Michigan policy change means more children can get help for lead poisoning

• State officials have lowered the threshold for what they consider to be “elevated” blood lead levels in Michigan
• These changes will qualify more families to receive assistance for children exposed to lead
• Some advocates think the state can do more to address the issue

More Michigan families are eligible for the government’s help coping with lead exposure following recent updates to Michigan’s system for flagging children with high blood lead levels.

State officials this year lowered the threshold for what they consider to be “elevated” blood lead levels in children, a change that added 1,500 children to Michigan’s list. That makes many of them eligible for interventions such as nursing case management and lead paint abatement.

State officials announced last month that the change had increased the number of Michigan kids considered to have elevated levels by nearly 80 percent, to 3,400 children.

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• Check this Michigan map for childhood lead levels in your community

“This allows us to initiate public health action earlier than before,” said Angela Medina, a child lead exposure prevention coordinator at Michigan Department of Health & Human Services who oversaw the transition. “We will be able to prevent ongoing exposure and mitigate health effects that may come from lead exposure sooner.”

When it comes to identifying lead exposure, the earlier the better.

No amount of lead exposure is safe, and experts say even low levels of the neurotoxic metal can damage the brain and nervous system, causing behavioral and learning problems, nerve damage and other consequences. Children are especially vulnerable due to their developing bodies and tendency to touch and ingest objects that could be contaminated with lead, such as dust from now-outlawed lead-based paint in older homes.

Detroit resident TaNiccia Henry, 47, became familiar with lead’s damaging effects after she learned her son, Lloyd, had lead poisoning after taking him to the doctor at age four.

“As a parent, that was nerve-wracking,” she said. “Trying to find information, trying to understand it and trying to figure out where it came from.”

The telltale blood test triggered help, including a visit from a health department nurse who told her about the dangers of lead. Henry got rid of her son’s favorite toy cars (a possible source of exposure) and adjusted his diet, though she said she still struggled to access information about how to protect her son from further exposure. 

Until this year, state and federal officials relied on a benchmark of 5 micrograms per deciliter to identify kids with elevated blood lead levels and get them in line for help. MDHHS lowered that threshold to 3.5 micrograms per deciliter this year, following the U.S. Centers for Disease Control and Prevention’s 2021 decision to lower its own threshold.

Adding nearly 1,500 Michigan children to the “elevated” list is a sign of progress toward ridding Michigan communities of lead hazards.

Regulators made the change in response to the declining number of children flagged for elevated blood lead levels under the weaker standards. Experts attribute those declining rates to gradual progress in weeding out lead paint, pipes and other sources of exposure.

Diane McCloskey, executive director of CLEARCorps Detroit, a nonprofit focusing on reducing incidents of childhood lead poisoning, called the lower threshold “a great thing” for families with lead-exposed children, but expressed concern that some children are slipping through the cracks amid steep declines in blood lead testing. 

The number of Michigan children to receive a blood lead test decreased by 32 percent in 2020 and 2021, due to the COVID pandemic, compared to 2019. 

“We just need to get as many kids as possible tested and connected to resources,” McCloskey said. “The quicker we can stop them from being exposed and the more we can educate parents, the better it's going to be for the child.”

Despite its risks, lead was once widely used in plumbing, paint and gasoline, leaving behind health risks that linger today. Although lead paint, plumbing and gas were all banned in the U.S. by the mid-1980s, the toxic substance still lingers in homes built before those bans took effect. 

In Michigan, 62 percent of homes were built before 1980, according to census data, making them more likely to contain lead paint or plumbing. Lead also lingers in soils, the result of legacy contamination.

All families with children who have elevated blood lead qualify for nursing case management through their local health department. Those who qualify for Medicaid are also eligible for programs to weed out sources of lead in their homes, such as lead paint abatement.

MDHHS has approximately $35 million annually for such services and has used its funding to abate lead from approximately 5,000 homes since 1997.

Officials say they are prepared for a larger caseload under the new threshold and are updating their data systems to coordinate care for the larger number of kids who now qualify for assistance. But one lead advocate said she worries a lack of workers will hinder progress on lead abatement for newly-qualifying families.

A lack of available contractors and supplies has made it difficult to quickly connect families to lead abatement services after their child’s blood work shows problems, said Mary Sue Schottenfels, staff member for the Detroit Lead Advocacy Parent Group.

For families concerned about lead exposure, MDHHS suggests speaking with a primary care doctor about blood testing. If blood tests show elevated levels, families could become available for assistance.

Henry, the Detroit mom, said she wished she had been aware of the risks and the availability of testing before her son was exposed.

“We need to address this everywhere,” she said, “get every kid tested and get everyone the information they need.”