By the time the consequences of lead poisoning are revealed, it's too late. Even though children ages 6 months to 6 years are most at risk for lead poisoning, the results of high levels of lead in the blood -- reduction in IQ and aggressive behavior -- don't occur until the child is 7 to 9 years old. Unfortunately, New Orleans, with its combination of poverty and older houses with peeling paint, puts children in danger of ingesting high levels of lead. In fact, the city recently ranked 28th in a list of 100 places with houses with lead-based paint. Dr. Felicia Rabito, a clinical assistant professor at Tulane University's School of Public Health and Tropical Medicine who specializes in lead poisoning, discusses how to limit children's exposure to lead and when you should get your child tested for lead poisoning.

Q: Prior to Katrina, what steps did the city take to lessen the danger of lead poisoning to children?

A: They have a lead-poisoning prevention program (New Orleans Lead Poisoning Prevention Program: 658-2565). They do screening of children, they do case management, and they do health fairs, awareness and outreach to prevent lead poisoning. A couple of years ago, the City Council passed an ordinance that bans dry-sanding the outside of homes that have leaded paint, so that was another prevention measure. We were really proud of that.

Q: Since Katrina, has the danger of lead poisoning in the city increased?

A: I'm not sure of that. I'm not aware of any systematic study that has been done. It appears from the data that the EPA (Environmental Protection Agency), the city and the state have collected that the areas of the city Pre-Katrina that had problems continue to have problems. The dangers are really the same. If you live in a house that was built prior to 1950 (lead was phased out of residential paint beginning in 1950 and completely banned in 1978) and the paint is not stable on the inside or the outside due to flooding or any other reason, then you should be concerned and take precautions.

Q: What are the biggest contributing factors to lead poisoning?

A: The primary exposure source is deteriorating lead paint on both the inside and outside of homes. What happens is that kids can eat the paint directly, but what's an even bigger problem is that the paint chips become pulverized into dust, so the natural pathway is dust inside. You know, you drop your Cheerios; you pick it up and eat it. Kids pick it up and eat it, and that's the dust on the inside of the home. Outside of the home, it's the soil. The paint will chip and flake and it will be mixed in with the soil. Kids playing in the soil may ingest that as well, or you can track the contaminated soil into your home and that's another exposure source. So it's paint, dust and soil. The group we're talking about, children ages 6 months to 6 years old, the literature shows overwhelmingly the greatest risk factors are the ones I've described and the most predominant pathway by far is ingestion. It's possible to have inhalation, but it hasn't been proven to be very relevant in this population.

Q: With so many houses being demolished and many of them with lead paint, what's the safest way to contain the airborne lead?

A: There are safe practices. Primarily it's making sure that the area is wet before it's demolished to cut down on the spread of dust. Be sure the debris is cleaned up and not left there or else it can blow around and the lead can spread. When you clean up the debris, the primary factor is keeping it nice and wet to cut down on the dispersion of the lead in the air. If you don't, it will go up in the atmosphere and then deposit and eventually will be an exposure source.

Q: What about gutting a house -- only taking down the damaged walls? What kind of precautions should you take then?

A: If you've gutted drywall that has lead paint, then you don't want to just put it out on the ground. Cover it and get it removed as quickly as you can. If you've gutted something you think may be contaminated, first of all, don't have children present, and secondly, cover the debris -- a simple tarp or something -- so it doesn't contaminate the atmosphere.

Q: If you're rebuilding your older house, are there ways to contain lead paint already in the house?

A: The simplest way to contain it is to paint over it. If the paint is intact, it can't hurt you. I wouldn't sand it, but if you must sand it, you have to use the proper precautions. You want to wet-sand it with a wet HEPA (High Efficiency Particle Air) filter on it. The best practice is to not sand it all the way down. Stabilize it -- you might have to sand it a little to make it smooth and then paint over it.

Q: What about outside of the house? What can you can you do about the ground?

A: If you can, plant grass or any type of ground cover, because lead adheres very nicely to grass. Bare soil is the factor for contamination. Lead binds to the grass and is all locked up.

Q: Should kids get tested for lead poisoning?

A: Any child that's potentially at risk should be tested. At risk means living or regularly visiting a home built prior to 1950 that has deteriorating paint or is undergoing renovations. This also applies to kids who are living in or regularly visiting a neighborhood where there are a lot of renovations or demolitions of older homes.

Q: How often would you get them tested?

A: [Parents] would want to talk to their health-care provider, but [children] should be tested regularly, depending on the exposure.

Q: Will all of these house demolitions and gutting eventually lower the risk of lead poisoning in our area?

A: In the long run, I think so, but in the short run, we need to be very careful.


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