Lead Wars. Gerald Markowitz
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THE GROWING EPIDEMIC: FROM BALTIMORE TO THE NATION
As early as 1951, the American Journal of Public Health acknowledged both the centrality of Baltimore and Johns Hopkins in the unfolding story of lead-poisoned children and the reality of lead poisoning as a nationwide problem. It chastised the public health profession for not recognizing the extent of lead poisoning, sarcastically asking “whether babies brought up in the shadow of ‘the Hopkins’ develop peculiar alimentary tastes not common elsewhere” and arguing that “if such is not the case, perhaps other health officers have been missing something.”27 This was indeed the case in Chicago, where Robert Mellins, a young Public Health Service officer, uncovered an epidemic of childhood lead poisoning in 1953. Mellins had been assigned to Chicago in response to the continuing polio epidemic that terrified the nation in the post–World War II era. His first day in Chicago, he learned from local health personnel about what they feared was an outbreak among the city’s children of St. Louis encephalitis, a serious mosquito-borne neurological disease. Having been a medical student at Johns Hopkins in the late 1940s and early 1950s, Mellins was aware that lead poisoning was often mistaken for encephalitis, which led him to question the diagnosis and suggest the children be reevaluated. What he had come upon was, in fact, the first epidemic of lead poisoning in Chicago that would be recognized as such.28
In an internal summary of his LIA activities in 1952, Manfred Bowditch once again used the image of a “major headache” in what was emerging as a major national tragedy. Calling childhood lead poisoning “a source of much adverse publicity,” he counted 197 reports of lead poisoning in nine cities, of which 40 were fatal, but acknowledged that this was an “incomplete” estimate, especially for New York City.29 Others also began to notice the scale of the epidemic. Between 1951 and 1953, according to George M. Wheatley of the American Academy of Pediatrics, as reported in the New York Times, “there were 94 deaths and 165 cases of childhood lead poisoning . . . in New York, Chicago, Cincinnati, St. Louis, and Baltimore.”30 By the standards of the time, these were of course only the most acute cases, often life-threatening; lead poisoning that caused lesser damage was neither the focus nor in many instances even attributed to lead.
The LIA was caught in a bind. On the one hand, it had in its possession numerous reports from health departments demonstrating the widespread nature of the lead paint hazard. On the other hand, the association was fighting a rearguard action hoping to convince officials and the public that the number of lead-poisoning cases was exaggerated. To continue in this fight, Bowditch confided to an industry colleague, would be “prohibitively expensive and time-consuming.”31 Bowditch did not dispute that childhood lead poisoning could come from ingesting lead-based paint. But rather than concentrate on how to prevent lead poisoning—toward which a first step would be the elimination of lead from interior paint—Bowditch believed the LIA should focus on “securing more accurate diagnoses of lead poisoning or face the likelihood of widespread governmental prohibition of the use of lead paints on dwellings.”32 Robert Kehoe, the longtime head of the Kettering Institute at the University of Cincinnati, a research center established and funded by the Ethyl and General Motors Corporations in the 1920s, admitted in 1953 in a personal letter that the problem was not diagnostics but the paint itself. If the elimination of lead paint “for all inside decoration in the household and in the environment of young children . . . is not done voluntarily by a wise industry concerned to handle its own business properly, it will be accomplished ineffectually and with irrelevant difficulties and disadvantages through legislation.”33
By the mid-1950s, newspapers and public health departments in other cities had begun to report more systematically on cases of lead poisoning. The LIA responded by trying to divert attention from the lead industry’s role in distributing a known poison, sometimes in the process even mocking the children who were poisoned. In a private letter to the editor of the American Journal of Public Health, Bowditch suggested that the high rates of lead poisoning in Baltimore indicated that there was “all too much ‘gnaw-ledge’ among Baltimore babies.”34 When he was being serious he was even more dismissive of the victims: the problem was not lead in the paint, it was the housing and the parents. In 1956 Bowditch wrote to a former head of the LIA, Felix Wormser, then assistant secretary of the interior—the federal agency responsible for regulating lead and other mining and metal industries—criticizing an article on childhood lead poisoning that had appeared in Parade, the nationally distributed Sunday newspaper supplement. “Aside from the kids that are poisoned,” Bowditch complained, “it’s a serious problem from the viewpoint of adverse publicity.” The basic problem was “slums,” he argued, and to deal with that issue it was necessary “to educate the parents.” “But most of the cases are in Negro and Puerto Rican families, and how,” Bowditch wondered, “does one tackle that job?”35
Bowditch was a bit more discreet in his statements to the LIA’s general membership. At the association’s 1957 annual meeting, he argued that “the major source of trouble is the flaking of lead paint in the ancient slum dwellings of our older cities”—though in saying this he obscured the fact that lead had been the main component of interior paint as recently as the early 1950s (and still constituted 1 percent of many wall paints for the next twenty years). “The problem of lead poisoning in children will be with us for as long as there are slums,” he said. But then he absolved the LIA of responsibility, again arguing that the real problem lay with the ignorant children and parents. “Because of the high death rate, the frequency of permanent brain damage in the survivors and the intelligence level of the slum parents, it [the issue of lead-poisoned children] seems destined to remain as important and as difficult [a problem] as any with which we have to deal.”36
But how could the problem be addressed? Bowditch was not optimistic: “until we can find means to (a) get rid of our slums and (b) educate the relatively ineducable parent, the problem will continue to plague us.”37 This argument, that it was inevitable that black and Puerto Rican children would be damaged by lead for the foreseeable future, set the stage for the next half century of lead-poisoning policy. With the lead industry unwilling to accept its responsibility for this epidemic or remove all lead from paint, and with only sporadic moves to restrict use of lead products and enforce the housing codes that did exist, doctors were forced to treat more and more children suffering from lead-induced acute symptoms of severe brain damage with powerful drugs, the “chelating agents” that when introduced into the blood stream could bind with lead, allowing it to be passed from the body through urination. The more sophisticated and progressive public health departments would sometimes visit children’s homes and remove the lead from the walls. At best, this helped to prevent further injury, but such remedial actions did little to forestall the housing, pediatric, and public health crises that were emerging. The industry’s proposition that lead poisoning was largely a problem of “flaking of lead paint in the ancient slum dwellings of our older cities” rendered it a disease of poverty and the socioeconomically deprived. As lead poisoning became increasingly defined as a problem of poor African American and Latino children in urban slums, in this pre–civil rights era there was no active political constituency capable of making it a pressing concern.38
From the very first, then, lead poisoning and housing were inextricably linked. For housing officials, removing lead paint was (and still is) an expensive procedure that landlords were often unwilling to undertake. And housing officials in the few cities that passed regulations to control lead often ignored