"Lead paint is bad to eat": the lead industry and child lead poisoning.

• Author: Rabin, Richard
• Position: Lead: The Poisoning Continues

Historians of public health are familiar with Benjamin Franklin's letter to a friend in which he recounts his knowledge of the many professions in which lead is a health hazard. He concludes by saying: "This, my dear Friend, is all I can at present recollect on the Subject. You will see by it, that the Opinion of this mischievous Effort from Lead is at least above Sixty Years old; and you will observe with Concern how long a useful Truth may be known and exist, before it is generally receiv'd and practis'd on." [1] Unfortunately, old Ben made no effort to enlighten his friend (or future generations) as to why such delay being so common is a good example of how powerful economic interests can prevent the implementation of a "useful Truth."

For several decades after they became aware of the danger to young children of lead paint, the lead and lead paint industries continued to produce and sell it. Through a variety of tactics, including suppression of research findings, lobbying against government regulation and misleading advertising, these corporations and their trade associations created a public health problem of major proportions.

Although dramatic, life-threatening cases of lead poisoning had long since become a rarity, in 1991 the illness was still of such concern that the Secretary of Health and Human Services declared it the nation's most serious environmental pediatric disease. Even today, nearly one million children under the age of six have blood lead levels that can cause lowered intelligence, hyperactivity, learning difficulties and behavioral problems. Studies suggest that these effects persist beyond early childhood and into adulthood.

What did they know?

As early as 1904 an Australian physician, J. Lockhart Gibson, published an article on the source of childhood lead poisoning among his patients. He concluded that the lead-based paint on walls and porch railings was the main culprit. [2] Ten years later the first case study of a child poisoned by lead paint appeared in the US. The authors, Thomas and Blackfan, after searching the literature, concluded that such cases were rare. [3] However, three years later Dr. Blackfan reversed his judgment and asserted that reports of child plumbism were uncommon only because pediatricians were not looking for it. [4] As more doctors and public health authorities became aware of the problem over the next several decades, the medical and scientific literature would become full of studies describing the sources, symptoms and effects of childhood lead poisoning. Toys, furniture, windowsills, doorframes and other woodwork all were sources of lead for the young child. One author put it succinctly: "A child lives in a lead world." [5]

By the 1930s a number of hospitals and a city health department in North America were systematically counting and reporting lead poisoning cases. Boston's Children's Hospital reported 89 cases between 1924 and 1933. [6] In Toronto's Hospital for Sick Children 23 children were admitted, 5 of whom died, in a two-year period in the early 1930s. [7] Between 1931 and 1940, the Baltimore Health Department recorded 135 cases of child lead poisoning, including 49 deaths. [8]

There is ample evidence that early in the century the lead industry knew the dangers of lead paint for young children. A few years before it began manufacturing lead pigment and selling lead paint, the Sherwin-Williams Company instructed its sales staff to point out the toxic nature of lead paint to their customers. Even the industry's own medical and legal experts expressed their view that lead paint was highly toxic.

Dr. Robert Kehoe was medical director of the Ethyl Corporation, the producer of the gasoline lead additive, and arguably the nation's preeminent authority on the health effects of lead. For the most part, he tended to minimize the occupational and environmental health effects of lead. Yet on several occasions, both in scientific forums and in private correspondence with the Lead Industries Association (LIA, the lead industry's trade group), he made no secret of his view that lead paint was most hazardous to young children. At the annual conference of the American Medical Association in 1933 Kehoe emphasized the danger of lead in a child's environment:

It is of particular interest and importance that in children with lead poisoning there is a striking tendency for symptoms of the central nervous system to develop, indicating the fundamental difference in the disease in children and adults. Encephalitis in children, as in adults, has a bad prognosis. From available figures one concludes that the prognosis in children and the outlook for complete recovery are even somewhat worse than in adults.... [S]trenuous efforts must be devoted to eliminating lead from their environment. [9] Ten years later, a landmark study was published by Drs. Elizabeth Lord and Randolph Byers, showing the effects of lead on the intellectual and behavioral development of young children. [10] When...