As a summer intern with the Washington Department of Health, UW SRP trainee Megumi Matsushita's job was to assess an array of state and local primary prevention programs for childhood lead exposure.
Lead is famously toxic, especially for children. No amount of lead exposure is safe. It can damage almost every organ and system in the body; it lowers IQ; and it's strongly associated with learning and behavior problems. Many of lead's effects can be irreversible. For all these reasons, reducing exposure to lead, particularly during early childhood, is of enormous public health significance. To this end, public health agencies have an important role to play in designing and implementing effective policies and programs.
In 2016, Washington Governor Jay Inslee issued a directive to the Washington Department of Health (DOH) to reduce lead exposure through drinking water in Washington State. In response to the directive, DOH has partnered with schools, daycares, landlords and Public Water System Operators, among others to generate solutions that will help prevent lead exposure. At the same time, DOH is working with agency partners to improve monitoring and to find resources for upgrades to public water systems. At each step along the way, evaluating the success of the program is critical.
Since starting as an intern with DOH over the summer of 2021, UW SRP trainee Megumi Matsushita's job has been to review national, state, and local primary prevention programs for childhood lead exposure to make recommendations for Washington’s Childhood Lead Prevention Program. We asked Matsushita about her experience.
Q: What have you found so far?
A: We found that agencies across the board acknowledge the need for primary prevention, meaning preventing children’s exposures to lead altogether. However, most states, including Washington, focus on secondary prevention, which involves testing for lead in kids and treating kids with elevated blood lead levels. So, the question we wanted to answer is, what could DOH do to move forward with primary prevention strategies?
I conducted a few key informant interviews and researched existing policies and academic literature to find answers. My work will be used by DOH to inform decisions about future childhood lead poisoning prevention programs in Washington State.
Q: Have you uncovered any promising leads?
A: One policy intervention of great interest to us is increasing the enforcement of the Environmental Protection Agency’s Renovations, Repair, and Paint rule. It has been well documented that housing older than 1978, when lead-based paints were banned, poses a higher risk of exposure. Kids love to interact with their surroundings by touching and mouthing things, which can result in lead poisoning in children. EPA passed the RRP rule in 2010 for safe renovation activities involving lead-based paints. It set training requirements, standards, and enforcement mechanisms for renovations in pre-1978 buildings. A national study found that each dollar invested in enforcement of the RRP rule would have a return of over 3 dollars of benefit to society. My findings will be used by DOH for formal economic analyses and to eventually make a case to the legislature to fund primary prevention programs.
Q: Have you learned any valuable lessons through this experience?
A: This internship has been an invaluable experience in public health, where decisions have consequences on the health and lives of people. A key finding of my work is that local health jurisdictions are often better equipped to handle lead prevention programs than the state. There is a limitation to what the DOH can do—for example, Department of Commerce enforces the RRP rule, not DOH. The state, therefore, must build partnerships with local health jurisdictions, other government agencies, and local community groups for capacity building.