Nearly 4,500 children in New Jersey were found to have elevated levels of lead in their blood last year according to a new state report that involves a stricter standard than used in the past to identify — and help — more kids at risk for heavy metal poisoning.
The state’s 2018 report on childhood lead exposure released Friday notes that these cases account for some 2.3 % of the more than 191,000 youngsters tested last year. But the rate of children impacted varied significantly across the state, ranging from 0.4% in Sussex County to 5.6% in Salem County, and reaching 6.4% in two cities, Irvington and Trenton.
Previously the state considered children with 10 micrograms of lead per deciliter of blood to require follow-up attention, but in 2017 the standard was cut in half to 5 micrograms/deciliter to align with federal recommendations. The new standard, first included in the 2018 report, resulted in more than four times the number of kids flagged with elevated levels.
“The department’s role is to prevent, screen and intervene,” said acting Health Commissioner Judith Persichilli, whose department publishes the annual testing data. “Lowering the standard allows us to intervene earlier — interrupting lead exposure in the home and minimizing the challenges children will face due to lead exposure.”
Dr. Diane Calello, executive and medical director of the New Jersey Poison Control Center, who has studied lead exposure for years, agreed the lower threshold was a “positive change” that will enable more children to get help. “It also reflects the science behind the fact that even low levels of lead may have a negative effect on the developing brain,” she said.
Lead in paint — and water
When absorbed in the blood, lead can act as neurotoxin that can cause developmental, learning and behavioral problems; young brains are particularly at risk, experts note. Concerns about the presence of lead in Newark’s drinking water led to national outrage this summer, but experts note that more than three-quarters of elevated tests here are tied to contamination found in homes with old lead-tainted paint or plumbing — a concern in aging communities statewide.
“Even low levels of lead can disrupt the normal growth and development of a child’s brain and central nervous system,” Persichilli said. “It can cause learning disabilities, attention deficits and hyperactivity. Preventing lead exposure is critical to protect our children.”
State law requires children to be tested for lead at 12 and 24 months, at a minimum, and for health care providers to report these results to the DOH. More than eight in 10 children had at least one of these tests by age 3, according to the 2018 statistics.
The law also requires a “public health intervention” for any child that is found to have elevated blood-lead levels. The exact response depends on the levels of toxicity identified, but includes follow-up testing, assistance from a public-health nurse, home assessment to identify the potential source and possibly remediation of the pollution involved.
The state has invested $10 million annually in recent years to support the work of these local departments and the nonprofit organizations that conduct lead exposure prevention and education classes in communities with high lead hazards. The DOH has also launched a multi-lingual public information campaign of its own, #kNOwLEAD designed to increase testing among young children.
Overpowering kids’ natural defenses
While experts agree no level of lead in the blood is healthy, they also stress that not all children exposed will display symptoms or suffer long-term troubles. Lead exists naturally in the air and soil in levels humans can process, but added amounts of the metal — which was once blended into gasoline, paint and other substances — can overpower the body’s defenses.
Awareness of the issue spiked earlier this year when tests required by the federal government initially revealed concerns about one of the two water systems in Newark, prompting a flurry of responses from local, state and federal officials. That includes a proposal by Gov. Phil Murphy to finance $500 million in work to replace lead water lines, expand lead testing at schools and remediate toxins in homes.
According to the 2018 report, the vast majority of children who had elevated blood-lead levels that fell between the new level and the one used in 2017. Less than 1% had results that would likely require inpatient hospital treatment, experts noted.
Salem, Warren, Essex, Cumberland and Mercer counties had the highest level of children testing above the threshold in 2018, in descending order, according to the report. Irvington, Trenton, East Orange, Atlantic City and Newark were the large municipalities with the highest percentage of elevated blood-lead levels. Newark, with the largest population of young children in any city, reported 587 cases, the highest number of any city.
Calello, with the poison center, called it a “good news, bad news” situation for Newark, which recorded similar numbers last year — suggesting the impact of tainted water may be minimal. Overall, she said the report shows that lead pollution remains a concern, particularly in some urban areas. “There is still work to be done to make environments lead-safe for young children,” she said.