Lead Laws: NewPublicHealth Q&A With Katrina Korfmacher
An important session at this week Public Health Law Research (PHLR) Annual Meeting is on local lead laws and their impact on ending childhood lead poisoning. NewPublicHealth spoke with Katrina Korfmacher, Assistant Professor of Environmental Medicine at the University of Rochester School of Medicine and Dentistry, who spoke on the topic at the PHLR conference.
NewPublicHealth: Many people have the perception that lead is no longer poses a problem in the U.S. Why is it still an issue?
Katrina Korfmacher: Lead paint is permanently a part of our environment, so when people paint over it that’s good; it keeps kids from being exposed. But when it’s on friction surfaces, like windows and doors that can shed paint chips when opened, the old paint becomes a source of lead that continues to have an impact. In older neighborhoods rates remain quite high because of the older housing stock.
You can’t remove all the lead from houses—it's cost-prohibitive. The goal of many current laws is to get owners of housing, especially rental housing to get rid of the lead.
NPH: Do states have sufficiently strong lead laws?
Katrina Korfmacher: There is a huge variety. Most states have secondary prevention laws, which means they require that kids’ blood be tested for lead levels. But if we wait to find high levels, it’s already too late.
NPH: A CDC advisory committee recently recommended that the agency lower the threshold for diagnosing lead poisoning in children. What does that mean and why now?
Katrina Korfmacher: Currently, about 250,000 children are considered to suffer from lead poisoning. Lowering the blood level required for the official diagnosis from 10 micrograms of lead per deciliter of blood to five, the advisory committee’s recommendation could raise that number by hundreds of thousands, if not more. We know that lead poisoning can harm developing brains, kidneys and other organs, and the advisory committee based the recent recommendation on research that links any elevated levels of lead in the blood with the potential for cognitive and physical problems.
NPH: What might be the result of the change?
Katrina Korfmacher: Lowering the levels that require attention could increase funding for lead poisoning prevention, screening and follow-up.
NPH: What additional laws are needed?
Katrina Korfmacher: Many of the states have laws that require that blood be tested, but research shows that by the time kids have discernible levels of lead in their blood, the harm has been done. What we are looking for is primary prevention laws that require that lead hazards are found and repaired before a child is harmed.
NPH: Why does your project focus on local laws?
Katrina Korfmacher: Because we think they are most effective at targeting areas that have high levels. In Rochester, for example, the levels ten years ago were over ten times the national average. We found areas of housing being rented and not being properly maintained. Our goal was a local primary prevention law. In Chicago, the overall rate may not be high, but they may have pockets where the rates are high. Our study compares eight different cities and also looks in depth at the Rochester law to see how it works. The goal is to get the two parts of the study to inform each other.
NPH: Why has it been difficult to get more focus on this issue?
Katrina Korfmacher: Lead largely affects minority and low income children who have a fairly weak public and constituent voice. Also, the public is excited by new risks and lead is a very old one—but it remains the most significant environmental health threat in the country.