Lead-based paint in older buildings is the most common source of lead poisoning in children. Lead poisoning has been found to have long term health implications, including neurological damage and developmental disabilities, which can cause challenges in learning and behaviors. Although the federal government banned the consumer use of lead-based paints in 1978, residential units built before the federal ban may still contain traces of lead in paint, dust, and the soil around a building. Moreover, rent-burdened, Black, and Latinx households, may be disproportionately affected because of their likelihood of living in older housing units in poor condition. This is especially true in Rust Belt cities with a large supply of aging, low-value rental housing.

Key lessons

• Rochester’s lead law relied on local housing conditions and the city’s existing mechanisms for code enforcement. Adding lead inspections to the city’s inspection process for Certificate of Occupancy provided a low-cost and politically viable method to prevent lead exposure.
• Rochester’s focus on proactive testing before exposure appears to have been successful. Between 1997 and 2011, EBLLs have fallen much faster in Rochester’s Monroe County than in other New York counties.
• Partnerships among a diverse set of stakeholders played an important role in the law’s passage and implementation. Rochester’s lead law was initiated, shaped, and continues to be monitored by CPLP, which worked closely with strategic partners such as the United Way, public relations firms, and officials within the city government. The medical community was particularly effective in educating city council members on the importance of home-based interventions and helped produce local data that was influential in the policymaking process.
• Several years of community organizing efforts preceded the introduction of the lead law, which likely contributed to its adoption. CPLP built support for the law by engaging with residents and community leaders as stakeholders. This mobilization elevated the issue to become a priority for city council members. The community effort and lead law have served as a model for many other cities, including Syracuse and Buffalo, which passed similar ordinances in 2020.
• Well-executed educational campaigns continue to play an integral role. Ongoing outreach ensures that tenants know their right to request an inspection and how to protect themselves from landlord retaliation.
• Rochester has made ongoing improvements to the law, in response to federal policy changes and local data analysis. The law’s annual reporting requirement serves as a built-in tool to inform implementation over time.

Description

In 2005, the Rochester City Council passed a lead poisoning prevention ordinance, which adds lead inspections to the city’s existing Certificate of Occupancy (C of O) process. Buildings with three rental units or more must pass C of O inspection every three years to rent out a unit, while one- and two-unit buildings must pass inspection every six years. As of 2014, owners of one- and two-unit buildings in a designated Lead High Risk Area with prior lead violations must renew their C of O every three years. Critically, the law allows tenants, community groups, and doctors to request a free city inspection at any time. The law prohibits landlords from taking any retaliatory action against those who issue a request.

The “lead law” requires that rental property owners demonstrate the following:

• All buildings with rental units must pass a visual assessment that there are no areas of deteriorated paint nor exposed soil within three feet surrounding the house. The landlord must address any deteriorated paint or bare soil before he can obtain or renew a C of O.
• For rental units in areas deemed “high risk,” if a building passes the visual inspection, it must also pass a dust wipe inspection, which requires lead levels fall below federal limits.

If buildings fail either of these inspections, the property is cited for a violation. After completing repairs, which may include painting, cleaning, or structural changes, property owners must receive clearance from an unaffiliated, EPA-certified professional to receive a C of O from the city. The property owner is responsible for obtaining this clearance, which is then reviewed by the city inspector.

Accompanying resolutions: Three resolutions were passed alongside the lead law. First, the Rochester City Council mandated annual progress reporting and a timeline to prioritize properties in the target areas, as well as an ongoing plan to update which areas qualify as “high risk.” A second resolution encouraged funding for a public education campaign, led by Monroe County and the Coalition to Prevent Lead Poisoning (CPLP, described in more detail below), and formed a citizen advisory group to oversee the initial implementation of the law. The third resolution established a voluntary free inspection program for owner-occupied housing units, which are not subject to inspection under the C of O process. The voluntary program included a database to list lead-safe properties.

Process: The road to adoption and implementation

While Monroe County rigorously tested children under the age of two for lead exposure, as mandated by a 1993 New York state law, this approach only identified children at risk of further exposure. Despite long-standing federal bans on lead paint and gasoline, renters in Rochester remained vulnerable to lead poisoning due in part to the city’s aging housing stock. In fact, a 2002 study commissioned by the Monroe County Department of Public Health found that the prevalence of lead poisoning was nearly 24 percent in the city of Rochester, whereas rates of lead poisoning at the state and national level at that time were 5.8 percent and 2.2 percent, respectively. The responsibility to enforce inspections and violations fell to city government officials, many of whom felt that a largescale lead abatement program would be too expensive to implement.

In 1999, principal Ralph Spezio found that an alarming 41 percent of students entering kindergarten in his school were testing positive for lead poisoning. Spurred by these findings, Spezio invited diverse stakeholders together for an emergency meeting to discuss what could be done. This meeting prompted a group of educators, health care providers, researchers and community leaders to form the Rochester Lead Free Coalition in 2000, which became the Coalition to Prevent Lead Poisoning (CPLP) in 2001.

Over the course of five years, CPLP led a campaign to raise public concern over the damaging effects of lead poisoning on children, and to design a primary prevention mechanism that would be cost-effective for the city of Rochester. CPLP hosted community meetings and developed educational campaigns. Crucially, CPLP built strong, interdisciplinary relationships to gather data, develop resources, and build community support around lead poisoning prevention. This was done in a few key ways, including:

• CPLP employed a communications strategy that reframed lead poisoning as a costly health problem with a housing solution that, if implemented, could end childhood lead poisoning by 2010.
• CPLP developed key partnerships with the United Way of Greater Rochester, who provided advocacy and financial support, as well as Roberts Communications, who provided CPLP with access to marketing and communications support.
• CPLP hosted events to raise awareness of lead exposure’s negative impact on health, educational outcomes, and childhood development. In 2004, CPLP leaders and the United Way hosted a “Community Lead Summit,” which brought together over 500 residents, environmental health experts, and policymakers. At the Summit’s closing event, the Mayor of Rochester and the Monroe County Executive pledged to support lead abatement policy changes.
• To focus reform on housing-based primary prevention, CPLP drew from the expertise of its members, including health care providers and researchers, to publish short summaries of scientific literature. Informed by other local efforts such as the Get the Lead Out project, these summaries emphasized that education about nutrition and cleaning alone would not end childhood lead poisoning.
• To counter common critiques that a housing-based policy would be too costly, CPLP asked staff at the University of Rochester to gather research on the short-term costs of lead poisoning, such as necessary medical care and special education services. In its “Lead 101” presentations to stakeholders, CPLP included a projection of $1,500,000 estimated annual costs for Monroe County if childhood lead poisoning were not addressed.
• Finally, CPLP sought to develop a lead inspection protocol that was both housing-based and cost-effective. These efforts were essential to convince landlords and city officials that primary prevention through code enforcement was feasible.

In 2005, the Rochester City Council introduced and unanimously passed the Lead-Based Paint Poisoning Prevention Ordinance. The ordinance went into effect in July 2006. Sixteen years later, CPLP continues to track the law’s implementation and impact.

Additional amendments/mid-course adjustments: Following the U.S. EPA’s 2008 Renovation, Repair, and Painting rule on renovations that disturb paint in homes built before 1978, the Rochester City Council amended the lead law to require lead-safe work practices on par with federal guidelines. In 2011, after examining five years of data on the frequency of violations by property type, the Rochester City Council amended the law so that certain types of buildings that pass the visual inspection in Lead High Risk Areas do not also require a dust wipe inspection. Finally, after 2013 data revealed that 91 percent of children who had EBLLs resided in smaller buildings, the law was amended so that one- and two-unit buildings with a history of lead violations in the city’s Lead High Risk Area must renew their C of O every three years, instead of six. This amendment also eliminated dust wipes in dwellings with more than  5 units or complexes with more than 10, studio units and senior citizen facilities.  This helped fill the gap in frequency of inspections of higher risk units that resulted from elimination of the county’s Quality Housing Inspection program.

Outcomes

• Within four years of the law’s passage, nearly all rental units built before 1978 had been inspected.
• During the first four years of implementation, a focus group of Rochester landlords reported that the costs of compliance were not excessively costly. In a telephone survey of 183 respondents, 34 percent of landlords reported no additional costs due to compliance, and 37 percent reported costs of less than $1,000.
• Some landlords received federal funding for repairs through HUD Lead-Based Paint Hazard Control grants. The city of Rochester has benefitted from over $30 million in HUD grants to owner occupants and landlords for lead hazard control.
• Since the passage of the lead law, EBLLs in Monroe County have continued to decline to 1.4% of children screened in 2019, down from 3.9% of children screened in 2006.
• According to the city of Rochester, between the years 2006 and 2020, 193,584 rental units have been inspected for deteriorated interior paint and 5 percent of those units received interior deteriorated paint violations. Over that time period, 50,901 units in designated high-risk areas have received dust wipe inspections, and 90 percent of those units have passed inspections.

In 2009, CPLP was recognized by the Environmental Protection Agency (EPA) with the Environmental Justice Achievement Award. Its members continue to serve as community leaders on the issue, and, along with the city of Rochester, provide key insight to other cities interested in implementing a similar law. CPLP continues to raise awareness around the dangers of lead poisoning and exposure among children.

Policy significance 

Rochester passed a preventative, science-informed lead law to control lead hazards before they result in poisoning. Between 1997 and 2011, the prevalence rate of EBLLs per 100 children tested in Rochester’s Monroe County decreased from 13.4 to 1.1 children, a decline 2.4 times greater than New York state’s overall decrease. Additionally, the city’s unique emphasis on prioritizing areas identified as “high risk,” combined with their cost-effective methods for inspection, made it possible to inspect nearly all rental units built before 1978 by 2010 without significant cost to landlords (see “Outcomes” for more information).

Finally, the grassroots support for the law, due in large part to the work of CPLP, focused the lead law on housing-based primary prevention. Community champions worked alongside environmental health experts to rally the support of the mayor and the Rochester City Council.

Additional information

• Lead Abatement, Inspection and Risk Assessment resources by the Environmental Protection Agency (EPA)
• The University of Rochester Medical Center Partners to Eliminate Lead Poisoning – Case Study: Office of Policy Development and Research (PD&R) U.S. Department of Housing and Urban Development (HUD)

Related resources

• Burris, S., Korfmacher, K.S., Moran-McCabe K., Prood, N., Blakenship, K., Corbett, A., Saxon, B. 2020. “Health Equity through Action: A Blueprint for Systemic Legal Action.” Temple University & Center for Public Health Law Research.
• Kennedy, B.S., Doniger, A.S., Painting, S., Housing, L., Slaunwhite, M., Mirabella, F., Felsen, J., Hunt, P., Hyde, D., & Stich, E. 2014. Declines in Elevated Blood Lead Levels Among Children, 1997−2011. Am J Prev Med 46(3): 259-264.
• Korfmacher, K.S. Ayoob, M., & Morley, R. 2012. Rochester’s Lead Law: Evaluation of a Local Environmental Health Policy Innovation. Environmental Health Perspectives 120(2): 309-315.
• Korfmacher, K.S. 2019. Bridging Silos: Collaborating for Environmental Health and Justice in Urban Communities. MIT Press.
• U.S. Environmental Protection Agency (EPA). “Hazard Standards and Clearance Levels for Lead in Paint, Dust and Soil (TSCA Sections 402 and 403).”
• McDade, E. 2018. “The Mission: End Childhood Lead Poisoning in Rochester.” Shelterforce.