tag:theconversation.com,2011:/global/topics/lead-poisoning-2951/articlesLead poisoning – The Conversation2024-03-07T13:32:32Ztag:theconversation.com,2011:article/2180212024-03-07T13:32:32Z2024-03-07T13:32:32ZLead from old paint and pipes is still a harmful and deadly hazard in millions of US homes<figure><img src="https://images.theconversation.com/files/572091/original/file-20240130-19-tg1jv8.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3763%2C2822&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When lead-based paint blisters and cracks, lead dust may be released in the air. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/lead-based-paint-abatement-royalty-free-image/1735464372?phrase=lead%2Bpoisoning%2B">Douglas Rissing/iStock via Getty Images Plus</a></span></figcaption></figure><p>Lead is a potent neurotoxin that causes severe health effects such as <a href="https://doi.org/10.1186/s12889-023-15874-7">neurological damage, organ failure and death</a>. </p>
<p>Widely used in products such as paint and gasoline until the late 1970s, lead continues to contaminate environments and harm the health of people around the world. </p>
<p>The World Health Organization estimates that more than <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health#">1 million deaths each year are attributable to lead poisoning</a>, with the highest exposures in developing nations. Lead continues leaching from old paint, pipes and industrial sources into soils, homes and waterways across the globe. </p>
<p>In more recent years, this number has risen at an incredible pace, with some research showing that nearly 5.5 million adults <a href="https://doi.org/10.1016/S2542-5196(23)00166-3">die from lead-related health complications</a>.</p>
<p>I am a <a href="https://hhs.purdue.edu/directory/aaron-specht/">health physicist</a> and my research focuses on ways to improve the technology <a href="https://doi.org/10.1021/acs.est.0c06622">used to screen for lead</a> and other <a href="https://doi.org/10.1021/acs.est.1c00937">environmental toxicants</a>. In developing and applying my technologies to see how people are affected by toxicants like lead, I have tested more than 20,000 people around the world over the past five years.</p>
<p>This preventable health crisis especially threatens children during periods of <a href="https://doi.org/10.1289/ehp.7688">critical brain development</a> but can also <a href="https://doi.org/10.1093/aje/kwh333">impair intellectual development</a> and <a href="https://doi.org/10.1016/S2468-2667(18)30025-2">long-term health</a> in adults. Understanding and addressing this persistent problem will require improved monitoring, targeted remediation and a great deal more awareness and dialogue.</p>
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<figcaption><span class="caption">Lead is especially toxic to children under age 6.</span></figcaption>
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<h2>How lead damages the body</h2>
<p>Lead enters the body through three routes: <a href="https://www.atsdr.cdc.gov/csem/leadtoxicity/exposure_routes.html">ingestion, absorption or inhalation</a>. Once inside, <a href="https://doi.org/10.3390/ijerph182212051">lead mimics calcium</a> by binding to proteins and enzymes where calcium is typically involved. </p>
<p>Lead looks a lot like calcium to many of the systems in our body. By hijacking these calcium-dependent processes, lead disrupts many normal functions ranging from neurological function to cardiovascular health. </p>
<p>When lead replaces calcium in these processes, it causes <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health#">irreversible damage</a>, even at low levels of chronic exposure. Studies show that low levels of lead are associated with dangerous <a href="https://doi.org/10.1016%2Fj.envres.2016.10.007">lifelong illnesses such as Alzheimer’s</a> and <a href="https://doi.org/10.1289%2Fehp.9785">heart disease</a>.</p>
<p>Furthermore, like calcium, lead accumulates <a href="https://doi.org/10.1289/ehp.919133">in our teeth and bones</a>. This compounds lead’s adverse effects as our bodies grow and age, since the lead in bone will reappear as our body looks to its calcium stores during periods of growth or, critically, during pregnancy. </p>
<p>Lead exposure can come from many sources in our daily life, from water systems using <a href="https://www.epa.gov/ground-water-and-drinking-water/lead-service-lines">lead water lines</a> and <a href="https://www.hud.gov/program_offices/healthy_homes/healthyhomes/lead">legacy exposures from old paint</a> to things that people often don’t think about, such as <a href="https://doi.org/10.1016/j.envres.2023.115719">lead in firearms</a> or <a href="https://doi.org/10.1016/j.envres.2020.109860">metal pots and pans</a>. </p>
<p>Researchers often see <a href="https://doi.org/10.1001/jamapediatrics.2018.2382">exposures from soils</a> in highly polluted areas, but sometimes it can be <a href="https://doi.org/10.1016/j.jenvman.2022.115904">present in old donated toys</a> at a child’s day care. </p>
<p>Late in 2023, investigators working with the Centers for Disease Control and Prevention found <a href="https://www.cdc.gov/nceh/lead/news/lead-poisoning-outbreak-linked-to-cinnamon-applesauce-pouches.html">dangerous levels of lead in applesauce</a>, likely stemming from a cinnamon spice grinder. This highlights the <a href="https://www.nytimes.com/2024/02/27/world/europe/lead-applesauce-food-safety.html">Food and Drug Administration’s failures</a> in keeping lead out of the U.S. food supply. </p>
<h2>Fragmented testing</h2>
<p>Blood lead screening <a href="https://www.cdc.gov/nceh/lead/data/national.htm">serves as the first line of defense</a> against lead exposure, particularly in high-risk individuals and primarily in children. However, <a href="https://toxicfreefuture.org/research/children-at-risk/state-lead-screening-policies/">testing protocols and recommendations vary widely</a>, and most states lack universal testing mandates. </p>
<p>Even in cases where universal screening programs exist, the data obtained can be insufficient. This is because blood tests capture only recent exposure, and universal testing oftentimes mandates only one test of children within a six-year window. </p>
<p>This fragmented system, combined with research indicating that many doctors <a href="https://doi.org/10.1136/oemed-2023-109210">deviate from lead testing guidelines</a>, allows exposures to go undetected until irreversible neurological damage has been done. </p>
<p>We are hopeful that as research like ours draws more attention to the gravity of this issue, universal, standardized screening will become the norm across the U.S. This would save many children – and generations to come – from ongoing and preventable exposures.</p>
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<figcaption><span class="caption">Lead toxicity doesn’t affect just children.</span></figcaption>
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<h2>How testing is done</h2>
<p>Monitoring lead levels typically involves a <a href="https://www.cdc.gov/nceh/lead/prevention/blood-lead-levels.htm">simple blood test</a>, generally ordered by your doctor. These tests are widely available but <a href="https://doi.org/10.1016/j.chemosphere.2021.129832">can easily be inaccurate</a> based on when the test was taken. Since <a href="https://doi.org/10.1038%2Fs41370-018-0036-y">blood lead levels can change quickly</a>, children who get tested several weeks after exposure could falsely test as normal. </p>
<p>Moreover, because there is no requirement for doctors to be trained in how to test for and treat lead exposure, many pediatricians <a href="https://doi.org/10.1136/oemed-2023-109210">lack awareness about lead screening protocols</a>. As a result, many at-risk people <a href="https://doi.org/10.1289/EHP10335">are not being tested</a>. </p>
<p>When tests are given, they may yield inaccurate results due to the <a href="https://doi.org/10.1038%2Fs41370-018-0036-y">rapid changes in blood lead</a>. Or sometimes results are not properly reported to local health departments. Further complicating this, in 2010, the Centers for Disease Control and Prevention declared that the country’s progress in removing lead from gasoline was a <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5.htm">great public health achievment</a>. As a result, many lead-testing programs in the U.S. were discontinued, leading to critical information gaps. </p>
<p>However, there is some reason for optimism. Some state-based lead surveillance programs that were phased out in the early 2000s have been returning in recent years. A good example is my home state of Indiana. A law that <a href="https://www.in.gov/health/lead-and-healthy-homes-division/information-for-health-care-providers/testing-requirements/">went into effect on Jan. 1, 2023</a>, requires all health care providers serving children to offer lead testing to their patients. </p>
<p>Efforts from statewide programs like these will lead to more opportunities to inform physicians and to screen vulnerable populations.</p>
<h2>Ways to get tested</h2>
<p>Blood is by far the most widely used indicator for lead exposure. However, <a href="https://doi.org/10.1038/s41370-018-0036-y">in blood, lead dissipates quickly</a>, and after about a few weeks to a month, an exposure that was high enough to cause damage is no longer measurable from blood lead.</p>
<p>As part of my research, we have developed a handheld device that is able to <a href="https://doi.org/10.3109/1354750X.2016.1139183">noninvasively measure lead from bone</a> in minutes. Picture a Star Trek tricorder. We have patented the method we use to calculate lead in bone but currently have not commercialized it. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A hand wrapped around the handle of a small black, silver and gray lead-measuring device." src="https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=798&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=798&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=798&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1003&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1003&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579700/original/file-20240304-28-hr1ffe.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1003&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The author holds the Star Trek-esque device that he and his team developed at Purdue University.</span>
<span class="attribution"><span class="source">Aaron James Specht</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Bone lead is reflective of <a href="https://doi.org/10.1289/ehp.9783">years to decades of exposure</a> and is a more accurate test to reflect the permanence of damage induced by lead in the body. Bone lead has also been shown to have a strong relationship with <a href="https://doi.org/10.1515/reveh.2009.24.1.15">lead accumulation in the brain</a>, since lead hijacks places in both the bone and the brain where calcium is normally present. </p>
<p>Efficient and routine blood lead testing in children during their developmental stages could definitively identify exposure sources as they emerge. </p>
<p>While bone measurements allow researchers and physicians to effectively <a href="https://doi.org/10.1088/1361-6579/aa904f">measure years to decades of exposure</a>, health departments and the CDC currently lack the infrastructure to deploy this technology in communities that are highly affected by lead. </p>
<h2>What you can do</h2>
<p>People concerned about lead exposure <a href="https://www.cdc.gov/nceh/lead/prevention/testing-children-for-lead-poisoning.htm#">should request a blood lead test</a> from their doctor. Parents of young children should proactively ask pediatricians to conduct lead screening. If you live in an old home, especially one with peeling paint, you can contact your local health department to test for possible lead paint. </p>
<p>Additionally, your local water service provider should be able to tell you if lead water lines are in use leading to your home. Unfortunately, lead has no particular smell or taste to differentiate it from other possible contaminants.</p>
<p>Children and adults with elevated blood lead levels should talk to their pediatrician or doctor about effective <a href="https://www.cdc.gov/nceh/lead/advisory/acclpp/actions-blls.htm">follow-up testing</a> and potential dietary changes to promote lead excretion naturally. </p>
<p>For very high exposures, a treatment known as <a href="https://www.atsdr.cdc.gov/csem/leadtoxicity/patient_treatment.html#">chelation therapy</a>, which involves an oral medication that binds to lead so that it can be excreted in urine, has been shown to be <a href="https://doi.org/10.1203/00006450-200011000-00007">effective at reducing blood lead levels</a>. </p>
<p>These people should also notify their local health department, which can identify and remove lead sources in their environment to eliminate the risk to both current and future residents.</p><img src="https://counter.theconversation.com/content/218021/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aaron Specht receives funding from the National Institutes of Health, Centers for Disease Control, and JPB Foundation. </span></em></p>Although the US banned lead-based paint in 1978, homes built before then commonly contain lead paint.Aaron Specht, Assistant Professor of Health Physics, Purdue UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2155812023-12-06T13:26:50Z2023-12-06T13:26:50ZCitizen science projects tend to attract white, affluent, well-educated volunteers − here’s how we recruited a more diverse group to identify lead pipes in homes<figure><img src="https://images.theconversation.com/files/562552/original/file-20231129-21-kkvov4.jpg?ixlib=rb-1.1.0&rect=32%2C8%2C5431%2C3628&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A lead pipe in the kitchen ceiling of a home in Newark, N.J.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/NewarkLeadInWater/fb4c11b248d84f63ba555307855d6e23/photo">AP Photo/Julio Cortez</a></span></figcaption></figure><p>Recruiting participants for a citizen science project produced a <a href="http://dx.doi.org/%2010.5334/cstp.627">more diverse group</a> when people were signed up through partner organizations, such as schools and faith-based organizations, than when they joined on their own. We used this approach to recruit volunteers for <a href="http://crowdthetap.org">Crowd the Tap</a>, a citizen science initiative that crowdsources the locations of lead plumbing in homes.</p>
<p>We signed up 2,519 households through partner organizations, in addition to 497 households that signed up on their own. We recruited households from all 50 states, though the majority came from North Carolina. Our project was initially funded by the <a href="https://www.epa.gov/">Environmental Protection Agency</a>, which led to nationwide sampling, but additional funding from the <a href="https://wrri.ncsu.edu/">North Carolina Water Resources Research Institute</a> led to prioritizing sampling in North Carolina. </p>
<p>We recruited 2.2 times more Black participants and 2.3 times more Hispanic or Latino participants through partnerships than we did through individual sign-ups. This allowed us to assemble a group of volunteers that <a href="https://www.census.gov/quickfacts/fact/table/US/RHI125222">more accurately represented the U.S. population</a>. In addition, 11.2 times more lower-income participants took part in Crowd the Tap through partner organizations than on their own. </p>
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<h2>Why it matters</h2>
<p><a href="https://citizenscience.org/">Citizen science projects</a> use volunteers to collect data for scientific research. They can provide researchers with data that otherwise might not be available, such as the type of water pipes in people’s homes. </p>
<p>Unfortunately, many of these projects run by scientists at research institutions often <a href="https://doi.org/10.1093/biosci/biac035">fail to engage diverse participants</a>. When this happens, the projects can produce datasets that are <a href="https://acme-journal.org/index.php/acme/article/view/2178">biased toward predominantly white and higher-income communities</a>. </p>
<p>Lead poisoning mainly affects <a href="https://doi.org/10.1146/annurev-soc-073117-041222">lower-income communities of color</a>, so citizen science as traditionally conducted was unlikely to provide representative data on exposure to it. As scholars who study <a href="https://scholar.google.com/citations?user=DjJZRlAAAAAJ&hl=en">citizen science</a>, <a href="https://www.linkedin.com/in/valerie-ann-johnson-712b4a47/">community science</a> and <a href="https://scholar.google.com/citations?user=8C8IzV0AAAAJ&hl=en">public engagement</a>, we needed to <a href="https://idealscience.org/">overcome this diversity challenge</a>. </p>
<p>Lead plumbing is the primary cause of <a href="https://theconversation.com/the-us-is-making-plans-to-replace-all-of-its-lead-water-pipes-from-coast-to-coast-173963">lead contamination in drinking water</a> in the U.S. No amount of lead in drinking water is <a href="https://www.epa.gov/ground-water-and-drinking-water/basic-information-about-lead-drinking-water">safe for human consumption</a>.</p>
<p>Use of lead plumbing in public water systems and facilities that provide drinking water for human use has been <a href="https://www.epa.gov/sdwa/use-lead-free-pipes-fittings-fixtures-solder-and-flux-drinking-water">banned in the U.S. since 1986</a>. The federal government is working to replace <a href="https://www.epa.gov/ground-water-and-drinking-water/lead-service-lines">an estimated 9.2 million lead service lines</a> – the pipes that carry water from city water lines to individual homes – to reduce the risk of lead poisoning.</p>
<p>However, there is almost no data on drinking water pipe materials inside homes, so people could still be at risk for lead contamination. Any U.S. homes built before 1986 could have either <a href="https://www.bobvila.com/articles/lead-pipes/">lead pipes or lead solder</a> in their plumbing systems.</p>
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<a href="https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Infographic showing that solder, faucets or galvanized pipes inside homes can contain lead." src="https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=586&fit=crop&dpr=1 600w, https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=586&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=586&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=736&fit=crop&dpr=1 754w, https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=736&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/562995/original/file-20231201-29-wa39bn.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=736&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The federal government is working to replace lead service lines that run from public water lines to homes, but there can be other lead sources in indoor plumbing, especially in older buildings.</span>
<span class="attribution"><a class="source" href="https://www.epa.gov/ground-water-and-drinking-water/basic-information-about-lead-drinking-water">EPA</a></span>
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<p>Participants in Crowd the Tap identify the types of pipes they have using a magnet and a penny. If the magnet sticks, the pipe is steel. If the magnet doesn’t stick, participants scratch the pipe with a penny. A scratch the color of a penny indicates that the pipe is copper; if it has no shine, the pipe is plastic; and if it has silver streaks, the pipe is lead. People also conduct a simple at-home water chemistry test and provide information on the age of their home. </p>
<p>We combine this data to classify households based on the risk that they may have lead contamination. Anyone found to be at risk receives free laboratory testing of their water. Participants who have their water tested receive resources on how to address lead contamination in their water. </p>
<h2>How we did our work</h2>
<p>We got people to sign up for this project through high school and university classrooms and a Verizon corporate volunteer program. We also ran internship programs at North Carolina State University, where the students are predominantly white and signed up members of their own communities, and Shaw University, a historically Black university in Raleigh, North Carolina, where students recruited members of various faith communities. </p>
<p>Partnerships with historically Black colleges and universities, or HBCUs, and high school classrooms were especially valuable for engaging Black and Hispanic or Latino participants. The intern program at North Carolina State University was helpful for engaging lower-income participants.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/pgVwTclpN6A?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">This video explains to Crowd the Tap participants how to identify the types of pipes in their homes.</span></figcaption>
</figure>
<p>Faith communities received a stipend for engaging their members in Crowd the Tap through our partnership with the North Carolina Council of Churches’ <a href="https://ncchurches.org/programs">Partners in Health and Wholeness program</a>. We also adapted our project based on feedback we received from older faith community members, who indicated that our online data collection portal was too complicated. </p>
<p>In response, we made questions about demographics and water taste and color optional. Even though these questions helped us answer our research questions, they were a barrier for people who we were trying to engage. </p>
<p>Volunteers who signed up directly for Crowd the Tap came mostly from white households. Working with other organizations, we assembled a more racially and ethnically diverse set of participants. We see our results as a promising step toward making larger-scale citizen science projects more diverse. </p>
<p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.</em></p><img src="https://counter.theconversation.com/content/215581/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Caren Cooper received funding from the Environmental Protection Agency, the North Carolina Water Resources Research Institute, and the National Science Foundation. </span></em></p><p class="fine-print"><em><span>Valerie Ann Johnson received funding from the National Science Foundation and NASA SCoPE Seed Grant Project . She is affiliated with the Association for Advancing Participatory Sciences (Citizen Science Association). </span></em></p><p class="fine-print"><em><span>Danielle Lin Hunter does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>For a project on identifying lead water pipes in homes, outreach through partner groups produced a more representative set of volunteers.Danielle Lin Hunter, Postdoctoral Scholar in Forestry and Environmental Resources, North Carolina State UniversityCaren Cooper, Associate Professor of Forestry and Environmental Resources, North Carolina State UniversityValerie Ann Johnson, Dean of Arts, Sciences, and Humanities and Professor of Sociology, Shaw UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2148192023-11-22T13:17:53Z2023-11-22T13:17:53ZDigitized records from wildlife centers show the most common ways that humans harm wild animals<p>At hundreds of wildlife rehabilitation centers across the U.S., people can learn about wild animals and birds at close range. These sites, which may be run by nonprofits or universities, often feature engaging exhibits, including “ambassador” animals that can’t be released – an owl with a damaged wing, for example, or a fox that was found as a kit and became accustomed to being fed by humans. </p>
<p>What’s less visible are the patients – sick and injured wild animals that have been admitted for treatment.</p>
<p>Each year, people bring hundreds of thousands of sick and injured wild animals to wildlife rehab centers. Someone may find an injured squirrel on the side of the road or notice a robin in their backyard that can’t fly, and then call the center to pick up an animal in distress.</p>
<p>We study <a href="https://www.researchgate.net/profile/Tara-Miller-8">ecology</a> and <a href="https://scholar.google.com/citations?user=XfgB_BUAAAAJ&hl=en">biology</a>, and recently used newly digitized records from wildlife rehabilitation centers to identify the human activities that are most harmful to wildlife. In the largest study of its kind, we reviewed 674,320 records, mostly from 2011 to 2019, from 94 centers to paint a comprehensive picture of threats affecting over 1,000 species across much of the U.S. and Canada. </p>
<p>Our findings, <a href="https://doi.org/10.1016/j.biocon.2023.110295">published in the journal Biological Conservation</a>, point to some strategies for reducing harm to wildlife, especially injuries caused by cars.</p>
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<figcaption><span class="caption">The Wildlife Rehabilitation Center of Minnesota, the largest independent rehab center in the U.S., treats over 1,000 sick and injured animals yearly.</span></figcaption>
</figure>
<h2>Tracking the toll</h2>
<p>Humans are responsible for the deaths and injuries of billions of animals every year. Bats and birds fly into buildings, power lines and wind turbines. Domestic cats and dogs kill backyard birds and animals. Development, farming and industry alter or destroy wild animals’ habitats and expose wildlife to toxic substances like lead and pesticides. Extreme weather events linked to climate change, such as flooding and wildfires, can be devastating for wildlife.</p>
<p>Most Americans support <a href="https://www.ifaw.org/press-releases/survey-majority-americans-support-candidate-values-protection-endangered-species">protecting threatened and endangered species</a>, and <a href="https://biologicaldiversity.org/w/news/press-releases/survey-most-americans-believe-human-population-driving-wildlife-extinctions-2020-11-12/">recognize that human activities can harm wildlife</a>. But it is surprisingly difficult to determine which activities are most harmful to wildlife and identify effective solutions. </p>
<p>Information from wildlife rehab centers across the U.S. can help fill in that picture. When an animal is brought into one of these centers, a rehabilitator assesses its condition, documents the cause of injury or illness if it can be determined, and then prepares a treatment plan. </p>
<p>Wildlife rehabbers may be veterinarians, veterinary technicians or other staff or volunteers who are certified by state agencies to treat wildlife. They follow professional codes and standards, and sometimes publish research in peer-reviewed journals.</p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/reel/CwNiHd5AkSL/?utm_source=ig_web_copy_link\u0026igshid=MzRlODBiNWFlZA==","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<h2>A growing data pool</h2>
<p>Until recently, most wildlife rehab records existed only in binders and file cabinets. As a result, studies drawing on these records typically used materials from a single location or focused on a particular species, such as bald eagles or foxes. </p>
<p>Recently, though, rehab centers have digitized hundreds of thousands of case records. Shareable digital records can improve wildlife conservation and public health. </p>
<p>For example, the <a href="https://www.wildlifecenter.org/">Wildlife Center of Virginia</a> has worked with government agencies and other rehab centers to establish the <a href="https://www.wild-one.org/">WILD-ONe database</a> as a tool for assessing trends in wildlife health. This will be an exciting area of research as more records are digitized and shared.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Map showing distribution of wildlife centers that provided data for the study." src="https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=348&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=348&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=348&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=438&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=438&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560206/original/file-20231117-19-6un51w.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=438&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Locations in the U.S. and Canada where animals were found (blue dots) before being brought to wildlife rehabilitation centers (red stars) included in Miller et al., 2023.</span>
<span class="attribution"><a class="source" href="https://doi.org/10.1016/j.biocon.2023.110295">Miller et al., 2023</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Threats vary by species</h2>
<p>Using this trove of data, we have been exploring patterns of wildlife health across North America. In our study, we <a href="https://doi.org/10.1016/j.biocon.2023.110295">identified key threats affecting wildlife</a> by region and for iconic and endangered species. </p>
<p>Overall, 12% of the animals brought to rehab centers during this period were harmed by vehicle collisions – the single largest cause of injury. For <a href="https://www.allaboutbirds.org/guide/Great_Horned_Owl/overview#">great horned owls</a>, which are common across the U.S., cars were the most common cause of admission – possibly because the owls commonly <a href="https://www.fws.gov/story/threats-birds-collisions-road-vehicles">forage at the same height as vehicles</a>, and may feed on road kill. </p>
<p>Other threats reflect various animals’ habitats and life patterns. Window collisions were the most common injury for the <a href="https://www.batcon.org/bat/eptesicus-fuscus/">big brown bat</a>, another species found in many habitats across the U.S. Fishing incidents were the main reason for admission of endangered <a href="https://www.fisheries.noaa.gov/species/kemps-ridley-turtle">Kemp’s ridley sea turtles</a>, which are found in the Gulf of Mexico and along the Atlantic coast.</p>
<p>Toxic substances and infectious diseases represented just 3.4% of cases, but were important for some species. <a href="https://www.allaboutbirds.org/guide/Bald_Eagle/overview">Bald eagles</a>, for example, were the species most commonly brought to centers with lead poisoning. Eagles and other raptors <a href="https://www.wildlifecenter.org/lead-toxicity-raptors">consume lead ammunition inadvertently</a> when they feed on carcasses left in the wild by hunters. </p>
<p>In southern Florida, hurricanes and floods resulted in spikes in the numbers of animals brought to rehab centers, reflecting the <a href="https://theconversation.com/scientists-at-work-sloshing-through-marshes-to-see-how-birds-survive-hurricanes-146067">impact of climate-driven extreme weather events on wildlife health</a>. </p>
<p>About one-third of animals in the cases we reviewed were successfully released back to the wild, though this varied greatly among species. For example, 68% of brown pelicans were released, but only 20% of bald eagles. Unfortunately, some 60% of the animals died from their injuries or illnesses, or had to be humanely euthanized because they were unable to recover.</p>
<h2>Spotlighting solutions</h2>
<p>Our results spotlight steps that can help conserve wildlife in the face of these threats. For example, transportation departments can build more <a href="https://interestingengineering.com/lists/29-of-the-most-heartwarming-wildlife-crossings-around-the-world">road crossings for wildlife</a>, such as bridges and underpasses, to help animals avoid being hit by cars.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A large wild cat emerges from an underpass beneath a highway." src="https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560059/original/file-20231116-29-cl09dy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A mountain lion uses an underpass to safely traverse Route 97 near Bend, Oregon.</span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Wildlife management agencies can <a href="https://doi.org/10.1007/s13280-018-1132-x">ban or limit use of ammunition and fishing gear that contain lead</a> to reduce lead poisoning. And governments can <a href="https://www.humanesociety.org/resources/wildlife-disaster-preparedness">incorporate wildlife into disaster management plans</a> to account for surges in wildlife rescues after extreme weather events.</p>
<p>People can also make changes on their own. They can drive more slowly and pay closer attention to wildlife crossing roads, switch their fishing and hunting gear to nonlead alternatives, and <a href="https://www.allaboutbirds.org/news/how-can-i-keep-birds-from-hitting-my-windows/">put decals or other visual indicators on windows</a> to reduce bat and bird collisions with the glass.</p>
<p>To learn more about animals in your area and ways to protect them, you can <a href="https://www.humanesociety.org/resources/how-find-wildlife-rehabilitator">visit or call your local wildlife rehab center</a>. You can also donate to these centers, which we believe do great work, and are often underfunded.</p>
<p>The scale of threats facing wild animals can seem overwhelming, but wildlife rehabbers show that helping one injured animal at a time can identify ways to save many more animal lives.</p><img src="https://counter.theconversation.com/content/214819/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tara K. Miller received funding from the National Science Foundation. </span></em></p><p class="fine-print"><em><span>Richard B. Primack does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Hundreds of wildlife rehabilitation centers across the US and Canada treat sick and injured animals and birds. Digitizing their records is yielding valuable data on human-wildlife encounters.Tara K. Miller, Policy Research Specialist, Repair Lab, University of VirginiaRichard B. Primack, Professor of Biology, Boston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2104522023-08-30T12:16:10Z2023-08-30T12:16:10Z50 years after the Bunker Hill mine fire caused one of the largest lead-poisoning cases in US history, Idaho’s Silver Valley is still at risk<figure><img src="https://images.theconversation.com/files/544335/original/file-20230823-21-itpz3x.jpg?ixlib=rb-1.1.0&rect=0%2C21%2C4885%2C3224&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Waterways and communities for miles around Idaho's Bunker Hill mine were contaminated with lead after the 1973 fire.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/scenic-river-in-cataldo-idaho-royalty-free-image/489436366">gjohnstonphoto/iStock/Getty Images Plus</a></span></figcaption></figure><p>On Sept. 3, 1973, a fire swept through the baghouse of the Bunker Hill mine in Idaho’s Silver Valley. The building was designed to filter pollutants produced by smelting, the melting of rocks that separates metal from its ore. The gases produced in this process carried poisons, including lead.</p>
<p>At the time, the <a href="https://osupress.oregonstate.edu/book/leaded">prices of lead</a> and <a href="https://www.macrotrends.net/1470/historical-silver-prices-100-year-chart">silver were climbing</a> toward all-time highs. Rather than wait for new filters and repairs, company officials kept the mine running. <a href="https://www.oupress.com/9780806138985/idahos-bunker-hill/">They increased production</a>, bypassed the filtration steps and, <a href="https://nap.nationalacademies.org/catalog/11359/superfund-and-mining-megasites-lessons-from-the-coeur-dalene-river">for eleven months</a>, dumped noxious gases directly into the surrounding area.</p>
<p>Then, horses in the area <a href="https://osupress.oregonstate.edu/book/leaded">began dying</a>. </p>
<p>When data on children’s blood lead levels began to arrive in September 1974, one year after the fire, the results were shocking. The fire became one of the largest single lead-poisoning events in U.S. history. </p>
<figure class="align-right ">
<img alt="A large industrial complex lit up against snow." src="https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=550&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=550&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=550&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=691&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=691&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544196/original/file-20230823-15-j8fnct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=691&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Bunker Hill smelter in the 1970s. The mine closed in 1991, but planning is underway in 2023 to restart it.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/File:Bunker_Hill_smelter_operating_in_winter_snow,_1970s.jpg">US EPA</a></span>
</figcaption>
</figure>
<p>Without filters, the mine operations deposited an estimated <a href="https://www.restorationpartnership.org/pdf/d-Chapter_2_Hazardous_Substance_Sources.pdf">35 tons of lead per month</a> in the area, four times more than before the fire. Between January and September 1974, it also released more than 2 tons of arsenic and 2.5 tons of mercury, among other metals and toxic chemicals, according to data <a href="https://www.restorationpartnership.org/pdf/d-Chapter_2_Hazardous_Substance_Sources.pdf">collected by Restoration Partnership</a>.</p>
<p>Lead still contaminates the soil across <a href="https://www.deq.idaho.gov/waste-management-and-remediation/mining-in-idaho/bunker-hill-superfund-site/">Silver Valley</a> today, and it continues to wash down tributaries and into the Coeur d’Alene River and Lake Coeur d’Alene. Many people in this fast-growing region are unaware of the risks.</p>
<h2>How lead harms human health</h2>
<p>Our bodies use metals like zinc, iron and calcium. However, we have zero need for lead. Its chemical composition makes it both <a href="https://doi.org/10.1515/intox-2015-0009">highly toxic and able to infiltrate almost every organ in the body</a>.</p>
<p>Lead exposure can cause <a href="https://doi.org/10.1152/ajpheart.00158.2008">high blood pressure and cardiac disease</a>. It can also cause problems with <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health">brain development, kidney function and reproductive health</a>, including <a href="https://www.cdc.gov/nceh/lead/prevention/pregnant.htm">miscarriages, prematurity and low birth weight</a>. Children are especially susceptible to lead’s toxic effect on the central nervous system; they absorb it up to <a href="https://doi.org/10.2105/AJPH.2015.303003">17 times more</a> readily than adults, and their brains are still developing.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/76RKSQgduVQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">What lead poisoning does to a child’s brain. PBS.</span></figcaption>
</figure>
<p>The Centers for Disease Control and Prevention’s reference value for levels of lead in blood has changed as knowledge about this potent neurotoxin has evolved. In 1973, a blood lead level of less than 40 <a href="https://www.cdc.gov/nceh/lead/docs/lepac/blrv-recommendation-report-508.pdf">micrograms per deciliter</a> in children was vaguely defined as “undue lead absorption.” In 1991, anything above 10 micrograms per deciliter was considered a “level of concern.”</p>
<p>Today, <a href="https://www.cdc.gov/nceh/lead/data/blood-lead-reference-value.htm">3.5 micrograms per deciliter</a> is the reference value, meant to identify the 2.5% of children with the highest blood lead levels. The CDC no longer uses “level of concern” as a threshold, because there is <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health">no safe blood lead level in children</a>.</p>
<h2>Children’s health after the Baghouse Fire</h2>
<p>The children of the Silver Valley were exposed to extremely high levels of poisons after the Baghouse Fire at the Bunker Hill mine.</p>
<p>Ninety-nine percent of children within a mile of the smelter who were tested after the fire – 173 out of 175 kids – had blood lead levels of 40 micrograms per deciliter or higher. Their <a href="https://osupress.oregonstate.edu/book/leaded">average blood lead level</a> was 67.4 micrograms per deciliter. A 1-year-old tested at 164 micrograms per deciliter, the <a href="https://osupress.oregonstate.edu/book/leaded">highest ever recorded in a child</a>.</p>
<p>Cognitive impairment in children, as measured by loss of IQ points, can occur at levels of <a href="https://doi.org/10.1186/s13643-022-01963-y">less than 5 micrograms per deciliter</a>.</p>
<figure class="align-center ">
<img alt="A donut chart with concentric rings for each distance shows almost all children had dangerously high high blood lead levels close to the smelter. Even 6 to 15 miles away (10 to 24 kilometers), one-fifth of children had exceptionally high levels." src="https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=731&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=731&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545366/original/file-20230829-15-refhca.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=731&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://osupress.oregonstate.edu/book/leaded">Adapted from Leaded: The Poisoning of Idaho's Silver Valley</a></span>
</figcaption>
</figure>
<p>To put the Silver Valley numbers into context, the average blood lead level for children in Flint, Michigan, at the height of the lead-pipe water crisis in 2015 was <a href="https://www.sciencedaily.com/releases/2018/03/180326090313.htm">1.3 micrograms per deciliter</a>, and 21 children had blood lead levels <a href="https://www.statnews.com/2016/01/22/flint-children-lead-exposure/">over 10 micrograms per deciliter</a>.</p>
<p>It is difficult to assess the extent of the damage from the Baghouse Fire in the children of the Silver Valley. Doctors in the 1970s weren’t able to test for cognitive and neurologic problems in the most vulnerable children, birth to 3 years old. Michael C. Mix describes in “<a href="https://osupress.oregonstate.edu/book/leaded">Leaded: The Poisoning of Idaho’s Silver Valley</a>” how the politically powerful company that owned the mine also suppressed and distorted health findings. Blood lead levels in children in the area remained higher than 40 micrograms per deciliter into 1980.</p>
<h2>Continuing health risk in Silver Valley</h2>
<p>The legacy of the Baghouse Fire continues to haunt Silver Valley, but that incident 50 years ago is only part of the picture. Decades of contamination from other mines in the area poses further risks.</p>
<p>At its height, the Silver Valley area had over 200 active mines. Today, it is the largest contiguous Superfund site in the nation – 1,500 square miles (3,885 square kilometers) across northern Idaho and eastern Washington. Multiple agencies, including the U.S. Environmental Protection Agency, Idaho Department of Environmental Quality, Panhandle Health District, the Coeur d’Alene Trust and the Coeur d’Alene Tribe (Schitsu’umsh), are active in <a href="https://cumulis.epa.gov/supercpad/SiteProfiles/index.cfm?fuseaction=second.Cleanup&id=1000195#bkground">monitoring and cleanup operations</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A map is pocked with x's showing mine sites across the region, mostly east of the Bunker Hill fire site." src="https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=333&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=333&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=333&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=418&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=418&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544192/original/file-20230823-25-2hf4yv.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=418&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Hundreds of old mine sites dot the region east of Lake Coeur d'Alene.</span>
<span class="attribution"><a class="source" href="https://panhandlehealthdistrict.org/">Panhandle Health District</a></span>
</figcaption>
</figure>
<p>Early efforts to clean up contamination from the fire concentrated on residential areas in “The Box,” a 21-square-mile area (54 square kilometers) around the old smelter site and the towns of Kellogg, Smelterville and Pinehurst. Workers dug up contaminated earth and removed it, and officials monitored the environment and human health.</p>
<p>The cleanup today is much more extensive and ongoing, with efforts focused on cleaning up the old mine and mill sites and recreational areas.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A map shows the Superfund site including Cuoer d'Alene Lake" src="https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=418&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=418&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=418&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=525&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=525&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544199/original/file-20230823-29-57d7ij.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=525&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Bunker Hill Mining and Metallurgical Complex Superfund Site covers about 1,500 square miles across northern Idaho and eastern Washington. ‘The Box’ is shaded in gray.</span>
<span class="attribution"><a class="source" href="https://cumulis.epa.gov/supercpad/SiteProfiles/index.cfm?fuseaction=second.cleanup&id=1000195">EPA</a></span>
</figcaption>
</figure>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A map shows a boundary around the lake and along the river." src="https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=423&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=423&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=423&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=532&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=532&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544393/original/file-20230823-21-bhorjz.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=532&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The EPA’s active area within the Superfund site includes long stretches of the Coeur d'Alene River and Lake Coeur d'Alene. The EPA notes that there are also sites with contamination further downstream in the Spokane River, Washington.</span>
<span class="attribution"><span class="source">EPA</span></span>
</figcaption>
</figure>
<p>Lead does not biodegrade. It’s in the soil, along waterways and even visible in sediment to the naked eye. It is estimated that the Coeur d’Alene River delivers about <a href="https://www.spokanepublicradio.org/regional-news/2022-03-24/coeur-dalene-basin-cleanup-to-expand-to-lower-basin">200 tons of lead</a> to Lake Coeur d’Alene every year.</p>
<h2>Swan deaths show the continuing risk</h2>
<p>Blood lead levels in the area have come down dramatically since 1973, but they are still concerning. In 2022, the average blood lead level for children in “The Box” was estimated at <a href="https://panhandlehealthdistrict.org/">2.3 micrograms per deciliter</a>, above <a href="https://www.epa.gov/americaschildrenenvironment/biomonitoring-lead">the U.S. average</a>. The average for the surrounding area <a href="https://panhandlehealthdistrict.org/">was higher, 3.3 micrograms per deciliter</a>.</p>
<figure class="align-right ">
<img alt="A dead swan along a riverway." src="https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544200/original/file-20230823-21-wvd9n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Tundra swans, which dig in the soil along streams for food, have been dying in northern Idaho.</span>
<span class="attribution"><a class="source" href="https://idfg.idaho.gov/press/tundra-swan-deaths-continue-lower-coeur-dalene-river-basin">CC Kajsa Van de Riet/IDEQ</a></span>
</figcaption>
</figure>
<p>Lead also affects area wildlife. <a href="https://semspub.epa.gov/work/10/100447187.pdf">Over 95% of wetlands</a> in the Lower Basin contain sediment that is toxic to wildlife. Tundra swans, whose eating habits make them very susceptible to heavy metal poisoning, are a recent casualty. For these migratory birds, the area is a stopover. Since 2008, average swan deaths are estimated at 50 to 60 birds per year. <a href="https://idfg.idaho.gov/press/tundra-swan-deaths-continue-lower-coeur-dalene-river-basin">There were over 300 bird deaths</a> documented in 2022; a <a href="https://semspub.epa.gov/work/10/100447187.pdf">study is underway</a> into the cause.</p>
<p>To complicate matters, many local residents have forgotten or never learned about the Baghouse Fire and the environmental issues associated with the site. Others choose to simply disbelieve the harmfulness of lead.</p>
<h2>As Idaho’s population booms, people aren’t aware</h2>
<p>Today, Idaho is one of the fastest-growing states in the U.S., with an influx of new residents oblivious to the local history and unaware of the threat that lurks below their feet and in the beaches of the beautiful lakes and rivers in the area. With population growth comes development, digging and disturbing contaminated soil.</p>
<p>Even normal weather conditions – from dry windy days that stir up lead dust particles to heavy rainfalls that mobilize contaminated sediments – can have detrimental effects on human health and on the environment.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A photo of a large sign with warnings about soils and sediments containing harmful levels of lead." src="https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544197/original/file-20230823-29-pgg37e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A warning reminds visitors on the Trail of the Coeur d'Alenes of the area’s lead risks.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/File:Trail_of_the_Coeur_d%27_Alenes_(10490158534).jpg">Robert Ashworth via Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Health risks remain, particularly along the banks and shores of the South Fork and the main Coeur d’Alene River, which are now popular recreation areas. Advisories about the lead risk in fish are still common, <a href="https://doh.wa.gov/data-and-statistical-reports/washington-tracking-network-wtn/fish-advisories/fish-consumption-advisories-washington-state">even downstream in Spokane</a>, Washington.</p>
<p>Children and pregnant women are the most vulnerable; <a href="https://peht.ucsf.edu/search.php?pane=reference&topic=lead">lead crosses the placenta, and it is present in breast milk</a>. Major outreach efforts are underway to educate those living, working or visiting the area.</p>
<p>Idaho’s <a href="https://panhandlehealthdistrict.org/">Panhandle Health District</a> offers free lead screenings year-round to anyone living or spending time in the area. In-home follow-ups are offered to those found to have elevated lead levels. Meanwhile, the cleanup, which started in 1986, will continue for decades to come. </p>
<p><em>Mary Rehnborg, program manager for the Institutional Controls Program in the Panhandle Health District, contributed to this article.</em></p><img src="https://counter.theconversation.com/content/210452/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Martin Schiavenato does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A fire and decades of silver and lead mining created the largest contiguous Superfund site in the nation in what today is one of the fastest-growing states. It includes popular Lake Coeur d’Alene.Martin Schiavenato, Assistant Professor of Nursing, Gonzaga UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1848122022-06-24T15:25:27Z2022-06-24T15:25:27ZBelfast’s silent public health crisis? Why we need widespread testing for lead-contaminated water<p>The water crisis at Flint, a town in Michigan, US in 2014 has focused public attention on the dangers of lead exposure, especially in children. A late 2016 <a href="http://www.reuters.com/investigates/special-report/usa-lead-testing/">investigation</a> found that nearly 3,000 other communities in the US had even worse lead water levels than Flint. A recently published study <a href="https://www.pnas.org/doi/10.1073/pnas.2118631119">claims</a> that “half of US population was exposed to adverse lead levels in early childhood”.</p>
<p>Lead exposure during the critical brain development window between the ages one and five has the most adverse effects on humans, causing irreversible and permanent brain damage. The US <a href="https://www.cdc.gov/about/index.html">Centers for Disease Control and Prevention</a> (CDC) estimates that 500,000 children under the age of six have blood-lead levels that exceed the “reference level”, as it’s called.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/nTpsMyNezPQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>The UK and Ireland have largely escaped the same scrutiny even though lead water pipes were used ubiquitously in homes and community water systems prior to 1970. The early 20th century “<a href="https://mitpress.mit.edu/books/great-lead-water-pipe-disaster">great lead water pipe disaster</a>” in Glasgow was neither particular to the city nor the time.</p>
<p>High lead levels in the city’s water supply were known to scientists as early as 1855, but water regulators ignored them and touted the supply as the “purest water in the world”. But Glasgow’s water supply became associated with negative health effects, from heart and kidney disease to “mental retardation” among children. It wasn’t until 1979 that the water was treated with lime which saw median blood-lead levels drop by 61%. </p>
<p>Here on our doorstep in Belfast, there is a potentially alarming but little-known public health issue growing. As our small-sample <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003174080-1/pedagogy-workshop-nuala-flood-tristan-sturm">water tests</a> make clear, while leaded water lies buried within our infrastructure, children are still being exposed to harmful levels of lead.</p>
<p>We are now about to undertake a bigger investigation that will reveal the extent of lead in Belfast’s water.</p>
<h2>Risks and harms</h2>
<p>There is plenty of evidence to show the physical, emotional, and developmental <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/337733/LEAD_Toxicological_overview__v3.pdf">harms of lead</a>, even at levels well below what is judged to be officially acceptable.</p>
<p>One study found that even for children who tested under 5 µgPb/dL (micrograms per decalitre or parts per billion) – the point that triggers UK level of concern – they could expect <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080614/">significant declines in IQ</a>.</p>
<p>Other studies have found that children under the limit could also expect <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969711012782?via%3Dihub">increased social and behavioural problems</a> such as ADHD, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0013935116301037">juvenile delinquency and criminality</a>, plus an array of <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30043-4/fulltext">physical harms</a> including coordination difficulties, kidney damage, reproductive issues, hearing and speech problems, and even an <a href="https://ehp.niehs.nih.gov/doi/10.1289/ehp.1408171">increased prevalence of cancer</a>.</p>
<p>Studies have correlated above standard blood-lead levels to <a href="http://jamanetwork.com/journals/jamapediatrics/fullarticle/190628">violence</a>. One correlated high violent crime rates in <a href="http://www.motherjones.com/environment/2016/02/lead-exposure-gasoline-crime-increase-children-health">New York</a> in the 1970s and 1980s to lead exposure.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A timeline showing the harmful effects of lead in the human body." src="https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/470754/original/file-20220624-14-ba1zd6.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The toxic effects of lead in the human body.</span>
<span class="attribution"><span class="source">Queen's University</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>Worsening lead levels</h2>
<p>The UK reference level for lead are the necessary product of the ubiquity of “three Ps” of lead in 20th-century urban life: <a href="http://www.bbc.co.uk/news/magazine-27067615">petrol</a>, paint and pipes. While these products have been regulated out of use, their vestiges remain layered in the infrastructure of everyday life in the UK, slowly poisoning people.</p>
<p>As more evidence-based studies make clear, any lead in the body causes observable harm, even levels well below the reference limit act as neuro-toxins, and the effects are permanent. A prominent lead researcher has <a href="http://pediatrics.aappublications.org/content/pediatrics/113/Supplement_3/1016.full.pdf">called such standards</a> a “risk management tool rather than a threshold for intoxity”. In other words, no level is non-toxic or safe for children.</p>
<p>Our preliminary <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003174080-1/pedagogy-workshop-nuala-flood-tristan-sturm">research</a> randomly sampled water from 35 houses in Belfast. Mindful that the UK reference limit is 10 µgPb/L, we found five test results or 15%, exceeded the reference limit, and four exceeded 50 µgPb/L with a maximum of 95.2 µgPb/L.</p>
<figure class="align-center ">
<img alt="Map showing the location of lead pipe-supplied homes in Belfast." src="https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=448&fit=crop&dpr=1 600w, https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=448&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=448&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=563&fit=crop&dpr=1 754w, https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=563&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/470569/original/file-20220623-60671-jfkljd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=563&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Map of lead pipe-supplied homes in Belfast.</span>
<span class="attribution"><span class="source">Jeremy Auerbach</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Notably all tests found some lead in the system. The false economy of safety of water under 10 µgPb/L is one derived from the ubiquity of lead in our urban spaces and the cost of cleansing that environment of it.</p>
<p>No epidemiological study of the prevalence of lead water or poisoning has ever taken place in Northern Ireland. <a href="https://www.gov.uk/government/publications/lead-exposure-in-children-surveillance-reports-from-2021">NI Water</a> told us it bases its level of concern from studies that have taken place in England.</p>
<p>Without a specific study in Northern Ireland it is difficult to gauge the magnitude and scale of the effects lead contaminated water is having in Belfast, though NI Water admits that an <a href="https://www.niwater.com/news-detail/11964/is-your-house-older-than-1970-then-you-might-have-lead-water-pipes/">estimated 100,000</a> homes in Northern Ireland might be receiving water contaminated by lead. These are clustered in older built-up areas of Victorian and Edwardian houses, but one should assume any house built before 1969 has lead pipes and therefore leaded water.</p>
<h2>Raising awareness</h2>
<p>The question is, why is this not a high-profile public health issue? Where are the campaigns to raise awareness and educate people about what they should do?</p>
<p>Given the number of old buildings and homes in Belfast and the UK more generally, this is not an isolated incident. It is estimated that <a href="http://www.wrcplc.co.uk/Data/Sites/1/GalleryImages/WebImages/pdfs/articles/pipeup.pdf">25% of all service pipes</a> in the UK are lead. Ageing pipes, road traffic pollution and drinking water acidity can leach higher lead concentrations into the water.</p>
<p>In short, for adults in Belfast, this isn’t necessarily the water they drank as a child. The city tacitly recognises the severity of the impact of lead pipes on public health as it now systematically, street by street, replaces the lead service pipes over a 20-year period, but only to the property boundary.</p>
<p>It is not doing enough to warn its citizens that they should cautiously drink the water, filter it with activated carbon, or flush the pipes before each use, despite the now-closed <a href="https://www.gov.uk/government/organisations/health-protection-agency">Health Protection Agency</a> (HPA) highlighting its own <a href="https://academic.oup.com/qjmed/article/108/11/849/1903791/Investigating-lead-poisoning-in-children-could">prevention awareness shortcomings</a> in 2009. Under funding of water service providers likely limits such outreach. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/djphiNHncTw?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Even if the lead water service pipes are replaced, lead pipelines in homes must still be identified and replaced by the homeowner in NI. Under current regulations, if landlords and homeowners are aware of lead water lines, they do not have to share this information with tenants or during the sale of the home.</p>
<p>With rising inflation and the associated increased construction costs, supply chain issues and low supply of contractors, homeowners may postpone or indefinitely hold off testing their water and replacing home lead water lines thereby further concealing the problem.</p>
<p>Lead contaminated water is a silent crisis. And our cities are complicit in producing the next generation of children who might underperform, be prone to violence, or suffer debilitating bodily harm. The US has been having this conversation about exposure to lead in water for a decade; it is time we did too.</p><img src="https://counter.theconversation.com/content/184812/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tristan Sturm receives funding from an ESRC Impact Grant. </span></em></p><p class="fine-print"><em><span>Jeremy Auerbach receives funding from the QUB/ESRC Impact Acceleration Account.</span></em></p><p class="fine-print"><em><span>Nuala Flood receives funding from the QUB/ESRC Impact Acceleration Account. </span></em></p>Belfast needs to rid its infrastructure of lead water pipes and raise public awareness of the serious health issues caused by excess levels of lead in the water.Tristan Sturm, Senior Lecturer of Geography, Queen's University BelfastJeremy Auerbach, Assistant Professor, University College DublinNuala Flood, Senior Lecturer/Associate Professor in Architecture, Queen's University BelfastLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1808182022-04-07T10:19:16Z2022-04-07T10:19:16ZCould lead makeup really kill you? A scientist recreated centuries-old skin whitening recipes to find out – podcast<figure><img src="https://images.theconversation.com/files/456687/original/file-20220406-7054-wa4h2e.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C440%2C357&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The Countess of Coventry, Maria Gunning, was rumoured to have died of lead poisoning from her makeup. </span> <span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Maria_Coventry,_Countess_of_Coventry#/media/File:Mary_Gunning,_Countess_of_Coventry.jpg">Jean-Étienne Liotard via Wikimedia</a></span></figcaption></figure><p>Can makeup really kill you? That’s the myth attached to Maria Gunning, the Countess of Coventry, an 18th-century socialite who <a href="https://historyofyesterday.com/deadly-fashion-trends-from-the-georgian-era-58d120dad1c6">reportedly died</a> from her lead-based makeup in 1760, aged just 27. </p>
<p>In this episode of <a href="https://theconversation.com/uk/topics/the-conversation-weekly-98901">The Conversation Weekly</a> podcast, we speak to a scientist who has recreated some centuries-old recipes for white lead makeup to test how dangerous these cosmetics were. </p>
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<p>Lead poisoning can cause all types of health problems, including <a href="https://doi.org/10.1002/ajim.10096">high blood pressure</a>. It is a particular health hazard for women. It can cause <a href="https://doi.org/10.1289/ehp.7386">early menopause</a> and increase the risk of <a href="https://www.cdc.gov/niosh/topics/lead/health.html">stillbirth and miscarriage</a>. </p>
<p>And yet, lead used to be a common ingredient in skin-whitening makeup. The ancient <a href="https://www.nbcnews.com/id/wbna22546056#.WGrA8bF-IdU">Greeks and Romans put it in their cosmetics</a> and white lead makeup, also known as ceruse, was fashionable between the 16th and 19th centuries in Europe.</p>
<p>Fiona McNeill is an expert in lead poisoning at McMaster University in Canada. But when she heard the story of the Countess of Coventry dying from her makeup, McNeill was sceptical. </p>
<p>“I’ve got this background in lead poisoning and I thought, this just can’t be true,” she tells us. While ingesting lead is toxic, McNeill was unconvinced that the lead in makeup would cross the skin in sufficient quantities to kill somebody. </p>
<p>McNeill and her colleagues decided to investigate. They found various centuries-old recipes for white lead makeup, recreated them in the lab, and then tested them on pig skin to find out. </p>
<p>And along the way, they’ve found what the makeup really looked like. “It’s always depicted in the movies and on TV as this white mask, this ridiculous-looking face. When we started making it in the lab, it doesn’t look like that at all,” she explains. </p>
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Read more:
<a href="https://theconversation.com/dying-for-makeup-lead-cosmetics-poisoned-18th-century-european-socialites-in-search-of-whiter-skin-176237">Dying for makeup: Lead cosmetics poisoned 18th-century European socialites in search of whiter skin</a>
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<p>This episode of The Conversation Weekly was produced by Mend Mariwany and Gemma Ware, with sound design by Eloise Stevens. Our theme music is by Neeta Sarl. You can find us on Twitter <a href="https://twitter.com/TC_Audio">@TC_Audio</a>, on Instagram at <a href="https://www.instagram.com/theconversationdotcom/?hl=en">theconversationdotcom</a> or <a href="mailto:podcast@theconversation.com">via email</a>. You can also sign up to The Conversation’s <a href="https://theconversation.com/newsletter?utm_campaign=PodcastTCWeekly&utm_content=newsletter&utm_source=podcast">free daily email here</a>.</p>
<p>You can listen to The Conversation Weekly via any of the apps listed above, download it directly via our <a href="https://feeds.acast.com/public/shows/60087127b9687759d637bade">RSS feed</a>, or find out how else to <a href="https://theconversation.com/how-to-listen-to-the-conversations-podcasts-154131">listen here</a>.</p><img src="https://counter.theconversation.com/content/180818/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Fiona E. McNeill receives funding from the Natural Sciences and Engineering Research Council of Canada.</span></em></p><p class="fine-print"><em><span> </span></em></p>Listen to The Conversation Weekly podcast.Daniel Merino, Assistant Science Editor & Co-Host of The Conversation Weekly Podcast, The ConversationGemma Ware, Editor and Co-Host, The Conversation Weekly Podcast, The ConversationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1739632021-12-17T13:27:20Z2021-12-17T13:27:20ZThe US is making plans to replace all of its lead water pipes from coast to coast<figure><img src="https://images.theconversation.com/files/438106/original/file-20211216-21-126318e.jpg?ixlib=rb-1.1.0&rect=0%2C267%2C4965%2C3181&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Workers prepare to install new water pipes in Walnut Creek, California, on April 22, 2021.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/workers-with-east-bay-municipal-utility-district-stack-news-photo/1313906917">Justin Sullivan/Getty Images</a></span></figcaption></figure><p>The Biden administration has released a plan to accelerate removal of <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/16/fact-sheet-the-biden-harris-lead-pipe-and-paint-action-plan/">lead water pipes and lead paint</a> from U.S. homes. As a <a href="http://scholar.google.com/citations?user=MEp4948AAAAJ&hl=en">geochemist and environmental health researcher</a> who has studied the heartbreaking impacts of lead poisoning in children for decades, I am happy to see high-level attention paid to this silent killer, which <a href="https://doi.org/10.1029/2018GH000167">disproportionately affects poor communities of color</a>.</p>
<p>Childhood lead poisoning has <a href="https://doi.org/10.1367/1539-4409(2003)003%3C0027:POLTIU%3E2.0.CO;2">declined significantly in the U.S.</a> over the past 50 years. That’s largely due to the elimination of leaded gasoline in the 1980s and the banning of most lead-based paints.</p>
<p>But the U.S. Environmental Protection Agency estimates that <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/16/fact-sheet-the-biden-harris-lead-pipe-and-paint-action-plan/">up to 10 million households and 400,000 schools and child care centers</a> have service lines or other fixtures that contain lead. These pipes are ticking time bombs that can leach toxic lead into drinking water if they corrode. As long as they remain in service, children and families are vulnerable.</p>
<p>The same is true of lead paint, which is still present in many homes built before consumer use of lead paint was banned in 1978. Because it tastes sweet, children sometimes chew on paint chips or painted wood.</p>
<p>The Biden administration <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/16/fact-sheet-the-biden-harris-lead-pipe-and-paint-action-plan/">will spend US$15 billion</a> from the recently enacted infrastructure bill to replace lead service lines, faucets and fixtures over the next five years and is seeking additional money in the pending <a href="https://www.congress.gov/bill/117th-congress/house-bill/5376">Build Back Better Act</a> to reduce lead hazards in public housing and low-income communities. I see this as a key priority, since Black children and children living in poverty have average blood lead levels that are 13% higher than the national average. </p>
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<h2>Lead poisoning does permanent damage</h2>
<p>Lead poisoning is a major public health problem because lead has permanent impacts on the brain, particularly in children. Young brains are <a href="https://developingchild.harvard.edu/science/key-concepts/brain-architecture/">still actively forming</a> the amazing network of neurons that comprise their hardware. </p>
<p>Neurons are designed to use calcium, the most abundant mineral in the human body, as a transmitter to rapidly pass signals. Lead molecules look a lot like calcium molecules, so if they are present in a child’s body, they can penetrate the brain, impair neuron development and cause permanent neural damage.</p>
<p>Children with lead poisoning have lower IQs, poor memory recall, high rates of attention deficit disorder and low impulse control. They tend to <a href="https://www.cdc.gov/nceh/lead/prevention/health-effects.htm">perform poorly at school</a>, which reduces their earning potential as adults. They also face increased risk of <a href="https://www.kidney.org/atoz/content/lead-exposure-and-kidney-function">kidney disease</a>, <a href="https://doi.org/10.1289/ehp.9785">stroke and hypertension</a> as they age. Research has found strong connections between lead poisoning and <a href="https://www.brookings.edu/blog/up-front/2017/06/01/new-evidence-that-lead-exposure-increases-crime/">incarceration for violent crimes</a>. </p>
<p>Today researchers estimate that <a href="https://www.aafp.org/afp/2019/0701/p24.html">about 500,000 U.S. children</a> still have elevated blood lead levels. Health experts widely agree that there is <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health">no known “safe” blood lead concentration</a>. </p>
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<h2>Where are the lead pipes?</h2>
<p>The Biden administration’s plan calls for replacing 100% of lead service lines across the nation – a goal that the EPA aims to <a href="https://www.nbcboston.com/news/national-international/epa-to-tighten-rules-for-lead-in-drinking-water-details-plan-to-replace-nations-pipes/2592292/">write into regulations by 2024</a>. Step 1 is finding the pipes. </p>
<p>Most U.S. cities have countless miles of lead service lines buried beneath streets and sidewalks and feeding into people’s homes. Utilities don’t know where many of these aging lines are and don’t have enough data to map them. Replacing them will require significant analysis, modeling, data and some guesswork.</p>
<p>Old service lines have caused lead poisoning outbreaks in such places as Washington, D.C.; <a href="https://www.britannica.com/event/Flint-water-crisis">Flint, Michigan</a>; and <a href="https://www.njspotlight.com/2021/01/op-ed-lessons-from-newarks-aggressive-replacement-of-lead-service-lines/">Newark, New Jersey</a>. <a href="https://doi.org/10.1073/pnas.1913749117">The chemistry is a bit different</a> in each case. </p>
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<a href="https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Worker standing in a trench dug in the street hands a piece of pipe to a colleague." src="https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=554&fit=crop&dpr=1 600w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=554&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=554&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=696&fit=crop&dpr=1 754w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=696&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=696&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Workers remove water service lines in Trenton, New Jersey, on Jan. 9, 2020. The city is replacing 37,000 lead pipes over five years.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/LeadWaterPipesNewJersey/3de7106d9ea547e89027f07a6e502a10/photo">AP Photo/Mike Catalini</a></span>
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</figure>
<p>Lead service lines typically develop a protective “plaque” of minerals on their inside walls after a short time, which effectively separates the toxic lead pipe from the water flowing through it. This coating, which is called scale, remains stable if the chemistry of the water coursing through it doesn’t change. But if that chemistry is altered, disaster can ensue.</p>
<p>In 2002, Washington, D.C., shifted from chlorine to chloramine for treating its water supply. Chloramine is a more modern disinfectant that does not <a href="https://theconversation.com/can-drinking-water-be-delivered-without-disinfectants-like-chlorine-and-still-be-safe-55476">form dangerous reactive chlorinated byproducts</a> as chlorine can. </p>
<p>This rapidly corroded the protective plaque lining the city’s pipes, flushing highly absorbable lead into homes. <a href="https://www.washingtonpost.com/local/dcs-decade-old-problem-of-lead-in-water-gets-new-attention-during-flint-crisis/2016/03/17/79f8d476-ec64-11e5-b0fd-073d5930a7b7_story.html">Tens of thousands of children were exposed</a> over two years before the problem was adequately identified and fixed. </p>
<p>In Flint, state-appointed managers decided to save money during a fiscal crisis in 2014 by switching from Detroit water to water from the Flint River. But regulators <a href="https://doi.org/10.1021/acs.est.6b04034">did not require enough chemical analysis</a> to determine what additives should be used to maintain the pipe plaque. And they skipped the typical step of adding phosphate, which binds chemically with lead and prevents it from leaching out of pipes, in order to save <a href="https://www.scientificamerican.com/article/q-a-what-really-happened-to-the-water-in-flint-michigan/">about $100 per day</a>. </p>
<p>Corrosion chemistry is well controlled in many U.S. cities, but it is not a perfect science. And utilities don’t always have detection systems that adequately alert water suppliers to dangers at the tap. That’s why removing lead pipes is the only sure way to avoid the threat of more water crises. </p>
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<figcaption><span class="caption">Households can use some basic tests to identify water pipes that may be made of lead.</span></figcaption>
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<h2>Cities will need to innovate</h2>
<p>While $15 billion is a big investment, experts agree that <a href="https://www.brookings.edu/blog/up-front/2021/05/13/what-would-it-cost-to-replace-all-the-nations-lead-water-pipes/">it’s not enough to replace all lead pipes nationwide</a>. For example, the estimated cost of replacing all of Flint’s lead service lines is <a href="https://www.freep.com/story/news/local/michigan/flint-water-crisis/2016/05/27/flint-lead-lines-water-crisis/85032096/">about $50 million</a> – and there are <a href="https://www.vox.com/policy-and-politics/2019/6/12/18661193/lead-pipes-paint-flint-michigan-usa-cost-fix">thousands of U.S. cities to fix</a>. </p>
<p>My own city, Indianapolis, has a population of about 850,000 – about 10 times larger than Flint – and officials have only a rough idea of where to find the lead service lines. There are ways to <a href="https://www.wateronline.com/doc/statistical-modeling-in-support-of-lead-service-line-identification-inventory-and-replacement-0001">statistically model</a> the likelihood that a given portion of the water system has lead service lines, using information such as water main sizes, locations and construction dates, but they are imperfect. </p>
<p>Cities will need to get creative to make whatever funds they get go as far as possible. As one example, I am working with colleagues to develop a citizen science project that will provide <a href="https://www.hud.gov/sites/dfiles/PA/documents/2020_Lead-HH-Technical-Studies-Grant-Awards.pdf">thousands of tests for lead at taps around Indianapolis</a>. This effort, a partnership with the University of Notre Dame funded by the U.S. Department of Housing and Urban Development, may augment modeling with real data on levels of lead in homes, and will increase public awareness of this issue. </p>
<p>[<em>Over 140,000 readers rely on The Conversation’s newsletters to understand the world.</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-140ksignup">Sign up today</a>.]</p>
<p>In spite of these challenges, I believe more urgency on this issue is long overdue. Every lead pipe that’s replaced will pay off in higher lifetime earnings and lower rates of illness for families that gain access to safer tap water.</p>
<p><em>This is an updated version of an <a href="https://theconversation.com/bidens-infrastructure-plan-targets-lead-pipes-that-threaten-public-health-across-the-us-158277">article</a> originally published on May 4, 2021.</em></p><img src="https://counter.theconversation.com/content/173963/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gabriel Filippelli does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It will cost tens of billions of dollars to find and remove all the lead service lines that deliver water to US homes and schools. A public health expert explains why he sees it as money well spent.Gabriel Filippelli, Chancellor's Professor of Earth Sciences and Executive Director, Indiana University Environmental Resilience Institute, IUPUILicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1733952021-12-08T23:51:24Z2021-12-08T23:51:24ZA century of tragedy: How the car and gas industry knew about the health risks of leaded fuel but sold it for 100 years anyway<figure><img src="https://images.theconversation.com/files/436454/original/file-20211208-104971-1bl6u5i.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5227%2C3413&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For decades, most gas sold in the U.S. contained a lead additive.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/rusty-petrol-pumps-on-a-gas-station-royalty-free-image/74166712?adppopup=true"> Per Magnus Persson via Getty Images</a></span></figcaption></figure><p>On the frosty morning of Dec. 9, 1921, in Dayton, Ohio, researchers at a General Motors lab poured a new fuel blend into one of their test engines. Immediately, the engine began running more quietly and putting out more power. </p>
<p>The new fuel was tetraethyl lead. With vast profits in sight – and very few public health regulations at the time – General Motors Co. rushed gasoline diluted with tetraethyl lead to market despite the known health risks of lead. They named it “Ethyl” gas.</p>
<p>It has been 100 years since that pivotal day in the development of leaded gasoline. As a <a href="https://scholar.google.com/citations?view_op=search_authors&mauthors=bill+kovarik&hl=en&oi=ao">historian of media and the environment</a>, I see this anniversary as a time to reflect on the role of public health advocates and environmental journalists in preventing profit-driven tragedy.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A black and white photo of a man in an old laboratory." src="https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=353&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=353&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=353&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=444&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=444&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436459/original/file-20211208-17-xev9b9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=444&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Scientists working for General Motors discovered that tetraethyl lead could greatly improve the efficiency and longevity of engines in the 1920s.</span>
<span class="attribution"><span class="source">Courtesy of General Motors Institute</span></span>
</figcaption>
</figure>
<h2>Lead and death</h2>
<p>By the early 1920s, <a href="https://www.biologicaldiversity.org/campaigns/get_the_lead_out/pdfs/health/Needleman_1999.pdf">the hazards of lead were well known</a> – even Charles Dickens and Benjamin Franklin had written about the dangers of lead poisoning.</p>
<p>When GM began selling leaded gasoline, public health experts <a href="https://doi.org/10.1021/om030621b">questioned its decision</a>. One called lead a serious menace to public health, and another called concentrated tetraethyl lead a “<a href="https://doi.org/10.1021/om030245v">malicious and creeping</a>” poison. </p>
<p>General Motors and Standard Oil waved the warnings aside until disaster struck in October 1924. Two dozen workers at a refinery in Bayway, New Jersey, came down with severe lead poisoning from a poorly designed GM process. At first they became disoriented, then burst into insane fury and collapsed into hysterical laughter. Many had to be wrestled into straitjackets. <a href="https://www.nytimes.com/1924/10/27/archives/odd-gas-kills-one-makes-four-insane-stricken-at-work-in-standards.html">Six died, and the rest were hospitalized</a>. Around the same time, 11 more workers died and several dozen more were disabled at similar GM and DuPont plants across the U.S.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A cartoon showing a man going insane after lead exposure." src="https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=183&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=183&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=183&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=230&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=230&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436460/original/file-20211208-149721-820cnb.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=230&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The news media began to criticize Standard Oil and raise concerns over Ethyl gas with articles and cartoons.</span>
<span class="attribution"><span class="source">New York Evening Journal via The Library of Congress</span></span>
</figcaption>
</figure>
<h2>Fighting the media</h2>
<p>The auto and gas industries’ attitude toward the media was hostile from the beginning. At Standard Oil’s first press conference about the 1924 Ethyl disaster, a spokesman claimed he had no idea what had happened while advising the media that “<a href="https://www.nytimes.com/1924/10/27/archives/odd-gas-kills-one-makes-four-insane-stricken-at-work-in-standards.html">Nothing ought to be said about this matter in the public interest</a>.”</p>
<p><a href="https://billkovarik.com/wp-content/uploads/2012/08/Ethyl.Controversy.Kovarik.dissertation.pdf">More facts emerged in the months after the event</a>, and by the spring of 1925, in-depth newspaper coverage started to appear, framing the issue as public health versus industrial progress. A New York World article asked Yale University gas warfare expert Yandell Henderson and GM’s tetraethyl lead researcher Thomas Midgley whether leaded gasoline would poison people. Midgley joked about public health concerns and falsely insisted that leaded gasoline was the only way to raise fuel power. To demonstrate the negative impacts of leaded fuel, Henderson estimated that 30 tons of lead would fall in a dusty rain on New York’s Fifth Avenue every year. </p>
<p>Industry officials were outraged over the coverage. A GM public relations history from 1948 called the New York World’s coverage “a campaign of publicity against the public sale of gasoline containing the company’s antiknock compound.” GM also claimed that the media labeled leaded gas “loony gas” when, in fact, it was <a href="https://billkovarik.com/wp-content/uploads/2012/08/Ethyl.Controversy.Kovarik.dissertation.pdf">the workers themselves who named it as such</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="An old advertisement for Ethyl brand gas." src="https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436735/original/file-20211209-141178-1klcf7s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Leaded gas was marketed as Ethyl, a joint brand of Standard Oil and General Motors.</span>
<span class="attribution"><a class="source" href="http://hdl.loc.gov/loc.pnp/mrg.05719">John Margolies/Library of Congress</a></span>
</figcaption>
</figure>
<h2>Attempts at regulation</h2>
<p>In May 1925, the U.S. Public Health Service asked GM, Standard Oil and public health scientists to attend an open hearing on leaded gasoline in Washington. The issue, according to GM and Standard, involved refinery safety, not public health. Frank Howard of Standard Oil argued that tetraethyl lead was diluted at over 1,000 to 1 in gasoline and therefore posed no risk to the average person. </p>
<p>Public health scientists <a href="https://billkovarik.com/wp-content/uploads/2012/08/Ethyl.Controversy.Kovarik.dissertation.pdf">challenged the need for leaded gasoline</a>. Alice Hamilton, a physician at Harvard, said, “There are thousands of things better than lead to put in gasoline.” And she was right. There were plenty of well-known alternatives at the time, and some were even patented by GM. But no one in the press knew how to find that information, and the Public Health Service, under pressure from the auto and oil industries, canceled a second day of public hearings that would have discussed safer gasoline additives like ethanol, iron carbonyl and catalytic reforming. </p>
<p>By 1926, the Public Health Service announced that they had “no good reason” to prohibit leaded gasoline, even though <a href="https://billkovarik.com/wp-content/uploads/2012/08/Ethyl.Controversy.Kovarik.dissertation.pdf">internal memos complained that their research</a> was “half baked.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A graph showing that blood lead levels closely follow lead emissions from cars." src="https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=404&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=404&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=404&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=508&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=508&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436456/original/file-20211208-68670-1nmlwhl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=508&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">As leaded gasoline fell out of use, lead levels in people’s blood fell as well.</span>
<span class="attribution"><a class="source" href="https://www.epa.gov/lead">U.S. EPA</a></span>
</figcaption>
</figure>
<h2>The rise and fall of leaded gasoline</h2>
<p>Leaded gasoline went on to dominate fuel markets worldwide. Researchers have estimated that decades of burning leaded gasoline caused <a href="https://news.un.org/en/story/2011/10/393292-phase-out-leaded-petrol-brings-huge-health-and-cost-benefits-un-backed-study">millions of premature deaths, enormous declines in IQ levels</a> and many other associated social problems.</p>
<p>In the 1960s and 1970s, the public health case against leaded gasoline reemerged. A California Institute of Technology geochemist, Clair Cameron Patterson, was finding it difficult to measure lead isotopes in his laboratory because lead from gasoline was everywhere and his samples were constantly being contaminated. Patterson created the first “clean room” to carry on his isotope work, but he also published a 1965 paper, “<a href="https://doi.org/10.1080/00039896.1965.10664229">Contaminated and Natural Lead Environments of Man</a>,” and said that “the average resident of the U.S. is being subjected to severe chronic lead insult.”</p>
<p>In parallel, by the 1970s, the U.S. Environmental Protection Agency decided that leaded gasoline had to be phased out eventually because it clogged catalytic converters on cars and led to more air pollution. Leaded gasoline manufacturers objected, but the objections were <a href="https://casetext.com/case/ethyl-corp-v-epa">overruled by an appeals court</a>. </p>
<p>The public health concerns continued to build in the 1970s and 1980s when University of Pittsburgh pediatrician Herbert Needleman ran studies linking high levels of lead in children with low IQ and other developmental problems. Both Patterson and Needleman faced strong partisan attacks from the lead industry, which <a href="http://www.beacon.org/Toxic-Truth-P662.aspx">claimed that their research was fraudulent</a>. </p>
<p>Both were eventually vindicated when, in 1996, the U.S. officially banned the sale of leaded gasoline for public health reasons. Europe was next in the 2000s, followed by developing nations after that. In August 2021, the last country in the world to sell leaded gas, Algeria, <a href="https://www.nationalgeographic.com/environment/article/finally-the-end-of-leaded-gas">banned it</a>.</p>
<p>A century of leaded gasoline has taken millions of lives and to this day leaves the soil in many cities from <a href="https://doi.org/10.1073/pnas.1906092116">New Orleans</a> to <a href="https://doi.org/10.1073/pnas.2102791118">London</a> toxic.</p>
<p>The leaded gasoline story provides a practical example of how industry’s profit-driven decisions – when unsuccessfully challenged and regulated – can cause serious and long-term harm. It takes individual public health leaders and strong media coverage of health and environmental issues to counter these risks. </p>
<p>[<em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-youresmart">You can read us daily by subscribing to our newsletter</a>.]</p><img src="https://counter.theconversation.com/content/173395/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bill Kovarik does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Burning leaded gasoline releases toxic lead into the environment, and for 100 years people around the world have been dealing with the health effects. How did a century of toxic fuel come to be?Bill Kovarik, Professor of Communication, Radford UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1709292021-11-05T12:28:50Z2021-11-05T12:28:50ZA new, lower threshold for lead poisoning in children means more kids will get tested – but the ultimate solution is eliminating lead sources<figure><img src="https://images.theconversation.com/files/430091/original/file-20211103-23-1r7sfwm.jpg?ixlib=rb-1.1.0&rect=41%2C0%2C4639%2C3069&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Testing kids for lead exposure starts with a fingertip prick. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/brian-jones-a-first-responder-for-livingston-county-news-photo/506974822">Brett Carlsen/Getty Images</a></span></figcaption></figure><p><em>The U.S. Centers for Disease Control and Prevention has <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7043a4.htm?s_cid=mm7043a4_w">updated its blood lead reference value</a> – the level at which children ages 1-5 are considered to have high exposure to lead. Since 2012, this threshold had been set at 5 micrograms of lead per deciliter of blood; children at or above this level represented the top 2.5% with the highest blood lead levels in the nation. Now, in response to recent federal health surveys, the CDC has updated that number to 3.5 micrograms per deciliter. Environmental scientist <a href="https://scholar.google.com/citations?user=MEp4948AAAAJ&hl=en">Gabriel Filippelli</a>, who has studied urban lead poisoning in children, explains what this shift means for public health.</em></p>
<h2>Will this change affect how doctors detect and treat childhood lead poisoning?</h2>
<p>The Centers for Disease Control periodically reviews national data on blood lead levels in children. This new lower value is the <a href="https://www.cdc.gov/nceh/lead/data/blood-lead-reference-value.htm">average blood lead level exceeded by 2.5% of children tested</a>. </p>
<p>Many clinics have an on-site screening device that uses electrochemical detection to quickly test a small amount of blood from a fingertip prick. If children test positive, doctors refer them to have a larger blood sample drawn from a vein and analyzed in a diagnostic laboratory. The clinical test is fast, cheap and relatively painless, but the venous blood draw is the gold standard for diagnosing lead poisoning. </p>
<p>On-site clinical devices typically can detect lead at concentrations as low as 3.2 micrograms per deciliter, so the new CDC guidance means that nearly all children who show positive results at the screening level will be referred for follow-up testing. That’s much more protective from a public health perspective. </p>
<p>However, it will <a href="https://www.beckershospitalreview.com/public-health/new-cdc-standard-may-double-the-number-of-children-with-lead-poisoning.html">roughly double</a> the number of children who are classified as at highest risk for lead poisoning. Formerly, children had to have at least 5 micrograms per deciliter of lead in their blood to fall into that group; now it will include thousands more children with slightly lower blood lead levels. </p>
<p>Larger numbers of children means that many states will have trouble affording testing and follow-up care – which can involve <a href="https://www.aap.org/en/patient-care/lead-exposure/treatment-of-lead-poisoning/">dietary changes and medications</a>, as well as removing lead exposure sources – unless Congress increases federal support for programs to prevent and treat lead poisoning.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1437437173691727877"}"></div></p>
<h2>How are children commonly exposed to lead?</h2>
<p>The most pervasive source, especially in cities, is soil and dust generated from soil. Thanks to many years of emissions from degraded lead-based paint, leaded gasoline and industrial sources, typical urban soils have lead concentrations that <a href="https://doi.org/10.1016/j.envint.2021.106582">range from benign to toxic</a>. Children are exposed when they touch or play in contaminated dirt or inhale the dust. </p>
<p>The U.S. Environmental Protection Agency’s limit for lead in soils in public play areas is <a href="https://www.atsdr.cdc.gov/csem/leadtoxicity/safety_standards.html#:%7E:text=Soil%20contains%20lead%20concentrations%20less,play%20areas%20%5BEPA%202000a%5D.">400 parts per million</a>. That’s significantly higher than typical background levels, which are roughly 20 to 50 parts per million. This action level has remained in place for decades, even though studies indicate that it’s <a href="https://doi.org/10.1289/EHP10376">unacceptably high as a public health guideline</a>. </p>
<p>Some U.S. states, <a href="https://dtsc.ca.gov/faq/what-are-acceptable-concentrations-of-lead-in-soil-in-california/">such as California</a>, have much lower limits. In my experience, it’s not unusual to find urban soils with much higher levels, particularly near the exterior walls of buildings where lead may accumulate from degraded paints or <a href="https://doi.org/10.3390/ijerph15071531">dust buildup</a>. </p>
<p>The most lead-contaminated neighborhoods in cities are often the poorest and home to the <a href="https://doi.org/10.1146/annurev-soc-073117-041222">highest percentage of nonwhite children</a>. This is a legacy of <a href="https://www.npr.org/2017/05/03/526655831/a-forgotten-history-of-how-the-u-s-government-segregated-america">racist housing practices</a> that concentrated people of color in less desirable neighborhoods. Residents in these zones can have significantly higher rates of elevated blood lead levels than people in wealthier neighborhoods.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Young girl in front of a public housing complex." src="https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/430093/original/file-20211103-23-mwrpi9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Kaelynn Lott, one of 120 children living at the West Calumet Housing Complex in East Chicago, Indiana, who tested positive for lead poisoning. After soil at the complex was found to contain high levels of lead and arsenic in 2016, the city ordered over 1,000 residents to relocate.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/kaelynn-lott-a-resident-at-the-west-calumet-housing-complex-news-photo/599443064">Joshua Lott/Getty Images</a></span>
</figcaption>
</figure>
<p>Lead-based paint is also a major exposure risk, particularly in poorly maintained buildings. Lead paint tastes sweet, so children sometimes chew on paint chips or painted wood.</p>
<p>Lead water pipes are a third source, although less common than paint or soil. Many cities and towns across the U.S. have <a href="https://theconversation.com/bidens-infrastructure-plan-targets-lead-pipes-that-threaten-public-health-across-the-us-158277">lead service lines</a> that deliver water to homes. If their water is treated properly, a protective plaque forms on the inside of water pipes and seals their lead content away from the water. </p>
<p>But some cities, including <a href="https://wtop.com/dc/2016/04/flint-d-c-s-drinking-water-crisis-even-worse/">Washington, D.C.</a>, <a href="https://www.nytimes.com/2021/08/11/nyregion/newark-lead-pipes-drinking-water.html">Newark</a>, New Jersey, and <a href="https://www.npr.org/sections/thetwo-way/2016/04/20/465545378/lead-laced-water-in-flint-a-step-by-step-look-at-the-makings-of-a-crisis">Flint, Michigan</a>, have changed their water sources or treatment processes in ways that stripped out the protective plaque and carried lead to household taps. These water crises disproportionately affected communities of color. </p>
<h2>How does lead exposure at these levels affect children’s health?</h2>
<p>Historically, public health interventions focused on acutely poisoned children who exhibited clear neurocognitive issues such as attention deficit, memory lapses, agitation and even tremors. As lead was slowly removed from most home uses in the mid-20th century and the U.S. population’s blood lead levels decreased, these obvious clinical presentations for lead poisoning declined.</p>
<p>What we see now are more subtle neurocognitive deficits, which scientists and medical experts measure through neurological and behavioral testing. A child who is diagnosed as having high blood lead levels today may perform poorly on standardized exams, behave disruptively in the classroom or at home or have trouble retaining information. Follow-up research in Flint shows that many infants and toddlers who were exposed to lead in water there in 2015 <a href="https://www.cbsnews.com/news/flint-water-crisis-effect-on-children-60-minutes-2020-03-15/">are struggling now that they are in school</a>. </p>
<p>These types of tests show that blood lead levels even lower than the new standard <a href="https://doi.org/10.1016/j.ntt.2020.106888">still affect performance</a>. This research is the basis for statements from scholars and the CDC that <a href="https://www.cdc.gov/nceh/lead/prevention/health-effects.htm">there is no safe blood lead level in children</a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/p7WTBVVXsrQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A study that tracked 579 children born in the 1970s in New Zealand for more than 30 years found modest but long-lasting mental health and personality effects from exposure to lead early in life.</span></figcaption>
</figure>
<h2>What’s the trend for childhood lead poisoning in the US?</h2>
<p>It has been falling since most major environmental sources of lead, such as leaded gasoline, lead-based paints and industrial emissions, were eliminated starting in the 1970s. Recent analyses show that the median blood lead level for all U.S. children between ages 1 and 5 is about 0.7 micrograms per deciliter today, compared with <a href="https://www.epa.gov/americaschildrenenvironment/ace-biomonitoring-lead">15 micrograms per deciliter in the late 1970s</a>. </p>
<p>But Black children and children living in poverty have average blood lead levels that are <a href="https://www.epa.gov/americaschildrenenvironment/ace-biomonitoring-lead">13% higher than this national average</a>, which means that many of them are at risk. </p>
<p>For example, in a 2019 study, I worked with colleagues at Notre Dame to analyze blood lead levels of over 18,000 children in St. Joseph County, Indiana, which includes the town of South Bend. In some neighborhoods, over 30% of children had blood lead levels higher than 5 micrograms per deciliter, and over 65% of the census tracts had average blood lead levels <a href="https://doi.org/10.1057/s41271-018-0155-7">over that safety limit</a>. </p>
<p>We also found that there was no systematic, risk-informed approach to testing. In areas that had the highest potential risks based on poverty levels, less than 6% of eligible children had lead test results reported to the county health department – the same rate as in other, wealthier census tracts. Without more screening, and more work to eliminate lead exposure in the communities most at risk, this problem won’t be solved for a long time.</p>
<p><em>This article has been updated to add a link to an article calling for lower limits on lead in soils in public play areas.</em></p>
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<p class="fine-print"><em><span>Gabriel Filippelli receives funding from the Housing and Urban Development Agency. </span></em></p>The Centers for Disease Control has announced a new, stricter standard for lead poisoning in children, which will more than double the number of kids considered to have high blood lead levels.Gabriel Filippelli, Chancellor's Professor of Earth Sciences and Executive Director, Indiana University Environmental Resilience Institute, IUPUILicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1582772021-05-04T12:15:56Z2021-05-04T12:15:56ZBiden’s infrastructure plan targets lead pipes that threaten public health across the US<figure><img src="https://images.theconversation.com/files/398397/original/file-20210503-13-1hswze.jpg?ixlib=rb-1.1.0&rect=40%2C0%2C5422%2C3645&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A lead pipe (left) seen through a hole in the kitchen ceiling in the home of Desmond Odom, in Newark, New Jersey.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/EPADrinkingWaterLead/f8f74d0050304533ac70263c5c50bad7/photo">AP Photo/Julio Cortez</a></span></figcaption></figure><p>President Joe Biden’s infrastructure plan includes a proposal to upgrade the U.S. drinking water distribution system by removing and replacing dangerous lead pipes. As a <a href="http://scholar.google.com/citations?user=MEp4948AAAAJ&hl=en">geochemist and environmental health researcher</a> who has studied the heartbreaking impacts of lead poisoning in children for decades, I am happy to see due attention paid to this silent killer, which <a href="https://doi.org/10.1029/2018GH000167">disproportionately affects poor communities of color</a>.</p>
<p>Biden’s proposal <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/">includes US$45 billion</a> to eliminate all lead pipes and service lines nationwide. The funding would go to <a href="https://www.epa.gov/dwsrf#:%7E:text=The%20Drinking%20Water%20State%20Revolving,to%20state%20safe%20water%20programs">programs</a> <a href="https://www.epa.gov/dwcapacity/water-infrastructure-improvements-nation-act-wiin-act-grant-programs">administered</a> by the U.S. Environmental Protection Agency. </p>
<p>This effort would affect an estimated <a href="https://www.greenbiz.com/article/american-jobs-plan-gives-water-infrastructure-much-needed-boost">6 million to 10 million homes</a>, along with <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/">400,000 schools and child care facilities</a>. I see it as one of the nation’s best chances to finally get the lead out of the nation’s drinking water, and its children.</p>
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<h2>Lead poisoning does permanent damage</h2>
<p>Lead poisoning is a major public health problem, because lead has permanent impacts on the brain, particularly in children. Young brains are <a href="https://developingchild.harvard.edu/science/key-concepts/brain-architecture/">still actively forming</a> the amazing network of neurons that comprise their hardware. </p>
<p>Neurons are designed to use calcium, the most abundant mineral in the human body, as a transmitter to rapidly pass signals. Lead is able to penetrate the brain because lead molecules look a lot like calcium molecules. If lead is present in a child’s body, it can impair neuron development and cause permanent neural damage.</p>
<p>Children with lead poisoning have lower IQs, poor memory recall, high rates of attention deficit disorder and low impulse control. They tend to <a href="https://www.cdc.gov/nceh/lead/prevention/health-effects.htm">perform poorly at school</a>, which reduces their earning potential as adults. They also face increased risk of <a href="https://www.kidney.org/atoz/content/lead-exposure-and-kidney-function">kidney disease</a>, <a href="https://doi.org/10.1289/ehp.9785">stroke and hypertension</a> as they age. Research has found strong connections between lead poisoning and <a href="https://www.brookings.edu/blog/up-front/2017/06/01/new-evidence-that-lead-exposure-increases-crime/">incarceration for violent crimes</a>. </p>
<p>The prevalence of childhood lead poisoning has <a href="https://doi.org/10.1367/1539-4409(2003)003%3C0027:POLTIU%3E2.0.CO;2">declined significantly in the U.S.</a> over the past 50 years. That’s largely due to the elimination of leaded gasoline in the 1980s and the banning of most lead-based paints.</p>
<p>In the 1970s, nearly 90% of children in the U.S. ages 1 to 5 had blood lead levels <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5210a1.htm">above 10 micrograms per deciliter of blood</a>, which then was the “level of concern” under federal health guidelines. Today, according to Centers for Disease Control and Prevention officials, <a href="https://www.nytimes.com/2021/03/11/health/virus-lead-poisoning-children.html">roughly 2% of U.S. children</a> have elevated blood lead levels. </p>
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<p>This decline is a public health success story – but researchers estimate that <a href="https://www.aafp.org/afp/2019/0701/p24.html">about 500,000 U.S. children</a> still have elevated blood lead levels. In 2012 the CDC adopted a new blood lead “reference value” of <a href="https://www.cdc.gov/nceh/lead/prevention/blood-lead-levels.htm">5 micrograms per deciliter or above</a>, which identifies children in the highest 2.5% of those tested for lead in their blood. </p>
<p>Health experts widely agree that there is <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health">no known “safe” blood lead concentration</a>. And as long as lead water pipes remain in service, children and families are vulnerable.</p>
<h2>No maps of lead service lines</h2>
<p>Like many U.S. bridges, roads and ports, America’s water systems are old. Much of the drinking water infrastructure in older cities was <a href="https://www.circleofblue.org/2016/world/infographic-the-age-of-u-s-drinking-water-pipes-from-civil-war-era-to-today/">built before 1950</a>, before researchers started to grapple with the toxicity of lead. </p>
<p>Most American cities have countless miles of lead service lines buried beneath streets and sidewalks and feeding into people’s homes. Utilities don’t know where many of these aging lines are and don’t have enough data to map them. Replacing them will require significant analysis, modeling, data and some guesswork.</p>
<p>Old service lines have repeatedly caused lead poisoning outbreaks in places like Washington, D.C.; <a href="https://www.britannica.com/event/Flint-water-crisis">Flint, Michigan</a>; and <a href="https://www.njspotlight.com/2021/01/op-ed-lessons-from-newarks-aggressive-replacement-of-lead-service-lines/">Newark, New Jersey</a>. <a href="https://www.pnas.org/content/117/38/23211">The chemistry is a bit different</a> in each case. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Workers at an excavation remove lead pipes from underground." src="https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=554&fit=crop&dpr=1 600w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=554&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=554&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=696&fit=crop&dpr=1 754w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=696&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/398412/original/file-20210503-23-1cvv9hr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=696&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Workers remove water service lines in Trenton, New Jersey, on Jan. 9, 2020. The city is replacing 37,000 lead pipes over five years.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/LeadWaterPipesNewJersey/3de7106d9ea547e89027f07a6e502a10/photo">AP Photo/Mike Catalini</a></span>
</figcaption>
</figure>
<p>Lead service lines typically develop a protective “plaque” of minerals on their inside walls after a short time, which effectively separates the toxic lead pipe from the water flowing through it. This coating, which is called scale, remains stable if the chemistry of the water coursing through it doesn’t change. But if that chemistry is altered, disaster can ensue.</p>
<p>In 2002, Washington, D.C., shifted from chlorine to chloramine for treating its water supply. Chloramine is a more modern disinfectant that does not <a href="https://theconversation.com/can-drinking-water-be-delivered-without-disinfectants-like-chlorine-and-still-be-safe-55476">form dangerous reactive chlorinated byproducts</a> as chlorine can. </p>
<p>This rapidly corroded the protective plaque lining the city’s pipes, flushing highly absorbable lead into homes. <a href="https://www.washingtonpost.com/local/dcs-decade-old-problem-of-lead-in-water-gets-new-attention-during-flint-crisis/2016/03/17/79f8d476-ec64-11e5-b0fd-073d5930a7b7_story.html">Tens of thousands of children were exposed</a> over two years before the problem was adequately identified and fixed. </p>
<p>In Flint, state-appointed managers decided to save money during a fiscal crisis in 2014 by switching from Detroit water to water from the Flint River. Flint river water has completely different corrosivity than Detroit water, but officials <a href="https://doi.org/10.1021/acs.est.6b04034">did not require enough chemical analysis</a> to determine what additives should be used to maintain the pipe plaque. One egregious and ultimately toxic decision was to forgo the typical step of adding phosphate, which binds chemically with lead and prevents it from leaching out of pipes, in order to save <a href="https://www.scientificamerican.com/article/q-a-what-really-happened-to-the-water-in-flint-michigan/">about $100 per day</a>. </p>
<p>Corrosion chemistry is well controlled in many U.S. cities, but it is not a perfect science. And utilities don’t always have detection systems that adequately alert water suppliers to dangers at the tap. That’s why removing lead pipes is the only sure way to avoid the threat of more water crises. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/AiU7GHzD_Ck?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Households can use some basic tests to identify water pipes that may be made of lead.</span></figcaption>
</figure>
<h2>Cities will need to innovate</h2>
<p>While $45 billion is a huge investment, in my view it probably isn’t enough to replace all lead pipes nationwide. Take Flint as an example. The estimated cost of replacing all of the city’s lead service lines is <a href="https://www.freep.com/story/news/local/michigan/flint-water-crisis/2016/05/27/flint-lead-lines-water-crisis/85032096/">about $50 million</a>. As a rough calculation, then, for $45 billion, the nation theoretically could remedy slightly fewer than 1,000 Flints. </p>
<p>But there are literally <a href="https://www.vox.com/policy-and-politics/2019/6/12/18661193/lead-pipes-paint-flint-michigan-usa-cost-fix">thousands of U.S. cities to fix</a>. Some are smaller than Flint and thus likely cheaper to remediate, but others are much larger. </p>
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<p>My own city, Indianapolis, has a population of about 850,000. That’s roughly 10 times as big as Flint, which means 10 times as many households and water distribution end points. What’s more, officials have only a rough idea of where to find the city’s lead service lines. There are ways to <a href="https://www.wateronline.com/doc/statistical-modeling-in-support-of-lead-service-line-identification-inventory-and-replacement-0001">statistically model</a> the likelihood that a given portion of the water system has lead service lines, using information such as water main sizes, locations and construction dates, but they are imperfect. </p>
<p>Cities will need to get creative to make whatever funds they get go as far as possible. As one example, I am working with colleagues to develop a citizen science project that will provide thousands of tests for lead at taps around Indianapolis. This effort, a partnership with the University of Notre Dame funded by the U.S. Department of Housing and Urban Development, may augment modeling with real data on levels of lead in homes, and will increase public awareness of this issue. </p>
<p>Lead water pipes are ticking time bombs in cities across the U.S. Other important sources of lead exposure, such as <a href="https://doi.org/10.3390/ijerph13040358">soil and dust contamination</a>, also require urgent attention. But I believe fixing water systems is a critical step toward protecting children from the lifelong burdens of lead poisoning.</p><img src="https://counter.theconversation.com/content/158277/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gabriel Filippelli does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>President Biden has proposed spending $45 billion to replace every lead water pipe and service line in the nation. A public health expert explains why he sees this as a worthwhile investment.Gabriel Filippelli, Professor of Earth Sciences and Director of the Center for Urban Health, IUPUILicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1287692020-01-07T13:14:52Z2020-01-07T13:14:52ZEPA’s ‘secret science’ rule will make it harder for the agency to protect public health<figure><img src="https://images.theconversation.com/files/308532/original/file-20200105-11896-16h1pma.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5176%2C3453&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Blood samples from pediatric health screenings can provide valuable data for public health research.</span> <span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Lead-Testing-Michigan/93888290c7de46c28d566fe90abe955c/18/0">AP Photo/Carlos Osorio</a></span></figcaption></figure><p>The Trump administration has worked to <a href="https://www.nytimes.com/interactive/2020/climate/trump-environment-rollbacks.html">weaken U.S. environmental regulations</a> in many areas, from water and air pollution to energy development and land conservation. One of its most controversial actions is known as the “<a href="https://theconversation.com/why-the-epas-secret-science-proposal-alarms-public-health-experts-96000">secret science” rule</a> because it would require scientists to disclose all of their raw data, including confidential medical records, for their findings to be considered in shaping regulations. This measure <a href="https://www.federalregister.gov/public-inspection/2020-29179/strengthening-transparency-in-pivotal-science-underlying-significant-regulatory-actions-and">has just been finalized</a>.</p>
<p>This proposal drastically limits what kinds of scientific and medical research the Environmental Protection Agency can draw on as it makes policy. According to press reports, an EPA advisory panel with <a href="https://www.washingtonpost.com/news/energy-environment/wp/2017/11/04/pruitts-new-science-advisers-add-more-industry-experts-conservatives-to-the-mix/">many members appointed by President Trump</a> <a href="https://www.nytimes.com/2019/12/31/climate/epa-science-panel-trump.html">criticized the proposal</a>, saying it would do little to increase transparency and could limit what kinds of research get done.</p>
<p>As director of a <a href="http://www.urbanhealth.iupui.edu/">center on urban health</a>, I study issues including <a href="https://scholar.google.com/citations?user=MEp4948AAAAJ&hl=en">human exposure to toxic substances</a> such as lead and mercury. Confidential patient information is a key resource for my work, and I believe that children’s health will suffer as a direct result of this rule.</p>
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<a href="https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=452&fit=crop&dpr=1 600w, https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=452&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=452&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=568&fit=crop&dpr=1 754w, https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=568&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/308533/original/file-20200105-11909-u3qskf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=568&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Despite steps such as phasing out leaded gasoline, lead poisoning is still a serious public health problem across the U.S.</span>
<span class="attribution"><a class="source" href="https://directorsblog.health.azdhs.gov/program-successfully-reduces-unhealthy-lead-levels-in-children/">AZDHS</a></span>
</figcaption>
</figure>
<h2>Using child health records to map lead exposure</h2>
<p>My work is made possible because researchers can obtain confidential patient records, under strict regulations and oversight to ensure their confidentiality throughout analysis. These controls are mandated under <a href="https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html">federal regulations</a> that were rightly instituted to protect people’s identities and health data pursuant to the 1996 Health Insurance Portability and Accountability Act, or HIPAA. </p>
<p>I started researching lead exposure hot spots in U.S. cities almost 15 years ago, well before thousands of kids were poisoned by lead in Flint. Pediatric exposure to lead results in permanent neurological effects – namely, reduced IQ and deficits in attention, learning and memory compared with nonintoxicated peers. These impacts <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health">are permanent</a>, so it is critical to identify and eliminate lead exposure sources before children are poisoned.</p>
<p>Because I did not have the resources to obtain and analyze millions of samples of soil, dust and water for lead, I turned to medical records. Children around the country have routine blood tests, and many of them include an assay for blood lead levels. I realized that if I could obtain those records, as well as each child’s age, test date and home address, I could map out the distribution of lead poisoning. </p>
<p>In an ideal world public health experts wouldn’t use maps based on kids who have already been permanently poisoned to find exposure sources. Nevertheless, 16,000 medical records later, I was able to produce a detailed block-by-block map of <a href="https://doi.org/10.1007/s10653-012-9474-y">blood levels in children</a> in Indianapolis.</p>
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<a href="https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=518&fit=crop&dpr=1 754w, https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=518&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/308531/original/file-20200105-11904-1id8b3c.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=518&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Blood lead levels of children in Indianapolis, Indiana, for the period February 2002 to December 2008 (n = 12,431) for children between ages 0 and 5.99 years (area = 1,044 km2).</span>
<span class="attribution"><a class="source" href="http://dx.doi.org/10.12952/journal.elementa.000059">Filippelli et al, 2012.</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
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<h2>Pinpointing exposure sources and timing</h2>
<p>This approach led me and my colleagues to two major discoveries that have improved communities and shaped policy at the local and national levels. Neither of these insights could be used to implement solutions under the proposed secret science rule.</p>
<p>First, we found that the pediatric lead poisoning distribution patterns we identified from medical records <a href="https://doi.org/10.1007/s10653-012-9474-y">matched a rudimentary map</a> of patterns of legacy lead contamination – lead emitted over decades by sources such as leaded gasoline, lead-based paint and industrial emissions – that we constructed from separate research work on <a href="https://www.mapmyenvironment.com/">urban soil and dust</a>. This indicated that at least in Indianapolis, soil and contaminated dust generated from it was likely the major exposure mechanism for lead in children.</p>
<p>We were able to leverage that finding in some particularly contaminated neighborhoods where the EPA had previously carried out cleanups. Indeed, our work spurred the agency to reanalyze one of these poorly mitigated neighborhoods and reopen the cleanup over a <a href="https://www.epa.gov/newsreleases/epa-completes-cleanup-100-properties-american-lead-site-indianapolis-soil-sampling">much broader target area</a>.</p>
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<figcaption><span class="caption">Lead poisoning symptoms don’t appear until blood lead levels are high, so reducing exposure is the only effective way to prevent permanent damage.</span></figcaption>
</figure>
<p>Second, we were able to verify the source of seasonal variations in children’s blood lead levels. Through some basic atmospheric modeling, we identified seasonal dust generation as the main driver of this pattern. For example, when soil becomes drier for an extended period of time, it generates more dust that can be tracked into homes or blown into the air. If that soil happens to be contaminated with lead, the dust is also contaminated and becomes a <a href="https://doi.org/10.1289/ehp.7759">regional exposure source</a>.</p>
<p>After expanding this analysis to 10 different U.S. cities, we were confident enough to begin recommending to clinical networks that they take blood test dates into account. An August blood lead value could be double the level from a February test, so we believed it was important to consider timing in evaluating whether a child might be at risk of unsafe exposure. This led to the first such screening policy to be implemented around the timing of lead test results.</p>
<h2>Putting blinders on regulators</h2>
<p>Neither of these findings would have been possible without access to original, confidential patient medical records. For each patient we needed a specific home address and exact individual results from blood lead tests. These both are protected classes of personal information that must be kept confidential under federal regulations.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1201607312244387840"}"></div></p>
<p>I participated in 2011 in the EPA’s <a href="https://yosemite.epa.gov/sab/sabproduct.nsf/264cb1227d55e02c85257402007446a4/B1B17FB48ACEFE8D8525776D006C55CE/$File/ISA_FOR_LEAD.PDF">Integrated Science Assessment for Lead</a> review process, in which the agency reviewed papers and consulted experts to determine whether provisions in the Clean Air Act regulating airborne lead exposure were adequately protecting Americans. Regulators were particularly interested in the small-scale links between blood lead levels and known sources of lead from dust that our research was finding. Eventually, the agency <a href="https://www.epa.gov/newsreleases/epa-and-hud-announce-new-lead-dust-standards-protect-childrens-health">lowered acceptable standards for lead in dust</a> in 2019.</p>
<p>Childhood lead exposure is still a <a href="https://www.reuters.com/investigates/graphics/lead-water/en/">public health hazard of epidemic proportions</a> in some parts of the U.S., particularly cities. The potential sources are relatively well known: soil, dust and water. The challenge is that researchers don’t have adequate environmental measurements for these sources. Until we do, fine-scaled results revealed by human health data remain our best way to identify sources, and thus inform policies to protect children. </p>
<p>Now, under the secret science rule, EPA officials will have to pretend that this kind of research doesn’t exist, since the patient records that it draws on can’t be made public. There are ways to reverse this measure: Congress could repeal it under the <a href="https://www.eenews.net/stories/1063712743">Congressional Review Act</a>, or the Biden administration could refuse to defend it in the face of legal challenges. The slowest path would be conducting a new rule-making to rewrite it. </p>
<p>Until one of these things happens, I believe the Trump administration’s action will leave hundreds of thousands of children across the U.S. at risk of a lifetime of avoidable harm from lead poisoning and other types of pollution that researchers analyze using private medical data.</p>
<p>[ <em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>. ]</p>
<p><em>This article has been updated to reflect finalization of the rule and possible next steps.</em></p><img src="https://counter.theconversation.com/content/128769/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gabriel Filippelli receives funding from the Environmental Protection Agency (Environmental Justice Small Grants Program) and from the Indianapolis Foundation</span></em></p>The EPA has just adopted a rule that limits what kinds of science regulators can use in setting rules. A scholar explains how this shift could impede his work mapping child lead poisoning.Gabriel Filippelli, Professor of Earth Sciences and Director of the Center for Urban Health, IUPUILicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1268152019-11-12T22:01:41Z2019-11-12T22:01:41ZLead-tainted water: How to keep homes, schools, daycares and workplaces safe<figure><img src="https://images.theconversation.com/files/301366/original/file-20191112-178494-19xfcz9.jpg?ixlib=rb-1.1.0&rect=191%2C66%2C4500%2C3172&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Health Canada has some of the strongest limits on lead in the world, but they can't be effective without testing and a plan to replace pipes. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>We worked behind the scenes with dozens of journalists on “<a href="http://www.globalnews.ca/taintedwater">Tainted Water</a>,” a year-long investigation into lead-contaminated drinking water in Canada. We were shocked by the results.</p>
<p>The journalists, co-ordinated by Concordia University’s Institute for Investigative Journalism, retrieved the results of municipal lead tests from 14 Canadian cities via Freedom of Information Act requests. They also collected water samples by knocking on doors and interviewed people who assumed their water was safe.</p>
<p>As the results poured in, any illusions we had about widespread compliance with lead safety standards for drinking water quickly evaporated.</p>
<h2>The problem with old plumbing</h2>
<p>One-third of water samples, most of them taken from older homes suspected to have lead service lines, exceeded Health Canada’s new guidance of five parts per billion (ppb); 18 per cent exceeded 15 ppb. <a href="https://globalnews.ca/news/6125107/lead-levels-5-canadian-cities-flint-tainted-water/">Five cities</a> — Montréal, Regina, Saskatoon, Prince Rupert, B.C. and Moose Jaw, Sask. — had levels of lead in their water that were comparable with Flint, Mich., during its peak period of water contamination. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/301392/original/file-20191112-178516-18ywhwz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Crews work to replace lead-tainted pipes in Flint, Mich. in 2016.</span>
<span class="attribution"><span class="source">(Jake May/The Flint Journal-MLive.com via AP)</span></span>
</figcaption>
</figure>
<p>In Ontario, the only province that required schools to test their water, <a href="https://globalnews.ca/news/6107982/ontario-schools-daycares-lead-levels/">more than 2,400 schools and daycare centres</a> exceeded the federal guideline.</p>
<p>These results confirm what studies have found over the past 10 years; lead-tainted water is, too often, present in our daycares and <a href="https://doi.org/10.1016/j.watres.2018.04.045">schools</a>, in our workplaces and <a href="https://doi.org/10.1016/j.watres.2013.02.010">homes</a>.</p>
<p>Drinking water that contains five parts per billion of lead — the equivalent to five tablespoons of lead in an Olympic-sized swimming pool — increases the amount of lead circulating in our blood by <a href="https://doi.org/10.1542/peds.2016-1493">20 to 30 per cent</a>; lead in water is the <a href="https://doi.org/10.2166/wh.2013.067">primary source for infants</a> who drink formula made with tap water.</p>
<p>The news wasn’t all bad. Some cities, like Toronto and Ottawa, already use chemicals to reduce leaching of lead from water pipes and, predictably, the amount of lead in drinking water plummeted. Corrosion control also reduces damage to drinking water pipes. Several cities have already begun to replace lead service lines.</p>
<h2>Health impacts of lead</h2>
<p>The amount of lead found in our blood today is much lower than levels found five decades ago. Yet the amount of lead in our bodies, which is mostly stored in our bones, is <a href="https://doi.org/10.1007/978-1-4612-2542-3_1">10- to 100-times</a> higher than levels found in our pre-industrial ancestors. On an evolutionary timescale, we are still heavily lead-exposed.</p>
<p>Scientists have found that lead — a metal so toxic that the World Health Organization said, “there is no safe level” — elevates the risk for various health problems. A pregnant woman who has too much lead in her blood is <a href="https://doi.org/10.1111/1471-0528.12756">more likely to deliver her baby preterm</a>. Minute amounts of lead <a href="https://doi.org/10.1289/EHP5685">diminishes a child’s ability to learn</a>. An uptick in a <a href="https://www.dx.doi.org/10.1016%2Fj.chemosphere.2012.01.017">man’s lead exposure reduces his fertility</a>. </p>
<p>Along with air pollution and smoking, <a href="https://doi.org/10.1016/S2468-2667(18)30025-2">lead irritates the interior lining of blood vessels that feed the heart</a>, causing plaque build-up and elevating the risk of a heart attack in middle-aged and older people.</p>
<h2>A national strategy for safe water by 2030</h2>
<p><a href="https://www.canada.ca/en/health-canada/services/environmental-workplace-health/reports-publications/water-quality/guidelines-canadian-drinking-water-quality-summary-table.html">Health Canada’s new guideline</a> for unsafe amounts of lead in water — five ppb — is among the strongest in the world, but it is useless unless we test the tap water using a standardized protocol mimicking how people drink the water, and then act decisively on the results.</p>
<p>In 2017, Parliament’s Committee on Environment and Sustainability <a href="https://www.ourcommons.ca/Content/Committee/421/ENVI/Reports/RP9037962/envirp08/envirp08-e.pdf">reviewed</a> the Canadian Environmental Protection Act and recommended expanding rights for transparency and public participation in decision-making about toxic chemicals, like lead. The committee also recommended legally binding and enforceable national standards for drinking water. We agree.</p>
<p>Canadians should not have to rely on investigative reporters to force release of lead tests done by public health agencies or to show that drinking water in some Canadian cities is worse than in Flint, Mich. Likewise, utilities and not reporters should be telling consumers how to best protect themselves from water lead using remedial flushing, lead filters and bottled water.</p>
<p>We call on the federal government to establish a national commission and develop a strategy to achieve safe water for all Canadians by 2030. The lack of safe drinking water in our cities — and in <a href="https://thenarwhal.ca/this-ontario-first-nations-boil-water-advisory-has-been-in-effect-for-25-years/">many First Nations communities</a> — is a threat to public health and will create a public crisis of confidence.</p>
<p>It won’t be easy to fix the aging system of pipes transporting water to our taps, but Canadians should be able to trust that the water we drink is safe.</p>
<p>[ <em><a href="https://theconversation.com/ca/newsletters?utm_source=TCCA&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=expertise">Expertise in your inbox. Sign up for The Conversation’s newsletter and get a digest of academic takes on today’s news, every day.</a></em> ]</p><img src="https://counter.theconversation.com/content/126815/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bruce Lanphear has received funding from the National Institutes of Health, the US Environmental Protection Agency and the Canadian Institutes for Health Research. Dr. Lanphear, who is the current President of the International Society for Children's Health and Environment, has served as an expert witness in lead poisoning cases, but he received no personal payment. </span></em></p><p class="fine-print"><em><span>Marc Edwards receives funding from the National Science Foundation, American Water Works Association, many water utilities and trade organizations. He led the Flintwaterstudy citizen science team, that helped uncover the Flint water crisis, which is the subject of hundreds of lawsuits to which Edwards is a fact witness (i.e., not a party to the lawsuits). His testimony and records related to Flint have been subpoenaed for both civil and criminal lawsuits. He has been outspoken about misconduct by the U.S. Centers for Disease Control, U.S EPA, state governments, and water utilities in relation to handling lead-in-water issues from 2003-2015, and he has defended these agencies' actions since they apologized in 2016 and worked on the Flint recovery. Edwards has testified to the U.S. Congress six times on lead in water issues since 2004. </span></em></p><p class="fine-print"><em><span>Michele Prevost has received research funding from CFI, NSERC, provincial agencies, hospitals, municipalities and technology companies. She has consulted for Canadian provincial and federal ministries of health, education and environment and the U.S. Environmental Protection Agency. Dr. Prevost is a member of the INSPQ committee on microbial standards, of the CSA Z317.1 (plumbing systems in HCF) and BNQ 3660 (distribution systems). Committee work is not retributed.</span></em></p>An investigation showed that five Canadian cities had lead levels in their water on par with those in Flint, Mich. during its peak period of water contamination.Bruce Lanphear, Professor of Children's Environmental Health, Simon Fraser UniversityMarc Edwards, Professor, Department of Civil and Environmental Engineering, Virginia TechMichele Prevost, Professor and Principal Chairholder, NSERC Industrial Chair on Drinking Water, Polytechnique MontréalLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1181532019-09-03T11:15:25Z2019-09-03T11:15:25ZHow to address America’s lead crisis and provide safe drinking water for all<figure><img src="https://images.theconversation.com/files/288477/original/file-20190819-123716-1utygm9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Warning signs in the Newark Health Department after the city learned that lead service lines to houses still were contaminating water. </span> <span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Newark-Lead-in-Water/96452a8543f940898a4a8b06f7dd11d2/5/0">Seth Wenig/AP</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Since the <a href="https://theconversation.com/the-science-behind-the-flint-water-crisis-corrosion-of-pipes-erosion-of-trust-53776">Flint drinking water crisis</a> erupted five years ago, Americans have realized that many cities and towns struggle to ensure safe water. Currently <a href="https://www.npr.org/2019/08/13/750806632/newarks-drinking-water-problem-lead-and-unreliable-filters">residents of Newark, New Jersey</a> are drinking bottled water after the city realized lead filters it handed out <a href="https://www.nytimes.com/2019/08/14/nyregion/newark-water-lead.html?module=inline">had failed</a>.</p>
<p>While most water systems in the United States <a href="https://theconversation.com/the-us-drinking-water-supply-is-mostly-safe-but-thats-not-good-enough-115028">provide reliable, high-quality drinking water</a>, our research has shown that as of a few years ago, <a href="https://doi.org/10.1073/pnas.1719805115">21 million people</a> in the United States relied on water from utilities with health violations. Why? Infrastructures are aging, environmental hazards are evolving and cities lack the funds to make fixes. </p>
<p><a href="https://www.epa.gov/lead/learn-about-lead">No amount of lead</a> in the body is safe, and children under age five are especially at risk. Lead poisoning can damage the central nervous system, reduce IQ, delay growth and cause behavior and learning problems. <a href="https://www.cdc.gov/nceh/lead/factsheets/Lead_fact_sheet.pdf">Nearly half a million children</a> in the U.S. have elevated blood lead levels. Exposure comes primarily from lead paint, but lead in drinking water also contributes. </p>
<p><a href="https://scholar.google.com/citations?user=pE7IqHwAAAAJ&hl=en">Our research group</a> studies long-term <a href="https://doi.org/10.1073/pnas.1719805115">trends in drinking-water quality</a> and what factors cause unsafe water. Our studies have shown that this public health crisis can be corrected through better enforcement, stricter sampling protocols, revised federal regulations and more funding for state agencies. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/288476/original/file-20190819-123720-11bh5og.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Loading bottled water in Newark, New Jersey, where city officials have found high lead levels in homes where they had installed filters to remove it.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Newark-Lead-in-Water/95dfb6524b2b45b485d92bccdd3268f7/2/0">AP Photo/Seth Wenig</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Lead contamination in water is widespread</h2>
<p>Since it began regulating lead in 1991, the Environmental Protection Agency has reported nearly 7,000 violations of the <a href="https://www.epa.gov/dwreginfo/lead-and-copper-rule">federal Lead and Copper Rule</a>, which sets maximum levels of these metals in drinking water. Of these violations, 4,110 occurred in community water systems, which serve people year-round. Another 2,639 were recorded in noncommunity water systems that serve places like schools. The violations have fluctuated over two decades, showing no clear downward trend.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=356&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=356&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=356&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=448&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=448&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279618/original/file-20190614-158953-1ax5ojx.gif?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=448&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Lead and Copper Rule, which regulates levels of these metals in drinking water, has been violated more than 6,000 times since the early 1990s. Community water systems serve year-round populations of at least 25 people; noncommunity water systems regularly supply a given population at least six months of the year in settings such as schools.</span>
<span class="attribution"><a class="source" href="http://csr.qlik.com/a/sense/app/2d9a5af2-7d5f-485a-8647-dc44c5c6f629">Columbia Water Center</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Between 2014 and 2018 the EPA reported 740 violations of the Lead and Copper Rule at community water systems. Montgomery and Harris counties in Texas had the highest number of violations. Several counties in the Northeast violated the rule multiple times, including Baltimore and Worcester, Massachusetts. </p>
<p>Although violations in cities are rare, six communities with populations of 100,000 people or more had water with too much lead and copper, including Portland, Oregon; Providence, Rhode Island; and systems in northern New Jersey, Mississippi and Wisconsin.</p>
<p>Very high lead levels tend to appear in very small communities. Three towns with fewer than 3,000 people – two in Michigan and one in Utah – experienced levels over 100 times the regulatory limit.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=320&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=320&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=320&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=403&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=403&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279620/original/file-20190614-158936-mvnz50.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=403&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">County-level map depicting violations of the Lead and Copper Rule since the Flint crisis, 2014-2018. Only violations at community water systems are included.</span>
<span class="attribution"><a class="source" href="http://csr.qlik.com/a/sense/app/2d9a5af2-7d5f-485a-8647-dc44c5c6f629">Columbia Water Center</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Lead accumulates as water travels through pipes</h2>
<p>At treatment plants, lead levels often are acceptable – but then they rise as water flows through service lines. Acidic water can corrode lead pipes and carry lead that leaches from them to the tap. Utilities can’t fully control the problem because property owners usually own the pipes that connect homes to the water mains. </p>
<p>Until the 1950s, lead pipes to houses were common. By 1986 they were banned, but old lead pipes remain – and are corroding – across the country, especially in the Northeast, Midwest and older urban areas.</p>
<p>Nearly <a href="https://www.awwa.org/Portals/0/files/membership/member%20recruitment/AWWA%20in%%2020Action.pdf">one-third of water systems</a> in the U.S. report that at least some of their service lines contain lead. The exact number of lead service lines is estimated at <a href="https://www.awwa.org/Portals/0/files/membership/member%20recruitment/AWWA%20in%%2020Action.pdf">7 to 11 million</a> - more than 50,000 miles of lead pipes. This would mean that service lines to the homes of about 15 to 22 million people, or 7% of those served by a community water system, could contain lead.</p>
<p>More than one in five utilities <a href="https://www.eenews.net/stories/1060039790">do not know</a> whether lead service lines exist for the homes they serve. Addressing this problem will require the federal government to update regulations, while states improve monitoring and enforcement. The EPA does not require lead testing in schools, and sampling procedures at community water systems can be inconsistent. </p>
<p>Lead is one of the few water contaminants that utilities are required to measure at a customer’s home, and utilities do not always follow EPA sampling procedures in practice. A violation is incurred only if 10% or more of samples have concentrations above the action level for lead, which is 15 parts per billion. Some utilities take many more samples than required and <a href="https://www.theguardian.com/environment/2016/jun/02/lead-water-testing-cheats-chicago-boston-philadelphia">discard those with high lead levels</a>, a 2016 investigation found. </p>
<p>Another hurdle is reduced funding for enforcement activities. State funding <a href="https://www.asdwa.org/wp-content/uploads/2017/03/SRNAP-Analysis.pdf">declined by 26%</a> from 2001 to 2011, while workloads have increased due to new rules.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/YBnwlIjRVn4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Procedures for sampling household water for lead and copper.</span></figcaption>
</figure>
<h2>Controlling corrosion and replacing pipes</h2>
<p>Water system managers must inform the public when they find elevated lead levels. They may need to reduce pipe corrosion or replace service lines made of lead. </p>
<p>Water treatments to adjust pH and lessen corrosion can be effective in reducing exposure to lead. They are required in cities of more than 50,000 and in smaller systems with violations. Flint’s system lacked proper corrosion control, which would have cost only about <a href="https://www.npr.org/sections/health-shots/2018/06/25/623126968/pediatrician-who-exposed-flint-water-crisis-shares-her-story-of-resistance">US$100 per day</a>.</p>
<p>Replacing lead pipes nationwide, which would permanently solve the corrosion problem, would cost <a href="https://www.epa.gov/sites/production/files/2016-10/documents/508_lcr_revisions_white_paper_final_10.26.16.pdf">$16 billion to $80 billion</a>. Utilities that cannot reduce lead levels through corrosion control are legally required to replace pipes at a rate of 7% yearly. However, they only have to pay for replacing pipes they own. Many homeowners decline to pay for their portion, which can cost between $1,000 and $12,000. </p>
<p>Partial replacements can worsen conditions by disrupting pipelines and dislodging lead. Nonetheless, some cities have launched replacement programs. Others, including Detroit, Denver and Newark, have taken steps to identify and inventory lead pipes in their service areas. </p>
<h2>Stricter rules</h2>
<p>Revised federal and state guidelines could limit oversampling by utilities and improve water testing in people’s houses. New regulations could prohibit the practice of “<a href="https://www.theguardian.com/environment/2016/jun/02/lead-water-testing-cheats-chicago-boston-philadelphia">pre-flushing</a>,” or running water for several minutes before drawing a sample, which some engineers use to <a href="https://www.michiganradio.org/post/states-instructions-sampling-drinking-water-lead-not-best-practice">clear lead from pipes</a> prior to testing. Another strategy would be for regional EPA offices to conduct random sampling of tap water quality.</p>
<p>The EPA currently is considering <a href="https://www.epa.gov/dwstandardsregulations/lead-and-copper-rule-long-term-revisions">long-term revisions</a> to the Lead and Copper Rule. In our view, an updated rule should require corrosion control, identification and replacement of lead lines, specific sampling procedures and better public education. </p>
<p>We believe that lead contamination can be eliminated through better enforcement, more funding for state agencies, stricter sampling and proactive efforts to control corrosion. These actions will pay off by improving children’s health nationwide.</p>
<p>[ <em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=youresmart">You can read us daily by subscribing to our newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/118153/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Maura C. Allaire serves as a research network expert for the Public Policy Institute of California's Water Policy Center.</span></em></p><p class="fine-print"><em><span>Qi Bing does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Newark is the latest US city to struggle with high lead levels in drinking water. Ending this public health crisis will require more money and enforcement, plus stricter water testing standards.Qi Bing, Ph.D. Student in Urban and Environmental Planning and Policy, University of California, IrvineMaura C. Allaire, Assistant Professor of Water Economics and Policy, University of California, IrvineLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1165062019-06-27T17:54:59Z2019-06-27T17:54:59ZWhy lead is dangerous, and the damage it does<figure><img src="https://images.theconversation.com/files/281212/original/file-20190625-81770-1xsoxow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Two house painters in hazmat suits remove lead paint from an old house. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/two-house-painters-hazmat-suits-removing-458202448?src=vvQkBkUCuohuBPZHOVUaUA-1-5&studio=1">Jamie Hooper/Shutterstock.com</a></span></figcaption></figure><p>Everything is a toxin, or has the potential to be, in the field of toxicology. In the 1500s, Swiss physician <a href="http://doi.org/10.1111/bcpt.12622">Paracelsus, the father of toxicology</a>, coined his famous dictum: “What is there that is not poison? All things are poison and nothing is without poison. Solely the dose determines that a thing is not a poison.” </p>
<p>Lead, however, is toxic at any dose. <a href="https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health">It serves no purpose in our body</a>. Unlike most other toxins that our body can eliminate through metabolism and excretion, our body has <a href="https://www.atsdr.cdc.gov/phs/phs.asp?id=92&tid=22">no ability to purge lead</a>. </p>
<p>As a clinical toxicologist, I care for children and adults who have been exposed to lead and assure that those individuals receive the best possible care. Lead can enter the body through a number of different routes, depending on the source of the element. Most commonly, it enters the body through ingestion or inhalation. </p>
<p>As an example, toddlers are constantly placing items, including their hands, in their mouths. If a toddler lives in an old home that was previously painted with leaded paint – which was <a href="https://www.govinfo.gov/content/pkg/STATUTE-84/pdf/STATUTE-84-Pg2078.pdf">banned in the United States in 1978 for use in homes</a> – the child may ingest old lead paint chips or lead contaminated dust from their hands on a daily basis resulting in gastrointestinal absorption of lead. This is by far one of the most common causes for elevated blood lead level that I see in my clinic. </p>
<p>On the other hand, I have evaluated adults in our clinic who had elevated blood lead levels after inhaling lead vapor following heating of lead in poorly ventilated areas. A couple of those cases included a hobbyist who made his own lead musket balls in his basement for Revolutionary War and Civil War reenactments and a military marksmen who was practicing target shooting with lead ammo. One of my patients who was pregnant was using a heat gun to strip lead paint in an old home and developed markedly elevated blood lead levels via inhalation, placing her fetus at risk since lead crosses the placenta. </p>
<h2>Clinical effects of lead</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=411&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=411&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=411&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=516&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=516&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281218/original/file-20190625-81750-pi8g8s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=516&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The people in areas of Flint, Michigan, were exposed to high levels of lead through the water supply.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/ypsilanti-miusa-jan-27-2016-sign-368463005?src=vvQkBkUCuohuBPZHOVUaUA-1-8&studio=1">Barbara Kalbfleisch/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>The clinical effects from lead toxicity are potentially subtle and may be slow to emerge and may not be noticed initially. The timing of symptoms is based on the dose taken into the body and the time over which lead enters the body. A child who ingests a lead fishing sinker that is retained in the stomach may have a rapid rise in blood lead levels and become symptomatic over days with nausea, vomiting, confusion, and sedation. On the other hand, a child exposed to ingested dust contaminating the hands daily may develop few and subtle symptoms that take years to manifest, if at all. </p>
<p>Once lead enters the body, it first flows through the blood stream where it slowly crosses into various organs such as the kidneys, muscles and brain. Lead is bad for humans because it interferes with numerous enzymes inside the cells of these organs. This results in symptoms such as muscle and joint aches as well as constipation and overall fatigue. It damages our brains by interfering with how brain cells send messages and communicate. Lead decreases fertility in both males and females. It harms our kidneys and can result in <a href="https://ghr.nlm.nih.gov/condition/hypertension">hypertension</a> later in life. Lead prevents our bodies from creating hemoglobin – the molecule that carries oxygen in our red blood cells – resulting in <a href="https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia">anemia</a>. </p>
<p>Rather than being eliminated, much of the lead we absorb into our bodies becomes deposited in bones and stays with us for the rest of our lives. From those tissues and the blood, lead will eventually enter the bone where it is deposited and remains for the lifetime of most individuals. That is why the Centers for Disease Control and Prevention has clearly stated that “<a href="https://ephtracking.cdc.gov/showChildhoodLeadPoisoning">no safe blood lead level in children has been identified</a>.” </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=361&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=361&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=361&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=453&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=453&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281216/original/file-20190625-81776-np2kee.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=453&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Chelation therapy uses ethylenediaminetetraacetic acid to remove lead, mercury, iron and arsenic from the blood.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/chelation-therapy-lead-mercury-iron-acid-1341184721?studio=1">rumruay/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Lead in the brain</h2>
<p>Lead is a dangerous toxin for people of all ages. But it is especially dangerous for young children. In young developing brains it alters brain development and changes the architecture, ultimately causing learning problems and lower IQs. In the brain lead interferes with with the release of signaling molecules called neurotransmitters, it inhibits function of a receptor (N-methyl-D-aspartate-type glutamate receptor) vital for memory and forming new neural connections, and raises the levels of a messenger molecule called protein kinase C. Taken together, these effects diminish the the number of <a href="https://www.ncbi.nlm.nih.gov/pubmed/9870138">synaptic connections during a critical early period</a> of postnatal development. </p>
<p>There are numerous treatments, such as a process called chelation which helps to eliminate lead from the body when an individual has been poisoned. Chelation is used when blood lead levels are above a specific critical threshold where such treatments might benefit. However, the first goal is to assure our population does not become exposed to toxins, especially lead. </p>
<p>Entities, such as the CDC, the <a href="https://www.osha.com">Occupational Safety and Health Administration</a> and local state health departments work to decrease adult and child lead exposure. Public health initiatives over the past few decades in the U.S. have been successful in <a href="https://www.sciencedirect.com/science/article/pii/S0002934316306003">lowering our public’s blood lead levels</a>. Such public health preventative work to decrease lead exposure will reduce future adverse health outcomes in subsequent generations.</p>
<p>If you have questions about lead, view information at reliable sites, such <a href="http://www.vdh.virginia.gov/leadsafe/">your state health department</a>, <a href="https://www.cdc.gov/nceh/lead/">the CDC</a> and <a href="https://www.atsdr.cdc.gov/ToxProfiles/tp.asp?id=96&tid=22">the Agency for Toxic Substances and Disease Registry</a>. </p>
<p>The U.S. poison centers can also help to answer questions regarding lead poisoning, day or night (1-800-222-1222).</p><img src="https://counter.theconversation.com/content/116506/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher P. Holstege does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Flint water crisis made the country aware of the dangers of lead. But why, exactly, is this element so toxic and what does it do to the body?Christopher P. Holstege, Professor of Emergency Medicine and Pediatrics, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1161252019-06-27T12:46:36Z2019-06-27T12:46:36ZHow the Flint water crisis set students back<p>When the <a href="https://www.npr.org/2019/04/25/717104335/5-years-after-flints-crisis-began-is-the-water-safe">Flint water crisis</a> took place in 2014 and 2015, one of my graduate nursing students decided to get involved.</p>
<p>Having already worked with me in the Greater Toledo area to screen children at risk for lead poisoning, my student helped conduct blood lead level screenings of the children exposed to the water. Test results later showed that the number of lead poisoned children in Flint had <a href="https://www.ncbi.nlm.nih.gov/pubmed/26691115">doubled</a> after the crisis.</p>
<p>Since that time, some have worried that children in Flint are suffering <a href="https://www.freep.com/story/news/columnists/rochelle-riley/2018/02/06/sh-h-h-snyder-state-update-left-out-75-drop-reading-proficiency-flint/1074057001/">academic setbacks</a> as a result of being exposed to high levels of lead in Flint’s water supply. </p>
<p>State officials advised that <a href="https://www.theguardian.com/us-news/2016/mar/24/flint-children-water-crisis-lack-of-data-lead">as many as 9,000 children</a> under the age of 6 in Flint be treated as having been exposed to high levels of lead after the city’s drinking water supply was switched in 2014 from water from Lake Huron to water from the Flint River. </p>
<p>Others, however, have pushed back, arguing that Flint’s water crisis is <a href="https://www.motherjones.com/kevin-drum/2018/02/lead-did-not-turn-flint-children-into-idiots-stop-saying-so/">not the culprit</a> behind any academic losses. Certainly lead was a problem for children in Flint <a href="https://www.sciencedaily.com/releases/2018/03/180326090313.htm">long before the water problems</a>.</p>
<p>But as a nursing professor and <a href="https://www.mendeley.com/authors/24741306400/">parent educator</a> who <a href="http://www.utoledo.edu/nursing/faculty_profiles/Marilynne-Wood.html">specializes</a> in treating children with elevated lead levels, I believe that just like in Detroit – where lead poisoned children have <a href="https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301164">suffered academic setbacks</a> after being exposed to lead, <a href="https://www.detroitnews.com/story/news/local/detroit-city/2017/11/14/lead-poisoning-children-detroit/107683688/">mostly from lead paint in their homes</a> – similar academic setbacks are likely taking place in Flint.</p>
<p>However, my experience shows that lead levels in children can be lessened by educating parents on simple things they can do to decrease exposure to lead in their homes.</p>
<h2>Ill effects</h2>
<p>Lead <a href="https://www.who.int/en/news-room/fact-sheets/detail/lead-poisoning-and-health">affects children’s brain development</a> and results in reduced “intelligence quotient,” or IQ. It also leads to behavioral changes, such as shortening of attention span, restlessness, conduct disorders, aggression and reduced educational attainment, as shown in “<a href="https://www.penguinrandomhouse.com/books/550935/what-the-eyes-dont-see-by-mona-hanna-attisha/9780399590856/">What the Eyes Don’t See</a>,” a book by Mona Hanna-Attisha, a physician who helped <a href="https://www.npr.org/sections/health-shots/2018/06/25/623126968/pediatrician-who-exposed-flint-water-crisis-shares-her-story-of-resistance">expose the Flint water crisis</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281008/original/file-20190624-97745-1ehzuom.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Mona Hanna-Attisha, a public health expert and pediatrician, wrote a book about the water crisis of Flint, Michigan.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Flint-Water-Doctors-Book/d6b4cbe7d4324237b439ba64020f0dbb/8/0">Carlos Osorio/AP</a></span>
</figcaption>
</figure>
<p>Lead exposure can harm children even <a href="https://www.sciencedirect.com/science/article/pii/S0065310114000164?via%3Dihub">before they are born</a>. The Centers for Disease Control estimate that approximately <a href="https://www.cdc.gov/nceh/lead/default.htm">half-a-million</a> children in the United States between the ages of 1 and 5 have an elevated blood lead level.</p>
<p>Although lead poisoning is <a href="https://www.healio.com/pediatrics/journals/pedann/2018-10-47-10/%7B96dc07b8-dc79-4aaa-a505-ad77c98fc731%7D/advocating-for-automatic-eligibility-for-early-intervention-services-for-children-exposed-to-lead#divReadThis">preventable</a>, the neurological and behavioral effects of lead are believed to be <a href="https://www.who.int/en/news-room/fact-sheets/detail/lead-poisoning-and-health">irreversible</a>. No <a href="https://www.who.int/en/news-room/fact-sheets/detail/lead-poisoning-and-health">level of lead</a> is <a href="https://www.atsdr.cdc.gov/csem/csem.asp?csem=34&po=8">safe for children</a>. </p>
<h2>Screening children</h2>
<p>Most of my work with lead poisoned children has taken place in the Greater Toledo area. My graduate nursing students and I have collectively screened more than a thousand students at Toledo Public Schools. Of those children tested, 577 – 38.9% – had blood lead levels above 4 micrograms per deciliter. The CDC says <a href="https://www.cdc.gov/nceh/lead/default.htm">intervention is warranted</a> at 5 micrograms per deciliter, but I prefer to intervene at 4 micrograms to focus in on problems before it reaches a higher level.</p>
<p>In individual schools in Toledo, the share of students at or above 4 micrograms per deciliter ranged from 21% to 73%. Many of the children we screened were already in special education classrooms because of their lead exposure. </p>
<h2>What actions are needed</h2>
<p>Whenever my graduate students and I detect lead in children, we educate their parents or caregivers about where lead comes from. We discuss what lead does to children’s brains and bodies once it enters their bloodstream. We also offer practical tips about how they can decrease lead exposure in their homes. </p>
<p>For instance, we recommend that caregivers wet mop and clean. Why? Because over 80% of the children that I’ve screened for lead in the Toledo area live in rental properties. That’s significant because many of these homes and apartments were built before 1978, the year the United States <a href="https://www.epa.gov/lead/protect-your-family-exposures-lead">banned lead-based paint in housing</a>, and are the most likely to have lead paint. As different families move in and out of these properties, many different children get exposed to lead in the same rental home over the years.</p>
<p>It is critical that these rental properties and family-owned homes be certified by local health departments and other governmental agencies as “lead safe.” But just as there are lead threats inside the home, there are also threats outside the home. Those outside threats come from children playing in lead-tainted soil around the home and tracking it inside.</p>
<h2>Fighting back</h2>
<p>When 18 of my graduate nursing students and I followed up with Toledo families with lead poisoned children between 2016 and 2018, we found 11 of the 577 children had significant decreases in their blood lead levels and improved academic performance.</p>
<p>One 8-year-old girl, for instance, had her blood lead levels drop from 22.6 micrograms per deciliter two years ago to 6.1 micrograms per deciliter.</p>
<p>The girl’s mother was diligent in following the recommendations we made to decrease lead absorption in her daughter, such as increased nutritional intake of vitamin C, iron and calcium. In addition, the girl began to take daily multivitamins and ate snacks during the day to avoid an empty stomach, since food decreases the gastric absorption of lead. Shoes were left at the door of their home to avoid tracking in lead-contaminated soil from outside. The mother also damp mopped and dusted to decrease exposure to lead from the air. The girl was also encouraged to wash her hands frequently. Referrals were made to the local health department for further assessment of the living environment and possible financial support to secure a “lead safe” home for the family.</p>
<h2>Future of Flint</h2>
<p>Five years after the Flint water crisis, people are still <a href="https://www.npr.org/2019/04/25/717104335/5-years-after-flints-crisis-began-is-the-water-safe">distrustful of the local water</a>. Efforts to hold officials accountable seem to go back and forth. Residents are trying to sue <a href="https://www.nbcnews.com/politics/supreme-court/supreme-court-denies-flint-officials-request-block-lawsuit-over-water-n1017816">city officials</a> and the <a href="https://www.cnn.com/2019/04/19/us/flint-water-federal-lawsuit-ruling/index.html">federal government</a> for lead contamination in the water. <a href="https://www.nytimes.com/2019/06/13/us/flint-water-crisis-charges-dropped.html">Criminal charges were dropped</a> on June 13 against several officials who had been charged in the crisis, but may be re-issued.</p>
<p>The circumstances by which children were exposed to high levels of lead in Flint and Toledo may be different. But as one who has worked directly with lead-poisoned children, I know it is likely the impacts will be similar. Lead-poisoned children in Toledo schools have struggled to stay on task, stay out of trouble, learn reading and math skills, and keep up with their peers academically and socially. There’s no reason to think that lead-poisoned children in Flint aren’t going through the same thing.</p>
<p>[ <em><a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=expertise">Expertise in your inbox. Sign up for The Conversation’s newsletter and get a digest of academic takes on today’s news, every day.</a></em> ]</p><img src="https://counter.theconversation.com/content/116125/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marilynne R Wood does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The children who suffered lead poisoning as a result of the Flint water crisis of 2014 are likely to struggle academically and socially as a result, an expert on treating lead-poisoned children argues.Marilynne R Wood, Professor, University of ToledoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/842672017-10-19T18:59:32Z2017-10-19T18:59:32ZFriday essay: toxic beauty, then and now<figure><img src="https://images.theconversation.com/files/191982/original/file-20171026-28041-1ust5n1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Beauty is still understood as a process of ongoing work and maintenance.</span> <span class="attribution"><span class="source">Shutterstock.com</span></span></figcaption></figure><p>Throughout history, humans have been willing to try almost any method or product to improve their physical appearance. In response, enterprising businesses and beauty moguls have conspired to sell us almost anything — from water to poison — in the guise of cosmetic treatments. While many cosmetic products have eventually proven to have little efficacy, a significant number have also caused physical harm and even death.</p>
<p>Cosmetics and cosmetic surgery are now subject to more stringent regulation than in the 19th century, when lead-based powders and face creams containing poisons were not uncommon. However, even today there are significant serious side-effects and potential dangers from cosmetic procedures, in particular.</p>
<p>For example, it was <a href="http://www.abc.net.au/news/2017-09-17/my-face-became-infected-again-and-again/8946230">recently reported</a> that cosmetic injections, such as platelet-rich plasma injections and facial fillers, are leading to a significant number of patients suffering from chronic, and potentially disfiguring, bacterial infections. While these kinds of non-invasive procedures are common, with over $1 billion spent annually on cosmetic jabs in Australia alone, research suggests that <a href="http://www.abc.net.au/news/2017-09-17/my-face-became-infected-again-and-again/8946230">almost one-fifth of patients</a> could suffer from such complications. </p>
<p>Of course, even when the greatest medical care is taken, there are still potential questions about the health risks of utilising Botox (Botulinum Toxin Type A) to combat or stave off facial wrinkles. While a large number of people, primarily women, have embraced Botox and <a href="https://theconversation.com/botox-can-reach-the-nervous-system-but-its-still-safe-39918">believe it to be safe</a>), in 2009 the <a href="https://www.theguardian.com/lifeandstyle/2016/aug/27/botox-safe-new-research-testing-toxins-fda">US Food and Drug Administration added a warning</a> noting that Botox “may spread from the area of injection to produce symptoms of botulism”, such as muscle weakness and breathing difficulty.</p>
<hr>
<p><em>Further reading: <a href="https://theconversation.com/safety-before-profits-why-cosmetic-surgery-is-ripe-for-regulation-39365">Safety before profits: why cosmetic surgery is ripe for regulation</a></em></p>
<hr>
<p>Even the most common beauty products still have potential risks associated with them. Consider lipstick, which is placed directly on the thin skin of the lips, readily ingested throughout wear, and reapplied multiple times throughout the day. Manufacturers are not required to list lead as an ingredient in lipsticks as it is regarded as a contaminant, but most contain lead, and some colours in much higher concentrations. An <a href="https://www.fda.gov/Cosmetics/ProductsIngredients/Products/ucm137224.htm">FDA test of 400 lipsticks</a> conducted in 2011 found that every one contained lead. Nevertheless, <a href="https://www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm534120.htm">the FDA advises</a> that up to 10 parts per million of lead is an acceptable level.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=781&fit=crop&dpr=1 600w, https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=781&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=781&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=982&fit=crop&dpr=1 754w, https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=982&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/190724/original/file-20171018-30428-qh5bqh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=982&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p>In her book <a href="https://books.google.com.au/books/about/Fashion_Victims.html?id=uZdlCgAAQBAJ&redir_esc=y">Fashion Victims: The Dangers of Dress Past and Present</a>, Alison Matthews David explains that lead was a popular ingredient in cosmetics for centuries “because it made colours even and opaque and created a desirable ‘whiteness’ that bespoke both freedom from hard outdoor labour and racial purity”.</p>
<p>In the 1860s, the American face lotion Laird’s “Bloom of Youth or liquid pearl” <a href="http://www.livingly.com/The+Most+Dangerous+Beauty+Trends+Through+the+Ages/articles/OIFbMgTFkyf/Laird+s+Bloom+of+Youth">promised to whiten skin</a>, helping “ladies afflicted with tan, freckles, Rough or Discolored Skin”. The skin lightener, however, contained such a significant amount of lead that it caused “wrist drop”, or radial nerve palsy, in a number of women. </p>
<p>One woman’s hand had become “wasted to a skeleton”, while a St Louis housewife is <a href="https://books.google.com.au/books?id=treG8BAnJcwC&pg=PA10&lpg=PA10&dq=laird%27s+bloom+of+youth&source=bl&ots=sYvmbDqbx2&sig=MjmNy-rs-tIzv2FNzaHt6W5GBu8&hl=en&sa=X&ved=0ahUKEwix5467gK7WAhWCUZQKHYdhCxk4ChDoAQg4MAM#v=onepage&q=laird's%20bloom%20of%20">recorded as dying of lead poisoning</a> after extensive long-term usage of Laird’s and a home-made preparation containing “white flake and glycerine”.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=781&fit=crop&dpr=1 600w, https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=781&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=781&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=981&fit=crop&dpr=1 754w, https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=981&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/190718/original/file-20171018-19058-1s3b2nl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=981&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An ad for Laird’s bloom of youth, or liquid pearl for preserving and beautifying the complexion and skin, circa 1863.</span>
<span class="attribution"><span class="source">Wikimedia images</span></span>
</figcaption>
</figure>
<p>In her book, Matthews David tells how she bought a vintage container of the American face powder “Tetlow’s Swan Down” that dates from the 1870s. It had been marketed as harmless and claimed to use whitening zinc oxide powder to replace once common toxic products such as lead, arsenic and bismuth. She had the powder tested with modern methods and found that it contained “a significant amount of lead”, which could be inhaled as dust during application.</p>
<hr>
<p><em>Further reading: <a href="https://theconversation.com/high-amount-of-toxic-metals-in-some-cosmetics-14225">High amount of toxic metals in some cosmetics</a></em> </p>
<hr>
<h2>A dark history</h2>
<p>The serious regulation of patent medicines and cosmetics did not occur until the 20th century. This lack of government oversight meant that manufacturers could bottle and sell almost anything without having to verify their claims, subject their products to the rudimentary testing that was available, or clearly label the ingredients.</p>
<p>The key way in which American and British consumers made their decisions about products was based on the claims made and reputations built in extensive magazine advertising, which became prolific in the late 19th century. The period also saw branded cosmetics rise to prominence, with long-established and well-advertised brands, such as Pears’ Soap, providing one of the few indicators of likely quality and safety. Most cosmetic advertising emphasised the purity and healthfulness of products to distance them from well-known examples of harmful creams, powders, and dyes.</p>
<p>“Celebrated American skin specialist” Anna Ruppert (Shelton) provides a ready example of the spurious nature of some cosmetic advertising and the reality of dangerous tonics marketed as “natural” and therefore healthful in this era. Throughout 1891 and 1892, numerous advertisements appeared in British women’s magazines, including high-quality publications such as The Queen, for lectures to be held in London by a purported American beauty expert.</p>
<p>The ads mentioned Ruppert’s book on “natural beauty”, as well as promoting various products including a skin tonic. Her signature tonic was originally marketed as “Face Bleach” in the United States, tapping into the demand for lighter skin not only from white women, but also African American women. The tonic is described in one Queen advertisement as harmless and invisible: “It is not a cosmetic as it does not show on the face after application”.</p>
<p>However, the reality was that Ruppert’s product was dangerous. After a chemical analysis, the British Medical Journal revealed in 1893 that the skin tonic included the harmful ingredient “corrosive sublimate (bichloride of mercury)”, and it was implicated in the mercury poisoning of a “Mrs K”. As <a href="http://blog.wellcomelibrary.org/2016/02/madame-rupperts-beauty-secrets/">Caroline Rance discovered</a>, that same year, Ruppert was prosecuted for infringing the Irish Pharmacy Act and her reputation was badly tarnished as a result.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=631&fit=crop&dpr=1 600w, https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=631&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=631&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=794&fit=crop&dpr=1 754w, https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=794&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/190723/original/file-20171018-30410-16und69.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=794&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Promotional material for Anna Ruppert.</span>
<span class="attribution"><span class="source">Author provided</span></span>
</figcaption>
</figure>
<p>Cosmetics originated in homemade preparations, with long traditions of women concocting their own skin remedies. However, the advice and recipes given in beauty manuals were no guarantee of safety. One British “Treatise of the Toilet and Cosmetic Arts” entitled <a href="https://books.google.com.au/books/about/The_Practice_of_Perfumery_A_Treatise_on.html?id=yHgKMQAACAAJ&redir_esc=y">The Practice of Perfumery</a> from 1870 included a recipe for one of the first depilatory creams, <em>poudre subtile</em>. The ingredients call for half an ounce of “sulpheret of arsenic”, although the author does warn that the preparation is “dangerous” and that “utmost caution” should be used.</p>
<p>Warnings such as this one indicate that the harmful effects of certain cosmetic products were well known. Another manual, Beauty: How to Get it and How to Keep It, from 1885 advised readers to avoid hair dyes because they “are sometimes injurious to the health; those that contain lead or mercury are especially so, and have been known to cause serious illness.” This fear of harmful dyes is reflected in the many magazine advertisements of the period for “hair restorers” that promise to return grey hair to its original shade without the use of “dyes”. </p>
<p>Dangerous home-spun beautifying techniques were also the subject of warnings. For instance, Toilet Hints, or, How to Preserve Beauty, and How to Acquire It from 1883 strongly advised women not to toy with the use of Belladonna berries to dilate their pupils. The use of an extract from the berries could cause blurred vision or even permanent blindness with prolonged use. This beauty guide offered up another, less dangerous, method for adding a spark to the eyes: </p>
<blockquote>
<p>If your eyes look dull, drink a glass of champagne rather than touch belladonna.</p>
</blockquote>
<h2>A gendered culture</h2>
<p>Disgraced skin specialist Anna Ruppert wrote in her A Book of Beauty in 1892 that a woman could never neglect her appearance, as even “[t]he most noble beauty, if unattended, will soon lose its charm”. Her comment has several important resonances with beauty culture today.</p>
<p>First, it is still primarily women who seek out cosmetics and cosmetic procedures. Ruppert’s advice to the Victorian woman was that maintaining her looks was vital to maintain a happy marriage. Our modern, postfeminist view is that women now make the “choice” to follow beauty and fashion norms.</p>
<p>Second, beauty is still understood as a process of ongoing work and maintenance. Procedures like Botox can be used pre-emptively to ward off wrinkles and sagging, but it requires continuous usage over time to maintain its effects.</p>
<p>Third, and most importantly, the gendering of cosmetic use means that women are most affected by dangerous products and procedures. As Matthews David points out, cosmetics and dyes continue to be less stringently regulated than products like shampoo and deodorant, which fall under the category of “personal care”.</p>
<hr>
<p><em>Further reading: <a href="https://theconversation.com/health-risks-beneath-the-painted-beauty-in-americas-nail-salons-41660">Health risks beneath the painted beauty in America’s nail salons</a></em></p>
<hr>
<p>Several centuries of lax attitudes toward the composition of cosmetics and now non-invasive cosmetic procedures add up to not only a collection of macabre or grotesque stories.</p>
<p>From lead-filled Bloom of Youth to cosmetic fillers being delivered under questionable conditions, the history of dangerous cosmetics shows us the harms that women have suffered to meet expectations of what is beautiful.</p><img src="https://counter.theconversation.com/content/84267/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Smith has previously received funding from the Australian Research Council.</span></em></p>The history of dangerous cosmetics shows us the harms that women have suffered to meet expectations of what is beautiful.Michelle Smith, Senior lecturer in Literary Studies, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/807962017-07-11T06:03:12Z2017-07-11T06:03:12ZHow worried should you be about lead from Aldi taps?<p>If you have bought an Aldi “<a href="http://www.abc.net.au/news/2017-07-10/aldi-spiral-spring-mixer-tap/8695150">The Spiral Spring Mixer Tap</a>” you should <em>not</em> use water from it for drinking or cooking until investigations of <a href="http://www.smh.com.au/business/consumer-affairs/aldi-tap-found-to-be-contaminated-with-lead-being-investigated-with-urgency-20170710-gx83c2.html">reported lead contamination</a> is complete. </p>
<h2>What we know</h2>
<p>The <a href="http://www.news.com.au/finance/business/retail/customers-warned-to-beware-of-cheap-aldi-tap/news-story/9be3c4f8aa5e04e0ef031d08d1aa7443">media reports</a> that water passing through the tap has up to 15 times the <a href="https://www.nhmrc.gov.au/guidelines-publications/eh52">lead levels</a> allowed in Australian drinking water (<a href="https://www.hunterwater.com.au/Water-and-Sewer/Water-Supply/Water-Quality/Guidelines-for-Drinking-Water-Quality.aspx">maximum 0.01 milligrams per litre</a>). <a href="https://www.health.qld.gov.au/qhcss/qhss">Queensland Health’s Forensic and Scientific Services</a> conducted the tests, so the results are credible. </p>
<h2>What we don’t know</h2>
<p>We don’t know how extensive the contamination is. So far, only one tap has been tested and I haven’t seen the actual results. So, we need a larger sample of taps to determine if this was a one-off contamination (unlikely) or represents a wider problem. </p>
<p>Aldi confirmed the taps were tested by a <a href="https://www.nata.com.au/nata/">National Association of Testing Authorities</a> accredited laboratory and passed Australian standards for lead leakage into water before going on sale. But it is not clear why the current tested tap exceeds the Australian standards by so much. </p>
<p>Is it a problem with a particular batch? Or did <a href="http://www.couriermail.com.au/news/queensland/how-aldi-tap-with-dangerous-levels-of-lead-may-have-passed-safety-tests/news-story/b94a7187ae7b4dfa4ccdaf91d58bb372">substitution of high lead components occur after the first samples were tested</a> as some media reports claim? Australia permits <a href="https://www.newscientist.com/article/2100806-lead-in-australias-drinking-water-is-leaching-from-brass-taps/">higher levels of lead in brass used in Australia’s plumbing fittings</a> than the US, for example. However, the reported lead levels seem too high for this to explain the current situation. </p>
<p>Aldi has suspended sales of the tap and is currently having the taps tested at an independent accredited laboratory. Answers to the questions should be available by the end of the month.</p>
<p>Another issue is the report of “up to 15 times the permitted lead level”. We don’t know if the level of lead is declining with each use of the tap, or if this is just simple assay variability. If the levels decline over time the risk to consumers are less (but still concerning). </p>
<h2>What is the risk if I have one of these taps?</h2>
<p>While the levels involved are substantially higher than the Australian guideline, they are still low and not likely to cause acute lead poisoning. One or two glasses will not poison you.</p>
<p>But lead is <a href="http://www.who.int/mediacentre/factsheets/fs379/en/">a cumulative toxin</a>. Continued consumption of low levels of lead (over weeks, months and years) can have adverse effects. </p>
<p>The major concern is in babies, young children and unborn babies. Babies and young children absorb more lead than adults, with significant effects on their developing bodies. Effects include <a href="https://ntp.niehs.nih.gov/pubhealth/hat/noms/lead/index.html">disruption of red blood cell production, kidney damage, behavioural disturbances and other nervous system effects</a>. The behavioural and nervous system effects are of most concern.</p>
<p>Exactly which effects occur will depend on how long and how much water has been consumed (and whether the reported lead levels are typical). For adults, <a href="https://ntp.niehs.nih.gov/pubhealth/hat/noms/lead/index.html">anaemia, high blood pressure, tremor, tiredness, sleeplessness, irritability, headache and joint pain</a> may be signs of long-term exposure to low levels of lead. </p>
<h2>What should I do if I have one of these taps?</h2>
<p>Until it is determined if other taps of this brand are similarly contaminated (again, previous test samples had complied with Australian regulations) people who have bought these taps should <em>not</em> use water from them for drinking or cooking. </p>
<p>Anyone who has any health concerns should consult their doctor.</p>
<hr>
<p><em>Aldi confirmed the taps were undergoing independent testing, which is expected to be completed by 31 July. “If these results present any indication that a health risk exists for our customers, we will take appropriate action,” a company statement said.</em></p>
<p><em>In the meantime the company recommends customers who have bought the taps register their <a href="http://www.productregistration.aldi.com.au/">product</a> to receive updates and the results of the testing.</em></p>
<hr>
<p><em>Updated July 26, 2017: Aldi says independent testing of its Spiral Spring Mixer Tap confirms it is safe to use. The company says the tap passed testing against the AS/NZS 4020:2005 standard, which was conducted at a laboratory accredited by the National Association of Testing Authorities.</em></p><img src="https://counter.theconversation.com/content/80796/count.gif" alt="The Conversation" width="1" height="1" />
<h4 class="border">Disclosure</h4><p class="fine-print"><em><span>Ian Musgrave receives funding from the National Health and Medical Research Council to study adverse reaction to herbal medicines and has previously been funded by the Australian Research Council to study potential natural product treatments for Alzheimer's disease. He has used workshops on lead contamination as a teaching tool for environmental toxicology.</span></em></p>If you have bought an Aldi “The Spiral Spring Mixer Tap” you should not use water from it for drinking or cooking until investigations of reported lead contamination is complete. What we know The media…Ian Musgrave, Senior lecturer in Pharmacology, University of AdelaideLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/794812017-06-16T00:42:05Z2017-06-16T00:42:05ZIs lead in the US food supply decreasing our IQ?<figure><img src="https://images.theconversation.com/files/174088/original/file-20170615-24915-1i3j0lg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A baby plays with blocks spelling out one of the most famous formulas in history. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/genius-baby-high-iq-playing-cubes-461058916?src=ygHBdVvcs9OKo5WBzS4ZZg-1-16">vchal/From www.shutterstock.com</a></span></figcaption></figure><p>The environmental advocacy group Environmental Defense Fund (EDF) on June 15 released a <a href="https://www.edf.org/health/lead-food-hidden-health-threat?_ga=2.61184942.363465047.1497539228-274183335.1497539228">study</a> about dietary lead exposure, with a focus on food intended for babies and young children. </p>
<p>Using a Federal Drug Administration (FDA) database of food samples, EDF reported some pretty worrying numbers, most remarkably in fruit juice samples intended for children. For example, 89 percent of the baby food grape juice samples had detectable levels of lead in them.</p>
<p>As researchers who served as independent reviewers on the EDF report, we think it raises important concerns about the safety of our food supply. Since EDF primarily focused on exposure (whether lead was detectable or not), we were interested to see if we could get a better sense of the magnitude of risk. Specifically, we examined potential IQ loss and the percentage of samples with high lead concentrations.</p>
<h2>Why is lead in our food and beverages?</h2>
<p>Most of us are probably familiar with the dangers of chipping and peeling <a href="https://www.epa.gov/lead">lead paint</a>. And the Flint water crisis has brought <a href="https://theconversation.com/piping-as-poison-the-flint-water-crisis-and-americas-toxic-infrastructure-53473">lead pipes</a> to the forefront of our minds.</p>
<p>But food is a source of lead exposure most of us probably aren’t thinking about. <a href="https://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm557424.htm">Soil contamination</a> is a known source of lead in food, but the EDF report also raised the possibility of contamination occurring via the use of lead-containing materials during food processing. </p>
<p>Eating lead-contaminated food increases the level of lead in the blood. Chronic, low-level exposure to lead during childhood can harm <a href="https://www.atsdr.cdc.gov/phs/phs.asp?id=92&tid=22#bookmark06">mental and physical development</a>. For each microgram (µg) per day of dietary lead intake, blood lead levels increase by about .16 micrograms per deciliter (µg/dL), though there is individual <a href="http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2010.1570/epdf">variation in how much lead is absorbed through the gastroinestical tract</a>. A microgram is one millionth of a gram – a very small unit of measure. </p>
<p>There is <a href="http://www.who.int/mediacentre/factsheets/fs379/en/">no known level of lead exposure</a> that is considered safe. Even <a href="https://ntp.niehs.nih.gov/pubhealth/hat/noms/lead/index.html">low blood lead levels</a> can harm child development and behavior. In 2012, the Centers for Disease Control and Prevention (CDC) reduced the <a href="https://www.cdc.gov/nceh/lead/acclpp/lead_levels_in_children_fact_sheet.pdf">definition of elevated blood levels in children</a> from 10 to 5 μg/dL.</p>
<p>This revised definition reflects findings from a <a href="https://ntp.niehs.nih.gov/pubhealth/hat/noms/lead/index.html">2012 National Toxicology Program Report</a> that concluded a wide range of adverse health effects are associated with blood lead levels less than 5 μg/dL. These included “decreased academic achievement, IQ, and specific cognitive measures; increased incidence of attention-related behaviors and problem behaviors.”</p>
<p>The FDA has set <a href="https://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm557424.htm">limits for lead</a> in the form of maximum parts per billion (ppb) for certain foods. The FDA reports that these differences in limits are due to what is considered <a href="https://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm557424.htm">achievable</a> after food processing. The American Academy of Pediatrics has the lowest recommended limit at <a href="http://pediatrics.aappublications.org/content/pediatrics/early/2016/06/16/peds.2016-1493.full.pdf">1 ppb for school drinking water</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=433&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=433&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=433&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=545&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=545&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173915/original/file-20170615-26091-16ilnpm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=545&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lead Limits in Juice and Water.</span>
<span class="attribution"><span class="source">Environmental Defense Fund</span></span>
</figcaption>
</figure>
<h2>How many of the samples had detectable levels of lead?</h2>
<p>EDF analyzed more than 12,000 test results from the 2003-2013 FDA national composite food sample data (the <a href="https://www.fda.gov/Food/FoodScienceResearch/TotalDietStudy/ucm184232.htm">Total Diet Study</a>). The Total Diet Study is an FDA “<a href="https://www.fda.gov/Food/FoodScienceResearch/TotalDietStudy/ucm494299.htm">market-basket</a>” survey of typical foods eaten by U.S. consumers and is used to assess average nutrient intake and exposure to chemical contaminants. </p>
<p>EDF did an exposure analysis (detection/nondetection), and reported the percentage of samples within different food types that tested positive for lead. Twenty percent of the samples designated by the FDA as baby food had detectable levels of lead in them, compared to 14 percent for regular foods.</p>
<p>This type of analysis is similar to measuring accident rates in workplaces, or even visits by children to the medical staff in schools. As with the lead data, increases in these numbers alert organizations to potential problems, but they don’t give enough indication to pinpoint the exact nature of the problem. </p>
<p>Even without specifics on the magnitude of the risks involved, when a lead exposure issue is flagged, it’s good practice to reduce the exposure – as a way to guard against associated negative health impacts such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1257652/">decreased intellectual function</a>.</p>
<h2>How might this be affecting our IQ?</h2>
<p>These data alone aren’t enough to indicate what the likely health effects are. Ultimately, the risk depends on how much contaminated food a child will eat through his or her childhood, and how much neurological damage this ends up causing.</p>
<p>Based on <a href="https://www.epa.gov/sites/production/files/2017-01/documents/report_proposed_modeling_approaches_for_a_health_based_benchmark_for_lead_in_drinking_water_final_0.pdf">EPA estimates</a> of average childhood dietary lead exposure, we are roughly dealing with a less than 1-point decrease in IQ in the adult population than it might otherwise be. </p>
<p>In its analysis, EDF calculated an 0.38 average IQ loss from dietary lead based on the following assumptions: </p>
<ul>
<li><p>Average dietary lead exposure for young children is 2.9 µg/day. This calculation is based on a <a href="https://www.epa.gov/sites/production/files/2017-01/documents/report_proposed_modeling_approaches_for_a_health_based_benchmark_for_lead_in_drinking_water_final_0.pdf">2017 EPA dietary lead intake estimate</a> for children ages 1-7 years.</p></li>
<li><p>2.9 µg/day dietary exposure elevates blood lead levels by 0.46 µg/dL. This calculation is based on a <a href="http://www.sciencedirect.com/science/article/pii/027323009290008W?via%3Dihub">ratio of dietary lead intake to the increase in blood lead levels</a> (for every 1 µg/day lead consumed in the diet, lead increases in the blood by 0.16 µg/dL).</p></li>
<li><p>This 0.46 µg/dL elevation in lead in the blood decreases IQ by an estimated 0.38 IQ points. This calculation is based on a <a href="http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2010.1570/epdf">2013 European Food Safety Authority (EFSA) ratio of blood lead level increase to IQ loss</a> (1.2 µg/dL lead in blood to a 1 point IQ loss).</p></li>
</ul>
<p>Recall that the <a href="https://ntp.niehs.nih.gov/pubhealth/hat/noms/lead/index.html">2012 National Toxicology Program Report</a> cited a wide range of measurable health effects occurring with blood lead levels less than 5 μg/dL. For comparison, we are talking about an average increase of 0.46 μg/dL blood lead levels from dietary exposure alone.</p>
<p>Though the estimated reductions in IQ here may seem low, they are not insignificant – in some cases, small losses in IQ might make the difference, for example, in the type of career one leads and subsequent <a href="http://www.nber.org/papers/w22470">lifetime earnings</a>. </p>
<h2>How many of the samples tested above specific lead concentrations?</h2>
<p>We went back to the same FDA data EDF used, looked at the measured amounts of lead, and then plotted the percentage of tested baby food products with lead concentrations above certain amounts.</p>
<p>This type of plot gives a ballpark idea of the percentage of the baby food being sold in the U.S. for certain levels of lead. But the data need to be treated with caution, as many of the measurements were below the Limit of Quantification (LOQ), meaning that they may not be particularly accurate.</p>
<p>Average dietary lead exposure for young children is around <a href="https://www.epa.gov/sites/production/files/2017-01/documents/report_proposed_modeling_approaches_for_a_health_based_benchmark_for_lead_in_drinking_water_final_0.pdf">2.9 µg/day</a>, which approximately equates to daily levels in food at about 2.9 ppb (assuming <a href="https://cfpub.epa.gov/ncea/risk/recordisplay.cfm?deid=236252">average consumption of about 1 kg of food</a>). Our analysis shows the percentage of baby food samples testing at higher levels. Eighteen percent of the baby food samples tested above 5 ppb lead, which is the amount the FDA allows in drinking water. This percentage decreased in accordance with the lead concentration: 9 percent of the samples tested above 10 ppb lead; 2 percent tested above 20 ppb lead; and less than 1 percent tested above 30 ppb lead. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173948/original/file-20170615-25014-v467x7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Percentage of baby food samples with lead concentrations greater than a given level.</span>
</figcaption>
</figure>
<h2>Where do we go from here?</h2>
<p>Even though these are not life-and-death type risks, we believe there is no room for complacency. The FDA sets limits for lead in food, but the current limits are based on levels that can be reliably measured and are considered achievable after manufacturing processes. However, a May 2017 <a href="https://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm557424.htm">FDA fact sheet on lead in foods</a> states that a Toxic Elements Working Group will be developing a risk-based approach. Establishing limits based on risk would help further curb the impacts of lead on society. </p>
<p>The good news is that this is possible. Many of the samples tested by FDA are already either lead-free (according to the limits of detection in the analyses used) or have low lead content. It should be possible to expand the number of products that fit into these categories, simply by understanding what some companies do right and replicating it.</p>
<p>The bottom line is that, even with relatively few products on the market with relatively high quantities of lead, the health risks from this metal are insidious, which means the more we do to eliminate it from our food supply, the better off we’ll be.</p>
<p><em>This story was updated on June 16 to correct the date of CDC recommendations and also to clarify that the 2017 EPA dietary lead exposure estimate is based on data from 2007-2013.</em></p><img src="https://counter.theconversation.com/content/79481/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Szejda's position is funded by the Center for Research on Ingredient Safety (CRIS) at Michigan State University.
She served as an independent reviewer on the EDF Lead in Food Report.</span></em></p><p class="fine-print"><em><span>Andrew Maynard receives funding support from the Center for Research on Ingredient Safety (CRIS) at Michigan State University. He is also on the Board of Trustees of the International Life Sciences Association North America. He served as an independent reviewer on the EDF Lead in Food Report.</span></em></p>A new report from the Environmental Defense Fund raises concerns about lead in our food supply. Here are some things you should consider.Keri Szejda, Postdoctoral Research Associate, Arizona State UniversityAndrew Maynard, Director, Risk Innovation Lab, Arizona State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/682202017-04-05T19:18:06Z2017-04-05T19:18:06ZPeople who shoot risk unhealthy levels of lead exposure<figure><img src="https://images.theconversation.com/files/145143/original/image-20161109-19092-prkury.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Shooters exposed to lead at work over long periods of time, like military personnel in firing ranges, risk a range of medical complaints.</span> <span class="attribution"><span class="license">Author provided</span></span></figcaption></figure><p>A gun is a dangerous weapon for obvious reasons. But there are less obvious risks to those who use them. New research shows people who shoot, for work or leisure, risk lead poisoning.</p>
<p>Our just published <a href="http://ehjournal.biomedcentral.com/articles/10.1186/s12940-017-0246-0">review</a> shows how exposure to lead from bullets, airborne particles in shooting ranges and other sources shows up in shooters’ blood at levels we believe pose a health risk.</p>
<h2>Who’s at risk?</h2>
<p>Security personnel, police officers and members of the military who fire guns at shooting ranges for work, and members of the public who shoot at firing ranges for recreation, are at risk.</p>
<p>Large numbers of shooters are involved, particularly in the US, where there are about <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a3.htm">16,000-18,000</a> indoor firing ranges. In the US, about <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a3.htm">one million</a> law enforcement officers train regularly at indoor firing ranges each year and <a href="http://www.nssf.org/PDF/research/TargetShootingInAmericaReport.pdf">20 million people</a> practice target shooting as a leisure activity.</p>
<p>The Geological Survey calculated that in 2012 about <a href="http://minerals.usgs.gov/minerals/pubs/commodity/lead/mis-201301-lead.pdf">60,100 metric tonnes</a> of lead were used in ammunition and bullets in the US. Given that lead is the dominant metal in bullets and primers (which initiates the combustion of gunpowder in the bullet cartridge), there are large numbers of people exposed by firing bullets.</p>
<p>It’s difficult to estimate how many Australians shoot at ranges and are exposed to lead. While the Sporting Shooters Association of Australia says it has <a href="https://www.ssaa.org.au/">180,000 members</a>, not all use shooting ranges.</p>
<h2>How are shooters exposed to lead?</h2>
<p>Shooters are exposed to lead when firing lead bullets. The bullet primer is about 35% <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Lead_styphnate">lead styphnate</a> and <a href="https://pubchem.ncbi.nlm.nih.gov/compound/lead_dioxide#section=Top">lead dioxide</a> (also known as lead peroxide). When a shooter fires a bullet, lead particles and fumes originating from the primer discharge at high pressures from the gun barrel, very close to the shooter. </p>
<p>Shooters are also exposed to lead from the bullet itself as some parts disintegrate into fragments due to misalignments in the gun barrel. The extreme heat during the firing of a bullet results in some vapourisation of these lead fragments.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/163751/original/image-20170403-25858-zx66yo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lead from bullets can fragment and vapourise, exposing shooters to airborne fragments and particles, which they breathe in or ingest.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/465583928?size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Shooters inhale lead particles emitted during the firing of a gun, whether that’s from the primer or the bullet itself. Once deposited in the lower respiratory tract, lead particles (and different chemical forms of lead) are almost completely absorbed into the bloodstream.</p>
<p>Lead dust from the shooting range also sticks to shooters’ clothes and can potentially contaminate vehicles and homes. Shooters can also ingest lead particles by transferring them from their hands into their mouths when they smoke, eat or drink.</p>
<p>Shooters’ blood lead levels tend to be higher <a href="http://journals.sagepub.com/doi/pdf/10.3109/10915818909018076">the more bullets shot, the more lead in the air</a> at shooting ranges and the <a href="https://www.ncbi.nlm.nih.gov/pubmed/18654794">increased calibre of weapon</a>.</p>
<h2>What our review found</h2>
<p>We reviewed 36 studies that measured blood lead levels at shooting ranges. The studies were from 15 countries, but most were from the US. About two-thirds of the studies looked at people who used shooting ranges for work.</p>
<p>We found blood lead levels of at least one of the participants in 31 of 36 studies had an elevated blood lead level. This means more than the current adult blood lead reference level of <a href="https://www.cdc.gov/niosh/topics/ables/description.html">5µg/dL</a>, or 5 micrograms of lead per decilitre of blood, as recommended by the US Centers for Disease Control and Prevention and National Institute of Occupational Safety and Health.</p>
<p>Importantly, we found elevated blood lead levels (greater than 5µg/dL) in shooters using both indoor and outdoor shooting ranges, consistent with the release of the fine grained primer-based lead close to the shooter’s face and body.</p>
<h2>How does lead affect the body?</h2>
<p>The US National Toxicology Program reviewed the <a href="https://ntp.niehs.nih.gov/pubhealth/hat/noms/lead/index.html">evidence</a> for health effects associated with chronic lead exposure in adults and children at levels identified in our literature review.</p>
<p>They found such blood lead levels were associated with a range of neurological, psychiatric, fertility and heart problems.</p>
<p>While studies have not specifically investigated all these outcomes in shooters, it is biologically plausible these conditions are associated with raised blood levels resulting from exposure to lead at shooting ranges. But few studies have been conducted on the shooting population to be sure.</p>
<p>There is a particular risk to women of child-bearing age exposed to lead at firing ranges because of the uptake and storage of lead in the mother’s bones where it <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485653/">substitutes for calcium</a>.</p>
<p>This is a particular problem for pregnant women, because the foetus requires calcium from her bones. So the foetus could be exposed to the mother’s lead stores during critical times in development. This could cause <a href="http://www.who.int/ceh/publications/leadguidance.pdf">serious neurological disorders</a> when born. </p>
<p>Female shooters can also pass on the lead exposure to their children through breast milk. Additionally, <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5423a1.htm">multiple</a> <a href="http://www.nejm.org/doi/full/10.1056/NEJM199909093411118#t=article">studies</a> have shown raised blood lead levels in children shooting guns at firing ranges due to direct exposure. Studies <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485653/">show</a> raised blood levels in children are linked with range of health problems. These range from being inattentive, hyperactive and irritable, to delayed growth, decreased intelligence, and short-term memory loss.</p>
<h2>How do we limit lead exposure?</h2>
<p>The ultimate solution to protect the health of shooters is to replace all primers and bullets with lead–free substitutes, which are already available.</p>
<p>We recommend measures such as ensuring adequate exhaust ventilation and wet-cleaning of surfaces at firing ranges, requiring people who work at firing ranges to have their blood lead levels checked, and for similar testing for frequent shooters.</p>
<p>We also recommend shooters be aware of the risks of lead exposure and follow guidelines recommended by health organisations such as the <a href="http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/OccupationalHealth/ManagementGuidelinesforAdult.pdf">Council of State and Territorial Epidemiologists</a> or <a href="http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/990/decision-regulation-impact-statement-managing-risks-associated-with-lead-in-the-workplace.pdf">Safe Work Australia</a>.</p><img src="https://counter.theconversation.com/content/68220/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gabriel Filippelli receives funding from Indiana University through the Indiana Clinical and Translational Sciences Institute</span></em></p><p class="fine-print"><em><span>Howard Walter Mielke receives funding from ATSDR (Agency for Toxic Substances and Disease Registry) and HUD (Housing and Human Development) and the Greater New Orleans Foundation.
I am the unenumerated President of Lead Lab, Inc. which is an education and research non-profit organization.
I do not have any conflicts of interest.
</span></em></p><p class="fine-print"><em><span>Andrew Ball, Brian Gulson, and Mark A.S. Laidlaw do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Millions of people who shoot, for work or leisure, risk lead poisoning, according to new research.Mark A.S. Laidlaw, Vice Chancellors Postdoctoral Fellow, RMIT UniversityAndrew Ball, Professor of Environmental Microbiology, RMIT UniversityBrian Gulson, Macquarie UniversityGabriel Filippelli, Professor, IUPUIHoward Walter Mielke, Professor, Department of Pharmacology, Tulane University School of Medicine, Tulane UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/653842016-09-20T09:17:15Z2016-09-20T09:17:15ZHMS Terror wreck found – but what happened to her doomed crew? Here’s the science<figure><img src="https://images.theconversation.com/files/138238/original/image-20160919-11120-k3qyzo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">HMS Terror. Engraving by George Back.</span> <span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/0/02/Hms_terror_1837.jpg">via Wikimedia Commons</a></span></figcaption></figure><p>It remains one of history’s best-known naval tragedies – and mysteries. The loss of all 129 men of the 1845 Royal Navy expedition led by <a href="http://www.rmg.co.uk/discover/explore/exploration-endeavour/sir-john-franklin">Captain Sir John Franklin</a> to navigate a north-west passage through the Arctic remains an enigma. The only informative document to be recovered from the expedition was a single page that reported initial good progress through 1845 to 1847, but then the desertion of the ships in 1848 by which point nine officers – including Sir John Franklin – and 15 other ranks were reported to have died. </p>
<p>Franklin’s two ships, HMS Erebus and HMS Terror, became trapped in ice off <a href="http://www.arctic.uoguelph.ca/cpe/environments/maps/detailed/islands/king_william.htm">King William Island</a> in 1846, where it is known that <a href="http://www.rmg.co.uk/discover/explore/sir-john-franklin">Franklin died in June the following year</a>. But what happened to the rest of the crew? We know that they deserted their ships in 1848 – after two winters trapped in the pack ice – and all eventually perished over the next two or three years. Three permafrost preserved bodies were found in graves at the expedition’s winter quarters of 1845/46 on Beechey Island in the northern Arctic. Forensic examination suggests that their deaths may have been caused by tuberculosis. </p>
<p>Skeletal remains of some other members of the crew have been found further south on King William Island and adjacent parts of the Canadian mainland. Their deaths occurred after desertion of the ships and were probably due to starvation and exposure. Some of the remains show <a href="http://www.smithsonianmag.com/smart-news/franklins-doomed-arctic-expedition-ended-gruesome-cannibalism-180956054/?no-ist">evidence that cannibalism occurred</a> in the last desperate throes of the expedition. </p>
<p>However, both of the expedition’s ships <a href="https://www.theguardian.com/world/2016/sep/12/hms-terror-wreck-found-arctic-nearly-170-years-northwest-passage-attempt">have now been discovered</a> – HMS Erebus in September 2014 by <a href="http://www.pc.gc.ca/eng/index.aspx">Parks Canada</a>, and most recently the “pristine” HMS Terror in September 2016 by the Arctic Research Foundation. Their locations and contents may provide new insights into the fate of the crew.</p>
<p>Early historians supposed that <a href="http://www.nhs.uk/Conditions/Scurvy/Pages/Introduction.aspx">scurvy</a> had caused widespread incapacity, while <a href="https://www.cambridge.org/core/journals/polar-record/article/a-re-analysis-of-the-supposed-role-of-lead-poisoning-in-sir-john-franklins-last-expedition-18451848/56977A2259A4CAA903C8CB256DC55C75">more recent research</a> proposed that the men were poisoned by lead from the solder that sealed their canned provisions. </p>
<p>Scurvy did occur in Arctic crews but research by Simon Mays of Historic England concluded that samples of the crew’s skeletal <a href="http://onlinelibrary.wiley.com/store/10.1002/oa.2305/asset/oa2305.pdf?v=1&t=itb97lb5&s=ab9f106c7e25e52826c4fcebfb8bcf2b056c666c">remains show little clear evidence of the disease</a>. Levels of lead in the remains of some of the crew are high relative to today, but it is debatable whether those levels would reflect incapacitating lead poisoning. The difficulty is the lack of normative data for levels of lead in the British population from which the crew was recruited in the 19th century. That population ingested high levels of lead from water pipes, pewter cooking utensils and drinking vessels, lead-based medical treatments and many other sources. In general, levels of lead in their bodies would have been high anyway.</p>
<h2>Uncovering medical records</h2>
<p>The supposed roles of scurvy and lead poisoning in the disaster would be answered if the expedition’s medical records had survived – but they have eluded discovery, as have all the formal logs and journals. So our team at the University of Glasgow College of Medical, Veterinary and Life Sciences and the College of Science and Engineering proposed that the medical records of those in the Royal Naval ships sent in search of Franklin and his crew might serve as a proxy for the health problems encountered by the expedition. Those ships were similarly equipped and provisioned to Franklin’s vessels and met similar conditions. Consequently, the illnesses and deaths that occurred on them might reflect those of the lost crew.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=468&fit=crop&dpr=1 600w, https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=468&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=468&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=588&fit=crop&dpr=1 754w, https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=588&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/138239/original/image-20160919-11117-18xdg1s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=588&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Old map of Arctic region charting Sir John Franklin’s Northwest Passage exploration. Created by Erhard and Bonaparte, published on Le Tour du Monde, Paris, 1860.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-81645172/stock-photo-old-map-of-arctic-region-of-sir-john-franklin-northwest-passage-exploration-created-by-erhard-and-bonaparte-published-on-le-tour-du-monde-paris-1860.html?src=D0qcn3fOZrPPW_TTihVUjw-1-3">Shutterstock</a></span>
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</figure>
<p>After examining the illnesses seen in almost 1,500 medical cases across nine search crews, <a href="https://www.cambridge.org/core/journals/polar-record/article/the-health-of-nine-royal-naval-arctic-crews-1848-to-1854-implications-for-the-lost-franklin-expedition/01961848A748B3BD958BD352D5294400">we concluded</a> that Franklin’s men would have suffered similar common infections, gastro-intestinal disorders and injuries. They also will have suffered exposure, and some deaths might have occurred from respiratory, cardiovascular and tubercular conditions. Scurvy was evident but was not so prevalent as to affect the operational efficiency of the crews: if the same pattern occurred in Franklin’s men then it would not have been significant, which would support Mays’ findings.</p>
<p>The search crews had similar canned provisions to Franklin’s men but their medical records showed no evidence of lead poisoning despite the relatively high exposure to lead that was inevitable on ships of that time. Unless a unique source of lead was present on Franklin’s ships, there is no clear evidence that lead poisoning played a part in the disaster. This conclusion supports the outcome of our earlier published reappraisal of the evidence for lead poisoning.</p>
<h2>The continuing enigma</h2>
<p>What then was the most likely fate of the crews, and particularly the officers who had a disproportionately higher death rate? Based on the evidence from the search ships, we proposed that the deaths of Franklin’s officers were probably due to non-medical factors such as accidents and injuries sustained when officers took on the dangerous task of hunting for wild game to supplement provisions, and continued the attempt, on foot over difficult terrain in a harsh climate, to discover the route of a north-west passage. Ironically, the expedition’s success in reaching a remote part of the Arctic resulted in entrapment that precluded escape or rescue.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=794&fit=crop&dpr=1 600w, https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=794&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=794&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=997&fit=crop&dpr=1 754w, https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=997&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/138240/original/image-20160919-11113-103bp7o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=997&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Sir John Franklin. Created by Morin and Trichon, published on Le Tour du Monde, Paris, 1860.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-82735426/stock-photo-sir-john-franklin-old-engraved-portrait-created-by-morin-and-trichon-published-on-le-tour-du-monde-paris-1860.html?src=VQ3qV6lKjFamDmctMdLohg-1-1">Shutterstock</a></span>
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<p>The discovery of the Erebus and Terror many miles from their initial desertion might confirm that they were re-manned and navigated to their new locations. It would be further evidence that a majority of the crew were in sufficient health to operate the ships, and counters popular portrayals of a sickly rabble staggering to their deaths in 1848. Such an end did come but <a href="https://books.google.co.uk/books?id=RbnvSlOc6twC&pg=PR3&lpg=PR3&dq=Unravelling+the+Franklin+mystery:+Inuit+testimony.++Montreal:+McGill-Queen's+University+Press,+1991.++ISBN+0-7735-0833-3&source=bl&ots=zfJ_KjYm87&sig=FnE_t3OWxvJiSn0957k5bxj__f8&hl=en&sa=X&ved=0ahUKEwi8vPGX0pvPAhWEF8AKHYZvBocQ6AEIHjAA#v=onepage&q=Unravelling%20the%20Franklin%20mystery%3A%20Inuit%20testimony.%20%20Montreal%3A%20McGill-Queen's%20University%20Press%2C%201991.%20%20ISBN%200-7735-0833-3&f=false">David Woodman’s</a> <a href="https://books.google.co.uk/books?id=Zn6iKRfSvFcC&pg=PR4&lpg=PR4&dq=Strangers+among+us%22.++Montreal:+McGill-Queen's+University+Press,+1995.++ISBN+0-7735-1348-5.&source=bl&ots=pkvxXNy0VZ&sig=1t1mAcnp5WPXUG9NEj5NHTfYIok&hl=en&sa=X&ved=0ahUKEwjB74bO0pvPAhVsLsAKHdOPBaIQ6AEIHjAA#v=onepage&q=Strangers%20among%20us%22.%20%20Montreal%3A%20McGill-Queen's%20University%20Press%2C%201995.%20%20ISBN%200-7735-1348-5.&f=false">thoughtful analysis</a> suggests that it was not until 1850 or 1851.</p>
<p>Initial exploration of the Erebus has retrieved items including the ship’s bell, bearing the date of the expedition’s departure “1845”, cannon, ceramic plates, buttons from tunics and a sword handle. The Terror appears much more intact but her discovery is too recent for an attempt to have been made to recover any contents, although the bell has been seen lying on the deck. We understand from our colleagues in Parks Canada that if any written records were stored on board the ships then they may remain legible and provide first-hand evidence of the events leading to disaster. </p>
<p>If any medical records have survived they will show whether health factors led to the failure of the expedition and put an end to further speculation, including our own. Whether they are ever recovered, however, remains to be seen. It is likely that the ships’ significant records would have been taken with the officers when deserting the ships so the reality is that they may now be irretrievably lost. Like all good mysteries, the Franklin saga may continue to withhold answers.</p><img src="https://counter.theconversation.com/content/65384/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Keith Millar does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>168 years on, experts are finally uncovering the secrets of the Royal Navy’s tragic expedition to the Northwest Passage.Keith Millar, Senior Research Fellow, Institute of Health and Wellbeing, University of GlasgowLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/656262016-09-20T01:47:07Z2016-09-20T01:47:07ZHow ZIP codes nearly masked the lead problem in Flint<p>I write this as we approach the first anniversary of my involvement in the <a href="https://www.theguardian.com/us-news/flint-water-crisis">Flint Water Crisis</a>, an ongoing catastrophe and basic failure of government accountability that will soon approach three years. </p>
<p>On Sept. 25, 2015, I received a call from my colleague – the now-renowned <a href="http://msutoday.msu.edu/news/2016/mona-hanna-attisha-named-one-of-times-most-influential-people/">Dr. Mona Hanna-Attisha</a> – asking if I could run some basic <a href="http://www.esri.com/products/arcgis-capabilities/spatial-analysis">spatial analysis</a> of blood lead data collected from area pediatric clinics. I had heard rumblings that <a href="http://www.mlive.com/news/flint/index.ssf/2015/09/study_shows_twice_as_many_flin.html">blood lead levels were on the rise</a> in Flint but that <a href="http://www.mlive.com/news/flint/index.ssf/2015/09/state_says_its_data_shows_no_c.html">state officials were pushing back</a> against her findings.</p>
<p>My job was to examine blood lead data from our local <a href="http://www.hurleymc.com/services/childrens-hospital/">Hurley Children’s Hospital</a> in Flint for spatial patterns, or neighborhood-level clusters of elevated levels, so we could quash the doubts of state officials and confirm our concerns. Unbeknownst to me, this <a href="http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2015.303003">research project</a> would ultimately help blow the lid off the water crisis, vindicating months of activism and outcry by dedicated Flint residents.</p>
<p>As I ran the addresses through a precise parcel-level <a href="http://pro.arcgis.com/en/pro-app/help/data/geocoding/what-is-geocoding-.htm">geocoding</a> process and visually inspected individual blood lead levels, I was immediately struck by the disparity in the spatial pattern. It was obvious Flint children had become far more likely than out-county children to experience elevated blood lead when compared to two years prior. </p>
<p>How had the state so blatantly and callously disregarded such information? To me – a <a href="http://geography.uwo.ca/">geographer</a> trained extensively in geographic information science, or computer mapping – the answer was obvious upon hearing their unit of analysis: the ZIP code.</p>
<p>Their ZIP code data included people who appeared to live in Flint and receive Flint water but actually didn’t, making the data much less accurate than it appeared.</p>
<p>ZIP codes – the bane of my existence as a geographer. They confused my childhood friends into believing they lived in an entirely different city. They add cachet to parts of our communities (think 90210) while generating skepticism toward others relegated to less sexy ZIP codes.</p>
<p>Dr. Tony Grubesic, an Arizona State University professor, has called them “one of the <a href="http://www.sciencedirect.com/science/article/pii/S0038012106000516">quirkier ‘geographies’</a> in the world.” Dr. Nancy Krieger, a Harvard University professor, and colleagues have called out their <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447194/">unacceptability</a> for small-area analyses.</p>
<p>If I were to have simply summarized blood lead statistics by ZIP code, the pattern would not have been striking. The state, having done just this, incorrectly concluded that the change in water source had no discernible effect on Flint children.</p>
<p>Why exactly were ZIP codes so poorly suited to analyzing the Flint water crisis? I will share some reasons and argue that public health researchers should move away from a sole reliance on ZIP codes, or at least admit the shortcomings of ZIP code analysis.</p>
<h2>When the boundaries don’t line up</h2>
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<img alt="" src="https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=776&fit=crop&dpr=1 600w, https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=776&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=776&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=976&fit=crop&dpr=1 754w, https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=976&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/138107/original/image-20160916-17029-ywva09.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=976&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">ZIP codes and city boundaries of Flint do not align.</span>
<span class="attribution"><span class="source">Author provided.</span>, <span class="license">Author provided</span></span>
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<p>In Flint’s case, the state’s error was introduced because “Flint ZIP codes” do not align well with the city of Flint or its water system. The city and water system are almost 100 percent coterminous – that is, they share the same boundaries.</p>
<p>One-third of all homes with a Flint ZIP code lie outside the city. Thus, the state’s numbers for Flint were watered down by an additional 50 percent of addresses that weren’t in the city and weren’t using Flint water. This is referred to in geography as the <a href="http://support.esri.com/other-resources/gis-dictionary/term/MAUP">modifiable areal unit problem</a>.</p>
<p>Of the residential ZIP codes with Flint mailing addresses, only 48502 and 48503 lie completely within the city. ZIPs 48504, 48505, 48506 and 48507 are split between the city of Flint and outlying municipalities. ZIP 48532 contains very few homes actually in the city of Flint. In total, Flint ZIP codes used in the state’s analysis blanket parts of eight different municipalities (seven townships and one city) surrounding Flint.</p>
<p>That the solution to this error was as simple as pinpointing patient addresses rather than relying on ZIP codes is both frightening and appalling. It reflects a fundamental ignorance of geography and a tendency to uncritically accept numbers at face value. While analysis by ZIP code tends to be the default analysis when public health professionals and researchers make a foray into mapping, more and more research in the past two decades has suggested that the reliance on ZIPs may be misplaced.</p>
<h2>Why are ZIP codes insufficient measures for geographically specific phenomena?</h2>
<p>The folly reflects an all-too-common reliance on arbitrary boundaries for defining public health issues. ZIP codes have recently garnered attention as being a <a href="http://commissiononhealth.org/PDF/0d5f4bd9-2209-48a2-a6f3-6742c9a7cde9/Issue%20Brief%207%20Dec%2009%20-%20Message%20Translation.pdf">key determinant of health</a>, curbing the old idea that biology was the primary director of one’s health. </p>
<p>The idea behind “why ZIP codes matter” is that where you live influences your opportunities to conduct a healthy lifestyle. While this emphasis on neighborhood-specific effects is important (and has been the focus of urban planning and geographical inquiry for decades), the use of ZIP codes can mask more local issues.</p>
<p>To be truly useful as units of analysis for defining neighborhood effects on health, any geographic area should be relatively homogeneous in terms of its social and built environmental characteristics. But unlike postal codes in other countries which represent small areas suitable for in-depth geographic inquiry (Google “N6C 2B5” for a Canadian example), ZIP codes are woefully unqualified as units of analysis.</p>
<h2>Created for mail, not health care, delivery</h2>
<p>The ZIP – or Zone Improvement Plan – code was designed by the <a href="http://www.zipboundary.com/zipcode_history.html">U.S. Postal Service in 1963</a> as a logistical solution to sorting the mail in growing cities. Thus, ZIP code designations were based on the area that a collection of mail carriers could reasonably cover each day; they had little to do with geography or municipal boundaries.</p>
<p>ZIP codes were arbitrarily delineated and covered a range of neighborhood types; in most small and midsized cities, one ZIP code can cover urban, suburban and rural neighborhoods with highly variable socioeconomic characteristics.</p>
<p>The public health field is now learning that their heterogeneity actually makes them very poor representations for understanding exposure or health disparities. ZIP codes aren’t even contiguous areas – they are actually just linear features along roads. Yet they influence many aspects of our lives, including car insurance rates, sales tax assignment and home appraisal values, to name a few.</p>
<p>The reality is that very few tangible urban amenities – including school attendance zones, city boundaries, water systems and voting districts – are coterminous with ZIP code boundaries. </p>
<p>More useful are units such as census block groups, wards, planning districts or municipal designations for neighborhoods within a city. Each of these adhere to some temporally consistent, spatially bounded definition, and can more appropriately be used to understand how one neighborhood varies compared to another.</p>
<p>The use of ZIP codes by the public health and medical fields as a primary way to understand health statistics is thus concerning because heterogeneous populations can mask inequalities. As well, program deployment based on ZIP code inquiries is often not well aligned geographically with populations that need assistance.</p>
<h2>Where do we go from here?</h2>
<p>Still, we should be careful not to remove ZIP codes from consideration entirely. They can still be useful for characterizing phenomena that manifest disparities at a large scale, such as rates of chronic disease, exposure to non-point source pollution, regional employment trends and so on. But we must be more critical toward unusual geographies, particularly when our topic of interest is more local.</p>
<p>A solution to the ZIP code problem could come from either side. For example, a U.S. Postal Service-led redesign of ZIP codes into something more coherent as a planning tool would enable their continued use in public health with greater integrity. Conversely, a more critical eye toward ZIP codes by the public health profession would open the field to better spatial measures for exposure.</p>
<p>Either way, the current arrangement is clearly not working. If we are content with using ZIP code-level data, we leave open the possibility that further health issues could be masked by these quirky geographies. </p>
<p>The Flint water crisis is not the only example of ZIP codes hiding a public health problem; it is just one of the more apparent. When the ZIP code is the final arbiter of health statistics, we risk assuming that all public health issues can be packaged neatly into the same box.</p>
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<p><a href="http://www.aag.org">Richard Casey Sadler is a member of the American Association of Geographers</a></p>
<footer>The association is a funding partner of The Conversation US.</footer>
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<p class="fine-print"><em><span>Richard Casey Sadler is a member of the American Association of Geographers.</span></em></p>High blood lead levels in children in Flint, Michigan were obscured in part because of an outdated method of studying public health – the ZIP code. Here’s why we need to make use of a better way.Richard Casey Sadler, Assistant Professor, Michigan State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/625252016-09-08T10:16:30Z2016-09-08T10:16:30ZHow big data and algorithms are slashing the cost of fixing Flint’s water crisis<figure><img src="https://images.theconversation.com/files/136813/original/image-20160906-25237-rutqkr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A big data analysis indicates the focus on service line replacement may only go so far at fixing Flint's water issues. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/hz536n/27805760502/in/photolist-Jn6MRQ-8CJqeH-8UwScV-oXJBB1-oXJhMr-reXmpG-oXJABf-oXJgVM-pferGx-pfcqE3-oXKfPK-oXJB8A-pferM2-oXKfxT-pdcvYW-oXJBph-7rVXe8-pdcvEu-pfeqEc-pdcwu5-peXzSD-e5yH7Z-6twbbV-oXKeyt-oXKfZp-oXJh1B-oXKim9-u87foW-peXzEe-u8gAJg-pfeqTZ-v2Nea3-g9jjuz-pfcqWL-gaibLK-6twbbK-oXJB5Q-gahAZh-oXJBSb-oXKga4-uMwvSG-gahJC2-peXAyP-oXKgUS-pfern4-g9iSNL-gahtDM-qY8HVS-oXJhSr-peXzf6">George Thomas/flickr</a></span></figcaption></figure><p>The water crisis in Flint, Michigan highlights a number of serious problems: a public health outbreak, inadequate urban infrastructure, <a href="https://theconversation.com/we-helped-uncover-a-public-health-crisis-in-flint-but-learned-there-are-costs-to-doing-good-science-54227">environmental injustice</a> and political failures. But when it comes to recovery, the central challenge, and one that has received relatively little attention, is our lack of useful information and understanding. </p>
<p>Who is most at risk? Where are the harmful sources of lead? Where should resources be allocated? Using modern big-data tools, we can answer these questions and help inform the response to this crisis. </p>
<p>With the support of our <a href="http://mdst.eecs.umich.edu">student team at the University of Michigan</a>, we have aggregated a trove of available data around Flint’s water issues, including water test results, records of the service lines that deliver water to homes, information on parcels of land and water usage. Leveraging new algorithmic and statistical tools, we are able to produce a significantly more complete picture of the risks and challenges in Flint.</p>
<p>These methods strongly resemble those used by Facebook, Amazon and other large tech companies who collect vast amounts of data from users. But whereas Facbeook’s algorithms crunch through uploaded photographs to detect faces and Amazon’s models predict which products you’ll like, we are using these analytics tools to detect homes with high risk of lead contamination and to predict the locations of lead pipes buried underground or hidden in the homes of residents.</p>
<p>What have we learned? Here are a few takeaways from our research.</p>
<h2>Lead contamination varies widely across homes and is highly scattered around Flint, but it is surprisingly predictable</h2>
<p>The headlines on Flint could easily lead one to believe all homes in the city have dangerously high levels of lead. But in fact, using data from the state’s <a href="http://www.michigan.gov/flintwater/0,6092,7-345-76292_76294_76297---,00.html">sentinel program</a>, we found during a period in February only between 8 and 15 percent of homes had lead above the federal action level of 15 parts per billion (ppb). </p>
<p>Indeed, things have been improving from January through August 2016, according to the test data from the sentinel program. Based on about 750 homes monitored repeatedly, fewer homes have tested above the action level over time. Almost half of all samples have virtually no detectable level (below 1 parts per billion).</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/136829/original/image-20160907-25240-1xu40mp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Percent of samples in the DEQ’s sentinel program that tested below the federal action level. Credit: Jonathan Stroud, Ph.D. student at UM.</span>
</figcaption>
</figure>
<p>These low numbers provide little comfort when we don’t know which homes are at risk. Only around 30 percent of homes in Flint have had their water tested, according to government data, and these water tests do not guarantee safety; they only identify danger. Also, it is clear from the data that homes that are slower to sample their water tend to be those at much greater risk.</p>
<p>So can we find these homes? The answer is yes, to a modest degree of accuracy. We have built statistical models that profile a home based on several attributes (year of construction, location, value, size, etc.), and provide an estimate of the risk level. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=836&fit=crop&dpr=1 600w, https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=836&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=836&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1051&fit=crop&dpr=1 754w, https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1051&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/136936/original/image-20160907-16611-75jffp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1051&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Based on our statistical models, we can display locations which we estimate to be at high risk of lead contamination. Credit: PhD students Guangsha Shi, Jared Webb, and others at UM.</span>
</figcaption>
</figure>
<p>The quality of these models is driven by the huge swaths of data from <a href="http://www.michigan.gov/flintwater/0,6092,7-345-76292_76294_76297---,00.html">water samples</a> submitted by residents and tested by government officials in response to the crisis. This provides us with a database of measurements that includes over 20,000 water samples covering roughly 10,000 homes in Flint since November 2015 to present. We have made our risk assessments available to government officials, and are being incorporated into an mobile application, <a href="http://www.engin.umich.edu/college/about/news/stories/2016/may/google-u-m-to-build-digital-tools-for-flint-water-crisis-2">funded by Google</a> and built by students at UM Flint, that allows Flint residents to learn of their home’s risk level.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/136850/original/image-20160907-25253-1s8q1le.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Younger properties have lower lead levels, on average and based on the 90th percentile (blue line). There were 8 percent of tests above federal action level 15 ppb (dotted red), and still some well above 150 ppb and even 1000 ppb. The highest 0.5 percent of samples are not shown.</span>
</figcaption>
</figure>
<p>These statistical models not only provide predictions; they also give a better understanding of the problems. This has much broader implications, as these factors predicting lead may generalize beyond Flint.</p>
<p>The data suggest that lead contamination is associated with a number of factors; older homes tend to be at greater risk, for instance, as are those of lower home value. Lower-value homes also tend to be those with the lowest rates of water sampling. Additionally, while the highest readings are geographically scattered, the homes predicted to be at high risk tend to cluster in specific neighborhoods. </p>
<h2>Flint’s lead pipe records are spotty and noisy, but statistical methods can significantly fill the gap</h2>
<p>Media reports and political efforts have continued to focus on the so-called “water service lines” that connect each house to the distribution system in the street. The assumption is that homes with lead service lines are most at risk for lead exposure and poisoning. As a result, much of the attention has been on locating and replacing these lines. </p>
<p>The Michigan legislature has allocated over US$25 million toward replacing the harmful lines, beginning with a <a href="http://www.detroitnews.com/story/news/local/michigan/2016/08/31/flint-mayor-visits-homes-water-line-replacements/89657488/">pilot phase of roughly 250 homes</a>. This effort is being headed up by a team under <a href="http://michiganradio.org/post/flint-mayor-unveils-ambitious-plan-replace-all-lead-drinking-water-lines-one-year#stream/0">National Guard Brig. Gen. Michael McDaniel</a>.</p>
<p>The problem, however, is not only with lines made out of lead material: Lead particulate can accumulate on the walls of corroded galvanized steel pipes. Pipes made of copper or plastic, on the other hand, are generally considered to be safe. </p>
<p>But there are immediate challenges with the line replacement program. And the most obvious is: Where are these dangerous pipes? </p>
<p>The city, unfortunately, did not maintain consistent records on service line installations and materials. But city officials eventually found, after some searching, a set of maps with handwritten annotations (last updated in 1984), and these records were digitized by a <a href="http://www.mlive.com/news/ann-arbor/index.ssf/2016/03/u-m_flint_professor_says_expos.html">UM Flint research team lead by Professor Marty Kaufman</a>. These appeared to identify the material of the service lines for most home parcels in Flint. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=899&fit=crop&dpr=1 600w, https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=899&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=899&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1130&fit=crop&dpr=1 754w, https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1130&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/136645/original/image-20160905-4758-1c59n81.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1130&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Using paper records, researchers were able to get a rough idea of what type of material – lead, copper or plastic – was used to bring water service to home.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>How complete and accurate are these records? Unfortunately, not very. For over 30 percent of homes, either there are missing labels or the records disagree with a home inspection of a portion of the service line.</p>
<p>We can again fill in gaps with the help of algorithms and data. Looking for patterns in the existing records, statistical tools can provide a reasonable “educated guess” as to the type of material in a home’s service line. We have been working directly with Gen. Michael McDaniel’s line replacement team, providing statistical estimates of where lead pipes are most likely to be found, and this has guided their targeting of replacement resources. </p>
<p>Our recommendations are adapting to incoming data, using techniques applied in online advertising experiments or clinical trials, to identify the risky homes quickly and efficiently.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=234&fit=crop&dpr=1 600w, https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=234&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=234&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=294&fit=crop&dpr=1 754w, https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=294&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/136831/original/image-20160907-25240-8iwxkr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=294&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Professors Schwartz (left) and Abernethy (right) at a service line replacement site in Flint, Michigan.</span>
</figcaption>
</figure>
<p>Our machine learning techniques, which utilize all of the available city data, parcel records and a database of over 3,000 inspection reports, are able to estimate line materials with better than 80 percent accuracy. We find, for instance, that houses built in the 1920s to 1940s are many times more likely than those built after 1960 to have lead in their service line. Our guesses aren’t perfect by any means, but estimates of this level can save millions of dollars on recovery efforts. </p>
<h2>Home service lines may not be the largest contributor of lead</h2>
<p>Despite the huge media attention focused on the service lines, one of the major takeaways from our analyses is that these service lines may not be the major driver of the lead in Flint’s drinking water. Yes, it is the case that those homes with copper service lines have lower lead levels, on average, than those with lead in their service line. But when you look closely at the water testing data, the differences are much smaller than you might think. </p>
<p>While it is difficult to determine with certainty due to the spotty records, what we have found is that large spikes of lead occur in homes with and without lead service lines. This suggests a large fraction of the dangerously high lead readings are probably not being driven by the service line material but instead by other factors. <a href="https://theconversation.com/the-science-behind-the-flint-water-crisis-corrosion-of-pipes-erosion-of-trust-53776">Environmental engineers who study these problems</a> report that lead can leach from several sources, including the home’s interior plumbing, faucet fixtures and aging pipe solder. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/133163/original/image-20160804-493-ob1jpl.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We can look at homes that, based on records and home inspections, appear to have copper-only service lines versus those containing some lead. We plot the distribution of the lead readings for water samples from these two home categories.</span>
</figcaption>
</figure>
<p>What we can conclude is that citizens as well as policymakers may need to widen their focus beyond the service line materials and consider alternative efforts to address other sources of lead. Service line replacement is certainly a necessary part of the solution, but it will not be sufficient. </p>
<p>Toward solving the broader problem, data and statistical tools can help greatly reduce risks at much lower cost, and a data-oriented understanding of the problems in Flint can guide efforts to address <a href="https://theconversation.com/is-lead-in-water-a-problem-beyond-flint-we-dont-do-the-testing-to-find-out-54012">lead concerns in other regions</a> as well. </p>
<p><em>For more information about getting water filters and testing your water, visit <a href="http://www.michigan.gov/flintwater/0,6092,7-345-76292_76294_76296---,00.html">michigan.gov/flintwater/ </a></em></p><img src="https://counter.theconversation.com/content/62525/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacob Abernethy receives funding from the National Science Foundation and Google.org. </span></em></p><p class="fine-print"><em><span>Eric Schwartz does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>By tapping into diverse data sources in Flint, researchers can predict vulnerable homes and even have found that home water service lines may not be the biggest contributor to lead poisoning.Jacob Abernethy, Assistant Professor, University of MichiganEric Schwartz, Assistant Professor of Marketing, Ross School of Business, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/557892016-03-08T11:49:12Z2016-03-08T11:49:12ZWhat the Flint water scandal says about US politics in 2016<figure><img src="https://images.theconversation.com/files/114260/original/image-20160308-22129-s2uk7j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A troubled town.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/michigancommunities/9550280862/in/photolist-fxVFLS-bY2woC-u7QcYw-bY2p6s-bY2ncq-bY3dHQ-bY3a2y-bY3axy-bY3cmN-fxFwqg-bY3dgm-fxVFjQ-bFeuuC-8iu4kj-bU9pDz-fxVEVJ-fxFrae-fxFqmi-fxVKCy-fxVMQU-bY3bxw-fxFwaa-fxFpwe-fxVNEb-fxFquH-fxFt4r-fxFvq6-fxFtUT-fxVLqj-fxFuiK-fxVJwb-fxVLFL-fxFvTp-fxVGW9-fxFwTT-fxFriR-fxFs5V-fxFvxe-fxFvEi-fxFttH-fxVKUG-fxVJrw-fxFwYg-fxVMb5-fxVKfQ-fxVFxG-fxVLPo-fxVHFo-fxFrDV-fxVGLs">Michigan Municipal Leage via Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>As the US 2016 presidential election rumbles on, the city of Flint, Michigan has become a national symbol of inequality and government failure. It first <a href="http://www.theguardian.com/environment/2016/jan/16/flints-water-crisis-what-went-wrong">inadvertently poisoned thousands of its residents</a> with lead in their water supply – including many children vulnerable to lasting developmental damage – and then responded to their complaints with a slowness that looks to many like sheer negligence. </p>
<p>The seeds of disaster were sown in April 2014, when the city <a href="http://www.mlive.com/news/flint/index.ssf/2014/04/closing_the_valve_on_history_f.html">switched its water supply to draw from the Flint River</a> while awaiting the completion of a new regional water treatment system. By switching temporarily to the river, it could begin saving immediately on the $21m cost of paying nearby Detroit for water, as it had done until that point. </p>
<p>This decision was made in the context of a severe municipal financial crisis. After a long period of economic decline and falling population, the Republican governor of Michigan, Rick Snyder, had placed the city’s near-bankrupt finances under the control of an “<a href="http://fortune.com/2016/02/18/michigan-public-act-436-flint/">emergency manager</a>” with almost total power to implement cuts.</p>
<p>There immediately were signs of serious problems. Residents complained that the water they were now receiving was discoloured and noxious. It turns out that there was indeed a serious threat to public health: the inadequately treated water from the Flint was so corrosive that it was eating into the ageing pipes delivering it to homes, allowing lead to enter the water at dangerous levels in some districts. Lead poisoning in children can cause irreparable and lifelong developmental problems, so speed was therefore of the essence in identifying the problem and warning those affected.</p>
<p>Unfortunately, the state’s Department of Environmental Quality <a href="http://www.detroitnews.com/story/news/michigan/flint-water-crisis/2016/02/03/flint-water-congressional-hearing/79728072/">insisted for months</a> that residents’ safety concerns were unjustified, and the state government downplayed the necessity of action even as complaints continued to pour in. The state only admitted there was a problem when outside scientists from the university Virginia Tech conducted a <a href="http://flintwaterstudy.org/about-page/about-us/">study</a> that found dangerously elevated lead levels in homes. </p>
<p>With the problem laid bare and any further denial untenable, the city <a href="http://www.mlive.com/news/flint/index.ssf/2015/10/flint_reconnecting_to_detroit.html">switched its water supply back to Detroit</a>, but it still cannot not guarantee the safety of water flowing through the damaged pipes, or if or when those pipes might be replaced. For the moment, the state has made <a href="http://www.abc12.com/flintwaterworries/headlines/Flint-water-resource-sites-365175551.html">water filters, bottled water, and testing kits</a> available to residents. The long-term consequences of those poisoned during the extended period when action was delayed remain to be seen.</p>
<p>The political fallout from the crisis has been substantial – and has also been sharply divided along party lines. </p>
<h2>Back and forth</h2>
<p>A number of state officials responsible for water safety have left their posts, but Governor Snyder has <a href="http://www.bbc.co.uk/news/election-us-2016-35747877">defied all calls to resign</a>, accepting responsibility for addressing the crisis but not for causing it. How much he and his office knew about Flint residents’ complaints, when they knew it, and the extent to which evidence supported them remains a matter of claim and counterclaim. </p>
<p>At the national level, the Republican candidates have sought to minimise comment and contact with the issue. In their most recent debate, held in Detroit, Senator Marco Rubio went so far as to say that “<a href="http://www.mlive.com/politics/index.ssf/2016/03/truth_squad_rubio_gets_warning.html">this should not be a partisan issue</a>”, noting that he wanted to “give the governor credit” for taking responsibility for the issue, and criticising Democrats for “politicising” events in Flint.</p>
<p>Both Democratic candidates, on the other hand, <a href="http://edition.cnn.com/2016/02/25/politics/bernie-sanders-flint-michigan-water/">visited the city</a> after the scandal broke – Hillary Clinton <a href="http://www.huffingtonpost.com/entry/hillary-clinton-flint-water-crisis_us_56b7857ee4b01d80b246ac9f">got there first</a>, in early February – to show solidarity with those affected. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/PbNQkhiiqGY?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>In their debate in the city on March 6, both Democratic candidates embraced the outrage of Flint residents at the way government had failed them, and called for the governor’s resignation and a no-expense-spared approach to rectifying the ongoing problem.</p>
<p>These starkly contrasting responses from the parties reflect the same dynamics that likely led to the suffering of Flint in the first place. </p>
<p>The city’s residents are <a href="http://www.census.gov/quickfacts/table/PST045215/2629000">mostly African-American</a> and <a href="http://www.msnbc.com/interactives/geography-of-poverty/ne.html">more than 40% of them are poor</a>, meaning that they’re as far as can be outside the Republican Party tent. Many reasonably believe that this (along with the standard inertia and reluctance to admit fault common to large institutions) is what led the state government to ignore, downplay and marginalise the legitimate fears of residents, even as evidence mounted and the urgency of the situation became clear. </p>
<p>Put simply, if the same circumstances had affected a whiter, wealthier area, there is little doubt that the response would have been very different.</p>
<p>For the Democrats, the African-American vote is a decisive part of their coalition at state and national level. Indeed, Clinton’s ability to win large majorities of black primary voters is the <a href="http://www.politico.com/magazine/story/2016/03/why-black-voters-dont-feel-the-bern-213707">single largest factor driving her lead over Bernie Sanders</a> in the contest. Both Democrats know they need voters like the African-Americans of Flint to win the nomination, and that whoever runs in the general election will need high turnout among that group to prevail. </p>
<p>Republicans, on the other hand, have all but written off any prospect of winning many votes from that demographic quarter. With the exception of Snyder, scrambling for his political survival, they feel no need to appeal to such voters or engage directly with their concerns. Such is the polarised politics of 2016 America.</p><img src="https://counter.theconversation.com/content/55789/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adam Quinn has previously received funding from the Economic and Social Research Council.</span></em></p>A lead poisoning crisis caused by corroded pipes has made Flint, Michigan a symbol of American inequality.Adam Quinn, Senior Lecturer in International Politics, University of BirminghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/540122016-03-01T11:20:56Z2016-03-01T11:20:56ZIs lead in water a problem beyond Flint? We don’t do the testing to find out<p>Public uproar over lead poisoning in children due to the ongoing water crisis in Flint, Michigan, has dominated the news cycle this winter. The deck was already stacked against kids growing up in Flint. And due to a decision by the city’s emergency manager to start using the Flint River as a municipal water source in April 2014, there has been a <a href="http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.303003">dramatic increase</a> in the number of children who will be living with the effects of lead toxicity from tainted water. </p>
<p>Lead contamination in Flint’s water is a true public health emergency, and there are still no clear solutions. But is Flint an anomaly, or does it sound the alarm to a much bigger, systemic lead problem? </p>
<p>The unfolding story in Flint has left people across the country wondering if lead poisoning is a problem in their own community. As primary care doctors, we wanted to understand how widespread lead poisoning is in America. What we learned was surprising. It’s very hard – if not impossible – to find out how widespread this problem is in the United States today.</p>
<h2>Lead testing standards vary from state to state</h2>
<p>Work by <a href="http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.303003">Dr. Mona Hanna-Attisha</a>, the pediatrician in Flint who initially called attention to this issue, found that the number of children with blood lead levels greater than five micrograms per deciliter doubled since Flint switched its water source. That level is the Centers for Disease Control and Prevention’s (CDC) cutoff for elevated blood lead levels.</p>
<p>To figure out if Flint is an outlier or representative of a broader problem, we need to find out which communities in the U.S. also have many children with elevated blood lead levels. That means we need to compare pediatric lead toxicity between communities across the entire country. </p>
<p>Unfortunately, this is not as straightforward as one might think. In fact, we learned it’s not even feasible to do, because lead screening and reporting guidelines vary by state, and rates of lead screening across states are dramatically different. In some cases, the data <a href="http://www.vox.com/2016/2/17/11034642/lead-poisoning-flint-statistics-data">just aren’t available</a>.</p>
<p>We can estimate the rates of lead testing across the nation, though. To do this, we aggregated <a href="http://www.cdc.gov/nceh/lead/data/national.htm">publicly available data</a> from the CDC and individual state Department of Health websites. We took the number of children screened in the most recent year available and divided by the total population of children under six in each state. However, this means that in some states the percentage of children who were screened for lead may be underestimated (i.e., a child may have been tested for lead in an earlier year and not tested again). </p>
<p>As you can see in the map below, rates of lead testing vary quite a bit.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=487&fit=crop&dpr=1 754w, https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=487&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/113292/original/image-20160229-4076-1tqrg90.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=487&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Percent of children under six years old screened for lead toxicity in the United States. Data were collected from the most recent screening reports from the CDC or state health department sources. States without data available do not report data on the number of children screened for lead toxicity in their state.</span>
<span class="attribution"><span class="source">Nicole Gergen and Tammy Chang, CC BY-NC-ND</span></span>
</figcaption>
</figure>
<p>For example, in <a href="http://www.mass.gov/eohhs/gov/departments/dph/programs/environmental-health/exposure-topics/lead/child-health/test-and-treat/">Massachusetts</a>, all children must be tested twice before age three. Children living in high-risk neighborhoods are tested again at age four. With this legal mandate, Massachusetts has the highest rate of pediatric lead screening in the country, with 47 percent of children under six years old screened in 2014. Similar to Massachusetts, 17 other states require all children to have blood lead testing done before age six. </p>
<p>By contrast, less than five percent of children under age six were screened in <a href="http://chfs.ky.gov/NR/rdonlyres/A39F9BE2-A6A6-4FFE-A3D9-2D2326AA7C28/0/DPHGuidelinesforBloodLeadScreeningandManagementofElevatedBloodLeadLevels2012.pdf">Kentucky</a> in 2014. Kentucky requires only “at-risk” children, including those eligible for Medicaid, those living in certain zip codes or those who meet high-risk criteria based on a lead paint exposure questionnaire, <a href="http://chfs.ky.gov/NR/rdonlyres/894A7D46-2E98-4CA6-B30E-4BE48B465FF7/0/LEADPoisoningVerbalRiskAssessmentQuestionnaireMarch2014.pdf">be screened.</a> Kentucky is one of 27 states that use a targeted blood lead screening strategy.</p>
<p>In all, 44 states either require that all kids be tested or use targeted screening protocols. Other states have no formal screening protocol at all. </p>
<p>However, looking at both CDC data and state health department sources, we could find data about blood level testing for only 35 states. Fifteen states – including those that require testing of some kind and those that don’t – don’t publicly report these data.</p>
<p>Lead toxicity is likely not an emergency in most communities, but we don’t really know. Wide variation in screening guidelines and dismally low pediatric lead screening rates at the state and national level likely mask the true distribution of lead toxicity in the U.S. that is actually happening at the community level.</p>
<p>Based on the data we have, it is difficult to tell if the rate of lead toxicity in Flint represents a true outlier, or if other communities are quietly struggling with lead epidemics of similar magnitude. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/109843/original/image-20160201-32254-1mpyhyg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Water testing isn’t routine.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-210713029/stock-photo-water-tap-and-droplets.html?src=qtpKTOxsALi_ah0mSlIUdQ-1-3">Faucet image via www.shutterstock.com.</a></span>
</figcaption>
</figure>
<h2>Looking through the lens of Flint</h2>
<p>Targeted lead screening protocols are different in every state, but they uniformly recommend testing children who are at high risk for <a href="http://www.epa.gov/sites/production/files/documents/parent_checklist3.pdf">exposure to lead paint products</a> – usually low-income children living in older homes with peeling paint. Although lead paint was <a href="http://www.cpsc.gov/en/Recalls/1977/CPSC-Announces-Final-Ban-On-Lead-Containing-Paint/">banned</a> in 1978, lead paint used in homes built before this regulation went into effect is known to pose a lead poisoning risk to children.</p>
<p>When testing identifies a child with an elevated blood lead level, <a href="https://www.gpo.gov/fdsys/pkg/FR-1996-08-29/pdf/96-21954.pdf">EPA and state protocols</a> recommend a home lead hazard assessment which usually focuses on exposure to lead paint. If lead paint is detected, steps for lead paint removal in the home are recommended.</p>
<p>At this point in time, there is no governmental recommendation to routinely check for lead-contaminated water when a child is found to have an elevated blood lead level.</p>
<p>If lead is contaminating the drinking water in communities outside of Flint, we might not be catching kids with lead poisoning from the water because our current targeted lead screening protocols do not consider water to be a risk. By focusing mostly on lead paint exposure, we miss possible lead exposure associated with water source contamination.</p>
<p>Flint is only <a href="https://theconversation.com/piping-as-poison-the-flint-water-crisis-and-americas-toxic-infrastructure-53473">one of many postindustrial cities</a> with an outdated network of lead water pipes. The water crisis in Flint has taught us that confirming water safety at the treatment plant does not necessarily ensure safe water in the homes of our patients. We don’t routinely collect water lead levels in homes of children who have elevated blood lead levels, so we don’t know if lead contaminated drinking water is part of the reason why their lead levels are high. </p>
<h2>States should follow their own testing guidelines</h2>
<p>A first step toward a better understanding of lead poisoning in the U.S. is for states to promote adherence to their current lead screening guidelines. </p>
<p>Then when a child with elevated blood lead levels is identified, states should require home water lead level data be collected and reported to the state. </p>
<p>If elevated home water lead levels are in fact contributing to lead poisoning in other communities, besides removing the source of the lead, it will be important for states to retool their targeted screening protocols to better address water as a potential lead poisoning risk factor. </p>
<p>The tragedy in Flint was human-made. It is time to reexamine our policies and practices around lead exposure so that what happened in Flint is an isolated incident rather than a harbinger of more preventable tragedies that may be silently unfolding across the country right now.</p><img src="https://counter.theconversation.com/content/54012/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Flint water crisis has left people across the country wondering if lead poisoning is a problem in their community. But it’s very hard to find out how widespread this problem is.Tammy Chang, Assistant Professor, Family Medicine, University of MichiganNicole Gergen, Robert Wood Johnson Clinical Scholar, Internal Medicine and Pediatrics, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/542272016-02-29T11:14:30Z2016-02-29T11:14:30ZWe helped uncover a public health crisis in Flint, but learned there are costs to doing good science<figure><img src="https://images.theconversation.com/files/112598/original/image-20160223-16455-xuunc3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Virginia Tech students process water samples from homes in Flint.</span> <span class="attribution"><a class="source" href="https://www.facebook.com/flintstudyupdates/photos/a.1018987271479001.1073741827.1012700432107685/1110136909030703/?type=3&theater">Flint Water Study/Facebook</a>, <span class="license">Author provided</span></span></figcaption></figure><p>Our team of <a href="http://flintwaterstudy.org/about-page/about-us/">more than two dozen students and research scientists</a> at Virginia Tech has spent much of the past year analyzing and publicizing unsafe drinking water in Flint, Michigan.</p>
<p>Our “open science” research collaboration with Flint residents revealed high levels of lead, <em>Legionella</em> and damage to potable water infrastructure due to a failure to implement corrosion control treatment.</p>
<p>Despite Michigan Department of Environmental Quality (MDEQ) and U.S. Environmental Protection Agency (EPA) messages that the water was safe, we fought to educate residents about severe public health risks. That work led to a declaration of a public health emergency, first by the city of Flint and later by the state of Michigan and President Barack Obama; garnered hundreds of millions of dollars in relief for Flint residents; and informed a national debate on “safe” drinking water in America. </p>
<p>Our work, by any measure, succeeded. But at the same time, this experience has forced us to confront broader questions.</p>
<p>We have learned that as well-trained scientists and engineers, we can be agents for positive change. However, we have also learned that many obstacles make it hard to do good science – not only in crisis situations, but every day. </p>
<h2>Why we had to get involved</h2>
<p>By now the details of Flint’s water crisis are well-known. </p>
<p>In 2014, a state-appointed <a href="http://flintwaterstudy.org/2015/08/the-unintended-consequences-of-migrating-to-flint-river-water/">emergency manager</a> decided to stop buying treated Lake Huron water from the city of Detroit, and instead to treat and distribute Flint River water to city residents. </p>
<p>The MDEQ, which was responsible for ensuring that Flint’s water met federal standards, <a href="http://michiganradio.org/post/state-admits-flint-did-not-follow-federal-rules-designed-keep-lead-out-water#stream/0">violated federal regulation</a> when it did not require the city of Flint to properly treat the water – which we now know is <a href="http://flintwaterstudy.org/2015/09/test-update-flint-river-water-19x-more-corrosive-than-detroit-water-for-lead-solder-now-what/">highly corrosive</a> – to minimize leaching from lead pipes.</p>
<p>Citizens in Flint could smell, taste and see that their water was contaminated almost immediately following the switch. But when they tried to bring their concerns to public officials’ attention, they were <a href="http://www.usatoday.com/story/news/nation-now/2016/01/19/michigan-flint-water-contamination/78996052/">ignored</a>, dismissed and ridiculed. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/112604/original/image-20160223-16425-1k9gk70.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Students in the Flint Water Study pack water testing kits to send to Flint residents.</span>
<span class="attribution"><a class="source" href="https://www.facebook.com/flintstudyupdates/photos/a.1018987271479001.1073741827.1012700432107685/1110136225697438/?type=3&theater">Flint Water Study/Facebook</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>We became involved in April 2015 when Lee Anne Walters, a Flint resident and mother of a lead-poisoned child, <a href="http://blogs.rollcall.com/218/flint-resident-ignored-months-now-hero-congressional-hearing-water-crisis/">contacted</a> <a href="http://www.cee.vt.edu/profile/?pid=edwards">Dr. Marc Edwards</a>, our research adviser at Virginia Tech. After the city detected elevated lead in the Walters family’s water, and she was refused help by MDEQ, Mrs. Walters took her case to EPA Region 5 employee Miguel Del Toral, who collaborated with our lab to sample her tap water. </p>
<p>Mrs. Walters sent us samples from her home, and we found lead levels that on average contained over 2,000 parts per billion (ppb) of lead – more than 130 times the EPA’s maximum allowable limit of 15 ppb.</p>
<p>Lead is a neurotoxin that is especially harmful to children’s developing brains and nervous systems. According to health experts, there is <a href="http://www.niehs.nih.gov/health/topics/agents/lead/">no safe level</a> of lead exposure. </p>
<p>Based on his findings and the Walters’ lead data, Mr. Del Toral wrote an <a href="http://flintwaterstudy.org/wp-content/uploads/2015/11/Miguels-Memo.pdf">internal memo</a> to his colleagues at EPA and MDEQ in June 2015, which was ignored. When the memo was leaked to the press, MDEQ brushed off Del Toral’s and the public’s concerns with a statement that told everyone to <a href="http://michiganradio.org/post/leaked-internal-memo-shows-federal-regulator-s-concerns-about-lead-flint-s-water#stream/0">“relax.”</a></p>
<p>We saw city officials dismissing public concerns, knew that the city was not treating the river water to prevent corrosion and found high lead levels in samples from the Walters’ home. We believed there was an urgent threat to public health, and no one else seemed to be doing anything to help the citizens of Flint. </p>
<p>We set a plan in motion to help citizens in the best way we knew: with science.</p>
<p>As a first step, we mailed 300 sampling kits to citizen activists in Flint. Over just four weeks, Flint residents helped us gather and analyze 861 water samples – more than 12 times the number that city officials collected in six months. </p>
<p>Our results clearly showed a <a href="http://www.mlive.com/news/flint/index.ssf/2015/09/new_testing_shows_flint_water.html#incart_river">widespread lead-in-water problem</a>. MDEQ <a href="http://flintwaterstudy.org/2015/09/commentary-mdeq-mistakes-deception-flint-water-crisis/">questioned</a> whether our testing was reliable. In response, Flint citizens organizing the sampling developed quality control procedures, such as taping the kits closed once samples had been collected and signing their names across the tape, to make it clear that no samples had been tampered with.</p>
<p>We went to Flint several times to confirm and expand these findings by taking and analyzing more water samples. Again MDEQ tried to discredit our results, calling us lead “magicians” who could “<a href="http://flintwaterstudy.org/2015/09/commentary-mdeq-mistakes-deception-flint-water-crisis/">pull that rabbit out of that hat anywhere they go</a>.” </p>
<p>This struck a nerve. As scientists, we spend significant amounts of time making sure our results are accurate. In response to MDEQ’s claims, we became completely transparent about what we were doing and how we were sampling for lead. Because we took this approach, people in Flint trusted us.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/112824/original/image-20160224-16425-1xb94cr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Graffiti in Flint rejecting Professional Service Industries (PSI), a firm city officials proposed hiring in January to test residents’ tap water.</span>
<span class="attribution"><span class="source">LeeAnne Walters/Flint Water Study</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Meanwhile, both MDEQ and EPA were sluggish to respond to our questions and reluctant to share data with us. We filed several Freedom of Information Act requests (FOIAs) to gain access to agency records and were <a href="http://flintwaterstudy.org/2015/09/commentary-mdeq-mistakes-deception-flint-water-crisis/">alarmed</a> by what we found. </p>
<p>For instance, <a href="http://flintwaterstudy.org/2015/09/commentary-mdeq-mistakes-deception-flint-water-crisis/">MDEQ had misinformed EPA</a> about having corrosion control treatment in place. We also found that the state agency had <a href="http://michiganradio.org/post/expert-says-michigan-officials-changed-flint-lead-report-avoid-federal-action#stream/0">thrown out two critical water samples</a> – including one from the Walters home – so that Flint would meet the requirements of EPA’s <a href="http://www.epa.gov/dwreginfo/lead-and-copper-rule">Lead and Copper Rule</a>. The rule, enacted in 1994, requires cities to monitor drinking water at customer taps and take action to reduce corrosion if certain numbers of samples contain lead or copper above specific levels.</p>
<p>Our findings, combined with <a href="http://flintwaterstudy.org/2015/09/pediatric-lead-exposure-presentation-from-hurley-medical-center-doctors-concerning-flint-mi/">data on blood lead levels</a> in Flint children released by Dr. Mona Hanna-Attisha at Hurley Medical Center, finally prompted city, state and federal officials to declare emergencies in Flint and switch back to Detroit water. </p>
<h2>A culture of compliance</h2>
<p>One hard lesson we learned is that people in our field – environmental engineers and water managers – helped cause Flint’s crisis. </p>
<p>Somewhere along the line, in deciding what compounds to regulate and how to control them, the U.S. system for regulating drinking water has become extremely complex. There are now more than <a href="http://www.cdc.gov/healthywater/drinking/public/">150,000 public water utilities</a> in the United States. Our National Primary Drinking Water Standards cover <a href="http://www.epa.gov/your-drinking-water/table-regulated-drinking-water-contaminants">more than 80 contaminants</a>, and EPA is reviewing <a href="http://www.epa.gov/ccl/chemical-contaminants-ccl-4">some 100 others</a> to determine whether they should also be regulated. </p>
<p>Individual utilities are responsible for monitoring and reporting to state agencies, which in turn report to EPA regional offices. With this segregated approach and so many things on their radars, a culture has developed that seems to be geared more toward meeting regulations and standards than toward protecting public health. This is especially true in programs like MDEQ’s that are <a href="http://www.detroitnews.com/story/opinion/2016/02/17/issues-deq-cited-years-flint-crisis/80532786/">“understaffed, underfunded and [have personnel] lack[ing] knowledge and experience,”</a> in the words of <a href="http://flintwaterstudy.org/2015/10/podcast-lead-in-drinking-water-is-flint-a-washington-dc-2-0-and-other-tales-a-conversation-with-dr-yanna-lambrinidou/">Dr. Yanna Lambrinidou</a>, a medical ethnographer and adjunct assistant professor of science and technology studies at Virginia Tech. </p>
<p>As the U.S. Government Accountability Office has <a href="http://www.gao.gov/products/GAO-06-148">reported</a>, EPA does not have enough power or resources to properly oversee sampling that cities carry out to show they are complying with the Lead and Copper Rule. Professors Edwards and Lambrinidou and others have documented that, as a result, agencies in charge of proving that regulations are met have developed techniques for <a href="http://mediad.publicbroadcasting.net/p/michigan/files/201511/Gaming_the_LCR_WASA_2003-2009_Oct_2009.pdf">gaming the system</a> to avoid collecting water samples that contain enough lead or copper to trigger action. </p>
<p>Well-known techniques that took place in Flint include <a href="http://www.theguardian.com/us-news/2016/jan/27/michigan-water-testing-rules-pre-flushing-taps-flint-lead">preflushing</a> water from taps the night before sampling and using small-mouthed bottles, which artificially lowers lead concentrations in samples, as well as <a href="http://www.mlive.com/news/flint/index.ssf/2015/11/documents_show_city_filed_fals.html">failing to identify and test</a> homes known to have sources of lead in their plumbing from lead services lines or older brass components that contain significant amounts of lead.</p>
<p>At a recent national conference, one of our team members spoke with a utility manager about how his utility sampled for compliance with the Lead and Copper Rule. The manager was proud that his utility had never found a violation. But when our team member probed further, the manager acknowledged that a couple of homes in their distribution system had lead levels high enough to be of concern. However, he argued that the utility did not need to report these high levels:</p>
<blockquote>
<p>Flint Water Study Team Member (FWS): So, do you inform the homeowners if the lead levels are high? </p>
<p>Utility Manager (UM): We don’t need to inform homeowners if the 90th percentile is below 15 ppb. [If fewer than 10 percent of homes produce lead readings above 15 ppb, the Lead and Copper Rule does not require the utility to take action.]</p>
<p>FWS: Yes, but, if you were a parent in a home which was tested over 15 pbb, wouldn’t you like to know?</p>
<p>UM: I understand what you are saying, but that is not how the rule works.</p>
<p>FWS: I know, but would you agree that it is a problem and that the rule should change? Isn’t it important to inform homeowners if they are over the action level?</p>
<p>UM: Yeah, but that is not up to me. Our job is to follow the rules and regulations.</p>
</blockquote>
<p>We are concerned by this attitude and believe we need to change it so that everyone involved is more focused on protecting public health than only complying with regulations.</p>
<h2>Conflicting incentives for scientists</h2>
<p>As budding academics, we are proud that our group went “all in” for Flint. We provided accurate technical information that was desperately needed, developed legitimate research questions and uncovered government wrongdoing. </p>
<p>We did not have a direct funding source when we got involved, and there was a real risk that we would not be able to raise money to support our work. But Dr. Edwards chose to move forward because the risk to Flint families and their children was much greater. He spent more than <a href="http://flintwaterstudy.org/2016/01/the-flintwaterstudy-research-support-fundraiser/">US$150,000 from his own discretionary research and personal funds to cover our costs</a>, and the National Science Foundation later backed us with <a href="http://flintwaterstudy.org/2015/09/our-virginia-tech-research-team-wins-a-50000-grant-from-the-national-science-foundation-to-study-flint-water/">a $50,000 RAPID Response grant</a>. </p>
<p>If Dr. Edwards had not been able and willing to do this, people in Flint might very well still be getting unsafe Flint River water from their taps.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=339&fit=crop&dpr=1 600w, https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=339&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=339&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=426&fit=crop&dpr=1 754w, https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=426&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/112609/original/image-20160223-16459-1wn569g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=426&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Award presented to Marc Edwards and the Flint Water Study research group by the city of Flint.</span>
<span class="attribution"><a class="source" href="https://www.facebook.com/flintstudyupdates/photos/pb.1012700432107685.-2207520000.1456244450./1066427390068322/?type=3&theater">Flint Water Study/Facebook</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Academic researchers are supposed to contribute to the public good, and scholars are supposed to have academic freedom to explore important questions without undue interference. But at the same time, they are under tremendous pressures to meet metrics such as publishing papers and bringing in research dollars. This pressure can make researchers less independent and less willing to pursue roads less traveled.</p>
<p>We are worried that a reward structure has developed that supports mainly self-promotion and dissuades the altruistic motives to do science for the public good that attracted many of us to the profession in the first place.</p>
<p>Our experience in Flint has shown us some unpleasant costs of doing good science. It can mean burning bridges to potential funding, and damage to your name and professional reputation. There also are emotional costs associated with distinguishing right from wrong in moral and ethical gray areas, and personal costs when you begin to question yourself, your motives and your ability to make a difference. </p>
<h2>What scientists and engineers can do</h2>
<p>Things have started to change in Flint, but fixing its water system will take years, and its citizens will need continued support in many areas – including nutrition, health care and education – to manage the effects of lead poisoning over the coming decades. </p>
<p>From our perspective, it is hard not to feel that the regulatory system is broken, or at least critically flawed. Only an active and engaged public can drive reform forward, and make EPA and state agencies more responsive to fulfill their mission statement and truly protect the public.</p>
<p>As academic researchers, we do not always have an active role in fixing such regulatory shortcomings, but we can help influence change in unconventional ways. The Flint crisis showed that listening to the public is critical if we wish to do our jobs better as scientists and engineers and serve society. </p>
<p>Engineers don’t take oaths similar to medical doctors’ Hippocratic Oath, but maybe we should. As a start, we have all made personal and professional pledges that include the first Canon of Civil Engineering: to uphold the health and well-being of the public above all else. In doing so, we affirm Virginia Tech’s motto, “Ut prosim,” which means, “That I may serve.”</p><img src="https://counter.theconversation.com/content/54227/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rebekah Martin receives funding from the National Science Foundation. </span></em></p><p class="fine-print"><em><span>Siddhartha Roy receives funding from the Water Research Foundation. </span></em></p><p class="fine-print"><em><span>William Rhoads does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Virginia Tech University engineering students blew the whistle on Flint, Michigan’s toxic drinking water. Hailed as heroes, they’ve also learned that it isn’t easy to do science for the public good.William Rhoads, Ph.D. Student in Civil and Environmental Engineering, Virginia TechRebekah Martin, Ph.D. Student in Civil and Environmental Engineering, Virginia TechSiddhartha Roy, Ph.D. Student in Civil and Environmental Engineering, Virginia TechLicensed as Creative Commons – attribution, no derivatives.