Walking Back Flint’s Childhood Blood Lead Crisis

Flint graph.gif

Chart borrowed from Mother Jones’ commentary on Gómez and Dietrich’s op-ed.

Because I took an active part in the public debate over childhood blood lead levels here in Shoshone County in the early 2000s — when the EPA proposed the expansion of the Box’s Superfund site to the entire Coeur d’Alene Basin — I had more than a passing interest in the blood lead crisis in Flint, Michigan when it erupted into headlines in the nation’s press in 2014-2015.

Although article after article lamented the regrettable lead contamination situation in Flint, I never seemed to be able to find accounts that included actual data on changes in juvenile blood lead levels there.  Hence, it was with no little surprise that I encountered, this past summer, an op-ed in The New York Times (July 22, 2018) saying, in effect, that there had been no juvenile blood lead crisis at Flint in the first place – that the juvenile blood lead situation had been grossly exaggerated.

The op-ed in question was coauthored by Hernán Gómez and Kim Dietrich.  Its title proclaimed its thesis very plainly, “The Children of Flint Were Not ‘Poisoned.’”  The piece’s authors were credible voices regarding blood lead science.  The blurb accompanying the article offered the following about them:

Hernán Gómez, an associate professor at the University of Michigan, emergency medicine pediatrician and medical toxicologist at Hurley Medical Center, was the lead author of the study “Blood Lead Levels of Children in Flint, Michigan: 2006-2016.” Kim Dietrich, a professor of epidemiology and environmental health at the University of Cincinnati College of Medicine, is the principal investigator of the Cincinnati Lead Study.

The authors, moreover, were not known for histories of rejecting the significance of elevated juvenile blood lead as a public health problem.  Wrote Mother Jones’ political blogger, Kevin Drum (July 23, 2018) on this point:  “I don’t personally know Gómez, but I’ve spoken with Dietrich several times and there’s no one on earth more concerned about the effect of lead on children than he is.”

What, then, did Gómez and Dietrich have to say?  They began their op-ed with a simple but important assertion:  “Words are toxic, too.”

“Labeling Flint’s children as ‘poisoned,’ as many journalists and activists have done since the city’s water was found to be contaminated with lead in 2014,” they wrote, “unjustly stigmatizes their generation.”  Yes, the ingestion of lead by children was dangerous, they conceded.  But Flint’s drinking water situation had not risen to the level of a significant neurotoxic threat.

Gómez and Dietrich’s op-ed put the notion of blood lead poisoning into perspective.  They began by noting that average juvenile blood lead levels in the U.S. in the 1970s stood at about 14 micrograms of lead per deciliter of blood.  A successful public health effort in the U.S. had greatly reduced that mean figure over the intervening years.  The current “reference level” for juvenile blood lead maintained by the Centers for Disease Control and Prevention was five micrograms per deciliter.  This “reference level” did not, however, imply a need for treatment.  “In fact, the C.D.C. recommends medical treatment only for blood lead levels at or above 45 micrograms per deciliter,” the authors wrote,  “Not a single child in Flint tested this high,” they added, “This was a surprise for several visiting celebrities, who requested a visit to the ‘lead ward’ of Hurley Children’s Hospital.”

The percentage of children with blood leads higher than the CDC’s reference level had increased in Flint after the water supply switch, but only from 2.2 percent to 3.7 percent.  A small change in mean juvenile blood lead levels had also been registered.  But fluctuations of this magnitude, they wrote, were not inconsistent with random variations in blood lead measures in the past in Flint.

Just two decades ago, the authors pointed out, almost 45 percent of Michigan’s children had lead levels exceeding the current five microgram standard.  Undue excitement over Flint’s putative blood lead problem, they added, deflected attention away from more concerning blood lead circumstances elsewhere in Michigan.  “Right now in Michigan,’ they wrote, “8.8 percent of children in Detroit, 8.1 percent of children in Grand Rapids and an astounding 14 percent of children in Highland Park surpass the C.D.C. reference level. Flint is at 2.4 percent. A comprehensive analysis of blood lead levels across the United States reveals at least eight states with blood lead levels higher than Flint’s were during the water switch.”

All of this sounded very, very familiar to me.  Back when the Shoshone Natural Resources Coalition’s Science Committee was casting doubt on the human health rationale for expanding “The Box” Superfund site to the entire Coeur d’Alene Basin, I repeatedly tried to bring attention to important contextual aspects of the blood lead issue.  For instance, as early as the Science Summit we staged in April, 2001 – which faced-off Science Committee members against EPA’s scientific specialists – I presented a bar chart (below, source here) illustrating that the “exceedance rates” (i.e., percentage of children above the then-reference standard of 10 micrograms per deciliter) of entire U.S. states were substantially greater than the then-current exceedance rate EPA’s human health research had suggested for the Coeur d’Alene Basin.*

State exceedance rate chart

Gómez and Dietrich’s walk-back of the Flint childhood blood lead “crisis” did not make the Times’ front page and it certainly did not receive the sustained press attention that the original crisis-promoting news reports had received.  Admittedly, numerous voices in the lead-health science community vehemently rejected Gómez and Dietrich’s op-ed, too.  (See, for example, an August 13, 2018 report in The Detroit News titled “War of words, science still rages over lead contamination in Flint.”)  Still, it was refreshing and heartening for me to see (at long last) both actual blood lead findings and the contextualized good sense displayed in Gómez and Dietrich’s op-ed.

Words do matter.  And the lingering stigmatization that may attach to Flint’s children (or, for that matter, to our own children here in the Coeur d’Alene Basin) because of a lack of scientific and historical sophistication combined with unwarranted hysteria — that stigmatization is both unjust and inappropriate.

*A record of 47 documents written by members of the SNRC Science Committee and others arising from the struggle against EPA’s expansion of the original “Box” Superfund site is available here.

— Ron Roizen

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5 Responses to Walking Back Flint’s Childhood Blood Lead Crisis

  1. Sharon says:

    Context- it’s important!

  2. Jann says:

    Thank you Ron!
    After reading the highlights of the Michigan study, I find interesting “Between 1960 and 1990, the BLL reference concentration was gradually lowered from 60 µg/dL to 25 µg/dL. In 1991, the CDC lowered the reference concentration to 10 µg/dL and in 2012 to the current value of 5 µg/dL.24, 25 This reference concentration, originally intended by the CDC as a tool to identify children at greater risk, has been frequently misinterpreted as a definitive threshold of lead toxicity or poisoning.”

    There was a decrease in Flint childhood blood lead levels, from 2.33 µg/dL in 2006 to 1.15 µg/dL in 2016. The mean BLL in 2015 was 1.3 µg/dL, up from 1.19 in 2014 before the water source switch. (Source: https://labblog.uofmhealth.org/body-work/study-examines-blood-lead-levels-of-flint-children) This means that there was an overall BLL increase of just 0.11 µ/dL and the 2016 1.13 µg/dL is 3.87 µg/dL lower than the tool’s guideline of 5 µg/dL. Stated otherwise, at the ZENITH of this “crisis” the kids’ BLLs were only at 22% of the guideline.

    After a little research, I see that this “crisis” was financially beneficial to Flint and its fundraisers. Over $34,571,611 was raised by 2 Foundations and a few celebrities. NONE of this went to infrastructure remediation; that has to come from the state & federal agencies. These millions have been mostly been spent/squandered on improved health, nutrition & lead education programs, new hires, new learning centers, grocery stores, neighborhood redevelopment projects and leadership development. (Source: https://www.mlive.com/news/flint/index.ssf/2017/09/see_how_334m_in_flint_water_cr.html)

    So far over 10,000 lines at $9,900 need to be repaired: $100,980,000. The Michigan state budget was originally $200 million, but was reduced to $165 million; Flint to get $25 mil for lead pipe replacements and $50 mil for emergency funds. The rest spread around the state, whose needs are far greater than Flint’s. The HHS paid $480k for school-based counseling and mental health issues. I cannot locate as yet any other federal funds spent on the “crisis”.

    Back to the Bunker Hill Superfund Site and BLLs. From 1988-1991, fully 88% of ALL U.S. children 1-5 years old had BLLs above the CDC’s 10 µg/dL level of concern. (Source: Pirkle J.I. etal “The decline of blood lead levels in the United States”) How were the local children “poisoned” while the rest of the nation was just “elevated”?

    Historically, the mean BLLs dropped dramatically immediately after the smelter stopped openly emitting around 1975. There were NO changes from 1975-1980 during the “emergency response to the epidemic” & before the smelter closed. By 1982, the mean BLLs were BELOW the CDC standards and have remained so to date. The latest 2017 data reflects a mean of 3.0 µg/DL and 3.5 µg/dL for the Box and the Basin respectively (2.0 & 1.5 µg/dL below the guidance level).

    Clearly Mr. Roizen is completely correct in comparing Flint’s “crisis” with the Bunker Hill’s “crisis”. Neither crisis has existed for decades, but there ARE those who have benefited financially from scientific misinformation.

    Since the EPA acknowledged 10 years ago that the populated areas of the Box (OU 1) have been certified as completely remediated with no further response required, it is well past the time for the EPA to delete this area from the Superfund site. It’s called a Partial Delisting, and the current Administration is eager to process all appropriate delistings.

    • ronroizen9 says:

      Thanks Jann! As your further findings suggest, there is a lot more to be learned — and said and written — about the Flint experience.

  3. paultrow says:

    I’m particularly interested to see the graph showing the declining percentages of children in Flint with elevated lead levels. The minor upward trend from 2014-15 appears to be almost statistically insignificant. Of course, no one in the media mentioned this long term trend, as that wouldn’t have contributed to the goal of generating as much public attention – and fear – as possible.

    • ronroizen9 says:

      Hi Paul. As it is said, to the hungry dog the world is comprised of food and not food. Thanks for your comment. Ron

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