Perspectives | Editorial May 2016 | Volume 124 | Issue 5
Crumbling Infrastructure and Learning Impairment: A Call for Responsibility
Edward D. Levin
Duke University, Durham, North Carolina, USA
Citation: Levin ED. 2016. Crumbling infrastructure and learning impairment: a call for responsibility. Environ Health Perspect 124:A79; http://dx.doi.org/10.1289/EHP69
The author declares he has no actual or potential competing financial interest.
Final Publication: 1 May 2016
PDF Version (126 KB)
We have known for many decades that lead exposure in children causes long-lasting cognitive dysfunction (Byers and Lord 1943; McKhann 1932). A great number of basic and human health studies have shown in great detail the neural mechanisms and behavioral consequences of developmental lead intoxication and how early-life lead exposure can lead to lifelong cognitive and emotional impairment. We have learned that even quite low levels of lead exposure can cause persistent cognitive impairment (Lanphear et al. 2005).
The removal of lead from gasoline and paint was one of the great successes of the environmental health movement (Needleman 1998), and lead levels in our children have declined steadily over recent decades (Jones et al. 2009). However, that improvement has stopped in recent years (NCEH 2016) and in some places reversed, like in Flint, Michigan, where a deteriorating public water system has resulted in elevated lead levels in people’s drinking water (Hanna-Attisha et al. 2016). Deferred maintenance and deteriorating infrastructure do not just result in the nuisance of leaking pipes and potholes, but also cause increased risks to human health. Lead neurotoxicity is not as immediately catastrophic as collapsing bridges, but is often more insidious, impairing cognitive and emotional function over a period of decades. Abdicating our social responsibility to maintain our nation’s infrastructure not only results in the obvious crumbling buildings and bridges, it also jeopardizes the brain development of our next generation.
As Dr. David Bellinger recently detailed in his excellent perspectives piece in the New England Journal of Medicine (Bellinger 2016), the excessive lead in Flint’s drinking water is “an abject failure to protect public health.” We know better and should be better stewards. We risk leaving our children not only a compromised environment but also compromised minds. The lead-laden drinking water in Flint is not only an environmental health crisis that must be remedied, it is also a call to be vigilant to prevent harmful exposures due to crumbling infrastructure, which can considerably add to the neurotoxic risks posed by other environmental toxicants found in and around our homes.
The cost of keeping our water (and air and food) clear of toxics pales in comparison to the cost of our impaired brain and health function over the decades to come. It is quite short-sighted to say that we cannot afford to maintain our infrastructure and environment, when in fact we cannot afford not to do so. Can we learn the lesson of Flint and come clean with our environment? Lead intoxication during development causes cognitive impairment. However, even those of us older folks who grew up in the era of higher lead levels should be able to learn the lesson of Flint and develop cleaner solutions for the drinking water of our children.
Bellinger DC. 2016. Lead contamination in Flint—an abject failure to protect public health. N Engl J Med 374(12):1101–1103, doi: 10.1056/NEJMp1601013.
Hanna-Attisha M, LaChance J, Sadler RC, Schnepp AC. 2016. Elevated blood lead levels in children associated with the Flint drinking water crisis: a spatial analysis of risk and public health response. Am J Public Health 106(2):283–290, doi: 10.2105/AJPH.2015.303003.
Jones RL, Homa DM, Meyer PA, Brody DJ, Caldwell KL, Pirkle JL, et al. 2009. Trends in blood lead levels and blood lead testing among US children aged 1 to 5 years, 1988–2004. Pediatrics 123(3):e376–e385, doi: 10.1542/peds.2007-3608.
Lanphear BP, Hornung R, Khoury J, Yolton K, Baghurst P, Bellinger DC, et al. 2005. Low-level environmental lead exposure and children’s intellectual function: an international pooled analysis. Environ Health Perspect 113(7):894–899, doi: 10.1289/ehp.7688.
McKhann CF. 1932. Lead poisoning in children: the cerebral manifestations. Arch Neurol Psychiatr 27(2):294–304, doi: 10.1001/archneurpsyc.1932.02230140048004.
NCEH. 2016. CDC’s National Surveillance Data (1997–2014). Atlanta, GA:National Center for Environmental Health, Centers for Disease Control and Prevention. Available: http://www.cdc.gov/nceh/lead/data/national.htm [accessed 30 March 2016].
Needleman HL. 1998. Childhood lead poisoning: the promise and abandonment of primary prevention. Am J Public Health 88(12):1871–1877 [Pubmed].
EHP is pleased to announce that Prenatal Exposure to Glycol Ethers and Neurocognitive Abilities in 6-Year-Old Children: The PELAGIE Cohort Study, published in EHP on 14 October 2016, has been selected by the Children’s Environmental Health Network (CEHN) as its May 2017 Article of the Month. CEHN Article of the Month summaries discuss the potential policy implications of current children’s environmental health research. The CEHN summary can be viewed here.
Among the Resources now available on our Children’s Health page is the text of Executive Order 13045, “Protection of Children from Environmental Health Risks and Safety Risks” (21 April 1997). The Executive Order noted the particular vulnerabilities of children to environmental hazards, codified the need to identify and alleviate such risks, and created the President’s Task Force on Environmental Health Risks and Safety Risks to Children to identify data resources and promote research in these areas. As we mark 20 years since the order was enacted, we can see how these efforts have produced important research and mitigation of hazards—a strong base for continued work on behalf of children’s environmental health.
EHP is excited to announce that, starting later in May 2017, the journal will transition from a traditional, issue-by-issue publishing model, to a new, article-by-article publishing model known as continuous publication. This is a more modern way of publishing an online journal, and one that should help to significantly improve EHP’s time to publication. (more…)