CLEVELAND STATE UNIVERSITY
POLICY BRIEF
____________________________________________________________________________________________________
MANDATORY BLOOD LEAD LEVEL TESTING
FOR ALL CHILDREN
COURTNEY E. BROWN-CHEATHAM
May 13, 2009
SWK 300: SOCIAL WELFARE POLICY
PROF. MICHAEL A. DOVER
SPRING 2009
1. GOAL STATEMENT
The goal of this brief is to help eradicate lead poisoning in children by having a statute
developed that would mandate all medical insurance companies to test all children from ages
1 year to 18 years at their immunization visits. All children would be tested despite any or no
exposure to lead and those with elevated blood lead levels (BLLs) to be tested weekly,
monthly, or quarterly as needed. The dates of the tests and the results are to be recorded on
the child’s permanent immunization record. This information would need to be present, in
order for the child to register for day care, preschool, and kindergarten.
2. SCOPE OF THE PROBLEM
In 2006, the Centers for Disease Control and Prevention reported that an estimated
310,000 U.S. children ages 1 to 5 years have blood lead levels greater than 10 mcg/dl, a level
at which harmful health effects occur. They also noted that 1,056 children in Cleveland were
identified as lead poisoned, 8% of those tested. The top 10 cities for the number of children
tested at least 10 mcg/dl in 2003 were: Cleveland, Philadelphia, Buffalo, Providence,
Milwaukee, St. Louis, Detroit, Chicago, Baltimore, and New York City (in that order). Lead
poisoning is one of the most common and devastating environmental disease in young
children. According to the U.S. Department of Health and Human Services (1991):
“Millions of U.S. children from all geographic areas and socioeconomic strata have
blood lead levels high enough to be associated with adverse side effects. Poor, minority
children in the inner cities, who are often already disadvantaged by inadequate nutrition and
other factors, are particularly vulnerable to this disease” (United States Department of Health
and Human Services).
Lead is a heavy metal used in materials and products and is a very strong poison. The
Latin name for lead is “plumb” and lead poisoning used to be called “plumbism.” It does not
leave the environment naturally; it does not breakdown; it cannot be diluted or dissolved; and
it is not biodegradable. Those who are at higher risk are young children (because it is easily
absorbed into their bodies and interferes with the developing brain and other organs and
systems), pregnant women (lead ingested by the mother can cross the placenta and affect the
unborn fetus; even a woman who was poisoned as a child is at risk for passing lead to the
fetus; and, the lead stored in a woman’s bones is released during pregnancy as the hips expand
for childbirth), and those who work around lead. In other words, the younger the child, the
more harmful lead can be. Unborn children are the most vulnerable.
Ingestion (taken in by mouth by sucking on hands, toys, pacifiers, bottles, dirt,
furniture and other objects) and inhalation (breathing in airborne dust from renovation
projects, blowing dust or from the fumes of a heat gun used to remove paint) are the ways that
lead can get into the body. Some other sources are: jewelry, toys, clothing (painted snaps and
zipper pulls), old vinyl mini blinds (pre-2000), garden hoses, glazed bathtubs with a worn
finish, some vinyl and metal lunchboxes, some Halloween costumes, some imported candy,
imported glazed pottery, some home remedies (greta, azarcon, litargirio, ayurveda medicines),
imported art supplies, and even water.
The amount of lead in the blood is measured in micrograms of lead per tenth of a liter
of blood (mcg/dl). The CDC has designated a level of 10 mcg/dl as a “level-of-concern.”
Cuyahoga County has designated 5 mcg/dl as its “level-of-concern”. Based on this bloodlead-level of awareness, 3,532 children in Cleveland were identified as lead poisoned, 26% of
those tested in 2006. With only 26% of children being tested, many children hurt by lead
were never identified. In several Cleveland neighborhoods (east and west side), a third or
more of children tested at 5 mcg/dl or above, such as: Cleveland, East Cleveland, Euclid, and
Lakewood. Lead poisoning causes irreversible effects in different parts of the body. There is
no cure for this illness.
Over time even low levels of exposure can harm a child’s mental development, such
as: reduced I.Q., memory loss, impaired concentration, failure at school, headaches, learning
difficulties, and emotional problems (depression and anxiety). Some signs and symptoms of
lead poisoning to watch for involving the digestive and renal body systems include: colic, low
appetite and energy, weight loss, vomiting, constipation, and abdominal pain and cramping.
Lastly, very high levels (70 mcg/dl and above) may cause staggering gait, muscle weakness,
seizures, coma, and even death.
Those with levels 45 mcg/dl or higher undergo chelation therapy to remove high levels
that have built up in a person’s body over time. For those who have possibly eaten a high
toxic dose of lead in a short period of time may need to undergo gastric lavage and/or bowel
irrigation with polyethylene glycol solution. Long term effects on the body are: loss of
calcium and iron in the bones (therefore, red blood cells cannot be made causing anemia, joint
problems, and arthritis), kidney damage, damage to the reproductive system (lowered sperm
count, abnormal sperm, and infertility), high blood pressure, hearing loss, vision problems,
slowed body growth, and hearing problems.
3. PAST POLICY
In the 1950s, caseworkers in a few U.S. cities tried to locate lead poisoned children.
In 1966, Chicago began the first mass screening program, followed by New York and then
other cities. The Lead-Based Paint Poisoning Prevention Act, passed in 1971, initiated a
national effort to identify children with lead poisoning and abate the sources of lead in their
environments. Federal funds appropriated under this Act were administered by the Centers
for Disease Control (CDC).
In 1981, the Omnibus Budget Reconciliation Act amended Title V of the Social
Security Act, which had authorized the Maternal and Child Health (MCH) Services Program
since 1935. This helped to create the MCH Services Block Grant Program and consolidated
many programs. The Lead Contamination Control Act of 1998 authorized $20 million for
Fiscal Year 1989, $22 million for Fiscal Year 1990, and $24 million for Fiscal Year 1991 for
the CDC to administer a childhood lead poisoning prevention grant program. The President’s
budget for 1992 included $14.95 million for this program. As a result of this Act, the CDC
Childhood Lead Poisoning Prevention Branch was created, and its duties included:
developing new programs and policies to prevent childhood lead poisoning and educate
everyone about the problem, provide funding to health departments to screen children and
follow-up with those with elevated levels, and support research to determine the effectiveness
of prevention efforts at federal, state, and local levels.
In 1990, the CDC established the Childhood Lead Poisoning Prevention Program,
which provides leadership to state and local health departments in developing new programs.
It has:
•
Funded 58 childhood lead poisoning prevention programs to develop,
implement, and evaluate lead poisoning prevention activities
•
Provide assistance to develop lead screening plans
•
Train public health professionals
•
Support the formation of collaborative relationships between CDC’s funded
partners and other lead poisoning prevention organizations and agencies
(community-based, non-profit, and housing groups)
•
Foster agreements between state and local health departments and state
Medicaid agencies to link surveillance and Medicaid data
•
Developed the Childhood Blood Lead Surveillance System by which 40
programs currently report data to the CDC
•
Expanded public health laboratory capacity in states to analyze blood and
environmental samples and to ensure quality, timely, and accurate analysis;
and,
•
Published target screening and case management guidelines that provide health
departments and health care providers with standards to identify and manage
children with elevated blood lead levels
The President’s Task Force on Environmental Health Risks and Safety Risks to
Children was formed in 1997. It consisted of government officials from the EPA
(Environmental Protection Agency), the Department of Health and Human Services, the
Consumer Product Safety Commission, the Department of Housing and Urban Development
(HUD), and others. One of its first projects was to formulate a plan to eliminate childhood
lead poisoning, a goal that was incorporated into the Healthy People 2010 goals for the nation,
which is still in effect today.
4. CURRENT POLICY
In 2005, Kemper and Clark noted that:
“The Centers for Disease Control and Prevention recommend that children
receive blood lead testing based on their risk of exposure (i.e., targeted
testing). It seems that Medicaid-enrolled children have a threefold increased
risk of having an elevated blood lead level. Federal regulations therefore
mandate that all Medicaid-enrolled children receive lead testing at 1 and 2
years of age or between 3 and 5 years if not previously tested. Despite these
recommendations, the rate of testing among Medicaid-enrolled children has
been low (290). In 2002, only 30% of 1-year-old children enrolled in
Michigan Medicaid had blood lead testing” (Kemper & Clark 290).
Although Medicaid was mandated to test toddlers (1 and 2 year olds), in 2004, in
Cuyahoga County, only 63% of one-year-olds and 42% of two-year-olds on Medicaid were
tested. Also, according to ODJFS, Medicaid contracting HMOs, (Buckeye Community
Health Plan, Care Source, MediPlan, Paramount, QualChoice, and SummaCare), failed to test
64% of one-year-old and 79% of two-year-old Medicaid-enrolled children in 2003; therefore,
the HMOs did not identify at least 5,300 lead-poisoned children across the state. This is a
clear violation of federal and state law. Also, the Ohio HMOs conducted less than one third
of the lead tests for which they were paid in 2000, 2001, and 2002.
The Medicaid Act, administered by the federal government, dictates that providers
conduct a comprehensive battery of screening services known as Early and Periodic
Screening, Diagnostic, and Treatment Services or EPSDT, which include a “blood lead level
assessment.”
The Ohio Department of Health developed its own program to combat lead poisoning
in children. The Ohio Childhood Lead Poisoning Prevention Program (OCLPPP) provides
program funding, public and professional education, public health lead investigations, case
management, data collection and analysis. The program addresses the needs of lead-poisoned
children from birth through 72 months of age. The program assists family members, medical
care providers, and other community members to reduce and prevent lead poisoning, with
greater emphasis on children from birth through age 36 months. This program is the flagship
agency for the Centers for Disease Control and Prevention for childhood lead poisoningprevention efforts in Ohio. The OCLPPP receives all blood lead lab reports on Ohio resident
children. The OCLPPP uses this data to add to the national database on lead poisoning and to
promote the national guidelines set forth by the CDC. These guidelines require that children
ages 6 months to 36 months of age, living in designated high-risk zip code areas, should be
tested for blood lead content twice, with at least 12 months between tests. Those who test at
confirmed elevated levels should receive case management services. Their residence should
receive a public health lead investigation. Now, President Obama has earmarked funds ($100
million) for HUD’s Office of Lead Hazard Control and Healthy Homes to help eliminate lead
poisoning by 2010 in his American Reinvestment and Recovery Act.
5. PROPOSED SOLUTION(S)
The Department of Health and Human Services and the CDC established the goals that
would eliminate elevated blood lead levels (BLLs) in children (below 10 mcg/dl) by the year
2010. The CDC has identified five steps that provide a clear path to achieving that goal:
•
Continue the intensive efforts to identify and provide services to children with
elevated BLLs, while also expanding program activities into the area of
primary prevention (i.e., strategies that control or eliminate sources of lead
before children are poisoned
•
Target efforts to clearly identifiable areas where risk for lead exposure is
disproportionately high
•
Provide resources to address lead in all geographic areas known or presumed
to be high risk
•
Identify special-risk populations and control or eliminate exposure to both
paint and nonpoint sources of lead; and,
•
Test strategies for continued surveillance of children’s potential exposure to
lead in the U.S. and develop cost-effective methods to ensure that the risk of
exposure remains low once elimination of elevated BLLs is achieved.”
The State of Ohio as well as greater Cleveland has developed plans to eliminate
childhood lead poisoning by 2010. A component of Ohio’s plan is targeted testing. This is to
ensure that all at-risk children receive a blood lead test(s) and appropriate follow-up tests by
increasing lead testing rates of at-risk children. In their plan, they have outlined activities to
be completed by a certain time and which agency is responsible to do such acts. Some of the
activities include: developing an education plan for parents and health care providers detailing
the need for testing and give current information, implement blood lead testing in select high
risk WIC clinics, develop a list of locations for free or reduced cost tests, determine if lead
testing is covered by health insurance companies, and mobilize community care coordinators
to eliminate barriers to obtaining lead tests (e.g., transportation, fear, payment, and/or
translation).
Other efforts involve educating child care inspectors and providers; fund case
management activities for children with a confirmed blood lead level equal to or greater than
6 mcg/dl and less than 10 mcg/dl; help facilitate links between various agencies to hold lead
poisoning prevention activities; and to target high risk properties and assist housing programs
in eliminating hazards in homes.
My goal would go in conjunction with the above named efforts. I would like to have
all children tested so that we can identify poisoned children, get them help, and possibly
locate any new high risk areas. One of my ideas would be to eliminate the restrictive criterion
that exists now. I would, also, have it that all insurance companies make blood lead testing
mandatory for children yearly starting at age 1 and continuing until age 18; and those with
elevated BLLs would have more frequent tests. Lastly, these test results would be
documented on the child’s immunization record and this information would be necessary for
registering the child for daycare, preschool, and kindergarten. If this can be accomplished
now, the goal of eliminating blood lead poisoning by 2010 may be attainable.
6. KEY ORGANIZATIONS/INDIVIDUALS
Robin Brown
Founder and Director
CCOAL (Concerned Citizens Organized Against Lead)
75 Erie view Plaza, 3rd Floor
Cleveland, Ohio 44114
Phone: (216) 402-8227
Fax: (216) 664-3353
Email: ccoal2@yahoo.com
Matthew Carroll
Director
Cleveland Department of Public Health
1925 St. Clair Avenue, NE
Cleveland, Ohio 44114
Phone: (216) 664-6790
Fax: (216) 664-2197
Email: Mcarroll@clevelandhealth.org
Website: http://www.clevelandhealth.org
Wayne Slota
Childhood Lead Poisoning and Prevention
Cleveland Department of Public Health
75 Erieview Plaza, 2nd Floor
Phone: (216) 664-2175
Fax: (216) 664-2197
Email: Wslota@clevelandhealth.org
Website: http://www.clevelandhealth.org
Brian J. Cummins
Ward 15 – Cleveland City Council
601 Lakeside Avenue, Room 220
Cleveland, Ohio 44114
Phone: (216) 664-4238
Fax: (216) 664-3837
Ward Office: (216) 459-8400
Email: ward15@clevelandcitycouncil.org
Website:
http://clevelandcitycouncil.org/Home/CouncilMembers/ward15BrianJCummins/tabid/104/Def
ault.aspx
Gene Phillips, R.S.M.B.A.
Chief, Bureau of Environmental Health
Ohio Department of Health
Childhood Lead Poisoning Prevention Program
246 North High Street
Columbus, Ohio 43215
Phone: (614) 728-9454 and (877) NOT-LEAD
Fax: (614) 728-6793
Email: LEAD@odh.ohio.gov
Website: BFCHS@odh.ohio.gov
Ramona Redding
Cuyahoga County Board of Health
5550 Venture Drive
Parma, Ohio 44130
Phone: (216) 201-2001 X1317
Email: rredding@ccbh.net
Website: http://www.ccbh.net
Ed Murray, Ph.D.
Acting Director
Agency for Toxic Substances & Disease Registry
4770 Buford Highway NE
Atlanta, GA 30341
Phone: (800) 232-4632
Email: cdcinfo@cdc.gov
Website: http://www.atsdr.cdc.gov/contacts.html
Donna Stein-Harris
Director, National Education Center for Agricultural Safety Office
10250 Sundown Road
Peosta, Iowa 52068
Phone: (563) 557-0354 or (888) 844-6322
Fax: (563) 557-0353
Email: harrisd@nsc.org
Website: http://www.nsc.org
David E. Jacobs, Ph.D.
Director of Research
National Center for Healthy Homes
10320 Little Patuxent Parkway, Suite 500
Columbia, MD 21044
Phone: (410) 922-0712
Fax: (443) 539-4150
Email: djacobs@nchh.org
Website: http://www.nchh.org/Home.aspx
Ruth Klotz-Chamberlin
Project Coordinator
Alliance for Healthy Homes
50 F Street NW, Suite 300
Washington, DC 20001
Phone: (202) 347-7610
Fax: (202) 347-0058
Email: afhh@afhh.org
Website: http://www.afhh.org
7. GLOSSARY
AAP- American Academy of Pediatrics; its mission is to obtain physical, mental, and social
health and well-being for all infants, children, adolescents, and young adults
Biodegradable- capable of being broken down especially into innocuous products by the
actions of living things (as microorganisms)
Block Grant (federal) - federal funds given to state or local government which must be spent
for general purpose specified by the grant
CDC- Centers for Disease Control and Prevention; an agency of the U.S. Department of
Health and Human Services based in Atlanta, Georgia; it works to protect public health and
safety
Chelation therapy- the administration of certain agents to remove heavy metals from the
body; it is used as a treatment for forms of toxic metal poisoning; it may be administered
intravenously, intramuscularly, or orally, depending on the agent and the type of poisoning
Eliminate- to remove, eradicate
Eradicate- to eliminate, abolish, or extinguish
Gastric lavage- also known as stomach pumping or gastric irrigation; the process of cleaning
out the contents of the stomach
Lead- a heavy malleable bluish white chemical element
Lead poisoning- the absorption of quantities of lead, sometimes resulting in brain damage,
respiratory illness, other health problems, or death in the affected individual (The Social Work
Dictionary 2003)
Mandate- the authority, expectations, and requirements to carry out some order or desire
expressed by those to whom the administrator is responsible (The Social Work Dictionary
2003)
ODJFS- Ohio Department of Job & Family Services; supervises the provision of Medicaid,
food stamps, child welfare, and child support in Ohio; also provides services such as
unemployment compensation to Ohio’s citizens; the largest state agency in Ohio
Plumb- the Latin name for lead
Plumbism- the prior name for lead poisoning
Strata- a group of people representing one stage in cultural development
8. BIBLIOGRAPHY
AFHH. Lead Poisoning. (2009). From AFHH Web site:
http://www.afhh.org/chil_ar/chil_ar_pv/chil_ar_lead_poisoning_pv.htm
American Reinvestment and Recovery Act Update. Retrieved March 4, 2009, from
NCHH Web site: http://www.nchh.org/Policy/National-Policy/AmericanReinvestment-And-Recovery-Act.aspx
Binder, S., & Falk, H. (1991). Strategic Plan For The Elimination Of Childhood Lead
Poisoning. Atlanta: U.S. Department of Health and Human Services.
Brown, M.J. (2008). Childhood Lead Poisoning Prevention: Getting the Job Done by 2010.
Journal of Environmental Health. 70, 56-57.
Center for Disease Control. (2008). About the Childhood Lead Poisoning Prevention
Program (CLPPP). Retrieved March 3, 2009, from Center for Disease Control Web
site: http://www.cdc.gov
Committee on Environmental Health (2005). Lead Exposure in Children: Prevention,
Detection, and Management. Pediatrics, 116, 1036-1046.
Cuyahoga County Board of Health. Lead Poisoning Prevention Program. (2009). Cuyahoga
County Board of Health Web site: http://www.ccbh.net
Environmental Health Watch. Childhood Lead Poisoning. (2009). From Environmental
Health Watch Web site: http://ehw.org/Lead/LEAD_home3.htm
Environmental Health Watch. Lead Poisoning: Too Many Children on Medicaid Not Tested
for Lead. (2009). From Environmental Health Watch Web site:
http://ehw.org/Lead/LEAD_Few_Tested.htm
Kemper, A., & Clark S. (2005). Physician barriers to lead testing of Medicaid-enrolled
children. Ambulatory Pediatrics, 5(5), 290-293. Retrieved March 9, 2009, from
CINAHL Plus with Full Text database.
Morelli, Jim (1997). Poison! How to Handle the Hazardous Substances in Your Home.
Kansas City, Missouri: A Universal Press Syndicate Company.
Ohio Department of Health. Lead Poisoning-Children. (2009). From Ohio Department of
Health Web site: http://www.odh.ohio.gov/odhPrograms/cfhs/lead_ch/leadch1.aspx
Reith, D.M., O’Regan, P., Bailey, C., & Acworth, J. (2003). Serious lead poisoning in
childhood: Still a problem after a century. Journal of Pediatric Child Health, 39, 623626.
Roulet, N. Announcing “Greater Cleveland Plan to Eliminate Childhood Lead Poisoning by
2010.” (2005, April 1). Plain Dealer.
The New York Times. Lead Poisoning Overview. (2005). P.1-3 Health.
Courtney E. Brown-Cheatham
564 East 222nd Street
Euclid, OH 44123
Ph: (216)533-6745
courtneycheatham@yahoo.com
May 13, 2009
The Honorable Dennis J. Kucinich
10th District Congressman
2445 Rayburn House Building
Washington, D.C. 20515
Re: Mandating Blood Lead Level Testing for All Children
Dear Congressman Kucinich:
I am writing to ask for your support in my measure to mandate blood lead level testing for all
children. I have composed a policy brief that would help eradicate lead poisoning. In the
brief, I discuss the existing problem in Cuyahoga County, especially in the Cleveland area.
And, I present a possible statute that would mandate all medical insurance companies to test
all children from ages 1 year to 18 years at their immunization visits. I propose that all
children would get tested despite any or no exposure to lead. This information would need to
be present, in order for the child to register for day care, preschool, and kindergarten. If
enacted into law, this legislation would ensure that children who may have been exposed to
lead would be identified and would receive the necessary treatment.
In 2006, the Centers for Disease Control and Prevention (CDC) reported that an estimated
310,000 U.S. children ages 1 to 5 years have blood lead levels greater than 10 mcg/dl, a level
at which harmful effects occur. They also noted that 1,056 children in Cleveland were
identified as lead poisoned, 8% of those tested. In 2003, Cleveland was the city with the most
children testing at 10 mcg/dl. The CDC has established a level of 10 mcg/dl as a “level-ofconcern,” whereas, Cuyahoga County has lowered the level to 5 mcg/dl. Based on this bloodlead-level of awareness, 3,532 children in Cleveland were identified as lead poisoned, 26% of
children being tested; many children hurt by lead were never identified. In several Cleveland
neighborhoods (east and west side of Cleveland, East Cleveland, Euclid, and Lakewood), a
third or more children tested at 5 mcg/dl or above. Lead poisoning causes irreversible effects
in different parts of the body. There is no cure for this illness.
As a parent of lead affected children, I am asking for your support in developing legislation
and increasing public awareness about this problem. Over the past 20 years, various agencies
have tried to eliminate this problem by developing new programs. The initiative was to
eliminate lead poisoning by the year 2010. By passing my proposed legislation, that goal may
be met.
The health risks associated with lead poisoning (brain and nervous system ailments,
behavioral problems, and low test scores, etc.) are undisputed. It is therefore alarming that
lead poisoning remain a problem in the U.S. today. It is vital that Congress consider passing
my proposed legislation and continue to educate the public (parents and medical providers)
about the problem. I thank you for your assistance on this important health issue and look
forward to having a meeting with you to present my proposal and discuss proposed
legislation.
Sincerely,
Courtney E. Brown-Cheatham
Courtney E. Brown-Cheatham
564 East 222nd Street
Euclid, OH 44123
Ph: (216)533-6745
courtneycheatham@yahoo.com
May 13, 2009
The Honorable Marcia L. Fudge
11th District Congresswoman
1513 Longworth House Office Building
Washington, D.C. 20515
Re: Mandating Blood Lead Level Testing for All Children
Dear Congresswoman Fudge:
I am writing to ask for your support in my measure to mandate blood lead level testing for all
children. I have composed a policy brief that would help eradicate lead poisoning. In the
brief, I discuss the existing problem in Cuyahoga County, especially in the Cleveland area.
And, I present a possible statute that would mandate all medical insurance companies to test
all children from ages 1 year to 18 years at their immunization visits. I propose that all
children would get tested despite any or no exposure to lead. This information would need to
be present, in order for the child to register for day care, preschool, and kindergarten. If
enacted into law, this legislation would ensure that children who may have been exposed to
lead would be identified and would receive the necessary treatment.
In 2006, the Centers for Disease Control and Prevention (CDC) reported that an estimated
310,000 U.S. children ages 1 to 5 years have blood lead levels greater than 10 mcg/dl, a level
at which harmful effects occur. They also noted that 1,056 children in Cleveland were
identified as lead poisoned, 8% of those tested. In 2003, Cleveland was the city with the most
children testing at 10 mcg/dl. The CDC has established a level of 10 mcg/dl as a “level-ofconcern,” whereas, Cuyahoga County has lowered the level to 5 mcg/dl. Based on this bloodlead-level of awareness, 3,532 children in Cleveland were identified as lead poisoned, 26% of
children being tested; many children hurt by lead were never identified. In several Cleveland
neighborhoods (east and west side of Cleveland, East Cleveland, Euclid, and Lakewood), a
third or more children tested at 5 mcg/dl or above. Lead poisoning causes irreversible effects
in different parts of the body. There is no cure for this illness.
As a parent of lead affected children, I am asking for your support in developing legislation
and increasing public awareness about this problem. Over the past 20 years, various agencies
have tried to eliminate this problem by developing new programs. The initiative was to
eliminate lead poisoning by the year 2010. By passing my proposed legislation, that goal may
be met.
The health risks associated with lead poisoning (brain and nervous system ailments,
behavioral problems, and low test scores, etc.) are undisputed. It is therefore alarming that
lead poisoning remain a problem in the U.S. today. It is vital that Congress consider passing
my proposed legislation and continue to educate the public (parents and medical providers)
about the problem. I thank you for your assistance on this important health issue and look
forward to having a meeting with you to present my proposal and discuss proposed
legislation.
Sincerely,
Courtney E. Brown-Cheatham
Courtney E. Brown-Cheatham
564 East 222nd Street
Euclid, OH 44123
Ph: (216)533-6745
courtneycheatham@yahoo.com
May 13, 2009
Brian J. Cummings
Ward 15 - Cleveland City Councilman
601 Lakeside Avenue, Room 220
Cleveland, OH 44114
Re: Mandating Blood Lead Level Testing for All Children
Dear Mr. Cummings:
I am writing to ask for your support in my measure to mandate blood lead level testing for all
children. I have composed a policy brief in which I hope to present to various politicians to
help eradicate lead poisoning. In the brief, I discuss the existing problem in Cuyahoga
County, especially in the Cleveland area. And, I present a possible statute that would
mandate all medical insurance companies to test all children from ages 1 year to 18 years at
their immunization visits. I propose that all children would get tested despite any or no
exposure to lead. This information would need to be present, in order for the child to register
for day care, preschool, and kindergarten. If enacted into law, this legislation would ensure
that children who may have been exposed to lead would be identified and would receive the
necessary treatment.
As I am sure you know, the CDC has reported that 1,056 children in Cleveland were
identified as lead poisoned, 8% of those tested. In 2003, Cleveland was the city with the
highest number of children tested at 10 mcg/dl. The CDC has established a level of 10 mcg/dl
as a “level-of-concern,” whereas, Cuyahoga County has lowered the level to 5 mcg/dl. Based
on this blood-lead-level of awareness, 3,532 children in Cleveland were identified as lead
poisoned, 26% of children being tested; many children hurt by lead were never identified. In
several Cleveland neighborhoods (east and west side of Cleveland, East Cleveland, Euclid,
and Lakewood), a third or more children tested at 5 mcg/dl or above. Lead poisoning causes
irreversible effects in different parts of the body.
As a parent of lead affected children, I am asking for your support in the effort to develop
programs that would target testing all children. Over the past 20 years, various agencies have
tried to eliminate this problem by developing new programs. The initiative was to eliminate
lead poisoning by the year 2010. With your support and the support of our legislative
members, that goal may be met.
The health risks associated with lead poisoning (brain and nervous system ailments,
behavioral problems, and low test scores, etc.) are undisputed. It is therefore alarming that
lead poisoning remain a problem in the U.S. today. It is vital that we approach Congress on
considering passing my proposed legislation and continue to educate the public (parents and
medical providers) about the problem. I thank you for your leadership on this important
health issue and look forward to having a meeting with you to discuss and advance this
important legislation.
Sincerely,
Courtney E. Brown-Cheatham
Courtney E. Brown-Cheatham
564 East 222nd Street
Euclid, OH 44123
Ph: (216)533-6745
courtneycheatham@yahoo.com
May 13, 2009
Jacqueline Knox Kelly
Deputy Project Director
Cleveland Department of Public Health – Division of Environment
1925 St. Clair Avenue
Cleveland, OH 44115
Re: Mandating Blood Lead Level Testing for All Children
Dear Ms. Kelly:
I am writing to ask for your support in my measure to mandate blood lead level testing for all
children. I have composed a policy brief in which I hope to present to various politicians to
help eradicate lead poisoning. In the brief, I discuss the existing problem in Cuyahoga
County, especially in the Cleveland area. And, I present a possible statute that would
mandate all medical insurance companies to test all children from ages 1 year to 18 years at
their immunization visits. I propose that all children would get tested despite any or no
exposure to lead. This information would need to be present, in order for the child to register
for day care, preschool, and kindergarten. If enacted into law, this legislation would ensure
that children who may have been exposed to lead would be identified and would receive the
necessary treatment.
As I am sure you know, the CDC has reported that 1,056 children in Cleveland were
identified as lead poisoned, 8% of those tested. In 2003, Cleveland was the city with the
highest number of children tested at 10 mcg/dl. The CDC has established a level of 10 mcg/dl
as a “level-of-concern,” whereas, Cuyahoga County has lowered the level to 5 mcg/dl. Based
on this blood-lead-level of awareness, 3,532 children in Cleveland were identified as lead
poisoned, 26% of children being tested; many children hurt by lead were never identified. In
several Cleveland neighborhoods (east and west side of Cleveland, East Cleveland, Euclid,
and Lakewood), a third or more children tested at 5 mcg/dl or above. Lead poisoning causes
irreversible effects in different parts of the body.
As a parent of lead affected children, I am asking for your support in the effort to develop
programs that would target testing all children. Over the past 20 years, various agencies have
tried to eliminate this problem by developing new programs. The initiative was to eliminate
lead poisoning by the year 2010. With your support and the support of our legislative
members, that goal may be met.
The health risks associated with lead poisoning (brain and nervous system ailments,
behavioral problems, and low test scores, etc.) are undisputed. It is therefore alarming that
lead poisoning remain a problem in the U.S. today. It is vital that we approach Congress on
considering passing my proposed legislation and continue to educate the public (parents and
medical providers) about the problem. I thank you for your leadership on this important
health issue and look forward to having a meeting with you to discuss and advance this
important legislation.
Sincerely,
Courtney E. Brown-Cheatham