Chris and Amanda Comeau said when their daughter Eleanor turned 10 months old, she hit lots of exciting milestones. She started moving around on her own a lot more, waving and gesturing and recognizing her grandparents on FaceTime.
It’s also when she had to get her first blood test for lead.
Testing kids’ blood for lead content shortly before a first birthday is fairly standard and covered by Medicaid and most insurance plans, according to Allegheny County Health Department Director Karen Hacker. Lead poisoning can damage the growing brain and cause developmental delays.
Hacker said the department is considering mandating such testing for all kids between ages 9 and 12 months.
“They're crawling around. This is a time when children are putting things in their mouths,” she said. “The primary source of lead is in the paint, in the dust.”
Hacker said 80 percent of homes in Allegheny County were built before 1978 when the federal government banned the use of lead in paint.
They're homes like Brandon and Erin Blache-Cohen’s 1924 craftsman in Squirrel Hill South. They said they knew that their house likely had lead paint, but thought they were safe, having put a fresh coat of paint on every surface when they renovated the home in 2009.
So when they found out last summer that their youngest daughter had lead poisoning, they were stunned.
“It was terrifying,” said Erin Blache-Cohen, 35. “My stomach immediately dropped and I panicked, and Brandon kind of talked me down a little bit. I think I immediately took to the internet to see what more we could read about it.”
Erin said the internet wasn’t very helpful. The couple found all kinds of conflicting information about what they should do and what the impact might be on their daughter.
“We really felt alone,” Brandon Blache-Cohen, 34, said. “We weren't sure how serious this was. Does this mean that our daughter is going to have a lower IQ because of her exposure to lead?”
A second test confirmed that the baby’s blood lead level was 9 micrograms per liter, or μg/L. According to the Centers for Disease Control and Prevention, anything above 5 μg/L is cause for concern. Above 20 μg/L requires immediate medical attention and could necessitate chelation therapy, which uses a binding agent to remove lead from the bloodstream.
Above 10 μg/L, the Allegheny County Health Department will actually send an inspector out to the home to try to figure out where the lead might be coming from.
“We spend probably a couple hours at the house interviewing the family (and) taking readings of all the paint on the painted surfaces of the walls the windowsills,” said Dave Namey, manager for the department’s housing and community environment program. “We also do environmental sampling. We test the water, the dust and the soil (and) we couple that with the child's behavior to try to determine how that child ingested the lead.”
Hacker said parents will often want to completely get rid of all the lead paint in the house, but that scraping away old lead paint can do more harm than good.
“What you don't want to do is mobilize this stuff,” she said. “Even in homes where the paint is very stable and it's not chipping and it's not dusting, (if) they go and they renovate something … during that process they're mobilizing it as well.”
Because the Blache-Cohens’ daughter was just under that 10 μg/L level, they weren’t subject to a county inspection, which meant they were mostly on their own. They started by testing the water, but when it came back below the EPA action level, they turned to paint.
They hired a private inspector who explained to them that anywhere there is friction in the home, there is the possibility of disturbing old layers of lead paint lurking below the surface.
“Something like a cabinet opening and closing, drawers opening closing, even if they had been repainted. That that posed a significant concern,” Erin Blache-Cohen said.
Friction triggered an idea. Both their daughters had loved playing in a bouncy chair hung from the doorway between their dining and family rooms.
“That was one of the places that they told us, just rubbing against it, even in places that you otherwise couldn't detect that paint had chipped … could have created some kind of dust,” she said.
Erin said they took down the bouncy chair and painted over the trim it had hung on. They also painted all the doors, doorways and window frames in their homes.
“But again, we have no idea,” said Brandon Blache-Cohen. “This is eight months later. We still have no idea what caused it or if we did anything to prevent future issues.”
Brandon said, at a certain point, kids just stop putting things in their mouths, chewing on baseboards and crawling around on the floor where lead dust is likely to settle. Once the risk factors in the home are dealt with, a child’s lead level should naturally decrease over time.
The Blache-Cohens had their youngest daughter’s blood lead level tested again this month, and found that it had dropped to 3 μg/L. Erin said they won’t need to do any more blood tests, but her daughter’s pediatrician will continue to monitor the girl's development closely with her exposure history in mind.
Having weathered the storm, the pair has some advice for parents just finding out their child has high lead levels.
“Be patient,” said Brandon Blache-Cohen. “Unless there are dangerously high lead levels … take care of what you can take care of, but don't make yourself go crazy trying to figure out where she got it or how she got it.”
The Blache-Cohens said they’re lucky, because they had the resources to make the needed changes in their home, and they know that not every family does.
Last year, Allegheny County received $3.4 million in federal funding to do lead remediation in the homes of low-income families with small children without proof of elevated levels.
Amanda Comeau, 32, said she knows they’ve got lead paint in their Stanton Heights home.
“With the house being built in 1949, I’m certain that there’s lead paint somewhere in the house. It’s just an issue of keeping her out of it,” she said, pointing to a window jamb in the kitchen where layers of paint are peeling off.
So far, their efforts at keeping Eleanor away from lead paint are working. Her blood lead levels came back at 2 μg/L, well under the CDC action level.
Though no level of lead is completely safe, Hacker echoed the Blache-Cohens. Once parents address the issue, she said, children should recover just fine.