Milwaukee's Chronic Problem With Lead: Dr. Veneshia McKinney-Whitson Explains What Parents Can Do To Keep Kids Safe
Milwaukee's aging housing stock and its more than 70,000 lead laterals pose a serious public health problem for the city's families.
And health experts fear the problem may have grown worse — fears exacerbated by the combination of more children being at home during the pandemic year and a 37% statewide decrease in lead testing of kids.
To get some perspective on lead poisoning, we turned to Dr. Veneshia McKinney-Whitson, a family medicine physician and assistant professor at the Medical College of Wisconsin.
She will be a guest on our next Listen MKE Live event at noon on April 27 on Facebook Live. Listen MKE is a collaboration between WUWM, the Ideas Lab at the Journal Sentinel, Milwaukee PBS and the Milwaukee Public Library.
We spoke with McKinney-Whitson about lead poisoning, safety, testing and prevention. The interview has been lightly edited for clarity.
Question: How many patients do you know who have been affected by lead?
Answer: I see newborn babies, kids and adolescents. So, it’s probably one in 10 kids that I see. We have three (tests) by the age of three: at 12 months, 18-24 months and 36 months. A normal range for lead is anything less than one microgram per deciliter. ... If one kid is elevated, I’m testing all the kids in the household. If no one has had a lead level, you should do at least one test by the age of 6.
Q: What should parents be thinking about as far as testing?
A: Have a conversation with your physician. A lot of times, parents will get the testing done at WIC (Women, Infants and Children Nutrition Program), and I don’t have access to those WIC records. Ask for it when you go to WIC and write it down or ask them to send it to over to your doctor.
Q: What should people who don't have a primary care physician do?
A: You should get a physician who can help you navigate some of your health care needs and be an advocate for you. If you currently don’t have one, the Milwaukee Health Department can help and also, WIC clinics do testing.
Q: Last year, there were very few tests. As a physician, are you concerned about that?
A: Yes, I am very concerned. In Wisconsin, lead testing declined by 75% in April 2020, compared to April 2019. Rightfully so, parents kept their children home due to COVID-19. At my office last year, we discontinued scheduling well-child exams for a short period of time to protect our patients. With doing that, we are now behind in seeing our pediatric patients and testing them for lead. We are now actively contacting parents to schedule appointments for their children. I would encourage parents to contact the doctor’s office to schedule an appointment, if their child is overdue for a checkup.
Q: What are the biggest sources of lead?
A: Lead comes from so many places. A lot of the houses built before 1978 usually have lead-based paint — for sure if the house was built before the 1960s. The paint chips that come from lead-based paint, they often have an almond flavor and kids like to eat them. We don’t think about the soil sometimes. If it’s an older house built on that land, it can be in the soil.
There are a lot of lead in the pipes in Milwaukee, so water is one thing I talk about with parents and especially infants. If parents are getting their water out of the tap and mixing that with the formula, then infants are absorbing it more than other kids of an adolescent age. And lead is absorbed more efficiently in infants.
Then you think about the parents, if they work in factories or industries like where batteries are made — they can bring that lead exposure back to their home and expose their kids to lead. Or when parents have hobbies like ceramic-making, glass-blowing, jewelry-making, you can get exposed to lead and bring that home to your children. Also, old antique stuff; a lot of toys that were built in the 1970s were painted with lead paint. If you’re into antiquing, that’s something you should think about and make sure that’s not exposed to your children.
Q: What symptoms or behaviors should parents look for as a sign their kids might have been exposed to lead?
A: First, when you’re looking for symptoms, it’s too late.
But things you’ll definitely look for is if you notice their behavior is changing. Are they not as attentive as they used to be? Sometimes they’re more impulsive, they can’t sit still, they can’t concentrate.
We know that one in five children who are diagnosed with ADHD have had a lead exposure that was high enough to cause those symptoms. If they’re not doing well in school, that’s not a good thing. Even a small amount of lead in a child’s system can decrease their IQ by 19 points. (Other signs) are if you notice they’re not growing as well, are anemic, if they have changes in their hearing or if they become more aggressive.
Women who are pregnant and have been exposed to lead put their baby at risk for IUGR (intrauterine growth restriction) — the baby doesn’t grow on the right curve when they’re in their uterus. It also increases the risk for women with preterm birth.
Q: What about adults?
A: In adults, there has been studies that show lead can be harmful. It leads to cardiovascular disease, increases the incidents of high blood pressure and it’s been linked to decreased kidney function and reproductive problems.
Q: Do you think children being kept at home and people being indoors more during the pandemic has led to increases in lead exposure?
A: Yes and no. It really depends on the family situation. If their home is the primary source of the exposure then, of course, yes. Being at home all day increases the lead exposure and risk of lead poisoning. Now, if the school, daycare, or a babysitter/grandparent home is the primary source of lead exposure, and the child is no longer in those places, then their exposure may be less. It is important for physicians to converse with parents about the places the child spends her/his time and their potential exposures.
Q: What are some preventative measures parents can take?
A: Usually, I educate my parents when their kids are right around 6-9 months because that’s when they start to pick things up and put them in their mouth. I talked about washing your hands before you eat if you’ve been playing in soil. Some of the (water) filters don’t get rid of lead, so you have to look for a filter that says it removes heavy metals or removes lead.
One thing I think people do totally wrong is think turning on hot water or boiling their water will get rid of lead. That doesn’t get rid of the lead, that just concentrates the lead. If you think you have lead in your pipes and don't have a filter, I instruct patients in the morning when you first get up, turn the water on cold and let it run for a minimum of two minutes before you use it.
You absorb lead at a higher rate if you’re iron-deficient, but it also makes you iron deficient. We can do (testing) to check that and supplement if iron is needed. Also, eat iron-enriched foods, which are usually dark, leafy greens. A lot of meat, cereal, and make sure they have a lot of calcium and vitamin C. All of those decrease the amount of lead you are exposed to.
Q: What can other adults do to monitor children for lead poisoning?
A: The thing I always tell parents is, if mom and dad are at work all day and the child goes to the grandparent’s house or aunt’s house, you need to think about exposure there. If they’re at other homes during the week or on the weekend, think about those.