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Allegheny County moves forward with proposal to test children for lead

| Wednesday, Jan. 11, 2017, 6:36 p.m.

A proposal that would require lead testing for all young children in Allegheny County — possibly the first of its kind in the state — edged forward Wednesday.

The Allegheny County Board of Health voted to move the proposal to a 30-day public comment period, though some members expressed concerns about the details of the draft legislation.

The proposal would require children to undergo mandatory blood testing for lead at 9 to 12 months and again at 2 years of age. Children designated as “high risk” would undergo annual testing from ages 1 to 6.

The legislation would go into effect Jan. 1, 2018, and apply to children who are the ages for testing at that time, said Dr. Karen Hacker, the health department's executive director.

The department would receive copies of the results from all county schools when children enroll in kindergarten.

Dr. Donald Burke, who sits on the Board of Health, said he is concerned there would be no way for the county to learn whether children are getting tested before they enroll in kindergarten, which is after they've passed the years when they are most susceptible to lead poisoning.

“There could be three to four years before we know if a child was screened,” Burke said. “You're leaving a child in exposure for several years before you have a check in the system.”

The health department already requires schools to submit immunization data, so the lead results would be added to that, Hacker said.

Children would be exempt from testing if a doctor says it might be detrimental to the child's health or if a parent or guardian objects on religious or moral grounds, the legislation says.

Burke suggested removing both exemptions.

“I can't imagine a blood level screening would ever be detrimental to the health of a child,” Burke said. “Should a parent ever refuse to have the child tested? Maybe if they can show the child is not at risk by proving the house is lead free, or some other way, but just saying it shouldn't be done ... I'm not comfortable with that as an exemption.”

Michael Parker, an attorney for the department, said he suspects the religious exemption is included because everyone has the constitutional right to refuse medical care, but he will do more research.

Hacker said the exemptions would be left in for now to see what the public thinks.

Many pediatricians already test for lead at 1 and 2 years old, but some use a questionnaire that asks when the child's house was built before deciding whether to test, Hacker has said.

More than 80 percent of homes in the county were built before lead was banned from paint in 1978, which is a major concern, Hacker said.

The number of children in the county whose blood contains high levels of lead has been decreasing in recent years, Hacker said, with 135 children in the county having lead levels over 10 micrograms per deciliter in 2015.

About 7 percent of children in Allegheny and Westmoreland counties had more than 5 micrograms of lead per deciliter, according to a 2014 report from the state Department of Health.

Water sampled from customers of the Pittsburgh Water and Sewer Authority — the largest such authority in Allegheny County — last year tested higher than the Environmental Protection Agency's action level of 15 parts per billion.

Lead-based paint, not water, is the most common source of blood-borne lead, Hacker said.

Allegheny County Controller Chelsa Wagner, who conducted an audit , has criticized the health department for not doing more to combat the issue of lead in public water. She was listed on the agenda to give public comment at Wednesday's meeting but did not appear.

The health department denied Wagner's request to speak as part of the agenda and instead placed her in the public comments section, which are limited to three minutes, so she declined, said Lou Takacs, Wagner's spokesman.

The board appreciates Wagner's offer and thanks her for her audit, said Melissa Wade, a spokeswoman for the board.

Hacker and health department staff said Wednesday they were unaware of any other jurisdiction in the state that requires lead testing among children.

Some states, such as Iowa and Massachusetts, require it statewide, Hacker said.

In Pennsylvania, lead testing is required only for children on Medicare, at ages 1 and 2, said Alicia Taylor, spokeswoman for Philadelphia's Department of Health and Human Services.

Lancaster also is considering mandatory lead testing, said John Brenner, deputy executive director for the Pennsylvania Municipal League.

After the 30-day public comment period, the matter will go back to the Board of Health and then to Allegheny County Council for final approval.Directions for submitting public comments and a copy of the draft legislation can be found at achd.net/legal/index.html .

Theresa Clift is a Tribune-Review staff writer. Reach her at 412-380-5669 or tclift@tribweb.com.

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