North Carolina Childhood Lead Poisoning Prevention Program

1. North Carolina Childhood Lead Poisoning Prevention Program Division of Environmental Health Lead poisoning can be prevented.

2. Lead-based Paint • Paint manufactures used to put lead pigments in paint because the pigments make the paint last longer, dry faster and cling to surfaces better. • Paint that is disturbed or that is breaking down with age can contaminate dust and soil. • Lead is highly toxic. Exposure to it can be dangerous, especially for young children.

3. Child Exposure • Children are poisoned because they eat lead dust that has gotten on their hands, toys, pacifier, etc. Damage to the child’s health is usually done before symptoms show. • Children who may be exposed to lead hazards should be tested for elevated blood lead levels.

4. CDC Guidelines • Targeted Screening of 12 and 24 month old children. • N.C. - mandatory screening for recipients of Medicaid, WIC, and HealthChoice. • Blood lead analysis provided at no charge through the State Laboratory.

5. Blood Lead Levels • A blood test tells you what a child’s recent exposure to lead has been. Lead in blood is measured in micrograms of lead per deciliter of blood (ug/dL). 0 5 10 15 20 25 30 35 40 low risk moderate risk high risk urgent risk A level above 10 is of concern.

6. N.C. Surveillance Data • In 1999: • More than 105,000 kids tested. • 625 confirmed 10 ug/dL or greater • (50% of EBL children were never retested). • 80 confirmed lead poisoning.

7. Health EffectsA lead-poisoned child usually seems healthy. Exposure to low levels of lead can permanently affect children. In low levels lead can cause: • Nervous system and kidney damage. • Learning disabilities, attention deficit disorder, and decreased intelligence. • Speech, language, and behavior problems. • Decreased muscle and bone growth. • Hearing damage.

8. Societal Cost • Lifetime cost of a moderately poisoned child: $40,000 - $60,000. • Reduction in lifetime earnings, medical and special education cost. • Does not include: reduced family time, anxiety in caring for a lead-poisoned child, decreased stature and hearing ability, increase juvenile delinquency and crime, and hypertension later in life.

9. Adult Exposure • Inhalation/Ingestion • Long term health risks • high blood pressure • reproductive problems • anemia • kidney failure • memory and concentration problems • muscle and joint pain

10. Family Exposure • Lead can be dangerous to workers and their families if the worker brings equipment and clothing home from the job site. • Vehicles and homes can be contaminated with lead-based paint and dust if safe work practices are not followed.

11. Global Action • Countries that either banned the use of lead paint or severely restricted children’s contact with it: • France 1840’s Spain 1931 • Germany 1870’s Yugoslavia 1931 • Australia 1920 Cuba 1931 • Great Britain 1926 USA 1978

12. Affected Housing • According to HUD estimates: • 64 million homes have LBP. • 20 million homes with deteriorated LBP likely to cause exposure. • 890,000 children with elevated blood lead levels.

13. Hazard? • Is all lead-based paint a hazard? • The mere presence of lead paint does not mean there is a hazard. • Lead-based paint that is intact and covered with several layers of non-lead paint is not a health risk if it is maintained.

14. Equipment • HEPA filter-equipped vacuum cleaner • Properly fitted respirator • Protective clothes • Heavy duty polyethylene plastic sheeting • Duct tape • Wet-sanding sponges/paper • Spray bottles • Detergent

15. Safe Work Practices • Control access to the work area • Cover the work area with plastic • Cover the ground with plastic • Shut off HVAC • No eating, drinking, smoking in work area • Protect occupant and belongings • Mist painted surfaces before disturbing

16. Safe Work Practices cont’d • Wet sweep • Perform specialized cleaning when project is completed. • Change clothes and shoes before leaving work area. • Wash work clothes separately from family laundry. • Dispose of wash water down a toilet.

17. Exterior Work • Cover the ground with 6 mil plastic sheeting. • Move play equipment at least 20’ away from the work area. • Close all windows and doors. • Daily site cleanup

18. Unsafe Work Practices • Stripping paint on-site with methylene chloride-based solutions. • Torch or flame burning • Heating paint with a heat gun above 1100 degrees Fahrenheit. • Uncontrolled abrasive blasting, or uncontrolled waterblasting.

19. Specialized Cleaning • Using a HEPA equipped vacuum cleaner, vacuum from the cleanest areas to the dirtiest areas. Work from the top of the room toward the bottom, cleaning, door frames, chair rails, window sills and troughs, shelves, counters, baseboards and floors.

20. Specialized Cleaning cont’d • Wet Cleaning • Detergent solution and two buckets • Work from the cleanest to the dirtiest areas. • Change Rinse water at least once per room. • Change mop heads after each unit/house. • Flush dirty water down the toilet.

21. In 1997 the North Carolina General Assembly adopted the Childhood Lead Exposure ControlAct establishing a voluntary preventive maintenance program (PMP). The PMP is designed to to reduce childhood lead exposure in pre-1978 rental housing. The PMP is primary prevention! Preventive Maintenance Program

22. Who is Eligible to Participate? • Participation Is Voluntary. • Owners of pre-1978 residential rental property are eligible to participate. • Owners of property identified as a potential source of childhood lead poisoning are also eligible to participate.

23. Who cannot Participate? • Child occupied facilities such as child care centers and schools.

24. Benefits Of Participation • Protect children from exposure to lead-based paint and lead-contaminated dust. • Liability relief from lead poisoning related lawsuits. • Property Marketing.

25. Maintenance Standard Activities • Repair and repaint interior areas of deteriorated paint. • Adjust doors and windows to minimize friction. • Make interior surfaces smooth and cleanable. • Cap window troughs with vinyl or aluminum. • Pre-1950’s property must also: • repair and repaint exterior areas; • cover bare soil within 3 ft. of the foundation.

26. Maintenance Standard Activities(cont’d) • Use safe work practices to prevent the spread of lead dust. • Protect occupant’s belongings. • Use specialized cleaning to remove residual lead dust. • Provide occupant information. • Undergo annual monitoring.

27. Maintenance Staff Maintenance staff should have proper training and a clear understanding of lead-based paint hazards, safe work practices, occupant protection, and dust cleanup methods.

28. Questions? Claudia Rumfelt-Wright Preventive Maintenance Program Coordinator Division of Environmental Health 1632 Mail Service Center Raleigh, NC 27699-1632 • Tel. (919) 715-8497 • Fax (919) 715-4739