Full of Lead
Experts Say There’s a Direct Connection Between Lead Poisoning and Violent Crime, But Will Public Policy Ever Catch Up With the Research?
The primary suspect is a fellow inmate who was sitting directly behind Parker: Kevin G. Johns Jr. Johns, 22, was serving a 35-year term for the grisly murder of his uncle Robert Lee Percell in February 2002 and had recently been charged with strangling 16-year old Armad Cloude, a fellow inmate at the maximum-security Maryland Corrections Training Center in Hagerstown. During a pretrial hearing hours before Parker’s murder, Washington County Deputy State’s Attorney Joseph Michael informed the judge that Johns had said he “would do it again,” and asked the court rhetorically, “Who’s next?”
The answer, if state investigators are right, turned out to be Parker, and Johns’ crimes can be added to an ongoing wave of violence that finds Baltimore with 48 murders so far this year. (A grand jury has indicted Johns for Parker’s murder.) A small reference in a Feb. 13 Sun article about Parker’s death provides what may be one clue as to why crimes like Johns’ continue to plague this city: Grouped in a litany of mental maladies attributed to Johns, the article stated that he suffers from lead poisoning.
While it may seem like an inconsequential fact, a side effect of living in a city filled with houses marred by lead paint, scientists, child advocates, and even politicians are publicly arguing that there is a link between lead poisoning and violence. Lead affects a variety of vital organs, including the brain. The brain damage resulting from lead is permanent and can be extensive: the loss of IQ, serotonin production, and other neural motor functions, causing impulsivity and anti-social behavior—in short, some key factors that might tip someone toward a life of violence. A study published in the April 2003 New England Journal of Medicine by Dr. Bruce Lanphear and his colleagues found that blood-lead levels as low 10 micrograms per deciliter of blood can cause substantial loss of IQ.
As lead paint has been outlawed for use in homes since 1978 and the medical effects of lead poisoning are so well known, the problem should be on its way to being solved. Far from it, though, according to the latest statistics issued by the Maryland Department of the Environment: In Baltimore City in 2003, 1,166 children of 51,892 children tested by the state had levels of lead in their blood of more than 10 micrograms per deciliter, which is considered an “elevated” level; 160 had at least 20 micrograms per deciliter, the level at which children are considered lead-poisoned by the state. Given that only 35.2 percent of children from 0-72 months of age were tested in Baltimore, according to the 2003 Maryland Department of the Environment annual report “Childhood Blood Lead Level Surveillance in Maryland,” there are likely thousands more who were not tested that are positive for lead as well.
According to a 2002 report on the state of city’s housing stock commissioned by the Abell Foundation, titled Childhood Lead Poisoning in Baltimore: A Generation Imperiled as Laws Ignored, at least 114,000 housing units in 11 targeted Baltimore ZIP codes pose a moderate to high risk for containing lead hazards, such as peeling or chipping lead-based paint. Which means that if lead poisoning does have an effect on long-term behavior, the seeds of future crime and social ills have already been cast in more than 100,000 unsafe and unfit homes throughout the city.
At a Feb. 7 press conference, just five days after Parker’s murder, Mayor Martin O’Malley publicly acknowledged the problem, saying that “there is an established correlation between violent crime and lead poisoning.” The press conference had been called to protest a cut in state funding for Baltimore City’s lead-enforcement program.
The problem of lead poisoning is caught in the murky crosscurrents of politics and landlord-tenant relations, liability, money, and to a certain extent, race. In Baltimore, the landlords who own and illegally rent out lead-laden housing are predominantly white, while African-American children make up the majority of those being poisoned (according to the federal Centers for Disease Control and Prevention, an African-American child is five times more likely to be poisoned by lead than a Caucasian child). Even as Gov. Robert Ehrlich calls for the elimination of lead poisoning by 2010, legislation was introduced in the Baltimore City Council in 2004 and in the legislature in Annapolis this year that, in part, eases property owners’ liability for poisoning children, threatening one of the few legal incentives for landlords to comply with law. Not that Maryland’s existing lead laws are particularly harsh to begin with—Baltimore-based lead-litigation attorney Saul Kerpelman characterizes them as among the most “lax” in the nation.
As officials and citizens alike look for solutions to the violence that continues to help define the social landscape of Baltimore, maybe it’s time to question what role lead poisoning might play. More importantly, maybe it’s time to question whether we have the political will to untangle the complex issues of legality and liability that allow such a well-understood health risk to remain a problem. The fate of generations of Baltimoreans—both those already irreparably, and perhaps negligently, damaged and those who may face lead poisoning in the future—rests on the answers.
Lead is a naturally occurring element detrimental to the health of any living thing. Once it enters the human bloodstream—usually through ingestion of chips or dust from old house paint (manufacturers once used the metal as an additive to improve paint’s durability)—it retards almost every functioning organ in the body, especially the kidneys, the liver, the heart, and the brain. Particularly for children between the ages of 1 and 6, when the brain is in its most aggressive stage of development, lead can have devastating long-term mental-health effects.
The basic concept that connects lead poisoning to behavior problems is something called “neurotoxicity”—the point at which lead interferes with the growth of the prefrontal lobe, the part of the brain that controls impulsivity, long-range thinking, and communication skills. Even mildly elevated blood-lead levels, scientists argue, can cause irreparable damage to the prefrontal lobe, decreasing a child’s potential IQ, a key predictor in both propensity for crime and even mortality, while increasing impulsivity and aggression. Maryland doesn’t consider a child poisoned until he or she has at least 20 micrograms of lead per deciliter of blood, but some studies contend that lead levels as low as 5 micrograms per deciliter can be harmful.
Dr. Herbert Needleman, a pediatrician and child psychiatrist at the University of Pittsburgh Medical Center, was one of the first scientists to study how lead poisoning leads to anti-social behavior. The study, Needleman says, was a logical outgrowth of treating children with elevated blood-lead levels and listening to their parents complain about their behavioral problems. “The mothers of poisoned children would complain that their children were more aggressive and difficult to control,” he says. “I was curious why this was happening.”
Needleman’s first study, conducted in 1979, measured the lead levels in the baby teeth of children with behavioral problems in the classroom and compared those to blood-lead levels of children with no history of such problems. What he discovered opened the door for further study. “There was a significant difference in the lead levels with children who had attention or behavioral problems,” Needleman recalls.
Delving further into the correlation between lead and anti-social behavior, he tested bone-lead levels of 194 children in the Allegheny County, Pa., juvenile justice system in 1998. Compared to a control group of 146 students living in the same county with no criminal record, the convicted youths had lead levels 10 to 11 times higher than their nonoffending counterparts. Needleman calls his results “startling,” adding that “there is no doubt that lead affects important functions of controlling impulses, and I believe this relates to crime.”
Needleman’s work has been supported by broader studies that paint an even grimmer picture.
In 2001, scientists Paul Stretesky and Michael Lynch used federal Environmental Protection Agency data from 1990 that measured lead levels in the air in 3,111 counties across the United States. Comparing the data to the homicide rates for the same counties, Stretesky and Lynch found that the counties with the highest rate of lead-air pollution had four times as many homicides than the counties with the lowest. While Stretesky and Lynch concluded that their study could not make a direct causal link between lead and violence (counties containing or near large cities are more likely to have more lead-air pollution and more homicides anyway), the results supported “recent findings that there is an association between lead exposure and violent behavior.”
Rick Nevin, an economic consultant hired by the federal Department of Housing and Urban Development to study the cost of removing lead paint from public housing, studied the correlation between lead exposure and violent crime as well. Nevin’s study, published in 2000 in the scientific journal Environmental Research, concluded that lead-exposure rates of children nationwide between 1941 and 1986 correlated precisely with national fluctuations in violent crime rates, including robbery and aggravated assault. Nevin’s study showed that blood-lead levels in children could almost predict what the violent crime rate would be two decades later, when those children were adults.
Deborah Denno, a law professor at Fordham University School of Law, did what has been called the first longitudinal study—that is, following a group of individuals over an extended period of time—to determine the most accurate predictors for anti-social behavior. Using data from a government study that followed 487 boys in Philadelphia from age 0 to age 22, Denno weighed more than 3,000 variables to discover what correlated with incarceration and criminality. She tells City Paper that lead kept “popping up.”
In fact, Denno’s results cited elevated blood-lead levels as the strongest predictor of disciplinary problems in schoolkids and the third-strongest predictor of juvenile crime. One of the other two strongest predictors of juvenile crime, previous disciplinary problems, relates back to lead, too, Denno says. The results, published in her 1990 book Biology and Violence, led her to conclude that at the very least “lead predisposes people to act in an impulsive and anti-social way.”
How research correlating lead poisoning to impulsivity, violence, homicide, and criminality applies to Baltimore is simply a matter of connecting the risk factors to reality—or in this case, realty. According to the 2002 Abell Foundation study of city housing stock, 114,000 housing units still in use in Baltimore were built before 1950 and are thus likely to be “high risk” for lead paint and possible sources of lead poisoning.
Ellen Silbergeld, an environmental scientist at Johns Hopkins University and a leading authority on toxicology and lead poisoning, says there is strong evidence linking lead poisoning to violence. Although the case is not closed, she says that “it is a plausible hypothesis.”
“I was astounded by the article,” Silbergeld, who won a MacArthur Foundation “genius” grant in 1993 for her work on lead toxicology, says of Nevin’s Environmental Research piece. “So I passed it around to what I believed to be experts, and they confirmed the methodology was correct.”
Mary (who asked that her family’s last name not be used) says she has seen the insidious effects of every stage of lead poisoning. In particular, she says, she has seen it in her 20-year-old son, Evan. In 2004, Evan was convicted of first-degree murder and sentenced to life in prison with all but 50 years suspended. Mary thinks lead poisoning played a role in his crime.
“He is a sweet child, and never had any problems,” Mary says, sitting in her East Baltimore kitchen, “until he was poisoned.”
The problems started in 1984 when she moved newborn Evan and his sister Andrea into an apartment in Southwest Baltimore. “I didn’t know anything about lead, nobody told me,” she says. But a routine visit to the children’s pediatrician in 1986 changed that. “I got a letter saying they both had high lead levels in their blood,” she recalls.
Mary moved her family out of the apartment, but the damage had already been done. Both children, it turns out, had blood-lead levels in excess of 40 micrograms per deciliter, well above the poisoning threshold.
Andrea had to be hospitalized and given chelation therapy, which removes some lead from the bloodstream by injecting drugs that bind with the lead and reduce its acute toxicity. Chelation therapy is an expensive and painful procedure that consists of twice-daily deep-muscle injections that continue for weeks, or even months (Mary recalls that it required “all sorts of needles”), and has life-threatening side effects. Evan didn’t have to be hospitalized, but the effect of lead poisoning became immediately obvious.
“In kindergarten, I had to go pick him up all the time because he wouldn’t sit still,” Mary recalls. “By first grade I had to go to school almost every day.”
Neuropsychological testing done when Evan was 3 revealed severe brain damage that had not existed before he was exposed to lead. Taking care of him became a full-time chore, Mary says, forcing her to drop out of Baltimore City Community College.
“He couldn’t ride the bus—I had to ride in a cab with him to school every day,” she says. “He couldn’t be with anyone but me.”
Evan’s problems persisted, and he was transferred from school to school, even spening time in the Sheppard Pratt Health System. Mary says that he ended up in court at one point for assaulting a teacher at school.
The effects of his mental impairment took a toll on Evan’s self-esteem as well. Mary remembers the day her son revealed that he liked a new girlfriend because, he told his mother, she was “‘like me’—meaning slow.”
Mary relates her family’s troubles with dry eyes until she gets to the part about the shooting that landed her son in the Maryland State Penitentiary for 50 years. She says the judge in her son’s case failed to take into account her son’s mental handicap, despite numerous motions from his defense attorney.
“They can find money to build prisons, places to lock us all up,” she says, her eyes narrowed and angry, “but they can’t find money to keep our children from being poisoned.”
Irene, another Baltimore mother, also watched an ostensibly normal child succumb to behavioral problems after being poisoned by lead. The story she relates is eerily similar to that of Evan. She says her 16-year-old nephew Curtis was poisoned when he was 2 years old, while living in an apartment on Division Street, in 1991. Irene took care of the children after her sister died of breast cancer. “I didn’t know at the time they were poisoned,” she says.
Irene recalls that Curtis had “learning problems, he wouldn’t listen.” She had Curtis evaluated and learned that his blood-lead levels were, like Evan’s, above 40 micrograms per deciliter. Doctors prescribed medication for attention deficit hyperactivity disorder that Irene says “worked for a while,” until he became immune. Without medication, Irene recalls, “he was very aggressive, he would act out before thinking.”
After several run-ins with the law for what Irene describes as “petty crimes,” and a few stays in the state juvenile detention system for car theft and assault, Curtis is now hospitalized at Spring Grove, a state mental-health hospital in Catonsville. He’s getting what Irene describes as “better treatment. He gets his medication regularly now and is doing much better.”
Wendy Foy of Baltimore also has a story about lead poisoning that echoes those of Mary and Irene. Foy, 44, has custody of her niece Tierra, 11, and nephew Deontaye, 10. She says she has been dealing with behavioral problems that started when the children were toddlers, poisoned at their former home on the 1100 block of North Carlton Street in West Baltimore.
“After they were poisoned, the children were unable to keep still, they couldn’t focus,” Foy says. “My nephew is irritable, he is much more aggressive than he was before he was poisoned.”
Foy, who ran unsuccessfully for City Council in the 9th District in 2003, has since educated herself about the lead-poisoning problem. She takes her niece and nephew to see doctors at Kennedy Krieger Institute, where they learn how to cope with the learning disabilities and behavioral problems associated with lead poisoning. Foy says she spends lots of time at school dealing with the kids’ teachers. “A lot of teachers think the kid is just bad, without understanding the problem,” she says. But lead poisoning complicates almost every aspect of the children’s lives, and hers, and will continue to do so as they grow into teenagers.
“The thing you have to understand, you can’t tell them to wash the dishes, then put them away,” Foy says. “The kids can’t focus long enough to remember. You have to tell them to do one, then another. . . . Lead poisoning has hurt a lot of kids in our community, and I’m living with it every day.”
The purpose of the Oct. 20, 2004, meeting at the Canton offices of the Baltimore City Coalition to End Childhood Lead Poisoning (CECLP) seemed straightforward enough. Billed as a quarterly “prevention partnership,” the gathering was advertised to the health-advocacy community as a means to promote coordination between nonprofits, like the Association of Community Organizations for Reform Now (ACORN), and governmental agencies, such as the city Health Department and the Maryland Department of the Environment. The ultimate goal was to assess the progress of eliminating lead contamination from Baltimore’s aging housing stock. But a few minutes into her opening remarks at CECLP’s spacious offices, executive director Ruth Ann Norton found herself in the midst of heated questioning and acrimonious debate.
The opening salvo came from ACORN head organizer Mitch Klein, who was piqued by the lack of compliance on the part of landlords, who are supposed to provide lead-free housing for tenants, and the failure of city agencies to follow up on several landlords he had reported for lead violations. Maryland Law 1245, enacted during the General Assembly session of 2003, prevents landlords from evicting a tenant without registering the property with the Maryland Department of Environment and providing a risk-reduction certification number—basically a document that states the unit is compliant with state lead laws. Yet Klein contended “only three of the properties we investigated were registered. Obviously some were not in compliance, which means these landlords are committing perjury on a massive scale.”
Norton acknowledged that the certification system has flaws—many of the inspections are done by private companies, not the state—but she contended that the system is mostly effective. But assurances from Norton and Jean Y. Kim, assistant attorney general for the Maryland Department of the Environment, didn’t mollify Klein.
“We really need to know,” he said to both Kim and Norton, “whose side you’re both on—the landlords or the children.”
Norton moved through the agenda until Lisa J. Smith, a local attorney who represents lead-poisoned children, passed around a handout on Baltimore City Council bill 04-1276.
“We covered that at the last meeting,” Norton said bluntly.
“We just want to know where your organization stands on this,” Smith replied.
The bill in question proposed an amendment to the city housing code that would, as Smith described it in a memo she circulated through the room, “return Baltimore City lead laws to the Dark Ages.” The bill would negate a November 2003 decision by the Maryland Court of Appeals that said that the city housing code must require landlords to take reasonable steps—such as conducting periodic inspections—to ensure that their properties remain free of lead hazards while occupied by tenants. The decision made it clear that landlords in the city could not wait for tenants to complain about potential lead problems—that things like chipping and flaking lead paint is a landlord’s responsibility and that, with or without notice from a tenant about such problems, landlords could be held liable for not attending to them. Klein characterized the City Council bill as being “like a favor to a bunch of slumlords that donate to the mayor.”
Norton, the executive director of the city’s largest and most prominent lead-poisoning advocacy group, patently refused to discuss the bill at the meeting, noting that it was not likely to pass anyway. “This bill is a nonstarter,” she said. “We are not negotiating with anyone on this, I’m not going to give it fuel.” (The bill never made it out of committee for a vote.)
Though it may seem baffling that the city would even consider such a bill, it’s not when one considers that the biggest landlord in Baltimore is, in fact, the city of Baltimore. With more than 14,000 public-housing units under its control, the city is liable for keeping them compliant with lead laws. And enforcing lead-law compliance is not cheap. In the 2006 proposed state budget, the city may lose $375,000 of its budget for lead enforcement. According to city Health Commissioner Dr. Peter Beilenson, that amounts to losing one attorney and five inspectors.
In an interview after the meeting, Norton reiterated her previously stated position—reluctant to say unequivocally that she was against the bill. “I’m trying to tell everyone we’re all on the same page, but they’re not listening,” she says of the lead-poisoning advocacy community. “We all agree.” But she acknowledges that “the mayor really wants this bill. The city is potentially liable, and as the biggest landlord in Baltimore, there is a lot at stake.”
Asked whether O’Malley had pressured her on the bill, Norton offered her first one-word answer of the evening: “Yes.”
When asked about Norton’s assertions, O’Malley spokeswoman Raquel Guillory says she is “unaware” of any pressure directed at CECLP.
Thus some members of the lead-poisoning advocacy community believe the CECLP’s public equivocation on bill 04-1276 is indicative of the organization’s conflicting prerogatives: The organization must reach out to landlords and help affected families.
While Beilenson characterizes the conflict between the CECLP and other advocates as a “clash of the lead titans,” the coalition recently retained the firm of Schwartz and Metz to lobby the General Assembly for the governor’s recently introduced lead law. In 2001 the firm, which boasts a client list including Exxon and Mettiki Coal, represented the National Paint and Coating Association, a trade association for paint companies, according to the organization’s web site. Norton says she was “not aware” of the lobbying firm’s connection to the paint industry.
Some of the CECLP’s problems are considered so acute by its critics in the lead-poisoning advocacy community that a new coalition is being formed. The new organization, tentatively named the Baltimore Healthy Homes Alliance, is being brought together, says Mitch Klein, “as a way to bring scientists and environmentalists and tenant organizations together” to solve what he characterizes as “urban environmental problems.”
Although all aspects of keeping homes safe from toxic chemicals will be considered, Klein says “lead is the first thing on the agenda. We need a new voice on this issue.”
The view of pre-1950s rowhouses from the Coalition to End Childhood Lead Poisoning’s Canton offices were the perfect backdrop for Gov. Robert Ehrlich’s Nov. 23, 2004, press conference on lead. It began with the chairman of the board of CECLP, Mark Sissman, touting the success of a mailing program in which the Maryland Department of the Environment sent 50,000 letters to property owners, the first in a series of mailings targeting noncompliant property owners, reminding them that they must register their properties with the state to prove that they have been certified as lead-free.
“Over 17,000 properties are newly registered,” Sissman said, concluding that “the good news is that statistics show that registered properties have zero problems with lead poisoning.”
Sissman’s statement was echoed by the governor (who professed that he “loved” Ruth Ann Norton, and backed it up with a kiss before underscoring Sissman’s point). “Registered properties means no new lead poisoning,” Ehrlich said, promising to “eliminate all lead poising by the year 2010.”
But ACORN takes issue with the state’s assurance that the registered lead-free properties are indeed safe. The group’s Environmental Justice Project sent neighborhood canvassers out to 272 rental units in the city and tested them for lead last year. They found that nearly 24 percent of the apartments they tested that were registered and certified as “lead safe” by the state had elevated lead readings in at least one part of the house.
Local lead-litigation attorney Saul Kerpelman, says he’s seen evidence that supports ACORN’s claim. “Registered properties turn up in our cases all the time, and registering a property doesn’t really mean anything,” he says.
The law that requires properties to be certified and registered with the Maryland Department of the Environment required all pre-1950 properties be registered by Dec. 31, 1995, nearly a decade ago. But as of this year, these 50,000 properties were still not registered.
On Jan. 18, Ehrlich announced new legislation for lowering the incidence of lead exposure at a press conference in Annapolis. He wielded numbers provided by the Maryland Department of the Environment showing what seems like a positive trend: The number of children with lead poisoning is down some 92 percent since 1994.
But the numbers may be misleading. In reviewing the raw data used to compile these statistics and understanding the science behind lead poisoning, it becomes clear that the plummeting drop in lead poisoning may not be at all accurate. The Maryland Blood Lead Level Surveillance reports prepared by the Maryland Department of the Environment reveal that only 35.2 percent of children aged 0-72 months living in Baltimore City were tested in 2003, meaning that some 64 percent were not. The number of children tested annually has dropped from a peak of close to 58.8 percent in 1995 to the 35.2 percent tested in 2003. So the reported 92 percent reduction in lead poisoning may be attributed to the fact that there are so few children, comparatively, being tested.
“I’ve always been puzzled by how much we know and how little we’ve done,” Dr. Herbert Needleman says. When asked why he thinks so little real progress is made in combating the lead-poisoning problem, without hesitation he says, “Number 1, it’s a black problem.”
Needleman may be right. Kerpelman says that 99 percent of his clients are African-American. Even more damning is the Maryland Department of Environment high-risk lead map, which outlines the highest-risk areas for lead poisoning in Baltimore based on existing housing stock and blood-surveillance reports. Overlay the dark red areas on top of a 2000 U.S. Census map and it’s clear that neighborhoods with the worst lead problems are predominantly African-American.
“Lead is certainly a civil-rights issue,” Kerpelman says.
For many, the vagaries of politics and law, and by extension the implication of lead poisoning as a civil-rights issue, seem too difficult to grasp. But for many residents of the city, like Mary and other young mothers struggling to find decent housing for their children, the risks associated with lead are very tangible. And unfortunately, like Mary, many are vulnerable and don’t have the resources to fight their landlords to provide better living environments for their families.
“When I first found out my child was poisoned, someone was supposed to burn the paint out of my home,” Mary says, referring to the process of full lead abatement, which removes lead paint from all surfaces in the home. But the work wasn’t done correctly and, Mary says, “there was still lead dust in the house.”
She finally relocated, moving her family to Flag House Courts, a city-owned housing project near Little Italy. But soon after she moved in she had to move again. Mary is certain that if she had not had so many problems finding an affordable place to live that was not contaminated with lead her son would not have had a mental handicap or be spending 50 years in prison.
Mary is in the process of appealing her son’s murder conviction, and she stares blankly at the dark TV screen in her East Baltimore apartment. She runs her hand over her brow, as if to wring some sense out of a situation her mind cannot totally accept.
“Once they have lead, it’s with them for the rest of their lives,” she says. “It’s just sad, just so sad.”
The legacy of lead poisoning is far reaching and has dire consequences, not just for parents like Mary, but for the city as well, says Health Commissioner Beilenson. He noted at a Feb. 2 press conference that there is “an indisputable correlation between lead and criminal-justice problems,” and in an interview he expounds on that thought.
“Lead poisoning is a contributing factor for all the major ills in the city, it’s all interconnected,” he says. “[In Baltimore] we have 15 to 18 percent of our children in special education. A substantial proportion of those children are probably lead-poisoned.”
A group gathered at ACORN’s 25th Street offices for a tenants’ rights meeting puts a human face on the lead epidemic in the city. The meeting’s attendees are predominantly African-American, and almost all are female—mothers, sisters, aunts, and caretakers. They are the ones who have watched their children succumb to lead.
Nicole Johnson, 29, lives in a Southeast Baltimore rowhouse, which she shares with her husband and three children. Derrick Jessup, a Maryland Department of the Environment-certified lead tester who works for ACORN, tested her house recently, and the results were not good.
“We had a level of 900 in the kitchen, and unsafe is 50, so I’m taking my children to the doctor to be tested,” Johnson says.
When ACORN organizer Shera Williams talks about her son, heads in the room nod with understanding.
“My son wasn’t slow,” Williams says, “until he started crawling around on the floor. . . . No child should be handicapped because of a house. Where’s the landlord going to be in 16 years when the teacher calls your child slow and he can’t get job. Where’s [the landlord] going to be when he’s out on the corner and [the police] come to your door? Where are they going put him then?”
As if participating in a church service, the entire group responds together: “In jail.”
“That’s right,” William answers. “And it all starts with lead in the house.”
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