The Plain Dealer series reveals the ongoing nightmare of lead poisoning

Sometimes the most insidious health threats are those that keep falling off our radar. In such cases, it often takes sustained, enterprise reporting to pull an issue back into public view.

This week, The Cleveland Plain Dealer’s Brie Zeltner and Rachel Dissel are doing just that, putting the issue of lead poisoning in children back on the map with an ambitious, deeply reported series of stories, photography, and videos, including a dramatic “trailer” by visual artist Andrea Levy. The 20-story series was rolled out online this week and goes to print on Sunday with a 10-page special section.

“Toxic Neglect” provides a sustained look at the quiet devastation wrought by lead poisoning, decades after lead paint and gasoline were banned. Some 2,000 kids a year are poisoned in Ohio’s Cuyahoga County alone, the Plain Dealer reports, and the CDC estimates half a million kids nationally have unsafe levels of lead in their blood. Even small amounts of lead poisoning can be debilitating, experts explain, and the range of effects includes “diminished IQs, lower test scores, higher school-dropout rates, violent crime, high blood pressure, and chronic kidney disease.” As a pathology professor who investigates the ways in which lead damages the brain tells the paper, “These kids really have an acquired brain injury from their lead exposure.”

We learn about Clevelanders such as Shamara Henderson and and her 3-year-old son, whose blood levels well exceed recommended thresholds. When the family voices concern about their living conditions to their landlord, the problem — and exposure levels  — only grow worse. Meanwhile, the city’s small, overworked inspection staff responds at a glacial pace, if at all. Efforts to fix faulty homes can stretch on for years, and city enforcement is often lax, The Plain Dealer shows.

The reporters also tell the heartbreaking story of Haneen Alwaeli, an Iraqi refugee who moved with her family into a Cleveland duplex when she was less than 2 years old. Seven months later, the toddler was in an acute care clinic for 10 days as doctors tried to remove the buildup of lead in her blood, which was 25 times higher than the CDC’s reference level. The irony is inescapable: After escaping the dangers of Iraq, the child’s new home poisoned her.

The problem is an expensive one as well: behavioral problems, special education, medical care, lower earnings, and incarceration all carry price tags that dwarf the costs of removing lead from old houses (lead paint was banned in 1978 but is still prevalent in older housing stock). Dissel and Zeltner devote an entire story to the question of just how much the problem is costing taxpayers and families.

Meanwhile, “dismal” screening rates mean lead poisoning goes undetected in many children, and the problem is often found in homes after harmful levels of exposure have occurred.

“We’re stuck in this model of responding to kids once they’ve been poisoned, and at that point, there’s not much that can be done for them,” Zeltner told Reporting on Health. “Everyone acknowledges that the best thing that can be done is to prevent the exposure in the first place.”

The reporting team started work on the series about four months ago. Zeltner says she began rethink her beat about a year ago to focus on the intersection of poverty and health, and lead poisoning was on her long-list of story ideas. Dissel, an enterprise reporter, suggested now was a good time to tackle a series on the issue, which they hadn’t seen done well elsewhere in recent years.

As with any ambitious project, reporting the series was a challenge, with Cleveland officials often not responding to requests for information. “It really does take setting someone’s hair on fire in order to get some responses or action,” Zeltner said.

Beyond detailing the extent to which lead remains a threat to Cleveland’s kids, the series is also careful to put forth potential solutions, pointing out how other cities have successfully addressed their lead problems. A tour through the paper’s archives turned up several strongly reported series on lead poisoning from decades past, Zeltner said, but little evidence they’d incited meaningful change. She said they felt the need to try something different. “What are we doing that’s different and that’s going to make people pay attention to this?” Zeltner asked. “That’s where the focus on solutions comes in.”

Stories published online Friday outlines efforts by cities such as Rochester, New York, where the city’s older housing stock has been targeted for code improvements, and Milwaukee, where a registry identifies homes that have lead contamination as well as homes that have been cleaned up. The paper even created it's own "lead-safe" registry for Cleveland. “Hopefully that will move people from frustration and sadness to more outraged hope,” Zeltner said.

It’s a series that asks why Cleveland officials aren’t doing more to solve the region’s lead problem, while outlining the unacceptable costs of perpetuating the status quo. Lead poisoning in children isn’t exactly a trendy, talked about public health issue these days. Dissel and Zeltner show us why it should be.

[Photo by Orin Zebest via Flickr.]