Angel Varela, a rambunctious 4-year-old, darts back and forth across the living-room carpet and near the walls of peeling paint, playing with his dinosaur toys. He appears unaffected by the lead-based paint that is all around his family's Pico-Union apartment.
It is when Angel is near someone eating that the effects of the lead he has ingested are noticed. The mere sight of anyone chewing makes him so nauseous, he vomits.
Children like Angel, who suffer the effects of lead poisoning, are found throughout the nation. Most of these youngsters, however, are in inner cities, where there are nearly three times as many lead-poisoned children as in more affluent areas. Although recent legislation has mandated procedures for lead-poisoning prevention and testing, government has been slow in providing the resources to reach inner-city children, including those in Los Angeles.
"Lead poisoning is really an issue of poverty," said Donzella Lee, vice president of Administrative Affairs at the Watts Health Foundation. "No matter who you are, if you are poor and live in impoverished areas, you will have problems with lead poisoning."
Of the lead-poisoning cases reported to the Los Angeles County Department of Health Services in 1992, more than 50% were in Central Los Angeles, mostly among black and Latino children. These children, like Angel, live in buildings or homes with peeling and cracking paint, or have parents who work in industries that use lead and bring lead dust home on their clothes. Federal health officials have called lead poisoning, which can cause developmental delay and reduced stature, the No. 1 environmental threat to young children.
In 1991, new research showing the potential damage from even low levels of lead in the bloodstream prompted then-Secretary of Health and Human Services Louis W. Sullivan to drop the threshold of lead poisoning in blood levels from 25 micrograms per deciliter to 10.
The question of how much lead in the bloodstream is harmful has roused much debate in recent years among prevention advocates, public health officials, landlords and homeowners. There is disagreement on whether to spend billions of dollars to clean up lead, given the existence of life-threatening childhood health problems, such as malnutrition and sickle cell anemia.
"In an era of shrinking public health resources, it is a fair question to say, 'Why pay all this money to chase after lead'?" said Dr. Paul Papanek, chief of the county's toxic epidemiology program.
In most cases, lead poisoning's effects are so subtle that they can easily be chalked up to other sources. Hyperactivity, crankiness, slowed reactions, impulsiveness and difficulty in sticking to tasks are some signs of lead poisoning, but they are also symptoms of other childhood disorders. The difference is that the end result of lead poisoning is irreversible brain damage.
Erick Monroy betrays no trace of illness from lead. Two months shy of his third birthday, Erick is quiet around strangers, playful with his family and other children and occasionally cranky, says his mother, Georgina Morales. Ten months ago, during a routine checkup, a blood test revealed 30 micrograms of lead in his system, three times the acceptable level.
Lead checks of Morales' apartment, in the Wyvernwood Garden Apartments in Boyle Heights, showed lead everywhere, from the windowsills and walls to the doors and the carpeting.
Erick's blood lead level is now down to 12 micrograms, thanks to treatments and an increase of iron in his diet. But even at low levels, lead can reduce a child's IQ level by five points, experts say. Nationwide studies have shown that learning and behavioral problems linked to childhood lead poisoning persist in adulthood.
"There are kids throughout this housing project who are probably walking around with lead in their blood," said Linda Kite of the Lead Poisoning Organizing Project. Kite, who teaches lead prevention and safety to residents at Wyvernwood, is also working with Concerned Citizens of South-Central Los Angeles to start similar community groups in South-Central.
Nationwide, one in six children have at-risk levels of lead in their blood, according to the U.S. Public Health Service. Of those living in urban low-income areas, one in two children have at-risk blood levels of lead.
In Los Angeles, exact numbers of children in low-income areas with lead poisoning are sketchy because of scattered and limited testing. No records are kept of the number of children tested, but so far this year, 184 inner-city children have been found to have at-risk lead levels with 20 or more micrograms of lead per deciliter of blood, according to the county Department of Health Services.