Department of Toxic Substances Control
Matthew Rodriquez
Secretary for
Environmental Protection

Barbara A. Lee, Director
1001 “I” Street
P.O. Box 806
Sacramento, California 95812-0806

Edmund G. Brown Jr.
Governor

SENT VIA ELECTRONIC AND U.S. MAIL

November 25, 2015

Mr. Angelo J. Bellomo, REHS, QEP
Deputy Director for Health Protection
Los Angeles County Department of Public Health
Kenneth Hahn Hall of Administration
Los Angeles, California 90012

NEED TO ADDRESS ELEVATED BLOOD LEAD LEVELS IN CHILDREN

Dear Mr. Bellomo:
I would like to request the Los Angeles Country Department of Public Health’s
assistance in investigating and addressing high levels of lead found in the blood of a 16month-old child who lives within a home with three other children in Commerce,
California. His family contacted the Department of Toxic Substances Control (DTSC or
Department) when testing results showed blood lead levels (BLL) in the range of seven
to eight micrograms of lead per deciliter of blood (µg/dL). We would like to closely
coordinate our efforts to assist this child and his family.
As you know, no safe blood lead level in children has been identified and lead can affect
nearly every system in the body. The federal Centers for Disease Control (CDC) has
stated that epidemiologic studies and reviews “suggest there is no discernible threshold
for lead effects on IQ, and deficits are measureable at least down to 5 µg/dL.” They
have found that the “areas of neuropsychological performance that appear to be
impacted in particular are within the domains of attention, executive functions (i.e.
cognitive processes, including working memory, reasoning, task flexibility, and problem

Printed on Recycled Paper

 Mr. Angelo J. Bellomo, REHS, QEP
November 25, 2015
Page 2

solving), visual-spatial skills, social behavior, [and] speech and language...” (Attachment
2, Managing Blood Lead Levels of Young Children).
The CDC recommends monitoring the health of children with BLL equal to or greater
than 5 μg/dL. The CDC’s Advisory Committee on Childhood Lead Poisoning Prevention
recommends that health department officials take a number of actions when children
have elevated blood lead levels, including visiting the child’s residence and other sites
where the child spends significant amounts of time a minimum of two times; assessing
factors that may impact the child’s BLL; developing a written plan for intervention; and
evaluating compliance with the plan and the success of the plan.
DTSC visited the home, spoke with the family, and sampled their yard and paint for lead
by using an X-ray Fluorescence Analyzer (XRF). The Department found soil lead levels
up to 379 parts per million (PPM) and lead levels in paint, as estimated by the
contractor, are in the range of 5,000 PPM to 200,000 PPM. There is a wide range in
possible values because of uncertainties involved in converting the type of
measurement used for lead-based paint on walls versus the type of measurement used
for lead in soil. A paint sample is being analyzed by a certified laboratory for
confirmation of the amount of lead. We are ready to clean up the lead in the soil, though
we note that the lead-based paint represents a source of exposure or soil
recontamination that could threaten the health of the children in the home. We would
like to work with the County to protect the health of the children in this home.
To accomplish this important goal, DTSC asks that Los Angeles County Department of
Public Health visit with the family, assess factors that may be impacting the child’s BLL,
and work with the family to successfully reduce those levels. We realize that the
County’s Case Management Guidelines for Children with elevated BLL (see Attachment
3) does not call for a home visit until children have blood lead levels between 15 and 19
µg/dL, and that the Guidelines allow the County to stop assisting a child who has two
consecutive blood lead level readings below 15 µg/dL over a six-month period. We ask
that the County exercise its discretion to provide assistance in this case.
DTSC also requests that Los Angeles County examine the availability of funds to
stabilize the lead-based paint that could re-contaminate play areas in the yard after we
clean the soil. We would like to coordinate closely with the County to ensure that DTSC
cleans up the soil as soon as these stabilization activities occur.

 Mr. Angelo J. Bellomo, REHS, QEP
November 25, 2015
Page 3

Please contact Ray Leclerc (916.255.3582, ray.leclerc@dtsc.ca.gov) or Su Patel
(916.323.3513, suhasini.patel@dtsc.ca.gov) at your earliest convenience so that we can
coordinate the timing of these activities. Thank you very much for your attention to this
important matter.
Sincerely,

Barbara A. Lee
Director
Enclosures (3):
Attachment 1: CDC Response to Advisory Committee
Attachment 2: Managing Elevated Blood Lead Levels Among Young Children
Attachment 3: Matrix: Management Guidelines for Children by Blood Lead Level (BLL)