Lead Wars: The Politics of Science and the Fate of America's Children (California/Milbank Books on Health and the Public) (Volume 24)

When society faces a serious threat to public health, there are four main ways to address it:1) Rely on public education to try to change behavior.2) Punish individual bad actors, such as drunk drivers or spouse abusers, by stepping up enforcement and tightening penalties.3) Use government regulation to change the environment so conducive to the harm, such as a ban on smoking in indoor public places or a ban on 2-for-1 happy hours.4) Adopt a combination of the three. With drunk driving and smoking, there was a combination approach.The main barrier to effectively addressing threats to public health comes from the industries largely responsible for causing the problem. The alcohol industry fought tenaciously against laws to lower the legal limit for DUI, and they strongly resist tax increases. Big Tobacco delayed regulations of smoking for decades after the evidence came out linking cigarette use to cancer and heart disease.The same scenario played out during the last 100 years with the powerful lead industry. It took generations to get lead out of gasoline and paint. Lead Wars focuses on the widespread and lasting damage to children’s health from pealing lead paint in older buildings, damage that continues to this day. The book also traces how the public health community tried to reduce or stop the damage, and how the industry used denial, deflection and delay to avoid responsibility for its products causing childhood lead poisoning.Internal documents from Sherwin Williams and other companies reveal that as early as the 1920s, industry officials discussed the harm that lead paint posed to children, and were well aware that lead was killing workers in factories that used it. Yet the industry nonetheless marketed their paint as safe and sanitary for household use. That same decade lead became an additive for gasoline; it took half a century to get it removed.Until the late 1960s, most public health officials believed that children’s exposure was not harmful at 60 micrograms per deciliter (pg/dl) of blood. In 1978, the CDC said the actual safe limit was 30 pg/dl. In 1985, the limit was lowered to 25 pg/dl, then to 10 in 1991, and to 5 pg/dl in 2012. These changes were based upon decades of research showing that children suffered harm at much lower levels of lead in the blood than was widely believed not so long ago. As late as 1977, however, the Lead Industries Association stated that “it is inappropriate to conclude that lead causes any neurological effects at blood lead levels in the 80 pg/100 pg range.”That harm is profound, and it occurs mainly in poor children who grow up in older inner-city housing contaminated with lead paint. When the paint deteriorates, generates dust, and peals, youngsters ingest lead. Decades of research show that children with high blood levels can suffer severe and sometimes fatal neurological damage. Even low blood lead levels can cause higher rates of hyperactivity, ADD, lower IQ scores, difficulty concentrating, behavioral disorder, and higher rates of juvenile delinquency and arrests. Research has also found a link between murder rates and lead poisoning.What’s heartbreaking is that we know how to prevent almost all lead poisoning, but our country has steadfastly refrained from implementing the lead abatement measures necessary to protect children’s health. Rather than changing the environment to protect all children, the default policy was to adopt incremental policies, to treat sick individuals, and to ago after individual slum landlords after their young tenants suffered irreversible harm. This hit-and-miss policy fails to prevent the harm, and often fails to compensate the families who suffer it. Landlords claim ignorance or blame the victims.Some voices in the public health community prescribed prevention by calling on the lead industry to clean up the mess it made. Prevention rather than treatment after the fact had long been the public health priority. Some public health professionals, however, were satisfied with identifying victims and treating symptoms. This sometimes led to abatement in the apartments where children had already been poisoned, though not to other apartments in the same building. The public health pragmatists believed incremental change was preferable to no change. The book authors are unsympathetic to the pragmatists.The lead industry used the same PR firm as Big Tobacco, Hill & Knowlton. That may explain the similarity in strategies that both industries used. One strategy was to deny harm caused by its products. A second strategy was to create doubt about inconvenient research results and to disparage the researchers, such as Dr. Herbert Needleman. According to industry spokesmen, more research was always needed to provide definitive evidence before regulations were adopted. Of course, there will never been enough evidence to satisfy those whose salaries depend upon them remaining dissatisfied.The Lead Industries Association (LIA) spent decades fighting regulations on lead in paint. The LIA argued that parental education was the key to preventing lead poisoning. “But most of the cases are in Negro and Puerto Rican families, and how does one tackle that job?” asked Manfred Bowditch of the LIA. In other words, black and brown parents were to blame when their children got sick and died from acute lead poisoning. “If this was a disease of white children,” said Julian Chisolm Jr. of Johns Hopkins, “we would have done something about this a long time ago.”The major public health disaster meant millions of children suffered acute or chronic lead exposure, and thousands had died. “Society as a whole had retreated from its responsibility to protect the most vulnerable.” When it comes to lead paint, there has never been a wholesale cleanup of the toxic environment. The ongoing tragedy relegates a new generation of mainly black and brown children to lead poisoning. It’s easier to blame the victims and denigrate government regulations than to take responsibility and protect poor kids. ###

Lead paint and "tetraethyl lead" poisoning of children resulting in brain damage and death represents one of the most hideous public health disasters in America.The Ethyl Gasoline Corporation manufactured "tetraethyl lead" because when mixed with gas, it improved vehicle performance and fuel economy. Gerald Markowitz and David Rosner wrote that "lead became part of the air Americans breathed when, in 1923, lead was introduced into gasoline to give cars more power. With the dramatic growth of this vast industry, every American child, parent, and neighbor began to systematically incorporate into their bodies a toxic heavy metal that was already known to be poisoning workers in the United States and elsewhere."For decades, Medical Director of the Ethyl Corp., Robert A. Kehoe, M.D., gave "scientific cover" for Ethyl, and became the principal defender of keeping "highly profitable" lead in gasoline, which contributed to the poisoning of millions of American children from 1928 until TEL or tetraethyl lead was outlawed in 1986. Industry-owned research facilities conducted lead studies, usually with pro-lead results; research was carefully crafted to benefit industrial sponsors, not the health of U.S. citizens. Incredibly, under oath in 1966, Dr. Kehoe told Congress that he and his colleagues at the Kettering Laboratory in Cincinnati, Ohio "had been looking for 30 years for evidence of bad effects from leaded gasoline in the general population and had found none." Kehoe argued that lead is "normal" in the human body and even recommended, for the sake of progress, elevating the lead level in gasoline. There was, he said, "not the slightest evidence" of harm from airborne lead, and claimed that leaded gasoline posed no risk at all to public health.Needless to say, Kehoe was tragically wrong. Herbert Needleman, M.D., a courageous pediatrician at Temple University discovered a direct correlation between lowered IQ and increased lead content of baby teeth collected from children in North Philadelphia. He got the idea from the 1950s, when strontium 90, a by-product of atomic testing in Utah, became a component in the teeth and skeletons of babyboomers across the USA. Needleman's research in the 1960s indicated that "leaded" gas exhaust poisoned babies both inside and outside the womb. A recent study found that children with attention deficit/hyperactivity disorder have elevated average blood-lead levels 20-30% higher than children without ADHD. The central nervous system of a fetus or young child, undergoing rapid changes, is particularly vulnerable to lead exposure. For his pioneering research, Dr. Needleman, now in his late 80s, should have received the Nobel Prize in Medicine.Many European countries banned the use of lead-based paint as early as 1909. The U.S. lead industry "chose to run massive marketing and promotion campaigns all through the first half of the twentieth century despite their knowledge that lead paint was causing children to go into comas, suffer convulsions, and die." The USA allowed the continued use of lead in paint until 1978, but lead does not biodegrade. Today, 2% of American children are diagnosed with lead poisoning.The demise of Kehoe's leaded gas was accelerated when Clair Patterson, a geochemist at Caltech analyzed core drillings of ice in Antarctica indicating that concentrations of lead in the environment had increased an alarming 350 percent between 1930 and 1965. When leaded gasoline was marketed nationwide in the late 1920s and in the 1930s, the frequency of childhood lead poisoning reported in medical journals increased dramatically. Unfortunately, scientists in the United States have lost funding and have been exposed to lawsuits (or much worse) after their evidence-based research produced results that threatened powerful economic interests. When Drs. Alice Hamilton, Harriet Hardy, Randolph Byers, Clair Patterson, and Herbert Needleman presented unwelcome lead data, petrochemical interests devoted considerable resources attacking them personally. Suppression of unwelcome lead research and fiendish harassment of independent scientists was not uncommon, particularly during the pre-EPA era.While children continue to be exposed to lead, those born in the 1990s have higher IQs than those born 20 years earlier, when lead was lavishly dumped along U.S. roads and highways. Based on the government's Agency for Toxic Substances and Disease Registry, about 68 million American children experienced toxic exposure from leaded gasoline during the Ethyl era. Between 1976 and 1996, removal of lead from gasoline precipitated nearly a 90% drop in children's blood-lead levels according to the CDC.Markowitz and Rosner remind us that society is measured by the treatment of its children. "For more than a hundred years, we have knowingly poisoned our children and destroyed the future of millions of our citizens." Lead in paint and gas has been foisted on us by "rapacious industries that have knowingly profited from our human suffering." The challenge for young pediatricians is that lead poisoning is a preventable disease.

Nothing more pro environment, pro education, pro social justice and pro law and order than getting rid of lead. Less lead less crime and higher test scores and higher IQ points in the youth. Find the Mother Jones Article from Jan. 2013 called "Lead: America's Real Criminal Element."

Good book

A must read for the self informer