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Threats or Promises: Which Way for the Trump Administration on Childhood Lead Poisoning Prevention?

Recent news articles suggest that Trump’s EPA hopes to drastically cut funding and staff for its lead poisoning prevention programs ("EPA Memo Outlines Plans to Defund Lead-Paint Program," in Remodeling, April 4; and "Trump’s EPA Moves to Dismantle Programs that Protect Kids from Lead Paint," in The Washington Post, April 5). This follows on the heels of a high-level meeting between the EPA’s new administrator, Scott Pruitt, and the National Association of Home Builders (NAHB). NAHB complained about so-called “excessive” regulations, specifically EPA’s Renovation, Repair, and Painting (RRP) Rule

But it was exactly inadequate regulations that led to the Flint crisis and others like it, such as the East Chicago disaster in Indiana, the vice-president’s home state.
 
The fact is that congressional action and regulations have worked: Blood lead levels in the nation’s children have been greatly reduced  as a result of the implementation of statutes and regulations (see "U.S. Policies vs. Children's Average Blood Lead Levels" below). When we as a nation mandated the removal of lead from food canning, gasoline, new residential paint, plumbing and other sources, all through regulations, it worked. If anything, the regulations should be strengthened, not weakened, because over half a million children still have blood lead levels above the CDC reference value.1 

Some industries have supported these regulations over the years,2 but a few others have actively opposed them.3 Most recently for example, the National Association of Home Builders (NAHB) wants the EPA’s RRP regulation restricted to only pre-1960 housing, even though lead paint was not banned (by regulation) until 1978. They want “training” of their contractors to be only online, when in fact construction contractors don’t really learn that way. They want a new cost-benefit analysis, even though many previous studies have already shown that the benefits far outweigh the costs.4, 5 NAHB already succeeded in previous years in eliminating a dust testing requirement that has existed for years in federally assisted housing rehab work with scientifically proven positive results.6 (Children’s blood lead levels in assisted housing are lower than in non-assisted low-income housing, and dust testing [dust is one of the main ways children are exposed] is the major reason why). NAHB should protect the interests of its members by ensuring that homes are safe, not cutting corners and weakening laws and regulations that, if anything, need to be strengthened. And it should work to ensure that its member contractors don’t inadvertently do sloppy work that can cost $100,000 per house to clean up.7

Furthermore, preventing childhood lead poisoning not only protects children, it will create at least 75,000 good-paying jobs.8

During his campaign, the president promised to fix things that don’t work right. What better example is there that lead poisoning needs to be fixed than the 24 million homes that still have lead paint hazards, or the 6-10 million homes that still have lead water pipes? The solution is not to weaken regulations or to cut budgets but to strengthen them, putting the resources in place to end this preventable disease. Lead problems are a sign of our crumbling infrastructure, something the president also vowed to fix. We think that an infrastructure bill should include lead poisoning prevention. 

At HUD, the new Secretary, Dr. Ben Carson, promised to “enhance” lead poisoning prevention and healthy housing, proposing to increase the budget for that program from $110 million to $130 million. But at the same time, the proposed HUD budget wipes out the multi-billion-dollar Community Development Block Grant (CDBG) program. Many local jurisdictions use CDBG to provide their local “match” funding, anywhere from 10% - 25%, for lead hazard control. So, even though the proposed increased funding for the lead program is welcome, it appears that with the CDBG proposed elimination, the net effect will reduce, not increase, the total HUD resources to protect our children from lead poisoning. Why give with one hand only to take away more with the other? 

The National Safe and Healthy Housing Coalition has produced a number of recommendations that will protect our children

We urge the new administration and the new Congress to act on those recommendations to improve (not weaken) regulations and to propose a budget that will get the job done.

Instead of paying over $50 billion a year for lead poisoning, let’s solve the problem, not eliminate EPA programs or reduce HUD funding. At its beginning, the Flint fiasco was supposedly an attempt to save money, and NAHB’s wishes sound just like that, don’t they? We cannot afford another Flint, and we cannot afford to continue to pay the high costs of needlessly poisoned children. In Flint and across the nation, we will now spend far more now than had we acted to solve the problem in the first place. And we do know how to solve it. We should act on what we know, put our people to work, protect our children, and stop wasting money by caving in to a few narrow short-sighted industries at the expense of the rest of us.





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1 Wheeler, W., & Brown, M. J. (2013, April 5). Blood lead levels in children aged 1–5 years — United States, 1999–2010. Morbidity and Mortality Weekly Report (MMWR), 62(13), 245-248. Retrieved April 6, 2017, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm

2 National Safe and Healthy Housing Coalition. (2016). Declaration of the Lead and Environmental Hazards Association. Retrieved April 6, 2017, from  http://www.nchh.org//Portals/0/Contents/LEHA_Declaration_2016.pdf 

3 Jacobs, D. E. (2016 July-August). Lead poisoning: Focusing on the fix. Journal of Public Health Management and Practice, 22(4):326-330. doi: 10.1097/PHH.0000000000000430. Retrieved from http://journals.lww.com/jphmp/Citation/2016/07000/Lead_Poisoning___Focusing_on_the_Fix.2.aspx
   
4 Gould, E. (2009, July). Childhood lead poisoning: Conservative estimates of the social and economic benefits of lead hazard control. Environmental Health Perspectives, 117(7), 1162-1167. Retrieved April 6, 2017, from https://ehp.niehs.nih.gov/wp-content/uploads/117/7/ehp.0800408.pdf

5 Nevin, R., Jacobs, D. E., Berg, M., & Cohen, J. (2008, March). Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement, Environmental Research, 106(3), 410-419. Retrieved April 6, 2017, from http://www.ncbi.nlm.nih.gov/pubmed/17961540
 
6 Ahrens, K. A., Haley, B. A., Rossen, L. M., Lloyd, P. C., & Aoki, Y. (2016, November). Housing assistance and blood lead levels: Children in the United States, 2005-2012. American Journal of Public Health, 106(11), 2049-2056. Retrieved April 6, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/27631737
 
7 Jacobs, D. E., Mielke, H., & Pavur, N. (2003, February). The high cost of improper removal of lead-based paint from housing: A case report. Environmental Health Perspectives, 111(2), 185-186. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241348/
 
8 National Center for Healthy Housing & National Safe and Healthy Housing Coalition (2017, February). Find It, Fix It, Fund It: A lead elimination action drive: Policy recommendations to Congress and the new administration. Retrieved April 6, 2017, from http://bit.ly/FFFAdmin

9 Jacobs, D., & Weinberg, A. (2017, February 22). Infrastructure and mortgages: What about the kids? National Center for Healthy Housing website. Retrieved April 6, 2017, from http://bit.ly/Infra_Kids



Dr. David Jacobs, former Director of the Lead Poisoning Prevention Program at the U.S. Department of Housing and Urban Development, is the Chief Scientist for the National Center for Healthy Housing and an adjunct professor at the University of Illinois at Chicago School of Public Health

Infrastructure and Mortgages: What about the Kids?


During the 2016 election season, Donald Trump (the Republican presidential nominee, now president) proposed spending $1 trillion dollars on infrastructure to put people to work and rebuild the sinews of the nation. Democrats have also called for infrastructure improvements. Those improvements must include making our homes and schools safe for our children. In its recent (January 2) editorial, "Housing that Ruins Your Finances and Your Health," The New York Times wrote, “One solution would be for Fannie Mae to eliminate dangerous lead conditions in foreclosed homes.” But lead requirements are antiquated or nonexistent not only at Fannie Mae but also at Freddie Mac and HUD’s FHA single-family mortgage insurance program. These federal housing programs are the only ones that were not reformed back in 1999 and are long overdue to be fixed.

In years past, both parties worked together to reduce childhood lead poisoning. But Flint is only the tip of the iceberg, and parents of lead-poisoned children are demanding that we do more to put a stop to the needless suffering. Lead poisoning costs us an estimated $50 billion annually for healthcare, substandard school performance, and lost work productivity (2008 dollars).1 The real tragedy is that we know how to fix lead hazards. The disasters in Flint and elsewhere could have been prevented and will now cost much more than if we had made the necessary upfront investments and reforms. The inadequate lead requirements at FHA, Fannie Mae, and Freddie Mac should comply with HUD lead-safe housing regulations, but they currently do not.

Traditionally, infrastructure spending only goes for roads and bridges and the basic equipment and structures that are needed for a country to function properly. But many are surprised to learn that the lead services lines bringing water into their homes are NOT part of the “infrastructure” and that the burden was on families to replace them. They are also surprised that home inspections required by mortgage companies do not include lead inspections. 

We think infrastructure and federally guaranteed mortgages should be used to make our homes safe for our children. Indeed, we have “shared” our homes with guests and friends and, of course, our families. But 37 million homes built before 1978 have lead paint,2 and at least six million homes have lead water service lines. This “shared” lead has poisoned millions of our children, sometimes poisoning one child after another as one family leaves and another moves in. Existing FHA, Fannie, and Freddie underwriting standards are part of the problem, but they could be part of the solution.

The biggest culprit is old single-pane painted windows, which have the highest lead paint and lead dust levels of any building component. Replacing windows is already a proven strategy. In a pilot program, Illinois replaced lead-contaminated windows in Peoria and Chicago in 500 homes,3 resulting in huge and sustained lead dust reductions not only on windows but also on floors; and many other studies have reached similar conclusions.

The time has come to replace all those old contaminated windows, those lead drinking water pipes, and the other lead hazards in our homes. Enormous benefits follow if infrastructure funds are used to address lead in homes:
  • First, over 75,000 jobs – good-paying jobs for both made-in-America window manufacturing and installation workers;
  • Second, increased property values anywhere from $5,900 to $14,300 per home4
  • Third, a return on investment of at least $17 per dollar spent on lead remediation or removal5
  • Fourth, up to $500 per household saved each year on reduced fuel bills, because new windows are more energy efficient.6 
With the right infrastructure improvements, we can all share safe drinking water and lead-safe homes. 

The evidence is clear – whether in small towns or big cities, rural or urban: We all win when we eliminate lead hazards and protect our children. Our traditional approach has been to respond only after a child is poisoned, but there is no reason to wait until the damage has already been done. We should test our homes and schools, not just our children’s blood. And we should insist that housing finance institutions like FHA, Fannie, and Freddie do the right thing and eliminate those hazards before children are poisoned.

As part of our new national infrastructure initiative, let’s include solving the lead problem. We urge the new president and Congress to protect our children. Let’s not wait for another Flint or another poisoned child. Get Fannie, Freddie, and FHA to do the right thing. Get rid of those old lead-contaminated windows and old lead pipes and put our people back to work to protect our children and our future.

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1 Tresande, L., & Liu, Y. (2011, May). Reducing the staggering costs of environmental disease in children. Health Affairs 30(5), 863. Retrieved February 21, 2017,
from http://content.healthaffairs.org/content/30/5/863.long
2 Cox, D. C., Dewalt, G., O'Haver, R., Salatino, B. (2011, April). American healthy homes survey: Lead and arsenic findings. Washington, DC: U.S. Department of Housing and Urban Development. Retrieved February 21, 2017, from  https://portal.hud.gov/hudportal/documents/huddoc?id=AHHS_Report.pdf
3 Jacobs, D. E., Tobin, M.,Targos, L., Clarkson, D., Dixon, S. L. Breysse, J., et al. (2016, September-October). Replacing windows reduces childhood lead exposure: Results from a state-funded program. Journal of Public Health Management & Practice, 22(5), 482-491. Retrieved February 21, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/26910871
4 Nevin, R., Jacobs, D. E., Berg, M., & Cohen, J. (2008, March). Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement, Environmental Research, 106(3), 410-419. Retrieved February 21, 2017, from http://www.ncbi.nlm.nih.gov/pubmed/17961540
5 Gould, E. (2009, July). Childhood lead poisoning: Conservative estimates of the social and economic benefits of lead hazard control. Environmental Health Perspectives, 117(7), 1162-1167. Retrieved February 21, 2017, from https://ehp.niehs.nih.gov/wp-content/uploads/117/7/ehp.0800408.pdf
6 Nevin, R., Jacobs, D. E., Berg, M., & Cohen, J. (2008, March). Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement, Environmental Research, 106(3), 410-419. Retrieved February 21, 2017, from http://www.ncbi.nlm.nih.gov/pubmed/17961540



 
Dr. David Jacobs, former Director of the Lead Poisoning Prevention Program at the U.S. Department of Housing and Urban Development, is the Chief Scientist for the National Center for Healthy Housing and an adjunct professor at the University of Illinois at Chicago School of Public Health

Anita Weinberg is a Clinical Professor and the Director of the ChildLaw Policy Institute at Loyola University Chicago School of Law, which spearheaded lead poisoning prevention efforts in Illinois for over 10 years.

Both House and Senate Move to Increase HUD Lead Hazard Control Funding

Thanks to all of you who called your senators last week to urge them to pass the HUD funding bill! The bill did pass the Senate, with $50 million in funding increases for lead hazard control, half of which will go to HUD’s Office of Lead Hazard Control and Healthy Homes (OLHCHH) – raising their budget to $135 million – and half for lead hazard control in public housing.  

Similarly, the House appropriations committee just passed a House funding bill that also increases HUD’s OLHCHH budget – to $130 million, an increase of $20 million. Both bills also provide level funding for CDBG and HOME and allow continued assistance to all households currently served by HUD programs, with some targeted increases. We'll need your help over the summer and fall to ensure that these lead hazard control funding increases are enacted at the Senate level.

Of course, this is only a fraction of the funding needed to eliminate lead poisoning, but it's a strong step forward in an austere budget environment. To help us press for more funding, sign up for the Find It, Fix It, Fund It campaign and/or register for our Find it, Fix it, Fund It webinar rollout meeting tomorrow (1 p.m. EDT).

We thank Chairman Mario Diaz-Balart (R-FL-25) of the HUD appropriations subcommittee for working closely with ranking members Representative Nita Lowey (D-NY-17) and Representative David Price (D-NC-4) to increase spending on lead hazard control. All three brought the issue up as a key success of the bill at the markup hearing today.

I was able to thank them personally and urge you to thank you them too by tweeting:

@MarioDB thank you for increasing @HUDgov #lead hazard control funding and protecting America's children!
@NitaLowey thank you for increasing @HUDgov #lead hazard control funding and protecting America's children!
@RepDavidEPrice thank you for increasing @HUDgov #lead hazard control funding and protecting America's children!


Here are additional highlights from the Senate bill in which Chairman Susan Collins (R-ME) and Ranking Member Jack Reed (D-RI) crafted numerous policy changes to improve lead poisoning prevention! The new bill will accomplish the following:
  • Provides more resources to the Office of Lead Hazard Control and Healthy Homes ($25 million) and lead hazard control in public housing ($25 million). 
  • Allows lead hazard control grants to serve zero-bedroom units for the first time.
  • Requires HUD to align its blood lead level standard with CDC’s (changing the standard from 20 μg/dL to 5 μg/dL).
  • Doubles the staffing at the Office of Lead Hazard Control and Healthy Homes’ Enforcement Division.
  • Also: Increases funding for Section 202 Housing for the Elderly program and the Section 811 Housing for People with Disabilities program, and homeless assistance programs.
Thanks for all you do, and don’t forget to join the next full National Safe and Healthy Housing Coalition webinar on June 7, which will include a panel on Healthy Housing for Older Adults!

Find It, Fix It, Fund It: A Bold Call to Action to Eliminate Lead Poisoning

The National Center for Healthy Housing (NCHH) and the steering committee of the National Safe and Healthy Housing Coalition (Coalition) have issued a call for national action to eliminate lead poisoning in the wake of the Flint water crisis.

Today they jointly announced the release of Find It, Fix It, Fund It, a bold new action drive to eliminate lead poisoning. The drive urges muscular national action by Congress and the Administration to develop and implement a comprehensive plan to eliminate lead paint hazards and lead pipes.

It's simple yet comprehensive: Find lead hazards, eliminate them, and build the political will to create key public and private investments and policies to do so.

As part of the drive, NCHH and the Coalition are leading initiatives to eliminate lead paint hazards and dramatically increase lead poisoning surveillance and home-based follow-up services and will support allies and partners in eliminating lead hazards in water and other sources.
Please join us in eliminating childhood lead poisoning:
  • Sign up to participate in the drive and/or add your organization’s logo to it. Select the box for the Find It, Fix It, Fund It Lead Elimination Action Drive round table, and we’ll send you details on the first round table meeting, scheduled for May 25, 2016, at 1 p.m. EDT.
  • Sign on in support of the drive’s principles in a letter to Congress and federal agencies.
  • We’d love your feedback on the drive: Send your thoughts to Julie Kruse.
A declaration supporting these principles passed unanimously at the Lead and Healthy Housing Conference on May 5, 2016, with support from the Coalition, the Lead and Environmental Hazards Association, and the National Association of Lead and Healthy Homes Grantees. We urge you to join the drive too!

“Eliminating lead poisoning could be America’s greatest public health success story of our time, similar to eliminating cholera and other epidemics caused in part by inadequate housing a century ago,” said Coalition’s steering committee member Roberta Hazen Aaronson, Executive Director of the Childhood Lead Action Project.

For more information on NCHH’s lead advocacy, click here. Click here to learn more about the National Safe and Healthy Housing Coalition.

Let’s win the fight against lead poisoning!

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