Michigan, where a man-made water crisis is still roiling one of its biggest cities, will consider requiring all infants and toddlers to be tested for lead poisoning as part of an initiative to eradicate children's exposure to the neurotoxin statewide.
The recommendation is among many unveiled Thursday by a state board that Gov. Rick Snyder tasked with proposing a strategy to protect children from all sources of lead poisoning.
The emergency in Flint stems from old lead pipes contaminating the water after the city was switched in 2014 from Detroit's water system to improperly treated Flint River water while under state financial management. But lead poisoning is more frequently linked to paint and dust in older housing and soil. The toxin was banned from paint in 1978.
The Child Lead Poisoning Elimination Board's report to Snyder calls for the screening of all children for lead by the time they turn 1 and again between ages 2 and 3. Such testing is currently only required for low-income kids in the Medicaid or Women, Infants, and Children (WIC) programs.
Under the federal health care law, lead screening for children at risk of exposure is considered a preventive service for which insurers cannot apply copays, deductibles or coinsurance.
The report also recommends requiring that a lead inspection and risk assessment be done when any house built before 1978 is sold or transferred, unless lead in the home has already been fully addressed. If lead hazards were found, abatement would be required at the point of sale or transfer.
In newer homes, the dust, soil and water would have to be tested. The owner would be required to disclose the information to a future buyer or renter.
Lt. Brian Calley, who chairs the board, said "great strides" were made when lead was removed from paint and gasoline decades ago but that since then lead-prevention efforts "kind of fell off the radar."
The current focus is on responding when kids have elevated levels of lead in their blood.
"Making that system work more efficiently is not good enough. We want to have a set of recommendations and to implement a system that prevents the lead poisoning from happening in the first place," he told The Associated Press on Wednesday, ahead of a news conference scheduled for Thursday.
The report says blood-lead screening rates are "very low" and cites inadequate federal and state funding, which has led to a depleted local public health infrastructure that is unable to fully apply current laws and regulations.
Calley, who said it will take "a generation" to implement the proposals, pointed to the U.S. government's "huge" approval this week of a waiver so Michigan can spend $119 million in predominantly federal money over five years to remove lead hazards from the homes of low-income residents in Flint and other communities. The Snyder administration also plans to propose lead-prevention funding in the next state budget, he said.
"There are a lot of clues out there that can give us a sense for where the biggest risks are and where we know there are problems," Calley said. "If we know that lead exists in a particular location and we have made the decision to allocate resources to remediate that exposure, why do we have to wait until a child gets poisoned in order to eliminate the exposure?"
According to the report, identified cases of child lead poisoning have declined significantly in Michigan. In 1998, 44 percent of children under age 6 who were tested had elevated blood-lead levels. It was 3.4 percent in 2015, or nearly 4,800 children of about 141,000 tested.
But Calley cautioned that only universal screening of young children and full reporting of results to a surveillance system for data analysis will help pinpoint the actual prevalence of lead exposure. About 38 percent of all Michigan 1- and 2-year-olds were tested last year.
It was not immediately known how many states require universal screening.
The 12-member board includes top officials in the Snyder administration and outside experts such as Dr. Mona Hanna-Attisha, who helped expose Flint's crisis more than a year ago after state officials initially dismissed her findings.