Dr. Kevin Stephens, director of the City of New Orleans Health Department, shares his insights about several aspects of lead exposure and poisoning. In addition to his post with the city, Stephens is an obstetrician-gynecologist, a former women's health medical director for the state's Department of Health and Hospitals' Office of Public Health, and is on the clinical faculty of Louisiana State University and Tulane medical schools, and Xavier and Dillard universities.
Q: Just how bad is this area's lead contamination problem?
A: We have a pool of houses that were built prior to the 1950s. After 1950, lead was taken out of household paint. A lot of our old architecture was built prior to 1950 Š and the paint is beginning to peel and so forth.
Q: Is it equally as dangerous in old public buildings, such as schools, as it is in homes?
A: Public buildings are not nearly as problematic as homes. The real population at risk for lead poisoning is basically 6 months to 6 years of age; past that age frame, it's not such a public health problem. The primary problem is ingestion of lead, and not that many adults would sit down and eat lead products. Lead is in many things: there's lead glass, lead (weights) in fishing tackle; lead is in a lot of things in our environment. Just because there's lead in the environment doesn't mean it's caustic or toxic to anyone. It's only when it's ingested that it becomes a problem. That's why there's a focus on kids from 6 months to 6 years of age. As we focus on interventions and ridding our environment of lead, it's more advantageous to rid our environment of lead for our children.
Q: What health problems can result from lead exposure?
A: It can be very toxic in terms of mental development, bone development -- and you can die from lead poisoning, but it would have to be a very high level of lead ingested. It's very rare that an adult would ingest enough lead to be harmful. However, a lot of pottery from Mexico has lead in it. If you ingest food served on that pottery, it can be dangerous. The bottom line is that Š ingestion is what we have to avoid.
Q: What about lead exposure from old water pipes?
A: Again, that can be a problem, because you ingest it. But most of the water lines have copper (pipes) instead of lead. The lead is mostly in the waste (pipes) from toilets, etc. In terms of waste, that shouldn't be a problem because of our water treatment. Our primary exposure in this city, I think, is not from water, it's from paint.
Q: Do you recommend that people use bottled water or tap-mounted water purifiers for their drinking and cooking water?
A: Not based upon lead exposure. There is no evidence I have seen that the drinking water is unsafe or problematic to make people need to go to some alternative drinking water. Our water supply is not unsafe.
Q: If you can't see, smell or taste lead, how can you tell if your home or office is affected by it?
A: Lead is not (naturally) airborne. It's a metal. [But when you sand] lead paint, you need to have very good ventilation and masks to protect you from inhaling the dust (which is another form of ingestion). There are guidelines for people who are remodeling in lead-based environments to protect them from lead exposure.
Q: How do you get rid of lead?
A: You need to have people who are very familiar with demolition and removal of lead. If not, it can be a problem. When you start sanding and lead is mobilized in dust particles, that's how kids come in contact with it -- breathing it, crawling in the dust; kids put everything in their mouths, and they'll ingest it.
Q: Are older people at as much risk for the effects of lead poisoning as those 6 years old and younger?
A: It's not nearly as dangerous for old people, because most of the exposure is from ingestion, and most people don't eat it. The same thing with school-aged kids. They are older; they don't crawl on the ground (in lead-contaminated dust) or eat paint chips.
Q: So we've been led to believe we're in more imminent danger than we are and should be more afraid of exposure than we need to be?
A: In a way, but in a way not. I think that the biggest harm is to the children, and unless we really raise awareness, you can go out and sandblast and do these things to a house and not be aware. It can cause all kinds of problems in kids. I think we should have everyone in the 6-month to 6-year range tested for lead. We should screen all kids for lead poisoning as part of a routine screening.
Q: I've read that lead poisoning can cause dramatic problems such as mental retardation, stunted growth, lowered IQ and there's even a link with delinquency. Are those worst-case scenarios?
A: That's a high dosage. Most of the time, kids who have lead exposure have no demonstrable ill effects. Most of the cases we see are not at the level for them to have those problems. I think it's because we're so aggressive in educating people and making sure they take precautions. But you can die from lead poisoning. Don't get me wrong, it's not an agent that's not problematic. But it's the direct ingestion of lead that is the most dangerous. That's why you need to make your house lead-proof for young children Š and when you are sandblasting, you can ingest lead through the (paint dust in the) air.
Q: Is there anything else you want people to know?
A: The main point is that children are the ones at risk. We have to be cognizant of lead in our environment and move it out of the way. And all children 6 months to 6 years old should have a blood-lead test. If anyone has questions or problems, we have a lead office in City Hall, 565-6900. Our goal is to eliminate childhood lead exposure.
