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Statement of David E. Jacobs, Ph.D.
Director
Office of Healthy Homes and Lead Hazard Control
before the U.S. Senate
Committee on Banking, Housing and Urban Affairs
Subcommittee on Housing and Transportation
June 5, 2002
Thank
you for the opportunity to discuss HUD's activities in the area
of childhood lead poisoning prevention. The evidence shows that
while the nation has made much progress, much remains to be done
to meet the goal of eliminating the disease by 2010.
I
am the director of the HUD Office of Healthy Homes and Lead Hazard
Control. Before joining HUD 6 years ago, I was deputy director of
the National Center for Lead-Safe Housing and a scientist on the
faculty at the Georgia Institute of Technology, where I conducted
research on residential lead hazard detection and control. I am
also a board-certified industrial hygienist.
HUD
Secretary Mel Martinez has made childhood lead poisoning prevention
one of the priorities of his administration. As a result of this
commitment, we have trained over 28,000 housing rehab and maintenance
workers and others in the past year alone in lead-safe work practices.
We have increased HUD's lead hazard control budget by 10% for FY
2002 and the President's budget proposal for FY 2003 increases it
further still, from $110 million to $126 million. The Secretary
has also increased our office's staffing to improve our grant delivery,
enforcement, public education and research efforts.
The
most current nationwide estimates from the Centers for Disease Control
and Prevention (CDC)1
show that 890,000 children had blood lead levels above the CDC level
of concern during the time of the survey (1991-94). That study also
showed that 21% of African-American children living in older housing
where lead-based paint is most prevalent were poisoned, compared
to 4.4% for the general population. In December of 2000, CDC provided
more recent data2 showing
that while some counties had prevalence rates as high as 27%, the
average blood lead level in young children declined by 25% from
1996-99 to 1.9 micrograms per deciliter, suggesting our efforts
to make U.S. housing lead-safe are successful.
The
reason for this success is that the nation took action. Lead exposures
from food canning, gasoline and new paint were eliminated. Lead
in air emissions, occupational exposures and water all were controlled
and older housing with lead paint is continually being rehabilitated,
abated or demolished. Studies of the numerous, but often subtle,
harmful effects of lead were completed and a consensus emerged.5
All of these actions have caused average blood lead levels to decline
by over 80% since the 1980s,2
an achievement that ranks as one the nation's most successful public
health stories.
Nevertheless,
the evidence is clear that the major high dose source for most children
today is existing lead-based paint in older housing and the contaminated
dust and soil it generates.6,7,8
More must be done to prevent hundreds of thousands of additional
children from being poisoned in the decades to come. HUD's new survey9
of lead-based paint in housing shows that the estimated number of
homes with lead paint declined from 64 million in 1990 to 38 million
in 2000. Of the 38 million units with lead paint, 25 million have
lead hazards. Of those 25 million, 5.6 million house children under
the age of 6. 1.6 million of those units house low-income families
with children under 6, the population most at-risk of elevated blood
lead levels. Forty-one percent of low-income housing has lead paint
hazards, compared to 18% of middle and upper income housing. HUD
expects to repeat the survey of housing with lead hazards in 2004,
which will help better determine long-term trends of lead hazard
reduction.
Importantly,
government-supported housing, which is almost all low-income housing,
has a prevalence rate of 17%, about the same as middle and upper
income housing. Therefore, from a lead-safety perspective, government
supported housing is also the safest housing, the strongest indication
yet that the Federal standards are effective. The data also show
that the problem is most severe in privately owned low-income housing
that is or will be occupied by families with young children. These
are precisely the houses that are targeted by HUD's lead hazard
control grant program.
HUD
has worked closely with other federal agencies to protect children
from lead poisoning. We must work more closely with other agencies
to match families with young children and houses that have been
made lead safe through our various programs. We should find ways
to get this information to families who need it most, such as Medicaid-eligible
families. One option could be to make more information about HUD
lead hazard control programs available to State Medicaid agencies
through Centers for Medicare & Medicaid Services (CMS), CDC and
other components of the Department of Health and Human Services
(HHS). When CDC conducted its High Intensity Targeted Screening
effort in Chicago recently, HUD was there to provide resources needed
to eliminate lead-based paint hazards for children who had not been
previously identified as being at risk.
After
a transition period, HUD's new lead-based paint regulation for federally
assisted housing is now in effect across the country. Federally
assisted housing now includes modern, more effective and scientifically
proven hazard identification and control methods to ensure that
it is safe for children. This regulation brings lead hazard control
procedures into routine housing finance, maintenance and rehab systems
and therefore represents a change from the way the nation approached
the problem in the past, which was largely reactive and inadequate.
In short, we take action before a child is poisoned, instead
of only acting after the damage has been done. HUD's procedures
for federally assisted housing provide a template for promoting
lead safety in other housing with lead paint hazards. Furthermore,
the capacity we have built to implement lead-safe work practices
among painters, remodelers, renovators and maintenance personnel
can be used more broadly, because many contractors often work in
both assisted and non-assisted housing.
In
addition to all this, we have:
- developed
a 10-year strategy to eliminate childhood lead paint poisoning,
which was published by the President's Task Force10
(this marked the first time that federal agencies developed a
coordinated approach and documented the resources needed);
-
linked lead safety to other children's health hazards that may
be caused by underlying
housing conditions through HUD's Healthy Homes Initiative;
-
created an effective lead hazard control grant program to eliminate
lead-based paint hazards in privately owned low-income dwellings
where hazards are greatest. Today the HUD program is active in
over 200 jurisdictions across the country;
-
together with state and local law enforcement, health and housing
departments, the Department of Justice and EPA, enforced the lead-based
paint disclosure regulation (so far, we have brought cases that
have resulted in compliance and lead paint abatement in over 158,000
high-risk dwelling units, as well as two criminal convictions
against landlords who failed to comply);
-
conducted the nation's largest study of modern lead hazard control
techniques to determine the effectiveness of the HUD grant program
(the results show that children who live in units where hazards
have been eliminated have a 25% lower blood lead level and their
homes have a sustained 50-88% decline in dust lead levels);11
- conducted
research to reduce the cost and increase the effectiveness of
hazard identification and control technologies;
-
completed the inspection and risk assessment of tens of thousands
of units receiving HUD Section 8 project-based subsidies;
-
paid for clearance testing in public housing and in HUD-funded
rehab programs covered by HUD's lead-safe housing rule;
-
performed public education and outreach services through private
sector organizations such as Sears;
-
been recognized by the Office of Management and Budget as an "effective"
program; and
-
published technical guidelines,12
in the form of a 500 page compendium of best practices that is
regarded by practitioners in the field as state of the art and
widely referenced in federal, state and local regulations.
Another
opportunity for collaboration is between HUD and the Environmental
Protection Agency (EPA). HUD and EPA have worked together to target
our regulations so that abatement contractors are used for the most
dangerous jobs, not routine housing rehab, and so that housing rehab
workers get the training they need to do their jobs safely. For
example, EPA developed a curriculum for lead-safe renovation work
practices, which HUD adopted for use in assisted housing programs.
HUD
and HHS already collaborate on the National Health and Nutrition
Examination Survey (NHANES), where HHS pays for analysis of children's
blood lead samples and HUD pays for analysis of dust lead samples
in children's homes. It is possible that this partnership could
be expanded to permit NHANES to characterize the extent of lead
hazards in the nation's housing.
HUD
has also coordinated with the Department of Energy's weatherization
programs. Weatherization measures are intended to make homes more
energy efficient and may include window replacement, door repair,
and restoration of deteriorated walls. Unfortunately, such measures
may also involve disturbing lead-based paint. If contaminated dust
and paint chips are not properly controlled and cleaned up, weatherization
may inadvertently increase children's exposures. When weatherization
is performed as suggested in such weatherization programs, it can
eliminate lead-based paint hazards -- a win-win opportunity. Many
HUD grantees leverage lead hazard control and rehab funding with
DOE weatherization funding. For example, replacement of windows
is both a key weatherization practice and an effective lead hazard
control method. While Title X of the 1992 Housing and Community
Development Act does not cover DOE weatherization programs, we believe
weatherization work practices must be consistent with lead-safe
work practices to ensure children are protected in homes undergoing
weatherization.
I
would like to close by discussing the Secretary's new effort to
increase the involvement of the private sector in lead poisoning
prevention. HUD will soon release a Notice of Funding Availability
for Operation LEAP (Lead Elimination Action Program). Grants will
be awarded to entities that can demonstrate they can leverage additional
funding and resources for local lead hazard control programs. Congress
appropriated $6.5 million for this new effort for FY 2002. We are
hopeful the private sector will respond to this opportunity to help
solve this problem.
Finally, let me recognize Senator Reed for his resolve and commitment
to this issue.
END
NOTES
1
Centers for Disease Control and Prevention, "Update: Blood Lead
Levels-United States 1991-1994," Morbidity and Mortality Weekly
Report, U.S. Department of Health and Human Services/Public Health
Service, Vol 46, No.7, Feb 21, 1997, p. 141-146 and erratum in vol
46, No. 26, p. 607, July 4, 1997
2 Centers for Disease
Control and Prevention, Blood lead levels in young children-United
States and Selected States, 1996-1999, Morbidity and Mortality Weekly
Report 49(50): 1133-1137, December 22, 2000
3
Agency for Toxic Substances and Disease Registry, The Nature and
Extent of Childhood Lead Poisoning in the United States: A Report
to Congress, July 1988
4
Brody et al., Blood lead levels in the U.S. Population: Phase 1
of the third National Health and Nutrition Examination Survey, 1988
to 1991, Journal of the American Medical Association 272(4): 277-283,
July 27, 1994 and Pirkle et al., The decline in blood lead levels
in the United States, Journal of the American Medical Association
272(4):284-291, July 27, 1994
5
National Academy of Sciences. Measuring Lead Exposure in Infants,
Children, and Other Sensitive Populations, Report of the Committee
on Measuring Lead in Critical Populations, Board on Environmental
Studies and Toxicology, Commission on Life Sciences, National Academy
of Sciences. Washington, DC: National Academy Press, 1993.
6
Jacobs DE. Lead-based paint as a major source of childhood lead
poisoning: A review of the evidence. In: Lead in Paint, Soil and
Dust: Health Risks, Exposure Studies, Control Measures and Quality
Assurance (Beard ME and Iske SDA, eds). Philadelphia: ASTM STP 1226,
American Society for Testing and Materials, 1995;175-187.
7
McElvaine MD, DeUngria EG, Matte TD, Copley CG, Binder S. Prevalence
of radiographic evidence of paint chip ingestion among children
with moderate to severe lead poisoning, St. Louis, Missouri, 1989-90,
Pediatrics 89:740-742 (1992).
8
Clark CS, Bornschein R, Succop P, Roda S, Peace B. Urban lead exposures
of children in Cincinnati, Ohio, Journal of Chemical Speciation
and Bioavailability, 3(3/4):163-171 (1)
9
Jacobs et al., The Prevalence of Lead-Based Paint Hazards in U.S.
Housing, accepted for publication in Environmental Health Perspectives,
2002. Also see HUD, National Survey of Lead and Allergens in Housing,
2001 (available at www.hud.gov/offices/lead)
10
President's Task Force on Environmental Health Risks and Safety
Risks to Children. Eliminating Childhood Lead Poisoning: A Federal
Strategy Targeting Lead-based paint Hazards. Washington DC: U.S.
Department of Housing and Urban Development and U.S. Environmental
Protection Agency, February 2000.
11
Galke W, Clark S, Wilson J, Jacobs D, Succop P, Dixon S, Bornschein
B, McLaine P, Chen M. Evaluation of the HUD lead hazard control
grant program: early overall findings. Env Res 86A:149-156 (July
2001)
12
Guidelines for the Evaluation and Control of Lead-based paint Hazards
in Housing. HUD 1539-LBP, Washington DC: U.S. Department of Housing
and Urban Development, 1997.
Content Archived: June 25, 2010
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