Office of the General Counsel

September 16, 2016

Office of the General Counsel Department of Public Health 250 Washington Street Boston, MA 02108

Re: Proposed Amendments to 105CR 460.000 Lead Poisoning Prevention & Control

We are pleased and encouraged that the Massachusetts Department of Public Health is taking action to revise the regulations regarding lead poisoning prevention to reflect recommendations from the Centers for Disease Control and Prevention (CDC) and other federal agencies. The evidence is clear that there is no safe level of lead, and we must do all we can to protect children from harm and ensure that they can reach their full potential.

Lowering the lead poisoning level Lowering the lead poisoning level to10 µg/dL and establishing a Blood Lead Level of Concern for 5-9 µg/dL is a significant advance from the previous standard of 25 µg/dL. However, this standard fails to bring enforcement action down to the reference level of 5 µg/dL currently set by the CDC. An elevated blood lead level of >5 µg/dL should trigger the same actions as the 25 µg/dL if we are to protect Massachusetts children. Even if the state determines to set the strict liability threshold at 10µg/dL, environmental investigation should occur at 5µg/dL, rather than relying on voluntary educational services.

While we understand that bringing it down to the reference level of 5 µg/dL would mean an increase in the number of children requiring Lead Law action, and a resulting need for funding to cover lead abatement, if the priority of the state is to protect as many children as possible, the level should be at least as low as the CDC reference level. Defining levels below 10µg/dL as not being lead poisoning is misleading to parents, the medical community and public health professionals.

Deleading standards The proposed regulations will remove the deleading standards for a small number of surfaces, which are currently considered accessible or “mouthable.” The word mouthable should be removed because research has demonstrated that lead containing dust is mainly the problem in homes and not the ingestion of lead paint flakes. The CLPPP’s reference to anecdotal evidence is not sufficient however to remove surfaces from the list to be deleaded. We recommend keeping the surfaces that are underlined and proposed to be eliminated in the final definitions. It is important to abate these surfaces since the paint abrades into dust and that abrasions are almost imperceptible but accumulate in the house dust which is ingested. Although reverting to the previous wording keeps the cost of abatement the same, it does allow for more fully eliminating lead paint from homes. This proposed softening of standards around dangerous hazards to children that can cause

PO Box 4895, Springfield, MA 01101-4895 • Phone (413) 794-7739 • FAX (413) 794-1451 [email protected] • www.partnersforahealthiercommunity.org numerous health defects simply to reduce the cost of lead hazard remediation should not be allowed unless there is a compelling scientific reason to do so.

In addition, we would suggest ensuring adding clarifying language in the regulations to state that if there are surfaces in elevated blood level occupied properties for which lead abatement is more appropriate to protect against future exposure for the child occupant, then abatement should not be precluded from being ordered, even if it is not an accessible surface. The focus should be on the surface’s current status as a hazard or its likelihood of generating a lead hazard if more permanent abatement measures are not utilized.

Finally, we would stress that interim controls are premised on the constant, ongoing maintenance of all lead containing surfaces to prevent hazards from being generated. As stated in the 2012 HUD Guidelines, “Interim control measures are fully effective only as long as they are carefully monitored, maintained, and, in some cases, professionally reevaluated.” In practical terms, in elevated blood level properties, interim controls may not be sufficient due to the lack of structural integrity of the property or certain components, water intrusion, expected ordinary wear and tear or an overreliance on continuous maintenance and paint stabilization interventions that may not be realized. Any efforts to soften these regulations may lower current costs of remediation, however, in the long run, there is a risk of lead poisoning if the lead paint is released due to poor maintenance. Given the experience in Springfield of the 2011 tornadoes, and the likely increase in unusual and severe weather and flooding due to climate change, an emphasis on permanent abatement rather than interim control measures would ensure the health of future generations.

Enforcement measures The proposed regulations omit many details or refer to policy and guidance or the “discretion of the Director.” Such language and designations are unenforceable. Regulatory requirements consistent with those policy guidance documents are needed to ensure that entities within the state will meet the requirements or face repercussions if they fail to comply. The serious consequences of lead poisoning on young children make it imperative that the regulations include strong and specific enforcement strategies. We urge the Department of Public Health to include more detailed and specific language on how these regulations will be enforced.

We appreciate that the Department of Public Health is moving to protect children from the risk of being poisoned in their homes. We urge you to consider even greater strengthening of these regulations as outlined above.

Sincerely,

Sarita Hudson Pioneer Valley Asthma Coalition Manager

PO Box 4895, Springfield, MA 01101-4895 • Phone (413) 794-7739 • FAX (413) 794-1451 [email protected] • www.partnersforahealthiercommunity.org