May 20, 2019
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More Maine kids need to be tested for lead. A mandate isn’t the only solution.

Gabor Degre | BDN
Gabor Degre | BDN
Workers remove cedar shingles, coated with lead-based paint from a camp in Northport.

Barely half of Maine toddlers are tested for lead poisoning, despite laws requiring such testing for many of them. This is a serious concern because Maine has one of the oldest housing stocks in the nation.

Lead poisoning — often resulting from lead-based paint in older buildings — can lead to development delays in children and other health problems, so early diagnosis is important.

Maine is the only New England state that does not have mandatory testing for all children. The state does require testing for children enrolled in MaineCare, the state’s Medicaid program.

Lawmakers are currently considering a bill, LD 976, would require testing of all Maine 1-, 2- and 6-year-olds. This effort is well intentioned, but as recent data show, a testing mandate isn’t likely to get Maine anywhere near testing 100 percent of children for lead.

In addition to a testing requirement, lawmakers must ensure continued support for ongoing Department of Health and Human Services and MaineHousing work to increase testing rates — and to support the needed work that comes after an elevated lead level has been found in a child.

In 2017, only about 55 percent of 1-year-old children and 30 percent of 2-year-olds were screened for lead in Maine, according to research released last week by the Maine Affordable Housing Coalition, a group of public and private organizations advocating for affordable housing policy.

Oddly, the testing rate for 1-year-olds enrolled in MaineCare — 52 percent — is lower than the rate for all Maine 1-year-olds. The rate for 2-year-olds enrolled in MaineCare is higher than that for all Maine 2-year-olds, at nearly 37 percent. Both of the MaineCare testing rates are woefully inadequate when federal law requires lead testing of these children.

This points to the need for other means to ensure more Maine children get these needed tests. Much of this work is already underway.

Lawmakers more than a decade ago created a Lead Poisoning Prevention Fund, funded by a 25-cent fee on every gallon of paint sold in the state, to support prevention activities. With support from the fund, the Maine Center for Disease Control and Prevention began several data-driven projects to better target the state’s efforts. Through this work, the state CDC identified five high-risk areas that account for 40 percent of the state’s childhood lead poisoning cases. Those high-risk areas are now Bangor, Portland/Westbook, Lewiston/Auburn, Biddeford/Saco and Augusta.

The U.S. Department of Housing and Urban Development and Maine Housing provide funds to support testing and removal, especially in rental housing. A relatively new state fund is available to help landlords remove lead from their units, in exchange for a pledge to keep the units affordable.

A more recent state CDC project involves tracking the testing history of every child that is in the state’s immunization database. By adding a blood lead level module to the system, the department and medical practices can identify children who need lead testing and monitor children identified with elevated lead levels. The system can also be used to identify medical practices with high testing rates so they can serve as models for practices with low rates.

This work could be especially useful because testing rates vary widely across the state. In Washington and Franklin counties, for example, more than 80 percent of 1-year-olds are being tested. But, in Sagadahoc County, fewer than 30 percent are.

Identifying Maine children who have elevated levels of lead in their body is critically important. More testing is a key part of this work. But, as the data show, simply mandating testing won’t solve the problem.

 



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