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1. NcIlvane, Mossammat and Prum - Lead Poisoning 33
The Traprock, Vol. 3, May 2004, pp 33 - 36
Lead Poisoning: The Silent Epidemic Affecting Poor and Minority Children
in Urban Areas
Magee McIlvaine, Fatema Mosammat and Narin Prum
Lead poisoning is often cited as the nation’s most preventable childhood public health problem (Bailey, 1998).
Common sources of lead poisoning are lead-based paint chips from interior exterior paint, soil, especially in
dense urban areas, dust and debris from older building renovation, drinking water, playground soil, household
dust, cosmetics, ceramics, etc. The accumulation of lead in one’s blood can cause coma, convulsions, brain
damage, reduced physical stature, growth, impaired hearing, reduced attention span, hyperactivity, behavior
problems and even death (Daghlian, 2001). Treatment of lead poisoning is expensive and requires frequent
visits. As a result, children from minority and lower income families are at a higher risk of getting poisoned.
Children from lower income families are four times more likely to suffer from lead poisoning than children
from higher-income families, and African American children are four times more likely to suffer from lead
poisoning than Caucasian children (Kassa, 2000). There is evidence that strong legislation can work to limit
the incidences of childhood lead poisoning. Unfortunately federal laws have yet to protect the most susceptible
children and are rarely enforced (Daghlian, 2001). The federal government needs to strengthen the current
laws by enacting stronger legislation and allocating more resources and funding to programs which have been
proven successful, thus ensuring the protection of children from an entirely preventable disease.
Introduction
For centuries, lead has been a silent but deadly
poison that deserves more attention than it currently
receives. In the United States alone, lead poisoning
has been related to thousands of deaths. Young
children living in an urban environment are most
commonly affected (Mielke). Industrialized
communities and advanced road systems play a
major role in the concentration of lead found in
urban environments. Paint chips, as previously
believed to be the sole reason of lead poisoning, are
no longer the only source. Emissions from cars
powered by lead gasoline affect the air we breathe,
the soil, surface on which we walk, and the water we
drink (Silver, 2001). Everyday children in urban
environments are exposed to more and more lead,
whether it is in the air, in paint chips, in baby food
cans, or in the soil of the playgrounds where they
play. Because the daily exposure to children is
constant, there must be some prevention or
education programs provided to prevent these
children from the long term damages to their health.
This can be done by decontaminating areas, raising
public awareness, and increasing public
transportation and decreasing private automobile
use.
Legislation and the creation of programs to deal
with the lead epidemic have been relatively useful.
While some locally organized programs produced
some success in terms of preventing deadly
exposure, most of the federally sponsored programs
seemed to have failed in alleviating this problem. In
the following paragraphs, through reviews of
literatures and journals on case studies, we will take
a closer look at assessment of some of the programs
in the battle against preventing poor and minority
children in urban areas or in the inner cities from
lead poisoning.
Materials and Methods
Reviews of several literature and journal articles
show various methods, experimentations, and study
areas used by researchers to understand the entirety
of lead poisoning and the severe damages on poor
and minority children in urban areas. We will look
at a few articles. In particular we will discuss “Lead
Based Paint: The Crisis Still Facing Our Nation’s
Poor and Minority Children” (Daghlian, 2001),
“Assessment of a Lead Manegement Program for
Inner-City Children” (Kassa, 2000), and “A Tale of
Two Counties: Childhood Lead Poisoning,
Industrialization, and Abatement in New England”
(Bailey, 1998) in order to understand a systematic
approach used by researchers in their studies.
Results/ Discussion
Daghlian (2002) questions the role the federal
government currently plays in order to ensure the

2. NcIlvane, Mossammat and Prum - Lead Poisoning 34
The Traprock, Vol. 3, May 2004, pp 33 - 36
protection of our nation’s most susceptible children
from lead poisoning. After gathering information
from scientific journals, case studies, personal
interviews, reviews, programs, and statistical
analysis of federal laws and prevention acts,
Daghlian concludes that the Lead-Based Paint
Poisoning Prevention Act (LBPPA) failed to provide
relief to children who were exposed to lead hazards.
In addition, the LBPPA also failed to provide the
substantive requirements necessary to attain even a
minimal amount of the procedural goals that were
set forth at the beginning. The act contains several
parts which are crucial to the protection of children
at risk. In its current form, the provisions has little
effect in terms of prevention mainly because it does
not require landlords or local housing authorities to
act before a child gets sick (Daghlian, 2000). A
specific example of the Residential Lead Based
Paint Hazard Reduction Act of 1992’s
ineffectiveness is the Dixson v. Wisconsin case.
This case provides further evidence of weaknesses
and flaws within federal programs. Contrary to the
federal programs, the Massachusetts Lead Poisoning
and Control Act has gained widespread acclaim as
the most successful state wide program in the
country. This program had fewer provisions for
treatment than the federal programs and was
enforced in a manner which provided lower income
families with affordable care, educational programs,
and decontaminated housing.
The author concludes that the current federal
legislation is not entirely ineffective but it needs to
be revised in order to address some lead-based paint
hazards. Lead based paint legislation needs to focus
upon both curative and preventative measures. To
enforce required inspections, abatement, and
reduction, private landlords and local housing
authorities together should be held accountable for
injuries resulting from lead based paint hazards.
People need to be educated about the hazards of lead
paint, how to inspect for peeling and chipping paint,
and to be aware of the health consequences of
exposure. The more aware and educated the people
are, the better off their children’s health will be.
More research also needs to be maintained in order
to develop new technologies for inspection,
reduction and abatement that are more effective and
less expensive than current technologies.
Kassa (2000) found that the main factor associated
with elevated blood lead levels (BLLs) in children in
the inner city was that many lived in houses
constructed before 1950. These houses tended to
have peeling paint that usually turned out to be lead
based. Chelation therapy, the most well known
treatment for lead poisoning, was used to treat many
of these children. However, for some reason, the
therapy alone was not enough to lower blood lead
levels to an acceptable level, less than 10
micrograms per deciliter (:g/dL).
Table 1: Blood Lead Levels (Mean +/- Standard Deviation) for Groups of Chelated and Nonchelated Children
(Kassa, 2000).
Group Gender Number Initial BLLsa
(:g/dL).
Final BLLs (:g/dL). b
Chelated
(N=45)
Male 23 45.4 +/-3.6 25.4 +/- 1.4
Chelated
(N=45)
Female 22 43.2 +/-1.7 23.2+/-1.5
Nonchelated
(N=61)
Male 36 18.0 +/-1.4 22.2+/-0.8
Nonchelated
(N=61)
female 25 17.5 +/-1.4 23.6 +/-1.1
Parents of the nonchelated groups received lead education between the initial and the final screenings. Parents of the chelated groups, however,a
received education after the final screening
For the chelated group, final BLL was determined at postchelation screening (a median of 14 days after chelation). For the nonchelated group, finalb
BLL refers to the results from the fourth screening (a median of 124 days after the first screening).
The distribution of pamphlets with instructions
on how to remove lead paint and how to
decontaminate areas with higher levels of lead did
not have the desired effect either. It wasn’t enough.

3. NcIlvane, Mossammat and Prum - Lead Poisoning 35
The Traprock, Vol. 3, May 2004, pp 33 - 36
Raised awareness and chelation therapy must be
provided together, not separately. The children
under this study, both those who received chelation
therapy and those who did not, continued to occupy
lead-contaminated homes. Kassa (2000) suggests
that while children continue to occupy lead-
contaminated homes, chelation therapy for children
with high BLLs and parent lead education should
also be continued. Educational programs needs to be
much more effective in terms of seeking a long-term
solution to elevated BLLs among children in inner
cities and urban areas. In his article, Kassa
concludes the following:
• Chelation therapy and parent education about
lead do not always adequately lower children’s
BLLs if occupancy of lead-contaminated homes
continues.
• Parents should receive more frequent and more
comprehensive education about lead poisoning
while children are treated.
• Residence in lead-free homes remains the most
effective way to control children’s BLLs.
Finally, Bailey (1988) provides important
insights into the multifaceted relations of industrial
heritage, urbanization, demography, and public
health policy regarding lead poisoning. Results
from nationwide samples suggests a 75 percent
decline in mean blood lead levels in the last decade,
but not all children or places have been winners.
Indeed, childhood lead poisoning remains a
significant public health issue in New England. His
studies focused on two industrialized counties of
New England (Worcester, Massachusetts, and
Providence county Rhode Island). His finding points
toward a disproportionate number of estimated
children, with excess blood lead level (higher than
10 :g/dl), are from poor and minority households.
Children living in poverty are also at high risk
because of diet, reduced access to information and
health care, and the increased likelihood that they
live in old housing in areas of general environmental
degradation. Minority children are more likely to be
living in poverty than non minority children, and
their poverty contributes to elevated blood lead
levels (Mielke, 1984). Elevated blood lead levels in
minority children have also been linked to biological
and cultural factors, including the use of products
(for example, medicines, and cosmetic) that contain
lead, consumption of food from lead soldered cans,
and, for immigrants, exposure to lead prior to arrival
in the United States (Bailey, 1998). Access to lead-
free public housing may also explain why some
minority groups have lower lead levels than others.
Because of income-and race-based residential
segregation, some neighborhoods are likely to differ
in their rates of lead exposure. Two interconnected
factors put minority neighborhoods at greater risk of
lead exposure. To further add to this point, Bailey
(1998) provides data collected on spatial and
demographic variations in lead exposure.
Table 2: Lead Exposure by Census Tract (Bailey, 1988)
Providence County Worcester County
Number of tracts 136 156
Mean BLL (:g/dL) 8.26 5.57
Standard deviation 2.37 1.28
Mean % kids with BLL > 10
:g/dL by tract
28.8 12.5
Standard deviation 14.26 9.08
Census tract with more than
30% kids with BLL>10 :g/dL
(%)
43.4 5.8
Source: Author’s calculations from public health data, U.S. Bureau of the Census (1990).
In table 2, both outcome measures reveal higher
lead exposures in the neighborhoods of Providence
county than in those of Worcester county. The
arithmetic mean calculated from the mean blood
lead level of each of the 136 Providence tracts (8.26
:g/dL) is 49 % higher than the corresponding

4. NcIlvane, Mossammat and Prum - Lead Poisoning 36
The Traprock, Vol. 3, May 2004, pp 33 - 36
arithmetic mean from the 156 tracts in Worcester
county. If these two counties are typical of broader
conditions in the region, then childhood lead
poisoning is indeed a continuing public health
concern in New England. As in the case nationally,
poverty and old (vacant) housing emerge as common
risk factors in both of these counties. However,
Bailey’s result, particularly for Worcester county,
suggests nuances to the contemporary geography of
lead poisoning that he linked to inter-county
differences in demography, public health
intervention, and patterns of industrialization. Bailey
concluded three major findings which seem to be on
the same line as discussed earlier by other authors.
• The pattern of industrialization expands our
understanding of geographic differences in lead
poisoning.
• Public health interventions, including
abatement, seem to reduce lead levels, perhaps
most dramatically in tracts with Latino
neighborhoods (Bailey, 1988).
• Need for careful analysis of the complex
relations between race, ethnicity, nativity, and
health outcomes.
Conclusion
Our research concludes the following points on
lead poisoning and its effects on minority children
and those living in the urban areas:
• Although lethal levels of lead can be found in
remote places, lead poison is most prevalent
amongst our nation’s poor and minority children
in inner cities and urban communities.
• The damages caused by lead poisoning are
inescapable and detrimental in terms of
physiological and psychological development in
young children.
• Prevention is the key against this battle of
protecting the most affected children in our
nation. The current movement towards this is
not adequate.
• People, especially parents need to be educated
about lead poisoning, its sources, its effects, and
prevention methods.
• Treatment needs to be made more available for
those who can not afford it and care should be
made available before children are seriously
affected by the disease.
• The federal government needs to revise current
policies by enacting stronger legislation and
enforcing the existing policies.
• The government can be much more effective in
alleviating this preventable disease by allocating
more resources to programs which have been
proven successful.
References
Bailey, J. Adrian. “A Tale of Two Counties:
Childhood Lead Poisoning, Industrialization,
and Abatement in New England,” Economic
Geography, v. 74, Special Issue 1998,Cark
University, Boston, Ma, 1998, pp. 96-111.
Daghlian, K. Kara. “Lead Based Paint: The Crisis
Still Facing Our Nation’s Poor and Minority
Children,” Dickinson journal of Environmental
Law and Policy, v. 9, n.3, Carlisle, PA, 2001,
pp. 535-551.
Kassa H., Bisesi M.S. , et al. “Assessment of a Lead
Management Program for Inner-City Children,”
Journal of Environmental Health, v.62, n. 10,
Denver, 2000, pp. 15-19.
Mielke, W. Howard. “Policies to Reduce Children's
Exposure to Lead May Be Overlooking a Major
Source of Lead in the Environment,” Am. Sci, v.
87, 1984 p. 62…
<http://emp.trincoll.edu/~cgeiss/ENVS_149/re
ading%20material/lead/lead_txt.htm>
Silver, P.A. “Lead Analysis of Sediments Cores
from seven Connecticut Lakes,” Journal of
Paleolimnology, v.26, issue 1, 2001, pp-1-10.