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NCLB Outrages

From the Government that is Insisting on "Scientific" Reading

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.

— Jonathan Cohn
The Lead Industry Gets Its Turn. Toxic
The New Republic
Dec. 23, 2002


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