Case: Lead Poisoning
Milestones In Public Health: Case Study Chapter 3
Mohammed Bensufia
ID#48011506
Public Health 2, Winter 2018
Dr. Zuzana Bic Step 1: Gather Background Information
The Industrial Revolution transformed much of the United States. Industries that were never before seen or imagine began to spring out of nowhere. This rapid growth became short-lived as cities became crowded, congested, filled with smoke, and health issues such as mounting waste, polluted waterways, and high noise levels plagued the population. In the early 1900’s, oil industries controlled the production of tetraethyl lead (TEL), which they used to improve the efficiency of car engines. Several workers died due to what we now know as lead poisoning, but these companies tried to abate public anxiety by “funding” research to prove that TEL does not affect the health of workers. This was a public health disaster which showcased the power that corporate money had on policies and the health of the public. After many failed attempts by congress to allow states to set their own safety standards, today we have agencies like the EPA that houses many federal bureaus to deal with population and environmental health [1].
Step 2: Analyze the Current Situation
The first published report of lead poisoning came out in 1911 by Graham Rogers, where almost 600 cases of lead poisoning had been studied following the rise of public panic due to the deaths of many employees that worked in lead related industries[2]. This followed by the TEL incident in the 20’s, where it would take almost a century for it to be banned [1]. During that time, it tainted the soil and was tracked into homes, where children play, where it can still be found in the environment today [3]. Carbonate, another type of lead, was mixed with linseed oil to create paint that would be used in homes until it was banned in the late 70’s. This paint can still be found in homes today, especially lower income homes where African Americans and Latinos live. No one knows how many people are affected, but it is in the millions. The current problem is facing minority communities and usually people who rent homes, where many homes do not undergo renovation. Korfmacher evaluates the effectiveness of the Rochester Lead Law in New York, which requires lead inspections of rental homes built before 1978. He concluded that although landowners argued against mandatory inspection of homes, citing an impact on the number of people willing to rent homes, the law has helped decrease the number of incidents of lead poisoning while having very little effect on the number of renters [7]. This gives hope that other laws would have a positive effect.
Step 3: Core Issues
According to the Center for Disease Control, approximately half a million U.S. children 0 to 6 years of age have blood lead levels at or above 5 micrograms per deciliter [4]. A core issue of lead poisoning is the idea that it would cost billions of dollars to find a solution to remove lead from the environment. This is a misconception though, as the World Health Organization (WHO) created a study that found that the childhood lead poisoning costs the United States around 43 billion dollars per year. In addition to that, they estimate that for every dollar that the government spends to reduce lead hazards, they would benefit from saving of more than 200 dollars. This cost benefit ratio is much greater than that of most vaccines [5].
Step 4: Analyzing Alternatives
If we refer to the Health Belief Model, we can come to the conclusion that to keep lead poisoning safety a priority, there needs to be a pressing issue. The recommendations should also be as cost effective as possible. We should utilize the Remodeler/Renovator Program under the U.S. Environmental Protection Agency’s 2010 Lead-Based Paint Renovation, Repair and Painting (RRP) Rule, which dictates that workers need to be certified and trained in the use of lead-safe practices when renovating homes that contain lead-paint [6]. This will help assure that new homes and old ones can be lead free and safe for the development of children.
Step 5: Provide Recommendations
Based on my readings and own knowledge, I recommend that we utilize a community based approach in which community members mobilize to tackle sources of lead-poisoning as well as provide educational programs on the risks of lead-poisoning as well as educating mortgage officers as well as land-lords. There should be a conduction screening to see who is affected in a community to elevate awareness. It is also important to implement policy changes by speaking with your elected officials. These recommendations have been proven to be very effective in tackling health disparities [1].
Step 6: Establishing an Action Plan
Eliminate childhood lead poisoning by 2028 will require cooperation from government and private sectors of all levels. This cooperation between government an private sectors would include public health experts speaking with companies and non-profits on ways to remove lead poisoning from the public sphere.
New Jersey is the first state to come up with a plan to end lead-poisoning in 10 years. The state proposes to tackle this issue focusing on those most at-risk for lead poisoning. This can be done through the sharing of data through local health departments, nonprofits, community groups and families to address root causes of lead-poisoning [6].
Step 7: Conclusion
Lead poisoning should not be added as a concern to a parent which has enough on their mind to worry about. I believe that Latino and African American communities affected by lead-poisoning is one of the best examples of institutionalized racism. It provides us with an idea of how these communities have been affected by laws and home institutions which do not care about the health of its citizens. People in Flint, Michigan are a prime example of this as well. The issue surrounding the community has exposed health disparities of residents. This type of health issue would not be happening in a wealthier area of Michigan. The EPA has taken long enough to analyze and assess the silent lead-poisoning epidemic in this country and should act now.
References
Mile stones in public health: accomplishments in public health over the last 100 years. New York: Pfizer Inc.; 2006. Accessed March 1, 2018.
(2) Lead Poisoning in the United States. (2009). American Journal of Public Health, 99(S3), S547-S549.
(3) Bachmann, John. (2007) Air Quality and Climate Connections. Journal of the Air & Waste Management Association 65:6, pages 641-644.
(4)“Reducing Childhood Lead Poisoning Rates.” Center for Disease Control, 2016, www.cdc.gov/nceh/lead/programs/docs/rhodeisland-2016_508.pdf.
(5) Amitai, Yona, et al. “Childhood Lead Poisoning.” World Health Organization, 2009.
(6) Green and Healthy Homes. (2018). New Jersey Lead Poisoning Prevention Action Plan.
Available at www.greenandhealthyhomes.org/sites/default/filesGHHI_NJReport_5E.pdf
(7) Korfmacher, K. S., Ayoob, M., & Morley, R. (2012). Rochester's Lead Law: Evaluation of a Local Environmental Health Policy Innovation. Environmental Health Perspectives, 120(2), 309-315. doi:10.1289/ehp.1103606