Everything Old is New Again: Lead Poisoning

So, like most of us, I'm reading over back issues of The Western Journal of Medicine and Surgery, and I stumble upon an article I'd dog-eared some time back. It's an "Analysis of Boston Waters," from their April 1846 issue. You know, page 362? The one that has Benjamin Silliman warning against lead poisoning. You know Silliman, leading light of the early years of American science, founded and editor of the American Journal of Science, incorporating member of the National Academy of Science? Yes, that Benjamin Silliman. Well, he's saying "it is the course of safety to avoid, as far as possible, the use of lead pipes for conveying water which is to be used for drinking." (For those reading from a university, you might have access to Pro Quest and the American Periodical Series here.)

I had reached back to that issue because one of the recent Science magazines (March 23) had a review of a new book (here, as a *.pdf), The Great Lead Water Pipe Disaster, by Werner Troesken (MIT Press: Cambridge, MA, 2006). Troesken's book, which was favorably reviewed, concludes that lead has "brought illness and frequently death to millions of people." For example, and as a historical comment: "In 1900, 85% of large U.S. cities had lead pipes and so did most major European cities. In regions supplied with corrosive waters, such as Massachusetts and northern England, tap water contained hundreds of times more lead than modern standards allow."

I take it from the review that Troesken has done an admirable job putting the not-new story of lead and public health together, combining historical evidence with modern epidemiology. (I haven't read the book, and so make no overtures about its quality.) I was struck, though, that the reviewer pointed to this claim: "Observant doctors and scientists began attributing sickness and death to lead pipes as early as the 1850s." I thought there was something weird about that, since Ole Benny S, and I'm sure many others, were talking about it at least in the decade before . Romans knew about lead problems, so there's nothing new in that specifically - but, I take it, an understanding of medically explainable causal mechanisms didn't fit into an effective medical mindset until the 19th century. My point being, lead pipes, water, and health have been linked in America since at least the 1840s.

I was also reminded of another lead and public health book, Deceit and Denial: The Deadly Politics of Industrial Pollution, by Gerald Markowitz and David Rosner. Their book is a powerhouse expose of the long, sordid history of industrial and then corporate involvement in the promotion of lead products, even as the industry was aware of the dangers, especially in the early part of the 20th century. As they say here, the book, published in 2002, "looked at questions regarding how two industries, the lead industry and the chemical industry, reacted when faced with information regarding the potential dangers of their products to human health during the twentieth century."

Markowitz and Rosner were subsequently attacked by the chemical industry ("Airco, Dow, Union Carbide, Goodyear, Goodrich, and Shell among others"), subpoenaed, and brought into the proceedings of some lawsuits involving the chemical industry. (Read about it at The Nation and in the Chronicle of High Ed.) The industry hired a history professor to argue that Markowitz and Rosner's scholarly standards were improper and, thus, their book was invalid. The industry claimed that "they had inadequately and inaccurately documented our statements." Anyway, this post isn't about M and R (although here is a review of the book in Science, and it's a favorable one). I was just brought to recall that incident because of the above references to lead and lead poison.

And to bring this from 1846, to the early 1900s, to 2007, we can look to the current lead pipe health issue in the DC water system. Troesken's reviewer points to the DC issue, and the fact that lead poisoning is still going on would also indicate that lead and public health are as alive as ever. (Quickly, about the DC issue: The Washington Post reported in 2004 that "Two-thirds of the 6,118 residences...tested last summer, or 4,075 homes, had water that exceeded the lead limit of 15 parts per billion set by the Environmental Protection Agency in 1991." Salon reported on broader lead poisoning and EPA issues here.) Perhaps this is no surprise, and perhaps the difference in scale and degree of the lead poisoning changes the tenor of the conversation. Perhaps. But the fact that we still have lead pipes in municipal water systems is distressing nonetheless.

It seems we always want to suppose a direct relationship between knowledge and action. That if we know "A," then the course of action "B" will follow. And it's likely that the fallacy of this belief in a simple and direct relationship between knowledge and action is what fascinates me most about studying science and technology in society (STS). As an STS scholar, I am most interested in practices of knowledge production - how do we do it, how have we done it before, what do we do so others know what we've done, what do we do with the knowledge once we've go it, and so on - precisely because that relationship between knowledge and action is not direct. This helps explain why and how I study and critique S and T -- it isn't to suggest that S and T are not valuable, but to examine in what ways they are valuable and how we make them so.

Dave just posted a comment on AIDS denialists, and the whole gamut of denialism would seem to fit a similar category - here we have the knowledge, but not the action. We know about HIV, but some in South Africa don't follow a course of action that seems clear to us. Why is that? What's it take to get from one to the other?