Lead exposure in children linked to violent crime

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Lead exposure in children linked to violent crime

Postby Username » Tue Jun 10, 2008 5:51 am

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LA Times article

Lead exposure in children linked to violent crime

A study finds that even low levels can permanently damage the brain. The research also shows that exposure is a continuing problem despite efforts to minimize it.

By Thomas H. Maugh II and Marla Cone, Los Angeles Times Staff Writers

May 28, 2008

The first study to follow lead-exposed children from before birth into adulthood has shown that even relatively low levels of lead permanently damage the brain and are linked to higher numbers of arrests, particularly for violent crime.

Earlier studies linking lead to such problems used indirect measures of both lead and criminality, and critics have argued that socioeconomic and other factors may be responsible for the observed effects.

But by measuring blood levels of lead before birth and during the first seven years of life, then correlating the levels with arrest records and brain size, Cincinnati researchers have produced the strongest evidence yet that lead plays a major role in crime.

The researchers also found that lead exposure is a continuing problem despite the efforts of the federal government and cities to minimize exposure.

The average lead levels in the study "unfortunately are still seen in many thousands of children throughout the United States," said Philip J. Landrigan, director of the Center for Children's Health and the Environment at the Mount Sinai School of Medicine in New York.

The link between criminal behavior and lead exposure was found among even the least-contaminated children in the study, who were exposed to amounts of lead similar to what the average U.S. child is exposed to today, said Landrigan, who was not involved in the study.

"People will sometimes say, 'This is in the past. We are cleaning up lead. We don't have lead problems anymore,' " said criminologist Deborah W. Denno of Fordham University in New York, who also was not involved in the study. "The Ohio study says this is still a big problem."

Nationwide, about 310,000 children between the ages of 1 and 5 have blood lead levels above the federal guideline of 10 micrograms per deciliter, and experts suspect that many times that number have lower levels that are still dangerous.

"It is a national disgrace that so many children continue to be exposed at levels known to be neurotoxic," said neurologist David C. Bellinger of Harvard Medical School, who wrote an editorial accompanying the study published in the online journal PLoS Medicine.

Although some urban soil is still contaminated with lead from gasoline, 80% of lead exposure now comes from houses built before 1978. Paint in such houses can contain as much as 50% lead, and even if it has been covered by newer, lead-free paint, it still flakes or rubs off.

About 38 million U.S. homes, 40% of the nation's housing, still contain lead-based paint, according to the U.S. Department of Housing and Urban Development. The problem is particularly acute in urban areas, which typically have older housing that has not been renovated.

More recently, parents and authorities have become concerned about increasing levels of lead-based paint in toys imported from China.

Researchers have long known that lead exposure reduces IQ by damaging brain cells in children during their early years.

It is also known that lead increases children's distractibility, impulsiveness and restlessness and shortens their attention span, all factors considered precursors of aggressive or violent behavior.

A landmark 1990 paper by Denno linked lead to increases in criminal behavior, but the children in the study were not tested for lead levels. The diagnoses were based on their physicians' evaluation, Denno said.

The Cincinnati lead study enrolled 376 pregnant women in Cincinnati's inner city between 1979 and 1984, measuring their blood lead levels during pregnancy and the children's levels during their first seven years of life.

In the new study, environmental health researcher Kim N. Dietrich of the University of Cincinnati College of Medicine studied 250 of the original group, correlating their lead levels with adult criminal arrest records from Hamilton County, Ohio.

He and his colleagues found that 55% of the subjects (63% of males) had been arrested and that the average was five arrests between the ages of 18 and 24.

The higher the blood lead level at any time in childhood, the greater the likelihood of arrests. "The strongest association was with violent criminal activity -- murder, rape, domestic violence, assault, robbery and possession of weapons," Dietrich said.

Blood lead levels in the children ranged from 4 to 37 micrograms per deciliter.

The researchers found, for example, that every 5-microgram-per-deciliter increase in blood lead levels at age 6 was accompanied by a 50% increase in the incidence of violent crime later in life. Confirming previous findings, the effect of lead was strongest in males, who had an arrest rate 4 1/2 times that of females.

In a related study, spectroscopist Kim M. Cecil of Cincinnati Children's Hospital Medical Center and her colleagues examined a "representative sample" of 157 members of the same group using whole-brain MRI scans. They found that those with the highest blood levels of lead during childhood had the smallest brain volume.

On average, the brains of those in the study were about 1.2% smaller than normal. The most affected regions of the brain were those regulating decision making, impulse control, attention, error detection, task completion and reward-based decision making.

"The most important message is that lead affects brain volume, independent of demographic and social factors that are often used to explain away poor outcomes" in life, Cecil said. "This is independent biological evidence showing that the brain is affected by lead."

thomas.maugh@latimes.com

marla.cone@latimes.com
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Postby bigearth » Sun Oct 05, 2008 9:41 am

. is it a wise man, who knows that he is not wise
. it's good to have cynicism but not be cynical
. the more truth you live with, in your life, the stronger you are
. intelligence is merely an attitude to knowledge and learning
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Postby Username » Sat Apr 11, 2009 4:19 am

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Salon

Health agency covered up lead harm

The Centers for Disease Control and Prevention withheld evidence that contaminated tap water caused lead poisoning in kids.

By Rebecca Renner
April 10, 2009
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From 2001 to 2004, Washington, D.C., experienced what may have been the worst lead contamination of city water on record. Tens of thousands of homes had sky-high levels of lead at the tap, and in the worst cases, tap water contained enough lead to be classified as hazardous waste. Not that the Centers for Disease Control and Prevention, the government oversight agency for public health, was worried.

A 2004 CDC report found that water contamination "might have contributed a small increase in blood lead levels." The study has been influential. School officials in New York and Seattle have used the CDC report as justification for not aggressively responding to high levels of lead in their water, and other cities have cited the report to dispel concerns about lead in tap water.

But the results of thousands of blood tests that measured lead contamination in children were missing from the report, potentially skewing the findings and undermining public health. Further, the CDC discovered in 2007 that many young children living in D.C. homes with lead pipes were poisoned by drinking water and suffered ill effects. Parents wondered whether the water could have caused speech and balance problems, difficulty with learning, and hyperactivity. Yet the health agency did not publicize the new findings or alert public health authorities in D.C. or other federal agencies that regulate lead, such as the U.S. Environmental Protection Agency or Housing and Urban Development.

"This is a disaster of accountability from CDC's point of view," says John Rosen, a pediatrician and national expert on lead poisoning at Montefiore Medical Center in New York City. "This raises troubling questions about CDC's complicity in passing on dubious data -- and further questions about why CDC did not publicize the 2007 results more broadly."

CDC scientists and press representatives did not respond to requests for an explanation about why the results were not widely publicized. George Hawkins, director of the District Department of the Environment, in Washington, says he became aware of the 2007 study only on April 2 this year, when Salon showed him an abstract of the study. Scientists from other agencies, including EPA and HUD, also say they were never told about the results. "CDC never told us," says an EPA scientist, "and they never asked our help or any other water expert's help when they did their studies. That's a shame and a waste, because when it comes to lead in water, you need engineers, chemists and health people to figure it out." The scientists requested anonymity because they were not authorized to speak to the press.

Salon raised questions in 2006 about the influential 2004 CDC report of lead contamination in the D.C. area. New scrutiny of CDC's work has been sparked by a scientific study published in January that contradicts CDC's conclusion of minimal harm. Environmental engineer Marc Edwards of Virginia Tech, and pediatrician Dana Best of Children's National Medical Center in Washington, used Best's data for children's blood-lead levels and found a jump in high-level results among kids who were infants and toddlers from 2001 to 2004. The authors conclude that hundreds, possibly thousands, of children were adversely affected.

Edwards and Best raised further health concerns about the 40,000 Washington children who were either in the womb or using formula during the crisis, for whom health effects are expected to be the most severe. These children (now 4 to 9 years old) are at particularly high risk for future health and behavioral problems linked to the lead exposure.

In February, a D.C. resident filed a $200 million lawsuit against the D.C. water company, claiming that lead-contaminated tap water poisoned his twin sons as infants, causing them to have ongoing learning and behavioral problems. The D.C. Inspector General is investigating the reasons behind the apparently conflicting results of the two CDC reports.

Mary Jean Brown, head of the CDC Lead Poisoning Branch and principal author of the 2004 study, acknowledges that thousands of blood tests were lost and not included in the study. But she defends the paper's conclusion -- that children's exposure to lead and consequent harm was slight -- on the grounds that only low-level test results were lost.

In a written memo to Salon, explaining the missing data in the 2004 report, Brown writes that the issue became apparent in 2004. The D.C. Health Department had reported testing the blood of 15,755 children in 2002, 18,038 in 2004, but only 9,765 children in 2003. When questioned, D.C. Health Department staff attributed the gap, according to Brown, to a commercial laboratory that failed to submit some test results in the last quarter of 2003, a year when lead levels in the water were high. Specifically, the lab was said to have omitted results below 10 micrograms per deciliter. (This is CDC's current level of concern and a level that many pediatricians and public health experts classify as lead poisoning.)

Brown accepted this explanation. She states that the highest results in 2003 were reported accurately and that a comparison with blood-lead trends in the city suggests that the loss of low-level results did not introduce a bias in CDC's analysis.

"This is just a circular argument, and it doesn't wash," says a government scientist who requested anonymity. "When CDC learned the data was missing, someone could have called the lab and asked for it. If it was the lab's mistake, they would have sent the data," the scientist adds.

Edwards, who examined the data used by CDC for the 2004 report, says that numerous high results were also omitted. Since 2004, he has made a number of attempts to question CDC scientists about apparent problems with the 2004 study. In 2007, Edwards filed a complaint of scientific misconduct with the CDC, alleging that Brown must have known about serious flaws with the data but failed to acknowledge them when writing the 2004 CDC report.

In a message to James Stephens, CDC's associate director of science, he wrote, "Why is it that every child I have personal knowledge of, who had a strong chance of having elevated blood lead from water, is either deleted or otherwise misrepresented in the data that CDC has and used for this publication?" Edwards did not receive an answer. In March 2008, Stephens wrote to Edwards, informing him, "We have examined CDC's role in the study and have found no evidence of misconduct."

CDC scientist Jaime Raymond presented the 2007 results at the American Public Health Association's 2007 annual meeting in Washington. The study used data from a total of 22,981 children under 6 years old who lived in Washington from 1998 to 2006. Twenty-nine percent of the children lived in houses with lead water pipes and were more likely to have contaminated tap water; the rest lived in houses without lead pipes.

Starting in 2001, when the lead levels in the city's drinking water soared, this CDC study shows that the number of kids with high blood-lead levels (above the CDC line of concern) also increased -- and the problem is more severe for kids living in the lead pipe houses. The number of affected kids went down in 2004 as the lead in water decreased. Raymond and colleagues showed that the link between the water and the lead was strong and couldn't be explained by other factors.

"Why has CDC kept quiet about these results?" asks Yanna Lambrinidou, president of Parents for Nontoxic Alternatives, a D.C. activist group "It makes no sense if they are concerned about public health. Are they trying to cover up the harm that lead contaminated water caused in D.C.?" Raymond would not respond to any questions posed by Salon.

Bruce Lanphear, a pediatric epidemiologist at Simon Fraser University in Vancouver, who has studied lead effects on children, says, "It is critical to investigate how and why these earlier studies failed to show any increase in children's blood-lead levels."

The House Science and Technology Committee Investigations and Oversight Subcommittee is beginning an investigation into CDC's handling of the D.C. lead crisis. Subcommittee chair Brad Miller, D-N.C., wrote the CDC on March 13, requesting all "records that indicate possible, probable or actual forgery, fabrication or other intentional misrepresentation of data," concerning lead in the water.

"It would be easier to understand CDC's nonchalance about losing almost half the results for 2003 if its conclusions were consistent with what other scientists found," Miller says. "It's also difficult to understand why the loss of so much data didn't merit a caveat or even a footnote in CDC's report." He adds, "If the CDC tells parents that they shouldn't worry about their children's health, its evidence had better be rock solid. It's hard to win back lost trust."
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Postby chiggerbit » Tue Jun 23, 2009 2:13 pm

http://content.nejm.org/cgi/content/full/358/15/1641

Lead Poisoning Due to Adulterated Marijuana




To the Editor: As a consequence of strict regulations, lead intoxication has not occurred in Germany in recent decades. Recently, during a period of 3 to 4 months, 29 patients (16 to 33 years of age) were admitted to four different hospitals in the greater Leipzig area (population, approximately 650,000) with classic signs and symptoms of lead intoxication. Twenty of these patients were admitted to our hospital (University Hospital Leipzig), 16 on an emergency basis (Table 1). The patients presented with abdominal cramps, nausea, anemia of varying severity, and fatigue. Most patients had basophilic stippling and a "Burton's line," and some had neurologic symptoms. In other hospitals, one patient had severe encephalopathy with hallucinations and peripheral neuropathy with permanent extensor palsy in the forearm, and another patient underwent exploratory laparoscopy.1


Table 1. Clinical and Laboratory Characteristics of 16 Patients with Lead Intoxication.




The diagnosis was quickly established, and chelation therapy was effective, but despite great efforts by health authorities and police, the source of lead could not be identified. After 8 weeks, we detected a common pattern: the patients were young, were unemployed or were students, had a history of smoking, and had body piercings. On questioning, all the patients eventually conceded that they were regular users of marijuana smoked in "joint" form or with the use of a water pipe. We recovered either half-used packages or aliquots of "home supplies" of marijuana from three patients, and we identified elemental lead by means of atomic absorptiometry and 9-tetrahydrocannabinol by means of high-pressure liquid chromatography. One package contained obvious lead particles (Figure 1); this strongly indicated that the lead was deliberately added to the package rather than inadvertently incorporated into the marijuana plants from contaminated soil. At this point, we involved the police, and a full criminal investigation was begun. Health authorities immediately started an anonymous screening program for marijuana users. After 2 weeks, 145 persons had used this service. A total of 95 of these persons had blood lead levels that required treatment (>25 µg per deciliter), and some of these persons had dangerous levels of lead (>80 µg per deciliter).

Figure 1. Typical Street-Size Bag of Marijuana.

In this 10 ($15.39) bag, which was obtained from a patient, the plant material had been mostly consumed. The small grayish metal particles were identified as elemental lead. They can be easily distinguished from marijuana leaves both in the original package (Panel A) and under the magnifying lens (Panel B).




The current working hypothesis of the police is that because of its high specific gravity and inconspicuous grayish color, lead was used to increase the weight of street marijuana sold by the gram and thereby to maximize profits among dealers. In the material that was obtained, the lead content on average was 10% by weight, which translates into a profit increase of approximately 1,000 ($1,500.00) per kilogram of marijuana. Lead particles smoked in a joint, which can have a core temperature of 1200°C,2 are very effectively absorbed in the respiratory tract. The medical community, including pediatricians,3 should consider adulterated marijuana as a potential source of lead intoxication.
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