Photo by Helen Stummer
Lead poisoning remains the foremost environmental health risk to American children, with just under 1 million children with elevated lead levels. While the average blood lead level in the U.S. population has dropped dramatically—by 82 percent—over the past two decades, and the number of children with elevated levels has also declined, these gains are principally due to regulations banning lead in gasoline and in solder used in food cans and plumbing. The major remaining cause of lead poisoning is lead paint in housing, especially housing built before 1950, when lead paint was commonly used.
Lead poisoning is a concrete expression of the affordable housing crisis, more prevalent in poor children, children of color, and those living in older housing. An emerging consensus over practical, cost-effective measures to protect children from lead hazards in their homes further emphasizes the importance of responsible property management and the need for enforceable housing quality standards.
The past few years have seen significant changes in both our understanding of the hazards of lead-based paint and in cost-effective approaches to prevention. The focus has moved away from removal or encapsulation of all lead paint from all housing to a set of preventive measures focused on controlling lead hazards.
Why Worry About Lead Poisoning?
Lead is the most studied of environmental hazards, and evidence of its toxicity from thousands of research studies is overwhelming and undisputed. A naturally occurring element that is highly toxic to almost all human organs and systems when ingested or inhaled, lead affects children and adults, although children under age 6 and fetuses are most sensitive. Lead poisoning is a disease of degree: coma, convulsions, and death occur at high levels; at low levels, the symptoms are more difficult to identify. In children, low-level lead poisoning affects the developing brain and nervous system, causing reductions in IQ and attention span, reading and other learning disabilities, hyperactivity, aggressive behavior, hearing loss, and coordination problems. For children, lead is typically measured by a blood test, and the “level of concern” established by the Centers for Disease Control and Prevention (CDC) is 10 micrograms of lead per deciliter of blood.
Children from poor families are eight times more likely to be poisoned than those from higher income families. Because they are more likely to be poor and to live in older housing, African-American children are five times more likely to be poisoned than are white children. The poisoning rate among African-American children living in older housing is 21.6 percent—a shattering statistic.
The Housing Connection
Most children with elevated lead levels are poisoned in their own homes, usually by peeling lead-based paint and the dust it generates. The mere presence of lead-based paint is not a hazard: two-thirds of all U.S. housing contains some leaded paint, and the vast majority of children live safely in these homes and apartments. Exposure to lead dust is now recognized to be the primary pathway of poisoning in children. Lead dust settles quickly, is difficult to clean up, and can be invisible to the naked eye. Young children are poisoned through normal hand-to-mouth activity after they get lead dust on their hands and toys. (Children can be seriously poisoned by eating lead paint chips, but this is much less common.)
Housing age is an important predictor of risk, because the lead content of paint varied substantially over the past century. While there is no clear dividing line, 1950 is often recognized as a threshold to lower levels of lead in paint. Prior to about 1940, paint typically contained high amounts of lead—often 10 percent and sometimes as high as 50 percent. In the early 1950s, voluntary paint industry standards called for limiting lead content to 1 percent, and in 1978 federal regulations effectively banned lead in residential paint.
There are two typical scenarios of lead poisoning. Most commonly, children are poisoned by deteriorated paint (and dust) in poorly maintained housing. But the most serious cases of poisoning are often caused by repainting and remodeling projects that disturb leaded paint without proper safeguards to control, contain, and clean up lead dust. Lead paint was used more on exterior surfaces than interior, more on trim than walls and ceilings, and more in kitchens and bathrooms.
Reaction to Prevention
During the 1970s and 1980s, federal attention to lead hazards in housing was limited to federally assisted housing, primarily public housing. The approach was reactive and ineffective: action was rarely taken until after a child had been poisoned, and the removal (abatement) of all lead paint, an extraordinarily expensive solution, was taken to be the only remedy. The result was that only a relative handful of units were abated, lead hazards in private housing were widely ignored, and growing lawsuits against property owners increased the anxiety of lenders, insurers, and owners alike.
In 1992, Title X of the Housing and Community Development Act, or the Lead-Based Paint Poisoning Prevention Act, shifted the national approach to prevention. Recognizing that lead-based paint threatens affordable housing as well as children’s health, Congress moved beyond concern over the mere presence of lead paint (and its complete abatement as the only remedy) to call for cost-effective measures to control lead hazards, which would be appropriate throughout the private housing stock.
The law directed HUD to develop technical guidelines for hazard evaluation and control practices and to overhaul its regulations related to lead-based paint. HUD began a categorical grant program to help cities control lead hazards in affordable housing. (Almost $300 million has since been awarded to 57 cities and states.) Title X also directed the Occupational Safety and Health Administration (OSHA) to issue regulations to protect workers from lead hazards on construction projects, and the Environmental Protection Agency (EPA) to define hazards and set standards for states to accredit laboratories and trainers and certify lead inspectors, risk assessors, and abatement contractors. To date, 34 states have enacted contractor certification laws.
Private Rental Housing Standards
Congress referred the sensitive issues related to legal liability, insurance, and financing to a national task force, appointed by then HUD Secretary Henry Cisneros. This broadly representative task force included experts from almost every interest affected: rental property owners and managers, tenants and legal services attorneys, lenders, insurers, contractors, medical, environmental, and technical experts, and advocates for lead poisoning prevention. The task force report recommended ways to control lead hazards in private housing, relying to the maximum extent possible on market forces, rather than public subsidies. It did explicitly recognize, however, that “distressed” housing, where existing rents would not cover additional costs and tenants could not afford to pay more, would require subsidies to be made safe.
At the core of the task force recommendations is a set of benchmark standards, which identify steps rental property owners need to take to control lead hazards. For properties that are well maintained and therefore low risk, a set of Essential Maintenance Practices (EMPs) applies. EMPs are low cost, commonsense procedures intended to keep paint intact and avoid the generation of lead dust. For “higher priority” properties, the task force calls for more aggressive measures, giving property owners the option of hiring a certified risk assessor to determine what paint contains hazardous lead levels and whether soil is contaminated, or performing a prescribed set of standard treatments, primarily at unit turnover.
The task force also recommended that states pass legislation to provide incentives for rental property owners to implement effective hazard controls, including limitations in legal liability for those who can independently document compliance. Several state and local governments have already revised or are now considering revising their laws and regulations along the lines proposed in the task force report.
Overhaul of HUD Regulations
Over the past 20 years, a patchwork of regulations related to lead-based paint has evolved across HUD’s housing assistance, community development, and loan guarantee programs. For the most part, these regulations are illogical, ineffective, and out of touch with current knowledge. In June 1996, HUD proposed an overhaul of its lead paint regulations. These proposed changes engendered sharp criticism in some quarters, particularly among those using CDBG and HOME funds for rehab, that the new lead paint requirements were excessive and too costly. HUD is now in the process of revising this package of regulations based on the comments received. It is hoped and expected that HUD will incorporate to a much greater extent the principles and recommendations of its national task force in its final regulations, to be issued in early 1998. Housing advocates concerned with the costs of complying with the requirements may want to urge HUD to use the task force report’s recommendations as a guide.
Lead Hazard Disclosure
The most far reaching part of the federal lead-paint law is the joint HUD-EPA regulation that took full effect in December 1996. The law requires that owners and agents of pre-1978 properties provide prospective buyers and tenants with an educational pamphlet about lead hazards to children and disclose known information about lead hazards in the particular property. In addition, buyers have up to 10 days to hire a lead inspector or risk assessor at their own expense.
These rules have important implications for both owners and tenants. All owners of housing built before 1978, including nonprofit providers, should take care to provide the required pamphlet and any available property-specific information about lead to prospective tenants and buyers. The penalties for noncompliance are substantial, and both HUD and EPA have enforcement authority. The disclosure requirements may also provide a new tool for tenants and tenant advocates in their struggles with recalcitrant landlords. These federal requirements and penalties for noncompliance may offer new causes of action and remedies above and beyond those existing under state and local statutes, ordinances, and common law.
Common Goals
Because subsidies will be needed for distressed housing, advocates should continue pressing for expanded federal housing assistance and oppose further cuts in HUD’s housing budget. The long-term benefits of controlling lead hazards are an additional argument for expanding this housing assistance.
The issue of lead poisoning provides a unique opportunity for collaboration among activists and groups working on a variety of issues but with common goals and values. Advocates for affordable housing and anti-poverty programs can enlist the support of those fighting to protect children from environmental health hazards, including but not limited to lead poisoning. Many of these advocates are ready to join the fight for better housing.
Lead Resources and Contacts (updated 2022)
- Maintaining a Lead Safe Home by Dennis Livingston is a do-it-yourself manual for home owners and property managers. The manual provides step-by-step instructions and detailed illustrations of affordable solutions to lead-based paint problems.
- U.S. Environmental Protection Agency’s EPA’s Lead Renovation, Repair and Painting Program. Information for renters, property managers, real estate agents, and others.
- EPA’s National Lead Information Center
- The National Lead Information Center provides general information, publications, and referrals.
- The National Center for Healthy Housing shares lead poisoning primary prevention policy recommendations from experts.
- U.S. Department of Housing and Urban Development’s Office of Lead Hazard Control and Healthy Homes
- The Alliance for Healthy Homes, a national public interest organization, advocates for protecting children from lead poisoning and using lead hazard disclosure to protect tenants’ rights. (Editor’s note: Until 2001, the Alliance for Healthy Homes had been known as the Alliance to End Childhood Lead Poisoning.)
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It never would have occurred to me that most children with elevated lead levels are often poisoned in their own homes. I would imagine that more people are exposed to lead by older paints in older homes. It seems like it would be a good idea to inspect an old home for lead paint before purchasing and moving into it.