By James Celenza 

Last year, a jury found that three paint companies created a public nuisance when they made and sold the lead paints that continue to poison children in Rhode Island. Now, Rhode Island Attorney General Patrick Lynch is proposing that the companies spend $2.4 billion removing lead paint from more than half the houses and apartments in Rhode Island. Some criticize the effort and expense that will be required, but lead poisoning is a serious issue that deserves our attention – and this settlement provides an opportunity to address lead poisoning and connected health issues in a systematic way that will benefit Rhode Islanders’ health in the long run.

The legal decision and the RI AG’s plan rests on a primary positive principal:  the primary polluters — those who made and marketed lead paint in full unambiguous awareness of its toxicity — would begin to provide funding to address the myriad problems associated with lead paint poisoning. 

What must be reckoned, however, is that lead poisoning is imbedded in a debilitating web of disparities that impact the environmental health of Rhode Island children.  The neurological harm of lead is accelerated and exacerbated by other related aspects of their environment, such as poor nutrition. And it is often the same neighborhoods where other significant environmental hazards, such as air pollution that’s linked to respiratory illnesses, are highly concentrated.  Both the Centers for Disease Control and Prevention (CDC) and the Institute of Medicine have linked environmental exposures (lead, air quality, unsafe and unhealthy housing) with significant risk and harm to family, maternal and child health.

Thus, lead must be seen not just as a signal toxicant but also as one health disparity within a matrix of housing and community issues that extend well beyond the paint on the walls.   If used in a creative and innovative way then the historic lead settlement may begin to erect the public health infrastructure needed to address these connected issues on a systematic and coherent way. Some specific steps could include:

A] Turn lead centers into Healthy Housing Centers.  The health centers and  hospital-based lead centers have been the front line agencies directly involved with most lead poisoning issues and support for families. Thus, they are centrally located to provide support and home visit services on asthma triggers, vermin, mold, safety hazards, nutritional education, and unsafe home chemical use.

B] As an adjunct, provide sustained funding for community healthy homes model projects to address housing and neighborhood environmental health issues. These include not only widely recognized public health hazards like lead paints and vermin, but a lack of recreational facilities and safe havens that provide alternatives to dangerous pastimes. (The two leading causes of fatalities to children are cars and guns.) These model projects could also be a pivotal vehicle for helping train and gain employment for residents in the areas hardest hit in environmental health projects like lead abatement or reducing asthma triggers. These projects could also serve as “demonstration projects,” which would test various models for achieving healthy housing practices.

C] Seed a dedicated Pediatric Environmental Health Unit (PEH) at a local Hospital to offer multidisciplinary evaluation and management of children and their families who suffer from the effects of occupational and environmental toxicants.  Model PEH exists throughout the country, funded by the CDC. (There is a PEH at Children’s Hospital in Boston.)

A hospital based PEH could serve as a resource-rich keystone to nurture and oversee (in collaboration with the Health and Environmental Management Departments and the Housing Resource Commission) these newly minted healthy housing centers and the community healthy housing projects. The RI PEH would have on staff pediatricians, medical toxicologists, nurses and housing resource specialists to provide medical management and environmental assistance for illnesses or intoxications resulting from heavy metals, indoor air pollutants, outdoor pollutants, pesticides, excessive heat and adolescent occupational exposures.

Ample precedents exist in many environmental and occupational settlement agreements to provide large scale abatement of a wide range of environmental hazards beyond the original source toxicant.  Rhode Island should take this opportunity to establish an interconnected healthy housing infrastructure.

James Celenza is Director of Rhode Island Committee on Occupational Safety and Health (RICOSH): 741 Westminster Street, Providence, RI 02903; 401-751-2015; jobhealth [at] juno [dot] com.