We Must Prevent Lead in North Carolina’s Child Care Programs

My children were born in the late ‘70s, and I remember as a young parent having discussions with our realtor about whether there was lead in the paint of the very old house we were buying. Almost all houses built before 1970, at least in the U.S., contain some form of lead paint. The house we were buying was built much before 1970, and it was clear that we would have to sand and paint every room, change the plumbing and all the good things that come with owning an old home. And fortunately, we did all of that over time, very carefully.

I will admit, however, that I do not rememberif lead testing was one of the many conversations I had with our pediatricianabout the health and safety of our children. Today, however, it is an essential conversation to have!

Lead Poisoning Today

Lead poisoning has been in the news a lot overthe last few months due to the concerning levels of lead found in the watersupply of child care programs and its potential impact on the health and safetyof the surrounding community. Currently, North Carolina does not requiretesting water for lead in child care programs, unless a child is found to haveelevated blood lead levels. The news has been especially alarming for parentsand families who work hard to keep their children safe and on a path to reachtheir fullest potential. Lead in the public water supply threatens that dailycharge.

This issue is not only an issue specific to child care programs: An estimated 10 million Americans get drinking water from pipes that are at least partially lead.

Young Children are the Most at Risk

Young children are especially at risk of harmfrom lead. Babies and young children’s bodies are still developing and are in acritical life stage for brain development. When they are exposed to lead fromwater or other sources, it enters directly into the bloodstream where it can harmdeveloping organs, muscles and bones. Infants who rely on formula get 100% oftheir nutritional intake from water. If that water is tainted with lead, theyget an enormous dose of it compared with older children and adults.

Research shows there really is no safe levelof lead exposure for a child. Even at the lowest levels of exposure, lead canreduce IQ and harm a child’s ability to concentrate and focus in school. Theseeffects are permanent and can affect a child’s education, health outcomes andlong-term earning potential.

Lead poisoning is preventable by identifying lead before children are harmed. The most important step that parents, teachers and others can take is to prevent lead exposure before it occurs. The North Carolina Commission for Public Health is proposing a change to a child care sanitation regulation that will significantly reduce exposure to lead for some of the youngest and most vulnerable children in our state. With U.S. Environment Protection Agency grant money to pay for the first round of testing, North Carolina can work to make drinking water safer for infants and young children without adding to child care costs.

Prevention: The Proposed Child CareSanitation rule

We all know that prevention is the best medicine. The proposed child care sanitation rule is an example of a good preventative approach to lead exposure. The following requirements included in the proposed rule will help ensure that it protects children from potential lead in child care drinking and food prep water:

Testingfor lead in drinking and food prep water every three years – Lead levels in water can fluctuate over time. Changes in water sourceor chemistry can cause leaching of lead from pipes into water, increasing waterlead levels.[1] This is what led to the Flint water crisis.Additionally, unforeseen plumbing problems such as a dirty aerator or a partialclog can release lead from pipes into drinking and food prep water. Finally,improper maintenance of filters by child care operators can decrease theeffectiveness of mitigation measures taken to prevent lead exposure.

Testingall buildings despite age – Buildings constructedafter the 1986 Lead Ban may still pose a significant risk of lead contaminationin drinking and food prep water. The ban, effective as of 1988, defined “leadfree” as materials containing less than 8% lead, which allowed lead to remainin pipes that convey drinking water to homes and in fixtures and faucets inhomes. An amendment to the Safe Drinking Water Act, effective as of 2014,redefined “lead free to require faucets and pipes to contain less than 0.25%lead; as such buildings constructed between 1988 and 2014 can still containplumbing and fixtures with significant lead content.”[2] Testing allbuildings despite age will ensure that no building poses a considerable risk oflead exposure.

Testingall taps – The concentration of lead in one tap is notindicative of the concentration of lead in all taps in a building. Leadconcentration across taps can vary because lead can originate from anindividual faucet, a dirty aerator or a filter that hasn’t been changed.Therefore, it is critical to test all taps to ensure safe child care centerdrinking and food prep water.

What You Can Do

The Centers for Disease Control and Prevention (CDC) has information on lead poisoning that you can read and share.

Talk with your health care provider about leadscreening. Lead screening measures the level of lead in the blood through ablood test in the finger or vein. It is important. Lead is a toxin that is particularlydangerous for young children because of their small size and rapid growth anddevelopment. It can cause behavioral and learning difficulties, anemia,seizures and other medical problems. A lead test is the only way to know ifyour child has lead poisoning. Most children who have lead poisoning do notlook or act sick. Talk to your doctor about this.

Early Years provides free referral services to families seeking child care, technicalassistance to child care businesses and educational scholarships and salarysupplements to child care professionals through the TEACH Early Childhood®,Child Care WAGE$® and Infant-Toddler Educator AWARD$ Plus Programs.Through the TEACH Early Childhood National Center, Early Years licenses itssuccessful programs to states across the country and provides consultation toothers addressing child care concerns. Ensuring that every young child can growand learn in a healthy and safe learning environment is central to our mission.

Early Years supports the adoption of this rule thatwould protect thousands of babies and children from lead exposure in child caredrinking and food prep water. Additionally, requiring cost-effective mitigationwhere elevated lead water levels are found will have the added benefit ofgetting rid of other harmful toxicants such as copper and chlorine by-products.

In North Carolina, public health officialshave been working for more than 30 years to eliminate childhood lead poisoning,and have come very close to doing so. Childhood blood lead levels have droppeddramatically population-wide. Unfortunately, some pockets of high exposureremain. Ending lead exposure in drinking and food prep water is an importantstep to move us toward the goal of no lead exposure for our state’s youngchildren. The proposed amendment will help get us there.

The best way to protect kids from lead exposure is to be proactive about getting rid of lead, rather than waiting for a child to be found with elevated levels in their blood. To do so, we must be willing to get rid of toxic lead in children’s environments. This rule will help us do just that. You can show your support of this rule and submit your comment to the North Carolina Commission for Public Health by August 2, 2019.

Below, are more resources on lead poisoning.

• The Harmful Effects of Lead on Children’s Health FactSheet
• Lead Screening: Well-Child Health Care Fact Sheet
• Ending Lead Exposureat NC Child Care Centers
• EPSDT & Title V Collaboration to Improve Child Health
• CDC’s Childhood Lead Poisoning Prevention Program
• New Pediatric Health Initiative
• AAP Commends CDC for Recognizing That for Children, Thereis No Safe Level of Lead Exposure

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