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Cleveland Schools Hopes to Fix Underreported Poisoning With Lead Testing Partnership

photo of Lyn Lotas

More than 300 homes in the city of Cleveland were declared unsafe to live in because of lead. Residents are being asked to move out quickly if they have young children. Lead poisoning in children ages 3 to 6 can have a drastic impact on their development and overall health, but it goes largely undiagnosed in the city’s kids. A group of educators are now trying to change that with a new partnership and free testing in the city’s schools.

Beverly Scott, a nurse with the Cleveland Metropolitan School District, gently pricks the finger of a young boy at Scranton Elementary School in Tremont, and in a small, clear vial, begins to collect the blood droplets that form. The boy is one of the 160 Cleveland students who had their blood tested for elevated levels of lead this year.

“What our program says is any kid ages 3 to 6 years old will be tested,” said Debbie Aloshen, director of nursing and health services for CMSD.

She’s helping lead the partnership between the district and Case Western Reserve University’s nursing school. Funded by a grant from the Prentiss Foundation, the program started with screenings at just four schools this year, but by 2020, Aloshen said their goal is to test every student ages 3 to 6 in the district.

An 'underreported disease'
“Lead is one of the most underreported diseases there is. It’s extremely underreported,” she said.

Extremely underreported, Aloshen said, because testing is only required for children ages 1 to 2 who are covered by Medicaid. The lack of testing is intensified by the lack of centralized reporting, according to Aloshen. While a database exists through the state Department of Health, she said it’s underutilized and reporting is inconsistent because it’s not mandatory.

“We have not been getting these lead numbers from facilities. We’re not getting them from doctors. We’re not getting them from hospitals, and we’re not getting them from parents. So, we have no idea what lead levels are out there,” she said.

But thanks to the partnership, they’re starting to get an idea.

Of the 160 kids tested, 11 percent had higher levels of lead in their blood than the Centers for Disease Control and Prevention’s public action standard,or the level at which it recommends a child seek medical treatment. That’s compared to 3.3 percent of children under the age of 5 nationally who had high levels in 2016.

The results also show inconsistencies in exposure across Cleveland neighborhoods. At Michael R. White Elementary School, for example, in Glenville, 16 percent of children who were tested showed heightened levels, but at Fullerton Elementary School in Slavic Village, only one students tested at an elevated rate.

Lynn Lotas, who teaches nursing at Case and is heading the partnership with Aloshen, said the age and condition of housing in the neighborhoods impacts those numbers.

“Partially it’s that Cleveland housing is old; 90 percent of it was built before 1978 when lead was banned, but it’s also poverty,” she said.

More than half of the city’s children live in poverty, which makes it difficult to pay to mitigate lead in a home or for health care to detect and reverse the effects of lead poisoning. Those effects are the most dangerous from ages 3 to 6, when Lotas said the brain is developing rapidly, and can manifest themselves in any number of ways in children.

“We know that they have more difficulty learning. We know they have behavioral problems. Statistically they drop out of school earlier, and they’re more likely to be incarcerated," she said. 

The screening results from the Case/CMSD partnership for each individual student will be accessible by their teachers, Aloshen explained, so that if a student shows signs of distress, his or her lead test results can be considered. It’s a public health problem, she said, but an education problem, too.

“We’ve got to make sure these kids learn, and to do that we have to change the style of learning sometimes for these babies,” she said.

Getting more help
After the first year of screenings, Aloshen and Lotas said they’ve learned they’ll need more help from community partners to educate parents and convince them to agree to the voluntary testing.

They’re also leaning on groups like Cleveland Legal Aid and the Greater University Circle Initiative of the Cleveland Foundation to provide supports for the families of students who test high and need help securing new housing.

“We know we can’t do it all, but we can collaborate with people who will pick up pieces of it so we can provide the services that families need,” she said.

With 68 K-8th grade schools in CMSD, Lotas said next year’s goal to screen half of the district’s students ages 3 to 6 is lofty, but she said they’ll get to as many as their resources allow.