By Dan Klepal and Sharon Coolidge
The Cincinnati Enquirer

An estimated 19,000 children across Ohio - and more than 2,000 in Hamilton, Butler, Warren and Clermont counties - suffer from lead poisoning and most don't even know it, according to a study released Monday by the nonprofit Environmental Working Group.

The Washington-based group, examined federal and Ohio health information and census data to arrive at the estimates. The reason so many poisoned children go unreported, the group says, is because few health-care providers screen children for elevated lead levels.

Hamilton County is second to Cuyahoga County for the number of confirmed child lead poisoning cases in Ohio, according to the Ohio Department of Heath statistics. But the group's study says thousands more children are poisoned from eating paint chips or breathing lead-based paint dust.

Lead poisoning causes a host of problems, particularly in children. It retards brain and cognitive development and can cause problems with the nervous system, growth, behavior, hearing, sight, the digestive system and other vital organs.

The Environmental Working Group is a nonprofit environmental organization funded through private donations. The Cleveland-based George Gund Foundation paid for the Ohio lead study.

The study also found Ohio taxpayers are paying for lead testing for all Medicaid recipients, but only about 30 percent have gotten tested. It says more than 12,000 children in the four southwestern Ohio counties should have been screened for lead under federal law but were not.

But John Allen, a spokesman for the Ohio Department of Jobs and Family Services, says taxpayers are not being ripped off.

Medicaid payments are negotiated every year and part of those negotiations, he said, is the percentage of eligible children actually tested.

"The rate we pay is based (partially) on the percentage of children who receive the lead test," Allen said. "We've written directly to every provider to inform them of the requirement, and made it part of the training for our new providers. We write directly to the parents. We want to see the percentage increased."

Dr. Bruce Lanphear, director of the Cincinnati Children's Environmental Health Center, whose research on lead-contaminated house dust helped shape federal standards, said research in Australia first linked poisoning to lead-based paint 100 years ago.

Lanphear said there are no safe levels of lead in the human body, and that health policy is to not do anything until after a child has been deemed poisoned.

The study offered four recommendations:

• Major increases in the amount of money spent on removing lead paint from the environment.

• Enforcement of federal and state lead testing requirements, with penalties leveled against health care providers who don't do them.

• Mandatory disclosure of blood-testing levels for all children tested, rather than those who are above federal limits.

• Cutting in half the level of lead allowable in a child's bloodstream.

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E-mail dklepal@enquirer.com or scoolidge@enquirer.com