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MILWAUKEE (AP) — An audit says Milwaukee’s health department has no record of conducting environmental investigations at more than 100 homes where children had elevated lead levels in their blood.

The report is a response to the health agency’s admission this month that it didn’t know whether it sent letters to more than 6,000 families whose children tested positive for elevated lead levels since 2015.

The audit released Monday says the Childhood Lead Poisoning Prevention Program is “deficient in several areas.” It cites staffing shortages, inadequate training, high turnover due to low morale and shoddy record-keeping. The agency’s troubles led to the Jan. 11 resignation of its commissioner, Bevan Baker. Mayor Tom Barrett ordered the audit.

Lead is a powerful neurotoxin that causes significant harm, including speech and language delays, behavioral problems and death in rare cases.