YOUNGSTOWN City, county to boost lead-poisoning enforcement

By WILLIAM K. ALCORN
VINDICATOR HEALTH WRITER
YOUNGSTOWN -- The city and Mahoning County health departments are poised to hire a special city prosecutor to step up enforcement of lead-poisoning violations.
Lead poisoning is the top environmental threat to children -- and is totally preventable, said Joseph Diorio, director of the county health department's childhood lead-poisoning prevention program.
Studies show that children with even minimal levels of lead poisoning tend to perform less well academically and are more at risk for delinquent behavior, said Matthew Stefanak, Mahoning County health commissioner.
In Youngstown, 279 children under the age of 6 are diagnosed with varying degrees of lead poisoning. It is primarily contracted by ingesting lead dust in homes with lead-based paint built before 1950 or in homes built before 1978 that have been remodeled or renovated. Children can also get lead poisoning from normal hand-to-mouth activities involving soil or water contaminated with lead dust.
When older homes are not kept in good repair, and the lead-based paint cracks, chips or peels, it allows lead dust to get in the air and be ingested by breathing, or onto floors and other surfaces where small children can get the dust on their hands and transfer it to their mouths.
It is this maintenance problem the health departments want to attack, particularly in rental houses.
Noncompliance
Stefanak said there are 285 rental properties in Youngstown in noncompliance with a Youngstown Board of Health order to remediate lead-poisoning dangers.
"It really is quite outrageous. At least 10 of these properties -- placarded "Do Not Rent" and "Unfit for Human Habitat" -- have been re-let to families with children," without lead abatement taking place and without informing the new renters, Stefanak said.
The county health department is under contract to the city health department to provide inspection and enforce the city's lead-poisoning law. Also, the county health department is fiscal agent for a $10,000 grant from the Alliance for Health Homes, which will be used to hire a special city prosecutor for lead abatement cases. And, $5,000 in Medicaid reimbursement has been set aside for landlord education, in conjunction with the Mahoning Valley Real Estate Investment Association, Stefanak said.
A lead-poisoned child is what triggers a house inspection for lead dust, Stefanak said.
Lead poisoning, legally required to be reported, is usually discovered through testing by a family doctor, pediatrician or outreach screening by health departments.
Stefanak said slow progress is being made in preventing childhood lead poisoning both locally and nationally. He said more needs to happen, more quickly.
Part of the enforcement problem is that there are no real consequences for noncompliance, Stefanak said. The county and city health commissioners believe stepped-up enforcement, in the form of a special prosecutor, will get the attention of errant landlords.
The prosecutor, who would have to be appointed by Youngstown Law Director John McNally, has not been hired. However, the health commissioners said they have talked with the law director and don't see any barriers to that happening now that money is available.
First case
The first case, which Stefanak and Neil Altman, city health commissioner, hope will be prosecuted by the end of the year, will be one they think they can win. Also, ideally the accused would own a number of properties so as to have the biggest impact, they said.
Failing to obey a board of health order is a criminal misdemeanor. The first conviction is a $100 fine, which can escalate and possibly include jail time with additional convictions.
Despite its being a misdemeanor, conviction could become expensive, Altman said.
For example, each day the violation continues is considered a separate offense. Also, the board of health could order complete abatement rather than interim controls, Altman said.
Diorio said there are a variety of options to make a home lead-safe, and said he works with landlords to help them meet requirements.
"We're not asking total abatement by removing lead-based paint. In many cases, repainting or replacing windows are options," he said. Also, Diorio said low-interest bank loans may be available to help finance lead abatement.
Homeowners who live in their homes are permitted to do their own lead abatement. However, owners of homes they don't occupy must hire a lead abatement firm licensed by the Ohio Department of Health.
The good news, Stefanak said, is that the prevalence of lead poisoning is declining nationally and locally. But in 2002, Youngstown still had 279 cases reported with blood lead levels of 10 micrograms or more per liter.
Even at levels below 10 micrograms per liter, the threshold level at which follow-up testing is needed, children tend to perform less well academically and are more at risk for delinquent behavior, Stefanak said.
Also, Diorio said, lead has a long half-life once it enters the system, with some of it supplanting calcium in the long bones.
"There is no generally accepted medical procedure for getting lead out of the system. That's why it's so important to prevent exposure," Stefanak said.
alcorn@vindy.com