Regina McEnery
Plain Dealer, 9/2/2001

On a blistering July day Ruquia Wilson walked outside and found her 18-month-old son, Angel Aponte, up against the porch railing of their first-floor apartment on W. 50th St., his red plastic bicycle momentarily forgotten. Tiny paint chips clung to his baby teeth.

Wilson feared that her son might have swallowed something harmful, but she was unprepared for what she learned next. MetroHealth Medical Center hospitalized Angel after a blood test detected a lead level nearly 12 times higher than levels that are considered safe.

In 1998, the Centers for Disease Control and Prevention surveyed 19 states to determine the level of childhood lead poisoning. Ohio had the second-largest percentage of children who tested positive. Cuyahoga County had the highest percentage among all the counties surveyed.

About 85 percent of Cuyahoga County's cases are Cleveland children.

The survey, published last December, marks the first time the CDC compared childhood lead-poisoning percentages in different states.

It also exposes how profound the problem is in certain regions of the United States, such as Cleveland.

"This is a major public health issue," said Dr. Thomas Matte, a medical epidemiologist at the CDC's National Center for Environmental Health and co-author of the study. "Lead poisoning is a preventable condition that is still affecting thousands and thousands of children. Scientific evidence is overwhelming that it impacts a child's growth and development."

Pediatricians at MetroHealth tried to flush the lead out of Angel's body by giving him intravenous doses of a chelating drug, a medication that attracts the metal like a magnet, then ferries it into the body's waste system. But simply because of the lead exposure, Angel is at greater risk of neurological problems that can lead to lower IQ and hyperactivity.

Inspectors from the city of Cleveland later detected traces of lead on the front porch, where paint had cracked and peeled during the dry summer.

"I was freaked out," said a weary Wilson during the first of her son's two hospital stays. "I felt like it was my fault."

Thousands of Cleveland children turn up lead-poisoned every year, state records show.

Tiny fingers, itching for something to hold, reach for sweet-tasting paint chips on porch railings, windows and walls as though the flakes were candy.

Children crawl on floors and rugs coated with lead dust. Or they play in soil sullied by lead paint and years of lead emissions from Cleveland factories.

Urban enclaves in the Northeast and Midwest, particularly ones with old homes and grinding poverty, have boasted dramatic declines in childhood lead-poisoning cases, even after the federal government in 1992 lowered the allowable lead levels. Bans on leaded gasoline and lead-based paint helped bring about the decline.

But lead poisoning continues to be a serious health problem. For example:

While Cleveland is among the cities claiming big declines, 2,200 of its children still turned up lead-poisoned last year.

Coinciding with the decline in cases has been a steady decline since 1998 in screenings at public health clinics and by private pediatricians and hospitals. Neither Rainbow Babies & Children's Hospital nor MetroHealth Medical Center, where most children get tested for lead, could fully explain the drop. Some doctors said the declining incidence of lead poisoning has reduced the need for follow-up testing.

Slightly less than 50 percent of Medicaid-eligible children 1 to 2 years old in Cuyahoga County received a lead test in 1999, even though the state requires doctors and clinics to screen for lead.

Of the 2,764 properties suspected of lead contamination, 8.2 percent were repeat offenders. One property was cited five times.

Cleveland's lead division runs primarily on federal grants. So when money comes late or grant applications are rejected, work slows down or gets shelved.

The city's Health Department laid off 10 employees in the lead division for several weeks in June, peak time for childhood lead screenings and inspections, after a CDC grant failed to arrive on time because of paperwork delays at the state and federal level. Caught short-handed, the lead laboratory took longer than usual to analyze lead tests, and fewer inspectors were available for home visits.

White began assault
In 1989, mayoral candidate Michael R. White considered childhood lead poisoning a scourge. Four years later the Health Department brought together 50 authorities on public health to gnaw away at the problem. It marked an ambitious moment in the 20-year history of Cleveland's lead program.

But projects stalled or expired. The city trained lead abatement contractors in the early 1990s, but the program was unable to spark the flurry of face-lifts needed in many of Cleveland's impoverished neighborhoods. Property owners couldn't afford or didn't want to pay to clear away the lead, says Stuart Greenberg, executive director of Environmental Health Watch. The grass-roots group partnered with Cleveland for three years on a lead abatement project.

The city's medical advisory committee formed in 1992 stopped meeting about two years ago after its chairman, Rainbow Babies & Children's Hospital pediatrician Dr. Mary O'Connor, moved to Denver.

The city suffered a major setback when the federal Housing and Urban Development Department responded to the city's poor record of abating homes by rejecting a 1999 grant. HUD came through with a new grant in 2000 after the city improved its record.

Grants fluctuated from a high of $2.7 million in 1998 to a low of $833,000 last year.

Ohio's strict lead abatement laws may actually be discouraging community development corporations from paying to eliminate lead hazards in their neighborhoods. That's because even simple jobs, like installing drywall and painting exteriors, must be completed by licensed contractors, who charge thousands of dollars to renovate a home. Proposed state laws would create a new category of worker who needs less training but can still remove the lead.

No city official would talk about the problem of lead in Cleveland.

But Greenberg can't seem to talk about anything else. "If we want to know why Johnny can't read, we have to think about lead poisoning," said Greenberg from his Ohio City office. "If the mayor is in charge of schools, he or she ought to be looking at lead poisoning. It's a terrible burden for the kid and the family, even more so in a community like Cleveland where the prevalence is so high."

At three different apartments on the near West Side, three of Beatriz Mercado's children were lead-poisoned. One of the children seems fine, but Luis, 7, flunked first grade last year. He can't read and he's hyperactive. His 6-year-old brother, Bryan, had to repeat kindergarten.

Five of Vanessa Glover's six children in the Miles-Broadway section had elevated lead levels in their blood as toddlers. Two of them needed to be hospitalized. Her eldest son, Jerome, now 15, is learning-disabled. His 6-year-old brother, Akier, needs speech therapy.

"I never knew anyone who tested positive for lead," said Petecola Peterson as a warm breeze kicked up a pair of white bed sheets used as curtains in her dining room windows. That is, she said, until the day a routine screening found lead in the blood of her two youngest sons. Two-year-old Larenzo's lead level wasn't toxic enough to require medication. But 1-year-old Charles needed to be hospitalized for three days last month at Rainbow because the lead level in his blood measured 45, dangerous enough to require chelation. Lead was found in the bathroom, on the front and back porches and in window wells of the Glenville flat.

Lead dulls IQ
A National Institutes of Health-funded study published last November by Dr. Bruce Lanphear, a pediatric researcher with Children's Hospital Medical Center in Cincinnati, suggests that lead levels lower than 5 may contribute to a drop in IQ.

Lanphear tracked 275 children in Rochester, N.Y., now 6 to 8 years old, to reach his conclusions. "It seems to me that we have erred on the side of protecting industry," Lanphear said. "Why aren't we erring on the side of protecting children?"

Roberta Anderson, a pediatric nurse practitioner who manages MetroHealth's lead clinic, says, "Once a child is lead-poisoned, the damage is done."

MetroHealth has already admitted 13 children for lead poisoning this year, double the number admitted during the first eight months of 2000. Four of the children had lead levels above 75.

The two worst cases were Angel Aponte, whose blood showed a lead level of 118, and 3-year-old Shanique Gaines, who had a level of 140, a record for MetroHealth. Kenisha Sims, Shanique's mother, asked MetroHealth to test Shanique in December after she found a paint chip in her daughter's mouth. Shanique's 2-year-old sister, Shanae, had a lead level of 52 and was treated on an outpatient basis.

City inspectors found lead in the window wells, doorways and exterior railings of Sims' second-floor apartment in the Detroit-Shoreway section. The owner, Nest Egg Properties, corrected some of the violations swiftly, said attorney Tom Horwitz. He said his clients spent $3,400 repairing the window well.

But a city re-inspection entry dated April 3, more than three months after the initial inspection, ordered Nest Egg Properties to "get the exterior in compliance ASAP" because Shanique's lead levels kept rising.

On April 19, Anderson wrote to the Cuyahoga Metropolitan Housing Authority, urging them to find alternative housing for Shanique, her parents and three siblings.

"Shanique has been hospitalized six times . . . since Dec. 15," she wrote. "She also has an iron deficiency in the body. X-rays of her bones show lead lines resulting from massive stores of lead in her body."

The family retained a Pittsburgh law firm that specializes in lead litigation in April and moved out of the apartment the following month after CMHA issued the family moving papers.

Shanique's lead level is one of the highest the law firm has encountered in three years and 1,000 cases, said Mark Coulter, who is representing the family.

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