Good morning. First, I’d like to express my dismay at the fact that, despite repeated requests from the minority, the Centers for Disease Control was not invited to testify. The National Center for Environmental Health, within the CDC, is the lead agency regarding childhood lead exposure, and their testimony would certainly have been germane. In preparation for this hearing, I sent the Director of the Center a letter with several questions about their work and would like to enter their response in the record.
Generally speaking, addressing lead exposure is one of the great American success stories. According to data from the CDC and others, the median concentration of lead in the blood of children 5 years old and under has declined 89% since the period of 1976-1980, to 1.6 micrograms per deciliter in 2003-2004. Despite our success, the CDC has found that “there are some populations and geographic areas that have disproportionately high risk of childhood lead poisoning.” To get at this problem, the Department of Health and Human Services has established an ambitious goal of eliminating elevated blood lead levels in children by 2010. I recognize this problem first hand due to my involvement in the Tar Creek Superfund Site where the blood lead levels in children are the highest in the state. Although these levels have been decreasing, there is much more work left to do.
According to the CDC, the two major remaining exposure pathways for children are lead in housing and non-essential uses of lead in other products, such as toys, jewelry, etc.
Regarding the toy issue, having 20 kids and grandkids myself, I am troubled by the recent toy recalls due to the presence of lead paint. It is a reminder to everyone who does business outside of the United States to be vigilant about product quality because other countries do not share the same environmental and public health ideals that we do. I have some studies here to enter into the record regarding lead in household paint manufactured outside of the US . As for Mattel, the company has already testified twice on the toy recalls, before the House Energy and Commerce Committee and the Senate Appropriations Committee. Mattel’s absence today should not be portrayed as an unwillingness to participate in the public dialogue on this issue.
I don’t want the toy issue, however, to make us lose focus. According to the CDC, paint, paint dust, and paint-contaminated soil account for more than 70% of exposure. Additionally, it is estimated that 24 million housing units have deteriorating paint and contaminated house dust. It has been shown that poorer children living in older housing units are disproportionately at risk for elevated blood lead levels. With extensive assistance from state and local agencies, CDC has identified housing, down to the apartment number in many cases, where multiple children with high blood lead levels have been identified. These “repeat offender” properties should be our greatest target. Without objection, I would like to enter into the record a study that appeared in Public Health Management Practice that developed a method for identifying and prioritizing “high risk” buildings that could be pursued for lead poisoning prevention activities. I appreciate the National Center for Healthy Housing and the National Association of Home Builders joining us today to discuss their efforts to address residential lead paint.
The Centers for Disease Control has established a national level of concern for children whose blood lead levels are more than 10 micrograms per deciliter. This is the level at which public health action is recommended. Compelling studies done by one of our witnesses, Dr. Lanphear, have shown adverse developmental and behavioral effects at blood lead levels below this number. Thus, there is an interest in lowering the national level of concern below 10 micrograms per deciliter.
My concern with this approach is that efforts to identify and provide services to children at levels below 10 will deflect needed resources from children who we already know have blood lead levels above 10 and are the greatest risk from exposure. Resources are scarce at all levels of government and I believe the biggest bang for our buck comes from directing our resources at those housing units and neighborhoods where there is documented chronic lead exposure and a revolving door of kids with lead poisoning. I’m also concerned that CDC has not identified any “effective clinical or public health interventions that reliably and consistently lower blood lead levels that already are below 10 micrograms per deciliter.”
Lead poisoning is a preventable disease, and we should focus our efforts on reducing or eliminating exposures before they happen. That will benefit all children, regardless of their current blood lead level. I look forward to hearing from the witnesses.