Erin Pavlica's family pediatrician had never recommended a blood lead test for any of her three children. And when she came in with her daughter Quinn in January, just after the girl's first birthday, the nurse initially brushed off her request for the test.
"She was like, 'Oh really? Why?'" recalled Pavlica, of St. Paul, Minn.
Pavlica pushed. Eventually, Quinn's lead level was checked and the result came back at just over 9 micrograms per deciliter of blood -- above the 5-microgram-per-deciliter threshold, which is when the U.S. Centers for Disease Control and Prevention considers a child to have lead poisoning.
"I was super shocked," Pavlica said. "The doctor was as well."
Pavlica suggested that her pediatrician may have never thought to test for lead since her family was white, well-educated and fairly well-to-do -- not the demographic traditionally perceived as being at risk. She said she probably never would have thought to ask had she not just seen a rough cut of the upcoming documentary, "MisLEAD." The film warns that many parents and pediatricians are unaware of the dangers of lead -- where it's still found despite being banned from gasoline and house paint decades ago, and the extent of the damage it can inflict even in tiny amounts.
Tamara Rubin, the film's director, said she aims to dispel a long-standing misconception that lead poisoning is confined to low-income communities and to children who eat paint chips.
The lead industry itself originated and perpetuated that myth, according to experts. In their book, Deceit and Denial, David Rosner and Gerald Markowitz share evidence of the industry's insistence in the 1950s and 1960s that childhood lead poisoning was "primarily a problem of the eastern slums," and a "result of the lack of education, racial inferiority, and inattentiveness of poor people."
"Even though we've come a long way in terms of equality, there's still a stigma," said Rubin, who is also the executive director of the nonprofit Lead Safe America Foundation.
She said that lead poisoning information continues to be primarily directed at low-income, multi-ethnic families such as those on the federal assistance programs Head Start or the Special Supplemental Nutrition Program for Women, Infants and Children. While these populations are very much at risk, she emphasized that they are not alone. "There's still shame in talking about lead poisoning for those with middle, upper incomes," she added. "People aren't getting the information they need, and they aren't testing their children."
Rubin said she was once one of those parents unaware of the risks. Two of her children got violently ill after a contractor removed old paint during renovations of their home in Portland, Ore., and it took their pediatrician months to consider testing them for lead. The possibility never crossed Rubin's mind.
Now, she has two kids -- and a whole family -- suffering the consequences.
Rubin has a black eye in some scenes of the documentary. Her son, Avi, gave it to her, she said.
"I get angry and I can't control my anger at all," Avi says in the film. "I throw stuff and sometimes hurt people that I don't want to hurt."
Howard Mielke, an expert in lead poisoning at Tulane University School of Medicine, noted that lead typically affects the prefrontal cortex of the brain -- the section that controls decision-making and compulsive behavior. Not surprisingly then, lead poisoning has been tied to everything from higher crime rates and lower test scores to attention deficit hyperactivity disorder and autism.
Lead that accumulates in the bones of a child can also seep back into the blood stream later on in life as bones deteriorate, Mielke said. This can lead to another round of problems, such as increased blood pressure.
"We still have a lead problem. It's handicapping the future generation," Mielke said.
In "MisLEAD," Dr. John Rosen of Montefiore Medical Center holds tiny flakes of lead paint, the size of grains of sand, on the end of his pointer finger. "This amount of contaminated household dust with lead-based paint in it will cause childhood lead poisoning," he said. "It takes very, very little."
The Pavlica's live in a 1936 house in a middle-class urban neighborhood that is quickly transforming from an elderly community to one of young families. Many of these couples are renovating their homes, which are part of the nearly 80 million homes in the U.S. that Lead Safe America estimates were built and painted (and perhaps repainted) before lead paint was banned in 1978.
"The highest concentrations of lead-based paint were in communities of the wealthiest people," said Mielke, who was involved in getting lead out of gasoline, and is now finding that lead's legacy lives in soils across the U.S. "It was expensive paint."
Indeed, lead paint was durable. It was long-lasting. But now it is deteriorating, and creating what Rubin calls a "new wave of lead exposure from house paint that wasn't happening 10, 20, 30 years ago." This, of course, is in addition to the hazards posed by lead that has accumulated in soil after years of leaded gasoline exhaustion from cars, as well as years of painting and renovating. There is also lead in an array of products including pipes, crystal, shoes, jewelry and car keys.
"Remodeling and sanding and that type of activity among people like me, college educated, is one of biggest ways to get lead poisoning," said Angela Michelsen, also of Portland.
Michelsen recalled telling her 90-year-old grandmother that her kids had been exposed to lead. "She freaked out," Michelsen said. "She remembers the time period when we were realizing the dangers, when kids were dying. Today, when you tell your peers, they say your kids look fine."
"We outlawed this for a reason and now many of us are oblivious," she added. "I was oblivious, too."