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Lead poisoning remains a serious environmental health threat for children in the United States, despite the fact that it is completely preventable. For 30 years, the Centers for Disease Control and Prevention (CDC) has emphasized the need for local jurisdictions to adopt lead poisoning prevention strategies that eliminate lead hazards in a home before a child is exposed. However, even though substantial progress has been made through federal and state efforts to reduce risk of lead exposure, challenges, largely at the local level, persist, and become greater without strong and savvy leadership.

What one finds at the local level is not always ideal. First, most jurisdictions lack a proactive approach to dealing with the problem and public health officials must wait until a child has high lead levels before any intervention can take place. Second, because lead poisoning is a multi-agency issue involving health, housing and the environment, poor inter-agency coordination negatively affects results. And finally, where interactions between government officials and advocates, who are also working to protect the public, are uncooperative, it can be challenging to develop comprehensive laws and regulations that protect residents and provide them with recourse at the local government level.

A system that is unable to offer solutions to these issues affects residents negatively and, as a consequence, children of low-income families who usually live in substandard, unsafe housing continue to be routinely exposed to lead-based paint and other lead hazards. 

A comprehensive lead poisoning prevention strategy includes several components: a proactive approach that provides resources for residents as soon as it is known that a child is being exposed to lead rather than wait until a child’s blood has reached high levels, inter-agency coordination among any and all agencies that would have to deal with the issue, and the cooperation of the advocate community.

In Washington D.C., led by nationally recognized experts in the field, the Department of the Environment’s (DDOE) Lead and Healthy Housing division has come a long way since the days of constant bad press, and it is now spearheading efforts to create a proactive model to deal with lead poisoning. Their model includes targeted education to families living in high-risk areas, expectant parents and families with children whose blood lead levels tested between 5 – 9 μg/dL, inter-agency coordination and, most importantly, cooperation with local advocates to find best practices and support change in the local regulatory environment that will mandate lead-safe housing, lead-safe work practices, and penalties for non-compliant landlords.

The District of Columbia has experienced serious, documented problems with lead poisoning. In early 2004, the Washington Post revealed that the District had been plagued by severe lead-in-drinking-water elevations over a two-and-a-half year period between 2001 and 2004 (Nakamura 2004). It was later discovered that the Department of Health (DOH), the agency formerly in charge of the lead program in D.C., helped the water utility and the Environmental Protection Agency cover up the problem (A Public Health Tragedy 2010), and the lead program failed to subsequently include drinking water samples in their risk assessments at the homes of poisoned children.