Rates for lead screening in MV children far below state average

Danger most acute from old paint, but toxic metal lurks in many other places.

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A tank truck full of leaded Avgas on the tarmac adjacent to a small plane at Martha's Vineyard Airport. Piston aircraft at the airport use Avgas, a type of leaded gasoline. – Ralph Stewart
Lead or lead-containing items purchased on the Vineyard: a lead-brass spray nozzle, round split-shot lead sinkers, a lead pyramid sinker, a lead bank sinker, and lead-antimony automotive wheel weights. — Stacey Rupolo

Island children receive far fewer lead screenings than children in the rest of the state, data provided by the Massachusetts Department of Public Health (DPH) shows. State regulations stipulate that every child in Massachusetts must undergo three lead screenings prior to their fourth birthday. Every child is also required to provide proof of one such screening when he or she enters kindergarten. The overall state rate for these screenings in 2016 was 77 percent, but on Martha’s Vineyard the rate was less than half that — 33 percent. In 2015 the Vineyard was a little above half the state rate, at 39 percent to the state’s 76 percent.

In an email to the Times, Lana Schaeffer, nurse at the Oak Bluffs School, said the state numbers seem low and don’t correlate with what school nurses know about screenings for the student population. “We do not report the lead screening statistics to the state unlike immunizations,” she wrote.

Long known for its neurotoxicity, lead is particularly damaging to children’s developing brains. No amount is considered safe to inhale or ingest.

The low screening rates on the Vineyard are concerning, Alicia Fraser, assistant director of the DPH’s Environmental Epidemiology Program, told The Times.

The Times made repeated attempts over the course of several days to seek comment from School Superintendent Matt D’Andrea, but he did not respond to calls or email messages.

Edgartown health agent Matt Poole told The Times he was unaware of the Island’s low screening rates. Mr. Poole said he found the percentages troubling, and noted that the Island’s vaccination rates are also well below the state average. He declined to speculate on whether a correlation exists between lead screenings and vaccinations, but said the matter deserved investigation.

“This sounds exactly like the thing we should look into,” said Dukes County Health Council chairman Dr. Charles Hodge, noting he was also unaware of the Island’s low screening rates for lead. He said he plans to put the issue on the council’s September agenda, and it could become a future topic for the Rural Scholars program, a team of University of Massachusetts medical and nursing students who analyze data related to Vineyard health issues.

In conversations and emails with The Times, Ms. Fraser said the DPH, through its Bureau of Environmental Health, began a community progress reports program last year, which sent out community lead-screening and blood-lead-level data to help “remind physicians that lead poisoning is still a public health concern, and to remind them to screen children in their practice.” While the program sends a cover letter and questionnaire to every physician in Massachusetts, it’s still compiling a contact list of all children’s healthcare providers in the state. Notable deficits on the list currently are nurses and nurse practitioners, who don’t often specify that they’re working in pediatrics.

Judy Jones, medical director for an Island clinic and a pediatric nurse practitioner, told The Times she was unaware of the commonwealth’s regulations for lead screening, and that she adhered to the American Academy of Pediatrics schedule for screening, which dictates that blood tests should only be employed after a risk assessment indicates a need for one. She said she would look into the Massachusetts regulations immediately.

Nicole Barlett, nurse at the Edgartown School, said pupils in her school who fail to provide evidence of blood screening by Oct. 1 will be sent a letter reminding them about the requirement.

The commonwealth doesn’t take a hardline stand when it comes to screenings.

“It is the position of the Childhood Lead Poisoning Prevention Program (CLPPP) that there is no exemption to required lead screening based on religious beliefs, since such an exemption was not authorized by law,” DPH spokeswoman Ann Scales wrote in an email. “However, CLPPP has advised schools that while a lead screening test is a prerequisite for entering school, they do not recommend denying children entry to school for failure to have a lead test. In contrast to the situation when families refuse vaccinations for their children, failure to have a lead screening test will not impact any other children, and therefore should not be a basis for denying school entry.”

The DPH is poised to toughen screening regulations, Ms. Fraser said, to “require proof of screening not just at kindergarten, but also for entering into daycare or pre-kindergarten programs. We hope that this effort, if promulgated, will prompt screening where it may not be currently happening.”

Vineyard children screened in 2016 showed a slightly higher rate of blood levels above the Centers for Disease Control (CDC) reference value of five micrograms per deciliter of blood than the state rate — 3.5 percent versus 2 percent, Ms. Fraser noted. The CDC replaced the term “level of concern” with “reference level” in 2012, its website states.

Lead paint to blame?

“The biggest source of exposure for children is leaded paint,” Ms Fraser said.  “Any child can be at risk, especially if they live or spend time in a home built before 1978, which constitutes a large portion of homes in Massachusetts.”

The state’s residential lead paint laws are strict, but they contain a loophole for a key piece of the Vineyard economy — short term-rentals. Unlike regular residences, condos, hotel and bed and breakfast rooms, and private homes rented for 31 days or less don’t need to abate lead when occupied by a child under 6, provided all interior surfaces are intact and notification is given of the presence of lead. Oak Bluffs health agent Meegan Lancaster told The Times that she encountered a landlord in Harthaven earlier in the summer who failed to notify short-term renters with children that their rental space contained lead. The landlord is now facing several violations, she said.

Lead is lurking in everyday items

Islanders can encounter lead in many everyday objects and materials. Wiring, pipe, flashing, and demolition debris found in the Vineyard’s booming homebuilding industry can harbor lead. PVC or vinyl school supplies like three-ring binders, lunchboxes, and backpacks can contain lead, and a number of other harmful substances. The Center for Health, Environment, and Justice recommends looking for the recycle number ‘3’ or the letter ‘V’ to identify products made of PVC or vinyl.

Tire weights, sold on the Vineyard and found on many Island vehicles, can be completely made of lead or lead-antimony alloy. These weights regularly fall off and get pulverized on roadways, James Schauer, an environmental engineer at the University of Wisconsin-Madison, told The Times. Mr. Schauer said that based on research he’s conducted with fellow engineer Martin Schafer, he’s concluded that much of the lead found on roadsides consists of these weights ground to particles and intermixed with road dust.

Angler’s sinkers and diver’s weights, readily found on the Vineyard, are made of solid lead.

The Woods Hole Oceanographic Institution’s protocol for lead weights dictates that gloves must be worn when handling them. According to WHOI’s website, the protocol also states,

“Thoroughly wash hands, arms, and face after handling lead. Do not eat, drink, or smoke in or around areas where lead is handled or stored.”

Brass items such as garden hose couplings and spray nozzles can contain lead. At an Island store, The Times recently purchased a spray nozzle labeled with a California Proposition 65 warning: “The brass in this product contains lead, a chemical known to the state of California to cause cancer and birth defects and other reproductive harm. Wash hands after handling.”

Gas station attendants Howard “Whit” Whitney, Gabriel “Gabby” Mello, and Walter “Scotty” Scott pose in front of Renear’s Service Station on Church Street in Vineyard Haven, sometime in the 1930s. Tetraethyl lead gasoline was in use at this time. — Courtesy Chris Baer

The enduring specter of leaded gasoline

Use of leaded fuel began in the 1920s when tetraethyl lead was mixed with gasoline to enhance engine performance.

“Lead, and tetraethyl lead in particular, was known to be toxic long before leaded gasoline was invented, and warnings were issued that leaded gasoline was a bad idea,” science writer Theodore Gray wrote in his book “Molecules.” “Dozens of workers died in the plants that produced it, and it’s quite clear that companies behaved very badly in their attempt to preserve their ability to use this cheap and effective chemical despite the inconvertible fact that it was causing tremendous harm.”

The EPA drastically curtailed leaded gas in 1976, and all but abolished it by 1996.

“The elimination of lead from gas is one of the great environmental achievements of all time,” then-EPA administrator Carol Browner said.  

But piston aircraft — small propeller planes — have kept using leaded fuel, and do so at Martha’s Vineyard Airport, where 93,267 gallons of Avgas LL 100 was dispensed in 2016, according to assistant airport manager Geoff Freeman. Avgas LL 100 (low lead 100) contains tetraethyl lead. Aircraft at Katama Airfield also use Avgas LL 100, according to assistant airport manager Alex Torres. The airfield purchases approximately 6,000 gallons of the fuel per season from Martha’s Vineyard Airport. A page on shell.com describes Avgas 100 LL as being not as low in lead as its name suggests: “This grade is the low lead version of Avgas 100. Low lead is a relative term. There is still up to 0.56 g/litre of lead in Avgas 100LL.”

General aviation airports tend to be fairly close to residential neighborhoods, and therefore a cause for concern because of the potential for lead exhaust exposure from flyovers, Harvard School of Public Health environmental epidemiology researcher Joel Schwartz told 

The Times. Mr. Schwartz called leaded Avgas “an unnecessary source of exposure.”

Dwellings on Vineyard Meadows Farm Road, Waldrons Bottom Road, Charles Neck Way, andCoffins Field Road are near Martha’s Vineyard Airport, as are buildings at the Airport Business Park, and may be routinely exposed to Avgas emissions. Likewise dwellings on Slough Cove Road, Thaxter Lane, Proprietor’s Road, Crocker Drive, and Mattakesett Way sit relatively near Katama Airfield, and may also be routinely exposed to such emissions.

Soilborne poison

Throughout the decades when leaded gasoline was in wide use, traffic puffed out lead-laden exhaust over the commonwealth’s roadways. This left a lead residue along roadsides that persists today, Massachusetts Department of Environment Protection Bureau of Waste Site Cleanup assistant commissioner Paul Locke told The Times. The older the roadway or the greater the volume the roadway saw, the higher the concentration of lead that is likely to be along it, he said.

Children who play in soil contaminated by leaded gasoline exhaust and then touch their mouths are in danger of lead poisoning, he said. He noted that too few parents realize the hidden danger of roadside lead — a threat that isn’t limited to road shoulders but also private yards, or any land adjacent to a given roadway. The contamination can extend up to a quarter-mile from some roadways, he said.

“Lead binds easily with carbon organic matter in the soil,” MassDEP spokesman Joseph Ferson told The Times in an email. “It’s not entirely immobilized, but less likely to migrate than other compounds, like road salt or solvents.”

However, acidic soils (which are plentiful on the Vineyard) tend to mobilize heavy metals like lead, Mr. Locke said.

Leafy greens and root vegetables grown in lead-tainted soil, be it from exhaust, paint, or some other source, can draw the heavy metal inside themselves and become toxic, University of Massachusetts Amherst Soil and Plant Nutrient Testing Laboratory supervisor Tracy Allen told The Times. Her lab offers a routine analysis that, along with other soil data, shows the amount of plant-extractable lead in soil. The test costs about $15, and requires a cup of soil.  Ms. Allen’s lab also offers a more sophisticated test called a total sorbed metals test, which shows minute traces of lead and other heavy metals in given a soil sample. This test uses strong acids and heat, and is equivalent to a standard EPA method. It costs about $55 per sample. Ms. Allen described the latter test as a proper choice “when caution is needed,” such as when lead paint is suspected in the soil around an old house where children are present.

Ms. Allen said the public should be aware of lead contamination in old orchards. Old insecticides applied to orchards contained lead arsenate, she said. Long after it was sprayed, the lead can endure. Isolated lead concentrations can be significant enough in old orchards that even after the trees are gone, testing can tell where they stood, she said.

Farmland was also sprayed with lead arsenate insecticides, according to Paul Locke. Sometimes when old farmland is subdivided into house lots, subsequent occupants don’t realize the land was once farmed and might contain lead, he said.

Read: The Edgartown School’s icemaker tests for lead. 

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4 COMMENTS

  1. This is terrible and sad. Given how many parents do not vaccinate their children here, it is not surprising, though.

  2. Not sure what spurred this article, has there been some burst of lead poisoning on the island? I prefer that my healthcare provider use evidence based practices when treating or testing my children for anything, not some heretofore buried state regulation. Many of us pay for our own healthcare out of pocket, why would I want to put my child through (and pay for) potentially unnecessary and expensive invasive testing? Shouldn’t those decisions be left up the the provider? How is practicing medicine by state mandate and ignoring the best practices recommended by professional healthcare organizations, the way to go?

    • It’s a finger prick. Results from 2016 show higher levels of lead in our island children, but the good news for the rest of us is that, unlike the selfish parents who do not vaccinate their kids, the parents who do not screen their children for lead do not endanger the rest of us. They just endanger their kids. And just so you know, Ms. Pitcher, informed healthcare professionals certainly do recommend lead screening, especially in high lead rural areas such as ours. When a pediatric nurse/medical director of an island health clinic is unaware of the screening regulations, you get parents who don’t know enough to screen their children. The state mandate came about from medical evidence. Ignorance is bliss, until you realize your ignorance hurt your children.

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