The lingering danger to children from lead.

The lingering danger to children from lead.

The lingering danger to children from lead.

Health and medicine explained.
Aug. 21 2007 12:47 PM

Getting the Lead Out

If only it were as easy as recalling the Mattel toys.

Sarge of the movie Cars. Click image to expand.
The Sarge toy car has lead paint

Mattel's recent recall of more than 1 million toys coated with lead paint has left parents feeling that their children's health was risked by poor safety procedures. So far, it's unknown whether the toys have harmed anyone. But as parents rush to doctors' offices to test their toddlers, many are bound to discover their children possess small amounts of lead, since epidemiological data before the Mattel scare suggest that millions of American children already have the heavy metal in their blood. These folks will be reassured by their pediatricians that the Centers for Disease Control and Prevention consider blood lead amounts under 10 mcg/dl —the amount present in many toddlers—safely below the "level of concern."

Unfortunately, recent medical evidence shows even trace amount of lead—at amounts now considered acceptable by the CDC—can damage a child's IQ. Why regulators refuse to believe the data continues a decades-old exercise in willful ignorance. And it's children who are still paying the price.


Doctors have known for more than a century that children could develop seizures and comas from severe lead toxicity, and that surviving victims were frequently brain-damaged. The question has become—and remains—how much lead is too much? Though federal authorities refuse to admit it, it's increasingly clear that no safe threshold for lead exists, and even the tiniest amount can hurt children's developing brains.

While tainted toys are in the news now, kids historically have gotten lead from two sources: the atmosphere and house paint. Roughly a quarter-million tons of lead compounds entered the atmosphere annually beginning in 1922, after a General Motors scientist developed a lead-based gasoline additive that prevented auto knocking. Lead's chemical durability, recognized centuries ago, also made it an attractive paint additive. Toddlers are particularly susceptible to eating lead paint because it has a sugary taste; ancient Romans used lead powder to sweeten wine. By 1980, more than half a million American children—4 percent of all toddlers—had quite toxic blood lead levels from these sources.

Initially, the Centers for Disease Control thought kids' brains could tolerate up to 60 mcg/dl of lead because no seizures occurred at that level. But in 1979, Dr. Herbert Needleman reported in the New England Journal of Medicine that lead levels considered safe by the CDC—though far lower than needed to produce seizures and coma—correlated with lower IQs in children. Later, his group reported that lead-poisoned children were more likely to drop out of school and have reading disabilities.

But lead controls were slow in coming, due to powerful industry resistance. As exhaustively recounted by journalist Jamie Kitman, the lead lobby openly retaliated against those promoting regulation. In the 1970s, Du Pont and Ethyl, the largest manufacturers of lead additive, sued the Environmental Protection Agency to repeal tighter emissions standards. Though lead paint in homes was banned in 1978, pro-lead lobbyists persuaded then-Vice President George Bush in 1982 to recommend removing limitations on leaded gasoline (the effort ultimately failed). In the 1980s, the Reagan administration barred the CDC from collecting data on national pediatric lead levels. To intimidate lead researchers, a bitter harassment campaign was launched against Needleman.


Though faced with more and more data from independent researchers about lead's dangers, the federal government chose an excruciatingly slow approach to children's health. The CDC, in a leisurely fashion, dropped lead limits (subscription required) from 60 mcg/dl in the 1960s to 40 mcg/dl in the 1970s, ambled down to 25 mcg/dl in the mid-'80s, and finally got to 10 mcg/dl in 1991. That's where it remains stuck now.

But the bad news about lead keeps coming. In 2003, Bruce Lanphear and colleagues wrote in the New England Journal of Medicine that kids with lead levels less than 10 mcg/dl lost roughly 7 IQ points. (Though the average IQ is 100, a populationwide average loss of 7 points makes tens of thousands of children fall below 70, the general threshold for mental retardation.) Using independent data, David Bellinger of Harvard and Needleman later confirmed these findings, which were novel but not unexpected: Serious damage happens at levels now considered safe for millions of American kids. The data should have galvanized public-health authorities to pursue zero-tolerance lead policies, which would mean nationwide de-leading of unsafe homes. After all, the New England Journal of Medicine reported in 2001 that medicines can't recover lost IQ points from lead poisoning. Once gone, they're gone forever.

Yet no de-leading program happened. Instead, opponents of comprehensive lead removal blatantly politicized the latest science and hatched an economic justification for inaction.

Just before the CDC considered lowering lead limits once again in 2003, Secretary of Health and Human Services Tommy Thompson removed a qualified scientist, Michael Weitzman, from the CDC's lead advisory committee and then rejected the appointments of Bruce Lanphear and Susan Klitzman, the researchers who found toxic effects of lead at low levels. Instead, Thompson moved to appoint Joyce Tsuji, who worked for two companies that represented lead firms, and William Banner, who has stated publicly that 70 mcg/dl of lead is safe for children's brains—a view not shared by any respectable scientists. (The Union of Concerned Scientists and Rep. Henry Waxman publicized Thompson's abuses [subscription required].) But the political message had already been sent, and no lowered limit resulted. Today, all those parents whose children will be tested in the wake of the Mattel scandal continue to be falsely reassured that all is well, even if the kids have lead levels of 5 to 10 mcg/dl, which may cost them 7 IQ points.

Meanwhile, though the Mattel toys have been recalled, little has been done about the wider threat to kids from lead paint. Removing leaded paint (mostly from housing built before the 1970s) can cost tens of thousands of dollars per dwelling, for a total tally of $58 billion nationwide, according to a 2000 EPA report. But progress halted over a pointless debate over the dollar value of a child's IQ points. In 2000, the EPA estimated that national de-leading would ultimately cost taxpayers about $8,000 per saved IQ point. Conservative economists like Randall Lutter of the American Enterprise Institute argued this was not worth the cost. Using a bizarre analysis—based on estimates of how much parents were willing to pay out-of-pocket for drugs to remove lead—Lutter valued a child's intelligence at only $1,100 per IQ point. Arguing for looser lead standards, Lutter concluded that authorities should "reconsider the need for environmental standards that protect children more than their parents think is appropriate." Since 2000, no progress on lowering allowable lead limits has occurred, and in early 2007, Lutter was appointed to lead policy adviser at the FDA.

A few years ago, I talked with Bruce Lanphear at a conference in San Francisco, just after he'd been rejected from the CDC's lead advisory committee. Resistance to lead control is a historical problem, he said. He was clearly frustrated by the politics but said he'd continue working in the field with the hope that somebody will listen. Perhaps the Mattel fiasco will finally bring attention to the hidden toll of lead paint.