What do you do when your home is poisoning your family with lead?
Lead paint in buildings is a major source of exposure in the United States, with walls, floors and even old furniture producing chips and fine lead dust. Small amounts of exposure to low levels of lead can cause health problems, especially in children.
Rosebud County in southeastern Montana is one of the state’s most sparsely populated. Aubrianne and Casey Kluver live here, about 16 miles from Colstrip, with their four kids – ranging in age from 10 months to 8 years. Their family owns and operates a multi-generational cattle ranch. Casey is also a fence-building contractor and pastor of a church. Aubrianne homeschools and handles marketing for their beef sales.
Their home, built in 1915, sits tucked away 14 miles down a gravel road. Inside, the kitchen and dining area open into a cozy living room where the kids play with toys and hang upside down from fabric swings attached to the ceiling. Their eight month old daughter hiccups in her high chair and takes in the scene.
“This was my great grandfather's place,” Casey Kluver says.
The Kluvers’ two oldest, 8-year-old twins, were exposed daily to a minuscule amount of lead for the first 13 months of their lives. The source was paint from this house.
“The dust on the dog's feet – they dropped their toy, on an averagely clean floor, and they get lead poisoning,”Aubrianne says.
It doesn’t take much lead to create a risk
“They say, like, a sugar packet could contaminate an entire gymnasium,” Casey Kluver says. “We found out and realized it was the house, we moved out.”
More than half of Montana homes were built before 1980, and many of them were painted with lead-based paint before it was banned in 1978.
Home renovations are a culprit for lead exposure, but simply opening and closing lead-painted fixtures like windows and doors can also generate a hazard. And some babies and toddlers are drawn to eating paint chips because they taste sweet.
Casey’s family home required intense renovation.
“We had painstakingly taken each piece of trim off and labeled it like we're gonna keep it because we're in our 20s and we're ranchers and so we need to save every penny,” Aubrianne Kluver says.
They moved into the house two weeks before the twins were born.
“You just love them with your whole heart and if I had it to do again, I wish I knew how little it took to have exposure.”
“We got the house where it was, like, you could live in it,” Casey Kluver says.
“They were just hard babies and they were having a bunch of issues in their diapers, like mucousy stools and stuff like that,” Aubrianne Kluver says. “And I was like, ‘I just feel like something's not right.’”
They took the twins to three doctors before making an appointment with a pediatric specialist in Billings.
“Their iron was so low, he's like, 'I also want to run a lead test,'” Aubrianne Kluver says.
Low iron levels can indicate a problem with lead. Bone-building receptors in the body have a hard time differentiating between lead and actual nutrients like calcium and iron. So, the body fails to identify lead as foreign or toxic, absorbing it into bones and leaching it into the bloodstream.
“And so that's when we found out that my daughter's was 11 and my son’s was 14-and-a-half,” Aubrianne Kluver says.
Aubrianne’s referring to how many micrograms of lead were in each deciliter of her children’s blood. There’s no safe level, but the Centers for Disease Control and Prevention has established a limit of 3.5 micrograms per deciliter. So the Kluver twins had high levels. Lead exposure can lead to a host of health issues even at low levels, like nervous system and brain damage, lower IQ scores, hearing loss and difficulty concentrating.
“And so that's when it kind of went from this internal, like, something's wrong, my babies are fussy, this is really, like, arduous and hard to, we don't know what to do,” Aubrianne Kluver says. “And then nobody else knows what's going on, and how to walk through it with us emotionally, but also, like, practically.”
Screening can be spotty
Blood lead tests above the CDC’s action level are reported to the county and state health departments. A county nurse followed up with the Kluvers and told them they were the first documented local case in over a decade.
“You're telling me we’re the first case in Rosebud County in 13 years?” Aubrianne Kluver says. “Like you just haven't been testing anybody.”
Eleven states mandate blood lead tests for all children. Montana’s not one of them. Medicaid requires that all enrolled children get tested for lead in their blood at 12 and 24 months, but half of U.S children are not on Medicaid. This patchwork of policies creates concern that lead-exposed kids are being missed.
Dr. Patricia Notario, a pediatrician, works at the Billings Clinic.
“The American Academy of Pediatrics recommends that every child at 12 months and at 24 months be evaluated at minimum with a set of screening questions to assess their degree of exposure,” Notario says.
Developmentally, this is when kids are crawling and walking and exploring the world by putting everything in their mouths. So they are more susceptible to coming in contact with lead dust.
“But that also requires that their caregivers be aware of whether or not lead is something that they have in their home,” Notario says.
A pediatrician might ask a caregiver screening questions: Has your child had frequent exposure to a home built before 1978 that’s been in recent repair? Or has she had exposure to a person who has a job or hobby that involves working with lead? Do they have access to toys made in other countries with lead-based paint? And in Montana, do you hunt or fish with ammunition or tackle that contains lead?
Only if there’s a positive answer to any of the screening questions is it recommended that kids have their blood tested. Sometimes the screening misses sources of potential exposure, as it did with the Kluvers. They thought the paint in their house had been dealt with, so the nurse checked no on the form.
It's not easy to clean up
“I had awareness that was probably lead paint outside,” Casey Kluver says. “We never put the kids down outside.”
The Kluvers knew the house was built in 1915. Lead paint doesn't look different from other paint except that when it degrades it creates a pattern that looks like alligator scales. Another sign is production of a chalky residue when it rubs off.
“I would say easily, it's the biggest trial we've ever been through. I put hundreds of hours in restoring this house and I was like, alright, it's gonna be this safe, super fun big house for my kids to grow up in, you know. I did all this work to try and create this life for my kids and it was actually attacking them.”
Casey took numerous steps to get lead paint and dust out of the house. He also removed all of the nearby topsoil. Eventually, the Kluvers moved back into their home.
“So we spent our weekends wiping this house down, over and over again for months and months,” Casey and Aubrianne Kluver say.
It took several years for the Kluvers to get the house to a manageable state. Over the course of a year, the twins’ blood lead levels slowly dropped. At around three years old their tests came back negative. The Kluvers’ next child born soon afterward never tested positive for lead.
“I would say easily, it's the biggest trial we've ever been through,” Casey Kluver says. “I put hundreds of hours in restoring this house and I was like, alright, it's gonna be this safe, super fun big house for my kids to grow up in, you know. I did all this work to try and create this life for my kids and it was actually attacking them.”
Bruce Lanphear is a public health physician and professor at Simon Fraser University in Canada. His work focuses on early childhood health, environmental neurotoxins and lead poisoning.
“If I could help prevent childhood lead poisoning, maybe I could at least take away an obstacle that kept children from thriving in today's society,” Lanphear says.
The U.S. Lead Based Paint Hazard Reduction Act of 1992 inspired his first study on lead poisoning prevention, “Which was to measure what levels of lead house dust are dangerous for kids,” Lanphear says. “Because up until that point, we basically used children as biological indicators of substandard housing. Actually, we still do, because these tools have not been deployed, even though we've had them for 25 years.”
Lead continued to be used in paint through most of the 1970s, and wasn’t fully banned from gasoline in the U.S. until the 1990s.
“Blood lead levels have come down by over 95% since the 1960s, 1970s,” Lanphear says. “And that seems like 'wow, what a drop, that's wonderful.' But children's blood lead levels, our blood lead levels today are still 10 to 100 times higher than our pre-industrial ancestors. So by that standard, our lead exposure is still too high.”
“There's been this, essentially, a pandemic of lead poisoning,” Lanphear says.
Lanphear remembers a colleague expressing concern about worrying parents unnecessarily.
“It would be ideal that our federal regulators and our health officials would take action and prevent lead poisoning before it ever happens so parents didn't need to know about it or do anything,” Lanphear says. “But unfortunately that's not the reality we live in.”
“We encountered people who diminished the actual risk – painters, doctors, friends, family,” Aubrianne Kluver says. “It was super emotionally taxing, not just failing your kids for lack of knowledge, but then also, like, other people dismissing your concerns.”
The Kluvers have a mortgage-worth of improvements in their house and they couldn’t just walk away. They had to find a way to live in their house while also protecting their kids.
“You just love them with your whole heart and if I had it to do again, I wish I knew how little it took to have exposure,” Aubrianne Kluver says. “We don't have any lasting scars that say, this is your fault and what you did to your kids, you know. But there might be hurdles that we didn't have to cross if there was no buckets of lead paint brought into our little oasis here, you know.”