and rodent infestation problems. However, this approach would be very expensive and would extend over a long period of time. Moreover, this approach would not systematically locate and treat children presently afflicted with lead poisoning; for these reasons it has been rejected as a sole approach.

CHILD SCREENING

A second approach would screen children at risk to detect those having lead poisoning or elevated body burdens of lead, place them under surveillance, and secure medical treatment for those requiring it. However, children treated for lead poisoning, when returned to an environment where the hazard still exists, frequently become repoisoned, often with disastrous results. Thus, programs that are limited to screening alone and do not assure followup activity are not satisfactory.

INTEGRATED APPROACHES

We studied an integrated approach to screen children at risk, place those with elevated body burdens of lead under surveillance, assure that those requiring treatment receive it, and that they do not return to hazardous home environments.

An alternative integrated approach would screen housing units, screen children located in housing units found to be hazardous, follow up with surveillance and assure treatment and hazard control as needed.

We are committed to a vigorous, effective program to control childhood lead-based paint poisoning. A realistic program must utilize an integrated approach which provides child screening, assures surveillance and treatment as indicated as well as a check on housing for lead hazards, and hazard reduction in the homes of children with excessive levels of lead.

As I emphasized earlier, the reduction of lead-based paint poisoning is a shared responsibility of Federal, State, and local government as well as individuals and communities, including volunteer activities. We see the Federal role as primarily one of funding projects concentrated on the screening of children at risk of having or acquiring lead poisoning, and at supporting the development of community organization and public education to reduce the extent of the problem in the future. Screening and lead hazard control in dwelling units should be approached through volunteer and community action, and local management of housing. An example of the local role is the adoption and enforcement by local authorities of local building codes. These can be an important component of the lead poisoning control effort.

We firmly believe that the success in preventing and controlling childhood lead poisoning depends on the knowledge that parents, the local health community and the local political community have of the hazards associated with lead-based paints. Such knowledge, when applied would contribute substantially to the reduction of childhood lead poisoning. Therefore, this Department's program design includes an objective to inform the parents as well as the local health and political leaders of the lead paint hazard and provide appropriate guidance to each group on effective action steps that may be taken.

Legislative authority. S. 3080 which is before your committee, would extend and amend the Lead-Based Paint Poisoning Prevention Act.

We feel that there are presently sufficient Federal authorities under which communities can be assisted. These authorities are included in section 314(e) of the Public Health Service Act, and title V of the Social Security Act. Authority under 314 (c) provides comprehensively for direct Federal initiatives in the form of special grants to meet health needs of limited geographical scope or of specialized regional or national significance. This highly flexible authority is ideally suited to support the Federal responsibilities in the lead poisoning control effort.

Highly relevant block and project grant authorities exist under title V of the Social Security Act-the maternal and child health provisions. These grants can be, and have been, utilized to encourage screening, detection and treatment of lead-based paint poisoning by States and other governmental units when their priority determinations indicate that these Federal resources should be so utilized. Under other legislation, HEW has ample authority for research, development and experimentation in support of the lead poisoning control effort.

In addition to the fact that sufficient Federal authorities presently exist to support all activities necessary for lead-based paint poisoning control, we also feel that the proposed bill by continuing a categorical grant program runs counter to the constructive efforts of the administration to simplify and consolidate Federal health grant programs and to encourage States and localities to meet their own individual requirements.

The Department is committed to assuring an effective attack on the lead-paint poisoning problem. Many resources, many legal authorities, and many programs, both in HEW and elsewhere in the Government are being brought into play. This can be achieved with greater effectiveness and less confusion to responsible authorities and program managers in the States and localities if it is fitted within the existing HEW legal framework as an on-going Public Health Service activity.

Accordingly, we cannot support the enactment of S. 3080. We believe the use of existing authorities contribute to a more orderly legal structure through which this and other problems of our nation may be most effectively attacked.

Thank you, Mr. Chairman, for permitting me to introduce this statement into the record. I will of course remain for questions as you choose.

Senator SCHWEIKER. Thank you very much for your statement. I do want to go back to page 14 about your study here, if I may, and find out a little bit more about the results or at least understand the results as you explained them. You made this survey and have results from 26 cities, as I understand it. What I'm not clear on is of all the children tested-maybe you gave us this figure, but I did not quite read it that way of all the children tested, how many children of those tested had elevated blood levels of lead? What percent of your sample showed elevated blood levels of lead?

Dr. DUVAL. In that study, 6.9 percent.

Senator SCHWEIKER. 6.9 percent?

Dr. DUVAL. Yes. Part of this is due to the fact that the technology of the blood tested involved in this instance, so I cannot take that per se as represented, but the manner in which this study was carried out was 6.9 percent.

Senator SCHWEIKER. What correlation did you find between those who did have elevated blood levels of lead and the degree of lead in the houses of those who did? In other words, you surely ran some correlation between the lead measures on their house and those who had had it in their blood.

Dr. DUVAL. For practical purposes, it is almost 100 percent, Mr. Chairman. That is to say in those instances where we had confirmed in that 6.9 percent of children with elevated blood levels that they were truly elevated-well for practical purposes all those children came from homes where there was an abnormally high concentration of lead on the exposed surfaces.

Senator SCHWEIKER. So you found 100 percent correlation between homes where there was an abnormally high concentration of lead and lead in blood levels?

Dr. DUVAL. Yes.

Senator SCHWEIKER. What did you survey to find as abnormally high in a house-in other words, what was your standard when you said you had abnormally high level on the wall? What technical standard did you use to define this?

Dr. DUVAL. We define the standard as being high lead concentration, if it was an excess of 2 milligrams per square centimeter of surface on the wall.

Senator SCHWEIKER. Say that again.

Dr. DUVAL. Two milligrams per square centimeter.

Senator SCHWEIKER. How does that relate to the pediatric definition that we heard the other day in terms of their measurement of a paint chip in terms of their standard? Do you know off hand? Does your assistant know?

Dr. DUVAL. Very, very far in excess. Far in excess. You understand, Mr. Chairman, if I may, that the paint we are referring to with concentrations of 2 milligrams per centimeter would be representative of the types of paint manufactured 20 or more years ago with excess of 20 percent lead.

Senator SCHWEIKER. And their standard test was based on a 1 percent figure, theoretical 1 percent?

Dr. DUVAL. That is correct.

Senator SCHWEIKER. That is an important distinction. I agree. The one problem that I see we are all having trouble addressing ourselves to is what to do with the existing dwellings we have with paint still on the walls from the old standards. That seems to be a tremendous problem. I notice you touched on that at several points in your testimony and cite it as something that takes a lot of time and effort and resources to really approach. You come up with programs such as house screening and child screening and so forth. I had raised the question with the HUD people as to whether we could not develop some inexpensive plastic kind of covering, since removing or burning off paint seems to be probably the most expensive way you can do it, whether it would be possible to develop some inexpensive plastic paper covering that could be put up over a wall, much like wallpaper, and that in fact would become the new wall material. You could either use it itself as the wall covering or go on back and put a coat of lead free paint over that, which is often done today. Just in developing an inexpensive material that in essence would seal the lead on the wall and stop the

chips from coming off, I questioned whether this would not be a relatively inexpensive way to solve the problem inasmuch as these walls periodically have to be redone anyway, whether it is another coat of paint or some other refurbishing.

I'm just throwing up a suggestion that it seems to me a little research in some of the new plastic materials that are used today to cover walls in terms of inexpensive materials might well be the quickest and most accessible way to solve this problem. I'm just throwing it up as a suggestion. I wondered if you folks have done any looking into this or what your reaction is to something like this.

Dr. DUVAL. Mr. Chairman, we share your enthusiasm for that approach. We are currently working jointly with HUD and with the Bureau of Standards to see if that type of approach is feasible. We find it attractive, as you know. There are clearly problems with it.

For example, when you cover an existing wall from which paint is flaking, getting a bond or adhesion between new material and the wall which is already giving up its surface, may defeat us. On the other hand, contemporary research may be able to solve that problem. There is further the problem of the cost of labor and so forth to get that covering on the wall as opposed to the cost of labor to get into the buildings and scrape the paint off the wall as it is. So we do not have this costing out. We do find the approach, however, attractive and we are going to continue to pursue it.

Senator SCHWEIKER. Now you have suggested a time frame schedule which FDA is going to follow in terms of its promulgation of its new standard. I just wondered what your logical reasoning was for this time standard and the various steps and time frames involved?

Dr. DUVAL. The steps in the time frame are primarily related to a series of events that must take place involving all paint. First, there is the matter of the paint that exists in ventory in the stores. That must be cleared either through replacement or through some other such matter.

Second, there is the technical obstacle switchover to a new formulation of paint with the lower introduction of lead standards.

Third is the problem visited on the very small producer of paint, who may not be able to make an accommodation in the same length of time, and if we move too rapidly, he would be of course forced out of business.

Fourth, there would be of course the problem of the raw materials and water supply. Some paint manufacturers are in locations where the lead in the water supply used in the manufacture of paints may introduce lead in some instances actually equal to the approved level of lead in paint.

Fifth of course you have the technological problem of finding in some instances some heavy metal substitutes for lead in order to make paint work, as it were, in order to make it dry. In these instances we may conceivably by moving too rapidly introduce a substance that would precipitate a further problem.

On these grounds, we feel a very progressive, but clear determination that there is an end point that must be reached in the particular way out of that particular set of problems. I am sure there are other reasons. I can only think of five at the moment.

Senator SCHWEIKER. On the matter a moment ago about affecting coverings or how to deal with the past painted buildings, how much

money will you folks have available to spend on this kind of work? In other words, do you feel that we need no new legislation? How much money is available in terms of what you are budgeting or requesting for budgeting in terms of the old housing problem and what category does this come under with regard to the availability of funds?

Dr. DUVAL. That is not within our jurisdiction. It is under title III of the public law that is under discussion, and that is assigned as authority to HUD. We understand the figure though is $5 million.

Senator SCHWEIKER. The problem was HUD did not ask for any money in this area at all, and this is what has us a little bit concerned. Now our understanding of the present law on the books now, title II does authorize HEW to make grants to identify high risk areas and to carry out local programs to eliminate lead poisoning hazards. There must be some misunderstanding here.

Dr. DUVAL. I think there is no question about the language you have read, Mr. Chairman. Title II by and large focuses on the identification and management of the child or the person in title III, if my memory serves me correctly, is identified to the housing and to the structure. I am sorry, I've got I and II and III mixed up.

We do have the authority under title II, as you correctly indicated. We have determined and it is possible that this was responded to prior to your entry into the room, and I would like the opportunity to repeat it, that in view of the fact that we have the authority under title II, as you pointed out, we had to examine the question of whether or not to expend the resources available on behalf of deleading or otherwise reducing the hazard in the home. For each dollar spent, we can go farther in achieving the objective than I know we share.

By making it a child based strategy, rather than home based strategy, and in view of the fact that HUD does have the authority to treat the home, we have preferred to emphasize and focus on the identification and treatment of this child, and only in emergency circumstances used those funds to treat the home itself, and we have incidentally done the latter.

In addition, we felt there was constraint that we should listen to, because as you may recall in the conference committee on appropriations language we were restricted from using these funds to treat the home.

Mr. SCHWEIKER. Another area of questions that I would like to pursue a minute is if you project that over 6 percent of your samples came up with some kind of level of lead in the blood, no doubt you interpreted this on a national basis. On the basis of projecting your sample, and strictly as a matter of estimating, how many people in the country today, based on your sample so far as a projection, would have some kind of elevated blood problem of lead?

Dr. DUVAL. We would estimate at least at this time among the child population which we consider to be the ones at an identifiable risk, about 600,000. May I make only this point, since the question drew from the specific study of the 26 cities, that to use figures of that kind and translate them from the 26 studies into the Nation as a whole would not neecssarily represent valid translation of statistics, because we picked cities where we expected we might find the problem. As you know, when you get farther and farther, for example, in the rural areas, we do not have hard data at this time to indicate the equivalent lead concentrations in the environment might be found.