the broader public also joined together to press for greater regulation following publication of Rachel Carson’s Silent Spring in 1962, with its vivid account of the devastating effects of DDT and other pesticides on birds and other wildlife, and then the revelation in 1966 that PCBs and other chlorinated hydrocarbons were accumulating in animals—including Homo sapiens—at the top of the food chain. Similarly, Congress began to pay more attention to pollutants following passage of the first Clean Air Act in 1963.
By the late 1960s, environmentalists, politicians, community activists, conservationists, scientists, and public health officials understood that lead was one pollutant that challenged them all. It was in the air people breathed and, as the previous decade had made clear, it was on the walls of the nation’s housing. With the new decade, physicians were more effectively treating the symptoms of acute lead poisoning, public health personnel were active in establishing more lead-screening programs to identify children most at risk, and community groups and others were calling for stronger housing codes and more effective enforcement for existing ones. But as they seemed on their way to solving one problem, all through the 1970s they would discover new ones that were in some ways ever more troubling, uncovering literally millions of children at risk of developing life-changing neurological and behavioral problems from the slightest exposure to this devastating metal, while intense resistance from the lead industry continually tried to discredit the new research.
AN INADVERTENT ADVOCATE
Within the government, a federal official played an instrumental role in getting Washington to acknowledge the importance of childhood lead poisoning. Jane Lin-Fu came to her work by a circuitous route. Born in Singapore of Chinese parents, Lin-Fu spent her early years in Shanghai, where her father, a teacher educated in China and the United States, joined his brother Lin Yutang, then a rising journalist, to work as a journalist at China Critic, an English-language periodical. Her father, a Quaker, had a strong sense of social justice, and she still remembers how upset he was by the British treatment of Gandhi. Her mother was well-educated, pragmatic, a strict disciplinarian and a devout Christian. Jane was raised to believe she shouldn’t worry what others thought as long as she was doing the right thing before God. “This upbringing molded me to be the free spirit who would take up social justice issues like lead poisoning, speak the truth about lead as I saw it, and not be intimidated by bureaucratic or academic authorities,” she believes.1
In 1937, when the Japanese Army invaded China, her parents fled with her to the Philippines, where Jane later attended medical school before coming to the United States in 1955. She accepted an internship, followed by a pediatric residency, at Brooklyn Jewish Hospital, an institution that served many children from the impoverished neighborhoods nearby—in what was later referred to as the “lead belt.” One summer, a two-year-old came to the clinic with a stomachache and vomiting. The physician thought the boy had summer flu but admitted him because he was quite dehydrated. On the ward, the child began convulsing and the attending doctor mentioned it might be lead poisoning. The event made a lasting impression on Lin-Fu.2
In the early 1960s her husband joined NASA and they moved to the Washington, D.C., suburb of Bethesda. She was a board-certified pediatrician, but she wanted a part-time job with the federal government so she could spend time with her children. In November 1963, just after John F. Kennedy’s assassination, she was hired by Alice Chenoweth at the Maternal and Child Health Program in the Children’s Bureau.
When Kennedy became president, the plight of his sister Rosemary led him to make a concerted effort to focus the nation’s attention on the study and treatment of mental retardation. The Children’s Bureau, a beneficiary of the subsequent funds appropriated by Congress for that purpose, helped develop statewide screening programs for phenylketonuria (PKU), a genetic disorder that causes mental retardation. Newborn PKU screening was a particularly exciting area then because, for the first time, severe mental retardation in children who suffered from this genetic disorder could be prevented through large-scale screening, early diagnosis, and dietary treatment.
When a colleague happened to ask Lin-Fu in 1965 what she knew about lead poisoning as a cause of mental retardation, the question triggered a flashback to that little boy who had convulsed from lead encephalopathy in Brooklyn Jewish Hospital a few years earlier. As she looked into the issue she was horrified to realize that her own training had not included lead poisoning, even though research indicated the prevalence of the problem in old, poor neighborhoods like the ones surrounding the hospital where she had done her residency. She was also deeply troubled that the Maternal and Child Health Program in the Children’s Bureau, which was so active in preventing mental retardation caused by the PKU condition, was not doing anything about lead poisoning so common in young children living in dilapidated dwellings. “This is really unfair because poor children have no voice in society,” she recalls thinking at the time. She could not understand how “we could ignore such a simple and readily preventable issue.”3 By December 1965, she had reviewed the existing literature on childhood lead poisoning and written a draft report on the subject that was intended as an internal memo. The Children’s Bureau was so impressed, however, that it sent the draft to outside reviewers, including J. Julian Chisolm, and then published it. That became Lead Poisoning in Children, a widely circulated 1967 government booklet that was instrumental in drawing the attention of Congress and the public to the lead problem.4
It also attracted the attention of the lead industry. “When my booklet came out in 1967,” Lin-Fu recalled, “the lead industry wanted to reprint it [with a gloss of their own accompanying it], and they hired Hill & Knowlton to contact me. . . . The industry found my early work useful because it emphasized that the [main] problem was lead paint, not all the other [lead-related] environmental issues [such as lead in gasoline, then the dominant interest of the lead industry]. . . . The lead industry kept sending public relations representatives to me to be my friend. They would call to chat and have lunch with me. They would be friendly and try to keep track of my work.”5 While the federal government distributed more than 28,000 copies of Lin-Fu’s pamphlet, this effort, as historian Christian Warren puts it, “paled next to the efforts of the Lead Industries Association which distributed 61,000 copies [of Lin-Fu’s work]. . . as part of its free booklet, ‘Facts about Lead and Pediatrics.’”6
Lin-Fu’s publication reflected the prevailing view of the time that lead poisoning was a problem mainly limited to “slums” and poor children, largely ignoring lead in gasoline, which exposed all children, rich and poor, urban, suburban and rural. People in public health and community organizations such as the Young Lords and the Black Panthers helped bring this scourge to public attention.7 But even so, many practitioners simply did not recognize lead poisoning because the symptoms were nonspecific except in extreme cases. Others thought lead poisoning “went away” when titanium oxide replaced lead as the major pigment in interior paint in the 1940s.8
Arthur Lesser, a well-respected federal public health official who was director of the Maternal and Child Health Program in the Children’s Bureau, said to Lin-Fu one day, apparently exasperated by her insistence about the lead issue, “You did not discover anything. We know lead poisoning was there, but this is a housing problem, not a public health problem. You screen children, diagnose them, treat them and send them home to eat lead paint again. Are you going to fix their houses and remove the lead paint? Obviously not. This is a housing problem—what do you want us to do?”9
THE EMERGENCE OF “UNDUE” LEAD ABSORPTION
While Lin-Fu remembers herself as naïve, someone who just tried to do the right thing, ignorant of the bureaucratic and political workings of the White House and Congress, she was in fact a very effective political infighter. Although she did not have a public health background, Lin-Fu saw lead poisoning from the position of a pediatrician and a mother of young children. In contrast to the kind of bureaucratic view Lesser expressed, she did not see why a housing problem causing such serious lead poisoning in children was not also a public health problem. As she put it, “It was a football bounced
