to testify about the history of lead poisoning in Maryland’s House of Delegates in conjunction with a hearing on proposed legislation. Lead poisoning had a special resonance in Maryland at the time because of the continuing epidemic that affected Baltimore’s children in particular and because of a highly controversial court case that had attracted national attention and was still fresh in the minds of community advocates, researchers, and legislators. This case, which revolved around research conducted at Johns Hopkins University involving more than a hundred African American children, is a leitmotif that runs through this book. As we looked into the case (in which we had played no role) and the circumstances behind it, we realized that it offered a window into the broader arguments about lead poisoning, society, and the emerging scientific evidence on the harmful health effects of relatively low-level exposure to various pollutants, lead among them.
If the history of lead poisoning has taught us anything, it is that the worlds we as a society construct, or at least allow to be built in our name, to a large extent determine how we live and how we die. The social, economic, political, and physical environments humans create bring about specific diseases that are emblematic of these conditions. If poverty, for example, and great disparities of wealth result in those on the bottom of the social scale living in crowded conditions without access to pure water, adequate sanitation, or pure air, we can expect infectious and communicable diseases to predominate as they did in nineteenth-century American cities. If we systematically pollute our water and air, we can expect chronic diseases emblematic of the late twentieth century to predominate.
Lead poisoning is a classic example of what happens when we take a material that was once buried deep underground and with which humans rarely had contact and introduce it widely into humans’ ecology. In the 1920s, the additive for gasoline, tetraethyl lead, was called a “gift of God” by an industry intent on profiting from it. Despite warnings at the time that this industrial toxin might pollute the planet, more than a half century passed before it was finally removed from gasoline. In the 1920s and 1930s, asbestos was touted as a “miracle mineral” despite its identification as a cause of fibrosis and cancers among industrial workers. Yet it too was broadly introduced into our homes, schools, and workplaces with little or no controls. From the depths of the Depression through the Cold War years, the tobacco industry used physicians themselves to sell cigarettes, promoting smoking as a means to reduce stress and enhance one’s personal appeal. In the 1940s and 1950s, DDT (marketed as “Doomsday for Pests” and even sold to consumers in a Sherwin-Williams paint called “Pestroy”),3 PCBs, and a variety of other poisonous chlorinated hydrocarbons were poured over our farmlands and began appearing in the tissue and blood of virtually all animals, people included, the world over. Today, bisphenol A, a proven endocrine disruptor, has been used in a wide variety of consumer products, including baby bottles, superglue, and water bottles, leading to the discovery that, like PCBs, it is in virtually all of us. Few of the synthetic materials that have been introduced into our environment and therefore into our bodies have been tested for their long-term health effects. Even more troubling, we are often not sure how to go about doing the appropriate testing or evaluating whatever data we accumulate.
This book is about an ongoing grand human experiment in which we as a society are unwitting subjects. It is about a test that is taking place on all of us, a test of thousands of existing materials and chemicals, like mercury and PCBs, and new chemicals and materials whose safety is largely unproven and whose effects are unknown. None of the industries that are introducing these new chemicals and materials have told us that they are unsure of the potential harm these products may cause, nor have we consented to be part of this “study.”
We tell of this grand experiment through the modern history of the oldest and perhaps most widely dispersed environmental toxin, lead, a material that has ofttimes been marketed as an essential ingredient in industrial society. For the past hundred years mining concerns, pigment manufacturers, the auto and chemical industries, and a host of other companies have based their profits on this material. But for the past hundred years it has also been known that lead was killing workers in the factories that used it and children in the homes that were painted with it. Now scientists are learning that even those adults who thought they had escaped its immediate effects are at higher risk of heart disease, kidney damage, and even dementia. In Deceit and Denial, we detailed the early history of the industry’s knowledge of lead’s dangers, showing how lead was sold to the American public through advertisements and marketing campaigns that “catered to the children” and portrayed lead products as essential to American life.
This new book takes a wider view. It attempts to show how, in the case of lead, growing scientific understanding of the effects of the grand experiment has led to the “Lead Wars” of the title—sharp contests among advocates for children’s well-being, the lead industry and other interests that have played out in federal, state, and local government; the media; the courts; and the university. These contests have involved everything from the meaning of disease, primary prevention, and abatement to who should bear responsibility for risk and poisoning in the nation. For a century, children, poisoned primarily by leaded gasoline fumes and lead paint in their homes, have borne the overwhelming burden of this grand experiment in the form of permanent brain damage, school failure, loss of intelligence, and even death.
In these contests over lead exposure the public health profession has played a critical role, and it accordingly has a prominent position in this book; the struggles within it offer a microcosm of the contending forces as they have played out in the larger society over how best to regulate our environment and how to protect our children. As we showed in our earlier work, the lead industry ensured that children would be forced, as one physician put it, “to live in a lead world.”4 But the task of protecting children was left to a public health profession divided within itself that, despite some remarkable successes, has neither the resources nor the authority to do what’s needed on its own. The remedies that do exist have so far proven to be politically unfeasible. In the meantime, the nation continues to sacrifice thousands of children yearly, deeming them not worthy of our protection.
Acknowledgments
The journey we have taken over the past decade writing about the lead wars has given us the opportunity to meet and work with an extraordinary group of dedicated people. We have gotten to know and to learn from public health scientists who, at various times, have been invaluable guides through the maze of the science and politics as well as the moral and ethical dimensions of our story. We are indebted to the people we have interviewed and who provided us with primary documents, including minutes of meetings at the National Institutes of Health (NIH), the U.S. Environmental Protection Agency (EPA), and other government agencies and public forums.
Paul Mushak was particularly helpful, forwarding boxes of documents from his personal files as well as providing us with extremely useful interviews. He generously and quickly responded to our numerous requests for information and clarification as we drafted portions of our book. Bruce Lanphear has also been an invaluable source of information and critical comment. He twice read the entire manuscript and provided detailed and thoughtful criticisms that have proved enormously important to us. Dave Jacobs, whose work with the U.S. Department of Housing and Urban Development (HUD) was a critical part of lead’s history but largely lies outside of this account, was another extremely generous source. We spent days in his home sorting through the files he had accumulated from his years at HUD as well as other boxes of material of his wife, Kathryn R. Mahaffey, whose work on the dangers of mercury, lead, and other heavy metals while at various government agencies (including the National Institute for Occupational Safety and Health, the National Institute of Environmental Health Sciences, the U.S. Food and Drug Administration, and the EPA), deserves its own special attention. We will never forget Dave’s generosity, despite his still-recent loss. Don Ryan, founding executive director of the Alliance to End Childhood Lead Poisoning, and whose career we briefly outline, was another important source and generous colleague. He too gave unstintingly of his time, documents, and insights. One of the special pleasures we had was visiting Jane Lin-Fu at her home in suburban Washington, D.C. The day we spent with her provided us with invaluable information and perspectives
