Rachel's Environment & Health News #827  [Printer-friendly version]
Oct. 17, 2005

PEDIATRICIANS URGE A PRECAUTIONARY APPROACH TO TOXIC LEAD

By Peter Montague

The American Academy of Pediatrics (AAP) has just issued a new
"policy statement" urging the U.S. to eliminate toxic lead from all
housing, to stop poisoning the nation's children.[1]

The Academy says 25% of children in the U.S. still "live in housing
with deteriorating lead-based paint and are at risk of lead exposure
with resulting cognitive impairment and other sequelae
[consequences]."

This means there are more children labeled "at risk" today than there
were 20 years ago. During the 20 years, the median level of lead in
children's blood has dropped nearly 8-fold (from 15 ug/deciliter to
1.9 mg/deciliter) because lead was banned from gasoline, from water
pipes, and from food containers. However, during the same period, bad
news about lead's harmful effects at low levels has accumulated year
after year.

According to the latest estimate from the Academy, about 20 million
children (ages 0-18) live in homes where lead-based paint is still a
hazard, 5 million of them age 5 or younger. The youngest three million
of these -- kids up to age 3 -- are in greatest danger because they
are most likely to lick or chew window sills or other sources of lead-
based paint, or to put their hands or household objects or toys in
their mouths. Lead-based paint tastes like lemon drops.

This is the first time the Academy has urged the elimination of toxic
lead-based paint at its source as the best way to stop the poisoning
of children. In the past the Academy has relied on pediatricians to
educate parents about ways to prevent their children from being
poisoned.[2]

Notice the difference: The old approach assumed that attentive parents
could manage to raise healthy children in a toxic environment. When
they failed, a "case manager" from the health department stepped in
locate the source of exposure and fix the problem. At least that was
the theory. This cumbersome and expensive one-on-one approach did not
protect the nation's children. In contrast, the Academy's new policy
assumes that persistent toxicants like lead cannot be managed but must
be eliminated -- signaling a clear shift to a precautionary approach.
As the Academy's new policy says, "The focus in childhood lead-
poisoning policy... should shift from case identification and
management to primary prevention, with a goal of safe housing for all
children." We salute the American Academy of Pediatrics for this
important step forward.

The Academy's new policy statement contains considerable new
information about the dangers of exposing young children to lead:

** The current "level of concern" for lead in a child's blood is still
set by the federal government at 10 micrograms of lead in a deciliter
(1/10th of a liter) of blood, expressed as ug/deciliter. The federal
government recommends taking no action on lead below 10 ug/deciliter.
From 10 to 15, monitoring is recommended but no action. Unless a child
has 15 ug/deciliter lead in their blood for longer than 3 months, or
if a child has 20 ug/deciliter in their blood at any time, then the
government recommends investigating the child's environment to find
the source of the lead exposure and reduce or eliminate it.

However the Academy's new policy statement confirms that no one any
longer believes that 10 ug/deciliter protects lead-exposed children
from harm, or that there is any "safe" level of lead exposure for
children. The federal government itself came to this conclusion in
2002: "there is no apparent threshold below which adverse effects of
lead do not occur," said the Centers for Disease Control and
Prevention (CDC). The Academy, too, acknowledges that, "Evidence
continues to accrue that commonly encountered blood lead
concentrations, even those less than 10 micrograms/deciliter, may
impair cognition [brain function], and there is no threshold yet
identified for this effect." In other words, any amount of lead in a
child causes some brain damage -- there is no "safe" level of lead
except zero. Yet the federal government continues to recommend that
children poisoned by lead be ignored if their blood lead level is
lower than 10 ug/deciliter.

The main effect of lead is to impair cognition, which is usually
measured (after age 5) by an IQ test. Any amount of lead reduces a
child's IQ to some degree.

The Academy's new policy statement says, "The best-studied effect is
cognitive impairment, measured by IQ tests. The strength of this
association [between increased lead and decreased IQ] and its time
course have been observed to be similar in multiple studies in several
countries. In most countries, including the United States, blood lead
concentrations peak at approximately 2 years of age and then decrease
without intervention." This decrease occurs because children older
than 2 don't put hands and objects in their mouths as often as babies
and toddlers do, plus the child is gaining weight, so lead is being
diluted.

For children with more than 10 ug/deciliter of lead in their blood,
each additional 10 ug/deciliter of lead reduces IQ another 2 to 3
points. However, two recent studies have shown that the first 10
ug/deciliter increase is the most damaging, reducing a child's IQ by
"more than 7 points," the Academy reports. In other words, the "dose
response curve" is steepest at the lowest doses; the greatest harm
from lead begins to occur when a children has the least lead.

Obviously, this means it is important to prevent that first 10
ug/deciliter rise in a child's blood lead levels.

The Academy acknowledges these studies but says that its new policy
statement does not reflect this new information. The Academy is
waiting for additional confirmation before acting more aggressively to
protect young children from that first 10 ug/deciliter "hit" to their
systems.

** The new policy statement acknowledges that toxic lead is associated
with aggressive behavior and delinquency in children. Past policy
statements by the Academy have ignored the body of literature, going
back to 1943, linking lead exposure with aggressive and violent
behavior and delinquency. The Academy now says:

"Other aspects of brain or nerve function [besides IQ], especially
behavior, also may be affected. Teachers reported that students with
elevated tooth lead concentrations were more inattentive, hyperactive,
disorganized, and less able to follow directions. Additional follow-up
of some of those children showed higher rates of failure to graduate
from high school, reading disabilities, and greater absenteeism in the
final year of high school. Elevated bone lead concentrations are
associated with increased attentional dysfunction, aggression, and
delinquency. In children followed from infancy with blood lead
measurements, self-reported delinquent behavior at 15 to 17 years of
age increased with both prenatal and postnatal lead exposure, and bone
lead, thought to represent cumulative dose, is higher in adjudicated
delinquents. These data imply that the effects of lead exposure are
long lasting and perhaps permanent."

** Effects of lead are irreversible

This is another important point in the Academy's most recent policy
statement: it reviews evidence showing that harm from lead is
irreversible. Physicians used to think (or at least hope) that ending
toxic exposure would allow a child to recover lost brain function.
That possibility now seems very unlikely.

** Damage to hearing, impaired sense of balance

The Academy's policy statement says that, "Subclinical effects on both
hearing and balance may occur at commonly encountered blood lead
concentrations." In other words, at levels of toxic lead routinely
found in many children today, we can expect hearing loss from lead.
Does this contribute to poor performance in school, with reduced life-
possibilities?

** Lastly, the Academy now recommends that all children should be
tested for lead in the blood at least once during their first 2 years
of life. In the past the Academy has said universal testing is not
worth the money. Now that levels of lead as low at 1 or 2 ug/deciliter
are known to cause some damage to a child's brain, the Academy has
reversed its position on universal testing.

* * *

The Academy did not rush precipitously to adopt a precautionary
approach to lead poisoning, urging removal of lead-based paint from
all housing. The paint industry openly acknowledged in the 1890s that
lead-based paint was dangerous; in 1897 at least one company was
advertising that its paint "is NOT made with lead and is not
poisonous." The poisoning of children by dust from lead-based paint
was first reported in medical literature just over 100 years ago, in
1904. Lead-based paint was banned for interior uses in Australia and
most of Europe during the 1920s.[3] The U.S. waited 50 more years
before banning it in 1978.

The problem of children poisoned by lead-based paint was widely
recognized by public health physicians in the U.S. in the 1930s. The
City of Baltimore began routine surveillance of lead poisoning in
children in 1931. Reports of large numbers of children poisoned by
lead-based paint appeared in medical literature in the 1950s. (See
Rachel's #294.) Unfortunately, those early reports emphasized that
lead was mainly a danger to poor, African-American children living in
urban slums. Public health specialists subsequently recognized that
even well-to-do children in the suburbs were being poisoned by lead,
but the original understanding of lead as a problem of poor blacks
proved hard to reverse. In a society oriented by 350 years of law and
custom to white supremacy,[4] a silent epidemic of poisoning thought
to affect only poor blacks had no political meaning.

Nevertheless, public-interest scientists (Barry Commoner, Rene Dubos
and others) pressed for controls on lead-based paint[5] and, in 1971,
Congress passed The Lead-Based Paint Poisoning Prevention Act
declaring lead-based paint a health hazard to children and ordering
that it be stripped from the nation's stock of federally subsidized
housing. However, President Nixon was then developing his "southern
strategy" to woo voters away from George Wallace, the avowedly white
supremacist candidate for president. In 1971, President Nixon
"rejected a recommendation of Government health specialists for a
national push this year against childhood lead poisoning."[6] That set
the tone for the federal response to the dangers of lead-based paint.
Twenty years later the New York Times would report that the federal
lead-paint-removal program had "produced a legacy of frustration and
failure." "The Government's record in dealing with this problem is one
of absolute dereliction," said Dr. Herbert Needleman in 1990,
according to the Times.[7]

Now, 100 years after the first medical reports of children poisoned by
lead-based paint in their homes, lead-based paint flaking off the
walls of homes is still the main cause of childhood lead poisoning.[1]
The victims are still generally, though by no means exclusively, poor
and they are still far more likely to be black or Latino than white.

Obviously the nation has dragged its feet on this problem. This seems
odd because it is widely acknowledged that huge sums of money could be
saved by cleaning up lead in housing. The new policy statement from
the Academy of Pediatrics discusses several cost-benefit analyses
showing that eliminating the lead hazard from housing would save
billions of dollars each year because lead diminishes a child's IQ and
IQ translates into earning power (which, in turn, translates into tax
revenues).

Here are some numbers from the Academy's new policy statement.[1]
There are 4 million homes in the U.S. needing lead removal. The cost
would be a one-time investment of $28 billion. The savings each year
thereafter would be $43 billion. So lead removal would pay for itself
the first year and then save billions each year thereafter. An
investment of $28 billion is less than the U.S. spends every six
months in Iraq.

The Academy cites other studies that make the same point, but you get
the idea -- there's a huge amount of money to be saved by ending the
poisoning of our children.

To state it in the reverse: we are foregoing billions of dollars in
income and taxes each year in order to keep our urban children
poisoned. This is an astonishing use of scarce resources, to put it
mildly. How can we possibly explain such a bizarre national policy?

All I can figure is that some things are more important than money.

Here is a hypothesis based on U.S. history: Perhaps both Republican
and Democratic administrations of the past 35 years have found it
advantageous to keep inner-city kids behind the 8-ball by diminishing
their IQs early in life, making them less successful in school, plus
making them more aggressive and violent. I know this is an outrageous
hypothesis, but hear me out.

For forty years, 1940-1980, the nation was ruled by a "bottom up" New
Deal coalition of liberal middle-class whites plus minorities plus the
organized working class. During this period, inequalities of income
and wealth were held in check chiefly by the power of labor unions, by
tax policies, and to a lesser extent by welfare programs. Recall that
the income tax rate on the top tax-bracket was 91% from 1949 to 1964
(including during the Eisenhower administration) -- compared to 35%
today.[8]

But "conservative" politicians (of both parties) began to undermine
the "bottom up" New Deal coalition in the early 1960s, using race as
the wedge issue to split the coalition.

This historical reality -- using race to divide and conquer the New
Deal coalition -- has been well-documented in four excellent books:

** Dan T. Carter, From George Wallace to Newt Gingrich: Race in the
Conservative Counterrevolution, 1963-1994 (1996; ISBN 0-8071-2366-8);

** Thomas and Mary Edsall, Chain Reaction; The Impact of Race, Rights
and Taxes on American Politics (1992; ISBN 0-393-30903-7);

** Sara Diamond, Roads to Dominion; Right Wing Movements and Political
Power in the United States (N.Y.: The Guilford Press, 1995); ISBN
0-89862-864-4,

** Jean Hardisty, Mobilizing Resentment (Boston: Beacon Press, 1999);
ISBN 0-8070-4316-8).

In 1964, Barry Goldwater ran for president on an anti-civil rights
platform. He lost, and two more civil rights laws were enacted in 1965
and 1968. These laws -- plus the civil disorder of the period
1965-1968 ("Burn, baby, burn!") -- fueled a backlash. (Many people
conveniently forget that this phase of 1960s civil disorder was a
response to 5 years of white supremacist riots, bombings, murders, and
assassinations, 1960-1965.)[9]

White supremacist "conservative" politicians fanned the backlash.
George Wallace discovered that a white supremacy message resonated not
only in the south but also in the mid-west. In 1963, Wallace had an
epiphany: "They all hate black people, all of them. They're all
afraid, all of them. Great God! That's it! They're all Southern. The
whole United States is Southern!"[10] In the 1964 Democratic primary,
Wallace took 34% of the vote in Wisconsin, 30% in Indiana, and 43% in
Maryland. In the 1972 presidential campaign, Wallace won 51% of the
vote in Michigan.

President Nixon went on to develop what is still today euphemistically
called the "southern strategy," a polite phrase for "white supremacy."
As we have seen, in 1971 Mr. Nixon rejected the advice of public
health specialists and refused to tackle the problem of toxic lead
poisoning among urban children. It wouldn't pay to be seen as
investing tax dollars in the health of those inner city troublemakers.
Ronald Reagan built on the Nixon legacy, openly hostile to civil
rights and affirmative action (at least affirmative action for blacks;
affirmative action for whites was OK with the Gipper[11]). Reagan even
tried to reverse the federal policy of withholding subsidies to
segregated schools, until the Supreme Court tripped him up. Despite
this setback, Reagan's white supremacist policies attracted
fundamentalist religious conservatives and thus helped cobble together
the current conservative coalition that slowly took power starting
about 1972.[12]

The genius of the white supremacist strategy (later to be combined
with other diversionary "social" issues -- anti-intellectual,
anti-gay, anti-abortion, pro-school prayer) is that it provided a
focus for the fears, hatreds and frustrations of lower middle-class
and working class whites -- deflecting attention away from the real
political action of those decades, which was to cut taxes for the rich
and the super-rich and redesign the world order to make it easy to
move money overseas (where it was easier to hide from the U.S. tax
man) -- a byproduct of "globalization" which had the effect of making
the super-rich richer.[13]

So that, in a nutshell, is the political usefulness of a permanent
underclass of blacks and Latinos trapped in poisoned housing -- they
provide endless targets for white supremacist frustrations and
fantasies, while they deflect attention away from the real political
action of the last 20 years, which is the funneling of hundreds of
billions of dollars from the middle class and the working poor into
the pockets of the super rich. During the Reagan-Bush years,
1980-1992, the super rich (the wealthiest 1%) saw their incomes rise
by 78% while the median wage-earner saw his or her income decline
5%.[14] Those with declining incomes have been seething with
frustration as the American dream has passed them by. They have tried
to tread water by putting more family members to work, working longer
hours, driving longer distances in worsening traffic to second and
even third jobs, but for low- and middle-income groups, keeping up
with the Jones gets harder each passing year. To deflect attention
away from this massive upward redistribution of economic rewards,
"conservative" politicians have developed a ready explanation,
expressed in the shorthand of white supremacy: "welfare queens" and
"Willie Hortons" have been stealing from hard-working, law-abiding
Americans.

To this day, white supremacy remains the central issue -- almost never
discussed openly -- that divides U.S. society.[15] The environmental
movement tried for a time to overcome this history, but the
"environmental justice" movement has, so far, been unable to claim its
fair share of the available funds. Wealthy white groups, and many of
their funders -- while adopting the rhetoric of environmental justice
-- have not offered equal space at the table for non-whites,[16] and
so the cycle of frustration and anger is perpetuated even among
liberal environmentalists.

It seems safe to say that until liberals figure out how to rebuild a
durable interracial political coalition (including a democratically-
run, all-inclusive labor movement), the "conservatives" will retain
political control of the U.S., wealth will continue to float upward,
destroying the middle class, and democracy will continue to fade into
empty rhetoric.

This then is the importance of the new policy statement by the
American Academy of Pediatrics. By advocating a precautionary policy
of removing lead from housing, it affirms that everyone has a basic
right to a non-toxic environment and a decent start in life. Making
such a policy real will not be easy -- the silent forces of white
supremacy remain arrayed against it -- but it nevertheless does keep
alive the hope that we may one day create a society "with liberty and
justice for all."

==============

[1] Committee on Environmental Health, American Academy of Pediatrics,
"Lead Exposure in Children: Prevention, Detection, and Management,"
Pediatrics (October 2005), pgs. 1036-1046.

[2] Committee on Environmental Health, American Academy of pediatrics,
"Screening for Elevated Blood Lead Levels," Pediatrics Vol. 101, No. 6
(June 1998), pgs. 1072-1078.

[3] Sven Hernberg, "Lead Poisoning in Historical Perspective,"
American Journal of Industrial Medicine Vol. 38 (2000), pgs. 244-254.

[4] Francis D. Adams and Barry Sanders, Alienable Rights; The
Exclusion of African Americans in a White Man's Land, 1619-2000 (New
York: HarperCollins, 2003). Betita Martinez points out that the phrase
"white supremacy" is more accurate than "racism" because it conveys
the inherent power relationship in racism; Elizabeth (Betita)
Martinez, "Racism: The U.S. Creation Myth and Its Premise Keepers," in
David Solnit, editor, Globalize Liberation (San Francisco: City
Lights, 2004; ISBN 0-87286-420-0).

[5] Sandra Blakeslee, "Experts Recommend Measures to Cut Lead
Poisoning in Young," New York Times Mar. 27, 1969, pg. 25.

[6] "Funds for Victims of Lead Poisoning Asked of Senators," New York
Times July 14, 1971, pg. 71.

[7] William E. Schmidt, "Lead Paint Poisons Children Despite 1971 Law
on Removal," New York Times August 26, 1990, pg. 1.

[8] Gar Alperovitz, "Tax the Plutocrats," The Nation Jan. 27, 2003.

[9] Hugh Davis Graham, "On Riots and Riot Commissions: Civil Disorders
in the 1960s," The Public Historian Vol. 2, No. 4 (Summer 1980), pgs.
7-27.

[10] Dan T. Carter, From George Wallace to Newt Gingrich: Race
in the Conservative Counterrevolution, 1963-1994 (Baton Rouge:
Louisiana State University Press, 1996; ISBN 0-8071-2366-8),
pg. 6.

[11] Ira Katznelson, When Affirmative Action Was White: An Untold
History of Racial Inequality in Twentieth-Century America (N.Y.: W.W.
Norton, 2005); ISBN 0-393-05213-3.

[12] On Reagan's white supremacist policies, see, for example, Francis
D. Adams and Barry Sanders, Alienable Rights (NY: HarperCollins, 2003;
ISBN 0-06-019975-X), pgs. 308-313; see also Thomas and Mary Edsall,
Chain Reaction; The Impact of Race, Rights and Taxes on American
Politics (1992; ISBN 0-393-30903-7), especially chapter 9.

[13] See these three books: Donald Barlett and James B. Steele,
America: Who Really Pays the Taxes? New York: Touchstone, 1994. ISBN
0-671-87157-9; and Donald Barlett and James B. Steele, The Great
American Tax Dodge; How Spiraling Fraud and Avoidance Are Killing
Fairness, Destroying the Income Tax, and Costing You. Berkeley, Calif:
University of California Press, 2002. ISBN 0520236106; and Charles
Lewis, Bill Allison, and the Center for Public Integrity. The Cheating
of America; How Tax Avoidance and Evasion by the Super Rich are
Costing the Country Billions -- and What You Can Do About It. New
York: William Morrow, 2001. ISBN 0-380-97682-X.

[14] Dan T. Carter, From George Wallace to Newt Gingrich: Race in the
Conservative Counterrevolution, 1963-1994 (Baton Rouge: Louisiana
State University, 1996; ISBN 0-8071-2366-8),
pg. 6

[15] Robert Jensen, The Heart of Whiteness; Confronting Race, Racism
and White Privilege (San Francisco: City Lights, 2005); ISBN
0-87286-449-9.

[16] In their report, Green of Another Color (Boston: Northeastern
University, 2001) Daniel Faber and Deborah McCarthy show that, of all
funds available for environmental work during the period 1996 to 1999,
some 96% went to the lawyers and scientists of the traditional
environmental movement, and only 4% went to all the thousands of
groups working to build the "environmental justice" movement.