Study: Flint children's blood lead levels hit historic low in 2016

Blood lead levels in Flint's young children hit an all-time low in 2016, according to research published Monday in the Journal of Pediatrics, suggesting that efforts to confront the city's water crisis are making a difference in public health.

The study analyzed 15,817 blood samples from children ages 5 and younger beginning Jan. 1, 2006, and continuing through the crisis until Dec. 31, 2016. Water filters, pipe replacements and a switch in the source of Flint's water supply were among efforts to protect people from poisoning in the years since an April 2014 switch resulted in dangerous lead levels in drinking water.

In the study's 11-year span, the percentage of kids with blood lead levels of 5 micrograms per deciliter, the level at which the U.S. Centers for Disease Control and Prevention recommend intervention, fell from 11.8% to 3.2%. And the mean amount of lead in their blood samples also dropped — from 2.33 micrograms per deciliter in 2006 to 1.15 in 2016.

"I think it's fantastic news, actually," said Dr. Hernan Gomez, the lead author of the study. He is a medical toxicologist and pediatrician at Michigan Medicine, focusing on pediatric care in the emergency department at Hurley Medical Center in Flint.

"That is a direct result of lead abatement efforts and citizens following warnings to use filters, bottled water and have their water tested and the like."

The study showed an increase in blood lead levels in young children from 2014-2015, at the peak of the water crisis, and an earlier unexplained increase in 2010-2011. But by 2016, blood lead levels dropped lower than at any point in the history of the city.

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"The fact that we managed to, with abatement efforts, not only lower from the peak levels during the crisis, but managed even to get it to a historic low: I think it's positive," Gomez said.

Still, Dr. John Bogden, a professor of microbiology, biochemistry and molecular genetics at Rutgers New Jersey Medical School, who collaborated on the study, cautioned that it's important not to shrug off the seriousness of toxic lead exposure for thousands of people in Flint during the water crisis.

"The good news is that the children in Flint, their blood lead concentration levels …. are very similar to that state of Michigan as a whole, to the United States as a whole," Bogden said, "and they’re not unusually high. But that’s also the bad news. … We know that there is no safe blood lead level in children, and even very low levels have been associated with reduced IQ, behavioral problems and other effects on the brain."

That's especially true among young children, whose brains are rapidly growing and developing from birth to age 5.

"When you’re exposed to lead, 90% goes to your bones and stays in the skeleton," Bogden said. "It is not inert there; it can go into the bloodstream."

Flint isn't alone in dealing with the problem of lead exposure among children. The researchers also noted that during the water crisis in Flint — when 3.75% of children ages 5 and younger had blood lead levels higher than 5 micrograms per deciliter — some other Michigan communities reported higher percentages of young children with elevated blood lead levels: 5.1% of kids in Jackson, 8% in Grand Rapids and 7.5% in Detroit. Statewide, 3.4% of children and 3.3% of kids nationally had lead levels above the CDC reference point during the same period.

"It's important to understand the historical impact of lead exposure in communities like Flint," Gomez said. "We have found blood lead levels in children were higher in the recent past, and that children ... in other communities in Michigan currently suffer from higher levels than Flint, even when taking into account the water-switch time period.

"We, as a research group, believe that resources should be allocated to reduce childhood blood lead levels in all communities that are impacted. All children should receive treatment. Flint children should receive appropriate resources, but so should all children."

Exposures for children in Flint included the drinking water from 2014-15. But most children are exposed to lead through old paint that chips or flakes or puts particles of lead into the air every time a window is opened, or from playing outside; soil can contain lead. Researchers have also found lead in some ceramic finishes, jewelry and in some folk medicinal remedies.

And that's important when examining the problem historically. The researchers noted that children in Flint — even at the height of the water crisis — had far lower blood lead levels than kids of any previous generation.

In the 1976, for instance, 88% of American children ages 1 to 5 had blood lead levels of higher than 10 micrograms per deciliter, double the current CDC threshold. That compares with 3.3% of children in 2016 with levels of 5 micrograms per deciliter or higher.

That's largely due to abatement efforts and awareness that lead is so toxic.

It's been banned from use in paint, gasoline and food cans for decades, and it's no longer used in plumbing materials and solder for pipes. More people now understand that during renovations of older homes and when refinishing antique furniture, caution must be taken to ensure lead paint chips or dust from the paint is not inhaled or ingested.

"It's brought national attention to childhood exposure. ... History occurred in Flint, and likely, the Flint water crisis will be included in textbooks ... for generations," Gomez said. "We simply wanted to view it from a historical perspective and do an accurate statistical analysis."

The Flint water crisis began when the city's water supply was contaminated with lead in April 2014, when a state-appointed emergency manager switched the source of the city's drinking water supply from Lake Huron to the Flint River. When the move was made, the Michigan Department of Environmental Quality did not require adequate corrosion-control chemicals to treat the water, causing lead to leach from joints, pipes and fixtures.

"This is the first paper that published one full year after the lead abatement process started," Gomez said, noting that the City of Flint switched back to Lake Huron as a source of water in October 2015, and filters continue to be used.

He said he's concerned about the stigma that's been placed on the children of Flint since the water crisis unfolded.

"I have been troubled by many individuals talking about literally poisoned brains, poisoned children, suggesting future Nobel prize winners or children who may have found a cure for cancer may not because of what had occurred here," Gomez said. "The fact of the matter is, we do know that there is no safe blood lead level. That we do know. We do not want to diminish or decrease our compassion for children with blood lead levels above 5, or suggest that nothing occurred here.

"This shouldn't have happened. It was unfair and unjust to the community because of some poor decisions regarding infrastructure. But to place a stigma, to say they were brain-damaged, that is incorrect.

"I say this as someone who is highly invested in Flint. Three of my children were born at Hurley Hospital. ... I spent 25 years of my life at Hurley. ... We love our children here. We do not want them to have false stigma."

Bogden agreed.

"For decades, I’ve had high blood lead," he said. "As an adult in my mid-20s/early 30s, it was between 14 and 17" micrograms per deciliter, about three times higher than the CDC's current threshold.

"President Obama came to Flint in 2016. He pointed out he probably had high blood lead when he was living in Chicago, and he’s probably right. And he’s done all right. ... Most of these kids will be OK, any effects will be subtle. But that doesn’t mean we shouldn’t try even harder to bring levels down."

The biggest problem is that the widespread use of lead in the past will continue to plague the future, as lead is an element that doesn't decompose.

"If you have a home built in 1900 and has multiple layers of paint on the walls, that lead is still on the walls," Bogden said. "So whenever that structure deteriorates, there will still be lead.

"Lead is forever. It’s not going to break down. That’s my big concern. It's in so many millions of homes on the walls. And eventually, it might take a thousand years, that home is going to break down."

"We have gotten smarter about lead, and maybe the kids will get smarter in the future."

Contact Kristen Jordan Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus.