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shortsighted approach of telling cities like Philadelphia that they want them to use most of the money for screening of kids, and therefore ignoring the environmental aspect of it, because of the few dollars available.

That means a lead poisoned kid is going to be returned to a lead painted home. We are thus going to have continuing generations of lead poisoned children.

Senator Pell. Thank you very much. I think Mrs. Singleton's statement was strong and moving and good, and in fact it was really quite horrifying that she herself has four grandchildren who have been hit by this sickness. I thought her recommendations were very good. That the houses where children have gotten sick should then be not rented unless they were overhauled and repainted, I think is an excellent

One could make sure the correct ordinances were passed on the local level. Thank you both very much indeed for coming.

We are pleased to welcome our final witness for today, Fred Fuges, who is supervisor of Social Service, the Pediatric Outpatient Department in Kings County's lead clinic.

The clinic has been in operation for almost 2 years. He brings with him Miss Elizabeth Johnson and Mrs. Bessie Goodwyn, who are active in the parents lead action group. Mrs. Goodwyn has a grandson who suffers from lead poisoning.

one.

STATEMENT OF FRED FUGES, SUPERVISOR OF SOCIAL SERVICE,

KINGS COUNTY MEDICAL CENTER, BROOKLYN, N.Y., ACCOMPANIED BY MISS ELIZABETH JOHNSON AND MRS. BESSIE GOODWIN, PARENTS LEAD ACTION GROUP

Mr. Fuges. I would like to begin by reading my statement.

Senator PELL. The statement will be printed in full in the record, and if you would extract it, I think we would be particularly interested in experiences that you ladies have.

Mr. Fuges. Why don't we forego my statement then.

Miss Johnson. I am Miss Elizabeth Johnson. I am here with Mrs. Bessie Goodwyn to represent the parents lead action group. Our group is made up of parents of children with lead poisoning and other community people and meets weekly in a pediatric clinic of Kings County Hospital in Brooklyn.

Our goal is to make the people of our community especially the parents of young children, aware of the danger of lead poisoning and to get them involved with us in our fight against this silent killer.

One of the reasons that our community is not more involved is that so many things have been promised us, and so little has actually been delivered. Laws at the local and State levels are inadequate, and those that do exist are not enforced. We hope that these mistakes will not be repeated here in Washington.

We don't have time to wait or discuss any longer. Something must be done now. The present generation of children should be our future leaders, but they are being brain damaged and physically crippled by lead poisoning In the past 3 years, we have visited schools and community groups.

3 We have demonstrated for more effective programs and met with public health and government officials.

We have educated parents in the clinics and Kings County Hospital about the danger of lead poisoning. We have recently completed a proposal to make an educational documentary movie designed to alert our community and more affluent communities to the threat of this disease.

After all of our efforts, we remain dismayed by the inadequacy of the lead poisoning repair

program in our city. There are delays and delays and more delays. When the work is supposedly complete, the danger is over even only partially eliminated with lead paint left surrounding the children with its poison.

Faced with this discouraging situation, we feel that the following things are needed :

1. More educational publicity through radio, television, newspapers, billboards, et cetera. Not just in low-income communities, but middleincome communities as well. A community based program that would consist of local offices, staffed by knowledgeable community persons who would conduct building to building educational programs and follow up, including testing of paint for lead and encouraging parents of poisoning children to keep clinic appointments.

These community workers would assist parents by contacting local housing and health agencies as well as pressuring landlords to make repairs.

We do not want other parents to go through what we have gone through.

2. Lead free convalescent facilities for children who have been poisoned and who are waiting for their homes to be repaired. As it is now, the children must wait in crowded hospital wards at $125 per day while the same bed could be used for children who are ill.

3. Research to find a more effective test for lead poisoning, since the present blood tests are so painful and frightening to both parents and children.

4. An extensive nationwide program to rehabilitate all bad housing and to check all housing, old and new for lead paint. We know that this disease is totally preventable, and we look to you to begin a real national preventive program that will eradicate lead poisoning from our country.

Thank you.

Senator PELL. Thank

Mrs. Goodwin. My name is Bessie Goodwin, from Brooklyn, N.Y. I am a little rushed up because I have so much to say but I have to cut it short and try to pick my very best points. I would like to say that in 1968 I was a member of a board of youth

а. in action, and at that time I joined the health council, and by going around I learned quite a bit concerning the health problems of Bedford-Stuyvesant. I was keen on the health problems, and also I had this grandchild that was coming and he was 2 years old, or a year and a half old.

I also was a little troubled because in attending these meetings I found that, you know, I was living in a rundown building, and I wanted to see what this lead business was about.

So I contacted my landlord, I spoke with him when he came to collect the rent to ask him to check my apartment to see if it had lead. He kept putting me off until finally the child grew up and was sucking this lead. When I knew anything, he had, through his monthly test,

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going back and forward to the hospital. This is when the child was found to have lead poisoning.

It was taken to Kings County and it stayed at Kings County quite a few months and later on about 8 or 10 months later, the kid went into convulsions.

This morning I was getting ready to go to work, and my daughter called me and said the baby was sick. I rushed into the room and started shaking it, trying to help it to get its breath. I don't know what happened, but anyway I was blowing and I was hitting the child, so finally it came to enough to scream and then while I was doing this, my daughter was calling the ambulance.

So when I called the ambulance, I called myself asking for Kings County, but St. Mary's came, and that is another hospital, and they wouldn't take me to the hospital where my grandchild was.

They took me to the first one. I couldn't understand then what happened. I wanted to go to the one that had the records. So after that, the child was sent to Kings County, and he stayed in the clinic a few days then.

So my apartment has been fixed partially. One side it was fixed and the other side that said lead was not found, and this sort of puzzles me, because I couldn't see where one side of a building could have lead poisoning and the other part would be free of it.

So I gave the inspectors a little trouble. I had the lead twice, and I am still not satisfied with the apartment.

Senator Pell. Thank you very much.

Incidentally, I understand that there is some HUD money, and I wonder if Mr. Fuges is aware of the money that is there? Maybe after this session you could talk with the staff, and that may be one approach here that might be help toward the reconditioning of some of the buildings.

I think that when you are dealing with a child's health you are not interested in qualifications concerning the amount of lead to be permitted in paint. You want to make sure that there is no danger whatsoever. I know that is what

you

ladies feel. One other question, which was brought up by the witness from New York earlier, needs to be asked. Why is it that more Black children suffer from lead base paint poisoning than Puerto Rican or White children?

There must be some other reason than just numbers involved because the percentage of instances of the disease in black children is far more, and in addition to that, the poverty rate is no greater than among Puerto Ricians.

Mr. Fuges. We have not seen a pattern in our clinic. Frankly, we feel it is a side issue at this point. Senator PELL. It is a side issue, but I wondered what the reason was.

Mr. Fuges. Whether or not it is a cultural problem, there is still bad housing, and whether or not you can solve the cultural problem is questionable. How can you work with that?

What we can work with is the housing.
Senator PELL. I just want to know all the information.
Mr. Fuges. We have no pattern.

Senator Pell. Thank you very much indeed for coming. This concludes this day's hearing. The hearing will resume again tomorrow at 9:30 a.m., and will be chaired by Senator Kennedy.

(The prepared statements of Mr. Fuges and Mrs. Goodwin follows:)

STATE UNIVERSITY

OF NEW YORK

DOWNSTATE MEDICAL CENTER

• DEPARTMENT OF PEDIATRICS

Mr. Chairman; Members of the Conmittee:

I am a social worker with Downstate/Kings County Hospital Center of Brooklyn, New York, and for the past two and one-half years I have supervised social services in the Out-Patient Lead Poisoning Clinic. I would like to share with you the experience we have had in working with the problem of lead poisoning and to make some recommendations concerning the direction we feel should be taken by any program whose purpose is to combat and eliminate lead poisoning.

Approximately 1000 children are being followed in our Out-Patient Lead Poisoning Clinic. Most of these childrenhave been hospitalized at least one time for lead poisoning, and are being seen it for follow-up care. The remainder have not yet reached the point of severe difficulty. The children generally have blood lead levels that fall in the range from 50 to 70 micrograms per cent. Visits to the clinic are scheduled every month or more often if necessary. Presently we are seeing about 60 children each week.

In the clinic, physicians,

,nurses, and social workers operate as a team to monitor the progress of the patient, to assist parents in making the environment as safe as possible, and to provide comprehensive medical care, including physical examinations, eye and ear screening, dental care, immunizations, psychological services, and social services. In addition we attempt to mobilize parents through our Parents Lead Action Group to take action toward eradicating this entirely preventable illness. Mrs. Jamison and Mrs. Goodwyn who are here today, are parents of children being followed in our clinic. Both are members of the Parents Lead Action Group.

In addition to the clinic,of course, we admit many children to the hospital for chelation therapy. In 1970 we admitted 333 children to the hospital for treatment of plumbism. In 1971 we admitted 343.

Within 10 days of admission the children's de-leading treatments are completed, but they are not discharged until their homes are certified lead-free. We have found that the time from admission to lead-free clearance ranges from 2 weeks to 8 weeks or longer. Even after waiting for this length of time we have little confidence that the children's environments are actually lead-free,repair work is often sloppy and lead-based paint apparently remains in many cases to threaten the children.

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I have with me photographs which show conditions in these apartments and how repairs are made.

The physicians of the Lead Clinic Team strongly suspect that children suffer brain damage each time they are exposed to high lead levels. The result of this brain damage can be seen in hyperactivity, learning difficulties, and behavior problems. To find out whether these suspicions are correct, Downstate/Kings County's Department of Pediatrics has submitted a research proposal to the National Institute of Health to study the long term effects of childhood lead poisoning on central nervous system integrity. We expect a decision in May on this proposal, which if funded, will begin in September of this year.

However, we feel very strongly that vigorous action at the various
levels of government should not await proof of our suspicions.
Action should be taken now to initiate preventive measures. Real
prevention must center around the housing crisis which is at the core
of the problem of lead poisoning. At the very least it would mean
determining where children are at risk and immediately expediting
repairs before they have the opportunity to ingest the minute amounts
of paint that are sufficient to cause poisoning. We realize that this
real preventive effort would require the expenditure of tremendous sums
of money,

but the cost that is now being paid in hospital bills,
special education for brain damaged children, and institutionalization,
is huge.

To say nothing about the value of children's brains and lives.
If strong measures are not taken immediately to eliminate the poison
that literally surrounds them, thousands of children will be sentenced
to death or to lives scarred by this needless disease.
Finally, I would like to submit a position paper adopted by the committee
of hospitals of Brooklyn to Eradicate Lead Poisoning. We at Downstatel
Kings County Hospital Center endorse this position paper without
reservation. It has been circulated among government officials and
representatives at all levels. It is my hope that you will keep its
recommendations in mind, as you consider the legislation before this
committee. I will finish by reading the final paragraph of the position
paper:V

There are things each of us can do. If you are a private citizen, you
can write to your : legislative leaders and urge them to pass
legislation and appropriate funds to create better housing. If
you are a physician or health worker, you can educate parents and
colleagues to the dangers of lead poisoning. If you are the parent
of a lead poisoned child you can take all precautions within your
home to eliminate or lessen the dangers. You can join or form a parent's
action group to help pressure those who can bring about change.
If you are a state or federal legislator you can use all of your
power to appropriate the funds needed. If you are the President
of this nation you can help change the priorities and use some of
this nation's wealth to bring health and equal opportunity to
millions of our citizens.

Fred E. Fuges, MSW
· Kings County/Downstate Medical Center
Pediatric OPD

"The Gradication of lead Poisoning." A position paper adopted by the Committee of Hospitals of Brooklyn to Eradicate Lead Poisoning. p. 5, of attachment.

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