North Carolina Childhood Lead Poisoning Prevention Program

1. 1 North Carolina Childhood Lead Poisoning Prevention Program

2. 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. Paints made with lead carbonate and lead oxides had excellent drying, adhesion ,a and covering attributes. So some paints contained up to 50% lead content. Paints made with lead carbonate and lead oxides had excellent drying, adhesion ,a and covering attributes. So some paints contained up to 50% lead content.

3. 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. 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. 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. North Carolina Law requires - laboratory reporting investigation of children with lead poisoning remediation Preventive Maintenance Program Elevated blood lead level - blood lead concentration of 10 or more determined by the lower of two consecutive blood lead tests within a six-month period. Persistent elevated blood lead level- concentration of 15-19 for six months. Confirmed lead poisoning means a blood lead concentration of 20 or more.North Carolina Law requires - laboratory reporting investigation of children with lead poisoning remediation Preventive Maintenance Program Elevated blood lead level - blood lead concentration of 10 or more determined by the lower of two consecutive blood lead tests within a six-month period. Persistent elevated blood lead level- concentration of 15-19 for six months. Confirmed lead poisoning means a blood lead concentration of 20 or more.

6. 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. 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. Lead poisoning is not easy to detect. Some of the early signs and symptoms of lead poisoning in children are - Persistent tiredness or hyperactivity. Irritability Loss of appetite Loss of appetite. Short attention span Weight loss. Headaches and joint pain Reduced attention span. Difficulty sleeping. Constipation. The only way to know if you have lead poisoning is to get a blood lead test from your doctor. Many people mistake the symptoms of lead poisoning for other common illnesses, such as a cold or the flu. Sometimes there are no symptoms at all. Lead poisoning is not easy to detect. Some of the early signs and symptoms of lead poisoning in children are - Persistent tiredness or hyperactivity. Irritability Loss of appetite Loss of appetite. Short attention span Weight loss. Headaches and joint pain Reduced attention span. Difficulty sleeping. Constipation. The only way to know if you have lead poisoning is to get a blood lead test from your doctor. Many people mistake the symptoms of lead poisoning for other common illnesses, such as a cold or the flu. Sometimes there are no symptoms at all.

8. 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. HUD estimate HUD estimate

9. 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 Lead mimics calcium so bones/tooth enamel become the record of past exposures. Long term health risk: hypertension, anemia, kidney failure and memory loss Massachusetts study, documented 380 cases of poisoning in construction workers and homeowners doing their own renovations 1991-1995. The harmful effects of lead exposure have long been know in the construction and painting trades. The 1921 Radford�s cyclopedia of Construction, Carpentry, Building, and Architecture, clearly discussed the need for a painter to reduce unnecessary exposure to lead paint. Some of the safety tips are still relevant today. The painter is exposed in a peculiar degree to the danger of poisoning. In his case especially, cleanliness is an absolute essential of continuous health. White lead, for example is a deadly poison. Lead poisoning is caused by minute particles of lead which are absorbed into the system through the stomach. It is much easier to prevent than cure lead poisoning. The first thing to be observed by the painter is to avoid eating or even taking a chew of tobacco until after he has taken off his overalls and thoroughly washed his hands.Lead mimics calcium so bones/tooth enamel become the record of past exposures. Long term health risk: hypertension, anemia, kidney failure and memory loss Massachusetts study, documented 380 cases of poisoning in construction workers and homeowners doing their own renovations 1991-1995. The harmful effects of lead exposure have long been know in the construction and painting trades. The 1921 Radford�s cyclopedia of Construction, Carpentry, Building, and Architecture, clearly discussed the need for a painter to reduce unnecessary exposure to lead paint. Some of the safety tips are still relevant today. The painter is exposed in a peculiar degree to the danger of poisoning. In his case especially, cleanliness is an absolute essential of continuous health. White lead, for example is a deadly poison. Lead poisoning is caused by minute particles of lead which are absorbed into the system through the stomach. It is much easier to prevent than cure lead poisoning. The first thing to be observed by the painter is to avoid eating or even taking a chew of tobacco until after he has taken off his overalls and thoroughly washed his hands.

10. 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. 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. 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. 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. Shift away from reacting to poisoned children with expensive and often unnecessary abatements towards primary prevention efforts to prevent poisoning. Federal Agencies: HUD, CDC, EPA, OSHA, CPSCShift away from reacting to poisoned children with expensive and often unnecessary abatements towards primary prevention efforts to prevent poisoning. Federal Agencies: HUD, CDC, EPA, OSHA, CPSC

14. 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 HEPA is a special type of vacuum cleaner that can remove very small lead particles and trap them inside of the vacuum cleaner. Respirator, properly fitted and NIOSH certified. Dust mask do not protect you from breathing lead dust particles. Protective clothes, coveralls, shoe covers, hats, goggles, gloves should be used to help keep lead dust from being tracked into areas outside of the worksite. HEPA is a special type of vacuum cleaner that can remove very small lead particles and trap them inside of the vacuum cleaner. Respirator, properly fitted and NIOSH certified. Dust mask do not protect you from breathing lead dust particles. Protective clothes, coveralls, shoe covers, hats, goggles, gloves should be used to help keep lead dust from being tracked into areas outside of the worksite.

15. 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. 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. 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. 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. 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. HUD has set what it calls �clearance levels�. These levels are considered the maximum acceptable levels of lead dust after work has been done and the home has been professionally cleaned HUD Interim Standards for Lead-Contaminated Dust Floors 40 ug/ft2 Interior window sills 250 ug/ft2 Window troughs 800 ug/ft2 Dust clearance levels have been lowered to be more health-based. HUD/EPA Guidelines for Lead-Contaminated Soil as of July 1994 Above *400 ug/g by weight in high-traffic play areas Above *2,000 ug/g by weight in building perimeter and yard Abatement required if 5000 ug/g or greater *Area must more than 9 square ft. 1.0 mg/cm2 by XRF or 0.5% by weightHUD has set what it calls �clearance levels�. These levels are considered the maximum acceptable levels of lead dust after work has been done and the home has been professionally cleaned HUD Interim Standards for Lead-Contaminated Dust Floors 40 ug/ft2 Interior window sills 250 ug/ft2 Window troughs 800 ug/ft2 Dust clearance levels have been lowered to be more health-based. HUD/EPA Guidelines for Lead-Contaminated Soil as of July 1994 Above *400 ug/g by weight in high-traffic play areas Above *2,000 ug/g by weight in building perimeter and yard Abatement required if 5000 ug/g or greater *Area must more than 9 square ft. 1.0 mg/cm2 by XRF or 0.5% by weight

20. 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. 21 Preventive Maintenance Program In 1997 the North Carolina General Assembly adopted the Childhood Lead Exposure Control Act 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!

22. 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. 23 Who cannot Participate? Child occupied facilities such as child care centers and schools.

24. 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. 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. Activities that many rental property owners already do. Activities that many rental property owners already do.

26. 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. Wet painted surfaces before sanding or scrapping cover work area with heavy-duty plastic Lead poisoning can occur with any type of housekeeping It is the responsibility of the occupants to clean their own homes but cleaning up lead dust requires special cleaning. Lead-painted surfaces must be well maintained for cleaning to be effective. Occupants should inform the property owner or manager if they find damaged or HUD has set what it calls �clearance levels�. These levels are considered the maximum acceptable levels of lead dust after work has been done and the home has been professionally cleaned. 100 ug/ft2 for floors 500 ug/ft2 for window stools 800 ug/ft2 for window troughs 1.0 mg/cm2 by XRF or 0.5% by weight Wet painted surfaces before sanding or scrapping cover work area with heavy-duty plastic Lead poisoning can occur with any type of housekeeping It is the responsibility of the occupants to clean their own homes but cleaning up lead dust requires special cleaning. Lead-painted surfaces must be well maintained for cleaning to be effective. Occupants should inform the property owner or manager if they find damaged or HUD has set what it calls �clearance levels�. These levels are considered the maximum acceptable levels of lead dust after work has been done and the home has been professionally cleaned. 100 ug/ft2 for floors 500 ug/ft2 for window stools 800 ug/ft2 for window troughs 1.0 mg/cm2 by XRF or 0.5% by weight

27. 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. 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 What is the preventive maintenance program? Who is eligible to participate? What are the benefits to owners and residents? What is involved in participation? What is the preventive maintenance program? Who is eligible to participate? What are the benefits to owners and residents? What is involved in participation?