Josephine M. Britanico PUBH 8165-1 Environmental Health Increasing the Knowledge of the Risk of Lead Poisoning and to Decrease the Childhood Blood Levels in Southwest Queens, New York City Josephine M. Britanico PUBH 8165-1 Environmental Health

Objectives of this presentation: To increase public awareness of the risk of lead poisoning To educate parents and women of childbearing age on how to prevent lead exposure To provide resources and information for parents regarding important web sites on imported products that contain lead

Targeted Audience: Residents of Southwest Queens Queens Health Coalition http://www.queenshealth.org Greater Brooklyn Health Coalition: http://www.brooklynhealth.org Global Healthy Living: http://www.ghlf.org New York City Health and Hospital Corporation: http://www.nychhc.org New York City Department of Health and Mental Hygiene : http://nyc.gov/doh New York City Department of Education: http://www/schools/nyc.gov Public Health Association of New York: http://www.phanyc.org These are other stakeholders.

What is Lead Poisoning? Lead is a metal that occurs in the earth’s crust. People have spread it through the environment in many ways. Lead used to be in paint and gasoline. It can still be found in contaminated soil, household dust, drinking water, lead-glazed pottery and some metal jewelry.

Public Health Significance: Lead poisoning remains a significant health problem in New York City. NYS law requires blood lead testing for every child at both 1 and 2 years and for other high risk children. In 2007, only 79% of 1 yr.olds tested and 66% of 2 yr.olds were tested and only 44% of children had been tested for both ages. Reference: NYCDOHMH

How does lead gets in the body How does lead gets in the body? What happens when it gets into your body? Breathing air, drinking water, eating food or swallowing or touching dirt that contains lead can cause many health problems. In adults, lead can increase blood pressure, and cause infertility, nerve disorders and muscle and joint pain. It can also make you irritable and affect your ability to concentrate and remember.

Lead Effects in Children Lead is especially dangerous in children. A child who swallows large amounts of lead may develop anemia, severe stomach ache, muscle weakness and brain damage. Even low levels of lead are linked to lower IQ scores associated with decreased intelligence. It has also been associated with learning and behavioral problems and delayed growth and developments.

Who are at most risk? All children under age of 6 years of age because they are growing so rapidly and they tend to put their hands or other objects into their mouths which may be contaminated with lead dust. Children living or below the poverty line who live in older housing before 1978 are at greatest risk Children of some racial and ethnic groups living in older housing are disproportionately affected by lead.

NYC 2007 Profile of Children newly identified with venous BLLs > 15µg/dL 87% were black, Asian, or Hispanic 82% lived in homes built before 1950 76% had lead-based paint hazards found in inspection of their address 60% were younger than 3 years old 17% were foreign born Among NYC pregnant women with elevated BLL’s , 94% are foreign born. Reference: NYCDOHMH

Statistics of newly identified childhood lead poisoning in Southwest Queens, NYC Areas covered are Ozone Park, Richmond Hill and Howard Beach, Queens, NYC There were 163 children (12/1,000) identified with lead poisoning ( defined as blood lead level greater than or equal to 10µg/dL.) Reference: NYCDOHMH

Newly Reported Blood Lead Levels > 5µg/dL among children and Women of Reproductive Age in NYC 2007 Data BLL (µg/dL Children ( 6m-5yr) ( 6-17 yr) Women ( 18-49yr) Infants ( 0-5m.) 5-9 21,475 2, 884 2, 053 158 10-14 1, 409 219 196 22 >15 538 74 123 8 TOTAL 23, 422 3, 177 2,372 188 Source: Unpublished 2007 Data NYC Dept. of Health and Mental Hygiene

Prevention Tips Ask about lead when buying or renting a home. Sellers and landlords must disclose known lead hazards in houses or apartments built before 1978. About 67% of NYC housing was built before 1960 Reference: NYCDOHMH

Prevention Tips Keep your child away from peeling paint and home repairs that disturb lead paint. Report peeling paint to your landlord. If your landlord does not make repairs, call 311.

Prevention Tips Frequently wash hands, toys, pacifiers, bottles, and other items your child puts in his or her mouth

Prevention Tips Clean floors, windowsills, and dusty places often with wet mops and wet cloths.

Prevention Tips: Avoid using health remedies and eye cosmetics (such as kohl, kajal, surma) from other countries. Some of these products have been found to contain high levels of lead

Prevention tips: Prevent children from playing in bare soil. If possible, provide them with sandbox.. Until the bare soil is covered, parents should move play areas away from bare soil and away from the sides of the house.

Prevention Tips: Parents should plant grass on areas of bare soil or cover the soil with grass seed, mulch, or wood chips if possible to avoid direct contact with soil.

Prevention Tips: Home remedies (bright orange, yellow, or white powders) like Greta, Azarcon, Paylooah, or Liga used in some cultures to treat certain illnesses contain large amount of lead.

Prevention Tips: Some candies from Mexico, and other countries, are made with chili and tamarind , and they may contain lead. Be cautious about them!

Prevention tips: Never sand, dry scrape, power wash or sandblast unless the paint has been tested, and does not have lead in it.

Prevention Tips: Most fishing sinkers are solid lead. Keep lead fishing sinkers and tackle boxes out the reach of young children. Never melt lead to make your own sinkers. Consider switching to sinkers made from other metals

Prevention tips: Use only cold tap water for making baby formula, drinking, and cooking. Let the water run for a few minutes before use. Hot water is more likely to contain higher levels of lead. Most of the lead in household water usually comes from the plumbing in your house, NOT from the NYC water supply.

Prevention tips: Keep your child away from the work clothes and tools of household members who do construction work or other work and hobbies that may expose them to lead. Shower and change clothes after finishing task that involves working with lead-based products such as stain glass work, bullet making, or using firing range.

Prevention Tips: Wash work clothes separately from other laundry. Remove shoes and work clothes before entering your home.

Prevention Tips: Some imported toys especially from China may contain lead products and re-called Remove recalled toys and toy jewelry immediately from children. Check Lead Recalls lists .

Prevention tips: Avoid using imported clay pots and dishes to cook, serve, or store food or liquids that are not shown to be lead free. Do not use pottery that is chipped or cracked.

Prevention tips: Be aware that some foods help keep lead from being stored in your child’s body. Foods with calcium: milk, cheese, yogurt, tofu, and green, leafy vegetables. Foods with iron: beans, lean meat, fortified cereal and peanut butter.• Foods with vitamin C: oranges, orange juice, grapefruit, tomatoes, green peppers

MOST Importantly: GET YOUR CHILD TESTED FOR LEAD. There are no visible symptoms of lead poisoning and children may suffer behavior or learning problems as a result of exposure to lead hazards.

What does your child results mean? The test result is in micrograms per deciliter (mcg/dL) 0-4 • There is very little lead in your child’s blood. The average lead test result for young children is about 2 mcg/dL. 5-9 • Your child has a little more lead than most children. Talk with your doctor and local health department to find out how your child might have come into contact with lead, and ways to protect your child. Your doctor might want to test your child again in 3 to 6 months. 10-14 • Your child’s lead level is high. A result of 10 or higher requires action. Your doctor and local health department will talk with you to help you find sources of lead, and ways you can protect your child. Your child should be tested again in 1 to 3 months. 15-44 • Your child’s lead level is quite high. You and your doctor should act quickly. Talk with your doctor or nurse about your child’s diet, growth and development, and possible sources of lead. Talk with your local health department about how to protect your child. They may visit your home to help you find sources of lead. If the lead level is 15 to 24, your child should be tested again in 1 to 3 months. If the lead level is 25 to 44, your child should be tested again in 2 weeks to 1 month. 45 or higher • Your child needs medical treatment right away. Your doctor or health department will call you as soon as they get the test result. Your child might have to stay in a hospital, especially if your home has lead. Your local health department will visit your home to help you find sources of lead. Your child should not go back home until the lead sources are removed or fixed. Your child needs to be tested again after treatment.

Resources: The National Lead Information Center at 1-800-424-LEAD (5323) or www.epa.gov/lead/nlic.htm can tell you how to contact your state, local, and/or tribal programs or get general information about lead poisoning prevention

Resources: Report heavy metal poisonings or products that may contain heavy metals by calling NYC Department of Health and Mental Hygiene (DOHMH) at 212-788-4290 during regular business hours. For more information on imported products that contain lead, visit the following DOHMH websites: www.nyc.gov/html/doh/html/lead-import-eyecos.shtml www.nyc.gov/html/doh/html/lead/lead-herbalmed/shtml For urgent matters during non-business hours, call Poison Control at 1-800-222-1222

Lead Recalls Resource: The U.S. Consumer Product Safety Commission (CPSC) is charged with protecting the public from unreasonable risks of serious injury or death from more than 15,000 types of consumer products. CPSC announces all recalls on their website http://www.cpsc.gov/.

More Local Resources: Talk with your child’s doctor or nurse. Call your NYC local health department, listed in the phone book blue pages or call 311. • Visit the New York State Department of Health website at: www.nyhealth.gov/environmental/lead

YOU HAVE THE RIGHT TO BE IN A LEAD FREE ENVIRONMENT. TAKE CARE NEW YORK. Thank you!!