Book Review Health AffairsVol. 32, No. 10: Economic Trends & Quality Trade-Offs Lead Debate: Protecting America’s ChildrenElizabeth Fee AffiliationsNational Institutes of Health Elizabeth Fee ( [email protected] ) is the chief historian at the National Library of Medicine, National Institutes of Health, in Bethesda, Maryland. PUBLISHED:October 2013Free Accesshttps://doi.org/10.1377/hlthaff.2013.0762AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSChildren's healthPublic healthDisabilities The prolific team of Gerald Markowitz and David Rosner has done it again. Lead Wars: The Politics of Science and the Fate of America’s Children is a thoroughly researched, passionate, and gripping history of a major public health problem—ameliorated, to be sure, but neither eradicated nor forgotten. The authors’ main research documents came from an unusual source. The New York City Law Department had amassed a huge trove of documents gathered though the discovery process of a lawsuit against the lead industry. The families who filed the suit claimed that their children had been injured by ingesting lead paint. Many of the documents from the Lead Industries Association recorded the minutes from meetings where representatives of lead paint producers discussed the dangers of lead paint poisoning, even as they developed strategies to present their products to the public as perfectly safe. The city wanted to know what these hundreds of thousands of documents could reveal about the history of lead and lead poisoning, so it asked Markowitz and Rosner to review them and find out. This book came out of that research.The book also circles around the recent legal and ethical controversies about lead paint research conducted at the Johns Hopkins University by J. Julian Chisolm and Mark Farfel. There was no doubt about both Chisolm’s and the younger Farfel’s dedication to protecting inner-city children from lead paint poisoning. But some have called into question the organization of one particular experiment.In the 1980s it was not known whether partial lead removal (abatement) from the walls and windows of dilapidated housing could protect children from lead paint poisoning or whether the much more expensive and complete process of lead abatement was necessary. The question was significant because landlords and city governments generally responded with hostility to the notion of spending a lot on lead paint removal. Chisolm and Farfel put single mothers and their children into three categories of housing: one-third in houses with complete lead abatement, one-third in houses with partial lead abatement, and one-third in houses where no abatement had occurred. They then studied lead levels and lead’s effects on the people in each group, obtaining comparative data. Because of its deliberate exposure of some children to lead paint, this research was denounced by some as akin to the Tuskegee study of syphilis or even to Nazi experimentation on humans.Markowitz and Rosner argue throughout this book that society as a whole has been conducting a grand human experiment by subjecting us all to many materials and chemicals whose long-term effects on our bodies are unknown. Children—in particular, poor black children—are sacrificed all the time to known toxins such as lead.Lead Wars also traces the distressing, century-old story of the struggle to limit the damage done by lead. We learn of a litany of discoveries, each revealing that lead was poisonous at lower and lower levels—and that even very low levels caused behavioral problems, learning disabilities, and reduced intelligence quotient in the children affected. The authors chronicle the political and ideological shifts that have encouraged or discouraged environmental regulation, applying pressure on federal agencies, such as the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Environmental Protection Agency.In the book’s final chapters, Markowitz and Rosner address the public health debate about primary prevention and harm reduction: Where prevention of disease or disability appears difficult or impossible, is it reasonable to focus instead on limiting harm? The authors clearly champion complete prevention but also recognize that, for political or economic reasons, it may not be feasible. They point to society’s lack of will and the general failure of the public health profession to make common cause with the poor, the disenfranchised, and social activists. As a result, the authors say, we will all remain “research subjects in a grand experiment without purpose.” They note that moral leaders, from Mahatma Gandhi to Hubert Humphrey, have stated that a society may be measured by how it treats its children. By that standard, our society is still lacking. Lead Wars challenges us to take better care of our children by fighting those industries that appear to regard them—especially poor black and Latino children—as disposable. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 October 2013 Information Project HOPE—The People-to-People Health Foundation, Inc. PDF download
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