The state’s battle with lead paint is far from won

Nina Bagby, 1, who had an elevated lead level, hangs out in the kitchen of her family’s home with her dad close by. Pat Greenhouse/Globe staff

Nina Bagby, just 1 year old, had lead in her system. The Centers for Disease Control and Prevention considers five micrograms per deciliter of blood a “level of concern”; little Nina’s was six.

“We were surprised and couldn’t figure out where the elevated lead level came from,” said her mother, Hannah Ireland. She, husband Rick Bagby, Nina, now 2½, and her older brother, Elliot, 5, live in a 195os Sherborn Cape the family bought in 2013.

“We thought that she must have been exposed to lead paint at my parents’ house in Vermont,” Ireland said. “But, in fact, she got that exposure right here at home. When we had the house tested, we found we had lead paint on the exterior and, on the inside, on all our doors, the trim, and on the kitchen cabinets. It was everywhere but in the living room and the bedrooms.”

A heavy, soft metal, lead has countless industrial uses, including in batteries and bullets. It was a primary ingredient in water pipes, solder, and paint until its use in those products was banned. “Numerous studies have documented correlations between childhood lead poisoning and future school performance, unemployment, crime, violence, and incarceration, making lead exposure an important social determinant of health,” the state Department of Public Health noted in a brief released in June.

Massachusetts has the fourth-oldest housing stock in the country, and the state considers lead exposure a significant health risk to children here.

“The Romans recorded the effects of lead on many of the body’s systems,” says Wendy Heiger-Bernays, associate professor of environmental health at Boston University’s School of Public Health. “We have certainly known about its dangers for a long time.”

Despite centuries of knowledge, its use in house paint was not banned for sale in the United States until 1978. Still, only roughly 10 percent of Massachusetts homes built prior to that year have been inspected and/or deleaded, according to the state, but some work may have gone unreported. By state law, sellers, realtors, and landlords are required to share known information about lead on property.

“Lead paint lasts for years,” said Doug Hanna, cofounder of S+H Construction in Cambridge. “The paint industry fought legislation banning lead for years. In Great Britain, they outlawed it in 1913.”

There is no safe level of lead exposure, the state says. The law requires that all children be tested between the ages of 9 and 12 months, again at ages 2 and 3, and – if they live in a high-risk community — again at age 4. Screening results in 2015 indicated that 3,737 children in the state may have blood-lead levels that require case management, the state reported. Sixty-four had levels so high they were legally considered “lead poisoned.”

“Even very low blood-lead levels may contribute to great, irreversible damage in the brain, affecting neurodevelopment,” Heiger-Bernays said. “It is dangerous for all, but children under the age of six are especially susceptible because of their rapidly developing brains.

“They put everything in their mouths,” she said, “and lead paint chips taste sweet. . . . Pregnant women exposed to lead will expose the fetus where the brain and other systems are rapidly developing. [It’s] particularly important for pregnant women and young children not to be living in homes where renovations of lead-painted surfaces occurs.”

High-risk remediation must be carried out by a licensed deleading contractor. State law allows homeowners and their agents to do low- to moderate-risk work, such as removing shutters and doors and covering lead-based paint with a special, approved liquid coating on surfaces that don’t get a lot of wear and tear. You have to read a booklet and take an at-home test before you’re even allowed to apply it, though.

Ireland and Bagby turned to Affordable Construction & Deleading Co. of Braintree, which tented the house while remediating the exterior paint. On the inside, they taped and covered all the windows before removing the lead paint there, cordoning off the areas that weren’t affected with heavy-duty plastic. The family went on vacation while the work was being done.

While lead cannot be absorbed through the skin, it can ingested or inhaled in the form of dust. According to Heiger-Bernays, lead dust is far more pernicious than many assume. Lead paint on a window sends up small clouds of lead dust every time the window is raised or lowered. “So much lead exposure happens when people do renovations,” she said.

A 2010 federal law requires workers to be certified and trained in the use of lead-safe work practices, and stipulates that renovation, repair, and painting firms be certified by the Environmental Protection Agency. Additionally, contractors performing renovation, repair, and painting of dwellings built prior to 1978 must be trained and licensed or certified by the state Department of Labor Standards.

As the water crisis in Flint, Mich., demonstrates, lead presents an ongoing danger to countless families, not only in paint, but also in the form of the pipes that bring water into their homes. And, while the dangers of lead were known, it was not until the late 1970s that medical professionals were able to measure levels accurately, and it wasn’t until the early ’90s that low levels of blood lead were measurable. Lead is still found in such products as toys and ceramics, typically those that are imported. It is also found in batches of the spice turmeric, Heiger-Bernays said. “The lead paint lobby was quite strong.”

House painting also produces long-lasting lead hazards, particularly when old lead paint is scraped from exterior siding. Old houses, repainted multiple times before 1978, are often surrounded by a toxic field of lead-infused soil.

“Lead in the soil is tracked into the house. It gets into the soil along the house’s dripline every time it rains and lead leaches from the paint,” Heiger-Bernays said. “I strongly recommend that homeowners who plant gardens locate them at least three feet away from the dripline of the house. Better still, build raised beds and bring in lead-tested fresh soil.”

Nina Bagby was retested six weeks after her initial blood screening; the lead level was the same. To help her body reduce lead absorption, her pediatrician recommended an iron-rich diet and prescribed supplements. After their home was deleaded, her lead level was down to three micrograms per deciliter. It has remained there.

The national average cost for abatement is around $10,000, according to the Environmental Protection Agency. (The state offers tax credits and zero- to no interest loan programs for lead paint abatement for owners who qualify, and funding through the US Department of Housing and Development may also be available in certain communities.)

Nina’s family did not receive federal or state funding.

“We said when we bought the house that we would remodel the kitchen eventually,” Ireland said. “This prompted us to do it sooner than we planned.”

With design help from Christine Fleskes of Longlook Kitchen & Bath in Dover, they installed a stylish and functional room featuring soapstone counters, dark green cabinets with black bar pulls, an apron farmhouse sink, subway tiles, new oak flooring, a large window over the sink, and a door to the backyard. To save money, they reused their existing appliances.

“Chris made it all work,” Ireland said. “She made sure that the remediation and the new construction blended. Now our house is opened up to the outside, and the kitchen is just what we wanted.”

They have something else that may prove very valuable if they decide to sell their home: a certificate that attests that their house is totally lead-free.

The kitchen before the renovation and lead abatement. Hadrien Dimier Photography

The kitchen afterwards. Hadrien Dimier Photography