In 2013, the year before a state-appointed official switched the source of drinking water for residents of Flint, Michigan, 2.4 percent of the county’s young children showed dangerously elevated blood-lead levels. By 2015, that figure had more than doubled, to 4.9 percent.
The cause of this tragic increase seems very clear: The city’s new water source—the Flint River—has enough chloride in it to corrode the lead pipes that compose the aging, local water-distribution system, thus releasing the toxic metal into the community. With good reason, Flint is now being used as a wake-up call to prevent lead exposures by updating America’s aging water systems. “The best solution would be to replace our lead lines systematically and proactively, not just one crisis-beset city at a time,” writes Chris Sellers for the Conversation. “Until we do so, it’s a safe bet that more Flints lie on our horizon.”
I completely agree, but let’s not forget the grim statistic that we started with—the 2.4 percent of Flint kids who had high blood-lead levels before lead contaminated their drinking water. Rather than focusing only on lead exposure from drinking water, perhaps we should treat Flint’s crisis as an alarm about all lead exposures.
While Flint is a special case, its victims are far from unique. In 2010, at least 243,000 American kids were diagnosed with elevated blood-lead levels, or BLLs. In the early 1990s, when the Environmental Protection Agency put in place comprehensive regulations for lead and copper in drinking water, the government estimated that contamination of the water supply accounted for just 10 to 20 percent of the nation’s lead exposure. Meanwhile, the fate of up to 70 percent of the kids who develop elevated BLLs can be attributed to eating or inhaling lead-contaminated house paint and dirt. And the remainder may be suffering exposure from other, unexpected sources: dietary supplements. Pottery and glassware. Candle wicks. Imported makeup. Cheap toys. Chocolate.
Some kids are even unintentionally poisoned by their parents. In 2003, the U.S. consumed 1.5 million tons and produced about 450,000 tons of lead. That’s a lot of lead—and a lot of people working with it: Approximately 48,000 families have one adult working with the metal, in industries such as construction, remodeling, mining, and recycling. At the end of the workday, lead-contaminated dust can ride home on a parent’s clothes, skin, and hair—a process known as “fouling the nest.” A 1999 meta-analysis estimated that the children in these contaminated homes were almost six times more likely to have elevated BLLs than those in the general population.
It may be more disturbing to learn that kids can be poisoned by the pills, powders, and supplements that parents use to keep them healthy. Unlike blood-pressure medication and pacemakers, the FDA has no authority to review supplements for safety and efficacy. Unsurprisingly, a 2003 study of 95 commercial dietary supplements, purchased from D.C.-area stores, found that 11 contained enough lead to be hazardous to children and pregnant women. The offending supplements contained bee pollen, spirulina, and shark cartilage, but the worst offender contained something called “pseudo-ginseng root” which had 81 times the tolerable lead intake for a child. FDA scientists found similar results in 1993 and 2004 analyses.
Poor manufacturing practices and a lack of oversight lead to some contamination of alternative medicine. Other medicines, including traditional Chinese, Ayurvedic, and Mexican remedies, may be formulated with lead on the theory that heavy metals are therapeutic. The consequences are predictable: Kids have developed acute lead poisoning after taking Mexican remedies such as azarcón and greta, and the Indian remedy ghasard. A 2015 study found that 40 percent of a sample of 115 American adherents of Ayurvedic medicine tested positive for elevated BLLs.
Lead can also contaminate imported toys and food. The Consumer Product Safety Commission has been kept busy issuing recalls for lead-contaminated toys from China—including a recall of 4 million children’s bracelets in the spring of 2007. And the huge amount of imported food absolutely overwhelms the FDA’s testing abilities.* As a result, imported food sold in the U.S. can be contaminated from the lead solder in cans and lead-based ink on wrappers. In 2001, candy was identified as the lead source for more than 150 Californian kids with elevated BLLs.
So with all this lead around—in workplaces, supplements, food, toys, dust, house paint, and water systems—what’s the best way to reduce exposure?
As the situation in Flint has made clear, we need to be more vigilant about lead pipes to prevent the sort of chronic lead exposure that elevates BLLs. But we should also pursue other measures, such as increased budgets for testing imported food and substantive regulation of dietary supplements. These measures could help reduce the sort of acute exposures that severely poison children.
Most importantly, we should work to reverse the $1.9 billion in cuts and the loss of 49,310 public health jobs from state health departments that have occurred since 2008. These are the people who are in the trenches: They track kids’ BLLs, so they know when there’s a problem. They counsel parents on how to avoid “fouling the nest.” They help inspect homes for lead paint—and then help remediate those homes. without the money to keep these people doing their jobs to stop lead exposures—from all sources—I can guarantee we’ll have more tragedies like Flint’s.