Lead Wars

Lead Wars: The Politics of Science and the Fate of America's Children

GERALD MARKOWITZ
DAVID ROSNER
Copyright Date: 2013
Edition: 1
Pages: 318
https://www.jstor.org/stable/10.1525/j.ctt2855gq
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  • Book Info
    Lead Wars
    Book Description:

    In this incisive examination of lead poisoning during the past half century, Gerald Markowitz and David Rosner focus on one of the most contentious and bitter battles in the history of public health.Lead Warsdetails how the nature of the epidemic has changed and highlights the dilemmas public health agencies face today in terms of prevention strategies and chronic illness linked to low levels of toxic exposure. The authors use the opinion by Maryland's Court of Appeals-which considered whether researchers at Johns Hopkins University's prestigious Kennedy Krieger Institute (KKI) engaged in unethical research on 108 African-American children-as a springboard to ask fundamental questions about the practice and future of public health.Lead Warschronicles the obstacles faced by public health workers in the conservative, pro-business, anti-regulatory climate that took off in the Reagan years and that stymied efforts to eliminate lead from the environments and the bodies of American children.

    eISBN: 978-0-520-95495-3
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-viii)
  2. Table of Contents
    (pp. ix-x)
  3. Foreword
    (pp. xi-xii)
    Carmen Hooker Odom and Samuel L. Milbank

    The Milbank Memorial Fund is an endowed operating foundation that works to improve health by helping decision makers in the public and private sectors acquire and use the best available evidence to inform policy for health care and population health. The Fund has engaged in nonpartisan analysis, study, research, and communication since its inception in 1905.

    Lead Wars: The Politics of Science and the Fate of America’s Children, by Gerald Markowitz and David Rosner, is the twenty-fourth book in the series California/Milbank Books on Health and the Public. The publishing partnership between the Fund and the University of California Press...

  4. Preface
    (pp. xiii-xvi)
  5. Acknowledgments
    (pp. xvii-xxii)
  6. 1 Introduction: A Legacy of Neglect
    (pp. 1-27)

    In August 2001, the Court of Appeals of Maryland, that state’s highest court, handed down a strongly worded, even shocking opinion in what has become one of the most contentious battles in the history of public health, a battle that goes to the heart of beliefs about what constitutes public health and what our responsibility to others should be. The court had been asked to decide whether or not researchers at Johns Hopkins University, among the nation’s most prestigious academic institutions, had engaged in unethical research on children. The case pitted two African American children and their families against the...

  7. 2 From Personal Tragedy to Public Health Crisis
    (pp. 28-51)

    By the mid-1950s the cat was out of the bag. Any doubt that lead exposure could permanently damage children was put to rest as researchers at Harvard documented continuing mental and neurological disorders among those ostensibly “cured” of acute lead poisoning, which was most often diagnosed after children showed a variety of symptoms, such as convulsions, muscle paralysis, “mental lethargy,” vomiting on eating solid food, and dizziness. For generations it was well recognized that workers in lead-based industries suffered severe neurological damage from lead poisoning, and by early in the twentieth century women and children were often barred from working...

  8. 3 Peeling the Onion: New Layers of the Lead Problem
    (pp. 52-86)

    Prior to 1970 and the establishment of the Environmental Protection Agency, the federal government rarely regulated environmental toxins. But by the late 1960s and early 1970s, environmentalists and public health officials were advocating such regulation to protect the food supply and improve air and water quality. The Food and Drug Administration had begun to expand its role in regulating foods and additives after a weed killer, aminotriazole, feared as a carcinogen, was found in cranberries just before the 1959 Thanksgiving holiday. Environmental activists and the broader public also joined together to press for greater regulation following publication of Rachel Carson’s...

  9. 4 The Contentious Meaning of Low-Level Exposures
    (pp. 87-121)

    The struggle over who would control the science and meaning of lead exposures continued into the 1980s as the lead industry recruited allies and sought to undermine the emerging scientific model that made its product the focus of regulation and increasing scrutiny. The election of Ronald Reagan in 1980 presented a wide range of polluting industries, lead included, with a fresh opportunity and a new lever to influence science and government policy, however. After a decade during which business leaders were caught off guard by the rising environmental movement, industry in the early 1980s sought to undermine the emerging scientific...

  10. 5 The Rise of Public Health Pragmatism
    (pp. 122-142)

    As concerns about lead contamination spread from the dangers of paint chips to leaded gasoline and lead-tainted soil and house dust, the problem of addressing the threat began to extend beyond the traditional limits of public health activity. In the 1960s, local public health departments headed the effort to address lead paint poisoning, and the medical care system treated acute lead-induced conditions. At the same time, local and federal housing authorities detoxified and remediated the often dreadful conditions that exposed children to peeling and flaking paint in both public housing projects and privately owned tenements neglected by absentee landlords. It...

  11. 6 Controlled Poison
    (pp. 143-167)

    During the 1980s in Baltimore, J. Julian Chisolm and his young colleague Mark Farfel had been at the center of research on, treatment for, and implementation of policies regarding low-level lead poisoning. The two researchers had shown that existing abatement practices advocated by public health officials and instituted in Baltimore and elsewhere were inadequate, if not dangerous, for young children exposed to lead. Children were being used as “canaries in the mines,” their blood lead levels and their deficits revealing—after the fact—which homes were “leaded” and which were not. State-of-the-art public health practice by 1990 typically identified children...

  12. 7 Research on Trial
    (pp. 168-197)

    Young Enid G. lived on North Monroe Street in the northwestern district of Baltimore, one of the two major African American neighborhoods that were part of the Kennedy Krieger Institute lead study.¹ She was born May 30, 1992, to a single parent who had lived at the North Monroe Street address since the summer of 1990 in a house that ostensibly had been completely abated in the late 1980s, and therefore was supposedly “lead free.”² In March 1993 the family was recruited to participate in the KKI Repair and Maintenance study, and Enid’s mother signed a consent form that would...

  13. 8 Lead Poisoning and the Courts
    (pp. 198-214)

    The Baltimore Kennedy Krieger case and the controversy surrounding it brought into high relief the contradictory strands of public health thought at the turn of the twenty-first century. Traditionally, public health had been a discipline that took prevention of disease as its primary, in fact vaunted, mission. That academic public health researchers at perhaps the leading research institution in the country could knowingly—without much internal questioning or debate—accept “amelioration” rather than prevention as a legitimate goal, and could use “vulnerable” children as study subjects, indicated how far the field had moved from its historical roots.

    While numerous members...

  14. 9 A Plague on All Our Houses
    (pp. 215-232)

    In 1992, just as the Kennedy Krieger Institute research was getting under way, prominent lead researcher Herbert Needleman and Richard Jackson, soon to be head of the CDC’s Center for Environmental Health division, bemoaned the ineffectual attempts to end the century-old affliction of lead poisoning. They were concerned that the size of the lead-poisoning problem, and the money and work required to solve it, had led to a “wave of pessimism. Self-styled realists, when confronted with [the high cost] to delead and improve the [millions of] dangerous houses in which children live . . . shrug and turn away.” They...

  15. Notes
    (pp. 233-286)
  16. Index
    (pp. 287-298)