News Coverage
Lead-poisoned kids not diagnosed, study says
Published May 3, 2004
An estimated 19,000 Ohio children are lead poisoned, and two-thirds of them probably don't know it, according to an analysis of state and federal health data.
In its study "Lead Astray in Ohio," the Washington-based Environmental Working Group, a nonprofit research organization, found the state has identified or diagnosed only 5,700 of those children with lead poisoning, with 58 of 88 counties missing 90 percent or more of their cases.
Even children on Medicaid, who are required under federal law to receive a blood-lead screening by age 1 or 2, are going untested the vast majority of the time, the study found.
A state law that took effect April 1 requires all children in high-risk ZIP codes to be screened.
Arianne Callender, the group's lawyer and a researcher on the project, said the costs of missed cases is high.
"Because of the failure to test these children, Ohio taxpayers are paying for medical care costs, remedial education costs and losing money in lost taxable income," she said.
She estimated those costs add up to $230 million a year for Ohio. The group used data from several sources including the U.S. census, the state health department and the Centers for Disease Control and Prevention to gets its estimate on poisoned children.
Urban enclaves in the Northeast and Midwest, where the housing stock is old and in disrepair, have reported dramatic declines in childhood lead-poisoning cases, even after the federal government lowered the allowable lead levels to 10 microliters per deciliter of blood.
Lead-poisoned children run the risk of developing neurological problems that can lead to lower IQ. Some lead researchers have also linked lead poisoning to higher rates of juvenile delinquency, attention deficits and, eventually, lost earning potential.
Karen Hughes, chief of the state Bureau of Child and Family Health Services, said too many people - including some pediatricians - believe the problem has been erased. That sometimes means they fail to recommend or perform the lead-screening tests.
Overall, Cuyahoga County fared well in the new analysis because all but 18 percent of its 4,011 cases of lead poisoning were discovered through early screening - the best detection rate in the state.
Dr. Terry Torbeck, chief medical officer for Care Source, Ohio's largest Medicaid HMO, acknowledged that statewide screening rates are low but disagreed with the study's contention that perhaps insurance plans have been failing to give the tests to save money.
Jon Allen, a spokesman for the state Department of Job and Family Services, said the state isn't paying for screenings that aren't performed. He said Medicaid contracts are adjusted to reflect actual testing rates, not the 100 percent federal mandate.
Torbeck blamed lack of awareness for the poor testing rates.
"Some members don't see it as a priority," Torbeck said. "And access can be an issue. We've tried to address that by providing free transportation for health checks."
Dr. Todd Locke, acting president of QualChoice, a Cleveland HMO with Medicaid members, said, "The fundamental problem is that a lot of children don't get regular check-ups, period."
But Callender questioned that assertion, noting that 80 or 90 percent of 1- and 2-year-olds in Ohio receive their immunizations, which means they are present at doctor's visits in those early years.
Dr. Bruce Lanphear, director of the Cincinnati-based Children's Environmental Health Center, cited the powerful interests of the lead industry. Like the tobacco industry before it, he said, it is swaying the public health agenda.