t music) - [Announcer] This is a Milwaukee PBS, Listen MKE special presentation.

- Welcome to another installment of Listen MKE in partnership between the WUWM Milwaukee's NPR, The Ideas Lab at The Milwaukee Journal Sentinel, Milwaukee Public Library and Milwaukee Public Television.

I'm Investigative Solutions Reporter Talis Shelbourne with Milwaukee Journal Sentinel and I will be co-hosting with Environmental Reporter, Susan Bence of WUW Milwaukee's NPR.

- So glad to be with you Talis.

We are here with two guests, Dr. Veneshia McKinney Whitson.

She's a family medicine physician and assistant professor at the Medical College of Wisconsin's department of family and community medicine.

Dr. McKinney Whitson is also the director of All Saints Family Medicine Residency in Milwaukee and the director of both community medicine and maternity care.

She's a very busy person.

We're also joined by Deanna Branch, a wonderful mum, parent of a child who's been affected by lead and is an advocate for identifying and eliminating lead poisoning and being, she's also a resource for other parents.

- Yeah we're gonna start with Dr. McKinney here.

So what are some common sources of lead poisoning and how can people best avoid them?

- Yeah, that's a great question.

So, you know, we learn a lot, we know a lot about lead in the water as well as lead in paint.

And so those are some of the, some of the major sources of lead for our community here in Milwaukee.

In Milwaukee's North side area, we have about 70,000 lead pipelines in Milwaukee.

So that is a source, that is a big source of lead for our Milwaukee children.

Also soil, so we, we think about water, we think about soil.

Soil, being that a lot of these homes that have lead paint and are you know, whether they've been had abatement or if they've had any kind of reconstruction or any renovation, and that lead that is on the exterior of the house or even on an interior of the house, the exterior house, it causes lead to be in the soil.

And then of course we all know about lead paints.

So before 1977, 1978, that was when we stopped putting lead in our paint.

And so if homes were built before that time, the likelihood of them having lead is very high.

And so when our children are looking out the window or, you know, by the window seal and it's chipped paint, you know by the window or chip paint off the wall, that definitely poses lead exposure to our, to our children here in Milwaukee.

So those are the main sources is soil, paint and water.

You also can get some in inhaled sources which is, you know, just the dust if anyone is doing any kind of renovation in their homes and their home has been built before 1977, 1978, and it's so important that we protect our children by not having them in those, in the home when renovations are taking place because you can definitely inhale lead as well.

- So Deanna Branch, thank you too for being with us and we'd love to have you share a bit about your son's lead story how he was exposed, if you know how that happened.

- Well, I have more understanding now how it happened.

It was a shock to me.

It wasn't until the routine finger poke at the WIC office that I realized how severe and exactly what, know what's going on with him.

I just talked about that as terrible twos because he was so young when it happened but the main source determining by the, the building, the apartment that we were staying in, it was a very old building a lot of lead paint, chip lead paint they found in the window seals, on the walls, layer pipes, the water.

So he definitely was exposed to it from, well for the main aspects of contracting lead poisoning.

At the time, I wasn't aware but now that I'm thinking back in doing my research I definitely could see that the house was a lead magnet.

And it came to the point where, the landlord track through renovations to get rid of the, the paint.

Then we were told to come back into the house after the lead paint and the windows were removed and he contracted lead poisoning again, just from drinking the water.

So it was just an ongoing struggle to the point we had to leave that apartment and find a better housing.

So it was, it was a struggle with him.

His lead got to the point where it was I wanna say up at, or above 60, I guess 10 it will be the highest it could get before it's considered lead poisoning.

Below 10 I believe it's the, it's the standard they want to be a below 10 to consider a child to be, less safe for, not as much in danger, but he had to be hospitalized twice for over a two week period.

It was very, very tough.

- Yeah.

Yeah, that sounds really, really difficult.

And all the things that I wanted to ask you, Dr. McKinney, is what do you think parents should be doing in terms of testing and keeping an eye out for symptoms?

What should they know about that especially... (indistinct) - Right so... Yeah, so Deanna thank you so much for sharing your story.

So I wanna, you know, be clear that no amount of lead in blood is good.

So, you know, we, our goal is for it to be less than one.

We know that if it's greater than five, we can actually see some effects on children.

And that can range from you know, like cognitive, cognitive impairment.

We know, that one in five children that have been diagnosed with ADHD actually have had a lead lead poisoning or lead exposure.

So we know it can really change our, you know, like our, our children in different aspects.

And we know it can cause anemia, it could decrease their hearing, slow their growth.

So in the cognitive function is a big thing 'cause sometimes we think, Oh, okay yeah, like you said, the terrible twos, you know like maybe my child is so like hyperactive or inattentive or impulsive.

And the first thing to think about is ADHD.

But the first thing that I think about as a physician is let me check the lead to make sure that it is less than one.

Being that we know anything that's greater than five can affect children.

So to get back to your question about like what parents can do, I mean, it's being, you know, like have, they're getting educated by their physicians and educating their selves so that they can make good decisions for their children and be a parent advocate.

So for physicians we like to check the lead three, we do this little neumonic that's three by the age of three.

So three by the age of three meaning that we check it at 12 months, we should check it around 24 months and at 36 months.

And of course if it's elevated anytime in between there, then we're gonna check it more frequently.

And then if there has been a child that hasn't had any lead testing in you know by the age of six, then they should get a test at least one time.

So I think parents can, you know, definitely when I go to their well-child visits, talk to their physician, know, you know, know exactly what your child's lead number was like I said you want that to be less than one.

So I think first for sure, parents that's one thing that parents can do.

And definitely if you notice, if you know that you're living in a home that's, that's older than 1977, then you wanna be, you know you wanna watch your children and make sure they're not eating, you know like eating by the window seal or eating the paint.

And one thing is lead, when lead based paint has like I haven't tasted it, but from what I've read is that it has an almond flavor to it.

So it can kind of be very sweet for children, so they will eat it because it's, you know it has a sweet flavor to it.

But I think the main thing that parents can definitely do is just be an advocate for their patients, make sure that they bring that up at their physicians at their well-child visits with their physician with their child's physician.

And then just making sure you're washing, your kids are washing their hands before and after eating even more so with you know.COVID, we're doing a better job on that but continuing to wash your hands before and after eating.

Also when they come in from playing, you know because like I said, you can find lead in the soil.

So if they're outside playing and they want to come in for a snack make sure that they've washed their hands when they come into the house.

And then also if you're doing any renovations, try to you know, like not expose your children to that because like I said, it can't be inhaled.

- So Deanna, you know, parents have so much to juggle and clearly the advice that Dr. McKinney has given is sound.

When you think back on your experience and what you've learned since your son's contamination you know, what do you want fellow parents to know?

- I just want them to know there are resources.

My church was a main resource for me.

One of my son's lead poison got to be severe.

There was people from the lead programs come by my house and do an inspection.

At first it was just like letters and just pamphlets I would get.

But once his lead became more severe, I've got more help.

So I felt like parents would just be more aware and to seek out additional resources and do their research on their own to learn more about the causes and effects of lead poisoning.

And the most support thing is just to be more patient with your children and understand it's a process for them as well, that you're going through it's just, be more patient with them and be supportive.

- Dr. McKinney is, do you think the pandemic I know you mentioned this has exacerbated lead exposure?

And if so, how?

What are some of the things that you're seeing?

- Yeah, I mean, that's a great question 'cause COVID has affected us in so many ways, but it definitely has it's affected lead poisoning or lead exposure in a couple of ways, number one, children are at home now.

I mean, not everyone is back to school.

I guess some districts are going back, but kids are in, at home a lot more.

So that means that if their home allows, it has a lot of lead in there, in the paint, in the water, and they're at home more frequently, for a longer duration of time, then that means that their exposure can be higher.

The other thing is because when COVID hit we rightfully so wanted to protect our children.

So a lot of physician's office we kind of halted some of our well-child visits because if the child was doing well, we didn't wanna expose them to COVID or other people that, we didn't want to expose them to COVID and put them in that situation where they ended up being quarantined or they get negatively affected from coming into our office.

So with that being said, we held a lot of our well-child visits and lead testing is something that you usually do at a well-child visit.

So your routine checkup with your pediatrician or your family physician, and, you know, we go through all of growth charts, we discuss what we can do to improve the child's health care.

But one thing is we do tests lead.

And being that we weren't bringing our children in, we weren't testing lead.

So I know in Milwaukee we're down by like I believe like 30% of testing here in the city of Milwaukee.

And I think just some research I've done across the United States.

We just haven't been testing our children as much for lead because of COVID.

So it has, COVID has negatively affected the care that we are providing children in that aspect.

- So we want you to know you're watching an event from Listen MKE which is a partnership between WUWM Milwaukee's NPR, The Idea Lab at Milwaukee Journal Sentinel, The Milwaukee Public Library and Milwaukee Public Television.

I think Talis you have a listener question?

- We do and they, the listener wanted to know if all providers, so like All Saints 16th Street Clinic, if they check all pregnant women and children for lead, essentially they wanna know if it's routine and if not, why not?

- Yeah.

So great question.

So yeah, we routinely check children for lead.

Like I said, we check at 12 months, at their one-year visit, at the 24th month visit and the 36 month visit.

And then of course in between if one is elevated, then I might check, you know someone, the child's lead a little bit sooner or if someone else in the household had tested positive for lead then I will check all of those children, even if they're out of that range of the, you know, one, two year olds so it is routine.

When it comes to pregnant women, it's a little bit different.

We do know that pregnant women that have been exposed to lead, it has been shown that it can have some effects on their fetus.

But some of our organizations that we get guidelines from look at risk and benefits and unless mom is having a symptomatic or if she has a child that has been exposed to lead or we know that she is living in a home where there is a high lead exposure.

then we can definitely test the pregnant woman.

But routinely like said, if you came into the office and you were pregnant and you were getting your prenatal labs, I wouldn't necessarily test you for lead unless after we had a conversation, you explained to me like, Oh yeah, my other children have been exposed to lead and their numbers have been high or I know for sure, you know, like my house is connected to a lead pipeline then unless you gave me more reasons then I wouldn't routinely check you for lead.

- So Deanna, another question has come in and this one's for you.

This person asked, how do you take care of yourself, your health and wellbeing when you're so busy caring for your sons now do you have two sons?

- Yeah.

I have two boys and I obviously had to deal with my own health issues as far as stage four kidney failure.

So Aiden's diet that he's on for his lead, it's actually helping me as far as eating better, healthier no more sodas, juice, junk food.

I got a pamphlet that said like a lot of junk food and other processed foods are you know, high in lead.

And I want him to get more iron rich foods because of the lead, he does have ADHD down and also anemia.

So his diet is definitely different but it's a lot better now.

And he's actually, I'm leaning more towards being a vegetarian or vegan and so his diet has definitely changed and improved my health and my other son's health too also struggling with weight issues.

So it actually improved our lifestyle and our health overall.

- It is so important that we, you know like we are feeding our children, iron rich foods.

So the dark green leafy vegetables, things that are iron enriched.

Also Vitamin C, So Vitamin C is something that I always give to patients when they are iron deficient, because the Vitamin C allows them to absorb the iron even better.

So Vitamin C and then also making sure they have a lot of calcium in their diet.

So those are the, all of the things that I think that is important to share with parents that if your child are lower deficient in these things, it can put them at risk for lead.

And if they've been exposed to lead even more so we should make sure that those Vitamins are right where they should be.

- Gotcha.

And we've got a listener question that I'm gonna combine a little bit with the question I was gonna ask, which is what are some important things parents can do if they have children with elevated lead levels?

One of the things that Candace wanted to know is who they can contact if they need to get their home tested for lead because they think their children are, might be poisoned.

And also they wondering if it can be passed through breast milk if a mother is exposed.

- Okay.

So that's a lot of questions but I can start with the, with the breast milk.

So yeah, it actually can be passed through breast milk but it has to be at such a high level.

So mom's level I believe has to be like greater than 50 to 60 if I'm not mistaken, for it to be passed through breast milk.

So what we'll usually do is, you know, if we know that mom has been exposed to lead and we've checked it and it's greater than 50 to 60 micrograms per deciliter, then we will probably say, you know breastfeeding is not the right thing for you.

Just, it's probably it's gonna be beneficial to the child for you not to breastfeed.

But levels that are lower than that, it's okay to breastfeed.

You just wanna make sure that your diet is high in Vitamin C and in iron as well as calcium.

Now Talis, I'm sorry what was the first part of, what was the first part of the question?

- [Talis] So yeah, it was who she could contact to get a lead tests and she was wondering if it was at the renter's expense or a landlords, which I think is a little bit of a different question in terms of who could answer that for sure.

- Okay.

- [Talis] But yeah.

- I can take a little bit of it.

So, you know, I think getting the resources well getting the resources for testing, you're gonna get that at your doctor's office.

I know some people will go to the WIC office.

And so for, from my aspect, when lead are elevated, there's a protocol that we go through for the Department of Milwaukee we have a Health Department, there is a protocol depending on what level the lead is, depends on what are the next steps?

But once the leads gets above 10, for sure like I recently had a case where someone one of my children, one of my patients lead was elevated and so that meant that, you know I talked to mom, I, yes, the lead is elevated, I tried to get more information of, you know like what was the reason that you know, she's been, she's living in the same home, but you know, these numbers have not been elevated in the past.

So just getting more information.

After getting that information then we retested the baby.

Probably in like a couple of weeks and wanted to see if that number was going up or higher.

In between time, the Milwaukee Health Department was contacted and they gave resources to the patient.

And then also my office gave resources intermittently making sure that, you know, like the Milwaukee Health Department has touched base with mom.

And then when the levels are much higher, I think from my experiences usually is the landlords expense but those are resources that the Health Department can help you with for sure.

- So Deanna, you've rented, I know that you said that you've just recently moved again into the, you're very happy to be in a new space with your sons and we're not speaking about all landlords here, clearly every situation is different, but what was your experience in having a landlord and when your son was diagnosed and then was found to have lead again?

- It was very stressful just to get them to, come out and treat the windows.

They had to be, the Health Department they reached out and did the, I will say a lead inspection lab reports and at the report was they, they pretty much came to the house and did an inspection of all the windows and that's where they found of lead in the paint.

I think in the floor, outside the house to where he played at, as well as the lay up pipe they checked the pipes for lead the water pipes.

It took all of that for the Health Inspector to come out and do a report and send it to the landlord for them to do the first treatment of the windows.

And then I was told that, you know, once he was discharged from the hospital, that he would be safe to return home.

And what the doctor did warn me was that the medicine that he was on to get rid of the lead so fast the succimer made him more susceptible to lead if he was exposed to it again.

So that's the reason why the second time he was exposed it was a lot worse since a lot higher.

And it got to the point where he had to be in the hospital I think right after, right before Christmas it was black Friday he had to call pe-- immediately rushed to the hospital again.

'Cause at that point he was getting routine lead checks because his lead was so high they wouldn't even poke his finger.

They took the blood straight from the vein.

That's why he has a fear of needles now.

So it got to the point where once he was admitted to the hospital again, I think someone from Health Department came to the hospital while he was there and they just, it made me feel awful.

They pretty much said something like we can't release your son to your care again or discharged from the hospital until you can provide a safe place for him.

So I just felt like I was, I thought I was providing a safe place for him.

I felt like it was my fault for paying rent there for going back after he was exposed the first time.

I had to resort to live with family members and I'm finally on my own feet now I'm finally more independent and have my own place now that he's safe.

But once we moved out of that apartment, it was as very stressful, it came with a lot of me skipping out on my rent 'cause I refused to pay rent there for a place that was literally hurting and killing my son.

I felt like I felt like I just left that month and I just charged on my phone from the hospital.

We went stay with family members and his lead improve dramatically, it went down and stayed down.

Is he still technically is lead poisoned?

I believe it's at 21 now, but that's just a lot better than what it was.

So I just feel blessed that we're somewhere safe where his lead is continuously going down.

Once it gets into the bone, they told me it takes a little bit longer for the leads to get out of the body but it's still slowly but surely leaving his bones.

So I'm just so blessed that, it's sad that it took all of that and it came to that, but I'm just glad that we're somewhere safer and that he's doing a lot better.

- Yeah.

So then in, I did wanna ask you Dr. McKinney, because I know you mentioned sometimes parents will stay at a place and it'll be fine but they don't think about their children going to the grandparents' house or to some other place for (indistinct) Can you speak to, kind of just housing in general and being aware of different sources of lead in different areas?

- Yes, yes, yes, yes.

So the thing is, a lot of times you think about, Oh, okay let me see when was your house built?

But if you work every day and your child stays at the grandparents' house and the grandparent's house was built in 1960 then we need to know that.

And I need to investigate that to say, okay that's probably where the lead exposure is coming from.

So I think it's important to ask the question, not only you know, like when did, when was your house built but also all the places that my child spends their time.

What year was that house built?

What, what kind of water supply do they have?

So exposure is everything.

And we can't just, you know like just go down the path of what is at our home but every place that our child goes to, we should think about that as well.

With water, that is a big source of lead and so I would help parents or new moms that are going home, you know make sure that when you're making bottles that you're not using tap water.

So we know that 50% of infants that have lead exposure it comes from parents mixing the formula with tap water.

If you have to use water for some reason, you know then you wanna run that faucet for like in the morning, when you first wake up turn the faucet on, on cold water, do that for 10 minutes.

First of the day just to try to clear out some of that lead.

Also the faucet aerator, so that's like that little, kind of screen that sits up under the faucet.

You wanna make sure that you keep that nice and clean 'cause lead can actually like get stuck on there.

And so every time you were on the faucet, a little bit of that just getting into your glass or you're using that.

The other thing parents sometimes think is, Oh, okay if I boil the water that will make it better for my child.

We know that boiling the water, just concentrates the lead using a filter at home, whether that's, you know like the filter that you put in the refrigerator, you know like you put the water in and it sifts through, you put in the refrigerator or you put it on your faucet, just making sure cause there's a lot of companies out there that I mean, you think, Oh, okay it's a filter should filter out the lead but make sure that it is filtering out lead that is on the label.

So read the fine print.

- Thank you so much, Dr. McKinney.

Thank you so much Deanna Branch.

I appreciate you coming on to share this information with us and yeah, we also wanna thank all of you out there for watching and tuning in.

This has been another installment of Listen MKE, a partnership between WUWM Milwaukee's NPR, The Ideas Lab at The Milwaukee Journal Sentinel, The Milwaukee Public Library and Milwaukee Public Television.

And thank you of course, to my co-host Susan has been great at helping us put this together.

So thank you.

- Thank you.

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