When a child has an elevated amount of lead in their blood, it’s often up to Tammi Holmes to find the source.
Once, it was a packet of turmeric, brought home after an international trip. Another time, it was the metal letter on an apartment door, traced by a little girl every day as she learned the alphabet.
“We’re missing a lot of kids,” Holmes told a group of educators during a free-testing day at the Gary Gore Elementary School in Jennings. "Sometimes people don't think about things like that, until we have that conversation."
As a health education coordinator for the St. Louis County Department of Public Health, Holmes has seen predictable and unusual sources of lead.
In one case, a child’s father worked painting yellow lines down the center of the road. Even though he showered at work and changed his clothes, lead dust remained in his long hair. Afterwards, the child’s father agreed to cut his hair.
But the St. Louis area has a high concentration of homes built before 1978, the year the federal government forbid manufacturers from making lead based paint for use in housing.
Lead also can turn up in unlikely places. That's why Holmes urges parents not to skip the test.
Every time she speaks with a new family, it breaks her heart.
“The first thing that comes to mind for me is, where did this exposure start?” Holmes said. “Is this the initial exposure, has this child been exposed before and they’re coming down. Then I think about the child’s future.”
Ingesting or inhaling lead can lead to learning challenges, developmental delays and kidney damage. At extremely high levels, it can cause seizures or even death. Children under six and pregnant women are particularly vulnerable to lead exposure.
Blood lead testing is required for children who spend more than 10 hours a week in the city of St. Louis. But only half of the city’s children under six were tested in 2014. According to the city’s health department, 700 children who were tested had blood lead levels above five micrograms per deciliter, the threshold that regulators consider to be elevated. The cutoff was revised in 2013, down from 10 micrograms per deciliter.
For a state map of required testing areas, click here.
Rates of testing are lower in St. Louis County, where the test is required for a handful of zip codes and recommended after a risk assessment for children who live in the rest of the county. But people who renovate their homes themselves — whom Holmes calls the “HGTV millennials”— may not realize they’re churning up lead dust when they do construction work on an older home.
Testing also is required for children in several zip codes along Southeast Missouri’s old lead belt, such as areas near the former smelter in Herculaneum. About 40 children tested positive for elevated levels in Jefferson County during the first eight months of 2017.
“The good news, is prevention,” Holmes said. “There’s a way we can stop this, and it’s testing.”
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