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How to Finally End Lead Poisoning in America

5 minute read
Philip Landrigan, MD, MSc, is a pediatrician and Dean for Global Health in the Icahn School of Medicine at Mount Sinai. David Bellinger, PhD, MSc, is a Professor of Neurology at Harvard Medical School and Boston Children’s Hospital.

Lead is a devastating poison. It damages children’s brains, erodes intelligence, diminishes creativity and the ability to weigh consequences and make good decisions, impairs language skills, shortens attention span, and predisposes to hyperactive and aggressive behavior. Lead exposure in early childhood is linked to later increased risk for dyslexia and school failure. When lead exposure is widespread, it can undermine the economic productivity and sustainability of entire societies.

Lead is a silent poison. In most children, lead wreaks its havoc in the absence of any obvious signs or symptoms. Infants in the womb and children under the age of 5 are the most vulnerable. Research has shown that higher levels of exposure are the most dangerous, but that no level of lead is safe.

Lead was everywhere in 20th-century America. It was marketed aggressively by the lead industry and used widely in paint, gasoline and water pipes. At peak use in the early 1970s, more than 100,000 tons was added to gasoline each year to boost octane and enhance engine performance. This lead was released to the environment via automotive exhaust. It contaminated air, water and soil. And it got into the bodies of Americans of all ages, especially small children.

The tide began to turn against lead in the 1970s. Two key events were the discovery by Herbert Needleman and others that lead could cause silent brain injury, a finding that was savagely contested by the lead industry, and the realization that lead in gasoline could destroy the platinum-containing catalytic converters mandated on new cars under the Clean Air Act. Lead was removed from gasoline beginning in 1976, from house paint in 1978 and from drinking water pipes and solder in 1986. Average blood lead levels in children under 5 in the U.S. fell from 17 micrograms per deciliter in 1976 to 4 micrograms in the early 1990s, a decline of more than 75%, and have continued to fall.

But as we have seen in Flint, Mich., lead exposure is still epidemic in America. According to the Centers for Disease Control and Prevention, an estimated 535,000 children under the age of 5 still have elevated blood levels with silent poisoning. Approximately 20 million older American homes still contain lead paint, and approximately 10 million homes have lead water pipes. And as the horrific and entirely avoidable events in Flint so painfully demonstrate, the burden of lead often falls most heavily upon the poorest and most vulnerable among us.

To go the last mile and finally end lead poisoning in this country, we need to put in place a comprehensive three-point program:

1. Map the sources of lead.

In this era of big data when we can monitor billions of telephone conversations and visualize traces of water on Pluto, it is incomprehensible that we do not have a fine-grained national map of the sources of lead in America. CDC, the Department of Housing and Urban Development, and state and city health departments need to be given the resources they need to enable them to rapidly and comprehensively map lead sources block-by-block across the U.S.

Miners once used canaries to warn them of dangerously low oxygen levels. We seem to use children in the same way to warn us of lead. We wait for a child to become poisoned before we investigate the source of exposure. Given the limited options for treating children with lead poisoning, this is poor public health and bad medicine. We need to identify lead hazards before they harm children.

2. Get the lead out.

Once lead sources have been identified, they need to be contained. This will require removing lead paint from homes, replacing lead pipes and cleaning up contaminated soils. These actions are highly cost-effective because they prevent disease and lifelong disability not only in today’s children, but in all future generations.

To build a national workforce for lead removal, green-jobs partnerships can be built between city governments and major unions to establish new vocational training programs that will prepare young men and women from urban communities to safely remediate lead. These programs will provide a portal to middle-class employment, increase the number of available housing units in inner cities and help lift entire neighborhoods out of poverty.

3. Make sure there is no new lead.

Despite the removal of lead from paint, pipes and gasoline, global lead production has remained steady. The major driver is the need for vast quantities of new lead in battery production. This is a dangerous trend that needs to be halted. It is time to eliminate all non-essential uses of lead. Replacement of the lead-acid battery by new lead-free technology is long overdue. Both to protect our children’s health and to build a clean energy future, we need clean power sources for the 21st century.

Now is the time to end the profound immorality of lead poisoning in America. We have the science. We know how to do the job. What we need is leadership, courage and political will.

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