Illinois Department Of Public Health Moves To Lower Action Level For Lead In Blood

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[August 30, 2018]  The Illinois Department of Public Health (IDPH) moves to lower the level at which public health interventions are initiated for children with blood lead levels from 10 micrograms per deciliter (µg/dL) to 5 µg/dL. IDPH has submitted rules to the Joint Committee on Administrative Rules (JCAR) to adopt the Centers for Disease Control and Prevention (CDC) childhood lead reference level. JCAR must approve the proposed change.

“The new lower action level means that more children will be identified as having lead exposure, allowing parents, doctors, public health officials, and communities to take action earlier to reduce the child’s future exposure to lead,” said Governor Bruce Rauner. “We’ve made great strides in reducing the number of children exposed to lead, and now we’re taking it to the next level to protect our future generations.”

“There is no safe level of lead exposure, which is why it is important to identify children with elevated blood lead levels quickly and take steps to intervene,” said IDPH Director Nirav D. Shah, M.D., J.D. “Even low levels of lead in blood have been shown to contribute to learning disabilities, developmental delays, behavioral problems, as well as a number of other negative health effects. The health effects of lead exposure cannot be entirely reversed.”

The burden of Illinois childhood lead poisoning remains one of the highest in the nation. Provisional data shows that of the approximately 229,000 children tested in 2017, more than 7,000 had blood lead levels at or above 5 µg/dL.

Illinois law requires that all children six years of age or younger be assessed for lead risk, and physicians must perform a blood lead test for children who live in high-risk areas or meet other risk criteria.

Ashley and Tyler Scudder learned that their oldest daughter Phoebe had a high level of lead in her blood when she was a year old. It was 23 micrograms per deciliter. Although she’s not sure it was due to lead exposure, Ashley said she noticed her daughter was having sleeping issues and slipped from the 90th percentile in weight to the 60th percentile in just a couple months. Little Phoebe had lost her appetite, which can be one of the symptoms of lead poisoning.

The Scudder’s were renovating a home that was around 100 years old while living in an apartment that was about the same age. Lead paint was often used on walls and window sills in older homes. Either place could have been the source of lead.

Ashley is now an advocate for lead education and getting the word out. “Even as a nurse, I had no idea that lead poisoning was so easy. That children can get it from dust, they don’t have to be gnawing on the walls or window sills.”

Ashley says she thinks lowering the level from 10 to 5 is important because more people will know about the dangers of lead. “It’s in the soil. It’s in the environment. It’s everywhere and people have no idea. I have friends that still didn’t know that lead poisoning can cause permanent damage.”

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With the news rules, children who test at or above the new intervention level of 5 µg/dL will receive a home visit from a public health nurse who will educate families on ways to lower the blood lead level and reduce lead exposure, including proper nutrition, hygiene, and housekeeping. Public health environmental experts will also inspect residences for all children with an elevated blood lead level of 10 µg/dL or greater to determine the source(s) of the child’s lead exposure.

The rules also propose increased enforcement authority for violations of the Lead Poisoning Prevention Act and Code, including property owners who fail to perform lead remediation on a property where children with elevated blood levels live. Additionally, the proposed rules increase the maximum fine for violators so that they comply with the U.S. Environmental Protection Agency rules and impose penalties for returned checks or insufficient payments. This rulemaking establishes the safest way for lead to be removed from homes and ensures that workers engaged in this work are appropriately remediating lead hazards and are not creating additional risk to residents.

Other State efforts to reduce childhood exposure to lead include:

- The passage of recent legislation requiring schools and daycares to sample for lead contamination in water.

- The Governor’s Cabinet on Children and Youth chose reducing childhood lead poisoning as one of its three priority projects. The Children’s Cabinet team has worked to improve identification of and response to affected children; ensure safe homes by working on strategies to remediate lead hazards and prevent future exposure; improve the quality and management of collected lead data to support data driven decision making; connect lead prevention and case management strategies with additional social service supports; and drive lead prevention and education initiatives.

- The state budget includes $15 million for the Comprehensive Lead Education, Reduction, and Window Replacement Program (Clear-Win). The primary goal of Clear-Win is to partner with the Illinois Housing Development Authority and the Department of Commerce and Economic Opportunity in hiring local contractors to remove sources of lead exposure from the residences of children with elevated blood lead levels.

- The state budget also includes $50 million for K-12 schools to mitigate sources of lead. This initiative will be administered by the Capital Development Board through grants issued from the School Construction Fund.

The proposed rules can be found in the Illinois Register on the Illinois Secretary of State website.

[Illinois Department of Public Health]

 

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