Childhood lead poisoning has been a sizable problem in the city of St. Louis for many years due to deteriorating lead paint in older homes and rental units. In 2000, 31 percent of children tested in the city of St. Louis were poisoned, according to Daniel Berg, M.D., assistant professor of medicine.
The situation has improved, however, and a new program in the OB/GYN Clinic at Barnes-Jewish Hospital is building on this success to prevent lead poisoning among the next generation of children.
Lead was a common ingredient in paint used in homes built before 1978. As lead paint falls apart, dust in a home becomes contaminated, and children are poisoned when they put their hands in their mouths. Lead poisoning causes irreversible brain damage, resulting in learning disabilities and behavioral problems.
Berg is working with a city of St. Louis program called Lead Safe St. Louis to prevent childhood lead poisoning. He started the Heavy Metal Project, an effort to offer home lead-hazard screening to pregnant women who live within the city of St. Louis and attend the OB/GYN Clinic. The Heavy Metal Project also is following these families in a two-year study to evaluate the effectiveness of the prenatal home-screening approach.
If a patient enrolls in the Heavy Metal Project, the city calls the patient to schedule an inspection of her home or apartment. The inspector looks for flaking paint, takes dust wipe samples and uses an X-ray fluorescence analyzer that determines how much lead is in the paint. If hazardous lead levels are detected, the city will scrape and repaint hazardous areas using lead-safe work practices and change windows when necessary. This service is free if either the tenant or landlord makes below a certain income.
Gil A. Gross, M.D., director of the OB/GYN Clinic and a collaborator on the Heavy Metal Project, said he got involved because he believes the project is a simple endeavor that can have enormous results. He facilitated access to patients in the clinic and helped design the clinical study.
“We want to help children achieve their fullest potential,” said Gross, associate professor of obstetrics and gynecology. “One of the ways we can do that is to make lead-hazard screening part of prenatal care.”
The city of St. Louis has changed its lead-screening approach in recent years. Originally, homes were inspected only after children showed signs of lead poisoning. Today, the city practices primary prevention, which removes lead in homes before children are exposed.
Berg said primary screening has played a large role in the dramatic reduction in the city’s lead poisoning rates. In 2007, 4.4 percent of children screened in the city of St. Louis were poisoned by lead.
“Removing the lead before it poisons children instead of after children are exposed makes so much sense,” he said. “This is a social problem that disproportionately affects children in poverty. If we can eliminate lead poisoning, we can give these children a better start on life.”