Dr. Mary Jean Brown: Lead pipes
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The federal government is taking steps to eradicate lead pipes that can contaminate drinking water, including allocating $15 billion to address the problem, and proposing a rule that would require localities to replace all lead pipes within 10 years.
On April 10, 2024, SciLine interviewed:
Dr. Mary Jean Brown, an adjunct assistant professor of social and behavioral sciences at the Harvard Chan School of Public Health. See the footage and transcript from the interview below, or select ‘Contents’ on the left to skip to specific questions.
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Introduction
[0:00:10]
MARY JEAN BROWN: Good afternoon, I’m Mary Jean Brown. I’m an adjunct faculty on the Harvard Chan School of Public Health. I have been working in the area of childhood lead poisoning prevention for more than 40 years.
Interview with SciLine
What are some of the ways lead exposure affects children’s health and development?
[0:00:38]
MARY JEAN BROWN: Now, lead causes a continuum of damage. The higher the blood lead level, the more severe the damage, and children can die from lead poisoning. And it doesn’t happen in the United States very often, but internationally, it continues to happen. Children can have major intellectual disabilities as a result of their exposure—so, IQs less than 75. They can be more likely to have—because of the impulse control and poor judgment—they could be more likely to commit violent acts and come to the attention of the criminal justice system. And as teenagers or young adults, they are less likely to graduate from high school. They are more likely to repeat a grade.
How does exposure to water from lead pipes compare to exposure to lead paint or its dust?
[0:01:35]
MARY JEAN BROWN: Lead paint in the 1920s was 50% lead by dry weight—so that’s 50 parts per 100. The action level for lead in water is 15 parts per billion. So, lead paint exposure is going to give a child a much higher blood lead level than a lead in water exposure. But because it’s everywhere—I mean the lead in water—it’s not just how much water the child drinks. It’s how is his formula made? How was her pasta made? Well, you know, it’s so pervasive that it is still very much part of the picture.
What can you tell us about the value of proposed policy efforts to remove lead drinking water pipes in the United States?
[0:02:27]
MARY JEAN BROWN: The EPA estimates from several years ago were that 20% of the average blood lead level of children was from lead in water. So, things are a little bit different now. But if that estimate still holds, I think it’s worthwhile to reduce blood levels by 20%.
What is the most common cause of high blood lead levels in American children?
[0:02:55]
MARY JEAN BROWN: Lead paint and lead paint contaminated house dust and soil is the most common cause of high by historic standard or by yeah, by historic standards, high blood levels. So, blood levels of 15 or 20 micrograms per deciliter. There’s most likely a paint source. Children are exposed to that just through their normal hand to mouth activities. I mean, most of these children are between 18 and 24 months. So, you know, there’s a lot of this that goes on.
What can you tell us about racial and socioeconomic disparities in lead exposure?
[0:03:35]
MARY JEAN BROWN: There has always been African American—Black children—have always been more likely to have high blood lead levels than other children in the United States. Poor children have always had higher blood lead levels than other children in the United States. This is for a couple of reasons. But the most important one is because in poorly maintained rental housing, the person that’s living there doesn’t have control over the paint condition.
What steps can parents take in their everyday lives to reduce their children’s risk of lead exposure?
[0:04:12]
MARY JEAN BROWN: There’s good reasons to wash children’s hands before they eat. And lead is one of them. There’s good reason to feed children a diet that’s rich in iron and calcium, and has moderate fat but not a high fat diet. And lead is one of them. There’s reasons to have a sandbox so that children aren’t digging in dirt right up against the house, right? So, you have a sandbox and play in the sandbox. Lead is one of them.
How can adequate levels of dietary calcium and iron reduce the health risks associated with lead exposure?
[0:04:53]
MARY JEAN BROWN: Iron and calcium and lead are all the same chemically. The body doesn’t distinguish between them. So, if you don’t have enough iron in your blood—if you’re anemic or have iron deficiency—your body will absorb lead more efficiently than it would if you didn’t have iron deficiency. So, there’s competition for sites, and that’s basically how it works. Yes, the absorption level goes up if the child doesn’t have enough iron and enough calcium, and the absorption level goes down when they’re iron sufficient, calcium sufficient.
How and why should parents monitor their children’s blood lead levels?
[0:05:43]
MARY JEAN BROWN: Parents can have their child tested. It’s a blood lead test. It is usually a finger stick. It can be a venous test. Children should be tested at one and at two, at the very least, or three if they’ve never been tested before. Because that’s the only way that you will know that your child is being exposed to lead in his environment. That’s beyond what’s average for people, right? So you know that if this child’s blood lead level is 3.5 micrograms per deciliter or higher, then that child is in the top two and a half percent of blood lead levels in the United States. And that means there’s something different about that child’s environment, and we need to get in there and make sure that we identify it and remove the source, and then continue to test him to make sure that the blood levels going—well, at least it’s not going up—and that over time, it’s going down.
What concerns do you have about the current push to replace lead pipes in the United States?
[0:06:55]
MARY JEAN BROWN: One of my concerns about the removal of these lead pipes—as much as I support that concept and I think it’s going to really have a big impact on average blood lead levels of children in this country—but I’m wondering where the lead is going. Lead is a commodity. It’s also an element. So, it’s very easy to recycle it, even in very unsafe, informal situations. It has a very low melting point. And when you are when you recycle it, you get back get back a product that’s just as good as something that’s brand new and was just mined yesterday. So, it’s very much in demand and used in battery production and battery repair. And I just think it would just be such a cruel irony if we prevent lead exposure in American children by shipping this stuff to poor countries where it will be recycled in these very informal situations that you know, there’s no control of their emissions. The men and women that work there go home with dust and ash from the lead on their clothing, and it has caused considerable—it has had a big impact on children in countries with developing economies.
What advice do you have for reporters covering lead exposure?
[Posted April 10, 2024 | Download video]
