Philadelphia Medicine Fall/Winter 2019 - 22

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Feature

Philadelphia
Makes Strides
Against Lead
Poisoning
By: Marilyn V. Howarth, MD, FACOEM

2019 has been a tremendously impactful year in the fight to protect
Philadelphia children from lead poisoning. Last month, historic steps
were taken in City Council to protect against lead poisoning with the
unanimous passing of a bill requiring landlords to obtain lead-safe
certifications for all their rental properties. This bill, an expansion of
a 2011 bill that required lead safe certification only when renting to
families with children under six, is a major milestone.
Considering that every year 1200 Philadelphia children have a newly
identified elevated blood lead level and 65% of them live in rental
housing, this ordinance is expected to protect hundreds of children in
Philadelphia from lead exposure in their homes and those they visit.
Physicians joined a broad community effort known as the Lead-Free
Philly Coalition to add their medical and scientific expertise to inform
the legislative conversation.
Even though the national rate of lead poisoning has been decreasing
since the federal ban on lead paint in 1978, children in Philadelphia are
diagnosed with lead poisoning at a rate more than double the national
average. The primary source of lead exposure for children is peeling
lead paint. However, even in a home with no overt peeling paint, lead
dust created from opening and closing windows and doors can result
in elevated lead levels in children living there. More than 90% of the
housing in Philadelphia continues to have lead paint.
Even when covered by multiple layers of latex paint, there remains
a risk. Even the smallest exposure to lead destroys brain cells and when
repeated small exposures take place they put children at risk for irreversible
neurological damage leading to cognitive and behavioralproblems. Physicians recognize that we have no effective treatment to protect children
from, or reverse the serious neurologic consequences of lead poisoning.
Chelators have reduced the risk of death from very high levels but have
been shown to be ineffective at reversing neurocognitive damage.

22 Philadelphia Medicine : Fall/Winter 2019

Given these serious consequences to children, it would seem that
physicians and medical providers throughout Philadelphia would routinely
test blood lead at 1 and 2 years of age, the time when children are most
vulnerable to exposure due to their behaviors of spending time on the
floor, putting items in their mouth including their hands and having
a rapidly developing brain. In fact, the Pennsylvania Department of
Health reports that only 44% of children in Philadelphia have had a
lead test by age two.

Philadelphia Medicine Fall/Winter 2019

Table of Contents for the Digital Edition of Philadelphia Medicine Fall/Winter 2019