FLINT, MI Dachelle McDonalds 10-year-old daughter has had numerous dental visits, a dental operation and teeth that seemed to practically fall out of her mouth without any effort.
McDonald isnt entirely sure any of those issues are related to lead exposure, but her daughter, Neveah Dixon, was drinking the lead-poisoned water just like many others six years ago when Flint changed its water source from treated Detroit Water and Sewerage Department water to the Flint River.
She could just pull her teeth out of her mouth when they started getting loose, McDonald said. It was just weird the way her teeth fell out her mouth.
McDonald remembers her daughter as having issues with her teeth for as long as shes had them.
Her teeth - she always has teeth problems, were always at the dentist, McDonald said. Her skin has two-tone on her face, which is weird because no one in my family, no one has skin like that.
In Flint during the water crisis, the percentage of children with elevated blood lead levels nearly doubled citywide, and nearly tripled among children in high risk areas of lead exposure, according to research by Dr. Mona Hanna-Attisha, the pediatrician credited with exposing the health crisis.
Lead exposure can affect children in different ways, Hanna-Attisha said.
One of the biggest concerns with the water crisis in regard to teeth is the lack of fluoride from not drinking public water, Hanna-Attisha said. Tap water has added fluoride to prevent dental cavities. When people stopped drinking tap water and transitioned to bottled water, they lost fluoride.
Some bottled water has fluoride, but many does not, Hanna-Attisha added.
In late August, state officials announced children 6 years old and younger during the Flint water crisis were the biggest potential beneficiaries of a historic $600 million settlement with the state of Michigan.
How does lead affect children?
According to the Centers for Disease Control and Prevention, exposure to lead can seriously harm a childs health. The adverse effects can include damage to the brain and nervous system, slowed growth and development, learning and behavior problems, and hearing and speech problems.
The health effects can include lower IQ, decreased ability to pay attention, and underperformance in school.
Hanna-Attisha said based on the science of lead, there is no safe level of lead that children can be exposed to.
Its probably the oldest and most well-studied of poisons, Hanna-Attisha said. Weve known about the evil of lead literally for centuries, weve known that lead was bad. Levels that we thought were OK decades ago when we had a lot of lead in paint and gasoline and plumbing - we now know through amazing science and research that theyre no longer OK.
Hanna-Attisha works with Neurodevelopmental Center of Excellence, located inside the Genesee Health System at 420 W. Fifth Ave., to offer assessments to children and individuals impacted by the Flint water crisis.
The big crux of our work, especially with the neurodevelopmental center is to see how kids are doing now and to get them what they need, now, Hanna-Attisha said.
To receive a free and Medicaid covered neuropsychological assessment, the individual must meet several requirements. Visit here to see the list.
Lead in paint, gasoline and plumbing were all banned, starting with gasoline in 1970, leaded-paint in 1978, and lead in plumbing in 1986. However, at the time lead free was defined as solder and flux with no more than 0.2 percent lead and pipes with no more than 8 percent, according to the U.S. Environmental Protection Agency.
Lead is quickly absorbed into the bloodstream. The half-life (time it takes for the amount to decline by 50 percent) of lead in blood is 30 days; some of the absorbed lead is excreted in urine, sweat, and feces. However, some of the absorbed lead is stored in other body tissues, mostly in bone. A persons body burden of lead is the total amount of lead that has accumulated from exposure over time and is stored in the body, said Perri Zeitz Ruckart, health scientist, for Lead Poisoning Prevention and Surveillance Branch, National Center for Environmental Health and Centers for Disease Control and Prevention.
Hanna-Attisha said when issues do present after being exposed to lead, its hard to prove causation.
Its really hard because theres a long time lag of the time from when youve been exposed to when you have a problem. In addition, the problem that you have - say its a learning disability - it can be caused by lots of other stuff too, right?
Hanna-Attisha pointed out issues that stem from lead exposure are multifactorial. Conditions such as poverty, poor nutrition and poor schools can all contribute to learning disability or issue.
Its so important that we have sequential assessments of people so that we can continue to follow folks over time, said Hanna-Attisha. So we can see the potential consequences.
Lead in families
Dixon is a bright, 5-foot-9, intuitive fifth grader at Eagles Nest Academy. Her teachers describe her as a leader in class.
She was 4 years old when the water was switched.
All her blood levels are perfect, shes fine as far as thats concerned. Her teeth - the dentist said it could possibly be that (exposure to lead) but all her blood work says shes fine, so nobody said shes lead poisoned. So, its like how do you determine that? McDonald asked.
In adults, approximately 94 percent of the total body burden of lead is stored in the bones and teeth compared to approximately 73 percent in the bones and teeth of children, according to Zeitz Ruckart.
Bone lead has a half-life of years to decades. Although lead in blood represents only a portion of the total body burden, a blood lead test is the best readily available way to assess a persons exposure to lead, Zeitz Ruckart said.
There are many different factors that affect blood lead levels such as the source of exposure, length of exposure, and underlying susceptibility (childs age, nutritional status, and genetics)," Zeitz Ruckart added. "Even in the absence of exposure, blood lead levels can rise during periods of bone turnover, which include periods of growth, metabolic disease, pregnancy, lactation, osteoporosis.
The issue of lead is a complex issue and often new studies are published that reveal more issues and findings as to how lead works and its harmful effects on humans, according to Hanna-Attisha.
McDonald said she talks to her daughter frequently about the lead situation because she knows its a lot for a child to understand.
She had dental surgery back in 2015, because of all the corrosion in her mouth, McDonald said. They put a lot of caps and stuff in her mouth and a bar.
Hanna-Attisha noted in regard to teeth about national studies that showed kids who drank bottled water had more cavities and worse teeth, but less lead exposure.
Healthy Kids Dental has been in the area for quite some time and it offers free dental care for those who are on Medicaid. The Flint Registry refers kids to Mott Dental as well, according to Hanna-Attisha.
Takisha Moller was pregnant with her daughter Destinee Wilson in 2014, the year the city switched its water supply.
I tasted metal when I was pregnant, like every time the water was boiled, I tasted metal and I told him (Destinees father), I cant drink this water, it tastes like metal. But I kept drinking it, Moeller said. I drank it all the way until they finally said lead was in the water, but that was after she was born.
After Mollers daughter was born she continued to boil the water, just as the city advised, to give her newborn baths.
I was feeding my baby lead all this time, drinking all this water, giving her baths in the lead water and I know it can soak through your skin and all of that so my first thought was: Is her brain going to be OK? Because she lived in my womb for 10 months - I was overdue. I was just worried about her well being and her development and stuff.
When Destinee was three or four months old, Moller remembers the city dropping bottled water off at her home for the family to drink, cook and clean with.
Sometimes I want to ignore it, Moller said of the issues shes noticed in her daughter. Sometimes I want to look past it, but you have to face it.
At nearly 2 years old, Moller observed her daughter wasnt making any strides toward talking. The toddler can be aggressive and she has a learning disability, the mother added.
Its just going to be a watch and wait game, I guess, Moller said as she sighed.
While Moller was growing her baby, fibroid tumors were also growing inside her uterus. The mother of one is scheduled to have a hysterectomy.
So now, I cant have any more kids because Im having a hysterectomy soon. I was just pregnant in February, Moller said. They gave me a surgery a year after Destinee was born to remove some of the fibroid tumors, they took them out but they grew back.
Moller said doctors told her the tumors are related to her drinking the lead water.
I try not to think about it, Moller said before she took a long pause. Im a very positive person. I have been through a lot in my life, so I have learned to take the bad things and spin them into something positive for myself because I understand that no matter what happens, the past is the past and you create your own future.
Lead prevention
Childhood lead poisoning is entirely preventable, according to both Hanna-Attisha and Zeitz Ruckart.
Theres no magical treatment besides prevention, Hanna-Attisha said. So when we realized theres not a magic pill we can give our patients, our focus became: what can we do to limit the impact of this exposure?
The focus of the Neurodevelopmental Center of Excellence studies how learning and behavior are related to brain development and neural networks through comprehensive neuropsychological assessments.
The center is a resource to help with secondary prevention of lead, said Hanna-Atttisha.
Things that help can help with secondary prevention include good nutrition, educational enrichments and mental health support.
Children can be buffered from a lot of those issues if its implemented in their lives, Hanna-Attisha said.
The Flint Registry, a tool built by the community of Flint to connect people to services and programs to promote health and wellness while navigating a health crisis, can provide support for families in those areas.
A partnering program to help provide good nutrition to the families of Flint is the nutrition prescription program, managed by Michigan State University and Hurley Childrens Hospital Pediatric Public Health Initiative, where $15 for healthy foods are prescribed to young patients by their pediatrician.
Chantel Dawson, research assistant for the nutrition prescription program, collects data from the program.
We aim to help individuals maintain a healthy lifestyle - dietary changes, like longevity, Dawson said. So with the program, we provide a prescription for $15, which can be redeemed at the Farmers' Market or it can also be redeemed at our mobile market, which is Flint Fresh.
Dawson said shes noticed more families have been taking advantage of the prescription since the pandemic.
Ive had individuals tell me that they saved it (the prescription) for Thanksgiving and they cooked a healthy Thanksgiving meal with nothing but vegetables, Dawson said. We had individuals even during the pandemic who werent receiving unemployment or any type of food assistance and they were relying on their appointment with their doctor because if they cant go to the clinic, we also offer services via telehealth.
Dawson said one of the things the program has focused on in the last several months is accessibility. The program has now expanded its delivery services outside of Flint and throughout Genesee County.
We are trying to make sure that we give them accessibility still during the hardest times that were going through, Dawson said.
The CDC supports state and local health departments through cooperative agreements to support childhood lead poisoning prevention activities including strengthening: blood lead testing and reporting, surveillance, linking children to recommended follow-up services, and targeted population-based interventions, according to Zeitz Ruckart.
Our work in recovery is holistic, said Hanna-Attisha. Nobody says that this water crisis was just a lead crisis because it it so much more than that. We have been framing everything as a trauma, this was one trauma and really leaning on the science of trauma and being trauma informed and thats kind of driven our holistic science-based community driven response.
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Flint children exposed to lead suffer from dental problems, learning disabilities, other issues - MLive.com