Physician's 2-year-old son poisoned by lead in their Philadelphia home

"We just fell in love with this house — it was one of the first houses we looked at," said Alana Sagin, 35, a family physician.

Sagin and her husband, Brendan Cooney, a musician, were first-time home buyers in 2014 when they purchased the house on Mower Street for $357,500 and moved in with their 3-month-old son.

The three-story, five-bedroom house, built in 1925, looked immaculate, full of ornate woodwork and lath-and-plaster walls that had been carefully painted and repainted over the years. They were charmed by its original stained-glass windows.

They never imagined those windows would later become the source of their son's lead poisoning — and of so much parental angst.

With more than 90 percent of Philadelphia homes built before the nation's 1978 lead-paint ban, the city struggles to eradicate childhood lead poisoning and ranks among the top U.S. cities for children at risk.

Year after year, thousands of Philadelphia children get lead poisoning after being exposed to harmful levels of the potent neurotoxin. Lead, even at low levels in the bloodstream, can cause irreversible damage to a child's developing nervous system and brain, including lowered IQ and hyperactivity.

In Philadelphia's poorest neighborhoods, children who live in rental homes — often owned by landlords who shirk upkeep — suffer the brunt of this preventable disease. But, in a city founded in the late 1600s, lead poisoning knows no socioeconomic boundaries.

For Cooney and Sagin, their story is not one of buyer beware, but rather, be aware.  After reading the first part of the Inquirer/Daily News/Philly.com series "Toxic City," they agreed to have their story told to encourage parents, Realtors, home inspectors, contractors, pediatricians, and city officials  to work together to address a public health crisis affecting children in every corner of the city.

When Cooney and Sagin first walked through the house as would-be buyers, they talked to their Realtor about possibly getting a lead inspection, which would cost extra on top of a home inspection. The Realtor, whom they liked and don't fault, thought it an unnecessary expense.

“This house is old. It has lead paint, but there are no paint chips,” Cooney recalled her saying. A lead inspection would only tell him what he already knew: The house had underlying lead paint.

Under Philadelphia law, a buyer has the right to pay for a lead inspection within 10 days of the final signing of a sale agreement. If tests reveal lead-based hazards, the buyer can terminate the agreement within five days, and the seller must return to the buyer any money put down on the house.

The Pennsylvania Association of Realtors requires its members to have sellers fill out a "Residential Lead-Based Paint Hazards Disclosure Form." The form, signed by the seller and buyer, asks sellers to reveal any knowledge of lead-based paint in the house and provide the buyer with any records or reports pertaining to lead paint, including an inspection report.

Cooney said he wondered if some Realtors discourage buyers from doing a lead inspection because it would create a record that might affect the buyer's ability to resell the house in the future, though Cooney and Sagin didn't think that was the case with their Realtor.

When the couple received their inspector’s 29-page report on their home, it did note cracks in a stone retaining wall at the side of their lot and the presence of horse hair in the old plaster as a possible allergen.

The word “lead” appeared in the detailed report only once, on the second-to-last page, as one of a long list of potential indoor air pollutants, including mold, cat saliva, radon, and asbestos.

Last month, Sagin sat at the kitchen table, bouncing the couple's 8-month-old daughter on her lap. Cooney jumped in and out of the conversation from the adjoining playroom, where he helped entertain their son, now 2-and-a-half years old.

Sagin and Cooney said they don't own a television. They believe too much screen time is bad for little kids. They wanted their children to embrace creative play.

Their son had invented a game that he called "sock soup," which he "cooked" on the home's windowsills and then "ate" by putting a sock in his mouth.

"He would line up his socks on the windowsills and then he would pretend he was eating sock soup," Sagin said. "But now we look back on that and think that could have been the problem."

Like a lot of busy, working parents, Sagin said, they figured it was no big deal to let cleaning and dusting “slide.”

Cooney and Sagin said their son was his usual self when they took him, at age 2, for his annual well-visit appointment at Mount Airy Pediatrics earlier this year.

Unlike many other states, Pennsylvania doesn’t require mandatory testing for lead poisoning in children. But a nurse practitioner there did order a blood lead-level test for the boy. Some Philadelphia practitioners, like those at Mount Airy Pediatrics, are aware of the city’s lead-paint scourge and test infants and toddlers as part of their routine checkup.

Sagin said she didn't know their son was tested for lead until the pediatrician called with the results. Their son's blood tested at a level 6, which the pediatrician described as "elevated." The Centers for Disease Control and Prevention calls for health intervention when a child's blood lead level reaches 5 micrograms per deciliter.

Sagin and Cooney said their pediatrician advised them to fix any chipping paint in the house, keep on top of dust with vigorous cleaning, regularly wash their son's hands, and give him an over-the-counter multivitamin with iron and calcium, which could help reduce lead absorption.

Meanwhile, Sagin tapped into a medical database and pored over research studies. "Everything was saying that even with an initial elevation in lead, there is a significant potential loss of IQ, and so, you know, everybody was trying to reassure me about my kid having only a very tiny elevated lead level, but all the research I did wasn't super reassuring," she said.

They hired a certified lead inspector to do testing and lab analysis. It turned out the windowsills were loaded with toxic lead dust.

Cooney knew it was unsafe for kids to eat paint chips or chew on windowsills. “But it never occurred to me that lead dust is the primary danger for kids," he said. "And that's something you can't see."

"That was my understanding, too, even though I trained as a family doctor," Sagin added.

"I don't think people are aware, even the pediatricians that I've talked to … that dust can be so dangerous."

At the inspector's suggestion, Cooney and Sagin bought a vacuum with a high-efficiency particulate air, or HEPA, filter. The inspector advised them to vacuum and wet-wipe "every horizontal surface" on all three floors of the house at least once a month. That meant tables, desks, baseboards, windowsills, trim, steps, and on and on.

The couple became consumed with cleaning and hand washing.

"We were constantly thinking about it. Whatever our son touched, we were concerned," Sagin said. "We did hand hygiene, like obsessive hand hygiene."

They hired a woman to help them clean twice a month and decided to stop using the home's third floor. For the entire summer, they didn't open any windows, for fear friction would generate more dust.

Sagin and Cooney said that with cleaning alone they were able to bring their son's blood lead level down from a 6 in May to a 3 in October. They said their son seems fine, hitting cognitive and developmental milestones.  

Only when they went on vacation did they realize how much more relaxed they felt while away from their home. So they decided that they needed to at least remove or encapsulate the lead from around their 15 windows.

A contractor federally certified to abate lead risks did the work for about $10,000, Cooney and Sagin said.

Cooney and Sagin said that if they had to do it over again, they would have opted for a lead inspection as part of the buying process.

"It's not just knowing what surfaces in the house have lead in them,” Cooney said. “It's really the dust you want to know about. Where is the dust?"

[This story was originally published by The Philadelphia Inquirer.]

[Photo by Jessica Griffin / The Inquirer.]