Although little data is available, the data that Oklahoma does have on lead provides a striking picture: Of the 316 ZIP codes where a sufficient number of children were tested for lead and the results reported to the health department, 106 of those ZIP codes have percentages of children tested for elevated blood lead levels that are at or higher than what was found in Flint, Michigan, the water lead crisis that grabbed national headlines and reminded the nation that lead is still a significant health issue that needs to be addressed.

story: Brianna Bailey and Jaclyn Cosgrove
design: Richard Hall
published Feb. 19, 2017

The home was perfect for the family they wanted to start.

Jessica Thompson fell in love with the 1920s-vintage bungalow's built-in wood cabinets and its proximity to a park in Oklahoma City's Classen Ten-Penn neighborhood.

However, she and her husband didn't know about the lingering lead-based paint on baseboards and window sills when they bought the property in 2010.

Thompson started to sand down and refinish some of the old painted baseboards in the home, but stopped after she became pregnant with her daughter, Olivia.

However, sanding down the lead paint likely increased the amount of lead dust in the home, creating a danger Thompson didn't know was there.

The first sign of a problem wasn't until Olivia was six months old and didn't seem to be gaining much weight.

Olivia's first blood test came back showing lead levels so high that Thompson's doctor called her on the weekend.

"He said 'You need to take her to the ER right away,'" Thompson said. "The amount of lead showed so high it was very much like she should be dead."

A follow-up test showed Olivia's blood lead level was much lower, but still alarming 10 milligrams per deciliter — twice the Centers for Disease Control and Prevention's level of concern.

The Thompson family was lucky — their doctor recommended the lead test and they were able to get Olivia's blood lead levels down.

However, the majority of Oklahoma children aren't so lucky.

Thousands of Oklahoma children aren't being tested for lead each year, even though state regulations require that physicians perform the blood test on children at ages 1 and 2. The state also recommends blood lead tests at 6 months old if the child lives in an older home, among other risk factors.

When children are tested, state law requires their results be sent to the state Health Department, regardless of whether the children tested high or had no lead in their blood.

The data that Oklahoma does have provides a striking picture: Of the 316 ZIP codes where a sufficient number of children were tested for lead and the results reported to the health department, 106 of those ZIP codes have percentages of children tested for elevated blood lead levels at or higher than what was found in Flint, Mich., where the water lead crisis grabbed national headlines and reminded the nation that lead is still a significant health issue that needs to be addressed.

For example, in Muskogee, 10 percent of children tested in the 74401 ZIP code had elevated blood lead levels. Watonga and Wewoka had similar results.

In Blackwell, more than 40 years after one of the largest zinc smelters in the world closed there, 8 percent of children tested have elevated blood lead levels.

The issue spans across the state: three ZIP codes in Tulsa with children with blood lead levels at or above the CDC's level of concern; 6 percent of children tested in Oklahoma City's 73106 ZIP code with similarly concerning levels of lead.

State health leaders blame an overall lack of awareness, mixed with older housing throughout the state, on why only one in four children ages 2 and younger have been tested.

"We're in a relatively new state, and we have relatively new housing stock, and I think you've got physicians in places where, even if they've tested historically, they get very few kids, maybe no kids, who test positive with an elevated blood lead level," said Julie Cox-Kain, Oklahoma deputy secretary of Health and Human Services. "So over time, they don't recognize the importance of it or they stop screening. I think that's probably the biggest thing that's going on."

Jessica Thompson and her daughter Olivia, 3, sit in front of their home just south of the Plaza District in Oklahoma City. Photo by Sarah Phipps / The Oklahoman
Understanding the issue

Because lead exposure often occurs with no obvious symptoms, it frequently goes unrecognized.

Nationwide, at least 4 million households have children living in them that are being exposed to high levels of lead, according to the CDC. About half a million U.S. children ages 1 to 5 have blood lead levels above 5 micrograms per deciliter, the reference level at which CDC recommends public health actions be initiated.

However, no safe blood lead level in children has been identified. Lead exposure can affect nearly every system in the body, causing learning disabilities, language and behavioral problems, damage to the nervous system and kidneys, lower IQ, and attention deficit disorder.

Dr. Dwight Sublett, vice president of the American Academy of Pediatrics Oklahoma chapter, said he doesn't believe most pediatricians know that the state requires children be tested at ages 1 and 2.

The impact of lead on children doesn't get the same level of attention as other childhood health issues, he said.

"If the state could come with a very organized approach that not only targets our SoonerCare population but also targets all the other kids, I have no doubt all the pediatricians and primary care people would not be resistant to that," Sublett said.

Contributing factors

In Oklahoma, lead paint is one of the biggest causes of elevated blood lead levels in children, health officials say.

Lead-based paints were banned for use in housing in 1978, and houses built before that year are likely to contain some lead-based paint, according to the CDC.

In Oklahoma, about 57 percent of housing units were built in 1979 or earlier, according to U.S. Census data.

A statewide housing assessment found that a little more than 240,000 occupied housing units in Oklahoma have lead-based paint hazards, and almost 20,000 of those homes are occupied by low- to moderate-income households with children younger than 6 present.

Susan Quigley, program manager for the Oklahoma Childhood Lead Poisoning Prevention Program, said people often think lead-based paint is no longer an issue.

"A lot of times when we have talked to pediatricians, they say 'That's not a problem any more — that was way back when,'" Quigley said. "And we've talked to different (groups of) people, and they'll say 'That's not the paint used any more, those houses would have already been destroyed or redone by now,' and I think unfortunately they're still out there."

After the Flint water crisis, the public awareness around lead was largely focused on water.

Although lead pipes aren't commonly found in public water systems in Oklahoma, leaded pipes were used in homes until the 1980s. For some families, plumbing accessories and lead pipes in the home are the cause of elevated blood lead levels, Quigley said.

The soil around a home can also play a factor. Lead paint chips off the exterior of homes, and then it doesn't deteriorate.

And soil can also have lead as a result of air lead pollution, an issue especially for families that live closer to highways, the result of years of leaded gasoline before it was phased out beginning in the 1970s.

Quigley said phasing out leaded gasoline is considered a major public health accomplishment: Average blood lead levels for both children and adults have dropped more than 80 percent since the late 1970s.

However, with that success comes less awareness about the lead-related issues that remain.

"We did such a good job bringing those numbers down that the fear of lead went away," Quigley said.

Funding increase requested

When a child tests positive for elevated blood lead levels, the best approach is to find and remove the source of lead, Quigley said.

However, Oklahoma has limited resources.

Currently, the state's lead program has $325,000, of which $65,000 is state money.

The state Health Department has asked the Legislature to appropriate $632,366 additional dollars for the lead program for the next budget year.

If the Legislature gave the department its full request, the federal government would match those dollars, increasing the lead program's budget to $1.8 million.

That would allow the Health Department to hire and train six people for the lead program, substantially increasing the number of home visits the agency provides when children have elevated levels of lead in their blood.

Under the agency's current guidelines, public health nurses visit homes only when children have blood lead levels of 20 micrograms per deciliter, significantly higher than federal guidelines for intervention.

With new money from the Legislature, the Health Department would provide home visits for children with elevated blood lead levels at or above 5 micrograms per deciliter, helping more families identify the source of the lead and how to remove it.

Cox Kain, the Health Department's senior deputy commissioner, said even with a 27 percent reduction in state money since 2009, the agency has been able to protect the lead program.

However, further budget cuts would make that more difficult.

"These are the kinds of programs that must continue to be in existence to prevent really negative consequences from happening," Cox-Kain said. "So for kids, (that's) loss of IQ and behavioral problems. They're six times more likely to drop out of high school and more likely to enter the juvenile justice system. It's another one of those issues where we're spending many more funds downstream after these ill effects occur."

Photo by Sarah Phipps / The Oklahoman
Intervention works

Once the source of lead is detected and removed, children's lead levels generally decrease.

Three years after the Thompson family discovered lead paint in their home, Olivia's blood lead levels have dropped significantly, after regular monitoring and eating lots of leafy green vegetables such as spinach.

Thompson also painted over all of the old baseboards in her home. Luckily, Olivia has not seen any developmental delays often associated with lead exposure in children.

"She's doing better, but she had to be tested every three months for a while," Thompson said. "It was somewhat exhausting to see her go through that."

Thompson, a Realtor, worries lead exposure for young children could increase as young couples who want to start families start to move into some of Oklahoma City's older neighborhoods.

"I wish there was more funding,” Thompson said. “We are kind of fortunate because we could do things about it, but a lot of people can't.”

Join the conversation

There will be an online chat on this subjectat 10 a.m. Tuesday, Feb. 21, on NewsOK.

Join reporters Brianna Bailey and Jaclyn Cosgrove as they talk with Susan Quigley, programs manager at the state Health Department's childhood lead poisoning prevention program, about lead and its impact on children. Quigley will answer questions and share more information about how parents and guardians can protect their children from lead. 

Blackwell reports cleanup is still continuing 40 years after smelter's closure.

BLACKWELL — Children still show high rates of elevated blood lead levels more than 40 years after one of the largest zinc smelters in the world closed its doors here.

In 2015, about 8 percent of kids in Blackwell showed blood lead levels greater than the Centers for Disease Control and Prevention's benchmark of 5 micrograms of lead per deciliter of blood, according to data from the Oklahoma Health Department.

Comparatively, 3.9 to 5 percent of children were found to have elevated blood lead levels in Flint, Mich., after the city briefly switched its public water supply to the more corrosive Flint River, causing problems with lead in tap water there.

"What is happening in Flint, Michigan, is what is going on everywhere," said Jessica Pepper, an activist who maintains the website "There is nothing special to any of that, other than someone is looking at them, and not Blackwell."

The number of children with elevated blood lead levels in Blackwell was once as high as 20 percent in 2009, according to Department of Environmental Quality reports.

Between 1916 and its closing in 1974, the Blackwell Zinc Co. operated a massive smelter in Blackwell that refined zinc and cadmium ore concentrates to be used in a variety of industrial and manufacturing purposes.

Today, Oklahoma is home to about 13 old smelter sites, including Blackwell, that can be potential sources of lead, arsenic and cadmium contamination in the soil and water.

By 1950, Blackwell was home to the single largest horizontal retort smelter in the world. Blackwell Zinc Co. employed 950 people at its peak.

Zinc ore was once mined around Picher, Miami, and Joplin, Mo. The raw zinc was then sent to smelters across Oklahoma including the cities of Blackwell, Quinton, Bartlesville and Henryetta. Two old Oklahoma smelters are still U.S. Environmental Protection Agency's Superfund sites including the former National Zinc Company site in Bartlesville. The former Federal Mining and Smelting Co. smelter is part of the Tar Creek Superfund site in Ottawa County.

The site of the former Blackwell zinc smolter in 2012. Photo by Jim Beckel / The Oklahoman

Lead contamination from old smelter sites can contaminate the soil from historic air emissions, but also from the usage of old scraps and debris from the smelter for fillers and building materials, said Kelly Dixon, director of the Land Protection Division at the Oklahoma Department of Environmental Quality.

"The most major thing about the smelters was they generated this brick kind of waste that was almost like construction material," Dixon said. "People used it to fill in low spots in their driveways like gravel."

In Blackwell, scraps from the smelter containing toxic heavy metals were used to fill in residential driveways and even the running track at Blackwell High School.

"The material sort of looks like broken bricks and it would get left lying around," Dixon said. "Cities and counties used it for road base and this material was contaminated with zinc, arsenic and lead."

In 2012, Blackwell residents settled a class-action lawsuit for $119 million with the Arizona mining company Freeport-McMoRan Inc., which inherited liability for the smelter cleanup.

In a statement, Freeport-McMoRan said it has been working since 2007 to sample and clean up yard soil in Blackwell under the supervision of the Oklahoma Department of Environmental Quality.

Feeport-McMoRan has sampled soil from about 85 percent of the properties in Blackwell, replacing soil that has shown elevated lead levels, the company said.

"Blackwell is a historic community where more than 50 percent of properties were constructed before 1950 when lead-based paint was readily available and commonly used," Freeport said in a statement. "Lead-based paint is the leading cause of elevated childhood blood lead levels in the United States."

Freeport McMoRan is now conducting a third round of cleanup in Blackwell that includes cleaning contaminated soil on private land and treating groundwater in the area, said City Manager Chip Outhier.

The city anticipates the third round of cleanup will be completed sometime this spring.

Blackwell's municipal water supply comes from the nearby Chikaskia River and has not had any problems with lead, Outhier said.

Outhier said he was unaware of a problem with elevated blood lead levels in Blackwell. Much of the city's housing stock is aging, built before the smelter closed in the 1970s, which could contribute to lead exposure problems, he said.

"Freeport has done a really nice job of contacting the community and saying 'you've got one more chance to get the ground cleaned up,'" he said. "I think they actually do care about my community."

The problem is most frequently caused not by lead directly in the water supply, but by old pipes and plumbing fixtures that can leach lead if the water is too corrosive.

There are 28 public water supplies serving more than 64,000 people in Oklahoma that have registered exceedances in lead since 2013, Department of Environmental Quality records show.

The problem is most frequently caused not by lead directly in the water supply, but by old pipes and plumbing fixtures that can leach lead if the water is too corrosive, said Shellie Chard, director for the Water Quality Division at the Department of Environmental Quality.

"Older houses with old plumbing fixtures have higher percentages of lead," Chard said. "What we do is work with the water system to ensure the water is not corrosive when it goes through old lines, older meters and plumbing fixtures so the lead does not leach out."

Moore's water system, which serves 41,138 people is the largest public water supply in Oklahoma that has registered a lead exceedance in recent years.

Testing in the summer of 2014 found lead levels as high as 0.04 milligrams per deciliter in Moore's water supply. The state's actionable level for lead is 0.015 milligrams per liter.

Additional testing done since 2014 have shown no further problems with lead in Moore's water supply, said Robert Pistole, project manager for city contractor Veolia Water.

"We are testing more frequently because of that one hit on lead that we had, and because of what happened in Flint, Michigan," Pistole said.

Moore's problem was caused when a few of Moore's water wells were down for maintenance and additional water from Oklahoma City was introduced into some areas, Chard said.

"In those areas where that water was mixing, they had a mixing zone that became more corrosive and caused more leaching than you would usually see," she said.

Photo by David McDaniel / The Oklahoman
Mobile home parks

Nearly all of the public water systems in Oklahoma that have had exceedances in lead are in rural areas. Many water supplies flagged for lead have fewer than 100 customers, including several mobile home parks.

"They have their own public water supply by federal definition, but it's the guy who owns the mobile home park as opposed to having someone with a lot of training," Chard said.

Mary Jackson Trailer Park's water system in Carter County serves just 50 customers. The trailer park showed lead levels as high as 0.0266 milligrams per liter of water for six months in 2014.

Although required by law to notify their customers of the exceedance, no public education materials were ever distributed to trailer park residents, according to the Department of Environmental Quality.

As of January, the Mary Jackson Trailer Park had taken no additional samples for lead since October 2014, according to The Department of Environmental Quality. The Park is registered to Ardmore resident Ricky Turner, records show.

The Department of Environmental Quality's Public Water Supply Program hand-delivered the notices of the lead exceedance to every resident of the Mary Jackson Trailer Park when park management failed to do so, said Erin Hatfield, spokeswoman for the Department of Environmental Quality.

"DEQ continues to work with the owner, and we are assessing the next steps," Hatfield said.

Attempts to contact the management of Mary Jackson Trailer Park were unsuccessful.

Circle P Mobile Home Ranch in Harrah, which serves less than 50 residential water customers, registered an exceedance for lead from June to September 2016. Park owner Mel Myers said the lead problem came from the tap of one vacant mobile home at the park.

Because of the elevated lead found at that one property, Myers was required to notify all of his tenants that lead had been found in the water at the park.

"DEQ (the Department of Environmental Quality) demands that we inform everyone when it looked like we had lead in our water when we didn't really," Myers said. "It did upset all of our tenants."

Myers said Circle P's water, from two groundwater wells, is tested on a monthly basis and has shown no further problems with lead.

"We have to go by the same guidelines that cities do, even though we only have 47 tenants," he said.

If a child tests positive for some level of lead, the next best thing to do is address where the child is being exposed.

Susan Quigley has a lot of advice for parents worried about lead.

For one, get your child tested.

State regulations require physicians test children at ages 1 and 2, and earlier, at 6 months, if they're living in an older home, or meet other risk factors.

"They should test them at 12 months, and not earlier, because usually that's when they're first getting around on their own and getting into things," said Quigley, program manager for the Oklahoma Childhood Lead Poisoning Prevention Program. "If they suspect for any reason they have an older home, and the child is 6 months old, by all means have the child tested. That will give them an idea if we're already seeing a problem."

If a child tests positive for some level of lead, the next best thing to do is address where the child is being exposed.

Addressing lead paint

In Oklahoma, one of the biggest issues is lead-based paint.

If a home was built after 1978, it likely doesn't have lead-based paint, Quigley said.

And the good news is, if the paint is intact in older homes, not peeling or chipping, then exposure is limited.

Families that want to test their home for lead paint have a few options.

They can hire a certified lead-based paint inspector, who checks the home using specialized equipment. However, this can cost between $350 to $1,000. A less costly option is to buy a test kit at a hardware store, although this is a less comprehensive approach, Quigley said.

"That gives you the idea, 'I do have the paint, now what do I do?'"

Lead-based paint removal can be expensive and there are few sources of help for struggling families.

Oklahoma City has a grant program to eliminate lead-based paint inside the home that gives homeowners up to $15,000 in assistance as part of the city's housing rehabilitation program, but there is up to a five-year waiting list, unless the home is in certain targeted areas of the city, said Darryl Lawson, federal programs manager for the City of Oklahoma City.

Soil issues

Before 1950, many Oklahoma homes were painted with paint that has a higher concentration of lead. When that paint chips off, it gets into the soil, and it doesn't degrade.

"The person who owned your home 30 years ago, when they scraped all that paint off, I'm sure they didn't go around and pick up every piece they scraped off," Quigley said. "It goes into the soil, and there it is. It doesn't degrade once it is in the soil."

Also, homes located near major highways and highly trafficked streets can have soil contaminated from pollution caused by leaded gasoline.

Testing soil generally involves sending samples to a lab, which can also be costly, she said.

Covering bare soil can be a simpler solution, using mulch, flowers and grass to provide a barrier between children and the soil.

Water testing

Quigley said the majority of Oklahoma's public water systems don't have lead pipes — but homes might have them.

"A lot of times you don't really know what your pipes are made of," Quigley said. "You may look under the sink and see plastic pipes and think 'I'm OK,' but what are those connected to? Are they connected to lead pipes?"

Changing a home's pipes can be costly. Instead, families can buy water filters or filtration systems that are rated to remove lead.

Also, for residents who want to test their water for lead, they can visit the Oklahoma Department of Environmental Quality, which provides water lead testing for $24.08.

At DEQ, residents can pick up the supplies and learn how to properly provide a sample. It takes two to three weeks to get the results back.

Additionally, in some cities, residents can also sign up with their public utility company to submit their water for testing. For example, DEQ requires a city the size of Oklahoma City to test at least 50 taps for lead every three years in homes that are known to have or likely to have lead or copper piping.

On the job exposure

It's important that parents who work in certain industries, such as construction and the oil industry, don't bring lead home with them, Quigley said.

Parents who remodel homes can bring lead dust home as a result of breaking down walls or removing lead paint.

Also, even though lead-based paint was banned for use in housing in 1978, lead paint can still be used in construction projects. For example, lead paint is sometimes used while painting bridges.

For parents who might be exposed to lead at work, it's important to change clothing at work and to wash that clothing separately.

Contributing: Staff Writers Brianna Bailey and Ben Felder

The Oklahoma Health Care Authority recommends children be tested for lead at 1 and 2 years of age. Children under age 6 who have not been screened before should also be tested.

Symptoms include

• Stomach ache

• Cramps

• Irritability

• Fatigue

• Frequent vomiting

• Constipation

• Headache

• Sleep disorders

• Poor appetite

Tips to prevent lead poisoning in children

• Don't allow children to put things in their mouth that may be dirty or contain lead paint.

• Have your child wash his or her hands before eating.

• Wash bottles, pacifiers and toys often.

• Wet mop and wet dust hard surfaces frequently. Vacuuming can force fine dust containing lead into the air.

• Be alert for chipping and flaking paint.

• Replace imported plastic mini-blinds made before 1997.

• Don't use pottery, pewter or lead crystal for cooking or serving food.

• Feed your children regular nutritious meals. Lead in the body stops good iron and calcium from working right so it is important to feed your child a well-balanced diet. Make sure children eat regular nutritious meals, since more lead is absorbed on an empty stomach.

More information is available from the Oklahoma Childhood Lead Poisoning Prevention Program 271-6617.

Source: Oklahoma Health Care Authority