July 13, 2018

Get the lead out

How can we mitigate the damaging effects of lead exposure in kids?

A child opens a water tap outdoors.


It’s been 40 years since lead-based paint was banned in the United States, and yet it continues to be a health threat in thousands of cities.

Children are especially vulnerable to lead poisoning. But there’s some good news: fast action to address the problems early on can mitigate the long-term damage to kids’ health and development, according to a paper published in the July issue of American Economic Journal: Applied Economics.

It is increasingly clear that we need continued investment in the reduction of lead exposure risks across America,” said Kevin Schnepel, who co-authored the study with University of Colorado Boulder professor Stephen Billings, in an email to the AEA. “While we work towards safer home environments, our results highlight the importance of closely monitoring early life lead exposure and suggest quick action when higher levels are detected to mitigate the negative impacts from lead exposure.”

Lead is a toxic metal that has been used in paints, gasoline, cosmetics, stained glass, ammunition, and toys, among other materials. It was banned for use in paints in 1978, but continues to be a problem in older homes with chipping paint that haven’t been properly remediated.

It is increasingly clear that we need continued investment in the reduction of lead exposure risks across America.

Kevin Schnepel

Exposure to lead can have serious health consequences. It is associated with cognitive and behavioral problems in children and, at high levels of exposure, lead has been known to cause coma, convulsions, and even death.

Testing for lead isn’t required in the US, which means many children exposed to the toxin are overlooked.

The paper comes at a time of renewed interest in lead poisoning in America because of the Flint water crisis, but the problem is even more serious outside the United States. In 2000, the World Health Organization estimated 40 percent of children under the age of 5 years old have levels of exposure associated with neurological damage, and nearly all of those children lived in developing countries.

Schnepel and Billings focused on children in Charlotte, N.C., born in the 1990s. They looked at blood lead surveillance data, public school records, and criminal arrests to estimate the impact that standard public health interventions for lead exposure had on educational performance and adolescent behavior.

The researchers compared children who were eligible for interventions — such as nutritional advice, medical treatments, and lead remediation for the home — to children that grew up in similar environments but who did not qualify for assistance.

Lead contamination
At least 4 million households have children living in them that are being exposed to high levels of lead, and the CDC says there is no safe blood lead level in kids. The map shows the percent of tested children under the age of 3 with elevated blood lead levels. States that did not report data to the CDC are in white.
Source: CDC


The impacts were significant, especially on children’s behavior. The likelihood of suspension or arrest in middle and high school was cut in half for kids that were eligible for treatment. There was also a modest increase in test scores for elementary and middle schoolers.

“Our estimates that isolate the impact of the higher-intensity interventions do suggest important effects for education outcomes,” Schnepel said. “However, given the connection between lead exposure and behavioral development as well as the strong impact of other early life health and education programs on antisocial behavior, we are not surprised by larger and more precise estimates across those outcomes compared to education test scores.”

The affected children were disproportionately low-income and black, and the results suggest that early life interventions could play a role in reducing racial and social inequality. However, the interventions aren’t cheap. The more intense ones include a doctor's appointment, nutritional counseling, follow up tests, a home inspection, and remediation of all lead hazards such as chipped paint. The average cost in Charlotte was $5,288 per household.

Still, the authors say it’s money well-spent. The boost to lifetime earnings, savings from less law enforcement, and other benefits was estimated at $9,666.

“We’re silly not to spend a good amount of money on that because we will save multiple dollars later on,” Billings told Chalkbeat.org. “But it seems to be politically tough to get people to have that time horizon.”

Life after Lead: Effects of Early Interventions for Children Exposed to Lead appears in the July issue of the American Economic Journal: Applied Economics.