Five Questions With: Michelle Rogers

"The primary concern about children and lead exposure is that it can affect their neurological development."

Michelle Rogers is a senior project analyst in the Brown University School of Public Health and lead author of a study to be published in the August issue of the American Journal of Public Health that examines the effects of Rhode Island’s lead abatement law.

PBN: It was hoped when RI’s lead-mitigation law was put into effect that the health benefits would emerge in short order. What has actually happened?
ROGERS:
Our study measured the impact of the law and the lead exposure of children in four RI cities after the law took effect in 2005. We found that by 2009 for homes covered by the law in Central Falls, Pawtucket, Providence, and Woonsocket, children living in compliant housing had lower blood lead levels than those living in non-compliant housing. We also found that children’s lead levels dropped when their non-compliant housing became compliant. That’s the good news.

We also found two problematic trends. Only 1 in 5 buildings covered by the law were in compliance by 2009. Even in properties with young children living there, less than three in 10 were compliant. The other problem is that approximately 70 percent of homes are not covered by the law, yet children still face a significant risk of lead exposure there, too.

PBN: As a public health expert, which lead-related conditions in children concern you the most?
ROGERS:
The primary concern about children and lead exposure is that it can affect their neurological development, leading to developmental delays, learning disabilities, lower IQ and behavior problems. Even low levels of lead exposure have been found to be associated with reduced academic performance.
These concerns remain very real in Rhode Island, as our data show. A blood lead level of 5 or more micrograms per deciliter of blood is the current “level of concern,” at which point public health actions need to be initiated. In the four cities we examined, 28 percent of all of the children had a lead level in this range.

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PBN: As so many buildings are exempt from the law (about two-thirds of those in your sample cities), does another law need to be created with fewer exemptions or does the one on the books need to be enforced first?
ROGERS:
We should have a discussion about whether more homes should be covered by the law. The law covers buildings built before 1978 that are rentals with more than three units. So the law exempts single-family homes or owner-occupied rentals with only 2 or 3 units. Most housing units even in these four big cities are exempt. We found that many children in exempt homes are still exposed to potentially concerning levels of lead.
The goal of the legislation is to protect children from exposure to lead. Our study shows that children benefit with lower blood lead levels when landlords comply with the law. There may have been significant progress since 2009, but it is very possible that better enforcement would have allowed us to make more progress in the first five years of the law.
The blood lead levels we found among children living in exempt housing were on average a bit lower than those of kids in housing covered by the law, but not by a huge amount. A lot of children in exempt housing are still being exposed to lead hazards.

PBN: Who is actually enforcing the law at present, and if I’m a landlord what do I stand to lose if my buildings aren’t in compliance?
ROGERS:
My understanding is that enforcement varies by city, but is handled by the Housing Resources Commission and the RI Department of Health. If a tenant files a complaint or a child is found to have an elevated blood lead level, the landlord is contacted and required to show their property is in compliance or else bring it into compliance. Compliance, however, is not especially onerous. A three-hour class to gain training about lead risks, possibly some new paint, and getting a certificate from an appropriate inspector is sometimes all it takes to bring a building into compliance. Failure to comply can result in notice of violations and ultimately could result in a lien being placed on the property.

PBN: What is going well and not so well with lead abatement in Rhode Island?
ROGERS:
It’s fair to say that our findings are a mixed bag. We are greatly encouraged that when landlords bring their properties into compliance, children’s blood lead levels decline by nearly one microgram per deciliter. It was something of an open question as to whether the law works, and we feel confident based on our data that it does indeed help children. We can’t be sure how much more progress has occurred since 2009, but it seems reasonable that any further progress was a benefit to the state.

What is also clear, though, is that a large proportion of the state’s old housing stock is not necessarily becoming any safer for children, due in part to being exempt. Even if 100 percent of non-exempt properties were compliant with the law, the majority of housing, by virtue of being exempt, is still under no pressure to improve. This is why we may need to consider expanding the law. Otherwise, we may not be fulfilling the goal of preventing the hazards of lead exposure.

Although there may still be a public perception that lead poisoning is a problem of the past, it is still a real concern with lifelong implications for Rhode Island children.

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