Doctors test only a fraction of Denver children for levels of lead in their blood each year, even though federal law requires the tests for thousands of them.
Medical experts believe testing should be more common, in part, because there are tens of thousands of lead service lines buried all around the city — and tests often are the only way to know whether a child has lead poisoning. As shown in Flint, Mich., the tests also serve as an early indicator of lead-contaminated water.
Denver Health pediatrician Mark Anderson said parents likely aren’t having their children tested because they don’t know they should — and doctors likely overlook the tests or consider them a lower priority. Colorado state health officials say they’re working to raise awareness and boost testing frequency, because without more data, they can’t make any broad assumptions about lead exposure in Denver.
“Our data gives us a good idea, but we need many more children to be tested,” state toxicologist Kristy Richardson said. “And right now testing rates are especially low.”
Nearly 51,000 children 6 and under live in Denver, according to the department’s lead poisoning data. Between 2017 and 2021, about 1.8% of children in Denver Water’s coverage area ages 6 and younger tested positive for elevated blood lead levels, meaning they have five or more micrograms of the toxic metal per deciliter of blood, Richardson said.
That’s better than the statewide average of 2% and the national average, which is 2.1%, according to Colorado Department of Public Health and Environment spokeswoman Shannon Barbare. .
Denver Water is in the early stages of a 15-year, $500 million program to replace lead piping and solder that connects up to 84,000 homes to the city’s water supply. Crews are replacing those pipes faster than anticipated, but the work isn’t projected to be finished until 2034.
Medical experts say the heavy metal isn’t safe at any level, but results in recent years suggest there aren’t any high concentrations of lead in Denver that might be related to the lead piping and soldering.
Gaps in testing
State health officials don’t have the staffing or resources to test kids themselves, Barbare said, so they rely on primary care providers and other doctors. The last full year of screening data comes from 2019 and Richardson said testing levels decreased even more during the pandemic.
Federal law requires all children covered by Medicaid to receive blood lead tests at 12 and 24 months. Only 16% of those children in Denver Water’s service area were tested in 2019, Richardson said, and the state health department doesn’t have data on how often other Denver kids are tested.
Anyone exposed to the metal — lead paint, contaminated soil, types of imported pottery and, of course, lead pipes carrying water to homes — should be tested, Richardson said.
Blood lead screenings are typically recommended when all kids turn one and two; Anderson said Denver Health tests up to two thirds of its young patients but those numbers are clearly lower with other practices.
To encourage more testing, state and local health officials must communicate the importance to parents and doctors alike, Anderson said. Richardson said that’s what her department is doing — and she wants up to 30% of children covered by Medicaid to receive the tests in the coming years, but even that would be too low.
The tests can also be a good way to catch underlying problems in infrastructure or water supplies — like in Flint, Mich., where for years nearly 30,000 schoolchildren were exposed to water contaminated with lead after city officials began drawing water from the Flint River in 2014, according to Glenn Patterson, a professor of environmental and occupational health at the University of Colorado’s Anschutz Medical Campus.
Pediatrician Mona Hanna-Attisha noticed elevated levels among Flint’s children and sounded the alarm, and years after Flint’s water crisis first started, researchers monitored blood lead levels in children to make sure they returned to pre-crisis levels.
While Denver doesn’t have the lead-heavy legacy of other cities, Anderson said the heavy metal can be found and should be taken seriously.
He praised Denver Water’s replacement program and said if parents — especially with older homes — believe they have lead pipes they should get their children tested.
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