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TRENTON, N.J.— Amber DeLoney-Stewart brought her 2-year-old, Valencia, to the doctor’s office for an annual checkup in early September. Valencia was a happy girl with round cheeks, and the appointment was a routine physical exam, with vaccinations and some bloodwork. But the lab result proved to be anything but routine.
“Her iron is fine,” the doctor said about Valencia’s test results. “But it’s showing that she has lead.”
A second finger prick confirmed significant lead levels in Valencia’s blood, prompting more lab work and tests at a separate facility. Within days, DeLoney-Stewart learned the child had five micrograms per deciliter of lead in her blood: a number considered elevated by CDC standards.
Children in Trenton are increasingly at risk for lead contamination. A 2022 state study revealed that 6.1 percent of Trenton’s children younger than 6 years old had elevated lead in their blood, the highest rate in the state. Under state law, the local health department must step in and follow up on the child’s condition with additional tests and the home must be tested within three weeks with blood lead levels like Valencia’s.
Notably, East Trenton is a newly named Superfund Site for health risks related to its historic pottery industry, and lead-based pottery is still found in the soil of residential yards. Trenton is located in Mercer County, the county with the highest rate of blood lead in children in the state. And Valencia had lived in Trenton from birth.
“Thank God (the doctor) tested her… because I wouldn’t have known,” DeLoney-Stewart said. “I would have been oblivious.”
After the exam, DeLoney-Stewart, a single mom, wanted her rental home, a brick duplex with a wide porch built in 1924, thoroughly tested. Sean Stratton, a public health researcher and Ph.D. student at Rutgers University who has focused on lead in the area for years, offered to provide a free high-level inspection when DeLoney-Stewart turned to Trenton Water Works for help. They connected through a local community leader, Shereyl Snider, who works regularly with Stratton.
Stratton arrived at her doorstep one October morning with a fluorescent scanner—an X-ray gun of sorts—that could detect the health-damaging metal through layers of paint.
He first read aloud a legal agreement that Deloney-Stewart signed that day. “You may not receive any direct benefit besides the lead results,” he said. “There’s no cost for you to participate in the study. It’s all free. You will not be paid to take part in the study. All your personal information will be kept private.”
Then Stratton began quietly looking around DeLoney-Stewart’s home, scanning potential lead-based surfaces including walls and baseboards. Stratton firmly pressed the scanning tool over the front door frame. It beeped. There was lead-based paint. The paint on the frame, right near the doorknob, had been rubbed off and was worn from everyday use.
“So the frame, the door jamb and door stop are all lead-based paint,” Stratton said. How to fix? Stratton said the only certain way was to remove and then repaint, work for a professional cleaning or painting service that could handle the lead-dust shed. It would be a costly repair.
While Stratton confirmed many parts of DeLoney-Stewart’s home are lead-based, his testing could not say where and why Valencia was affected. Her contamination could have come from lead-based pipes leaching into the water, paint chipping off or even dust outside the home. Stratton tested all three. All were positive for lead.
Lead circulates through the human body like calcium and can affect nerve signaling, bone growth and brain development. But unlike calcium, which is stored and released as the body needs it, lead circulates through those systems and can leave some lasting and debilitating effects.
“One of the things that we think it does is it makes the brain a little leakier,” said Brian Buckley, a public health researcher at Rutgers University. “The brain is designed to take in the nutritional things it needs and exclude the bad things. It doesn’t do as good a job when there’s a high concentration of lead.”
Symptoms of lead poisoning can be subtle and varied. Sometimes without symptoms, lead can damage a child’s nervous system, causing slowed growth, hearing and speech problems and decreased ability to pay attention. Even with small amounts of lead, kids can become inattentive, irritable or lethargic. Young children can absorb up to four to five times as much lead as adults, according to the World Health Organization, because they are growing and absorbing all nutrients—even harmful ones. The body can’t tell the difference between nutrients like calcium, iron or zinc and lead.
Although children are most at risk, Buckley said researchers are finding evidence of a myriad of health risks related to lead in adults, including elevated blood pressure, preeclampsia and even Alzheimer’s. If a pregnant person is exposed and has “blood lead,” it can pass to the child.
But that wasn’t DeLoney-Stewart’s problem.
“My child was never born with any issues. I had a perfect pregnancy,” said DeLoney-Stewart, 37. “I was so grateful because not everyone has that story. I don’t want my child to have any issues that she wasn’t born with.”
Valencia’s symptoms started with a fever, DeLoney-Stewart said, and within weeks the child was coughing violently while eating and vomiting. Valencia was still bubbly, the mother said, but increasingly lethargic.
For parents like DeLoney-Stewart, the signs of lead contamination can be easily confused with other sicknesses.
Since 1996, New Jersey has required regular testing to identify possible cases of lead contamination. Physicians or other licensed providers must screen children for elevated blood lead at key ages: between 9 months and 18 months and again between 18 months and 26 months old. The New Jersey Department of Health, however, its latest report found in 2022 that only 72 percent of children at age 3 had received ablood-lead test in their lifetime. In Mercer County, 24.1 percent of children under 6 were tested for lead in the state fiscal year, the report said.
Blood testing is only one part of resolving lead contamination. Proving and removing the lead source is much harder.
High-quality lead detection for paint, dust and water often requires specialized equipment, including Stratton’s $9,000 hand-held tool. Lead testing services in New Jersey start at $200 for a “lead safe visual inspection” for a studio apartment, according to Lead Testing Services New Jersey, a private company in the state. A visual inspection includes documenting chipped paint and deterioration—but no test to determine if the paint is lead-based.
Despite the urgency of childhood lead exposure, New Jersey’s testing is fragmented across agencies. Blood lead claims trigger a reporting and oversight regimen involving local and state health departments, landlords, contracted third-party inspectors and tenants—but no single agency is responsible for ensuring families get proper resources or updates on a child’s health.
Once a child is determined to have elevated blood lead and is reported to the state, local health departments are required to step in to survey. Landlords are required by law to have a basic lead test done at the premises. In DeLoney-Stewart’s case, the landlord sent AAA Lead Testing Pro, a company licensed in New Jersey, New York and Pennsylvania, to do a swipe test in her home.
A swipe test is a surface wipe of the walls and paint to determine if the dust is lead based. DeLoney-Stewart said she waited months and has yet to receive the results of that swipe test.
While waiting, DeLoney-Stewart contacted nonprofit organizations and law firms that she said offered little help. Stratton, found through a community advocate, performed a more comprehensive survey that regularly starts at $450 for a studio apartment.
New Jersey law requires landlords of pre-1978 rental properties to pursue lead hazard control if a swipe test is positive. Lead control will reduce, but not eliminate, exposure. Lead hazard control typically involves repainting over chipped surfaces or repairing specific problem spots including replacing high-risk windows. Full removal of lead paint and materials, as Stratton suggested, is far more expensive, costing tens of thousands of dollars.
While DeLoney-Stewart navigated the testing bureaucracy, she sent her daughter to live with her parents in Princeton Junction.
“You really don’t know which way to go,” she said.
Deloney-Stewart said used the crisis as a way to teach her daughter good, if playful, hygiene. DeLoney-Stewart said the girl, as toddlers do, puts her hands in her mouth, a risky behavior with lead flakes at home. She gives the girl at-home manicures in an attempt to limit the lead threat.
“Look, if mommy paints your nails, don’t put them in your mouth,” DeLoney-Stewart tells her daughter. Now when Valencia chips a nail, she pops her hand out expectantly for another manicure. “That’s how you know she’s my child,” DeLoney-Stewart said.
But the young mother also pursued a radical solution. After a decade in Trenton, she moved to Georgia, where her siblings live. DeLoney-Stewart works as a financial officer, and her employer agreed to transfer her there. She said she will miss her neighbors and walks along the Delaware River and her community work. She helped start flower tours in the city, one in April and another in August. Parting with her parents was also challenging. They visited for Christmas, DeLoney-Stewart said, and will visit again soon. They adore Valencia, she said.
But DeLoney-Stewart said she knows too much now about lead risks in Trenton to stay. She left behind information for her landlord, too: all the data that Stratton provided about lead in her home.
“Nothing personal,” she said. “I just gotta go.”
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