May 3, 2004

Lead Astray in Ohio: Cost of Failing to Test

Ohio faces enormous avoidable costs due to the failure to identify and prevent childhood lead poisoning. The January 2004 passage of Ohio's new lead poisoning prevention law, for the first time, institutes a legal requirement to test high-risk children for lead poisoning. Identification, treatment and prevention of lead poisoning will save Ohio nearly a quarter of a billion dollars it would otherwise lose due to medical costs, compensatory education, and lost taxable income. In addition, the failure to prevent lead poisoning costs the state in follow-up care, juvenile detention and adjudication, and increased infant mortality and neonatal care.

Lead poisoning in children imposes costs associated with medical care, special education, juvenile delinquency adjudication and incarceration, and lost taxable income. Children with high blood lead levels are more likely to require speech therapy, special education, and even face incarceration due to violent criminal behavior (HUD 1999). Studies show that juvenile delinquents are five times more likely to have elevated levels of lead in their bones (Needleman 2002).

At approximately $60.00 each, providing a blood lead test to every child under the age of six in Ohio would cost $38 million each year. In contrast, if all of Ohio's estimated 19,000 children with elevated levels of lead in their blood had been identified, treated, and had their levels reduced by 5 µg/dL, the state could have saved $223 million in lost taxable income alone. [1] The annual cost per lead poisoned child to the state of Ohio is approximately $2100 in medical costs, including costs of physician visits, laboratory testing, chelation therapy, neuropsychological testing, and follow-up testing (CLPP 2000, NASA 2004). The annual cost for a lead poisoned child's special education is approximately $4600 (CLPP 2000, NASA 2004). Studies indicate that 20% of children with severely elevated blood lead levels require an average of three years of special education (Schwartz 1994). Thus, the prevention of the lead poisoning of the 949 children that Ohio reported as having severely elevated blood lead levels, above 20 µg/dL, represents an annual avoidable cost of $8.5 million in medical care and special education expenditures. This estimate only includes children actually tested and reported to the Ohio Department of Health, so the actual costs are even greater.


[1] Based on approximately $2350 lost in lifetime earnings for each 1mg/dL lead elevation in the blood (Grosse 2002).


The Childhood Lead Poisoning Prevention Working Group (CLPP) Report to Ohio General Assembly, July 30, 2000 (amount adjusted for inflation).

Department of Housing and Urban Development (HUD). 1999. Economic Analysis of the Final Rule on Lead-Based Point: Requirements for Notification, Evaluation and Reduction of Lead-Based Point Hazards in Federally-Owned Residential Property and Housing Receiving Federal Assistance. U.S. Department of Housing and Urban Development, September 7.

Grosse, S.D., et. al., Economic Gains Resulting from the Reduction in Children's Exposure to Lead in the United States, Environmental Health Perspectives, Vol. 10, No. 6, June 2002.

National Aeronatics and Space Administration (NASA), Gross Domestic Product Deflator Inflation Calculator, (last visited April 27, 2004).

Needleman, H.L., et. al, Bone Lead Levels in Adjudicated Delinquents: A Case Control Study, Neurotoxicology and Teratology No. 24 711-717, 2002.

Schwartz, Joel, Societal Benefits of Reducing Lead Exposure, Environmental Research 66, p. 105-124, 1994.