing that; it’s a historic problem.

Her group, a Washington, D.C.-based nonprofit with offices in California, focuses on health and environmental issues and has tracked lead testing for nearly two decades.

Gov. Jerry Brown has until mid-October to decide whether the state should expand its guidelines for identifying children to be tested. That’s one requirement of a bill on his desk that passed both houses of the Legislature unanimously. A second provision would require the Department of Public Health to analyze data by community to identify hot spots.

Democratic Assemblyman Bill Quirk of Hayward said his bill could help all children. Image courtesy of Assembly Democratic Caucus

Democratic Assemblyman Bill Quirk of Hayward has a bill intended to increases lead testing. Image courtesy of Assembly Democratic Caucus

The bill’s author, Assemblyman Bill Quirk, a Democrat from Hayward, said he’s encouraged by the new report, “as it keeps a focus on the state’s efficacy of implementing the Childhood Lead Poisoning Prevention Program” and identifies needs for improvement.

His proposal would direct the public health department to revise its screening rules to help doctors decide which children they should test. Quirk said more information about the homes where kids live and play, where else they spend time and other indicators of possible lead exposure would help all children, not just those on Medi-Cal.

The problem is not a new one. In 1999 and in a 2001 follow-up, the State Auditor’s office found inadequate tracking of testing and results. The auditor said the state had “not ensured that all at-risk children (were) tested, nor tracked the results of testing to determine the extent of the problem lead poisoning presents to the state.”

That review came a decade after environmental advocates sued the state in 1990 for failing to adhere to the federal testing law. The state settled the case and agreed to test all young children on Medi-Cal. Typical follow-up may include home visits to help families remove or keep children away from lead sources.

State and county authorities are not adequately educating doctors and parents about the need for lead testing, said Grace Galligher, directing attorney for the California Welfare Rights Organizations in Sacramento. If doctors don’t know which children to test and parents are unaware of the need for testing, the message is lost, she said:

“There is a gap, a big gap.”

In Oakland, Stephanie Hayden, co-founder of the urban-issues group SmartOakland, was not surprised by the study’s findings. She said the Quirk bill is a great first step for putting teeth into the testing program but more needs to be done to prevent lead exposure in the first place and to create systems of accountability where the toxin is present.

“If you can’t find it,” she said, “you can’t actually get rid of it.”

SmartOakland has kicked off a “Get the lead out” campaign for families with children. It will test 100 homes in a known local hot spot and work with families to reduce exposure.

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