Toxic Environmental Exposures: Science and Health Impacts

1
Toxic Environmental Exposures Science and Health
Impacts
Lead and Child Development or Why the CDC Should
Lower The Blood Lead Action Level From 10 to 2
mcg/dL
Out of Harms Way Preventing Toxic Threats to
our Childrens Health October 15, 2005 Spokane,
WA
Steven G. Gilbert, PhD, DABT www.asmalldoseof.org
2
Agency Blood Lead Levels
3
Canfield et al, 2003
Conclusions Blood lead concentrations, even
those below 10 mgc/dL, are inversely associated
with childrens IQ scores at three and five years
of age, and associated declines in IQ are greater
at these concentrations than at higher
concentrations. These findings suggest that more
U.S. children may be adversely affected by
environmental lead than previously
estimated. Canfield et al. 2003, NEJM, 384
4
Lead Based Paint
1887 - US medical authorities diagnose childhood
lead poisoning 1904 - Child lead poisoning linked
to lead-based paints 1909 - France, Belgium and
Austria ban white-lead interior paint 1914-
Pediatric lead-paint poisoning death from eating
crib paint is described 1921 - National Lead
Company admits lead is a poison 1922 - League of
Nations bans white-lead interior paint US
declines to adopt 1943- Report concludes eating
lead paint chips causes physical and neurological
disorders, behavior, learning and intelligence
problems in children 1971- Lead-Based Paint
Poisoning Prevention Act passed
5
Lead Industry Advertisements
History of Lead Industry Advertisements
(LINK) http//www.cincinnatichildrens.org/research
/project/enviro/hazard/lead/lead-advertising/defau
lt.htm
http//www.cincinnatichildrens.org/research/projec
t/enviro/hazard/lead/lead-advertising/default.htm
6
A Small Dose of .
Toxicology The Vulnerability of Children
7
Lead In Homes
8
Lead - Absorption
Orally Consumed Lead Absorbed In Place of
Calcium CHILDREN 30-50 OF LEAD ADULTS 5-10
OF LEAD Increased During Pregnancy
9
Lead in Families
10
A Small Dose of .
Exposure (multiple sources)
11
Recycling Lead
12
Sources Of Lead

• Lead Paint
• Dust, Soil
• Water
• Industry
• Hobbies
• Traditional Ethnic Remedies

13
Lead in Jewelry
http//www.leadinspector.com/
14
Children Candy Lead
Data from WA DOH (http//www.doh.wa.gov/EHSPHL/Epi
demiology/NICE/Lead/candy.htm)
15
WA State Guidelines
The Washington State Department of Health advises
consumers not to eat candy from Mexico or
southeast Asia that contains tamarind or chili
powder. (http//www.doh.wa.gov/EHSPHL/Epidemiology
/NICE/Lead/candy.htm) California also has
documented lead in candy. See the Orange County
Register series on lead in candy
http//www.ocregister.com/investigations/2004/lead
/index.shtml
16
Lead in WA Candy
Data from WA DOH (http//www.doh.wa.gov/EHSPHL/Epi
demiology/NICE/Lead/candy.htm)
17
Pottery with Lead
Data from WA DOH (http//www.doh.wa.gov/EHSPHL/Epi
demiology/NICE/Lead/pottery.htm)
18
Lead Lunchboxes
The Center for Environmental Health (CEH)
http//www.cehca.org/lunchboxes.htm
19
Policy Implications
Drinking water in Seattle Schools
20
A Small Dose of .
Health Effects ( 21
Needleman, NEJM, 1979
22
Consequences for Society
(Slide from B. Weiss)
23
Lead-associated Reading Deficits in U.S. Children
Reading Score
Blood lead levels (?g/dl)
Lanphear BP, et al. Public Health Reports
2000115521-529. (BLs slide)
24
IQ and Blood Lead

• Life time overall
• Increase in 1 mcg/dl 0.87 IQ drop
• Covariates - 1 mcg/dl 0.46 IQ drop
• 1 to 10 mcg/dl (bigger drop)
• Increase in 1 mcg/dl 1.37 IQ drop
• Non-linear - 1 mcg/dl 7.4 IQ drop

Canfield R, et al. NEJM 20033481517-1526
25
IQ and Blood Lead
Canfield R, et al. NEJM 20033481517-1526.
(slide from BL)
26
Cost of Childhood Lead

• Assumptions in calculating costs
• All lead is harmful and from environment
• Blood lead of children age 5 2.7 ug/dl (CDC)
• 5-year old boys (1,960,200) and girls (1,869,800)
• 1 ug/dl of lead 0.25 IQ point reduction
• Cost boys 27.8 and girls 15.6 Billion
• Total Costs 43.4 Billion

Environmental Pollutants and Disease in American
Children Estimates of Morbidity, and Costs for
Lead Poisoning, Asthma, Cancer, and Developmental
Disabilities, by Landrigan, P. et al. EHP, 110,
July 2002, 721-728.
27
Policy Consequences of Lead
The Centers for Disease Control and Prevention
action limit of 10 µg/dL for children fails to
protect against most damage and economic cost
attributable to lead exposure.
Stephen J. Rothenberg and Jesse C. Rothenberg,
Testing the Dose-Response Specification in
Epidemiology Public Health and Policy
Consequences for Lead Environ Health Perspect
1131190-1195 (2005)
28
A Small Dose of .
Ethics Precaution Environmental Justice
29
Human Environmental Health
To ensure that all living things have the best
opportunity to reach and maintain their full
genetic potential. Steven G. Gilbert, 1999
30
The First Bioethicist
Aldo Leopold
"A thing is right when it tends to preserve the
integrity, stability, and beauty of the biotic
community. It is wrong when it tends otherwise."
- Aldo Leopold, 1949, A Sand County Almanac
---------- 1887 - 1948 ----------
31
A Small Dose of .
Regulation (CDC Guidelines)
32
Current CDC Policy
33
Proposed CDC Policy
34
Policy Implications
An Ethical and Precautionary Approach to
Protecting Our Children Drinking water in
Seattle Schools
35
Agency Blood Lead Levels
36
Lead 10 to 2 Campaign
Steven G. Gilbert www.asmalldoseof.org sgilbert_at_in
nd.org
37
Lead - References
EPA Lead site the best http//www.epa.gov/oppt
intr/lead/index.html
CDC Childhood Lead Poisoning Prevention Program
http//www.cdc.gov/nceh/lead/lead.htm
A Small Dose of Toxicology www.asmalldoseof.org
38
Authorship Information
This presentation is supplement to A Small
Dose of Toxicology
For Additional Information Contact Steven G.
Gilbert, PhD, DABT E-mail smdose_at_asmalldoseof.org
Web www.asmalldoseof.org
39
A Small Dose of Toxicology
See www.asmalldoseof.org -- smdose
40
A Small Dose of Lead