This time of year, I should be glad I don't have children. Not long before the current story about cell phones and DNA broke, there was a huge recall of costume jewelry because some of it contained lead. Lead, of course, is an automatically terrifying substance, even though it used to be in most plumbing, and of course it used to be in toy soldiers, most tin cans, and even toothpaste tubes:

Food came in cans sealed with lead solder. Water was often stored in lead-lined tanks. It was sprayed onto fruit as a pesticide in the form of lead arsenate. It even came as part of the packaging of toothpaste tubes. Hardly a product existed that didn't bring a little lead into consumers' lives. However, nothing gave it a greater and more lasting intimacy than its addition to gasoline.

Now, we are told that if your child puts a piece of jewelry in his mouth, he'll shave 2 points off his IQ. There's nothing new about these lead stories, of course.

This warning is typical:

Lead poisoning is epidemic in Cleveland. One-in-six children tested are lead poisoned. In some neighborhoods the rate is as high as 36%.

Lead poisoning is a personal and family tragedy. It robs children of their potential -they enter the race of life weighed down by lead:

If a child can't read, sit still, or stop hitting their playmates, it may be lead poisoning.

If a child drops out of school, can't get a job, uses drugs, it may be lead poisoning.

Lead poisoning makes it tough for children and their families. When there are lots of lead-poisoned children, it makes it tough for the entire community.

Worried about children's poor school performance - low proficiency scores and high drop-out rates? Worry about lead poisoning.

Worried about poor workforce preparation - inadequate work skills and low productivity? Worry about lead poisoning.

Worried about crime - delinquency, drug use, drug dealing, violence? Worry about lead poisoning.

Lead poisoning is not just a problem for the poisoned child and their family. Lead poisoning is a problem for the entire community. It's your problem too.

By examining the relationship between lifetime earnings and IQ, and the relationship between IQ and lead in blood, researchers have shown that the current average lead level in the nation's 3.8 million 5-year-olds (2.7 mcg/deciliter) will reduce their cumulative lifetime earnings by $43.4 billion dollars. This will be true of next year's 5-year-olds as well, so lead in blood is costing us about $43 billion each year in lost earnings alone (not to mention the lead-related costs of medical care and violence).[31]

In 2000, the federal government estimated that it costs $9000 to fully remediate an average lead-contaminated home and that complete remediation of all pre-1960 housing would cost the nation $16.6 billion per year for 10 years.[2, pg. 5] With benefits of $43.3 billion each year, investing $16.6 billion per year in lead abatement would provide the nation an enormous gain (extending well beyond 10 years), and would serve our national goal of "justice for all." Unfortunately, President Bush has allocated only $139 million for lead abatement in 2005 -- 20% less than in 2004, and less than 1% of what's needed. At the current rate of federal spending, the lead paint problem will be with us for another 120 shameful years.[32]

Are these claims exaggerated? At least one book says so:

Anyone who owns a house built before 1978--the year that Congress banned the use of lead paint--already must disclose all known information about lead in the unit and give the buyer a pamphlet about the dangers of lead, or face imprisonment and a fine of $10,000. In addition, there are regulators who would like to see all lead paint removed, an approach that would cost in excess of $30 billion. Moore argues that those regulators have greatly exaggerated the danger that most Americans face from lead. "Before government pours additional millions or even billions into lead abatement, before homebuyers shoulder extra financial burdens, and before the rental housing stock shrinks further, perhaps it is time to undertake a long-overdue reassessment of the premises on which the Department of Housing and Urban Development, the Environmental Protection Agency, and the Department of Health and Human Services, and Congress base their pronouncements and proposals."

In this paper, we will accept the association between lead exposure and mental deficit as fact; however, we will argue that, since in all of these studies the lead exposure was due to pica, it is not the lead exposure responsible for the mental deficit, but the mental deficit that is responsible for the lead exposure. Placing mental deficit rather than lead exposure as the cause has been referred to by commentators as the theory of reverse causation and, for clarity, we will use this term.

Who Can Get Pica?

• Pregnant woman. Most frequently, pica occurs in women before or during their pregnancies or while they are breastfeeding. The incidence of pica during pregnancy varies. It has been suggested that pica during pregnancy occurs more frequently in people who exhibited similar practices during their childhood and non-pregnant states.

• Those who have poor nutrition (malnutrition) or vitamin deficiency
Pica is also found in people who diet; they may attempt to ease hunger cravings with low-calorie and non-food substances. Sometimes, people with pica have family, ethnic, or religious customs that include eating a particular non-food substance.

• Mental Retardation
Pica also has been found among small children and people with epilepsy, mental retardation, and mental illness. Sometimes, several household members may share these cravings, and those in lower socioeconomic groups seem to have more non-food cravings than those in higher socioeconomic groups.

• People who have ethnic customs or live in cultures where this is practiced

For some pica is a cultural feature of certain religious rituals, folk medicine, and magical beliefs. Some people believe that eating dirt will help them incorporate magical spirits into their bodies. Still others believe that consuming certain kinds of clay can suppress morning sickness.

• Individuals who live in poverty

• A family history of Pica

Lingering Menace

Regina McEnery
Plain Dealer, 9/2/2001

On a blistering July day Ruquia Wilson walked outside and found her 18-month-old son, Angel Aponte, up against the porch railing of their first-floor apartment on W. 50th St., his red plastic bicycle momentarily forgotten. Tiny paint chips clung to his baby teeth.

Wilson feared that her son might have swallowed something harmful, but she was unprepared for what she learned next. MetroHealth Medical Center hospitalized Angel after a blood test detected a lead level nearly 12 times higher than levels that are considered safe.

...

Inspectors from the city of Cleveland later detected traces of lead on the front porch, where paint had cracked and peeled during the dry summer.

"I was freaked out," said a weary Wilson during the first of her son's two hospital stays. "I felt like it was my fault."

In the case of Lamont Stoves v. the City of New York, LPK Attorneys Alan J. Konigsberg and Adam R. Cooper obtained a compensatory verdict totalling $3,850,000 on behalf of an 8-year-old boy who was lead poisoned for over 5 years while residing in an apartment owned by the City of New York. The jury concluded that the City was negligent in failing to maintain the apartment and that the infant's lead poisoning was a substantial factor in causing his cognitive and behavioral deficits. Tried in New York State Court, Kings County, 1999. This is one of the highest verdicts for childhood lead poisoning in the country. According to a report in the November 19 1999 edition of the New York Daily News, the verdict "was one of the costliest lead-poisoning verdicts ever against the city, legal experts said."

In a long article in The Atlantic, Ellen Ruppel Shell argues that many of the premises of the anti-lead movement are as questionable as their data. The piece is subscription only, but there's an excerpt here:

"The triumph over lead is widely touted as one of the great public-health successs stories of the century, a stunning example of the strength of activism over vested interests," writes Shell. "But many are unwilling to declare victory, and the news media too have "picked up the chant, citing widespread low-level lead poisoning as the trigger for ills ranging from attention deficit disorder to juvenile violence." Shell sees things otherwise and writes that "the characterization of lead poisoning as a 'silent epidemic' is not scientific truth but a rhetorical pose." She writes that "symptomatic lead exposure that causes clear clinical effects of mental or physical impairment is exceedingly rare," and says factors such as birth order, parental attention, and parental education are far more important than low blood lead levels in influencing IQ. Among basic points made by Shell: She argues for targeted testing rather than universal testing for blood lead, and she suggests that stripping of intact lead paint from woodwork "should not take priority over patching a leaking roof or fixing a heating system that belches carbon monoxide." In the end, she writes, "only by targeting lead poisoning for what it is -- largely a disease of the poor -- do we stand a chance of beating it."

Government agencies are telling people that childhood lead poisoning is often named as the leading environmental threat to our children. This conclusion is not accepted by most practicing physicians, who almost never see a case of symptomatic lead poisoning.

The validity of Needleman's original studies and the scientific work and statements of some others involved with the 1991 CDC report have been questioned, as have other actions taken by the CDC, the EPA, and HUD. As early as 1983, the methodology and validity of Needleman's 1979 studies were challenged and were the subject of an investigation, as was the work of Claire Ernhart, whose studies on childhood lead poisoning did not support Needleman's conclusions (22). The findings of the investigatory board confirmed Ernhart's results but raised questions about inconsistencies in Needleman's work which were never resolved (22). In spite of this, Needleman, with support from federal grants and environmental advocacy groups, assumed an increasingly influential role as chairman and member of the CDC advisory committees and as consultant to government agencies--including the EPA. He played an important role in the CDC Advisory Committee on Childhood Lead Poisoning in 1977, 1991, and 1993, during which time the official CDC threshold of concern about PBb was lowered from 60 µg/dL (before 1970) to 40 µg/dL (1970-75) and then progressively to 30 µg/dL (1975-85), to 25 µg/dL (1985-91), and to ]0 µg/dL ( 1 991). It seems logical to empirically set the BPb level of concern lower than the reported symptomatic mean BPb ( 178 µg/dL) by a reasonable multiple. Indeed, the BPb level (25 µg/dL) which the CDC set as a cutoff for concern prior to 1991 was seven times lower than this mean symptomatic value and twice as low as the generally-accepted minimum symptomatic level (50 µg/dL). However, lowering the level of concern further to 10 µg/dL in 1991 at the behest of Needleman and other low-lead crusade protagonists at the CDC has unjustifiably resulted in a tenfold increase in "abnormal" results, thus creating parental anxiety, lack of acceptance among practitioners, and exorbitant costs--all based on contradictory evidence.

In 1990, Needleman cited his 1979 studies when he testified for the EPA in a case against a steel company (23). The validity of these investigations was challenged by Ernhart and Sandra Scarr, a psychology professor from the University of Virginia. Because his work was financed by federal grants, Needleman was ordered to reveal his original data (23). Partial review of these data by Ernhart and Scarr unearthed questionable data and methodology and resulted in an inquiry of Needleman's work by his own university, the University of Pittsburgh (24); and by the Office of Research Integrity (ORI) (25). The findings of these investigations--released in 1993 and 1994--were critical of the quality of Needleman's scientific methodology, but the multiple misrepresentations in his work fell short of the rigid current ORI definition of scientific misconduct: fabrication, falsification. and plagiarism (FFP).

The report of the University of Pittsburgh Hearing Board (24) found Needleman's studies to consist of a "pattern of errors, omissions, [and] contradictions" going back for many years.

In regard to a 1979 article by Needleman (14 ), the University of Pittsburgh Hearing Board unanimously believed that Needleman was deliberately misleading, stating that "if the paper had contained all the caveats it should have contained regarding subject selection and model selection, it might not have been published, and it certainly should not have been a basis for federal policy" (24). Nonetheless, this study was published and Needleman became a consultant for the federal 1991 CDC recommendations (1), which introduced universal childhood lead screening as well as lower BPb levels of concern.

A subsequent review by the ORI (25) seconded the University of Pittsburgh findings, confirming the "pattern of errors, omissions, [and] contradictions," and discovering additional defects. Needleman was found to have misplotted graph points in a way that was "difficult to explain ... [as] honest error" and to have ignored the pleas of Gunnoe, coauthor of the 1979 article (14), to correct known methodological errors before submitting the article to the journal. However, like the University of Pittsburgh, the ORI [begin p. 264] concluded that Needleman's scientific deficiencies could not be defined as FFP and thus did not constitute scientific misconduct. Commenting on this "fuzzy verdict," Taylor questioned the Pittsburgh Board's decision "for what most scientists would consider a reprehensible act: deliberately misrepresenting procedures used in a study to enhance the study's perceived value or its chances of publication" (26).

With these questions about validity of his scientific methods coming from both his own university (24) and the ORI (25), one would have thought that Needleman would have opted to moderate his views. A more realistic expectation was that medical journals, federal granting agencies, and the scientific community would have hesitated to support Needleman's work. Very little has happened, however. Because his multiple scientific infractions were not found to be FFP, Needleman claimed that he was "vindicated." He instituted lawsuits against his university (27) and the ORI (28), and preemptively published an article in Pediatrics attacking his critics and claiming he was a victim analogous to the Salem witches (29). Although Needleman was directed by the University of Pittsburgh to submit a correction to the New England Journal of Medicine indicating that his studies "were not as originally reported and did not meet scientific standards of reproducibility," he initially failed to do so. When he finally submitted a "correction" (30), his statement did not reflect the true nature of his errors as the University had directed (24). He was successful in gaining the support of environmental advocacy groups and a strong activist organization--which, however, he helped to found--the Alliance to End Childhood Lead Poisoning.

In 1996, after the reports of his university and the ORI had been released, Needleman published a paper claiming that increased delinquency was related to elevated bone lead (31). This study was again criticized for methodological irregularities (32. 33. 34), consistent with earlier demonstrated patterns of substandard science and contradictions. The article contained a major contradiction: that African-American boys with high bone lead levels not only had a higher rate of delinquency but had a greater mean IQ (31). In other words, according to the study. elevated bone lead levels resulted in smarter delinquents. When this contradiction was pointed out to him, Needleman's response was that it was "puzzling" (35).

I am not an expert on lead, although I did play with lead soldiers as a child, ate food which came from leaded tin cans, brushed my teeth with toothpaste from lead tubes, and I have fired, cleaned and handled firearms for many years. Not to be morally judgmental about other people or their parenting techniques, but I don't think my mom would have let me eat paint, so maybe I didn't ingest as much lead as the kids whose moms did let them do things like that. Actually, I don't think I was particularly known for eating paint, plaster, or even dirt.

But what if the dangers are being exaggerated? It strikes me that if they are, the public would never be told. The resources devoted to debunking and questioning these things are few and poorly funded, and usually amount to private skeptics like an occasional scientist, a writer here or there, or maybe someone with an axe to grind. They're all easily dismissed, and I'd be willing to bet that scientists like the one who questioned Needleman are denied funding, or (as I noted in an earlier comment), people see to it that they don't advance.

Thus, Robert Maas (the guy who says costume jewelry shaves points off your child's IQ) cites Needleman repeatedly in his research papers. (Like this one, arguing that we need to regulate plastic Christmas trees, which Maas claims contain lead.)

Obviously, attacking lead is the smart thing to do. Defending lead is for the brain damaged.

Will you be serving your child plastic Christmas trees to eat with the jewelry?

UPDATE: More on Herbert Needleman from Steven Milloy:

As pointed out in the New England Journal of Medicine (search), University of Pittsburgh and federal investigators determined that Needleman’s work involved a “pattern of errors, omissions, contradictions and incomplete information” in the original and subsequent publications.

The University of Pittsburgh found that Needleman engaged in “deliberate misrepresentation” and “substandard science.” The university referenced Needleman’s dismissal of critics as lead industry representatives and further noted his attempts to intimidate investigators.

The federal Office of Research Integrity (search) said Needleman’s results were “difficult to explain as honest error.”

Are you getting the picture? Well, there’s more and it’s particularly ironic since Needleman is featured on the “Silencing Scientists” panel at the CSPI conference.

But does bad science cause prestigious awards? Do prestigious awards cause bad science? Obviously, further research is necessary!

MORE: Here's a more glowing summary of Needleman's work, via Bill Moyers:

Dr. Herbert Needleman is a distinguished researcher who, after having determined the developmental implications of excessive exposure to lead, played a key role in the five-fold reduction in the prevalence of lead poisoning in American children. In 1979 he mounted the first large-scale study of intelligence and behavior in children with no outward signs of lead poisoning. He followed these children into adulthood, showing that lead exposure is associated with increased risk for failure to graduate from high school and for reading disabilities. His work was instrumental in the decisions made by the Environmental Protection Agency to mandate the removal of lead from gasoline and by the Consumer Product Safety Commission to ban lead from interior paints. Additionally, Dr. Needleman's studies prompted the Department of Housing and Urban Development to remove lead from thousands of housing units across the country. He founded the Alliance to End Childhood Lead Poisoning, an education and advocacy organization with which he continues to work to reduce the hazards of lead-based paint in many inner city homes.For his extraordinary contributions to the understanding and prevention of childhood lead poisoning, Dr. Needleman received the Heinz Award in the Environment in 1995. Currently a professor of pediatrics and child psychiatry at the University of Pittsburgh Medical Center, Dr. Needleman has been a consultant to the Environmental Protection Agency, the Centers for Disease Control and Prevention, the Office of Housing and Urban Development, and to state and local governments, including the Commonwealth of Pennsylvania lead program. He is a member of the Institute of Medicine at the National Academy of Sciences, and co-authored Raising Children Toxic Free with Dr. Phil Landrigan and Mary Landrigan, M.P.A. Dr. Needleman earned his M.D. from the University of Pennsylvania and trained in psychiatry at Temple University Health Sciences Center.

MORE: Hmmph! I guess I must have misunderestimated Dr. Needleman's credentials. According to SpaceDaily, he's a prominent physicist who's angry at the Bush administration:

Several climate experts have complained that they were unable to include in official reports information linking pollution and global warming.

"It's so egregious what this administration is doing, particularly in regards to the environment," said Herbert Needleman, a physicist at the University of Pittsburgh, Pennsylvania. "And their whole approach to global warming has been ignorant and cynical."