Toxic

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DECEMBER 23, 2002

Toxic

You didn't have to be a fortune-teller to see that the October
meeting of the Advisory Committee on Childhood Lead Poisoning
Prevention was going to be more controversial than usual. The
panel, which advises the Centers for Disease Control and Prevention
(CDC), had been gearing up for a few months to consider whether the
federal standard for lead poisoning, set in 1991, should be even
tougher. The answer was likely to be yes, given new research
linking even modest lead exposure to developmental problems in
children.But, just a few weeks before the meeting, the Bush administration
shook up the advisory committee's membership. When it came time to
fill a group of vacancies on the panel this year, Secretary of
Health and Human Services (HHS) Tommy Thompson rejected several
nominees recommended by the staff scientists at the CDC in favor of
five people who seemed likely to look upon further tightening of
lead regulations skeptically, if not to oppose it outright. One of
the nominees had repeatedly stated that the current
standard--endorsed by everybody from the National Academy of
Sciences to the American Academy of Pediatrics--was too strict.
Another had stated that children could tolerate lead levels seven
times the current standard without suffering cognitive harm. Even
more disturbing, at least two of the new appointees had direct
financial ties to the lead industry: One was a consultant whose
clients included a prominent lead-smelting company fighting a
lawsuit over pollution in Washington state. Another, a pediatric
toxicologist from Oklahoma, had been a paid defense witness in
several liability suits against lead-paint companies.

Word of these appointments drew the ire of a few Congressmen,
California's Henry Waxman calling it an attempt to "turn back the
clock on children's health. " And when the panel convened for its
October meeting, inside a windowless conference room at a San
Francisco Hyatt, veteran members of the panel looked upon the
newcomers with some wariness. In an apparent attempt to win their
trust through brutal candor, one of the new appointees, Sergio
Piomelli, a Columbia University pediatric hematologist, decided to
confront suspicions about him and the other new appointees head-on.
"Before some reporter detects it," Piomelli said in his thick
Italian accent, "I would like you to know that I was called a few
months ago from somebody from the lead industry, whom I don't know
his name and don't remember, and asked if I don't mind if they
nominated me for this committee. I said, `Yes.' This was my
involvement with the lead industry."

Although nobody questioned Piomelli's personal integrity --as he
noted for the group, his original research had helped to convince
the government to ban lead from gasoline in the 1970s--the idea
that the lead industry was going around recruiting nominees seemed
to validate suspicions that President Bush was stacking the
committee at the industry's behest. And it would soon turn out that
Piomelli wasn't the only person the industry approached. William
Banner, the Oklahoma toxicologist who has testified on behalf of
lead-paint companies, recently told The New Republic that he, too,
got his first contact about the committee from a lead-industry
representative. Like Piomelli, he couldn't remember exactly who
spoke with him or even whether that person was a lobbyist, a
lawyer, or a corporate official. But he recalled that the person
said something like, "Do we have your permission to mention your
name?" (The other proposed panelist with known relationships to the
lead industry, consultant Dr. Joyce Tsuji of Washington state,
didn't return repeated phone calls for this article. She withdrew
her nomination shortly after it became public, saying she wanted to
avoid the perception of a conflict of interest.)

Although HHS officials insist all the panelists' names came up in
routine consultations with academic experts and professional
associations--"The lead industry had nothing to do with their
appointment," says Robert Wood, Thompson's chief of staff--it's
hard to take those statements at face value. After all, this is the
same administration that removed information about contraception
from HHS websites to appease the religious right; that stacked a
CDC panel on environmental health with scientists tied to the
petroleum industry; and that screened nominees for another CDC
panel, on occupational safety and health, by asking would-be
members for whom they voted in the last presidential election.

And, while it remains unclear just how these new appointees will
impact the lead committee's final recommendations --to a one, they
say they have open minds about where the standard should be--it's
not hard to draw from this episode a lesson about the Bush
administration's political priorities. Ever since the November
elections, the White House and its allies have put out word that
that this generation of triumphant conservatives wouldn't do what
the Gingrich revolutionaries did after 1994, tearing down popular
regulatory programs in order to satisfy K Street contributors. But,
if the lead-panel episode is indicative, the administration is
doing just that--and has been for some time.

As environmental hazards go, lead is a pretty nasty one. Prolonged
exposure in any human is known to cause such serious conditions as
anemia, brain damage, and kidney failure. In children, the effects
of even more modest doses can be equally devastating, sometimes
causing mental retardation. In the '70s, the government cracked
down on the top two sources of lead exposure in humans: gasoline
and household paint. But, while the ban on leaded gasoline
substantially reduced the nation's exposure to airborne lead
particles, it's taking much longer to remove the lead from paint on
homes and public buildings since outright removal of paint from
walls is extraordinarily expensive. According to the most recent
estimates, nearly 40 million homes in the United States still have
lead paint either on the inside or the outside. In these homes,
small children often end up eating chips of lead paint, which have
a sugary-sweet taste, that have fallen from high-friction areas
like windowsills or door frames. The problem is most acute in
low-income, urban communities where landlords tend to be less
responsible about maintenance and where tenants may lack the
resources or the awareness to act on their own. To assist
physicians and public health officials dealing with this situation,
the CDC in 1975 defined "lead poisoning" as the presence of more
than 30 micrograms per deciliter of blood; in 1985, it lowered the
threshold to 25; and, in 1991, it reduced it to ten, where it sits
today.

Naturally, the regulation of lead has never sat particularly well
with the lead industry. Petroleum and paint companies fought their
respective lead bans furiously at first. And, while neither oil nor
paint companies have an interest in overturning the ban
anymore--both have retooled to produce lead-free products--they do
care about the CDC blood-level standard since it could affect their
liability for past actions. Over the years, petroleum, mining, and
smelting companies deposited waste containing lead in landfills,
exposing their employees to it along the way; a lower CDC standard
would mean a potentially higher bill for cleaning up those sites or
for taking care of those employees. The paint industry, meanwhile,
is already fighting lawsuits that closely parallel tobacco
litigation. In one typical case, the Rhode Island attorney general
contends the paint industry concealed lead's true dangers for much
of the twentieth century and, as such, ought to finance the removal
of lead from older Rhode Island homes. A stricter CDC standard for
lead poisoning could lead the court, should it find the paint
industry liable, to increase the clean-up bill it slaps on the
industry.

To be sure, there are some valid reasons to question the most recent
lead studies--and the attempt to tighten the existing lead
standard--such as the fact that it's hard to measure small
disparities in cognitive abilities (i.e., a few IQ points). But
it's one thing to question the new studies, quite another to
question the entire body of research suggesting that lead could
cause intellectual or behavioral problems in children--which is
precisely what Banner, the Oklahoma toxicologist, has done. When a
lawyer in the Rhode Island paint case asked Banner if studies had
ever demonstrated a link between lead exposure and cognitive
problems in children, he said flatly, "I don't think anybody has
demonstrated that." When a lawyer pressed him, Banner indicated that
except in cases of encephalopathy--a severe physical condition that
shows up at blood levels of 70 micrograms per deciliter or
higher--there was no proof that lead causes "central nervous system
deficits or injuries."

These statements seem to put Banner well outside mainstream
scientific discussion: "If he's saying there's no such thing as
asymptomatic lead poisoning, I'd have to disagree," says John
Graef, a well-known lead expert from Children's Hospital Boston who
has served on the advisory committee before. "That flies in the
face of data ... going back forty years." Banner, for his part,
says people have been taking those deposition statements out of
context; his questions, he says, echo those that other
well-respected scientists are asking. And, he says, he also
acknowledges that the current standard "has done a good job" of
identifying at-risk patients and says that, whatever his
preconceptions, he has an open mind about what the committee should
do next.

But, regardless of Banner's intentions and qualifications, it's hard
to imagine he and the other lead-industry-connected members got on
the panel through a disinterested vetting process. For one thing,
nobody whom I interviewed could recall an HHS secretary overruling
staff nominations before. (HHS officials insist the move has
precedent but couldn't provide any specific examples.) What's more,
the list of rejected nominees included some of the best- known
names in lead research today. And finally, keep in mind that
companies with a significant financial stake in lead-poisoning
issues--everybody from Dow Chemical to Dupont to ExxonMobil--all
gave disproportionately to the Republicans in the 2000 and 2002
campaigns.

Admittedly, the CDC's panel doesn't have the power to make policy.
It merely makes recommendations based on its understanding of
available science. But that's precisely the point: To provide
lawmakers with disinterested scientific expertise, such panels need
to be insulated from politics. That's why the law authorizing the
CDC panels says they should "not be inappropriately influenced by
the appointing authority or by any special interest." Yet, as a
recent Science magazine editorial noted, this
administration--unlike its predecessors-- has largely dispensed
with that notion. "Every administration advances its agenda by
making political appointments of scientists and managers to direct
its agencies. But disbanding and stacking these public committees
... devalues the entire federal advisory committee structure."
Alas, that may be exactly what the Bush White House wants.

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