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Lead Poisoning: Maybe
It's Beyond That
Chapter 7 of A Strange Ignorance
http://www.azsba.org/lead7beyond.htm
For more articles on disabilities and special ed visit
www.bridges4kids.org.
Perhaps the most cogent commentary I found on lead poisoning
was in a study of tooth decay that reported "For children ages
5 to 17, an increased lead burden of 5 micrograms per
deciliter of blood corresponded to an 80 percent jump in
cavities." Mark E. Moss of the University of Rochester (N.Y.)
Medical Center and his colleagues analyzed data from a
nationally representative sample of 24,901 children, part of
the Third National Health and Nutrition Examination Survey (NHANES
III), and concluded:
We've been thinking about tooth decay in a way that's almost
like blaming the victim -- if your children have tooth decay,
it's because you don't brush their teeth right, or maybe their
snacking habits are bad. This study says that maybe its beyond
that. (JAMA, Volume 281, No. 24, pp.2294-2298)
"Maybe it's beyond that" is what we need to understand about
"All Children Can Learn." When children have normal teeth,
where lead has not replaced the calcium, then issues like
candy and tooth brushing are important. But when lead replaces
the calcium in children's teeth, it goes beyond that.
Similarly, when children have normal brains, where lead has
not replaced the calcium necessary for intellectual
functioning, then perhaps things like quality teachers and
curriculum standards will make a difference. But like the
dentists discovered with cavities, when environmental lead is
creating irreversible damage before the schools (or the
dentists) ever become involved, "Maybe it's beyond that."
"Lead is the most well-studied example of an environmental
contaminant that interferes with learning."
-The Center for Children's Health and the Environment
What I find particularly puzzling is why school governing
board members continue to allow public schools to be
chastised, even condemned, for deficiencies that clearly are
outside the control of the public schools. More importantly,
how can people who have volunteered to supervise the education
and welfare of children sit idly by when those children are
clearly being irreversibly brain damaged by a well-known,
well-documented widespread neurotoxin just a few months before
entering their care? And even if they are that callous, how
can they then stand by while highly trained and dedicated
public school employees are scourged for not overcoming this
irreversible brain damage?
Am I exaggerating the impact of environmental lead?
If so, why would a "public health" official, not even an
educator, be quoted by a national newsmagazine lamenting the
failure of educators to recognize "there's a very large number
of kids who find it difficult to do analytical work or [even]
line up in the cafeteria because their brains are laden with
lead."? Why would The Center for Children's Health and the
Environment of the Mount Sinai School of Medicine have a
factsheet on its web site that reads: "Lead is the most
well-studied example of an environmental contaminant that
interferes with learning."
Did I invent a presidential task force that committed the
federal government to eliminate lead from children's lives
within ten years? Did I somehow trick most other
industrialized countries into banning lead paint twenty years
before I was born? Did I secretly sneak my opinions into the
Newsweek cover story ten years ago about lead poisoning? Was
the health journal Prevention just spoofing us over the
devastating effects of just drinking tea and coffee from a
lead-glazed tea cup? Did I invent the research published in
prestigious medical journals showing that lead poisoning
creates brain damage that lowers IQs, makes children
aggressive, triggers Attention Deficit Hyperactivity Disorder,
and reduces even normal functioning of children? Were the mice
and monkeys faking in the research that showed identical
responses to lead in their diet?
What am I to make of the federal investigators in the
congressional General Accounting Office who reported NOT that
lead poisoning was being exaggerated, but rather reported "One
underlying reason for low screening rates is the widespread
belief among providers that lead exposure is no longer a
problem in their communities." Or that a National Academy of
Sciences panel looking into the over-representation of
learning disabilities in minority children reported NOT that
educators were prejudicially putting minorities into Special
Education but rather that environmental lead poisoning was
implicated?
As a statistical maven, what am I to make of the "coincidence"
that failing schools seem to be located in lead-laced
neighborhoods, or that children who are most abused by parents
somehow coincidentally have high lead levels, or that juvenile
delinquents have higher blood lead levels than
non-delinquents, or that children treated with legal drugs for
ADHD coincidentally avoid illegal drugs when they become
adults, or that incredible coincidence where it turns out that
the classic studies which showed children found with higher
blood lead levels do poorly in academics were conducted on
children in communities that today dominate national headlines
over "failing schools?"
"A call to action for legislators to protect our children by
requiring landlords to not simply disclose known instances of
lead paint in their properties, but to remove it" issued over
five years ago by Dr. Needleman when he demonstrated the
pervasiveness of lead poisoning has gone unheeded nationwide
(except for the 16 pilot states in the federal program).
Instead of testing for lead poisoning, Talibanic politicians
simply test crippled children for academic deficits so that
they can then label those trying to help them as "failing
schools." They force schools into curricular burqas and
require educators to chant "All Children Can Learn" like some
Orwellian doublespeak "1984" nightmare where the salient
feature of Talibanic legislation called "No Child Left Behind"
is precisely to allow unpoisoned children who can learn to
leave behind those lead-poisoned children who cannot.
I do not think I am exaggerating, but I am certain they are.
All children cannot learn, not if they have been irreversibly
intellectually crippled in their first three years of life by
environmental lead poisoning. Lead is extremely toxic and even
endangers workers attempting lead abatement. The Houston
public health official explained that lead dust cannot simply
be mopped up, as if the problem was simply poor housekeeping.
In the May, 1989, American Journal of Public Health (Volume
79, No. 5, pp. 643-645) Dr. Needleman explained:
… de-leading houses is dangerous business. Children must be
removed from the premises, workers must be trained and
supervised in the use of safe techniques, and the property
must be scrupulously cleaned after de-leading.
I was told the same thing by Phoenix lead abatement officials
who perform pre- and post- abatement testing.
"For too long, policy decisions about lead poisoning have
ultimately favored the lead industry or economic concerns over
children's health."
-Dr. Bruce P. Lanphear
It is becoming clear that there is no alternative to removing
lead-based paint from housing, other than removing the
housing. With the passage of time, the paint deteriorates and
the poisoning increases. More tragically, unsuspecting young
families just starting out move temporarily into these
low-cost houses until they can find jobs before moving into
better housing, but meanwhile their young children are
permanently poisoned by lead dust; they move out and another
unsuspecting young family moves in and a new child is
permanently poisoned; and then another; and then another. And
even after they leave, many of these children will go to good
schools but be unable to learn. No matter how hard they try.
Children pass through these poisoned homes ingesting
brain-damaging neurotoxins like pop-bottles being filled in a
bottling plant on a conveyor belt of tragedy.
Bruce P. Lanphear, one of the lead authors of studies
demonstrating the cognitive damage of low-level lead
poisoning, wrote an article titled "The Paradox of Lead
Poisoning Prevention" in Science magazine's Policy Forum:
Collectively, the results of these studies argue that efforts
to prevent neurocognitive impairment associated with lead
exposure should emphasize primary prevention -- the
elimination of residential lead hazards before a child is
unduly exposed. …. Because lead exposure is cumulative and its
detrimental effects are irreversible, any strategy that is
limited to screening children after an exposure has occurred
is flawed. …. It is more critical to expand our efforts to
identify and eliminate residential lead hazards before
children are unduly exposed. …. National, state, and community
surveys of housing need to be conducted to identify and
prioritize the elimination of lead hazards before occupancy by
children. …. Finally, it is necessary to develop a plan for
the gradual elimination of lead hazards during renovation or
demolition of older housing. …. For too long, policy decisions
about lead poisoning have ultimately favored the lead industry
or economic concerns over children's health. The lead industry
has left a toxic legacy comparable with that of the tobacco
industry -- yet it has contributed nothing to its resolution.
It is time to establish a scientifically based strategy to
eliminate subclinical lead toxicity by controlling residential
lead hazards; it is within our grasp. (Volume 281, No. 5383,
pp. 1617-1618, 11 September 1998)
In an editorial titled "Primary Prevention of Childhood Lead
Poisoning -- The Only Solution" published in the May 10, 2001,
issue of the New England Journal of Medicine (Volume 344, No.
19, pp. 1470-1471) Dr.s John F. Rosen and Paul Mushak of the
Children's Hospital at Montefiore in New York comment on the
failure of an attempt to medically reverse the effects of lead
poisoning in children in a study by "Rogan et al." They note
that the irreversible effects of lead poisoning
… clearly cast doubt on the value of public health programs
that rely primarily on treatment after lead poisoning has
occurred. Rogan et al emphasize the importance of primary
prevention of lead poisoning, which is the only satisfactory
solution to this devastating problem. The predominant source
of toxic exposure to lead for children in urban areas is lead
paint, although some incremental but far less substantial
toxicity may be due to other sources, such as tap water
contaminated by lead pipes. For the primary prevention of lead
poisoning from paint, we recommend permanent abatement -- that
is, the complete removal or replacement of lead paint before a
child lives in a home. In contrast, 'interim' measures, which
were introduced for the short-term reduction of hazards
associated with lead paint and which involve scraping and
painting over deteriorated surfaces and controlling household
dust, have been claimed by some to save substantial cost;
however, there is no evidence of savings in terms of net
benefit over cost in the long-term prevention of childhood
lead poisoning. Lead-painted surfaces in good condition rarely
remain so. What was once intact lead-based paint is the source
of all lead-bearing dust and paint chips. Therefore, it is the
presence of lead paint on surfaces that defines the hazard,
not the condition of surfaces containing lead paint.
Bruce Lanphear in his Science Magazine Policy Forum article
states:
The costs of eliminating childhood lead poisoning from
residential hazards are substantial. It has been estimated,
for example, that the first-year cost of reducing residential
lead hazards in federally owned or federally assisted housing
would be $458 million. The overall estimated benefit, defined
as increase in lifetime earnings of children who are protected
from the detrimental effects of lead exposure, was $1.538
billion -- a net benefit of $1.08 billion. This estimate does
not include other anticipated advantages, such as reduction in
cardiovascular disease, behavioral problems, and delinquent
behaviors.
As one lead abatement official in Houston, Texas, said of
existing environmental lead policies,
I think it's absolutely outrageous when someone says to wait
until a child is poisoned before we do anything. The first
seven micrograms has the highest potential for I.Q. damage.
They wouldn't let garbage lie around until someone got
cholera.
"They," of course, means politicians, and they, of course,
allow environmental lead to "lie around" in low-income
communities across the nation damaging children. Cholera, of
course, can be cured even if we do let garbage lie around
until the damage is done. The damage from lead, however, is
irreversible.
And, of course, there is a tragic irony about schools being
"criminal production factories" in these words from the author
who demonstrated the connection between lead poisoning and
juvenile delinquency:
"This study provides further evidence that delinquent behavior
can be caused, in part, by childhood exposure to lead," said
Dr. Needleman. "Of all the causes of juvenile delinquency,
lead exposure is perhaps the most preventable. These results
should be a call to action for legislators to protect our
children by requiring landlords to not simply disclose known
instances of lead paint in their properties, but to remove
it."
The roots of the political Taliban become apparent in Dr.
Lanphear's words: "The costs of eliminating childhood lead
poisoning from residential hazards are substantial ... For too
long, policy decisions about lead poisoning have ultimately
favored the lead industry or economic concerns over children's
health." The alternative to substantial costs in dollars is to
continue to allow small children to be permanently brain
damaged.
No amount of "best practices" or educational fads or intensive
instruction is going to make neurological connections between
brain cells constructed of lead.
This is a dichotomy, plain and simple: the loss in IQ, the
violence, the academic failure, the drug addiction, the human
costs are easier to ignore than the financial costs. Ignoring
science and chemistry while permanently damaging children is
possible because it is easier for politicians to intimidate
school officials and governing board members into curricular
burqas and mandated test practice three times a day. And,
nobody seemingly cares about the kids with their "somatic
complaints" and their academic failure and their desperate
self-medication with illegal drugs and their inability to have
careers and their eventual propensity toward violent impulsive
criminal behavior.
Politicians piously shed crocodile tears for the victims of
criminal behavior, while expending enormous sums of dollars on
a "war on drugs" (part of their defacto "war on kids"), at the
same time they offer vouchers to middle class voters to escape
the "failing schools" where the strange ignorance of educators
oblivious to lead poisoning encounters the accountability of
academic standards forced upon the impoverished victims of
lead poisoning.
Governing board members and educators in failing schools
cannot simply look at "asymptomatic" children and assume they
are normal. Even if a lead poisoned child is found to have a
normal IQ and behavior, the reality is that this normal IQ is
likely 10-15 points below what the child was born with and the
child will still be struggling with inner demons due to
impulsivity unleashed by lead. A child born with a 115 IQ has
a right to a 115 IQ, and if the child now has an IQ of 100,
that is NOT normal. If the lead is there, the child is brain
damaged. Ignoring the damage is easy, but it does not mean it
does not exist.
However, it would seem that we are at a rational confluence of
forces to resolve this problem. Lead is unequivocally linked
to "failing schools." Lead is also implicated in ADD/ADHD,
violence, unemployment, crime, alcoholism, drug abuse and
other social problems such as divorce, child abuse, and mental
retardation. The lead and paint industry already face
mitigation fees in California. The federal government has
already mandated medical screening of children on Medicaid and
its attendant health costs. And the legal system is beginning
to recognize the inherent liability of landlords who rent
lead-laced homes to families with children.
The political, economic, rational and moral forces are in
place for a final confrontation over environmental lead. The
key is to make the poisoning of young children too expensive
to ignore any longer. Whenever a child is found to have any
blood lead level at all, the community, including educators,
need to bring lawsuits against the source of the lead. Let the
politicians set blood lead levels at whatever they want, but
show the trial juries the medical research on brain damage,
educational failure, and subsequent earnings loss to that
child. Sue for lost earnings on behalf of the child. Sue for
educational costs to the schools for Special Education. Sue
for the screening equipment costs. Sue for punitive damages
because the presence of lead had to be known since the test is
simple to perform.
Whenever a "failing school" is identified, the school should
immediately demand lead screening of all students, through
both blood lead level testing and bone screening through K
X-ray fluorescence spectroscopy. Students identified as having
been exposed to lead should receive a three-pronged
intervention effort.
First, the source of the lead should be determined and abated.
If housing is implicated the landlords should be sued by the
district for school intervention costs.
Second, a school intervention program should ensure that
children identified as having been exposed to lead immediately
be evaluated by psychiatrists for learning and behavioral
problems including ADD/ADHD and proper medical intervention
strategies implemented.
Third, all housing within the attendance area of the school
should be evaluated for the presence of lead and community
organizations should be vigilant to ensure that children are
not allowed to occupy those homes. Curbs in front of all
housing with lead hazards should be painted in "candy stripe"
to warn of the hazard (sidewalks and curbs are public
property).
There should be a "zero tolerance" for the presence of
environmental lead contamination within any school attendance
area that could endanger children. State statutes should make
it a felony to knowingly rent or sell housing containing
lead-based paint for the occupancy of children under three
years-of-age, and a misdemeanor for children over that age.
Contractors and subcontractors involved in housing renovation
should be required to pass lead awareness training before
licensing. Real Estate agents should be required to determine
and disclose the presence of lead-based paint in all housing
transactions.
Districts in conjunction with the overall community around
"failing schools" need to demand that all children under three
years-of-age be screened for lead exposure on a regular basis
either through private or public health agencies. Lead
exposure screening should be mandated before children can be
enrolled in daycare or public school programs. More
importantly, AHCCCS and KidsCare regulations should prevent
"capitation" payments to physicians for children in their care
who have not had annual blood lead screening.
But since the unlikely acquiescence of politicians would be
required for those actions, educators and parents should form
community alliances with social service agencies, public
health activists, and public interest lawyers to ensure that
lead poisoning of all children within their school boundaries
becomes financially impossible. Schools should form alliances
with community groups to monitor state AHCCCS or KidsCare
populations for potential lead poisoning victims and sue on
behalf of any children found to be exposed to lead through
housing or other sources.
The precedent has already been set for occupants of lead-laced
housing to sue the owners for damages whenever children suffer
subsequent lead poisoning. If the landlord has also failed to
notify low-income renters of the lead hazard, there could be a
criminal prosecution as well. The liability for the damage
that creates "failing schools" should be assessed through
lawsuits on behalf of poisoned children.
Like the experience of public lawsuits against the asbestos
and tobacco industries, politicians are likely to be an
impediment to resolving the problems of lead poisoning but the
courts will ultimately prevail. There are sufficient federal
laws and tort opportunities that can be utilized to make the
costs of victimizing children too expensive for potential
litigants to absorb. Only by making lead poisoning impossible
will the severe costs to the community, to the schools, to the
crime victims, and to the lead poisoning victims themselves be
eradicated.
Finally, public service efforts to educate the general public
about the dangers of low-level lead contamination should be
instigated. Hardware stores' employees should be educated to
warn those who purchase sand paper that sanding lead-based
paint is very dangerous and that all painted surfaces should
be tested for lead before sanding. Community organizations in
older neighborhoods should be educated to watch carefully that
housing renovations are properly conducted. Unless this is
done successfully, all children will not be able to learn.
In this report I referenced a newspaper reporter in Baltimore
who illustrated the problem of lead poisoning with a story of
a suicidal twelve-year-old who "can barely read a word more
than three letters wrong. He cannot do math at all, not even
two plus two. He was in special education, but nothing the
teachers tried or said seemed to stick." I referenced a
newspaper reporter in Pensacola who matter-of-factly quoted "a
child psychiatrist and medical director" as defining the
signature of lead poisoning as "especially if the child can't
seem to learn, no matter how hard he or she tries."
School district governing board members have to face the
overwhelming evidence that all children cannot learn if they
have been lead poisoned and thus if accountability for
learning penalizes schools for not teaching children who have
been poisoned, then schools have no alternative other than to
take action against the poisoning. No amount of "best
practices" or educational fads or intensive instruction is
going to make neurological connections between brain cells
constructed of lead. No amount of counseling and discipline
will stop angry frustrated students embarrassed by punitive
accountability measures from acting out their aggressions when
the very brain circuits responsible for controlling
"impulsivity" have been damaged by lead. No amount of
counseling, threats and wall posters will stop drug abuse in
schools where children find those drugs have a calming affect
on lead induced agitation and ADHD symptoms.
Only actions that prevent children from being poisoned in
their first three years of life will prevent schools in
low-income neighborhoods from failing. As the houses age and
the paint deteriorates further, more children in cradles will
breathe and ingest lead dust like pop-bottles being filled in
a bottling plant as they start down the conveyor belt of
tragedy in the "criminal production factories" that only our
strange ignorance allows to continue. The children will fail,
the schools will fail, and the inevitable consequence of what
science and chemistry adequately explain will continue to
impact school districts across the nation.
School accountability means that governing boards and
educators can no longer ignore lead intoxication. Society has
decided that all children can learn. Even those poisoned by
society with a brain crippling neurotoxin. If it is the
responsibility of public schools that all children can learn,
it is thus the responsibility of schools to stop the brain
crippling before it occurs. In time, all the children will
have to learn, but that will only happen when the conveyor
belt of tragedy is stopped in the beginning. Meanwhile, a few
other things have to stop.
Stop automatically blaming the victims and the teachers and
the schools when lead poisoned children fail. Stop chanting
about reading by grade three when children are poisoned by age
three. Stop chanting "Just say no to drugs" when drugs are the
only respite the poisoned children have from lead poisoning.
Stop testing brain damaged children to flaunt what society has
done to them. Stop imputing moral and religious inadequacies
upon children crippled by society's indifference. And stop the
strange ignorance of their travail revealed by mountains of
medical research.
As long as "The education community has not really understood
the dimensions of this" continues, then the failure of public
schools will mount, governing boards will be dismissed, the
achievement gap will widen, violence will infest the schools,
and more children will not be able to learn. No matter how
hard they try. The problem is beyond them, beyond teacher
competence, beyond funding shortages, beyond standards and
testing and vouchers and every other ill-conceived
rationalization that ignores lead poisoning. And there is no
"maybe" about it.
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