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Few Utah children are tested for exposure to lead — a situation that state agencies are taking steps to change amid calls for increased monitoring by a Utah environmental group and the American Medical Association.
Utah Physicians for a Healthy Environment announced this month that it plans to launch a campaign asking the state to provide blood tests for lead to all expectant mothers and infants to detect lead exposure in time to prevent developmental delays.
Brian Moench, the group's president, said a nationwide study published this year in The Journal of Pediatrics suggests more children are exposed to unsafe levels of lead than is commonly assumed.
The study found that 2.86 percent of children tested in Utah had levels of lead in their blood that exceeded health thresholds, and another 2.69 percent had elevated levels that do not exceed the threshold of 5 micrograms per deciliter of blood.
The Centers for Disease Control and Prevention does not consider any level of lead concentration to be safe — even low levels of lead are associated with developmental delays and decreased intelligence later in life — and uses the 5 micrograms per deciliter threshold to identify children with abnormally high blood lead concentrations.
Nationwide, the study estimated, about 3 percent of children under 6 years of age have concentrations of lead above 5 micrograms/deciliter, and 2 percent have blood lead levels between 3 micrograms/deciliter and 5 micrograms/deciliter.
Utah tests between 3,000 and 5,000 children per year, according to Sam LeFevre, who oversees the Utah Department of Health's environmental epidemiology program. Based on the state's birthrate, there are about 200,000 children in Utah in that age group — meaning 3 percent of Utah children are tested for exposure to lead in any given year. The CDC recommends blood tests for all children ages 2-5.
LeFevre said Utah Physicians' proposal could help increase the number of children who get tested, and deserves consideration. But there are already resources available for parents who want to have their children screened, he said. Insurance should cover the blood test, but if for some reason a family is unable to afford the test or the physician is unable to administer it, the local health department should be able to assist them, he said.
In cases where a child does test positive, LeFevre said, there are resources available to help the family locate and eliminate the source of the exposure.
Lead exposure can occur just about anywhere, but household sources such as lead-based paint and old plumbing fixtures are the most common risk factors, according to the Environmental Protection Agency. According to the Journal of Pediatrics study, children who lived in homes built prior to 1950 were especially at risk.
With those issues in mind, Moench said, it would be well worth it for the state to subsidize or pay for testing, as the results could help determine where and how often children in Utah are being exposed to lead.
"Even if we found a small number of children exposed to high or moderate levels of lead," he said, "and tried to figure out the cause of that exposure — and who knows where that would lead — it would have a profound impact on their life and career prospects."
He estimated that testing all infants and pregnant women would cost the state $2 million to $3 million.
While blood testing has its value, LeFevre said, the state health department is pursuing a more proactive approach intended to prevent lead exposure, rather than simply detecting it.
The project is still in the works, he said, but sometime this summer, the department will send mailers to school districts to find out which schools have mechanisms in place for testing their tap water and drinking fountains for lead, and which would appreciate assistance in conducting such testing.
"We don't know whether there's a problem," LeFevre said, "but it would be nice to say we've looked at it and we know there's no problem."
Lead can contaminate drinking water when the pipes that deliver it corrode and begin to leach lead and other metals into the water. This can occur not only in the municipal systems that deliver water, but also in individual homes and structures, particularly in structures with older plumbing systems.
Waters systems are required to collect samples they use to evaluate their water quality from a home or apartment because of the potential for localized contamination. But schools can fall by the wayside because they aren't a required sampling site, said Emily Frary, an environmental scientist for the Utah Division of Drinking Water.
Frary said the Division of Drinking Water plans to work with the state health department to create a sort of training program for schools that do not have water quality monitoring programs in place.
The state's approach is similar to the American Medical Association's new policy on lead monitoring, released this month. The association is calling for the creation of laws that would require all schools and day care facilities to receive regular water quality testing.
Both Frary and LeFevre said their respective agencies began pursuing school testing initiatives before the AMA policy was publicly announced. Schools are currently required to identify and remove sources of lead contamination from their facilities, but there is no specific requirement to conduct water quality tests. And inquiries of local schools suggest that few do.
Frary said she felt it was important to help schools test their water quality to prevent issues from slipping through the cracks.
"The way water monitoring works right now is decent," she said, "but I do like the idea of addressing schools or day cares, because that's not something that's addressed by current EPA rules. If we could set up some kind if bridge, that would be really beneficial to protect that aspect of public health."
Frary said she expected the rules about water quality testing in schools could change in the next five or 10 years, given that school children are considered an at-risk population where lead is concerned.
She too thought the Utah Physicians' proposal had merit, but said she preferred monitoring the schools, rather than the children.
"Monitoring lead levels in schools would be more preventative," she said. "You could see where the pipes need work, where with blood level testing, you only see it once they've been exposed."