Already high child lead poisoning cases expected to rise in Alameda County

Lead poisoning cases remain high in Alameda County, and the Public Health Department expects them to rise in the next couple years, as parents return to having children tested after a slowdown during the pandemic. 

In 2019, testing found 303 children under the age of 6 with elevated blood lead levels — 83% of the infants to 21-year-olds who tested high, state data shows. In the first year of the pandemic, that number went down, along with the total number of tests and cases. However, 219 children were still found to have lead levels greater than 4.5 micrograms per deciliter of blood. 

Total lead cases have hovered between 18,000 and 20,000 in Alameda County in the past decade, except for 2020, when fewer tests dropped the case count to about 13,000. Larry Brooks, director of the county’s Healthy Homes Department, expects numbers to rise as families come in for testing after spending more time at home, where the majority of lead hazards are found.

In October, the Centers for Disease Control and Prevention lowered its guidance for blood lead levels in children from 5 micrograms per deciliter of blood to 3.5 micrograms. Children whose blood lead levels would have previously gone unreported will now be flagged to the California Public Health Department. 

Once a case is flagged to the state and the Alameda County Healthy Homes Department, several actions may be taken depending on the severity. Healthy Homes has received a $1.5 million grant toward those services for the 2023 to 2026 fiscal years. 

“It’s not enough money in order to provide what I call the gold standard for all children, we have to triage,” Brooks said. “And only the children at the higher levels will see a nurse. Mid-range levels, they’ll see a community health outreach worker. And then the lower levels, they’ll get a phone call and perhaps a letter.”

Developing fetuses exposed to lead through the maternal bloodstream may also be at risk, Brooks noted. In a report published on Epigenetics in April, researchers studied how exposure to lead and manganese in early pregnancy may impair DNA processes associated with immune responses and nervous system development.

“Our goal is to identify modifiable risk factors, things that we can then intervene on at some point to prevent the adverse outcomes,” said Lisa Croen, a Kaiser Permanente researcher involved in the study.  

Alameda County is working to prevent lead exposure. In 2019, 10 California jurisdictions, including Alameda County, reached a settlement with several paint companies that knowingly sold lead paint products for years. Oakland and Alameda County split a $24 million award, 60% of which was earmarked for “lead poisoning prevention purposes” in Oakland. 

To address these concerns, Oakland’s Department of Race and Equity partnered with Environmental Justice Solutions to produce an analysis of the county’s lead paint hazards in 2021. 

In the analysis, Marybelle Tobias, founder of Environmental Justice Solutions and author of the report, criticizes the current model for identifying hazards. Tobias found 11 equity gaps in prevention programs, including lack of policies to identify and remove residential lead paint hazards, insufficient outreach in at-risk areas, and outdated data. The report also brought attention to the communities in Oakland and Alameda County at highest risk for lead exposure. 

Fremont and Oakland report the highest number of elevated cases in the county, with the Fruitvale neighborhood having one of the highest number of reported cases. A 2018 report by the Healthy Homes Department found that among children with elevated blood lead levels, 28% were African American and 25% were Hispanic. Oakland said in a 2021 press release that it will change its approach to remediating lead concerns to address the equity issue. The city said then it was shifting to a targeted approach to abatement that focused mostly on older, dilapidated houses which carry the highest risk for lead contamination. 

As Alameda County officials work to equitably address lead hazards, Brooks encourages Oakland parents to test their kids early for lead.

“Don’t just assume because you live in a newer home that there aren’t lead hazards there,” Brooks said. “There’s just a number of sources. So to me, it’s better to be safe than sorry.”

Alameda County has information on its website about blood lead levels, and about free and low-cost testing.