David Rosner

Poisoning America

Air Date: April 17, 2016

Public health historian David Rosner on origins of the lead epidemic in Flint and beyond


HEFFNER: I’m Alexander Heffner, your host on The Open Mind. The contamination of the American city, the devastating tragedy in Flint, Michigan, where lead is infecting a community of lower-income families, is a terrifying déjà vu, a hazard to the public well-being we thought American had eradicated. Not so, alas. In the case of Michigan governor Rick Snyder, it seems not simply a sin of omission, neglecting decades-long poisoning, but the retrograde regressive decision to reintroduce these chemicals into the American bloodstream. Joining me today for an exploration of this political and public health crisis is David Rosner. He’s co-director of the center for the history and ethics of public health at Columbia University’s Mailman School and author of Lead Wars: The Fate of America’s Children. So David, I want to ask you today, what is the prescription for this tainted infrastructure that we are becoming cognizant of once again.

ROSNER: Well the prescription is simply that we’ve had an ongoing disease, we’ve had a crisis going back into the early part of the 20th century. We’ve had children being poisoned literally, uh, since 1917, 1914 when we discovered the first cases of children being poisoned by lead. And it’s been an unfolding tragedy of the first order for public health and for children around the country.

HEFFNER: Well it’s unfathomable that uh, this, that we, we’re experiencing this kind of insurrection when we have thought that the political legal and ethical conscience of this country would have adapted, adapted because new technology, new paint had emerged and there was the opportunity to solve this crisis but not really in the most desperate lower-income communities. And is that, is that really the story of Flint as much as anything else, the fact that there is the industrialized modern society for a certain segment of the population and then everyone else has to suffer? Or is there more, is there something more at, at the heart of this crisis in Flint?

ROSNER: Well the crisis in Flint is really emblematic of this tragedy we’ve been facing and our unwillingness to face it as a society. Uh, the issue has largely affected African-American and Hispanic children, and somehow, even though we know that lead continues to poison kids, continues to be on the walls of cities, continues to be in the pipes, continues to be in the ground because of the tetraethyl lead that we used to use in our cars, uh, we have done noth—virtually, well I wouldn’t say nothing but we’ve tried only sporadically to address this issue. It’s a huge issue. It’s not just Flint, it’s many other communities that are suffering with, with pipes but also with paint in decrepit buildings, and we’ve been able to in some sense isolate these issues in these crises, uh, by basically uh, saying it’s not our problem as a kind of middle-class society. Uh, it’s a problem of poor people. Uh, it’s, there’s a problem of environmental racism, a problem of the indig—uh, kind of insidious racism that we’ve addressed and also the story of the enormous power of corporations to make us think that somehow it was, it’s a problem of the past. Um, the history of lead is a history of neglect. It’s a history of decisions on our part not to address, uh, the broad implications of what we did to ourselves during the industrial revolution and in the first part of the century when our cities expanded broadly, when we built our housing and we began to depend upon lead as a mainstay of our, of our new industrial culture. We put this stuff in, uh, even though we knew it was dangerous, we knew it was going to hurt kids. Uh, and we found ourselves believing or allowing ourselves to believe what our industries told us, which is uh, lead helps to guard your health was one of the ads that appeared in the 1920s. Lead takes place in modern games, lead is part of our everyday life, all these ads and propaganda that came out of the very time when, when physicians and public health workers and uh, reports were appearing of children around the country who were, who were literally at that point dying and going into convulsions because it was, ‘cause lead was poisoning them.

HEFFNER: What is the scope of the problem today?

ROSNER: Well the scope is uh, huge. Uh, you know, lead is literally, while we banned lead in paint in 1978 and we banned lead from gasoline in the 1980s and 1990s, we got rid of tetraethyl lead so it stopped going into the air, the simple fact is that the lead that was put on uh, between the years, you know, 1900 and 1950, was on every, virtually every house in the country. Uh, still presents a sitting, uh, crisis waiting to emerge. Um, so today we still, the CDC has continually lowered what it defines as the uh, important moment, important blood lead level that we should be paying attention to. It used to be 40, it went down to 25, then it went down to 10. Now it’s down to 5 and uh, five micrograms per deciliter of blood. Um, and the CDC now estimates that there are still over a hundred, uh, 500 thousand children in the country that have above that level. And they also say that that five micrograms is not an indication of safety. It’s just what we can handle. We should not have more than that. But um, it’s certainly not a safe level. They don’t know of any safe level of lead for a child. Lead has terrible neurological effects at very, very low levels depending upon the neurological stage at which a child is developing. An infant or even uh… A pregnancy, a child can be affected before birth. Um, lead interferes in neurological development, and once that neurological development has changed, altered, stopped, it doesn’t matter almost what happens afterwards. It means you’re going to have a different kind of potential for that child.

HEFFNER: Do we need to do a holistic survey in this country of where the lead still resides? Because just recently in the aftermath of, of Flint, a number of other municipalities were at least coming forward and being straight with their citizens that there was a problem. New work being another example in fountains, water fountains.


HEFFNER: So I, I guess the question is if the scope remains that wide and broad from years of, of poisoning and remains on the walls and remains in the pipes, what kind of wholesale, uh, reform is, is possible and, and is the CDC um, equipped to do the kind of monitoring of, of public and private institutions it needs to?

ROSNER: Well certainly the way to think about, there’s many ways to think about it. One way is the way the industry has been arguing for decades, which is this is just too expensive. We’ll never be able to deal with it. You’re talking about trillions of dollars of infrastructure that have to be changed. Um, another way to think about it and you know, I am a historian, so that’s how I think about these things. Is that that’s a kind of misstatement of what the problem is. We know where and who is going to be affected. We know that children are most vulnerable. We know that young families are most vulnerable. If we set out today on a campaign really to make sure that families and children living in homes that have lead in them have a safe environment, we can systematically over the course of the next thirty or forty years virtually make those families safe. We’ll save those children, we’ll make sure they’re not damaged, and in the process we’ll be getting rid of lead in many of the homes in our country. We don’t have to write the check right now, I guess that’s—

HEFFNER: You’ve, you’ve said though, and you and your co-author in this book have said that the legal process has not been a friend of public health necessarily in furthering those goals. In 2016 has that changed at all?

ROSNER: Well there are a couple of very important cases that have developed over the last few years that really changed the landscape. In the early years when we found a house that had lead on it, let’s say, on its walls because of the decades of painting with lead paint, um, and that the house was decrepit, these were act—to remedy that problem basically meant moving the child out, detoxifying the house, finding, suing a landlord to pay for it, suing a landlord to maintain, maintain the apartment, uh, in, that was always a retroactive act, I don’t know, it was a, an act after the damage was done. The child was identified as lead poisoned by a public health authority. They were in some sense a, a canary in the mine or a rat in a lab place, you know, you looked and saw he was sick or she was sick and then you went and looked at the house. It was a terrible way of identifying damage and what it meant essentially is that uh, millions of children over the course of the last century have been damaged, uh, because they were the ones who were the, they identified it, they were the monitors. Um, their biology was the monitors. Uh, and, and it was very difficult through the la—legal system to ever really address this issue because you can only sue a landlord, let’s say, or sue anyone for damage after the act was done and the child was therefore damaged, and you hoped on an individual basis one by one there’d be some kind of individual remedy. But in recent years, there are a new set of cases that have developed. Um, uh, I was involved in Jerry Markowitz, my co-author, was involved in a case in, uh, Rhode Island brought by uh, attorney general, uh, Sheldon Whitehouse who is now senator from that state, a US Senator, but at that time he was the attorney general. In the nineteen, late nineteen nineties, he said it’s crazy to keep suing people after the damage is done. That’s a crazy way of having a legal system respond to a pro—problem. And he said what we really need to do is we have to get the lead off the walls before damage is done. We have to get lead off the walls before the child’s, uh, hurt. Uh, that’s basic public health 101 point, right? You prevent disease. You don’t, you don’t, uh, uh, you don’t try to cure it after the fact. You can’t do it with lead poisoning. So he decided to bring a suit, um, in whi—which was really novel, I mean brand new at the time. Uh, and the suit was to demand from the industry that had knowingly, uh, sold this poison to the American public and to communities and to public agencies and private people who had knowingly so—sold lead in advance, um, in the 1910s, 1920s, 1930s, 1940s, when for, in Rhode Island, the city of Providence which was its major city, uh, was being built, uh, was expanding in population. If we could sue them for money to remove lead to provide money to the public health department, to get lead off the walls where, housing where children lived before the damage was done, this would be an extraordinary public health victory. So he actually, it, he’s a wonderful man, he came and he looked at these documents, we talked with him and his lawyers, um, and uh, we showed him these documents of what they were discussing in their meetings in the 1930s about children being damaged by their product and we ended up um, starting a suit and uh, we presented the history to a jury and after four months of trial, um, the jury came back, uh, saying it makes sense to say let’s get the lead off the wall before the damage is done and also we should hold those who made the mess accountable, in some sense the basic principle, if you make a mess you clean it up. And he basically said, they basically said yeah, they should be held accountable. It was a long trial, it went through a mistrial, it went through a, you know, it was a huge many year project and he stuck with it. Um, and what was interesting is that in the end they decided to ask for between the costs at anywhere between one and four billion dollars for the state of Rhode Island, the smallest state in the nation. That was the happiest, uh, day I, I sometimes say the happiest day of my life but it was, my family says you know, you have children, you have a wife, you got married, you know, there are a lot of happy days, don’t… It was the happiest day of my professional life. Uh, when I thought that history, this history of what this co—corporation did could finally play a role in actually preventing disease. I’m a public health professor, that we could actually prevent disease, and the longest lasting childhood epidemic in American history could be resolved and, and history could play a little, a small role in it. So I felt very proud. But the most depressing day, of course…

HEFFNER: So, yeah.

ROSNER: The most depressing day was two years later when the State Supreme Court of Rhode Island overturned it on a technical, on interpretive issue and the issue was this from a public health point of view a kind of crazy issue, uh, what they said was um, since the damage hasn’t happened yet, the lead is sitting on the walls but we don’t know whether the kids are really poisoned. There’s no standing of these children to prevent disease. Uh, I don’t know whether that makes sense to you…

HEFFNER: Well this is the kind of Minority Report, have you seen that movie? Minority Report scenario in which the crime hasn’t been committed but there was the intent.


HEFFNER: And the crystal ball comes rolling down and um, the kind of a pre-crime cop, uh, seeks out the assailant before he or she has committed the crime, but in this case, the crime is, can be retroactively um, understood in that when the, when the lead went on the wall, it might not have been illegal but um, that seems to me to be the technicality to which you, to which you allude, um, and, and it seems, it seems like the vehicle through which you can hold accountable the lead paint and lead industry would be the legislative body that would rule that they have to uh, renumerate for various health, uh, medical expenses incurred and for preventative care for people who had been exposed in the past.

ROSNER: There have been a number of times when legislatures around the country have tried to legislate around lead and they’ve been very, very, uh, strenuously resisted. I’ll give you an example, uh, in 1949, a very simple act was passed by the house of delegates and the legislature in uh, Baltimore which was in Maryland, which was a site of a huge number of lead poisoning cases. Um, the legislation simply said you have to put a, you have to make sure that there’s a warning on the side of, of cans of paint that say this has lead in it, and also that you can’t put lead on, on objects, you can’t put lead paint on objects that toy, like toys, furniture, and furnishings around the house that children could get a hold of, mouth, dust could fall off or chips could come off and will end up poisoning a child. And it was a very simple piece of legislation. You basically have to tell parents that this is not to be used around children. The ind—the industry went to the governor and their minutes are fascinating, how they basically, it’s unclear whether the legislature withdrew the, uh, the legislation or whether the governor vetoed it, but they went to extraordinary acts to get this, this very simple measure suppressed. They did not want any mention or alliance in the public mind between the idea that, between lead and danger. And children and poisonings. This was damaging to them and they worried about it. They also tried to resist warning labels and labels in New York and in Chicago and other cities. Uh, they visited legislatures, they visited, um, uh, city officials demanding that they, not demanding but asking that they put lead in schools, that they put lead paint on walls, uh, that they adopt, uh, standards that would allow them to sell lead to school districts and public officials. So in the, historically there’s been this resistance. Recently we’ve had a situation where, well you know as well as I that there’s been a 30 year, 40 year period now that um, sees government regulations as onerous, that presents it as a, a way of stifling industry and every time OSHA or NIOSH or the EPA tries to put a new standard in for virtually anything, they’re accused by some group of having undermined American free enterprise and stifled the independent entrepreneur, you know, some, you know, the language of the kind of Reagan revolution that government is onerous, it’s not a help, it’s not a way of protecting us, it’s a problem.

HEFFNER: In this political season, Secretary Clinton has become the champion of um, the poisoned and I want to ask you if it’s consistent with um, and you can’t hold her responsible for the 90s policies but um, in terms of swinging that pendulum back to reform and regulation, smart regulation that is going to assess the damage and seek support for those who are damaged, how have the Clinton and now Obama years further, furthered that goal and you know, it’s, it’s a, it’s a political issue now. Uh, does The Secretary have standing on the basis of how she dealt with this issue as a senator and how the Clinton Administration dealt with this issue in the 90s?

ROSNER: Well she certainly has standing in making this a broad issue. I was very heartened quite honestly when I listened to the recent discussion between Bernie Sanders and uh, Hillary Clinton that both of them were very, really identified lead poisoning as a national problem. She was very specific in saying it’s not just Flint and it’s not just pipes, it’s also paint on the walls and paint, uh, or lead on the walls and lead in the soil as it’s a broad environmental problem, so I was really heartened by that. Um, I was also heartened that she had made this a broader issue than just Flint. Um, there’s always a problem that we’re going to address this and this is how we’ve historically addressed it and, you know, as a way of, we confine it to a crisis only in Flint. What could, you know, there’s a danger that we will say when we change the pipes in Flint, as, because of the tragedy that’s occurring there, the real tragedy, or we get rid of the governor, that we’ve addressed the problem. Uh, I’m hoping this is, you know, I have my students watching Twitter counts, they’re all following the Flint situation to see how it, you know, kind of plays in the public arena. Um, you know, I’m really hopeful that this time we’ll see this as part of the national priority, but historically all politicians are in some sense terrified of the implications not just of lead but of the kind of indu—impact or the blowback from a century of industrialism, you know, I don’t want to make this more overwhelming but you know, the simple fact is we’ve had a century in which we’ve allowed these industries to basically pollute the air, pollute the water, pollute the ground, pollute the rivers, um, and we haven’t really, we’ve been trying sporadically to have clear, clean air acts and ways of regulating them. Um, but you know, we now are sitting in a world that’s filled with all sorts of materials that we don’t really know the impact of. Um, it’s not like they’re necessarily all poisonous but it’s odd to put all these materials into our environment and watch. Uh, the CDC, uh, right now has a study going on, it’s following uh, 223 chemicals that are now in the human body, literally in our bloodstreams, that weren’t here 75 years ago, that weren’t in us. You know, and they’re following it in some sense to see what the impact is. But there’s, we haven’t developed a national policy that could rationally address this. We haven’t developed what some have called the precautionary principle which will say look, if there’s a reason, if a product is safe, that’s fine, but it’s really the responsibility of an industry to tell us it’s safe and to make sure it’s safe. It’s not our responsibility to wait until the damage is done. And that with certain chemicals and certain materials there’s a long history of industrial, as with lead, industrial poisonings, there’s a long history of knowledge about kindred chemicals causing problems, chlorinated biphenyl is the basis for, for, or chlorinated hydrocarbons are the basis of DDT. We know they were dangerous. Did it make sense to allow PCBs to be introduced in our environment when we discovered that? Did, could we have stopped that before it happened?

HEFFNER: We’re running out of time and you leave us on a depressing thought which I don’t fault you for, it’s truly depressing the way the situation has evolved, um, the, the constant uh, refrain in response to the, the movement for reform is it’s like you said, it’s a trillion dollar solution. Is there a way that we can design solutions that are counter-affecting, a counter-punch to the chemical that’s having an adverse effect on us? Because that, as with the idea of a cancer vaccine, um, and we had Dean Laurie Glimcher of Cornell Medicine talking about that, you know, it seems like when the scope is so broad you need some kind of panacea, but in this instance it seems, it seems nearly impossible to develop one.

ROSNER: No it’s not, it’s not impossible. We built the American city basically in a 40-year period, between around 1890 and 1930. The basic infrastructure of virtually all our modern cities appeared. You know, Chicago which was a fort in the wilderness in 1841, by 1900 is the second-largest city in the country. New York which had 50 thousand people in 1800, by 1900, it has 4 million people. It, vast expansion of populations, vast expansion of these cities, and in that time we built a water system that brings water from hundreds of miles away into New York City into virtually every apartment. In California we brought water from the Sierra Madre all the way down to, Sierra Madre? I’m sorry… all the way down from the, you know, the Sierras down to Los Angeles. We put it into every, piping into every home. In a very short period of time we built this infrastructure. We painted the entire cities. We developed the buildings.

HEFFNER: We’re out of time but we can rebuild is your point. And, and that’s, and that’s an entire note.

ROSNER: The city, one, we’ve done it before and the final thing is that we can do it again. And the trillion dollars can be spread out over 40 or 50 years and it doesn’t sound so overwhelming then. We would save hundreds of thousands of lives.

HEFFNER: Thank you David. And thanks to you in the audience. I hope you join us again next time for a thoughtful excursion into the world of ideas. Until then, keep an open mind. Please visit The Open Mind website at Thirteen.org/openmind to view this program online or to access over 1,500 other interviews. And do check us out on Twitter and Facebook @Open MindTV for updates on future programming.