Drs. Gary Silverman (left) and Hailu Kassa

Drs. Gary Silverman (left) and Hailu Kassa

BGSU program to help counties combat lead poisoning

The dangers of lead poisoning in aging, urban homes have been well documented, but the problem is equally severe in rural homes, say Drs. Gary Silverman and Hailu Kassa, College of Health and Human Services. A new, $228,000 grant from the U.S. Environmental Protection Agency will enable BGSU to expand its lead-abatement efforts to counties in northwest Ohio that have not had sufficient resources to address the issue.

Silverman and Kassa will oversee the formation of a network among local health districts, beginning with Erie, Huron, Williams and Wood counties, with three other counties potentially joining later. By preparing public health officials to deal with lead prevention and poisoning recognition and intervention, the benefits of the project should endure well beyond the one-year term of the grant, said Silverman, director of BGSU’s Environmental Health Program.

Lead poisoning, which primarily results from exposure to flaking, lead-based paint, is particularly dangerous for young children. Inhaling or ingesting the lead particles can cause developmental, neurological and other acute problems. “Babies crawling across the floor in these older homes pick up dust, and then they put their fingers or their toys in their mouths. That dust is where the lead is,” explained Silverman. “It tends to be created where wood is rubbing against wood, as in painted windows and doors opening and shutting.”

Silverman and Kassa have extensive experience directing community projects. They have for several years collaborated with local officials in Toledo conducting a grant-funded program in economically stressed neighborhoods teaching parents and homeowners how to minimize the risks of exposure to lead. The two presented their article, “Reducing Children’s Blood Lead Exposure through Neighborhood Education” at the National Environmental Health Association’s annual education conference in July. In addition, Kassa, public and allied health, has completed an Ohio Department of Health lead train-the-trainer program. And in 2006, Silverman was awarded the Ohio Childhood Lead Poisoning Prevention Program Appreciation Award.

The new network will enable collaboration between the participating health districts, significantly expanding their capacity to serve their communities. It is typically difficult for local health districts to individually justify significant expenditures on lead programs where the homes are scattered and the number of children affected is relatively low, say the two project directors. Yet “it’s a huge issue” in terms of pediatric care costs, Kassa said.

The regional approach will serve to “break the system of each individual health district relying exclusively on its own resources and not being able to contribute substantially to reducing lead problems among its constituency,” Silverman and Kassa explained in their grant proposal.

It is difficult to know precisely the number of houses and children at risk from lead poisoning in the region, but in an exploration of the magnitude of lead poisoning in Wood County, the county planning commission estimated that 24,474 homes in the county presented a lead paint hazard. “Similar calculations could be done for the other counties involved in the study, but the major point is already clear—there are children at potential risk in these rural counties,” say Silverman and Kassa. The information gathered through the project can help in planning future intervention programs.

Like the affected homes in the urban neighborhoods, the rural homes to be addressed by the new project were built before 1978, the year the federal government banned lead-based paint from housing. Unfortunately for rural children, the risk from lead poisoning is perhaps greater because fewer lead-poisoning prevention programs are in place in their areas, Silverman said.

Building capacity
The first step will be to build the long-term capacity of local health districts by organizing a regional lead committee, which will establish a framework for each health district to identify and fill in the gaps in training and certification where needed.

Reaching the communities
The second step of the project is to deliver the actual community training and education programs.

An ambitious schedule of outreach activities has been established, including:

• Participation in at least four health fairs and four community festivals in each county
• Eight educational programs directed by pediatricians
• A minimum of four educational programs per country directed at day care centers
• A minimum of two educational programs per country for renovators, remodelers and painters
• Distribution of educational materials from at least four home improvement stores
• Holding at least two educational sessions per county for landlords and renters, including training on real estate disclosure requirements
• Holding educational sessions at churches and community groups at least three times per county
• Publicizing the various educational programs through inserts in at least four newspapers
• Publicizing the various educational programs through television and radio public service announcements

The ultimate goal is a long-term decrease in lead poisoning, say the project directors. The two hope that, as a result of the project outreach, more parents will have their children screened at local health departments and through their pediatricians.

September 4, 2007