Seattle & King County, Washington

Although lead was banned from paint for residential use in 1978, it is still used in consumer products for children, certain foods, traditional medicines, cosmetics, and other products. Aluminum cookware, purchased locally and online, was recently identified as a significant source of lead exposure but the extent of the problem is not well understood. The Seattle & King County Lead and Toxics Program has been engaging with community partners for more than five years to prevent lead exposure. Partners have provided feedback about product safety and prioritized actions, such as product testing. Community partners are frustrated by the lack of information about the safety of the products they use in their homes and the failure of government agencies to enact effective safety measures.

From October 2021 through September 2022, the Lead and Toxics Program partnered with 10 community-based organizations (CBOs) to hold 19 events to conduct lead testing on a wide variety of products used in the home. CBOs funded to host events serve Seattle & King County populations at higher risk of childhood lead poisoning, including families with young children who have lower household incomes, refugee and immigrant families, and families living in geographic areas with older homes. CBOs found event locations, recruited participants, provided participation incentives, collected demographic data, interpreted as appropriate, and followed up with families about laboratory test results.

The Seattle & King County Lead and Toxics Program staffed events, provided translated lead education materials, conducted X-ray fluorescence (XRF) testing, collected product samples for laboratory testing, and provided the laboratory results to the CBOs. Items appropriate for XRF testing included cookware, jewelry, pottery, and toys. Items appropriate for laboratory testing included cosmetics, incense, personal care items, and spices. Product testing events had three primary goals:

1. Increase opportunities to learn about current and emerging sources of lead exposure.
2. Encourage childhood blood lead testing when appropriate.
3. Provide product testing information to participating CBOs to inform their efforts to create culturally relevant messaging and intervention strategies.

A total of 296 households (representing 1,232 individuals and 261 children younger than age 6 years) from 66 Seattle & King County zip codes participated in product testing events and brought items for testing. Languages of participants served included Amharic, Arabic, Dari, English, French, Hindi, Maay Maay, Oromo, Pashto, Somali, Spanish, Swahili, Tamil, Tigrinya, Vietnamese, and Yoruba. Of the 255 households who reported race, the most frequent races were Black/African American (48%), Latinx (20%), and Middle Eastern/North African (15%). These testing events produced the following results:

• 703 items were tested, and 151 (21%) items had high levels of lead.
  • 97 items including pottery, aluminum cookware, and jewelry tested above 90 ppm of lead using XRF.
  • 52 cosmetics/personal care items sent to a laboratory, purchased both inside and outside the U.S., tested above 10 ppm of lead.
  • 3 items sent to a laboratory tested above 2 ppm of lead and included incense from Saudi Arabia and candy from Mexico.
• None of the spices or food items tested at a laboratory had high lead levels.

The Seattle & King County’s Lead and Toxics Lead in Products Action Group has relied on the product testing data and evidence to inform their strategies and develop their 2023 Action Plan, including social media strategies to educate community members about sources of lead exposure. The Lead in Products Action Group is a coalition of eight community-based organizations, formed to address lead contamination. This collaborative effort aims to raise awareness, advocate for policy changes, and implement effective strategies to combat lead poisoning in our communities. Product testing data were posted on the Lead and Toxics Program website in January 2023 and shared with other public health professionals. CBOs are planning 18 product testing events for 2023.

Blood lead testing rates in King County are very low, and little is known about non-paint sources of lead exposure.

The Lead and Toxics Program collaborated with the King County Medical Society and the Washington Poison Center to implement 26 blood lead testing events in King County during the summer of 2019. Events were focused on communities with higher poverty rates, people of color, and housing built before 1978  and were structured either as “Lead Screening, Health, Outreach, and Partnership (LeadSHOP)” or “Days of Testing” events.

• LeadSHOPs were primarily run by Public Health staff and included opportunities for x-ray fluorescence testing of products, blood lead testing, and education. Additionally, participants could sign up for free lead assessment home visits through the Lead Pilot Program.
• “Days of Testing” events were implemented by health clinics. These events were staffed by volunteer doctors and nurses and included opportunities for blood lead testing and education. “Days of Testing” had two primary goals: to increase opportunities for free blood lead testing and build medical clinics’ capacity to integrate routine blood lead testing into their clinic systems. Participating medical providers used the media attention generated by the events to amplify messaging on the importance of blood lead testing and developmental services for lead-exposed children through blog posts, local news coverage, and magazine articles.

There was a 5% increase in blood lead testing in King County in the first four months of 2019 compared with all of 2018. More than 330 children were tested (227 under age 6), over 100 families signed up for free in-home lead assessments, and over 150 products were tested for lead on-site or sent to a lab. At Days of Testing, 9 of the 227 children tested had elevated blood lead levels. At LeadSHOP events, 4 of the 102 children tested had elevated blood lead levels.