Prevention of Lead Paint Poisoning among Baltimore Children: A Hard-Sell Program

Abstract

Since 1935, as an aid in diagnosis, the bureau of laboratories of the department has provided a free service to physicians and hospitals for the quantitative determination of lead in blood (3). The resultant followvup in the field and the heightened interest on the part of the pediatric services of the city's large hospitals enabled the department to acquire relatively accurate morbidity data. From 1956 through 1964 there were 540 clinically diagnosed cases of lead paint poisoning (plumbism) and 797 cases of abnormal lead absorption among Baltimore children, or a total of 1,337 cases. All the clinically diagnosed cases of lead poisoning were investigated as were all instances of abnormal absorption of lead as evidenced by a blood level exceeding 0.06 mg. of lead per 100 grams of blood. The homes of patients were visited, and paint samples obtained for testing from surfaces accessible to the affected children. The owners were required to remove paint from the indicated areas (2). In 1949 a public health nurse was assigned to the department's bureau of industrial hygiene to investigate reported instances of abnormal absorption of lead in young children and to insure compliance in the removal of the offending paint (4). Preventing a recurrence of the disease was deemed especially important as there is a highly significant correlation between second attacks of encephalopathy and severe permanent brain damage (5). Pamphlets designed to highlight the problem were used by public health nurses and sanitarians in clinics and in their home visits. Information on lead paint poisoning was mailed periodically to physicians and hospitals. Exhibits and otlher visual aids were shown at various meetings and in public buildings. Newspapers, regional trade periodicals, medical and public health publications, and radio and television programs all were used to inform the public of the serious consequences attending the ingestion of lead paint by children. The first effort toward legislative control of the problem was the adoption in 1951 of a regulation, under the ordinance on the hygiene of housing, that prohibited the use of paint containing lead pigment in the interior of dwellings (6). This was followed in 1958 by an ordinance requiring a warning label on paints containing more than 1 percent of lead and stating that the paint contained lead; was harmful if eaten; Alr. Schucker is director of sanitary services, Baltimore City Health Department. Mr. Vail is a principal sanitarian, Miss Kelley is director of the bureau of biostatistics, and Dr. Kaplan is assistant director of the bureau of laboratories and chairman of the department's lead paint poisoning prevention committee.