The long shadow of Flint’s lead cri­sis

Modern Healthcare - - NEWS - By An­dis Robeznieks

A year ago, a Gen­eral Mo­tors en­gine plant dis­con­nected from the city of Flint’s wa­ter sup­ply af­ter dis­cov­er­ing its min­eral-laden wa­ter was caus­ing newly man­u­fac­tured car parts to rust. It was the prover­bial ca­nary in the coal mine. Last week, Flint and Michigan of­fi­cials found them­selves scram­bling to solve a public health night­mare caused by the cor­ro­sive wa­ter leach­ing the lead out of the city’s ag­ing wa­ter mains and lines.

There’s no short­age of irony in the latest blow to the strug­gling post-in­dus­trial city, whose de­clin­ing eco­nomic for­tunes gained no­to­ri­ety in 1989 with the re­lease of home­town film­maker Michael Moore’s “Roger and Me.” Nearly a cen­tury ago, a GM engi­neer dis­cov­ered that lead in ga­so­line low­ered en­gine noise, set­ting up decades of in­dus­trial and com­mer­cial use of the min­eral with dev­as­tat­ing health ef­fects, es­pe­cially in chil­dren.

Flint’s latest tra­vails be­gan in April 2014, when the im­pov­er­ished city sought to save money by dis­con­nect­ing from Detroit’s wa­ter sys­tem, which had been pro­vid­ing Flint with Lake Huron wa­ter. Af­ter months of protests about the sub­sti­tuted wa­ter from the Flint River by sick­ened lo­cal res­i­dents—who hired sci­en­tists to doc­u­ment el­e­vated lead lev­els in their homes and chil­dren—Gov. Rick Sny­der last week fi­nally an­nounced a $12 mil­lion plan to re­con­nect the city to Detroit’s sys­tem un­til a di­rect pipeline from Lake Huron is com­pleted next sum­mer.

The state acted only af­ter wa­ter sam­ples taken from three Flint schools tested pos­i­tive for high amounts of lead. The Michigan cri­sis il­lus­trates how lead can per­sist in the en­vi­ron­ment for decades. It also re­veals the her­culean ef­fort re­quired to mit­i­gate the prob­lem. While Flint’s wa­ter mains are cast iron, they are prob­a­bly held to­gether with lead-con­tain­ing solder, of­fi­cials said. Homes and build­ings also con­nect to the wa­ter mains through lead-con­tain­ing ser­vice lines.

A decade ago, when the Dis­trict of Columbia at­tempted to re­move its lead ser­vice lines, it ac­tu­ally in­creased lead ex­po­sure. “Cut­ting the pipe mo­bi­lizes the lead and makes the prob­lem worse,” said Michigan Depart­ment of En­vi­ron­men­tal Qual­ity spokesman Brad Wur­fel.

Given the well-doc­u­mented harms from lead, es­pe­cially in young chil­dren, the gov­ern­ment has been orches­trat­ing cleanup ef­forts since the 1970s. It was re­moved from ga­so­line and paints, and leg­is­la­tion was passed in the 1990s to clean up old build­ings and con­duct sys­tem­atic test­ing in chil­dren to iden­tify hot spots.

But in re­cent years, those ef­forts have been sharply cut. This year the U.S. Hous­ing and Ur­ban De­vel­op­ment Depart­ment’s grants to states and cities were suf­fi­cient to clean up only 7,000 low­in­come hous­ing units. Its 2015 $110 mil­lion bud­get is only two-thirds of what it was 10 years ago, with con­gres­sional Repub­li­cans seek­ing to cut $35 mil­lion more.

Early child­hood lead ex­po­sure puts life­long lim­its on in­tel­li­gence, re­duces self­con­trol in teens, and leads to crim­i­nal be­hav­ior in adults, ac­cord­ing to ex­perts. (See re­lated Data Points, p. 31).

“The con­se­quences of lead poi­son­ing are mind­bog­gling,” said Dr. Mona Hanna-At­tisha, a physi­cian-re­searcher at Hur­ley Chil­dren’s Hos­pi­tal in Flint who con­ducted stud­ies on lo­cal chil­dren af­ter Flint switched its wa­ter sup­ply. “At 5 years old, they may need to be in a spe­cial ed­u­ca­tion class. At 10, they may have at­ten­tion deficit hy­per­ac­tiv­ity dis­or­der. At 15, they’re prob­a­bly in­volved with the crim­i­nal jus­tice sys­tem.”

De­spite these con­cerns, the Cen­ters for Dis­ease Con­trol and Preven­tion’s child­hood lead-screen­ing pro­gram gets lit­tle fund­ing. The pro­gram’s bud­get was slashed from $29.2 mil­lion in fis­cal 2011 to $2 mil­lion the next year. For 2014, pro­gram fund­ing went back up, but only to $15 mil­lion. Those swings cre­ate un­cer­tainty for states that rely on the CDC to pay for their pro­grams.

Dr. Jen­nifer Lowry, di­rec­tor of the en­vi­ron­men­tal health cen­ter at 301bed Chil­dren’s Mercy Kansas City (Mo.) hos­pi­tal, par­tic­i­pates in lead-sur­veil­lance ef­forts in two states. Mis­souri has main­tained its pro­gram, but ef­forts in Kansas are slight and sup­ported by in­ter­mit­tent grants rather than steady bud­get ap­pro­pri­a­tions.

“Un­for­tu­nately, en­vi­ron­men­tal health is not in the fore­front of our fun­ders’ minds,” Lowry said. “Congress isn’t in­ter­ested.”

Stu­dents on Oct. 8 help un­load bot­tled wa­ter do­nated to their Flint ele­men­tary school be­cause of the lead cri­sis.

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