Sharon Broussard, Plain Dealer

July 11, 2004

The 1-year-old toddlers Dorothy Hunter cares for in her wood-frame Kinsman Road home have not tested positive for lead poisoning. Still, when she heard she could get her home day-care center tested for free through Environmental Health Watch, she was eager to sign up.

A few weeks ago, Kim Foreman, health coordinator for the group, which focuses on the environmental issues in Cleveland's poor neighborhoods, wiped the dust off Hunter's narrow window sills, using a special cloth. Then she put the wipe in a vial and sent it to a lead-testing laboratory.

She returned on a rainy summer day with the results: There was no lead dust on the carpet or the floor. But the window sills were loaded with it.

The normal level is 250 micrograms of lead per square foot. The sills, all within easy reach of a toddler, had more than three times that.

“Probably when you have the windows open, it just comes in through the windows,” Foreman said.

Hunter, surprised to find she had any lead problems, went to work with soap and water, as Foreman recommended.

“I didn't have any paint peeling or anything like that,” she said. But others do. In fact, Hunter lives in a city rife with old, lead-painted homes, some of them in poor condition. Lead-based paint has been off the market since 1978, but the median construction year of Cleveland's homes is 1920.

The combination of old homes and a frequent lack of routine maintenance accounts for Cleveland ranking third nationally in childhood lead poisoning, with 3,424 sickened in 2001, the latest data available, according to the Centers for Disease Control study. Only Chicago and New York had more cases.

Although Hunter's home is well-maintained, St. Clair-Superior is among the top three neighborhoods for lead poisonings.

The consequences for children under 6 can be disastrous. Lead can cause lasting neurological damage, affecting academic performance and behavior.

Cleveland and Cuyahoga County hope to change that bleak outlook with teamwork and Environmental Health Watch's plan: Get to sick homes in poor neighborhoods before they create sick kids. For the first time, the city and the county will work together to encourage new mothers and pregnant women in 75 homes to take part in a pilot lead-testing program.

Homes with high concentrations of lead will be repaired next spring. The youngsters and the homes will be tested before and after, said Terry Allan, the county's health commissioner.

If the pilot is as successful here, as it has been in Milwaukee and other cities, it could mean the end of using healthy Cleveland babies as canaries.

Currently, the authorities discover that a home is dangerous only after a child — usually a toddler whose sticky hands are everywhere — tests above the CDC-recommended limit for lead.

The city-county partnership reverses that approach. If the home of a new mother tests positive for lead, usually because of dust on window sills or peeling, flaking paint, health officials will assume a toddler could be poisoned.

Parents will be given tips on how to keep surfaces clean, and some repairs will be made to reduce the lead. It is nearly impossible to remove it. The county estimates the new program will cost about $1,000 per home, compared with $9,000 for repairs after a child is poisoned.

“The mantra is primary prevention, primary prevention,” said Matt Carroll, Cleveland's health commissioner.

That makes plenty of sense. For years, officials have known how to reduce a child's contact with lead paint: Make sure the paint is not chipping or flaking, clean window sills regularly and urge people to use runners in entries. And wash hands and wipe feet when coming indoors.

What has been long missing is the political will to get the job done. Finally, Mayor Jane Campbell and the three county commissioners — Jimmy Dimora, Peter Lawson Jones and Tim McCormack — seem ready to supply it. The program will need an estimated $250,000 to start and if successful, it will cost millions, as it has in Milwaukee.

Milwaukee started its stellar lead detection and repair program 12 years ago, prodded by the federal government's charge to all cities to eliminate childhood lead poisoning by 2010.

Now it spends about $4 million a year helping landlords repair their homes. Those who refuse might find city workers on their property, painting walls or replacing windows. And they'll find a bill for the work in their mailboxes.

Lead poisoning isn't the only scourge of Cleveland's children. So are ozone, soot (tiny particles that can worm their way into children's lungs) and mercury, products of power plants.

Critics complain that the federal government has been lax with standards for those emissions. And it doesn't help that the government has not made asthma a reportable disease, as it has lead poisoning. That means exact figures on asthma cases don't exist, although there is plenty of anecdotal information that it has been on the rise in Cleveland and other cities since 1980.

Many children diagnosed with asthma lack medication and treatment plans.

Here again, teamwork is key to prevention, and the Greater Cleveland Asthma Coalition, which claims more than 50 agencies, businesses and elected officials as members, is on the case. The coalition is a division of the Ohio American Lung Association.

Carrie Zukauckas, the coalition's project coordinator, wants to link up with parents to help them reduce asthma by improving the air in their homes.

Asthma can be triggered by a range of irritants, from cockroaches to the common cold. Parents can limit attacks by keeping their homes free of insects, mold and dust mites that live in mattresses and even stuffed toys.

The coalition has just published a directory for Greater Clevelanders who want to know more about asthma.

Now it is working with the American Lung Association and Kaiser Permanente on a pilot program that will focus on making several Cleveland schools “asthma-friendly.”

Youngsters and their parents will receive information on asthma and on how to reduce medical emergencies.

“Our main objective is to get asthma under control,” said Zukauckas.

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