Tests show lead levels down in kids

Two years of testing the blood of hundreds of children indicate elevated lead levels are not a significant problem in most of Idaho, and the problem had diminished in Shoshone County where removal and replacement of lead-contaminated soil is continuing into its third decade.

“Since 2003, we’ve tested a few hundred kids and have not found one case of elevated blood lead level,” said Dr. Terence Neff of Coeur d’Alene Pediatrics. “It’s a big expense, and if we find children not at risk we need to accept that and put tax dollars toward bigger needs.”

Elevated lead levels are still present in the blood of some Shoshone County kids, but only 2 percent of kids tested in the last two years are above the federal level of concern – 10 micrograms per deciliter of whole blood, said Jerry Cobb, director of the Panhandle Health District’s Shoshone County operations. When testing for lead in the blood began in Shoshone County in 1974, the average lead level of kids tested was 65.

“It’s not as high as it was in the 1970s and ‘80s, but it’s still out there, and people should pay attention,” Cobb said.

Idaho’s Medicaid program was the target of a class-action lawsuit in 2000 for failing to comply with a federal requirement to screen all children up to 2 years old in the program for lead in the blood. Medicaid is tax-supported health insurance for people living near the poverty level.

Since 1988, Congress has required Medicaid programs nationwide to screen all children in the program at 12 months and 24 months for elevated levels of lead in the blood. It also requires screening for children 36 months to 72 months if they’ve had no previous blood lead tests.

Lead is most commonly found in old paint, some hobby materials and dirt. Exposure to it can cause learning problems and damage kidneys and reproductive systems, according to the Centers for Disease Control and Prevention. Exposure to high levels of lead can cause mental retardation, coma, convulsions and death. Children’s bodies easily absorb lead.

The blood screens are part of Medicaid’s Early and Periodic Screening, Diagnosis and Treatment services designed to catch and treat health problems early. States that participate in Medicaid also are required to educate children and families in the program about the dangers of lead and how to prevent exposure.

Idaho’s Medicaid officials agreed in a consent decree to distribute blood lead screening equipment to doctors throughout the state and promote testing. The program distributed brochures about lead around the state.

“Medicaid’s done quite a bit,” said Tom Shanahan, public information officer for the state Department of Health and Welfare in Boise. “We purchased 50 blood lead testing machines in 2002 and distributed them in 2003. I think we’ve met most things from the consent decree.”

The Idaho Pediatrics Society agreed to support Medicaid by promoting and providing the screenings for children for a minimum of two years. Pediatricians were ready to continue the testing if results indicated it was necessary, Neff said. But results are indicating otherwise.

“We’re in the process right now of communicating to the state Medicaid program that it should consider asking for a waiver” from the federal blood lead screening requirement, Neff said. “It’s the impression of the pediatricians in the state that lead is not a major health issue. If there’s not a problem, let’s move on.”

Cobb agrees. Shoshone County’s lead contamination is related to a century of silver mining operations, but the rest of Idaho doesn’t share the problem, he said.

“Idaho is a fairly young state in housing. Most of the new housing stock is post-‘70s when they banned lead-based paint,” he said. “It’s not out there in the rest of Idaho. The limited resources available for screening could be spent more judiciously.”

Such assessments don’t fly with Barbara Miller, leader of the Silver Valley Community Resource Center in Kellogg. The center has dedicated itself to battling for better health care for lead-exposed Shoshone County families. It wasn’t part of the lawsuit against Idaho’s Medicaid program, but it supported the plaintiffs’ cause.

“Lead exposure is not specific to Bunker Hill (Mining Co.) but a serious health problem especially for children,” Miller said. “Education and awareness is important and people are not even getting the consideration of being informed. We feel every effort is being made to cover it up.”

State Medicaid officials met last month in Coeur d’Alene with Miller’s group, other environmental organizations and officials from Health and Welfare and the Division of Environmental Quality. The meeting produced an agreement to form a committee to help Medicaid comply with the federal regulations. Miller said she envisions a committee with a doctor, representative of her center and parent as members.

But the committee is still unformed and the opinion of the medical community isn’t. Medicaid needs cooperation from doctors to comply with the federal requirements.

“We can’t make doctors take blood machines. If they take one, they have to maintain it, train people to use it,” Shanahan said. “And we can’t make parents take kids in to be tested. We can ask, mail brochures. But it’s still their decision.”