The American Public Health Association,
Noting that the US Department of Health and Human Services considers lead poisoning to be one of the most common and serious environmental diseases in young children in the US, completely preventable;l and
Noting that early and recent research has found neurodevelopmental delays in children at increasingly lower levels of lead exposure;2-12and
Recognizing that 4.4% of children aged 1-5 years have blood lead levels above 10 mcg/dl;13 and
Noting that children who live in poorly maintained, older housing are at disproportionate risk of being lead-poisoned;1,13,14 and
Noting that the single most important source of lead poisoning in children in the US is lead paint;1,14 and
Noting that over 50 million housing units in the US have lead paint;15and
Noting that the cost of abating the nation's residential lead paint hazards and treating the short- and long-term effects of lead poisoning is many billions of dollars,15 and that there is no source to fund abatement efforts on a consistent, large-scale and long-term basis, which means that the public health problem will remain fundamentally unaddressed; and
Understanding that lead paint was recognized as a source of lead poisoning in young children as early as 1904;16 and
Being aware that scores of articles on child lead paint poisoning were published in medical and scientific journals between 1904 and 1950;17,18 and
Noting that the major lead paint and lead pigment manufacturers became well aware of the dangers of lead paint to children in the early 1900s, yet continued to sell lead paint well beyond 1950;17 and
Understanding that lead pigment manufacturers, despite the knowledge of the hazards, continued campaigns to promote and increase the sale of lead-based paint and minimize the public and governmental knowledge of the hazards;17,19 and
Recalling that the principle of "polluter pays" is well-established in cases of environmental damage and public health problems, some examples being: tobacco (taxes, state government law suits);20-23asbestos (governmental24 and private law suits); Superfund (trust fund, governmental law suits);25 Florida Everglades pollution from sugar production (state constitutional amendment requiring that the polluter pay);26 and
Noting that over the 1920-1936 period alone, the lead pigment industry sold over $455 million (in 1920-1936 dollars) worth of white lead pigment;27,28 and
Noting that the largest manufacturers of lead pigment in this century, or their successors, are still in business as profitable companies (combined net assets in 1995 of approximately $30 billion)29,30 and have not been held financially accountable for the damage caused by their products; and
Recalling that there are precedents (such as the cases of asbestos,24cigarettes,20-23 Superfund25) for governments suing polluting companies to recover damages; and that doing so in the case of lead paint poisoning could help increase public visibility of the issue; and that doing so may help discourage corporations from engaging in future irresponsible behavior that damages the environment or the public health; and
Recognizing that residential lead-based paint abatement has been found overall to be safe and effective in reducing children's exposure to lead,3l-34 despite some conflicting data;35,36
Noting that data are lacking on the optimal methods of lead paint abatement to maximize safety, efficacy and cost-effectiveness;
Recognizing that HUD-proposed standards and EPA guidance levels for lead in dust and soil do not adequately protect children from sub-clinical lead toxicity. In fact, these standards and guidance levels are 4- to 10-fold higher than levels estimated to be associated with 10% of children having a blood lead level in excess of 10 mcg/dl.37 Further recognizing that other studies indicate that dust lead levels considerably lower than 100 mcg/dl on floors are inadequate to protect children from undue lead exposure;38,39 therefore
- Supports efforts to increase the resources devoted to lead abatement, reduction of lead hazards in housing, and community-based prevention and health education;
- Supports efforts to raise such resources through a variety of means including litigation against manufacturers of products that contain lead (such as lead manufacturers), legislation, negotiation, and fees;
- Urges the federal government to pass legislation establishing a tax on the production of lead to be used for a trust fund for removing lead paint hazards in low-income housing and for community-based prevention and risk reduction health education;
- Reaffirms the recommendations provided by APHA policy statement #8909: Reducing Health Risks Related to Environmental Lead Exposure;
- Urges the EPA to promulgate a health-based standard for house dust and residential soil that are adequate to protect preschool children from unacceptable lead exposure;
- Urges HUD to conduct a national survey of housing, incorporating sources of lead exposure and children's blood lead levels; and
- Urges HUD, EPA and CDC to collaboratively fund or conduct research on the optimal methods of abatement to maximize safety, efficacy and cost-effectiveness.
- Centers for Disease Control. Preventing Lead Poisoning in Young Children. Atlanta: US Department of Health and Human Services, 1991.
- Byers R, Lord E. Late effects of lead poisoning on mental development. Am J Dis Child 1943;66:471-494.
- Needleman HL, Gunnoe C, Leviton A, Reed R, Peresie H, Mager C, Barrett P. Deficits in psychologic and classroom performance of children with elevated dentine lead levels. N Engl J Med 1979;300:689-695.
- Winneke G, Lilienthal H, Kramer U. The neurobehavioural toxicology and teratology of lead. Arch Toxicol 1996; 18(Suppl):57-70.
- Landrigan PJ, Todd AC, Wedeen RP. Lead poisoning. Mount Sinai J Med 1995;62:360-364.
- Bellinger D, Dietrich KN. Low-level lead exposure and cognitive function in children. Ped Annals 1994;23(11):600-605.
- Needleman HL. The current status of childhood low-level lead toxicity. Neurotoxicol 1993;14(2-3):161-166.
- Agency for Toxic Substances and Disease Registry. The Nature and Extent of Lead Poisoning in Children in the United States: A Report to Congress, 1988. Atlanta, GA: US Department of Health and Human Services, Public Health Service.
- Needleman HL, Gatsonis CA. Low-level lead exposure and the IQ of children. JAMA 1990;263:673-678.
- Schwartz J. Low-level exposure and children's IQ: A meta-analysis and search for a threshold. Environ Res 1994;65:42-55.
- Shukla R, Dietrich KN, Bornschein RL, Berger O, Hammond PB. Lead exposure and growth in the early preschool child. Pediatrics 1991;88:886-892.
- Needleman HL, Riess JA, Tobin MJ, Biesecker GE, Greenhouse JB. Bone lead levels and delinquent behavior. JAMA 1996; 275:363-369.
- Centers for Disease Control. Update: Blood lead levels-United States, 1991-1994. MMWR 1997;46:141-146.
- Sargent JD, Brown MJ, Freeman JL, Bailey A, Goodman D, Freeman DH. Childhood lead poisoning in Massachusetts communities: its association with sociodemographic and housing characteristics. Am J Public Health 1995;85:528-534.
- HUD. Comprehensive and Workable Plan for the Abatement of Lead-Based Paint in Privately Owned Housing. Washington, DC: US Department of Housing and Urban Development, 1990.
- Gibson JL. A plea for painted railings and painted walls of rooms as the source of lead poisoning amongst Queensland children. Australian Medical Gazette 1904;23:149-153.
- Rabin R. Warnings unheeded: a history of child lead poisoning. Am J Public Health 1989;79:1668-1674.
- Lin-Fu J. Lead poisoning and undue lead exposure in children: history and current status. In: Needleman HL (ed): Low Level Lead Exposure: Clinical Implications of Current Research. New York: Raven Press, 1980.
- Environmental Defense Fund. The Hour of Lead. Washington, DC: Environmental Defense Fund, 1992.
- Commonwealth of Massachusetts v. Philip Morris, Inc. et al., Civil No. 95-7378, Massachusetts Superior Court.
- Moore v. The American Tobacco Co. et al., CN 94-1429, Chancery Court of Jackson County, Mississippi.
- McGraw v. The American Tobacco Co. et al., 94-C-1707, Circuit Court of Kanawha County, West Virginia.
- The State of Florida, Lawton M. Chiles Jr., Individually and as Governor of the State of Florida, Department of Business and Professional Regulation, and the Agency for Health Care Administration v. The American Tobacco Co. et al., CN 95-1466, Fifteenth Judicial Circuit, Palm Beach County, Florida.
- State v. Owens Corning Fiberglass, et al., Massachusetts Superior Court, Civil docket #90-3791-A.
- Comprehensive Environmental Response, Compensation and Liability Act of 1980, US Congress.
- State of Florida Constitution, Amendment No. 5.
- US Bureau of Mines: Minerals Yearbook. Washington, DC: US Bureau of Mines, 1921-1935.
- Oil, Paint and Drug Reporter: Lead, zinc pigment sales: 1936. June 28, 1937.
- Moody's Investors Service. Moody's Industrial Manual. New York: Moody's Investors Service, 1996.
- Moody's Investors Service. Moody's OTC Industrial Manual. New York: Moody's Investors Service, 1996.
- Farfel MR, Chisolm JJ. An evaluation of experimental practices for abatement of residential lead-based paint: report on a pilot project. Environ Res 1991;55:199-212.
- Farfel MR, Chisolm JJ, Rhode CA. The long-term effectiveness of residential lead paint abatement. Environ Res 1994;66:217-221.
- Staes CJ, Matte T, Copley G, Flanders D, Binder S. Retrospective study of the impact of lead-based paint remediation on children's blood lead levels, St. Louis. Am J Public Health 1994;139: 1016-1026.
- Swindell SL, Charney E, Brown MJ, Delaney J. Home abatement and blood lead changes in children with class III lead poisoning. Clin Ped 1994;September:536-541.
- Farfel MR, Chisolm JJ. Health and environmental outcomes of traditional and modified practices for abatement of residential lead-based paint. Am J Public Health 1990;80:1240-1245.
- Aschengrau A, Beiser A, Bellinger D, Copenhafer D, Weitzman M. The impact of residential lead-based paint hazard remediation and soil lead abatement among children with mildly elevated blood lead levels. Am J Public Health 1997;87:1698-1702.
- Lanphear BP, Weitzman M, Winter NL, Tanner M, Yakir B, Eberly S, Emond M, Matte TD. Lead-contaminated house dust and urban children's blood lead levels. Am J Public Health 1996;86:1416-1421.
- Rabinowitz M, Leviton A, Needleman H, Bellinger D, Waternaux C. Environmental correlates of infant blood lead levels in Boston. Environ Res 1985;38: 96-107.
- Clark S, Bornschein R, Succop P, Roda S, Peace B. Urban lead exposures of children in Cincinnati, Ohio. Chemical Speciation Bioavailability 1991;3:168-171.
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