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CAIRO — Water filters have been installed in all Alexander County Housing Authority occupied units after testing revealed some water samples at two developments contained levels of lead at or above the Environmental Protection Agency’s lead action level, according to a spokesman for the U.S. Department of Housing and Urban Development.

In an emailed statement, Jereon Brown, HUD’s general deputy assistant director for public affairs, said the last of the water filters were to be installed on Tuesday inside units in Thebes.

In total, close to 400 water filters were installed in the ACHA’s units, which include multiple developments for families, seniors and people with disabilities and scattered site community housing. The move has been described as precautionary, and HUD officials have said that Cairo’s drinking water is safe and that the lead contaminant likely can be traced to water pipe joints given the age of the ACHA’s housing stock.

Brown provided this update on the progress of installing the water systems in response to a letter that U.S. Sens. Tammy Duckworth and Dick Durbin sent last week to HUD Secretary Ben Carson asking that federal housing officials prioritize drinking water safety for people living in public housing in Alexander County.

Duckworth and Durbin called for this action even as HUD prepares to move people out of two large complexes because they are a health and safety risk to the roughly 400 people who live there, close to half of whom are children.

Specifically, the Democratic U.S. senators from Illinois called on HUD officials to test the water for lead at all Alexander County Housing Authority managed housing developments; to conduct ongoing tests of recently installed water filters to ensure they are effective; and immediately provide bottled drinking water for families with infants and young children if the tests show the filters ineffective at removing lead.

Brown indicated that the agency was already working to address water quality concerns weeks before the letter arrived on Carson’s desk.

The state lists Alexander County among its high-risk regions for the potential for lead poisoning of children. A 2015 state report indicated that the percentage of children living here with elevated levels of lead in their blood is significantly higher than the statewide average. Because of that, it is a requirement that all children are tested prior to enrolling in school. The school district superintendent estimates that close to 40 percent of the district's children live at Elmwood and McBride. 

Dereliction of lead mitigation duty alleged

The Elmwood and McBride apartment complexes subject to the testing were built in 1942, long before the federal government outlawed the use of lead-based products in residential construction. HUD officials have criticized past ACHA managers for apparently neglecting testing and mitigation duties. They also have indicated that it’s been difficult to get a complete picture of the scope of the ACHA’s operations in recent years because records were in such disarray when they arrived.

A year ago, Towanda Macon, HUD’s Region V Public and Indian Housing operations director, who has been overseeing the ACHA in federal receivership since Feb. 22, 2016, said during a meeting with residents that it did not appear the ACHA had properly tested for lead-based paint.

Asked by a resident at the May 2016 meeting about whether she should be concerned about chipping paint in her apartment and possible lead poisoning or exposure for her young grandchildren, Macon told the resident she was asking “all the right questions” as there were “several things that were just not done” by past managers.

In a follow-up email to the newspaper last year, Gina Rodriguez, a Region V HUD spokeswoman based in Chicago, said that upon taking over the ACHA’s operations, HUD conducted a review of all property records, leases and related information and was “not able to locate lead-based paint inspection reports for all the properties.” At the time, in May 2016, Macon said the ACHA was working to secure a contractor to test the paint and water for lead.

Last month, also at a meeting with residents, Macon provided an update on the water testing and explained why HUD had decided to move forward at this time with installing water filters at Elmwood and McBride. A few residents asked Macon at the meeting why HUD would make such a decision now, only days after announcing everyone would have to move out. Though HUD intends to begin issuing emergency relocation vouchers in late May, a deadline has not been set for the planned relocation of residents. HUD has estimated it may be upwards of 11 months and possibly longer, and Macon said the housing managers have a duty to maintain residents’ health and safety while they continue to live there.

Macon also addressed why HUD officials did not install water filters a year ago following their initial round of testing. She said that when HUD took over management of the ACHA, federal officials began looking for ways to preserve Elmwood and McBride, and as part of studying their options, conducted tests of the water for lead because of the age of both sites. In May 2016, the housing authority contracted with an environmental firm to test water in vacant units at Elmwood and McBride, she said.

Macon said that “all of the results came back favorable except one result” and that one abnormal result “was slightly above the elevated level, but just slightly.” At that time, HUD officials managing the ACHA sent out fliers and notices to families letting parents and others know that testing services were available at Southern Seven Health Department if they had concerns for themselves or their children about elevated blood levels, she said.

“The housing authority did not receive any confirmed reports of children or families or adults with elevated blood levels,” Macon said.

Macon said the housing authority contracted with a different firm to conduct further testing this past March as the agency prepares for demolition of the complexes. In the March 2017 testing, of the 11 units where the water was tested at Elmwood, five tested at or above the EPA’s action level. Of the 11 units tested at McBride, eight tested at or above the EPA’s action level.

HUD says lead levels ‘not an emergency’

Though no amount of lead is considered safe for human consumption, the EPA’s action level of 15 parts per billion in drinking water is not a health-based standard. Studies suggest that in most adults, lead-contaminated water near the action level is not likely enough to cause illness, though it could affect the health of unborn babies if consumed by pregnant mothers, as well as infants and some other children age 6 and younger. Frail seniors in poor health also are at risk.

“The water is safe to brush your teeth, take a bath, cook, do all of those things,” Macon told the residents at the mid-April meeting. She described the lead levels the test found in the water as slightly elevated but not as such that they would “cause an emergency.”

“We have not received any confirmed reports of anyone being exposed to lead through water. So everything we are doing is precautionary,” she said. Shortly after the announcement was made about installing filters at Elmwood and McBride, HUD officials decided to install them in all of the ACHA’s complexes in Cairo and nearby Thebes.

An aide to Duckworth said the drinking water quality of ACHA residents is a particular concern for Duckworth. In March, the freshman senator was tapped to serve as the ranking member of the Environment and Public Works Subcommittee on Fisheries, Water and Wildlife, which includes among its tasks preventing lead contamination of water systems.

“It is widely known and accepted that there is no safe level of lead and that lead hazards present an urgent health and safety threat to children,” Duckworth and Durbin wrote in their recent joint letter to Carson. “Exposure to lead results in significant health, neurological, behavior, intellectual and academic impairments. Although children are primarily at risk, lead poisoning is also dangerous for adults, specifically seniors.”

Brown said that the letter had been received, and that the mitigation efforts addressing many of the senators’ concerns already underway. 

Water filters were installed at the Elmwood and McBride complexes in April, and installation began May 3 for the other units in the ACHA’s housing portfolio, including complexes for seniors, people with disabilities, another family housing site in Thebes and the ACHA's scattered sites. Brown said Wednesday that 373 water filters have been installed, including a final 36 filters installed at the housing complex in Thebes on Tuesday, completing the job. Brown said that "in an overabundance of caution" HUD officials decided to provide water filters for all public housing units prior to any additional testing. 

The city’s water, which is supplied by American Water Co., did not test positive for lead, leading officials to believe the cause could be caused by the joints of the copper water pipes. Lead containing solder for copper piping was not banned until 1986, more than 40 years after Elmwood and McBride were constructed. The water and paint lead tests were conducted by Louisiana-based ATC Group Services. HUD provided the results to the newspaper last month.

Also recommended: lead paint mitigation

In addition to the lead test results, also provided to the newspaper was a summary sheet for the agency’s lead-in-paint review from HUD’s Office of Lead Hazard Control and Healthy Homes.

That document stated that the ACHA provided limited and incomplete documentation indicating compliance with HUD’s Lead Safe Housing Rule — which went into full effect in 2000 — for Elmwood and McBride. The summary indicates that the only records available predated the Lead Safe Housing Rule. Records indicate that in 1993, lead dust testing during paint abatement work identified lead-based paint chip samples. “The report does not indicate specifically where work was completed,” the summary states. The contracted was listed as Leroy Paint and Schemel Construction.

A 1994 single page letter indicated that lead abatement was conducted on several surfaces at McBride, including interior doors and window frames. In 1995, ACHA issued a certification of completion to Schemel Construction for lead-based paint abatement totaling $376,407.

This spring, ATC Group Services completed its lead-based paint inspection reports for Elmwood and McBride. The results confirmed lead-based paint on metal stair risers and stair stringers property-wide in both complexes, the summary indicates. Lead-based paint also was found at Elmwood Place on one percent of ceilings; three percent of closet shelf supports; and seven percent of door jams, though not at a level to indicate the presence of lead-based paint on these components across all properties, the summary indicates.

The summary concludes with a finding that lead-based paint is present in both properties, and is primarily limited to metal stair systems. The lead is likely in the original factory applied corrosion coating or primer. Because deteriorated paint was noted on several stair systems, it is considered a lead-based paint hazard, and HUD’s Office of Lead Hazard Control and Healthy Homes therefore recommended the ACHA take immediate action to repair deteriorated paint.

Cairo is a high-risk area for lead poisoning

The state rankings that make Alexander County a top concern for lead poisoning in children were based on a number of factors. Those factors include poverty rates and the percentage of homes built pre-1978, given that the federal government banned the manufacture of lead based paint for residential use in 1978. It also includes the prevalence of children who tested with blood lead levels above 10 micrograms of lead per deciliter of blood, which Kert McAfee, lead program manager for Department of Public Health, said is the state’s regulatory response level that would trigger a public health intervention.

In those instances, a local health department nurse responds with a home visit, which includes education and outreach efforts to mitigate risks, McAfee said. Four percent of children in Alexander County tested at or above that level in 2015, which was significantly higher than the state’s average of 0.8 percent, and was the second highest percentage in the state, behind only Mason County in central Illinois. Though, the sample size in Alexander County was relatively small, comparatively.

There were 126 children in Alexander County tested that year, meaning about five children would have had blood levels prompting a home visit. Another 5.6 percent — or 7 children — tested above the Centers for Disease Control and Prevention’s recommended intervention level of five micrograms per deciliter.

The report does not indicate whether the children with elevated levels of lead in their blood live in public housing. Though nearly 200 children live in Elmwood and McBride, the housing stock throughout Cairo is aging. Because the state considers the region high-risk, it is a requirement that children age 6 and under are tested for lead exposure.

McAfee said efforts are afoot to change the state’s regulatory response level prompting case management to five micrograms per deciliter, in line with CDC recommendations. Doing so would require additional state dollars to fund the additional case management and environmental service efforts, he said. 

HUD also has continuously updated its regulations regarding lead testing and mitigation in public housing. In February, the agency issued a final rule on Lead Safe Housing, lowering its action level from 20 to five micrograms per deciliter. 

The rule states that when a child under age 6 living in government-assisted housing has an elevated blood level, the housing provider will have to test the home and other potential sources of the child’s lead exposure within 15 days and ensure that hazards from lead-based paint, dust or soil are controlled within 30 days.

The local housing provider also is required to report the case to HUD so that federal oversight officials can ensure that follow-up is completed on time. It is estimated that the rule covers about 500,000 homes built prior to 1978 and that have children living in them.

It is known that lead does interrupt the process by which neurotransmitters in the brain send signals across brain waves, causing potential challenges for a child’s development, said Dr. Sameer Vohra, executive director of the Southern Illinois University School of Medicine’s Office of Population Science and Policy.

In updating its lead response policy, HUD wrote that childhood lead poisoning has long been documented as causing reduced intelligence, low attention span and reading and learning disabilities; it has additionally been linked to juvenile delinquency, behavioral problems and many other adverse health effects.

Still, medical research is inconclusive as to what degree exposure to small amounts of lead over a long period of time may affect a child’s brain development, said Vohra, who also is an assistant professor of clinical pediatrics and medical humanities at the SIU School of Medicine, based in Springfield. “We think overall, medically, that it’s going to have effects and the more sustained exposure the more effects that may occur over time,” he said.

In most instances, people are not medically treated unless they have elevated levels of 45 micrograms per deciliter, a stage at which they are likely to display outward signs of lead poisoning such as shaking or delirium. In today’s society, it is rare for someone to have lead levels in their blood that high. But it is quite common for it to show up in children at levels above five and 10 micrograms per deciliter, Vohra said.

The medical response at those lower levels, he said, is most often a risk reduction strategy to reduce or eliminate the lead exposure risk for children or vulnerable adults with elevated blood lead levels. But there are often barriers to removing the risk of exposure, such as an inability to afford to move or pay for home repairs.

“These are increasing challenges,” he said, noting the SIU School of Medicine is at the center of discussions about improving living conditions in its 66-county coverage area through the state’s central and southern regions, which includes Alexander County.


On Twitter: @MollyParkerSI ​



Molly Parker is general assignment and investigative projects reporter for The Southern Illinoisan.

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