He loves to sing, but it's hard for him to pay attention.
Learning basic skills, such as potty training, is an arduous process.
These challenges are just some of the side effects of lead poisoning that Kyle copes with daily.
To his mother, Kathy Leonard, Kyle is an energetic symbol of strength. He's a fighter.
But every morning his mom struggles to keep him calm, and on Kyle's worst days she admits it can be hard not to cry.
"He really is a good boy, and he's very loving," she said, as Kyle lunged toward the coffee table. "It can be very hard sometimes. I try to tell myself that we're taking each day at a time. Getting by together."
Kyle's family isn't alone in the struggle against lead. Recent state and nonprofit studies suggest that thousands of children and adults in Mercer County are at risk of lead poisoning, but it's likely that many are unaware .
In Kyle's case, his mother learned he suffered from lead poisoning when he was rushed to the hospital at age 2. His blood level for lead came back at 66 micrograms per deciliter - more than six times the safety standard.
It's a tiny amount roughly equivalent to a small spoonful of dust in a half-cup of water, but powerful enough that doctors warned it could result in a coma or death.
Children under 6 who are exposed to hazardous amounts of lead are at risk for permanent neurological damage, behavior disorders, seizures and death, according to the federal Agency for Toxic Substances and Disease Registry.
The federal government identifies elevated lead levels in the blood as being 10 micrograms per deciliter or more. Researchers say damage can begin at much lower levels.
When Kyle was rushed to the emergency room two years ago, Kathy Leonard said she remembers sitting by his hospital bed praying for him to stay alive - to be OK. All the while, she had no clue how this happened to her son.
"When I bought this house, I had no idea lead was inside. I was shocked when the doctor came back and said that's what it was. I sat there wondering how in the world could this have happened to him," said Leonard during a recent interview at her brick, single-family home on Genesee Street.
Leonard didn't realize the connection between lead and her home until it was too late.
She thought it was odd when Kyle started licking the walls when he was a 1-year-old.
"After he was tested the doctor told me that lead tastes sweet," she said. "It made sense then."
She knew his hyperactivity wasn't normal, and the mood swings went wild after Kyle would come back from playing outside.
"I then realized there was a problem, and not just in our house, but also in the soil in the backyard," she said. "I had no idea. And now, how do I tell a young, active boy that he can't play outside?"
Even though she knew the urgency of the problem, though, she had to overcome her fear of what she could do to house her family.
Once notified about his lead levels by the hospital, Leonard was told that she could not re-enter the property until it was completely abated - a process that took six months and nearly $10,000.
"I didn't really have anywhere to go; we never planned on leaving home and finding somewhere to live, just like that," she said, snapping her fingers.
Thankfully, Leonard - a waitress - and her two children were able to stay with a friend. They have since moved back to their "lead-safe" home.
Once a month, Kyle goes back to the doctor to have his blood levels checked.
While it's much improved over earlier readings, Kyle's blood lead levels still fluctuate between 20 micrograms per deciliter and 11 micrograms per deciliter.
His mother already knows he will need speech therapy and other services, but right now she said it's too soon to think about anything but today.
"I try to stay hopeful that as he grows older, he'll be fine," she said. "That he'll be just like any other boy."
But in the back of her mind, she must accept that her giggling, wide-eyed boy may never be on the same playing field as his peers.
Kyle's exposure to lead has since developed into behavioral and learning disorders.
Saying no to juice can result in a temper tantrum with Kyle throwing himself to the ground or stomping upstairs to scream at the top of his lungs behind a slammed bedroom door.
He loves affection and hugs, but sometimes when he gets frustrated, he bites himself.
It's not that he's a bad boy, Kathy Leonard said, it's just that he sometimes finds it difficult to express himself.
At the Noah's Ark Daycare Center in Trenton, Kyle plays well with others. He shares his toys and does a good job listening to his teachers.
Forming sentences is getting easier for him, but looking toward Kyle's adolescence, his mother wonders what his future holds.
"Will more permanent damage show up as he grows older? I don't know," said Leonard, fighting back tears. "It is scary, and he's already been through a lot."
A preventable - but very costly - health problem
Making a home safe from the threat can cost thousands
Published December 14, 2008 in The Times (Trenton, NJ) By Lisa Rich and Andrew Kitchenman
Although the statistics are sobering, experts agree lead exposure and poisoning are preventable problems that should be a matter of concern rather than panic.
The solutions, however, will likely be costly.
Just ask Shannell Wimbush.
The Trenton woman had to move her three children out of their home on Hoffman Street so it could be stripped down and made "lead safe" - an effort that took months and cost more than $64,000.
"We have three loans right now and a lien on the house," Wimbush said. "Everything had to be replaced: the roofing, the doors, the walls, the electric system. It took a long time to get it done."
Wimbush also had complaints about the work, calling the contractors back to her house several times to finish jobs left undone.
It's going to take a concerted effort to reduce the lingering threat of lead poisoning, including more tests done on homes and additional funding to abate the homes for families who can't afford to do so on their own, according to Isles, a nonprofit housing and community advocacy group .
Testing a home for lead costs less than $200.
Isles estimates the cost of cleaning up a property at roughly $10,000, though some homes require more than $60,000 in work, depending on the size and condition of the house.
The crucial parts of a house that require abatement are the windows and doors.
Old windows and doors rub against layers of paint, increasing the possibility that leaded paint chips and dust will be spread throughout a house. Children are frequently exposed when they put their hands on dust and then into their mouths.
Dust can travel to the floors where young children often play or crawl, and onto toys that youngsters sometimes put in their mouths.
The cost of testing and abating a home raises another concern among Isles officials: getting property owners to agree to have their homes tested is not always easy.
The state Department of Community Affairs provides money for home lead testing as part of a program that aims to eliminate all lead hazards from New Jersey homes by 2010.
In addition, the state-funded Lead Hazard Control Assistance (LHCA) program provides up to $10,000 in either a loan or a grant for residents to fix their homes.
But, "it was very difficult to get the money on the streets," said Isles founder and president Martin Johnson.
Residents are discouraged from applying for the LHCA funding by a 20-page application that can be intimidating, said Elizabeth Johnson, chief operating officer of Isles, who runs the group with her husband, Martin.
"People are not inclined to want to go through that complicated process," she said.
Some landlords also prefer not to have testing done because they're afraid of the cost if a lead problem does exist, said Martin Johnson.
In addition, low-income families pressed to pay for more immediate needs like food can find it difficult to take the time and money to test their homes.
Elizabeth Johnson said statewide requirements are needed in order to achieve the necessary amount of home testing.
"If I'm really tough on landlords in my city, they're going to go somewhere else," she said.
State lacks data on blood tests for two Mercer communities
Published December 14, 2008 in The Times (Trenton, NJ)
By Andrew Kitchenman and Lisa Rich
TRENTON - Every year since 1996, the state has compiled a report with results of tests of children's blood-lead levels as part of its effort to eliminate childhood lead poisoning.
But parsing those results on a town-by-town basis for Mercer County is not as straightforward as it might seem. In fact, the state has virtually no data for Hightstown and Pennington.
Children are prescribed blood-lead tests by their doctors and then the laboratories that analyze the test results send the information to the state. The state Department of Health and Senior Services alerts local health departments about children with elevated lead levels .
The state also tracks how local health departments respond to the alerts. The state collects the data and uses the information to analyze statewide trends, as well as trends in municipalities with more than 35,000 residents.
The percentage of children between 6 months and 2 1/2 years old who have been tested has increased from 30 percent in 2000 to 46 percent in 2006, according to the latest report.
The state only includes information on larger towns in its annual report. In response to a request from The Times, state officials provided results for every town in Mercer County.
However, there were no test results for Hightstown and Pennington. In the previous three years, there was a total of one test result for Hightstown and none for Pennington.
State Department of Health spokeswoman Marilyn Riley said that does not mean that no children were tested from the two towns.
She said some children from the two towns may have had parents who provided a post office box when they had the lead tests done. This would lead to their children's results being included in the statewide totals but not in an individual town's totals.
State health officials also plan to take another look over the next few weeks at the East Windsor and Hopewell Township results to see if the Hightstown and Pennington children were included in those towns' totals.
Riley emphasized the importance of doctors testing all young children for lead in every town in the state .
Silent danger stalks kids
Lack of testing results in overlooked lead poisoning
Second in a three-part series
Published December 15, 2008 in The Times (Trenton, NJ)
By Lisa Rich and Andrew Kitchenman
Photo credit: Martin Griff/The Times
TRENTON -- When the doctor told her that her baby had asthma, Shannell Wimbush was not convinced.
She knew there was something wrong with little Maurice, but with all the instincts of a mother, she was sure it was more than asthma.
His eyes would roll back in his head, then he would struggle for breath. He didn't want to eat. He would become irritable and anxious.
Trips to the hospital became common.
Turns out, her boy didn't have asthma after all.
"It wasn't until I took Maurice for regular blood work that we were told his levels of lead were high," Shannell said in a recent interview at her home on Hoffman Avenue. "In all those hospital trips, he was never tested for lead poisoning. Not once."
By the time Maurice did get tested at age 4, the level of lead in his blood was 46 micrograms per deciliter - more than four times the federal standard and a level that often leads to permanent neurological damage and other disorders.
Now age 7, Maurice wrestles with the ailment .
"People look at him sometimes like there's something wrong, but really, he was misdiagnosed from the beginning," Shannell Wimbush said. "He does OK in school. His grades have been sluggish. But it's his behavior that is the worst."
The problems Shannell Wimbush and her son confront illustrate the difficulties and the dangers of lead poisoning.
Although the effects are devastating and long-lasting, children are not routinely screened for lead exposure and parents are in the dark about what precautions to take.
Then, when children affected by lead exposure get to school, they might need more attention than their peers.
Experts are increasingly looking to lead exposure as a potential reason for behavioral problems, learning difficulties and violence.
The lack of testing persists despite evidence that children who live in housing that predates World War II, especially those who live in dwellings considered substandard, face a heightened threat of lead poisoning.
That makes New Jersey's urban areas and older suburbs particularly vulnerable.
Up to 50 percent of the city of Trenton's 33,000 housing units are believed to have elevated levels of lead, with the number rising to 95 percent of the housing considered substandard in the city, according to Isles Inc., a community group that has conducted lead tests in city homes since the late '90s.
Although the problem is not as acute in the rest of Mercer County, Isles believes lead is a hidden danger that is prevalent in both urban and suburban communities.
Data provided by the state indicate nearly every Mercer County town has children who have tested positive for elevated levels of lead in their blood. In Trenton alone, 18 percent of the 3,450 children tested last year had elevated levels.
Lead, a heavy metal, was used in the manufacture of paint and batteries and as a binding agent in industrial products until prohibitions against its use were enacted in New Jersey in 1971 and nationally in 1978.
However, lead lingers in flaking paint, window sills, water pipe coverings and soil samples.
SCREENINGS NOT ENFORCED
Health experts agree exposure to lead is most devastating to children under age 6, but say that access to blood screening and awareness of the need is spotty.
A 1996 state law requires parents or guardians to test their children for lead at age 1 and 2.
But that requirement is hardly enforced by the state, with no penalties given to those who do not test their children, according to a 2005 report authored by Robin Dahlberg, an attorney with the American Civil Liberties Union.
Only 73 percent of New Jersey children had been tested before turning 3 years old, although 97 percent had been tested before turning 6, according to a 2006 state report.
The lead problem is exacerbated by parents who are unaware of the law, and by doctors who don't test for lead poisoning because they don't consider it to be a problem or who do not have the staff to carry out the procedures, the report indicates.
Even if a child is tested at ages 1 and 2, the permanent effects of lead poisoning can linger in children up to age 6 - a year after they typically enter the public school system.
State law does not call for school districts to test children for lead poisoning, or to track and monitor the students who have tested positive in the past.
A bill that would mandate lead screenings of children before starting school has been stalled in the Legislature since November 2007.
Sponsored by Sens. Joseph Vitale, D-Middlesex, and Ronald Rice, D-Newark, the proposed legislation would require school districts to send lead test results to the state Department of Health and Senior Services.
That agency would then have to compile the data and submit recommendations to the Legislature and governor on how to remedy the problem.
"I don't know if this legislation will end up moving forward," Vitale said. "There are other factors, such as cost - who's going to pay for these tests?"
Testing for lead is simple and involves a blood sample taken from a child's finger or arm. The cost for a test ranges from $10 to $75, depending on the health care provider.
Before entering school, state requirements mandate physical examinations for pre-K, kindergarten and new students.
The forms for the physicals - to be filled out by a doctor - include a space for lead testing results but compliance is not uniform, said Margaret Dooley, supervisor of nurses for the Trenton schools.
"Physicians are required to order lead testing on their patients," Dooley wrote in an e-mail. "Sometimes the results are not recorded on the physical form."
Dooley added the school district does not collect data on the students with known elevated blood levels.
In light of the attention recently paid to lead poisoning, the state Department of Education has started collecting information on lead testing from individual student health records for the first time ever, said spokesman Rich Vespucci.
"The Public Advocate's Office requested our assistance in identifying students in school who are lead-burdened," Vespucci said. "We revised our forms to collect lead testing information in response to that request."
Although not all children are tested for lead, there are avenues to obtain the service.
In 2007, 3,450 Trenton children were screened for lead poisoning through private and public testing. That figure represented 47 percent of the estimated 7,300 children younger than 6 who live in the city.
Of the total number screened, 460 were uninsured children screened at the city health clinics.
Leann Howell, Isles' program manager for environment and community health, said screening children early on is essential, and hopes one day to see blood tests for all children 6 years old and younger be required on an annual basis.
"On average, the school district sees a 40 percent mobility rate among its students," Howell said, meaning that each year, roughly 4,800 Trenton pupils move to a different home in the city. "So these are children who could be exposed one year, whereas they weren't the year before."
A SILENT ILLNESS
One of the biggest hurdles in addressing lead poisoning is getting the right diagnosis.
"Usually lead poisoning is silent," said Dr. David C. Bellinger of Boston Children's Hospital and the Harvard Medical School.
"In the old days, children would come in with seizures, changes in consciousness, terrible things like that," he said. "Now, it's very easy - unless you actually test for lead - to overlook a child with lead poisoning."
Fewer children suffer from extreme signs of lead poisoning - as in seizures and coma - because lead itself is not as prevalent as it was decades ago, Bellinger said.
However, that has also created a false sense of security that lead is no longer a threat, he said.
Now, many of the symptoms of lead poisoning are general, or are similar to other ailments and disorders, said Dr. Herbert Needleman, a professor of psychiatry and pediatrics at the University of Pittsburgh School of Medicine.
"The symptoms are vague, and usually overlooked," agreed Needleman, who has received 12 awards since the 1970s for his extensive studies and research regarding lead poisoning and children.
"Particularly at the lower levels, a child does not broadcast signs of lead poisoning, despite studies that show their IQ can be depressed from little exposure," he said.
Howell, Isles' program manager for environment and community health, said she is still learning about the effects of lead poisoning 11 years after her son was exposed.
Not only is the public ill-informed about lead, Howell said, so are doctors.
"I've talked to parents in New Jersey whose doctor has said, 'Your child had lead poisoning, but we've made it all better,'" Howell said.
In reality, most experts agree that once a child has lead poisoning, there is no "cure."
The only remedy is a painful process known as chelation, which extracts lead from a child's system. Even so, the neurological damage has already been done.
Lead testing could become easier in the future, Howell said, if a saliva test is proved to be as effective as the blood lead tests.
LONG-TERM EFFECTS
Testing for lead might still be a murky area, but the consequences of exposure are alarmingly clear.
Early in his career, Needleman conducted a study at Harvard Medical School that indicated low lead levels - meaning 10 or fewer micrograms per deciliter - can affect a child's IQ.
In that study, he provided evidence that showed low lead exposure not only reduces intelligence, but can also shorten attention spans and delay language proficiency.
In his later research, Needleman found that lead poisoning has long-term effects on a child's behavior, attentiveness and academic success.
But lead poisoning doesn't just hinder a child's ability to learn, Needleman said.
He believes exposure to lead - even at low levels - can affect a person's behavior throughout his lifetime.
"I treated lead-poisoned children, and frequently, mothers complained that after recovery, their child was difficult to manage, violent or wouldn't pay attention," said Needleman, founder of the Alliance to End Childhood Lead Poisoning, now known as the Alliance for Healthy Homes.
"You hear that a few times," he said, "and you start wondering what's really going on."
After multiple studies, including a long-term analysis of 300 students in the Pittsburgh region, Needleman found that teenage boys with elevated lead levels were more likely to have committed antisocial acts like bullying, vandalism, arson and shoplifting.
He also studied children in first and second grades, and analyzed the lead levels that had seeped into their bones.
"The higher the level of lead, the more frequent the occurrence of delinquencies and behavioral disturbances," he said. "Lead definitely changes a child's behavior."
Shannell Wimbush, however, doesn't need a doctor to tell her that.
She spends much of her time trying to keep her son calm, and focuses his energy on productive activities such as football and track.
Maurice hates to sit still.
The brown-eyed youngster with a charming smile squirms on the floor in circles while watching television.
At home, you can find him dangling from the staircase banister, playing on top of furniture or dashing through rooms while screeching in fits of joy, and sometimes rage.
"He's a really fast runner. He just loves it," Shannell Wimbush said as an exhausted Maurice finally stopped running to rest, then nestled into her lap.
"I think being active does help because he doesn't always know how to process the emotions he's feeling," she said, stroking his head. "Running around seems to help him let go of his stress ."
Schools get the lead out Testing finds numerous locations of tainted water in buildings
Published December 15, 2008 in The Times (Trenton, NJ) By Lisa Rich and Andrew Kitchenman
TRENTON - The city school district is waging its own fight against lead.
The district recently discovered more than 50 water sources throughout several school buildings are contaminated with the toxic metal, and it's unclear where officials will get the funding to remediate the problem.
Fewer than half of the district's schools have been tested but the remaining buildings are scheduled to be sampled soon for elevated lead levels .
Although not all schools have been tested, district officials said they're confident students are safe.
For the first time, the district earlier this year tested for lead in various water sources - such as drinking fountains - with funding from the state Department of Environmental Protection.
The schools tested were Columbus, Grant, Gregory, Franklin, Monument, Parker, P.J. Hill, Robbins, Washington and Wilson.
The acceptable standard for lead in water is 20 parts per billion, the same as one droplet in 25 barrels of water.
According to the data, eight of the 10 elementary schools tested have at least one or more elevated lead levels in a water source - some as high as 220 parts per billion such as Washington Elementary School, and others as low as 22 parts per billion such as Columbus Elementary School.
Parker and Franklin schools both received a clean bill of health.
The contaminated water sources have been shut down, and are no longer accessible to students, said Everett Collins, the district's director of buildings and grounds.
Collins said they only tested water sources that students drink from, so the water coming out of faucets in the bathrooms was not sampled.
School officials maintain the lead problem is isolated, meaning students are not at risk as long as they don't drink from the contaminated fountains.
"We certainly have concerns, but all of the concerns are local," Collins said. "None are widespread."
The district has already determined the source of the lead.
In most cases, contamination came from the actual fixtures - meaning the faucets or water fountains. In other instances, Collins said, the contamination came from an aerator, which is the device screwed into the end of a faucet spout that mixes air into flowing water.
The district is already in the process of replacing the contaminated fixtures and expects to finish by January.
So far, funding for the remediation effort has come from rearrangements made in the general budget. However, it's unclear how the district will pay for future remediation, Collins said.
When asked why the district only tested 10 out of the 25 school buildings and annexes, Collins said it's a matter of funding.
"Certainly we'd like to test all the schools, and we plan to," Collins said. "We tested the elementary schools first because children are more susceptible to lead at a younger age."
Health experts agree exposure to lead is more devastating to children under age 6, in which poisoning can result in permanent learning and behavioral problems, seizures, coma and death.
The district still has 15 schools in need of testing, with half considered outdated or in need of repair for other reasons.
The district will have to cough up funds for tests at the remaining schools. Lead tests cost roughly $75 each, Collins said, and water sources are tested multiple times - meaning one school alone could cost a few thousand dollars.
During the holiday break later this month, the district plans to re-test the facilities where contaminated fixtures have been replaced.
At that time, the district will also begin sampling water sources in the remaining schools with its own funding and assistance from the Environmental Protection Agency.
"And if those schools come back with elevated levels, we'll have to test those sites multiple times," Collins said. "It all comes down to the almighty dollar."
Testing the remaining sites and remediating the affected schools is expected to cost tens of thousands of dollars, Collins said.
Larger school districts face even bigger bills for lead testing. One example is the Seattle public school district.
Seattle is broken into seven districts that enroll more than 45,000 students in nearly 100 buildings. When several buildings tested positive for lead in 2004, the district estimated it would cost $500,000 to test all of its facilities. Remediation was projected at $13 million.
"That is a concern," Collins said of the cost. "The issue of lead contamination will have to be fixed in the places where lead is present. That will come at a cost."
Trenton is already strapped for cash.
Superintendent Rodney Lofton said it's important for the district to understand the extent of any lead problems in city schools.
"The whole purpose of testing the schools was to be proactive," Lofton said. "We want to figure out what kind of problem we're dealing with."
Hunting down lead
Cities fight to rid homes of silent poison
Third in a 3-part series
Published December 16, 2008 in The Times (Trenton, NJ) By Andrew Kitchenman and Lisa Rich
Ralph Spezio knew in 1999 that something was wrong with the health of the children in the Rochester, N.Y., elementary school where he was principal.
Some children would fly into rages without first showing annoyance. Other children would have no memory of lessons taught an hour earlier.
While some came from troubled homes, most had loving families, Spezio said.
Then he heard a school nurse and a neighborhood nurse exchange information about a child: "Whoa, another high lead."
Spezio didn't know anything about lead poisoning at the time.
But after he began to learn about the matter, he reached a unique confidential agreement with children's doctors that allowed him to review their health records.
Forty-one percent of the children in his school had blood-lead levels that have been linked to brain damage and are increasingly implicated in a variety of behavioral problems.
Spezio warned community leaders that lead is "an invisible and silent monster that is devouring our children."
He helped found a coalition in Rochester and has worked to remove lead from the environment, especially from dust in children's homes.
In Rochester, that effort led to a 2006 city law that increased the number of homes tested for lead, as well as the funds available to reduce lead in homes with high levels of the toxic metal.
Two years later, more than 3,400 Rochester homes have been - or will soon be - made "lead safe," according to a report by the Rochester-based Center for Governmental Research (CGR). In addition, the number of children diagnosed with elevated blood lead levels has dropped from 604 in 2004-2005 to 284.
Lead abatement experts consider Rochester's approach to be a success. The example has served as inspiration across New York and is being studied by others in New Jersey and elsewhere.
Rochester and other cities with success fighting lead abatement have increased the number of lead inspectors, focused on the highest-risk neighborhoods, held landlords accountable for high lead levels and built partnerships between the government and nonprofits.
A CLOSER LOOK AT HOME
New Jersey officials are seeking similar success, aiming to take abatement to another level.
The state Department of Community Affairs (DCA) is in the midst of doing visual inspections of 850,000 apartments over a five-year period.
In Trenton, the nonprofit Isles Inc. has compiled the results of chemical testing of dust in 885 city homes.
Of those homes, about 42 percent exceed the standard for elevated levels set by the federal Environmental Protection Agency and 60 percent are higher than the standard set by the National Center for Healthy Homes, which some researchers say is more appropriate.
The state Public Advocate's Office released a report in April urging that efforts be stepped up to reduce lead poisoning.
In the wake of the report, various state agencies and local governments have taken a series of steps to reduce the threat of lead.
For example, Trenton plans to reach an agreement with the public advocate to increase home testing. However, lead-safety experts and advocates have been calling for a comprehensive approach that will reduce the lead risk throughout the state.
While lead paint was banned in the 1970s, researchers are finding that the legacy from the toxic substance remains more than three decades later. Lead poisoning can lead to irreversible and lifelong brain damage to children, and a variety of other ailments in adults including cardiovascular disease.
A NEW APPROACH
Joan Roby-Davison, an activist in Rochester, said the city council there faced opposition from landlords and real-estate investors who said they would not keep properties that were too expensive to test for lead.
But the political will grew strong enough for officials to take action in 2006.
"It does take a level of courage, and we have that here in Rochester," Spezio said. "The only way to kill this monster is to educate people."
Since adopting the ordinance, Rochester has dedicated six members of its inspections department to lead testing. The results have been encouraging.
Landlords generally have been making repairs to their properties rather than abandoning them, city officials said. The costs also have been lower than expected, with the cost of improvements running less than $5,000 per property, according to the CGR report.
"We've seen no abandonment," said Roby-Davison, who now serves as the coordinator for the Empire State Housing Alliance.
While the cost of making repairs such as replacing windows is borne by the property owner, grants from the city, Monroe County, N.Y., and a private nonprofit have eased the expense.
Roby-Davison credits Spezio, as well as lead poisoning research in Rochester, for the effort.
In addition to requiring property owners to do lead testing to have a certificate of occupancy, Rochester residents can ask the city to test for lead.
"It's unconscionable that in 2008, it's not fixed already," Roby-Davison said.
Rochester's lead abatement program costs $1.2 million per year, including $450,000 for lead testing that is contracted to private inspectors.
A MODEL CITY APPROACH
Just as activists from Rochester have been seeking to expand its program beyond that city, New Jersey is planning to use different cities' approaches to lead as statewide models.
Under New Jersey's model city program, cities are signing up with the state Public Advocate's Office to take steps to reduce lead.
Camden has passed an ordinance requiring all houses built before 1978 - the year lead was banned from paint - to have a full lead inspection and risk assessment before residents move in or tenants change. Irvington is working on a similar ordinance for pre-1960 apartment buildings.
Iraida Afanador, the head of Camden's code-enforcement department, said a federal grant may cover the cost of the program. She credited the DCA with providing free lead training for inspectors.
Community organizations like Isles are hoping that state funds will allow similar programs to be expanded to all high-risk areas.
Several efforts do not require additional funding, noted Laurie Facciarossa Brewer, a spokeswoman for the Public Advocate's Office.
These include the training of building inspectors by the DCA, state assistance in applying for federal lead-abatement grants and a new mapping program for lead exposure levels developed by the University of Medicine and Dentistry of New Jersey.
Trenton Mayor Douglas H. Palmer said he plans to reach a model city agreement with the Public Advocate's Office and will consider ordinances similar to those pursued by Camden and Irvington.
He also plans to add a city lead inspector dedicated to addressing the issue, funded by a grant or through the city budget.
"I just think this issue is so important," Palmer said.
The city has been working to reduce the lead threat for more than a decade, Palmer said.
But Palmer said he's also frustrated the federal government hasn't put more funding into the lead remediation, saying the city was turned down two years ago for a federal grant.
City director of Health and Human Services Carolyn Lewis-Spruill said Trenton reaches out to parents through a variety of means, including health clinics and a city health van.
"We've tried to make the parents aware that their children need to be tested for lead," Lewis-Spruill said. She noted that undocumented residents without Social Security numbers can't participate in the city's family health care.
While suburban areas have fewer cases of lead poisoning than cities do, it appears all municipalities in Mercer County have children with elevated blood-lead levels.
Princeton Borough is third in the county in the percentage of children with 5 to 10 micrograms of lead per deciliter of blood - a level researchers say is harmful, but doesn't require further government action or testing.
Princeton Health Department Officer Dave Henry said his department is seeking more ways to increase the screening levels of Princeton residents by working with the University Medical Center at Princeton, and by reaching out to local pediatricians.
"We do take the prevalence of lead poisoning as a high priority," Henry said.
Health officials from Princeton, as well as Ewing and Lawrence among others, recently participated in a lead-poisoning training session with the state Department of Health and Senior Services, Henry said.
Many local activists and national researchers are exploring how to address lead exposure, and some are raising questions over the standard used by the federal government to determine "elevated" lead levels.
Since 1991, the federal standard has been 10 micrograms per deciliter, but lead expert Dr. Bruce Lanphear of Simon Fraser University in British Columbia is among those who contend the level should be lowered to 5 micrograms per deciliter.
The state health department is in the process of moving New Jersey's standard to 10 micrograms per deciliter, matching the national standard, with the rules expected to take effect in the late summer or early fall of next year. The state's current standard is not as strict as the federal rules.
State Department of Health and Senior Services spokeswoman Donna Leusner said the state would consider lowering the level needed for an environmental investigation below 10 if the evidence is there.
EXPERTS CONCERNED
Scientists and doctors who have studied lead poisoning say stronger steps are needed to tackle lead poisoning.
Lead expert Dr. David C. Bellinger said once someone has lead poisoning, the effects are lifelong. Drug therapies can't reverse long-term effects on children's ability to learn, he said.
"It's too late once exposure has occurred," said Bellinger of Harvard Medical School. "The key thing is primary prevention."
New Jersey and other states face a complicated set of issues to address lead exposure, said Deborah Cory-Slechta, a professor of environmental medicine at the University of Rochester.
"You've got a huge economic cost to undo this problem," said Cory-Slechta, the former director of Rutgers University's Environmental and Occupational Health Sciences Institute. "I know that the state of New Jersey has its own huge budget problem."
It's important, she said, to make it easier for low-income families to apply for lead abatement, saying residents aren't aware of the danger posed by lead and have other priorities that prevent them from focusing on lead exposure.
Pregnant women also should test their homes, she said.
"I'm all for that, because prevention is the only thing," Cory-Slechta said. "I think you have to go beyond these kids. You need to do this before kids are born."
In a study of lab animals, she found that relatively low blood-lead levels cause more permanent harm when they are combined with stressful experience.
"If you add stress to a low level, you can make something worse than it is with just lead alone," Cory-Slechta said.
The study also pointed to a possible cause of why lead is linked to such a wide variety of health problems. By affecting the body's response to stress, lead can increase hypertension and cardiovascular disease, she said.
"Once there's a stress response, the body then goes to shut down the stress response," she said, adding that when lead poisoning is involved, that stress response may continue too long. "You don't want that to be operating all the time."
Reducing lead hazards indeed comes at a cost, but the benefits far outweigh the dollar amount, said Martin Johnson, founder and president of Isles.
To put it simply, he asks, "What's it going to cost to address this challenge, versus what's it cost to not address this challenge?
