Many babies still not being screened for lead

June 12, 1993|By Jonathan Bor | Jonathan Bor,Staff Writer

Almost two years after the federal government called for the universal screening of babies for lead poisoning, a survey has found that 44 percent of family doctors in Baltimore and Baltimore County have failed to do the tests.

Additionally, the survey found that many family practitioners were failing to ask parents key questions that could determine whether their children are at risk for inhaling or ingesting dangerous amounts of lead. The toxic metal can dull intelligence, cause behavioral problems and stunt growth and hearing.

"We're going to continue to have this silent poisoning of children in Baltimore" until physicians begin testing all children and contractors adopt safer methods of renovating homes, said Dr. Barbara Sattler, director of the University of Maryland's Regional Lead Training Center.

The survey results were announced yesterday during a news briefing at the Bryn Mawr School organized by the Coalition for a Lead Safe Environment.

Rep. Benjamin L. Cardin, D-3rd, announced plans to introduce federal legislation that would impose a tax of 45 cents a pound on lead producers. The fees would raise an estimated $1 billion a year, creating a trust fund that would help homeowners remove lead paint from their homes.

The major sources are homes painted before 1978, when the federal government banned the production of lead-based paint. Children become poisoned when they inhale or ingest paint that has flaked off walls or degraded into a fine dust that can collect on windowsills and floors.

The survey was conducted by Dr. Sattler and two family practitioners, Dr. Jonathan Patz and Dr. Jeffrey Schultz. It was limited to 51 family practitioners, although Dr. Sattler said she hopes to obtain funding to survey local pediatricians, who care for a larger number of young children, and nurse practitioners.

The survey also found:

* 60 percent of family practitioners asked parents about the condition of their homes.

* 29 percent inquired about the age of homes.

* 23 percent asked parents if they planned to renovate. Without proper precautions, renovations can stir up large quantities of lead dust and particles.

In 1991, the federal Centers for Disease Control put out guidelines recommending that physicians test all children by their first birthday and perform follow-up tests on those whose blood shows high levels of lead or who live in homes that pose a risk. The agency also recommended that doctors ask a series of questions to gauge the environmental risk.

Although the survey showed that many physicians have yet to heed the message, screening appears to have increased dramatically.

"This is an improvement over what was going on a couple years ago," said Dr. Julian Chisholm, a nationally regarded authority on lead poisoning at the Kennedy Krieger Institute in Baltimore. "The general estimate then was that only 20 percent of the at-risk children were being screened."

As screening has become more common, he said, local clinics have been flooded with newly diagnosed cases. The Kennedy Institute, for example, is currently treating about 800 children for lead poisoning -- about triple the caseload of a year and half ago.

"Obviously -- and unfortunately -- if you look for it, you will find it," Dr. Chisholm said. In mild cases, doctors often recommend dietary changes to slow the rate at which tissues absorb lead. In more extreme cases, children can take a drug capable of removing lead from the bloodstream but not from the brain and bones.

"If you don't find it early enough, the damage has been done," said Dr. Schultz, who practices in Perry Hall. "There's a point where you can't go back and help people who are lead-poisoned."

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