Where Lead Lurks

Lead poisoning is different from other modern health risks, notes epidemiologist Eric Feigl-Ding. No medicine can reverse the damage and no amount of diet and exercise will help. The only solution is prevention.

This reality was at the forefront of his mind last year when he began following the alarming data on high levels of lead in drinking water in Flint, Mich.

“Although I didn’t previously work on environmental epidemiology, I couldn’t just sit there doing nothing,” said Feigl-Ding, a researcher with the Harvard T.H. Chan School of Public Health’s Nutrition Department. “Working in public health, I just really had to do something about the situation. For diabetes or heart disease, there are interventions to treat it, worst-case. However, for lead poisoning there is not. Lead poisoning’s brain damage in children basically is permanent.”

According to the Centers for Disease Control and Prevention (CDC), 4 million U.S. households have children with high lead levels in their bodies and 500,000 children age 5 or younger have blood lead levels of 5 micrograms per deciliter, the CDC’s recommended action threshold. While lead-based paint and dust are major exposure threats, tap water can also be a danger thanks to leaching from service pipes and old indoor plumbing. The CDC says even low blood lead levels can affect a child’s IQ, attention span, and academic performance.

Feigl-Ding assembled an all-volunteer team of software engineers and programmers, who, with head engineer Pius Lee, worked over six months to devise a new web platform, ToxinAlert.org. The site has several functions, including a U.S. map that allows users to enter an address or ZIP code to find water quality data for their location. A look at Flint, for example, shows a dense field of red and orange alerts, a few of which came from government reporting, but most of which originated in local and private testing in recent years as the city’s crisis developed.

The site also has a crowd-sourcing feature where individuals can upload test results of their own. For those who want to get their water tested, the site offers at-cost testing for lead, arsenic, mercury, copper, chromium, and cadmium, as well as more comprehensive tests for pesticides and other contaminants.

ToxinAlert went live in October. Feigl-Ding’s team, which also includes software engineers Naveen Vemula, Sean Moon and public health scientists Angelica Cristello and Andrea Feigl-Ding, is now at work on features intended to promote grassroots action through a school-centered advocacy and crowd-funding campaign that they expect to launch next month. The campaign will add schools and day care centers to the map so parents can see what testing data exists for those sites. For locations without data, the site will provide information for parents to take steps to have a school or day care center tested twice annually.

The site has become something of a second job for Feigl-Ding, who is looking for funding to help it grow. He’d like to continue to add features to engage elected leaders, and would also like to pursue corporate partners to help with sponsoring and subsidizing testing in communities that may have limited resources.

“There’s a national moment we want to build on and right now is the critical moment to focus on environmental health, just as [the Environmental Protection Agency] is being weakened in the new administration,” Feigl-Ding said. “But first is aggregating the data and building the public alert network. We hope to forestall another calamity like Flint. If we catch it early, we can save thousands, if not millions, of children from permanent brain damage and other poisoning.”

Read more on: Harvard News

Media

Taxonomy

• Public Health
• Purification
• Human Rights
• Drinking Water
• Infrastructure
• Contaminant Control
• Pipes and Pipelines

5 Comments

1. January/February 2013 issue of Mother Jones featured an excellent article by Kevin Drum, on the adverse societal effects potentials that research suggests that lead pollution has caused in the US. Some of the correlations remain to be clarified enough to be used to be demonstrated as being causative, but the general description of the research status and trends thus far does give a very good overview of how lead has taken a massive negative effect on societal wellbeing. There has been a very large amount of research accomplished to date that strongly suggests that lead pollution from many sources have harmed us all to varying degrees, and that indicates that it was done in a dose-dependent manner. The current The Flint MI water and public health crisis is just one example of the tragedy of lead poisoning across our nation and around the world. Public health assessment best management practices still almost exclusively use the blood lead test to biomonitor the current lead levels from very recent exposures. This reliance is too simplistic, though still very useful, to really grasp an appropriate understanding of the role of accumulative body burden of lead on individual health, and societal harms. Lead research is rapidly advancing, with many new techniques for biomonitoring exposures, uptakes, and toxicologic effects on individuals and on public health disease causation. Though Flint is just the tip of the iceberg of lead poisoning effects across our nation, we now have a societal awareness momentum that desperately needs to drive further research and drive public health system advances into a new age of lead poisoning prevention and toxic metal pollution cleanup for the nation. We stand to gain vast sums of money AND health, if we grasp this opportunity. The huge monetary costs of the Flint debacle, just beginning to be realized, could have been avoided with appropriate oversight through the years, but we have failed miserably. Divisive finger-pointing, and blame assessment does have a place, but the more advantageous opportunity would be to focus that energy toward directly improving the path from here forward into a more sane future of toxic pollution prevention and reduction. Blood lead testing, while important to do for part of the picture, also masks the more important body burden build-up of lead in individuals and populations. There are important new tools that beg to be utilized and refined in the Flint crisis, to provide a giant leap forward in public medicine advancement concerning lead poisoning, both acute, and chronic low-dose. It will be essential to use bone lead assessment with such tools as XRF non-invasive testing, ALAD-inhibition testing, genetic testing for susceptibility differences, and employing the rapidly evolving new science of sclerochronology of bioincrement growth history metals content in body hard parts such as teeth. Laser ablation ICPMS and similar techniques could take us giant leaps forward in understanding exposure and up-take histories through lifetimes and across populations. We need to insist that these tools be incorporated in the Flint paradigm, to turn such devastating negativity into knowledge and advancement into a more sane future.IMHO

    

2. It has to be remembered that lead is an accumulative toxicant in the body, it gradually builds up and much of it is stored in the bones. That is a long term problem however, because when the body is under stresses such as illness or pregnancy, the body mobilizes calcium out of bone, and lead is remobilized out where it becomes toxic again by being incorporated into important physiologic components. When the body has created new enzymes or other materials to satisfy a physiologic need, yet the lead has substituted for the calcium or zinc, it makes the material dysfunctional... the body thought it was doing what was needed, but illness still progresses. This can really mess up neurologic pathways resulting in behavioral effects that reduce abilities of people, especially children, to learn the consequences of of their actions...... that can lead to school dropout and trends toward drug addiction and prison. It takes very little lead to cause child to start down this path of neurologic damage.

3. There are many forms of lead pollution continuing today, that harm large numbers of people. yes, the measures to reduce gasoline lead, and house paint lead, have greatly helped reduce lead pollution across society in general... but there are many other sources of exposure that affect huge numbers of people from other sources. For example: sport fishing with lead sinkers, pollutes the interiors of tackle boxes with fine powder from sinkers rolling around against each other. This particulate contaminates, wet hands, lunches, cooler ice, and caught fish. The contaminated fish go into the frying pan at home to repeatedly dose the family. This never gets investigated because legislators do not want it to be known that this is a great risk to parts of society to fish regularly... the legislatures will not fund any water quality -responsible agencies or public health agencies to investigate such pollution. The state fish and game departments do not want to have to switch their regulations to using alternative (less toxic) ways to weight lines. People suffer because of current fishing sinker use. This is crazy public health policy, directly attributed to legislative failure to deal with it because of NRA and industry lobby pressures. The state fishing regulations that guide families allow and encourage sinker use. None of these sources are given any attention or grant funding to investigate the resultant pollution, and this is never reported to EPA for Clean Water Act or the Clean Drinking water act (as required by law and the 303d process). Children are harmed, largely because lead is an ACCUMULATIVE toxicant. Blood lead testing does NOT indicate the body burden, and a low blood lead result can mask the body burden. IMHO

4. The regulatory state agencies are themselves regulated by the legislators, who set the tone of how much pointedly investigative water quality assessment that they will tolerate ... or not tolerate. Almost all state legislatures erroneously see accurate water quality assessment effort by agencies as being politically and fiscally subversive, and they reduce funding to agencies that persist in making too many waves by sampling and assessment that might point out where new problems might need fixing. This attitude by the governments are usually pervasive (in most states as well as MI), and stifle agency intent. As this persists over many years it builds up a strong culture within the agencies of promoting those that will put up with the politic without comment or corrective actions and recommendations, or demoting any potential troublemakers. Currently, unsupportive legislators rule most environmental quality departments and stifle the science of environmental assessment and public health protections from toxic contaminants. We get what we pay for... or, we get what we do not want because we don't bother to vote for. The 'buck' stops with who we place into office hired to look out for our public health needs, but shirk those duties in favor of corporate lobbies to ignore almost all water quality threats. Funding does note prioritized to essential science that is needed to guide our ability to SAVE money by discovering our toxic health threats so we can work toward correcting them as we are able to manage so that we no longer have to continue to pay way off into the future with health declines and medical expenses. Corporations externalize their costs onto the public in order to maximize profit.... and lobby legislators to ignore environmental assessment where ever it can be suppressed. A lot of agency 'busy work is done to fake 'due diligence' but that is not science, and it is not GOOD politics that is supportive of the public wellbeing. The whole state government is to blame, because the system is broken by bad oversight. The federal agencies are similarly irresponsible for the same reasons. IMHO

5. Lead is obviously harmful and exposure should be reduced. Lead paint is still the greatest remaining concern as illustrated this week by a child in Washington DC whose blood lead was above 100 ug/dl because of lead paint in the home being rented under public housing authorities. Flint was a terrible situation that should never have happened. The only good news is that blood lead levels were only   slightly  elevated in about 2 % of the children to above 5 ug/dl--according to  the 2016 CDC report. There was no increase above 10 ug/dl. For perspective, the 2nd NHANES  national survey for 1976-1980 showed the AVERAGE child  blood lead for the country was 16 ug/dl. Average child blood leads in the US are now about 1 ug/dl. The 5 ug/dl CDC number cited above is their 'reference' level that they estimate 97.5 % of children are below. I suspect they will soon change  the reference level because more than 97.5 % are now probably below 5 ug/dl.  Lead in children has dropped precipitously since the elimination of leaded gasoline, removal from food can solder, and elimination of lead based solder from water applications in 1986, and more lead service line removals. There are now about  50% fewer lead service lines  since the 1991 Lead and Copper Rule was implemented, It is not always necessary to remove lead service lines to control lead leaching; proper corrosion control,such as phosphate addition at the water treatment plant  works very well.

   So it is important to keep focus on the major problem which is old lead paint. Flint was an aberration. The problem in Flint was that the Lead and Copper Rule was not being enforced by the  State of Michigan, which was their legal responsibility. Standard practice was not being followed when they changed water sources that increased the corrosivity of the water. The water taste, odor and color were so obviously bad that few people drank it. That is why there were not very high blood lead levels.

   2 Comment replies

   1. Ray-Right! I think blood lead half life is about 30 days. The good thing about the Flint child CDC data is that it represented thousands of samples in each period, before, during and after the water changes.  By the way, I checked the Detroit data from 2013 (where Flint did and now gets its water).  The Detroit blood leads were higher than Flint's in 2013 and  also during the Flint problem.  Detroit had about 8% above 5 ug/dl whereas Flint's were around 3% in 2013. I think a lot of both are coming from old housing with old lead paint. Pennsylvania also reported a lot of cities with elevated blood leads which they attribute mostly to lead paint. The other source in water that nobody mentions is adsorption and release from old galvanized iron pipe, again old housing that has not been rehabed.

   2. Good information Joseph, thanks. The blood lead levels used to indicate harm potential status and trends in public health can be very misleading, since they primarily only indicate current lead exposures or uptake only during the last several months. Blood lead levels quickly reduce by the body sequestering the lead in bones and teeth in accumulative fashion. This sequestration does help the current toxicologic risk of other physiologic pathway degradation, but tends to only put off the risks until stresses later in life (old age, illness, or pregnancy) develop to cause the body to seek to mobilize the calcium stores in bone to fill the sudden need for added calcium to build defensive molecules needed to counter the stresses. At such times, calcium is low in supply, and since the body does not correctly identify lead as being other than calcium, lead comes out with the Ca and becomes incorporated into the defensive components being made from calcium and zinc. This contamination of stored lead makes many of the molecules such as zinc finger proteins dysfunctional. The body thinks that it has responded well to the stress but has not because the accumulated body lead has poisoned the bodies defenses. Blood lead levels can thus drop well, because either the exposures have lessened, or because the body has been effective in storing it in bone, or both mechanisms. Any time the bbl drops, helps the current pathogenicity of the lead to the immediate physiology, but usually only postpones the damage till later in life when stresses remobilize it at precisely the vulnerable times of old age, illness, or pregnancy. Once body burden has increased, we all have increased risks through life from that lead uptake that has occurred earlier. The public health paradigm commonly misrepresents the meaning of the blood lead testing results, erroneously giving the impression that the dangers from the lead exposures have all passed, but science is not served well by this incomplete picture provided by the authorities. Bone lead levels are now 100 to 1000 times those that prehistoric bones had accumulated. Our bodies have not had evolutionary time elapsed to adapt better defense mechanisms to the greatly increased environmental pollution once we dug the lead up out of the ground and dispersed it around the globe as products that easily degrade to be taken up to contribute to our health challenges. As you say, prevention is primary, because once in the body, much of it stays there to eventually do more damage.