Even as U.S. children’s blood lead levels are at an all-time low, a new report says reducing them even further could yield billions of dollars in benefits.

Most lead exposure comes from lead paint, gasoline deposits in soil and lead water lines. Preventing all lead exposure of children born in the U.S. in 2018 could yield $84 billion in benefits, according to a report published Wednesday by the Health Impact Project.

That would come from higher lifetime earnings, lower spending on education and healthcare and longer life expectancy due to reduced lead exposure.

One of the recommendations is that the U.S. Environmental Protection Agency require utilities to submit plans to replace all lead service lines. That would cost about $2 billion, and it would offer $860 million to $2.7 billion in benefits.

“These interventions pay for themselves.”—Rebecca Morley, director of the Health Impact Project

“These interventions pay for themselves,” said Rebecca Morley, director of the Health Impact Project, a joint effort of the Pew Charitable Trusts and the Robert Wood Johnson Foundation.

The recommendations in the report aren’t new, but the cost-benefit analysis is. Many of the suggestions aren’t in practice in New Orleans.

Between paint, soil and water, New Orleans “has a lot of sources,” said Adrienne Katner, principal investigator with the New Orleans Lead Exposure Assessment for Drinking Water Project and an assistant professor at Louisiana State University’s School of Public Health.

Airplane fuel is the greatest ongoing source of lead emissions into the air, according to the report. The report estimates that shifting to unleaded fuel would reduce lead exposure of the 226,000 children around the country who live about a half-mile from airports.

The researchers found that poorly maintained houses built prior to 1960 and occupied by low-income families have the highest risk of lead hazards.

Children are more susceptible to lead poisoning. There is no safe level of lead, and over the past 40 years the U.S. Centers for Disease Control and Prevention has reduced what’s deemed an acceptable level in children.

In the early 1970s, the acceptable level of lead was 40 micrograms per deciliter, close to the level that now triggers medical intervention. Now it’s 5 micrograms per deciliter. The CDC is considering lowering it to 3.5.

The report says most of the financial benefit of reducing lead exposure would come from bringing down blood levels in children who would otherwise have 2 micrograms per deciliter or less — not a particularly abnormal level.

Children exposed to lead are more likely to be convicted of a crime, become pregnant as teenagers, have lower IQs, develop ADHD and behave impulsively.

That exposure results in lower lifetime earnings, higher healthcare costs, more expensive teaching services and lower tax revenues, according to research.

$10 billion to eliminate lead paint hazards in all houses built before 1978

Nationwide, about 75 percent of homes built before 1960, and half of those built before 1978, have lead-based paint and need remediation, according to the study.

The U.S. Department of Housing and Urban Development estimates that 3.6 million homes with young children contain lead hazards.

The report recommends removing all lead paint hazards from housing built before 1960, as well as childcare facilities, schools and other places frequented by children.

Remediating lead paint in homes built before 1960 would cost $8.4 billion and would yield $0.97 to $1.39 in benefits for each dollar spent, according to the study. There’s a greater benefit for homes with low-income residents.

It would cost $10.3 billion if the effort were expanded to all homes built before 1978, with a similar cost-benefit ratio.

3.6MHomes in the U.S. with young children have lead hazards$8.4BTo deal with all lead paint in U.S. homes built before 1960

The researchers found that poorly maintained houses built prior to 1960 and occupied by low-income families have the highest risk of lead hazards.

Sixty percent of New Orleans houses were built before 1960, and about a third of residents live in poverty, according to U.S. Census data. It can cost $10,000 to deal with lead paint in a home, according to the report. To help foot the bill, researchers recommend increased public funding for lead remediation and inspection programs.

Children at risk in older rental properties, improperly renovated homes

The report suggests that state or local governments require housing inspections and remediation of lead hazards when any home is sold, rented, or financed.

The EPA requires sellers of homes built before 1978 to disclose any lead hazards to buyers, but it does not require an inspection.

Louisiana has no lead-hazard inspection program for privately owned rental housing, except in cases of childhood lead poisoning.

In New Orleans, a proposal to create a registry of rental units and conduct safety inspections stalled last spring. Those inspections would not have addressed lead paint, according to a draft of the ordinance.[module align=”right” width=”half” type=”pull-quote”]In New Orleans, a proposal to create a registry of rental units and conduct safety inspections stalled last spring. Those inspections would not have addressed lead paint.[/module]

Public housing units in the U.S. are subject to periodic inspections, but they include only visual inspections for chipped or peeling paint. Children also can ingest lead from household dust, water and soil.

Renovating, repairing, and painting older homes can expose children to dangerous levels of lead dust, according to research.

The EPA has rules on lead-safe renovation, but “federal oversight is severely underfunded,” the report says.

Enforcing lead-safe certification requirements for contractors could cost $1.4 billion annually, the report says. It would yield $3.10 in benefits per dollar invested for children born in 2018.

While contractors are sometimes at fault, some studies have concluded children are at higher risk of lead exposure from “do-it-yourselfers” who aren’t trained in lead-safe practices, according to research.

Scraping, power sanding, and using heat guns to remove lead paint can create lead dust and fumes that endanger children.

The report says children can be protected from exposure by educating people who are renovating their own homes.

New Orleans city ordinances require dust containment barriers when sanding, grinding, sandblasting or pressure-washing, but enforcement sometimes comes after children are already exposed.

Replacing all lead water lines would cost $2 billion

Buildings built before 1986 are more likely to have lead service lines, and corrosion of those lines causes lead to leach into drinking water.

The EPA estimates drinking water accounts for 20 percent of lead exposure, and up to 60 percent among formula-fed babies.

The report estimates that replacing lead service lines would cost $2 billion nationwide and yield between $0.42 and $1.33 per dollar spent, depending on how much lead there is in the water.

25%Of children in New Orleans were tested for lead in 201511%Of them tested high for lead

The report recommends replacing the entire service line, including the portion on private property. Homeowners are typically responsible for the portion of the water line downstream of the water meter.

The study also recommends utilities provide water filters after that work because replacing lead water lines can temporarily dislodge lead into the water.

The Sewerage & Water Board of New Orleans has no record of where lead service lines are.

A city spokeswoman has said the utility is doing an inventory of the city’s 140,000 or so service lines to determine which are made of lead.

In a recent report, Inspector General Ed Quatrevaux warned that roadwork can elevate lead levels in city water. His office criticized the Sewerage & Water Board’s communication with customers.

When Sewerage & Water Board workers find lead pipes during projects, they replace them.

Researchers recommend utilities test more homes for lead in drinking water.

In 2016, the Sewerage & Water Board tested water in 107 homes and found lead levels within EPA guidelines. That included the homes of former Executive Director Cedric Grant and five other agency staffers, raising questions about how the agency selected its properties.

The report recommends the EPA require schools and childcare facilities to test their water supplies. The Lens reported last week that New Orleans’ two school districts abandoned plans to test water last year and now plan to install water filters.

Louisiana is in compliance with the report’s recommendation that all children under six years old are tested for lead.

But in 2015, only a quarter of Orleans Parish children were tested. About 11 percent of children tested had blood lead levels at or greater than 5 micrograms per deciliter, at which children are likely to develop behavioral disorders.

The report also recommends stepping up educational help for children exposed to lead, although it doesn’t estimate the cost or benefit of those interventions.

It says children with elevated lead levels who participate in early- and middle-childhood interventions tend to have higher high school GPAs and lifetime earnings, and they’re less likely to become teen parents and be convicted of crimes.

Kerry Nix

Kerry Nix was a staff writer for The Lens. Her work previously appeared in Pittsburgh