New York City

New York City (NYC) Department of Health and Mental Hygiene (DOHMH) 2010–2011 blood lead surveillance data showed that children with Georgian ancestry were at an increased risk for higher blood lead levels (BLLs). NYC DOHMH child and adult case investigations involve use of a detailed risk assessment questionnaire and environmental sampling, including lead testing of consumer products as needed. Information about consumer products collected are systematically tracked in a Consumer Products Surveillance Database. Product surveillance data revealed that spices bought in or sent from Georgia were a source of lead exposure for NYC’s Georgian population.

To prevent exposure from lead-contaminated Georgian spices, NYC DOHMH took the following actions between 2011 and 2019:

• They reported findings to Georgian authorities via the Consulate General of Georgia in NYC and collaborated with them to develop a multilingual health advisory to advise the public of the potentially higher lead levels in spices bought in or sent from Georgia.
• DOHMH surveyed local businesses to determine the availability of Georgian spices with higher lead levels and took enforcement actions for spices found to contain higher lead levels. They notified the U.S. Food and Drug Administration DOHMH’s findings.
• They provided data to the National Food Agency, Ministry of Agriculture of Georgia.
• They conducted an interview with a Georgia-based press outlet to raise awareness about the issue.
• DOHMH published A Spoonful of Lead: A 10-Year Look at Spices as a Potential Source of Lead Exposure.

Informed by NYC DOHMH findings, Georgian Food Safety Authorities conducted further investigations in Georgia which found similarly high lead levels in spices available for sale in the streets and supermarkets of Georgia (Source: Georgian National Center for Disease Control and Public Health). Follow-up response in Georgia engaged stakeholders, such as UNICEF and Pure Earth (NGO). Pure Earth tested potential lead sources in homes and confirmed higher lead content in spices introduced during processing by large importers and wholesalers (addition of Pb chromate) (Source: Pure Earth report; https://youtu.be/jxqLzGovT3g). Georgia launched an aggressive enforcement and education campaign.

From 2017 to 2022, the rate of children with BLLs at or above 5 mcg/dL declined 96% among NYC children with Georgian ancestry. In comparison, the rate declined 13% citywide. Additionally, from 2017 to 2020, DOHMH data showed a decline of more than 30% in the percentage of spice samples from Georgia with detectable lead. This illustrates that a targeted multi-pronged and multi-stakeholder intervention strategy can be effective in reducing lead exposures for communities at an increased lead exposure risk. However, for this to be effective, surveillance data is critical.

New York City (NYC) identified five census tracts within a single zip code in Brooklyn (the Williamsburg community) with increased cases of childhood lead poisoning. Compared with Brooklyn overall, this area had higher percentages of individuals living below the federal poverty line, housing built before 1920, and individuals who speak a language other than English at home. Williamsburg is also home to a large Hasidic Jewish community.

The NYC Healthy Homes Program (HHP) developed a targeted outreach and education approach to reduce lead exposure in this community. Activities included the following:

• NYC HHP conducted interviews in 2015 with healthcare providers to raise lead poisoning prevention awareness, especially related to the need for risk assessment, blood lead testing, and reinforcement of lead poisoning prevention measures for families. HHP also worked with community leaders to translate educational materials for healthcare providers into Yiddish.
• HHP partnered with three community-based organization (CBOs):
  • During 2016–2018, CBOs published advertisements in English and Yiddish in local community newspapers and held community outreach events to increase awareness of lead poisoning prevention.
  • In 2017, CBOs ran an ad campaign regarding landlord legal obligations and placed advertisements in English and Yiddish in neighborhood bus shelters.
  • In 2018, CBOs facilitated a focus group with contractors, collaborating with the NYC Department of Housing Preservation and Development and HPP staff members, to discuss how to encourage lead abatement and safe work practices.
  • In 2018, CBOs held a building owners forum to promote the availability of U.S. Department of Housing and Urban Development Lead Hazard Control Demonstration grant funding to support lead-based paint hazard repairs in child-occupied buildings.
  • In 2018, CBOs mailed letters to over 4,000 families in the greater Williamsburg community. CBOs sent letters and educational materials in both English and Yiddish. The goal of these letters was to educate residents about childhood lead poisoning prevention, the importance of blood lead testing, and landlord responsibilities under Local Law 1.

Blood lead testing increased in Williamsburg from 4,080 children under age 6 in 2014 to 4,231 children in 2018, a 3.7% increase. The percentage of children with an elevated blood lead level (≥5 micrograms per deciliter) decreased from 5.6% in 2014 to 4.1% in 2018.