By Nayvin Gordon and Karyn Pomerantz, October 28, 2019
The US Department of Health and Human Services promoted October 20-27, 2019 as national lead prevention week. As of 2017, pediatricians reported that more than half a million US children had lead poisoning (AAFP, 2019).
The poisonous effects of lead have been documented for over 2,000 years. It is an environmental toxin whose effects are totally preventable; it has no biological role in the human body. Lead causes irreversible brain damage, especially in children. It affects numerous organs, such as the heart and kidneys, and influences behavior and cognition measured by IQ scores and other tests. Researchers have postulated that lead poisoning contributes to higher rates of impulsive behavior, attention deficit disorders, and poorer ability to process information. Nonetheless, the law does not require testing of all children for dangerous lead levels.
We will see here how US corporations, federal agencies, and some public health researchers have blocked efforts to eradicate lead from gasoline, pipes, and paint.
Screening for Lead versus Screening for PKU (Phenylketonuria)
Public health researchers and environmental scientists now think that there is no safe level of lead, which is easily assessed by a blood test developed in 1976. (Lead levels in blood is expressed as micrograms in a deciliter of blood (ug/dl). Yet over 40 years later there is still no mandatory universal lead screening law in the US.
Contrast this with PKU. PKU is a genetic disorder that causes irreversible brain damage. It can be found in 1 in 10,000 white newborns and 1 in 50,000 black newborns. In 1963 a blood test for PKU was developed. Just a few years later in the late 1960’s, mandatory, universal screening became the law. (A special diet could prevent brain damage).
Racist Disparities in the Rates of Lead Poisoning
Lead poisoning disproportionately harms black children, especially those living in poor housing or near toxic dumps. Lead poisoning affects 1 in 40 children, and black children are 1.6 times more likely to test positive for it. Black children had 3 times the rate of white kids among those with high levels (over 10 ug/dl.
Dr. Herbert Needleman, a pediatrician, researcher, and a leading opponent of lead products, described lead poisoning as a racial issue, explaining that the lack of funding for remediation was because “… it’s a black problem.” On
Corporations and Government Agencies Collude Promote Lead Poisoning
The USPSTF (The US Preventative Service Task Force) writes guidelines for preventive services, such as breast or prostate cancer screening. Its recommendations are generally very cautious and conservative. In its 2019 report to Congress, it stated that “the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood levels.” The Task Force lists the potential harms of trying to help more than half a million children, disproportionately black, as cost and possible side effects of treatment for severe lead poisoning. (USPSTF)
The CDC (Centers for Disease Control and Prevention) implements prevention policies guided by experts in their fields. In 2012, it stated that there is no safe level of lead in children’s blood. What did the great believers in family values, the politicians in Congress, do with this information? In 2012 Congress cut the CDC lead program budget by $27 million.
Under President Bush, the CDC fired expert members from their Lead Advisory Committee and replaced them with industry scientists from paint companies, such as Sherwin-Williams – one example of government support of industry profits.
During the 1920s, gas companies, like Esso (now Exxon) and automobile manufacturers fought vigorously against removing lead from gasoline in spite of knowing lead additives were toxic and that safer alternatives were available. They launched a public disinformation campaign and attacked scientists, such as industrial hygienist Alice Hamilton, who argued against them. In later years, they launched a major campaign accusing their leading critic, pediatrician and researcher, Dr. Herbert Needleman, of scientific misconduct (eventually overturned) (Rosner).Needleman designed a plan to hire unemployed people to remove lead from housing, minimizing future exposures while addressing the socioeconomic damage of unemployment. His persistence in fighting the industry is a sterling model for public health workers; he was awarded the American Public Health Association’s (APHA) moral courage award.
The Lead Industries Association (LIA) represents lead interests. They published guidelines for the use of lead, misleading people into thinking they were acceptable lead levels. They created doubt about the dangers of lead, similar to the tactics of climate change deniers. This counters the safer strategy of only allowing the use of chemicals proven safe, known as the precautionary principle or “better safe than sorry” as practiced in other countries. Tobacco companies and many other corporations subsequently adopted the same tactics as the lead industry. The American Academy of Pediatrics stated that “requiring industries to prove that chemicals are not toxic before they are put on the market or emitted by polluting industries is the only way to protect children” (AAP, 2017)
In academia, researchers at the Kennedy Krieger Institute (KKI) of the Johns Hopkins University, a research and treatment center for children with developmental and intellectual disabilities, conducted a study on lead abatement to identify cost-effective programs. They subjected groups of children with high levels of lead to different interventions, allowing the use of less effective methods when they knew there were better ones. A lawsuit accused KKI of unethical behavior by not properly informing participants of the risks. Ethicists criticized the researchers for accepting governmental propaganda that it was too expensive to protect children from lead poisoning (too expensive a hit to corporate profits). Instead of pursuing a social justice strategy to demand funding for prevention and abatement, they pursued a cheaper, less effective one (Buchanan D).
Today, toxic chemicals and metals, such as lead, have flooded the drinking water used by millions of residents in Flint, Michigan and Newark, New Jersey due to failing infrastructure that federal and state governments refuse to repair. Neither city has safe water, but government officials in Flint refuse to spend the necessary $1.5 billion to repair the pipes leaching lead into the water. Instead, they blame residents for not paying their water bills while the water utility charges one of the highest rates in the US.
True to the American ideology of “personal responsibility,” the government and health educators place the blame on the victims. They advise the public to avoid lead poisoning by removing lead paint from their homes, using non-leaded paint, running cold water from the tap, and keeping a dust free environment. Clearly, these superficial guidelines do not address the upstream causes of living in environments with polluted air, soil, and housing, not to mention the inability of poor and working people to pay for lead abatement or secure safe affordable housing.
Racist Outcomes of Environmental Hazards
Lead poisoning disproportionately harms black children. In fact, “race” predicts the placement of hazardous waste more than socioeconomic measures. The residents of Flint and Newark are predominantly black. Their cities have been abandoned by the auto industry, leaving high rates of unemployment and poverty, and allowed to deteriorate. Racism causes the high rates of poverty due to lower wages, and systemic discrimination in employment, education, and housing. Yet even wealthy black families live in neighborhoods with high levels of toxic contamination. As David Rosner and Gerald Markowitz, authors of Lead Wars, wrote:
The mix of racism and corporate greed has put lead and other pollutants into millions of homes in the United States. The scores of endangered kids in Flint are just the tip of a vast, toxic iceberg.”
Drinking bottled water, keeping a clean home, and other individual based recommendations do not cut it. Residents have mobilized to demand more substantial changes, but a system based on exploitation cannot and won’t fix the problems. We need a political economy that protects the public. The economic system we have now puts profit over people. It’s time for change.
Dr. Nayvin Gordon is a California Family Physician who has written many articles on health and politics. He can be reached at firstname.lastname@example.org
Rosner D, Markowitz G. A ‘gift of God’?: The public health controversy over leaded gasoline during the 1920s. Am J Public Health. 1985 April; 75(4): 344–352.
Buchanan DR Miller FG. Justice and Fairness in the Kennedy Krieger Institute Lead Paint Study: the Ethics of Public Health Research on Less Expensive, Less Effective Intervention. Am J Public Health. 2006 May; 96(5): 781–787.
USPSTH. Recommended Statement. Elevated Blood Lead Levels.
https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/elevated-blood-lead-levels-in-childhood-and-pregn and Preventionancy-screening
American Academy of Pediatrics. Still Treating Poisoning After All These Years. https://pediatrics.aappublications.org/content/140/2/e20171400
American Academy of Family Physicians. Lead Poisoning in Children. https://www.aafp.org/afp/2019/0701/p24.html
Washington HA. A Terrible Thing to Waste: Environmental Racism and its Assault on the American Mind. NY: Little, Brown, 2019.