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Lead Follies in St. Louis
by Don Fitz
According to Missouri politicians, St. Louis is reducing lead poisoning by over two-thirds and instituting bold programs to remove lead from homes to prevent poisoning. Close scrutiny reveals a very different story. This raises the question: Since every local government is highly motivated to say it is coping with lead poisoning, which claims are real and which are bogus?
On May 8, 2006 St. Louis Mayor Francis Slay invited the public, and, of course, the press, to join him at a “community forum” to celebrate a model home where lead had been removed. In his opening comments, the Democratic Party mayor boasted that the City of St. Louis had achieved a 70% reduction in childhood lead poisoning since 1999. Republican Senator Kit Bond patted himself on the back for bringing millions of federal dollars to St. Louis for “a primary prevention model to keep children from being poisoned in the first place.” If these claims were true, then St. Louis would have a record that every other city should seek to copy. Instead of verifying a successful program, they illustrate political manipulation of data to create lead fantasies.
Children as lead detectors
The current lead crisis in the City of St. Louis has deep roots. In 1969, civil rights activist Ivory Perry helped persuade the Board of Aldermen to pass the City’s first lead law, designed to force landlords to detoxify rental property. But within a couple of years, Perry realized that the fines were too small and enforcement too lax to make a real impact on children’s health.
By the turn of the millennium some black neighborhoods had lead poisoning rates as high as 55% .
For the next several decades St. Louis legislators did little. By the turn of the millennium some black neighborhoods had lead poisoning rates as high as 55%.
By this time, lead activists realized that the approach of first finding children that were poisoned and then testing where they lived was terribly inadequate. This ensures that child after child is poisoned. The approach is misnamed “secondary prevention.” It would be more accurate to call it “lead poisoning reaction.”
Lead activists advocate “primary prevention.” This requires removing lead from homes in areas known to have a high rate of lead poisoning.
Closely related is the need for lead abatement using window replacement. Treatment of homes with lead can either be with interim controls, which are temporary fixes such as scraping, repainting, washing and vacuuming, or abatement, which is lead removal. Interim controls last somewhere between a few weeks to a few years before they must be repeated. Abatement is designed to be permanent. It includes window replacement because friction from opening and closing old windows means they are the greatest source of lead dust.
In recent years, the City of St. Louis has come under increasing fire for its inadequate lead program from the St. Louis Lead Prevention Coalition (LPC), Health and Environmental Justice (HEJ) and the Gateway Green Alliance (GGA). It also received critical coverage in the St. Louis Post-Dispatch, Riverfront Times, St. Louis American, Saint Louis Argus and South City Journal.
In 2003, LPC released an extensive report, Lead Canaries: The Tragic Tradition of Childhood Lead Poisoning in St. Louis. That report charged that the City continues to “use children as lead detectors.” The report estimated that abatement, including window replacement, would cost about $9000 per housing unit. Since interim controls cost about $7500 per living unit, it is clearly not cost effective to spend almost as much for a quick fix that will need to be repeated multiple times.
The LPC report also argued that the City needs to “advocate for substantial expansion of federal funds.” (p.12) It compared lead poisoning to the billions of dollars spent on the Superfund program since 1980 and maintained “Superfund sites pose a less direct and immediate threat to human health than the threats posed by lead paint hazards in children’s homes.” (p. 18)
Shortly after the LPC issued its report, the City of St. Louis began to change the words of its song while keeping the same tune. The Mayor’s Lead Safe St. Louis Report issued in late 2003 began to talk about the need to prevent lead poisoning from happening and even mentioned window replacement.
The City has been grabbing at buzzwords and jumping on linguistic bandwagons rather than examining its basic policy. In none of its many reports and proclamations does the City describe a plan for actually spending money on removal of lead from homes and window abatement in the most highly contaminated neighborhoods. The City plans to respond faster after children are poisoned. In other words, the City’s lead plan is more intense reaction to lead problems while mislabeling its reactive approach as “primary prevention.”
A 70% reduction in lead poisoning?
With mounting criticism but an unwillingness to make fundamental changes, the Mayor took to statistical manipulation.” Slay’s claim that there has been a 70% reduction in lead poisoning must be referring to the Department of Health’s Childhood Lead Poisoning in the City of St. Louis: Annual Report 2004. It claims that 31.1% of children under six were lead poisoned in 2000 and that the rate dropped to 9% in 2004 — a whopping decline of slightly over 70% (Table 2, p. 7). It is based on the Centers for Disease Control’s (CDC) standard that children with at least 10 micrograms of lead per deciliter of blood (mcg/dL) are “of concern,” or lead poisoned.
… we have no real idea of whether the lead poisoning rate is showing a decline or whether it is remaining the same or even increasing.
Scrutinizing the facts, including data from the City’s own report, indicates that we have no real idea of whether the lead poisoning rate is showing a decline or whether it is remaining the same or even increasing. First, the City has never tested a majority of children for lead. Despite state law mandating the testing of every child, the rate has been 33% – 48% since 1990. This makes it possible to manipulate which areas of the City receive the most testing in order to make the rate appear high or low.
Second, the report observes that “In 1999, Missouri Attorney General Jay Nixon sued Healthcare USA of Missouri LCC and Prudential Health Care Plan Inc. for accepting payments for lead testing that were never performed on St. Louis area children.” (p. 7) The tests that were never done coincided with a rate of lead poisoning (31.1%) that was the highest during the period of 1996 – 2004. It is possible that the rate was high because the companies wished to make sure that the faked tests documented a need for further testing.
Third, the St. Louis Post-Dispatch uncovered a major scandal for 2000 – 2001. In a series of articles, it reported that the Health Department’s lab had mishandled thousands of lead tests. “The improperly calibrated lab equipment resulted in a phony decrease in the percentage of lead-poisoned children in St. Louis.” (March 19, 2004, p. C1)
Fourth, as a result of the lawsuit, companies which received money for tests they did not perform in 1999 and 2000 had to do an extra $1.1 million of tests in 2003 and 2004. These extra tests could well have involved many children from areas that were not the most contaminated with lead. Increased testing of children who are unlikely to be lead poisoned would give the impression that the rate of lead poisoning is going down.
Fifth, the City’s own report suggests an increase in the number of vacant homes in St. Louis. People could well be moving out of homes to live with relatives or on the streets. This would contribute to a real decrease in lead poisoning but not because more homes are being made lead-safe.
Given the widespread fraud that permeated the time period for which the mayor claimed a great success, the most we can say about lead poisoning rates in the City of St. Louis is that official numbers are an interesting fiction. The authors of the report admitted “there is insufficient evidence to conclude that the [lead poisoning] problem is being resolved.” (p. 8)
Yet, even though his own staff informed him that they had been caught with so many funny numbers that they could not make a conclusion from them, the mayor had no trouble claiming a 70% reduction in lead poisoning when standing in front of cameras. After all, few reporters would be willing to wade through documentation showing how bogus the claims were.
Lead safe homes?
In 2004, the City decided that it could capitalize on the language of “primary prevention.” By claiming that it was removing lead before children were poisoned it could pretend that it was joining the progressive steps taken by many US municipalities while undercutting the widespread criticism directed its way. Its 2004 report to the Board of Aldermen announced a “Lead Safe Kids and Homes Week.” In March 2005, it said that the project would begin with a “Lead Safe Blocks” campaign that planned to address lead problems in “a City block in one of our most severely lead-affected zip code neighborhoods.” Its director announced an April 9, 2005 block party to initiate “a program of outreach, education, testing, and remediation with the plan to make every dwelling on the block lead safe.”
… the City of St. Louis had made no progress at all in completing the task of making the block “lead safe” …
At first, members of HEJ and GGA were enthusiastic that the City had finally begun a primary prevention program. But in July 2005, City officials reported that they had only been able to contact two property owners on 3300 Nebraska, the block it had targeted. Members of HEJ and GGA offered to help make the contacts and do interviews for the City. For months, City officials failed to respond to the offer and did not provide any information concerning progress of “Lead Safe Blocks.”
So, in September 2005, the GGA decided to conduct an independent survey to measure progress on 3300 Nebraska. The Greens designed a 10-item interview to be used with residents of 3300 Nebraska and two comparison blocks.
In order to reach residents at home, interviewers went door to door on weekends and after work between October 1 and October 11, 2005. When necessary, interviews were conducted in Spanish.
A totally unexpected finding was the degree of discrepancy between the City of St. Louis document, “3300 Nebraska Checklist,” and what interviewers found when they went door to door. There were seven addresses listed where there is no house. There were several locations where the checklist indicated 2 or 3 residences and there was only one residence. Interviewers also discovered two residences which exist even though they do not appear on the City’s Checklist for 3300 Nebraska.
By the seventh month after the beginning of the project, the City of St. Louis had an error rate of 31.9% in the relatively simple task of identifying homes on a single block. This did not inspire confidence that the City was making significant movement toward the elimination of lead from homes.
Several interview questions looked at respondents’ awareness of lead dangers. The first of these, “Did you know that lead poisoning can cause serious health problems, especially in children?” received over 90% “yes” responses on both 3300 Nebraska and the comparison blocks.
The two groups were differentiated by the second question, “Did you know that homes in this neighborhood have some of the highest levels of lead in St. Louis?” On 3300 Nebraska, 61.3% answered “yes,” but this was the case with only 37.8% of those on the comparison blocks.
This confirms that the City’s educational program raised awareness on the targeted block. Still, the fact that almost 40% of 3300 Nebraska residents did not know that they live in a highly contaminated area indicates the need for ongoing education.
Four questions examined the stage of lead treatment at each home:
1. Has this home been tested for lead this year?
2. Has anyone offered to do lead removal from this home?
3. Has anyone set a specific date for lead removal from this home? and
4. Has lead removal from this home been completed?
Comparing answers to these four questions reveals a very clear pattern. Residents of 3300 Nebraska were far more likely than those on neighboring blocks to report that their homes had been tested for lead since the beginning of the year. The question of whether anyone had offered to do lead treatment found the gap narrowing, but still favoring the 3300 Nebraska residents. The third phase, setting a specific date for lead treatment to begin, slightly favored the 3300 Nebraska residents. But the critical question of whether lead treatment had been completed found no difference between 3300 Nebraska and comparison residents.
Inclusion of the comparison blocks proved critical. If only residents of 3300 Nebraska had been interviewed, the two homes where lead had been treated might seem to indicate that the City’s program is proceeding, though at a very slow pace. But the finding that the number reporting the cleanup being finished was exactly the same in both groups demonstrates that if made no difference whether a person lived on 3300 Nebraska or a neighboring block. This evidence indicates that the City of St. Louis had made no progress at all in completing the task of making the block “lead safe” (over and above what would occur without the project).
(Complete survey results include interview questions, demographics of interviewers and residents, frequency of homeowners and renters, number of children, and statistical analyses. It is available at http://gateway-greens.org/2005/press/LeadEval_3300Nebraska.PDF)
The mayor’s showcase home received what is the Cadillac of lead treatment for St. Louis while other property has to settle for scraping and repainting …
The GGA invited the City of St. Louis to participate in two programs which included discussion of these findings: the January 4, 2006 panel “Is the City of St. Louis Removing Lead from Homes?” and the April 20 forum “Ivory Perry and the Struggle for a Lead Free St. Louis.” At both programs, the Director of Lead Safe St. Louis stated emphatically that she felt the Lead Safe Block program had been a “success.” Her only elaboration as to why it was successful was a vague statement that the City “had learned from it.”
This angered several people who had participated in interviewing residents on 3300 Nebraska and demanded an explanation of what the City had learned. They did not receive an answer.
Lead poisoning activists and government bureaucrats seem to have sharply diverging views of what constitutes success. From the point of view of parents of lead poisoned children and other activists, a successful program is one that removes lead from homes and lowers blood lead levels. From the perspective of a politician, a successful program would be one that received good publicity and improved the mayor’s ratings in the polls.
Looking at lead programs
The May 8, 2006 press conference which Mayor Slay called to celebrate lead removal from one home was part of the pretense that the City has a primary prevention program. On the surface, it looks like it does. The City put up money for window replacement and other paint removal for a home and four adjacent rental units. No children were living in the rental units and the child of the home owner had a lead level below 10 mcg/dL, meaning that the City was removing lead before any children met the criteria for being lead poisoned.
But the Mayor’s claim that 2,000 homes had been treated for lead gave the utterly false impression that other homes had received the same treatment. The mayor’s showcase home received what is the Cadillac of lead treatment for St. Louis while other property has to settle for scraping and repainting, which is a quick fix that often does not last.
cities need to be demanding that the US declare a Lead Emergency.
The owner of the model home had to put up $17,000 to get $21,000 funds from the City. As is typical for US cities, St. Louis has many people who own their own homes and perhaps some rental property but cannot come up with $21,000. Not surprisingly, this was the first home to receive such a loan for lead removal.
But the most revealing fact of the showcase home was that it was in the 63116 zip code, which is not one of the areas of the City that has high lead contamination. The mayor ignored the predominantly black zip codes where lead contamination is endemic and chose a white family that could afford to put up the cash to participate.
Local governments never announce that they design bad health programs. When politicians talk about lead poisoning prevention, people will hear that their programs are “state of the art.” But there are several things to look for when trying to figure out if lead work is headed in the right direction or is just hot air.
- The least important factor in assessing a lead poisoning prevention program is what it says about itself. This is true even if it claims that it is using primary prevention to remove lead before kids are poisoned.
- Look at where lead poisoning prevention dollars are actually being spent. This does not mean political grandstanding about a single home or even a block. The issue is whether, year after year, money is spent removing lead from homes in neighborhoods that have the highest rates of lead poisoning.
- Instead of relying on data gathered by people whose salaries depend on producing favorable data, it is better to use information from large studies that compare effects of several local governments.
- See if the local government accepts the propaganda that spending a few million dollars locally or a few hundred million nationally is enough to deal with the crisis.
Clearly, lead poisoning occurs on such a massive level that US cities need to be demanding that the US declare a Lead Emergency. Such an emergency would have legislative and financial precedent in Superfund laws that have devoted billions of dollars to addressing toxic sites. If a city government, state government, non-profit organization or political party truly opposes the poisoning of another generation of US children, then it will join the call to devote serious funds to stop it.
Don Fitz is editor of Synthesis/Regeneration: A Magazine of Green Social Thought and producer of Green Time TV in St. Louis. He can be reached at email@example.com
[20 sep 06]