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I call your attention in the next two pages of the testimony to the bureau of lead poisoning control budget which delineates New York City's program of $2 million of city funds which screens 100,000 children, but does not include the expense of repairing 1,500 apartments that are rehabilitated each year.

I think this type of data is useful for other sections of the country which may be interested in determining how much is necessary to do a particular job.

The New York City experience has been presented in considerable detail this morning, to afford this committee an opportunity to see the extent of the problem, the magnitude of the problem, and the financial resources necessary to attack it.

Thank you and I shall be open for any questions. Senator PELL. Thank you. How many actual deaths from lead poisoning were there in New York last year?

Dr. GUINEE. Last year there was one confirmed. The year before, there were two. This has gradually dropped the last decade from a level of about 20 to a level of one or two a year.

Senator PELL. What is the reason for the decline?

Dr. GUINEE. One of the reasons may be that hospital care has improved over this decade. A second may be that public housing is more available now than it was a decade ago. The lead problem is primarily a long term housing problem, the kind of program we have in New York City, is sort of a stop gap program, to protect the child of today until society can build a house tomorrow.

Senator PELL. What is the number of people who are sick and have to be hospitalized for lead poisoning in New York? Dr. GUINEE. In 1970, we had 2,649 cases. Senator PELL. Hospitalized ?

Dr. GUINEE. In 1971, we had slightly over 1,900. Of these, about a quarter of them are hospitalized, and the hospitalization may last anywhere from 1 week up to about 6 weeks.

Senator PELL. What are the symptoms of lead base paint poisoning?

Dr. GUINEE. The reason why we are stressing screening so much is that the symptoms of lead poisoning are insidious to start with. A child is irritable and loses his appetite. This is difficult to determine. It may get to the point, however, that a child may have convulsions and may in some instances die. It has been estimated that about a quarter of those who have had convulsions will have mental retardation.

Senator PELL. How much money is used to launch an attack on this in New York City ?

Dr. GUINEE. The way we are approaching it is to essentially go after the child who needs protection today. Our current budget is $2 million. We feel we could easily use another $2 million for detection, and $3 million for repair of apartments.

These are really rather small repairs. This is not fixing up the whole apartment. It is fixing only the surfaces that are deteriorated and where lead is found by a laboratory analysis. We are in a situation which is sometimes difficult to explain to somebody in the community, where one wall is fixed and another one is not, because we only find lead in one of them.

Senator PELL. Thank you very much, Dr. Guinee, for your testimony. You know as much about this subject as anybody in the United States. It is fine of you to come here.

Our next witness is Joanthan Stein of Community Legal Services in Philadelphia. Mr. Stein is a graduate of Columbia College and received his law degree from the University of Pennsylvania.

Following graduation, he spent a year at the London School of Economics in London and then began working as a Reginald Heber Smith Fellow at Community Legal Services, specializing in welfare and health law reform.

He then began to represent the Citywide Coalition Against Childhood Lead Poisoning, which was formed in 1968. His current position is chief of law reform, in which capacity he supervises and coordinates all law reform activities at CLS, including housing, urban renewal, employment, consumer and health laws.

With him is Mrs. Veronica Singleton of the Philadelphia Welfare Rights Organization.



Mrs. SINGLETON. First, I would like to say good afternoon to everyone. I am Mrs. Veronica Singleton and I am speaking on behalf of the Citywide Coalition Against Childhood Lead Poisoning. I speak from the firsthand experience of a grandmother of four lead poisoned children.

The coalition, one of the first organizations of its kind in the Nation, is comprised of over 50 inner city community organizations, civic associations, and professional health groups in southeastern Pennsylvania dedicated to eradicating the epidemic of childhood lead poisoning from our cities.

Lead poisoning is a preventable disease which with sufficient funds can be eliminated—and whether our Government does or does not eliminate this disease is truly a test of whether our elected representatives are honest and serious about improving the health of the poorest and most disadvantaged children in this Nation.

We are here to support S. 3080 with a number of recommendations for its amendment as it is seriously lacking in its present form.

We do not want to belabor the facts about the epidemic with which you are undoubtedly familiar, such as the HEW estimate of 400,000 children nationwide suffering from lead poisoning, but wish to only add a few recently obtained facts from our area:

First. Philadelphia Public Health Department statistics for 1971, during which the city and medical institutions began to do increased blood testing, show that of 3,294 tests of children, 1,204, or 37 percent, showed elevated, abnormally high levels of blood lead in their bodies, under the Surgeon General's standards.

Second. In Philadelphia alone, 89 children have died and over 200 have sustained permanent brain damage according to health department reported data.

Third. On going research at the University of Pennsylvania of lead in children's teeth which shows the buildup of lead in the body, has so demonstrated that ghetto children have over 500 percent more lead in their bodies than suburban children with resulting mental and learning problems. See Philadelphia Daily News article "Lead Poisoning Seen Brain Damage Cause, of January 17, 1972, attached.

Maybe I should comment without reading the rest of it. People say lead is not damaging to children but it is. We had a case recently in Philadelphia and the house had recently been painted. Even .06 percent is too much lead. I feel it should be lead free completely. .

. The paint industry would not be harmed by this ban on sale and only one or two individual companies would have to make temporary adjustments which most others have long since made.

Short of a total ban on sale, one could prohibit general retail sale to avoid household use and indiscriminate sale. This would allow nonhousehold uses, as on ships, bridges, or structural steel, which does not pose a threat to children.

In some parts of Philadelphia, they are selling surplus Army paint.

The mothers don't know anything about it. They buy it. All this lead they have in the landlord's stockpiles we know, and we feel there is lead in it. So it should be all taken out and disposed of, because when I was living in a house and my house needed painting all I needed to do is go to the real estate office. The man had the paint in the cellar.

The mothers are moving out and the house is still filled with lead paint and they do not notify the health department that they are moving, because they don't know no better. They don't know that they should do this, so the house can be posted as unfit.

I think there is more education needed all over the country, especially in Philadelphia. The coalition through me, has been doing this. We have gone around to the streets, we have talked on television and all the news media, telling about this problem.

Now lead poisoning is a serious problem to mothers. I know how my children acted when they had it. They were sluggish, sleepy, and laying around, and complained of pains in the stomach. I told my daughters immediately to take them to the hospital, and they diagnosed lead poisoning. I was thankful I noticed them when I was home, and they were not seriously affected.

Last month, we had a child on Christopher Street that went totally blind because of lead paint poisoning.

Getting back to the money funding that we believe the coalition beJieves needs to be done, on the medical screening and treatment side.

First. Assuming 200,000 children with increased amounts of lead in their bodies, but without symptoms, a conservative estimate, outpatient care at $200 each, would require $10 million.

Second. Assuming 75,000 children with clinical evidence of poisoning, 5 percent of 1,500,000 children between ages 1 to 6, their hospitalization and treatment, $1,000 each, would cost $75 million.

Third. The above figures are in addition to the basic sums of money required to find and screen the children with high blood leads.

It should be noted for the record that then according to Dr. Julian Chisolm of Johns Hopkins Medical School:

(a) For a severely brain damaged child, institutionalization for life cost $222,375.

(6) For a moderately brain damaged child, the cost would be $17,430 not including institutional care.




(c) For a child with abnormal amounts of lead, requiring hospitalization and treatment, $1,800 would be needed.

Thus a prevention program with emphasis on environmental control, including bans on sales and use, see above, and house inspections is essential.

The cost of removing lead paint from the 30 million dwelling units built pre-World War II is estimated to be $39 billion—at $300 a house. Less money would be needed if cheaper methods of removal were employed, and if part of the cost were borne by landlords.

I will let Mr. Stein go on because I get emotional. Money is not everything. We mothers don't have nothing. We are black and we are Puerto Rican mothers. We don't have nothing. We have to live in these dilapidated homes. The only thing we can give our children is love and medical care, and it really hurts me to say that a man sits up and say it don't hurt the children if this amount of lead is in the

. paint. We want it all out of the paint, because it is our children.

My children, your children, and everybody's else's children that are concerned here. We have a few whites that live in deteriorated conditions, too. We are the ones, the poor low man has got to suffer. So I think that the paint industry should really work out something that would help us save our children.

Our children, save them for tomorow. Maybe they will be sitting up there, but if they are mentally retarded or blind, or if they are dead, we mothers are the ones who are going to suffer.

So we are hoping they will reconsider and think about barring the lead paint completely. I am going to fight it. I don't know how far I am going but I am going to get the lead out of the paint.

Senator PELL. Thank you, Mrs. Singleton. That is very moving testimony. Mr. Stein.



Mr. STEIN. Yes. I don't think I will be quite as eloquent. I would like to point out a few of what I think are really major defects in the bill S. 3080, and I think if 3080 is passed as it is now, I think it will just really deal with a small proportion of the total problem.

The first thing which Mrs. Singleton spoke to is seeking a total ban on the use of and retail sale of lead paint.

Now a lot of the discussion up until now has gone to the percentage of lead allowable in paint. We support the 0.06-percent trace element standard, and we agree with you, Senator, that there is data which Congressman Ryan did put into the Congressional Record, among other sources, which shows that less than 1-percent lead by weight is dangerous to children.

The American Academy of Pediatrics report says the 0.5-percent standard which the industry is coming down with is inadequate to protect the health of children.

The National Committee on Product Safety sought a mandatory Federal safety standard which would include the prohibition on the use of lead. The study you referred to in New Haven, and additional data from Memorial Hospital in New York show that children have been poisoned with paint of less than 1 percent lead.

So we do support this 0.06-percent standard as the most enlightened current standard which should not be delayed in implementation.

But it is important then to note the following: The bill S. 3080 continues the very feeble prohibition of title IV. That prohibition just goes to prohibit the use of lead base paint in residential structures which are newly constructed or rehabilitated and which are federally financed.

That section excludes the great percentage of housing which is private housing, and the great percentage of federally financed housing which is old existing housing. Over 90 percent of the houses sold with Federal assistance in Philadelphia is not new or newly rehabilitated housing, it is old and existing housing.

So that what is needed in S. 3080 is an amendment to section 401 to prohibit the use of lead paint in all residential structures, private or public, old and new.

Furthermore, the idea of having a prospective prohibition on the use of lead paint is itself almost unenforceable. Philadelphia has had for 6 years in its health code a prohibition on the application of lead paint with no diminution on application.

Unless you have a health inspector in every paint store of the city every single day, you are not going to be able to prevent the uncaring landlord, or just the unsuspecting landlord, or buyer of paint from using lead paint.

That is why we see the need for a complete ban on the sale of lead paint in this country.

One could take into account the industrial needs of lead paints and could make exceptions for narrowly defined industrial uses and allow wholesalers to provide for the shipping industry or certain construction needs which lead paint is used for.

But certainly retail household sale of lead paint should not be allowed in this country any further. In fact Massachusetts has come to this conclusion through recent State legislation.

Senator PELL. Your statement will be put in full in the record. We have another witness, and I have to wrap up.

Mr. STEIN. Right. I think our other main focus is funding, aside from putting in a community participation requirement in the bill, that is, to establish local and national advisory boards composed solely of consumers to monitor the program's cost. Some $50 million is authorized by the current bill; we know that the appropriation is going to get knocked down considerably, and we also know that the magnitude of the problem is enormous. The coalition in Philadelphia is seeking a billion dollar authorization for a lead poisoning program in this

a country.

We know that the cost of inspecting and removing lead paint from homes in the country is estimated at $9 billion, and perhaps higher. We know the treatment and screening of kids runs into the tens or hundreds of millions of dollars.

Therefore, a $50 million authorization is going to lead people to believe that Congress is doing something about the problem when in fact, when the money finally gets appropriated, the money will be dribbled out to cities and there won't be enough for a city program.

Senator PELL. Right. Mr. STEIN. The last thing I would like to say about that is that HEW with the limited money that Congress has appropriated has taken the

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