Susan Wilson can drive through Harrisburg and point out the poisoned homes.
The chipping paint on the doorframes, windows and railings, it all tells a story. Over time, she has developed a keen eye for diagnosing old city dwellings.
For the past four years, Wilson has been on the lead beat, so to speak. In technical terms, she’s the client outreach and logistics coordinator for Harrisburg’s Department of Building and Housing Development—a mouthful. Fundamentally, her job is to protect kids from the poison their parents may not know exists right in their home. She does this with a small team through the city’s Lead Hazard Reduction Demonstration Program.
Wilson goes door-to-door, warning people that their families could be at risk for lead poisoning. In Harrisburg, like most other cities, this is no small feat.
“I’ve knocked on every door in just about every neighborhood in this community,” Wilson said. “No matter where you are or what the area might look like, we knock on those doors.”
About a year ago, Wilson was in Shawn Gillespie’s neighborhood in Allison Hill when they ran into each other.
Gillespie has lived in Harrisburg for over 50 years. He was born and raised in the city before raising his own kids and now helping with his grandkids. His youngest grandson, Ki’mere, is 18 months old and stays at Gillespie’s home daily.
It never really crossed his mind that his home could be unsafe. At least not until Gillespie had grandchildren in his house. That’s when he started thinking about lead.
He figures that his home was built in the 1960s, not super old, but, when it comes to the possibility of lead paint exposure, it’s old enough.
“Growing up in the ‘70s, it was a big issue,” Gillespie said. “But I didn’t really think about it until my grandkids started coming over.”
When he ran into Wilson, she confirmed that his home most likely had some traces of lead paint in it, which put his grandchildren at risk for poisoning. But, she had a solution.
In Your Blood
In the early 1900s, lead was beginning to find its way into paint cans in the United States. For over 50 years, homes and buildings were coated in the rich, bright paint. As early as the 1920s, health professionals linked lead poisoning to health issues, but the lead industry long downplayed the risks, according to a March 2016 story from National Public Radio entitled “America’s ‘Lead Wars’ Go Beyond Flint, Mich.”
The federal government finally banned lead paint for consumer use in 1978, but homes built before then had a high risk of contamination.
Joyce Ravinskas deals with a lot of families living in older homes in Pennsylvania. She is a registered nurse, but her job is more like a detective’s. The medical cases brought to her desk require investigation. Sometimes, her research involves digging through people’s drawers and medicine cabinets, but often, she can get answers through a simple home inspection.
In fact, most of the time the answer is right on the walls.
“There should be no lead in a child’s system or anyone’s system,” Ravinskas said.
But when she receives clients, there always is.
Ravinskas gets children referred to her from 15 counties in the state. She’s the program manager for UPMC Pinnacle’s Lead Poisoning Prevention and Education Program.
When kids come to her, it’s because they have elevated blood lead levels. This means that, somehow, they’ve come into contact with the substance, most likely through inhaling lead dust or eating paint chips, and now it’s in their system.
A blood lead level of five micrograms per deciliter or higher is considered concerning to the U.S. Centers for Disease Control (CDC). However, as a parent and grandparent, Ravinskas said she would be concerned if her child’s level was a three.
She’s seen children with blood lead levels as high as 88.
This is where Ravinskas’ sleuthing comes in.
“We don’t give up until we find what the source is,” she said.
Sometimes, lead is found in pots, dishes or other items brought from countries where the metal is less regulated. Most of the time, lead paint on walls, doorframes and windows is the culprit.
The higher the lead level in a child, the more it negatively affects their health, Ravinskas said.
Over the years, poisoned children may experience developmental delays, learning disabilities, lower IQs, hearing damage and behavioral issues, to name a few on the CDC list.
“The higher the level, the sooner we will get out there,” Ravinskas said. “We never turn anyone down.”
Once an inspection is done, a report is sent to the child’s doctor, the family’s landlord and the state health nurse. In Harrisburg, Ravinskas will then refer the family to the city’s Lead Safe Program to get rid of the problem.
Home (Lead) Free
After his run-in with Wilson, Gillespie applied for the city’s lead reduction program.
The inspection found lead around the windows, banister and back door of his home.
Through the program, the city pays for the remediation and for temporarily relocating residents for the days or weeks it may take to rid the house of the problem. Essentially, it’s free to those who qualify.
Applicants must have a child under 6 years old or a pregnant woman living or spending at least six hours per week in the home. In addition, there are location, income and other requirements.
“I’m a lot more relaxed,” Gillespie said, now that his home is lead-safe. “It’s comforting to know I don’t have to worry about it. It was definitely something that needed to be addressed.”
Since 1995, the city’s lead reduction program has made over 800 homes lead-safe. They can do this thanks to federal grants. Most recently, the city received a $5.6 million grant from the federal Department of Housing and Urban Development (HUD). With that money, Wilson’s goal is to make 230 homes lead-safe.
According to the U.S. Census Bureau, in 2012, about 85% of Harrisburg’s homes were built before the 1970s.
“We have such old housing here,” said David Olsen, the lead reduction program manager. “I don’t know how long it’s going to take to address every house in the city, but certainly Harrisburg is set up to continue doing this work for a while.”
Garrett and Kristin Kooiker live in Harrisburg’s Bellevue Park neighborhood.
During a visit with their son Holden’s pediatrician, the doctor suggested a blood lead level test since their home was built in the 1940s. It turned out that he had an elevated level of six micrograms per deciliter—just over the CDC’s baseline for concern.
“We really had no idea about it,” Garrett said. “We were concerned after we found out our son was in danger.”
Wilson and her team sprung to action, finding a high concentration of lead on the exterior of the Kooikers’ home.
Families from all neighborhoods and socioeconomic backgrounds can be affected by lead poisoning. However, communities of color and low-income areas are often the most poisoned.
According to Health Affairs journal, Black children are three times as likely to have elevated blood lead levels than white children.
“It’s important that we touch the community and touch the lives of those who are most affected by this, and they happen to be low-to-moderate income families,” Wilson said.
Why We’re Like This
In 2017, Lancaster passed an ordinance to further reduce lead paint in homes. The new regulation required landlords to certify that their properties were lead-safe or lead-free if they were built before 1978 and if they are renting to a family with a child under 6 years old.
Harrisburg, however, does not have such an ordinance, Olsen said.
HUD does have a lead disclosure rule at the federal level. It requires landlords or sellers to present any known information about lead-based paint hazards to renters or homebuyers.
But this does not require the lead to be abated.
Most lead programs in Pennsylvania right now are very reactive, Ravinskas said.
Often, homes only go through lead reduction programs after children are referred to her with elevated blood lead levels. That’s largely because regulations don’t mandate that all children get tested or that all landlords do pre-emptive remediation.
Therefore Ravinskas is part of a committee advocating for lead testing for all children and for insurance to pay for home lead inspections.
“I’m optimistic that, in less than two years, we will see all kids covered in PA,” she said.
With the COVID-19 crisis, many environmental inequalities were exposed. Racial and ethnic minority groups and those living in tightly packed cities are disproportionately impacted by the virus, according to the CDC. Where people live and their income levels often determine their health.
But lead poisoning has been telling us the same story for years.
Children may not be dying from lead at the rates people have died from coronavirus, but they are suffering consequences.
The Philadelphia-based Education Law Center, which works to ensure quality public education for Pennsylvania children, found that, as a child’s lead exposure increases, his or her classroom performance in school decreases and IQ goes down. Lead has even been linked to adolescent delinquency and adult criminality in males, the center found.
“I was one of those kids in low-income housing,” said Lillie Williams, the interim director for Harrisburg’s building and housing department. “I don’t remember eating paint, but that could’ve been me. I don’t remember, when I was a kid, there being a program like this.”
Olsen said that the Harrisburg team has a joke among themselves to explain their quirks or funny mistakes. Because they grew up during the years that lead was so prevalent, they’ll say, “That’s why I’m like this.”
But Olsen’s smile quickly turned to a straight face.
“But it’s not a joke,” he said. “It’s really serious.”
To learn more about Harrisburg’s Lead Safe Program, visit www.harrisburgpa.gov/leadsafeprogram.
To learn more about UPMC Pinnacle’s Lead Poisoning Prevention and Education Program, visit www.upmcpinnacle.com.