This Podcast Will Kill You - Ep 38 Lead Poisoning: Heavy Metal Episode

Episode Date: November 26, 2019

This episode, our first foray into toxic metals, is heavy in all kinds of ways - metallically, emotionally, informationally, politically. Lead poisoning has been around for about as long humans have been working with lead, but despite its extensive history, it still poses an incredibly huge public health problem today, especially for children. Tune in to hear us chat about the multitude of effects lead exposure can have on your body, the dark and often strange history of lead poisoning (ancient Rome, anyone?), and the alarming extent to which lead exposure affects people around the world today. See omnystudio.com/listener for privacy information.

This is exactly right. There are already enough things charging your card every month. Dinner should not be one of them, which is exactly why Blue Apron is now subscription-free. You heard that right, Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients, so there's no meal planning and no extra grocery trip. Order now at Blue Apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50.

Terms and Conditions Apply. Visit blueapron.com slash terms for more information. This is Bethany Frankel from Just Be with Bethany Frankel. Listen, I have a bone to pick with these dog food brands calling themselves fresh, natural, healthy. Sounds great, but a lot of these quote-unquote fresh dog foods in your fridge are not even 100% human grade, which is why feed your babies just food for dogs. It's good enough for big and smalls, my precious babies, so it's good enough for your babies. 100% human grade, real ingredients, beef, sweet potatoes, green beans, delicious.

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Val, bad pun. Outdo it with Intuit QuickBooks. Feature availability varies by product. John was a well-nourished, playful, and cooperative child, with no history of developmental problems, according to the admitting nurse. John was admitted to the hospital because he had developed an ear infection, but that was easily treated.

In the ensuing months, John returned periodically to the clinic for treatment of his chronic earache. but by the time he was two years old, he had developed symptoms that were not at all routine. In May 1941, his parents rushed him to the hospital. A few hours earlier, he had bent over to the left and couldn't straighten up, they told the admitting nurse. And since that time, he had been acting crazy-like. John had been eating plaster, they said, and the previous day he had eaten some paint. At the hospital, he fell to the left side when he tried to walk, and he reeled around to the left. He didn't respond to his next. He didn't respond to his

name or questions. The hospital raised the possibility that John suffered from lead poisoning, encephalitis, and secondary anemia. The blood work showed 390 micrograms of lead per decilator of blood, almost 80 times the level considered by the CDC to be dangerous for children 70 years later, and at the time clearly a cause of acute poisoning. When told that paint from the windowsills was dangerous, his mother said she had not realized its danger and had caught him. on frequent occasions with a mouthful of paint chips. She promised that in the future, she would make every effort to keep the child away from the paint. In mid-June, 1941, after more than a month in the hospital, John's symptoms subsided, and he was sent back home. But two months later, the mother was

back at the social service department. In the words of the social worker, the family had contacted the real estate agency several times about repair work, but with no success. There continued to be problems of loose plaster throughout the home in spite of their efforts at repair. The social worker contacted the health department, which promised to investigate the home conditions, but we know neither the results nor what befell John in subsequent years. Wow. Yeah. That's so sad.

Yeah, it really is. Unfortunately, not uncommon. Oh, no. That's like one case. That's like one story of millions. Yep. Yeah. So what was that from?

That was from the book Lead Wars. Hi, I'm Erin Welsh. And I'm Aaron Alman Updike. And this is This Podcast Will Kill You. And today we're talking about... Lead poisoning. Lead poisoning. Yeah, it's a huge topic.

Do we say that every single time? We absolutely do. Is it always true? It always is. Yeah, I'm excited for this one, though. We also say that every time and it's also true every time. I know. This is genuine, people. It really is. Okay. Well, it's also quarantine time.

That's right. What are we drinking this week? Today we're drinking the fall of Rome. We are. It's named that for reasons that I will tell you later on in the episode. Yes, it will become quite clear if you can't figure it out already. And what is in the fall of Rome? It's basically a sangria. It is. So it's red wine, brandy, cut up, oranges, lemons, green apples, and then a cinnamon stick tossed in there and maybe serve it over ice with a splash of club soda.

Try to avoid lead-lined mugs. Yes, please avoid lead-lined mugs. We will post the full recipe for our quarantini as well as our non-alcoholic placebo-rita version on this podcast Will Kill You.com as well as all. of our social media channels. Yeah. We have merch, including shirts, mugs, not lead-lined. Nope.

Pins, et cetera. Yeah. All of these are available from our website. Just click on merch. That's it. Let's just talk about lead poisoning, shall we? Let's do it. Okay.

Let's do it. All right. But first, let's take a little break. Dinner shows up every night, whether you're prepared for it or not. And with Blue Apron, you won't need to panic order takeout again. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients so there's no meal planning and no extra grocery trip. There, assemble and bake meals take about five minutes of hands-on prep.

Just spread the pre-chopped ingredients on a sheet pan, put it in the oven, and that's it. And if there's truly no time to cook, dish by Blue Apron meals are fully prepared. Just heat them in the oven or microwave, and dinner is ready. And here's the exciting news. Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Order now at blue apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50.

Terms and conditions apply. Visit blue apron.com slash terms for more information. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream is. is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a

protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly or work in harsh conditions because it actually works. O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth, no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keefs. Just visit O'Keef's company.com slash this podcast and code this podcast at checkout. A time

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amazing and they come in a bunch of different washes so I'm about to go order some more. Refresh your wardrobe with Quince. Go to quince.com slash this podcast to get free shipping on your order and 365-day return. now available in Canada too. That's Q-U-I-N-C-E-com slash this podcast to get free shipping and 365-day returns. Quince.com slash this podcast. All right, so lead. Everyone knows what lead is, right?

I mean, it's a metal. It's a metal. Okay. Episode over. Just kidding. Lead is a metal. It's a heavy metal. It's an element on the periodic table, P-B, that's its name.

I assume you're going to say why, right, Erin? I'm very excited about it, actually. Excellent. Good, because I'm not going to say why. And I've done a lot of biochem on this podcast, but never have I had to do pure chemistry before? Ooh, fun. I'm not going to do it, Aaron. Oh, Erin.

I can't. I don't know enough chemistry to be able to explain it well, okay? Okay. We're just going to talk today about what happens once lead gets into your bodies, okay? That seems like chemistry to me, but sure. Sure. It doesn't feel like chemistry. Okay.

In our bodies, lead, the element, exists as what's called a cation. That means that it's a positively charged molecule. Okay? So as it floats around through our bloodstream, it's floating around as a single molecule that is positively charged. Because it has a positive charge, it's attracted to other things in our blood that are negatively charged. If you think of something like a magnet where you have a positive and a negative pole, it's just like that inside of our bodies. Positive things are attracted to negative things

and vice versa. Okay. So in our bodies, it turns out that one of the things that is negatively charged are proteins. Okay. Oh. Proteins. All proteins? Yep, pretty much. Proteins are negatively charged. They have an end group that is negatively charged. And so lead in our bodies tends to bind two proteins. That's really interesting. Also, I feel like I should have known that all proteins were negatively charged and now I'm embarrassed. But hey, you know what? You don't have to be embarrassed, Darren. There's always things to learn. Always things to forget, too. So a lot of the toxicity of lead poisoning is because lead ends up binding to proteins and screwing up the way that they function. Makes sense. That's kind of the basic pathophysiology of it. Okay. The other thing is that because

essentially all lead is, I know it's, it's kind of hard to think of lead as just this positively charged molecule because when you think of a metal, it's like this, like a piece of metal, right? Right. But in our bodies, it's just a tiny little ion. And because it's so tiny and because it's charged, it can pass freely across a lot of membranes very easily. Oh, okay. Okay. Which is also bad. news. Very bad news because it's not supposed to be in our bodies. Okay, so what I'm going to do first, now that you know the very basics of how lead can end up causing problems in our body, it binds to proteins and it can cross membranes. We're going to first talk very quickly about what it might look like if somebody, say, came to the emergency room or their doctor. What are the kinds of symptoms

that might make someone think, hey, this could be lead poisoning? And then we'll talk about exactly how each of those symptoms might happen. Okay. All right. So the common symptoms that might make someone think we're looking at lead poisoning are things that are actually pretty general. Abdominal pain, especially very severe abdominal pain, joint pains, severe headache. You might have increased intracranial pressure, which means increased pressure in your cranium, in your skull. and then neurotoxic effects, which we'll talk in more detail about, anemia and kidney dysfunction. Okay, and so this is all, like these things could all happen at once or over the period of weeks, or like, what is the time scale? Great question. The time scale kind of depends on the time scale of exposure. So a lot of these symptoms you might not see until blood lead levels. That's going to be so hard to say for this whole episode.

by the way. Well, is it as hard as Gerardia? Yes, maybe harder. But until blood lead levels are above about 60, that's when you might see some of these acute symptoms like abdominal pain and joint pains, but lead is something that can build up in your body slowly over time, or you could be exposed to a large amount in a short period of time. So it kind of just depends on what your exposure is and where you were exposed. Okay. Okay. So we talked about those general symptoms. One of the big things that we see in lead poisoning, and even though it's probably not the most detrimental or acutely important, is anemia. Anemia means low blood count, so low red blood cells. Okay? Not enough red blood cells. Your red blood cells are what carry oxygen, so that's pretty important. Right. We've talked about it

in a hookworm, I think. Yeah, we totally did, for sure. And in hookworm, it's totally different because you're losing blood. What happens in lead poisoning is that lead actually blocks the action of an enzyme. Remember that enzymes are proteins and lead is binding to proteins. It binds to and blocks the action of an enzyme that is essential for the synthesis of hemoglobin. Oh. Yeah, hemoglobin is what's in your red blood cells that actually carries the oxygen. So if you can't make hemoglobin, then you can't make red blood cells, then you can't carry oxygen and you're anemic.

Okay. That's interesting. Yeah. It also ends up leading to a number of different problems down the line where it can cause kidney dysfunction, both because it's messing up hemoglobin synthesis, and because it actually can deposit in the tubules of your kidney. and cause direct damage to your kidneys. Yikes. Now, your kidneys, as it turns out, are really important in regulating your blood pressure. Right. So if you start messing with your kidneys, you can end up causing your kidneys to raise your blood pressure in your body. Why does it raise the blood pressure?

Because, great question. So your kidneys, the way that they interact with your blood pressure is when your kidney sense low blood pressure. is when your kidneys sense low blood flow, they release a hormone that tells your brain, hey, we've got low blood flow. You need to increase the blood pressure. Oh. And so, yeah, so the damage that lead can cause to your kidneys

reduces the flow of blood through your kidneys, and that releases hormones that says, hey, the blood pressure's low. We need to constrict our vessels and increase this pressure. But when in reality, what ends up happening is then you have high blood pressure, hypertension. Because it's not about blood volume, it's about these like false signals. Exactly.

Exactly. Oh, cool. Okay. Okay. So now we've talked about hemoglobin. We've talked about kidney dysfunction. We've talked about hypertension. That was so many things all at once.

Boom. Another thing about lead is that, so it's this charged molecule, right? It turns out it's functionally kind of similar to calcium. Calcium is also a charged molecule, a positively charged molecule. So lead can compete with calcium in our bodies. Where do you find calcium in our bodies, Aaron? Bones. Bones.

So lead can end up depositing in bones. It can deposit in joints. And it can disrupt the normal synthesis of bones. So this can cause joint pain, bone pain, and then also things like osteoporosis or osteopenia. And that's how you can see lead poisoning. Yes. In x-rays. lead lines in x-rays.

Now, as we know, it's a small charged molecule. It can cross membranes. It can cross the placenta. So in pregnant people with high lead exposure, it can cause stillbirth or different types of malformations in the fetus. It also can cross the blood-brain barrier. Classic. Classic. So that means it interferes with our central nervous system.

It does this in a whole bunch of dimens. different ways. So by binding to certain enzymes or certain proteins, it can inhibit the release of important neurotransmitters, things that your brain releases to communicate with your body. It can increase the release of others. So it basically just completely messes up the normal functioning of your central nervous system. So some people with lead poisoning, a very classic sign are certain types of peripheral neuropathies. So nerve problems in your peripheral nervous system as well as your central nervous system. So you might have things like what's called wrist drop where you can't flex your wrist anymore.

Huh. Or foot drop where you can't flex your foot anymore. Yeah. And so that means you can imagine it might lead to things like clumsiness because your feet aren't working properly. Weakness. In severe cases, it can lead to paralysis. And once it gets into your central nervous system, your brain can actually end up absorbing

that lead directly. which can lead to direct neurotoxicity on your brain cells. That sounds pretty stinking bad. It's pretty stinking bad. Yes. Okay. So in children, this is especially bad. Yeah.

Because it can end up interfering with the development of the nervous system. Right. So let's talk about children in more specific, because both adults and children are susceptible to lead poisoning. but children are especially susceptible. There's a number of reasons why. First of all, in adults, only about one-tenth of the amount of lead that you ingest, like through your mouth or your mucus membranes,

is actually absorbed in your GI tract. Only about 10%. Okay. Okay. If you inhale lead, about 40% of that lead is absorbed through your lungs. So inhalation of lead is a lot worse than absorption. Yeah. But in children, their guts, because they're not fully developed probably,

actually absorb a much higher proportion of the lead that they ingest. Oh. So they're absorbing lead at a higher rate. So right off the bat, they're at higher risk. But because kids are also kids, they're more likely to, like, eat dirt that might be contaminated, to lick a lead paint wall. Just put their hands in their mouths. Exactly.

Right. And so they're more likely to be exposed. to lead in the first place, and then they're absorbing more of what they're exposed to. Oh, wow. So my assumption was that it was just the behavioral risk was higher for children. I didn't realize it was also their bodies, like a physical higher risk category. Erin, it gets even worse. Oh, no. Yes. Because children's blood-brain barrier isn't fully formed, lead is even more likely to make it

into the central nervous system. Oh, my gosh. And because their central nervous system is still developing, On a cellular level, they're more susceptible to the effects of lead on their nervous system cells. So it's like a lot more permanent damage can be done. Exactly. Yeah. It also distributes in their body tissues differently, so it's more likely to go into soft tissues than it is to bones in children versus adults.

And that probably also has to do with just the differences in like water and fat content in babies versus adults and things like that. Okay. Yeah. I have a, I like a question. what is considered a child? Like at what point do they become no longer at like a high risk category? I assume it's a spectrum, right? With certain ages being of higher risk, but that's a really good question. So in looking into this, a lot of the data looks at children who are school age because that's when you can start to see some like of the behavioral and like neurocognitive issues that can develop. But lead exposures in children tend to be highest when they're about two years old or less.

Okay. So that's when exposure risk is the greatest, is when they're very little, because that is when they're toddlers and putting things in their mouths and stuff like that. But that's a good question in terms of like your brain isn't fully developed until after you're a teenager. So presumably the effects in that your susceptible effect wise would continue through young, like adolescents. Okay. But the exposure is going to be a lot less in that age group. Okay. Gotcha.

That's a really good question. though. Okay. So while the early symptoms of lead poisoning or the acute symptoms of lead poisoning in children might be similar to adults where they'll have things like abdominal pain, joint pains, clumsiness, staggering, things that we heard in the first-hand account, once the brain is involved, it can get a lot more serious and a lot more long-lasting in children. Because if a child is exposed to high levels of lead, once the brain is involved, it can progress to loss. of consciousness and eventually death. If they survive, though, they often have lasting cognitive impairments.

And what we have found that has taken unfortunately too long is that even at very low levels, chronic exposure can also cause these kinds of cognitive impairments. Right. There is no safe level. There is no safe level. Exactly. Aaron. There's also some interesting research into what has.

So in your bloodstream, lead only lasts for about 35 days. That's the half-life of lead in your blood. It's about 30 days. So your kidneys actually are helping to excrete lead. But once it deposits in your bones, the half-life is like 10 to 20 years. Oh my gosh. Yeah. So lead can, if you're exposed to very high levels of lead while you're young and it ends up depositing in your bones, it can be many years later where that lead sort of slowly leeches out of your bones. And then once it leeches out of your bones, then it's still in your body. It goes into your bloodstream, and from there it can potentially still cross the blood brain barrier and end up affecting your brain. Wow. So could you, like, could you as a child have been exposed chronically to lead and then you only see it 20 years from then? Great question, Aaron.

There's now some research being done where it seems like elevated lead in elderly people that were exposed when they were young. Like people who are elderly now who were exposed to high levels of lead when they were young because it used to be that pretty much everyone was being exposed to high levels of lead can actually lead to cognitive decline

and dementia in elderly people. Because it's finally leaching out of their bones into their blood brain barrier. Oh my gosh, or crossing their blood brain barrier. Holy cow. Yeah. Yeah. So yeah, that's lead poisoning.

biology-wise. Wow. Mm-hmm. We do have treatment, but really the treatments that we have, it's called chelation therapy, where you basically either orally or through IV give drugs that help to bind up the lead so that it doesn't cross your membranes and get into your organs, and you can just excrete that lead. It really only tends to work if your blood lead levels are quite high, like 40 or 60. Okay. So if you do chelation and your blood levels are 15, then... It doesn't seem to do much from what I have read.

Yeah. And what else happens is if you have very, very high levels of lead in your blood, that doesn't reflect your total body concentration of lead. So even, for example, like the child, John in the first hand account, who had three, 390. That's outrageous. Outrageously high. Once you give chelation therapy, that will reduce your blood lead levels. But then over time, it will start leaching out of your organs and your bones where it has already deposited.

And your blood levels will rise again to sort of equilibrate. Right. And then you might have to chelate multiple times, which is probably why he was in the hospital for so long. Yeah. Wow. Yeah. So the most important thing to do with lead poised. is to eliminate the source of exposure to begin with, figure out where someone was exposed and try to stop that exposure and prevent it from happening in the first place.

Yeah, well, yeah, I'll get into it. Yeah, yeah. So, yeah, that's the biology of how lead really does the number on your body. It really does. Yeah. So, Erin, how did it get here? What the heck? Great question.

Let's take a short break. Okay. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keeffe's Working Hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions.

Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly or work in harsh conditions because it actually works.

O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth, no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keefs. Just visit o'Keef's company.com slash this podcast and code this podcast at checkout. This is Bethany Frankel from Just Be with Bethany Frankel. Listen, I have a bone to pick with these dog food brands calling themselves fresh, natural, healthy. Sounds great, but a lot of these quote-unquote fresh dog foods in your fridge are not even 100% human grade,

which is why feed your babies, just food for dogs. It's good enough for big and smalls, my precious babies, so it's good enough for your babies. 100% human grade, real ingredients, beef, sweet potatoes, green beans, delicious. These are foods that you would want to eat. Not that the babies would ever share. Just Food for Dogs is the number one vet recommended fresh dog food back by over a decade of research. No marketing fluff. My dogs lose their minds at dinner.

They run to the bowl, tags wagging, paws tapping, full Broadway performance every single night. So I do care about the food I feed big and smalls. So go to just food for dogs.com for 50% off your first box, no code, no gimmicks, just real fresh food. Janice Torres here. And I'm Austin Hankwitz. We host the podcast, Mind the Business, Small Business Success Stories, produced by Ruby Studio in partnership with Intuit QuickBooks. And we are back for season four. We're talking to small business owners who are doing incredible things in their industries, achieving their

dreams, being their own bosses, putting in the work, and enjoying all the benefits that come with it. This is our most exciting season yet. We're talking to more entrepreneurs about how they launched their vision, and more importantly, how QuickBooks on the Intuit platform helps them do more in less time. Working in QuickBooks just makes it easier to run the business, right? There's so much that you need to do when it comes to running a business, building products, setting up marketing campaigns. And to run a business, you have to make sure that your finances are in order. So it removes my anxiety from one side of it so that I can focus on everything else. Whether you're a long time listener or just getting started, tune in and join us. You'll be so

glad you did. Listen on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Lead. This was a really interesting episode to research because it was so different than what we usually do. Oh my gosh, yeah. So it's like instead of reading about the evolutionary origins of this or that bacterium or virus or something, I got to read about how humans used a metal in different ways throughout history. Oh, that's cool. Yeah. And what that meant for their health. Okay.

Let's get started. So it turns out that lead is one of the longest used metals. Like it's been around for ages. There's no lead age the way there is like an iron age or a bronze age. but lead was used during all of these metal ages. And the reason that there wasn't a specific lead age is because it's not a very sexy metal. Like it didn't really cause like a revolution, I guess, or like a huge change. That's our title.

Lead, not a very sexy metal. Not a very sexy metal. Lead is soft and dull, and so people didn't really want to use it in jewelry or decoration or making weapons. Instead, lead was used to carry out some. of the grunt work, like plumbing, architecture, et cetera, especially in Greek and Roman times, and it was also used for pigments going back to the Paleolithic times. Wow. It's been around since before people could write about lead.

Yeah, I mean, it's just a part of our earth, so that makes sense. But wow, it's so interesting that humans were using it for so long. So long. Okay, how about some etymology real quick? Yes. I think this might be one of the most exciting etymology things that we've done in this podcast for me. I don't know. Okay. This is not really etymology. But so first of all, the use of lead was so widespread in ancient times that there's even an Egyptian hieroglyph for lead. What? Isn't that cool? Yeah. Okay, but etymology. So, as you mentioned, the chemical symbol for lead is P.B, capital P, lowercase B. And that actually comes from the Latin plumbum. Plumbum. which actually has older roots, even in some pre-Hellenistic language, so like pre-Greek.

And Plumbum was used to refer to basically any metal that was silvery, had a low melting temperature, and was easily oxidized. And these are the characteristics of lead, along with tin, zinc, and some other metals and alloys. To distinguish from the rest of those metals, though, lead was often called white lead. So people could distinguish them. Okay. But the word plumbum, plumbum, does that sound like anything to you? Like plumbing. Yes.

And plumber. Yeah. Lead was used in Roman water pipes. So that's how plumbing and plumber got their names. Oh, man. I never even put that two and two together. I know. Wow.

So it refers, like plumbing refers to the actual metal, which was lead that was used to construct those pipes. Wow. Isn't that, like, my mind went just, like, dropped out of the back of my head. Etymology is cool. bro. I love it. Yeah, I love it. And you can also find literary references to lead. Most of them using lead to describe something as being weighed down, like a heart of lead, as well as expressions like, I'm going to pump your guts full of lead. Like, because angels of dirty souls, yes. And then there's the word plum itself, PLU and B, which means upright or level. And that comes from the fact that

historically, people would use lead tools like a plum bob to get a true vertical line. Whoa. I didn't know that. It's so cool. Okay. But this isn't the history of lead. This is the history of lead poisoning. And it turns out that that reaches back almost as far as the use of lead itself,

which is unsurprising. Yes. Descriptions of lead poisoning date back basically to, I don't know, around 6,000 years ago. Okay. And these descriptions, yeah, really long time. And these descriptions didn't necessarily identify lead as the source of the symptoms. It was more just describing somebody who had clearly a case of acute lead poisoning. But some actually did make the connection between lead exposure and lead poisoning.

So some like scrolls from ancient Egypt, for example, discussed the role of lead in intentional poisoning, because people would sometimes use lead acetate to intentionally poison people. And lead poisoning in miners in ancient Rome also allowed people to make, this connection between exposure and illness. The history of lead poisoning can basically be divided into occupational exposure and the non-occupational exposure. So since lead was used in so many ways, like making glass or coins or kitchenware or statues or pigments or food additives or plumbing or roofs or gutters or shipbuilding.

Like literally all the things that humans have ever done or used ever. Everything, everything. then if you were involved in any of these trades, there were tons of ways to get exposed. But the biggest exposure probably happened for miners who would experience acute lead poisoning. So this is where the concept of myasma also probably gained some support because people who spent, yeah. I never even thought about that. Because these people who spent a lot of time in or near mines, which were also located in geographically or geologically very specific areas, probably got. sick. Oh my gracious. This is that cool? Yeah. I mean, not cool for them, but very interesting.

Very interesting. And there was so much lead mine historically, and there still is today. I mean, it has only gone up over time, basically, that current estimates, though, of the number of workers who were exposed to lead during the Roman Empire was around 140,000 people per year. So, what? Yeah, lots of lead exposure. That was just in lead miners. So even if you weren't a lead miner, though, there were plenty of ways that you could encounter enough lead to experience acute or chronic lead poisoning. And ancient Rome was not the only place that you had a high chance of getting that. In China, for example, cookware had a super high content of lead.

So some ancient bronze vessels contained over 30% lead. So if you cooked anything in those, like it's just going to leach out into your food. You're calling it bronze and it's mostly lead. Yeah. And drinking vessels were also made of lead or lead alloys. Lead tumblers have been found in graves dating back to 3,000 BCE. And let's throw an ancient Egypt into the mix as well. Wow. But ancient Rome is infamous for their use of lead in like all facets of life. So if your veggies weren't sweet enough, no problem. Just cook it in a lead pot or add lead acetate. You could become exposed by hands. handling lead coins or yarns, many of which were treated with lead salts. Children's toys were made of lead. Candle holders and wickholders made of lead or pewter could be partially evaporated while burning the candle. And then there's... I'm sorry, real quickly. Does lead make your vegetables taste sweeter? Yes. I'm still stuck on that. So like lead acetate

was a common or like something called Roman Sapa, I think, something like that. It was basically, like, you added, for some reason, adding lead acetate made things sweeter, like it imparted a sweet taste. Oh, that is horrible. Oh, yeah. Well, just wait. I mean, here it comes. So, yeah, okay. And then there's lead paint, of course, lead in cosmetics or hair dye. And then there's the medicinal uses of lead. So lead was prescribed to remove scars to curb nocturnal emissions. I don't know how exactly. To... I can have some guesses, but I don't think they're right. To this one is horrific. To heal the belly button of a newborn after the umbilical cord has fallen off. Oh no. You don't need to heal

that. No, nope. The goo is supposed to be there. To help scorpion stings for preserving your singing voice in contraception. So get this, you were supposed to smear a honey and cedar and lead mixture on your cervix before having sex. Okay, so many issues with that. Oh my goodness. Even just honey and cedar alone. Don't smear anything on your cervix. Don't smear anything on your cervix, please. My goodness. Lead was also used to soften tumors as eye medicine and to heal anal fissures. Oh, no, Aaron. I feel like these are 100% all problematic.

Yes. And so for these things, you know, for some of these medicinal uses, lead lotion was great, while sheets of lead were used for others. And then, so our quarantini is a sangria. The base is red wine. lead was used in wine making for centuries and centuries. So it could be used to stop fermentation or to add color or sweetness. That's why we decided to have a sangria for this one.

And then there's the lead pipes of ancient Rome. So in ancient Rome, water pipes were made of lead, and this lead, sorry, and this led to an interesting health disparity, kind of the opposite of the one that we see today. So those who were wealthier often had more access and exposure to lead, like having lead water pipes. So we see some of the most prominent cases of lead poisoning in richer populations and among the aristocracy. Later investigation, archaeological and anthropological investigation of sort of ancient Roman water pipes shows that the water was constantly, it wasn't sitting in pipes ever the way that it does now. And so there probably wasn't a lot of lead leaching into that water.

Okay. In addition to the fact that it was probably coated on the inside with like other scaly metals. And so the water itself was more or less protected from the lead in the pipes. Okay. Anyway. Interesting. Okay.

But so there's been a lot of retrospective diagnosis, which, you know, so take this with a grain of salt, of many of the Roman emperors from 50 BCE to 250 CE, and that suggests that they were basically all suffering from too much lead. I mean, yeah. I mean, and so I can't go this entire episode without talking about the fall of the Roman Empire, which is why we named our quarantini this. So a few decades ago, a guy named Jerome Nriaghu published his hypothesis that the decline of the Roman Empire was caused by widespread lead poisoning, especially among the wine drinking and lead water consuming aristocracy, and that the decreasing fertility and higher rates of psychosophobic. and that the decreasing fertility and higher rates of psychosis that followed really caused this, like, massive intellectual and structural decline. Wow.

This was not the first, like this is kind of an older hypothesis, but when he published this paper, it gained a lot of attention. And there's been a ton of response papers either in support or more often refuting this hypothesis. Studies examining the amount of lead in ancient Roman bones show. So similar lead levels as in modern populations or modern populations have higher lead, which is, yeah. And in general, this hypothesis doesn't really have a lot of widespread support anymore. So lead poisoning may have contributed, but it probably wasn't the main cause. Multifactorial, let's say. Yeah.

But despite this, we decided to perpetuate the false notion by naming our quarantini, the fall of Rome. It's a good name still. I know. I like it. Okay. So we know that people were likely experiencing acute or chronic lead poisoning based on how much lead they used, but when did they start making the connection between exposure and illness? Yeah. And that would have been really difficult to do because lead poisoning can manifest in so many different ways, especially with chronic low-level lead poisoning. Yeah. There do seem to be reports of epidemic or pandemic lead poisoning, which were often called pandemic attacks of blood poisoning.

which were often called pandemic attacks of colic, the first of which was sometime during the 7th century CE. And these pandemics continued until around the 16th century when a German physician figured out it was linked to wine that was supplemented by lead. And so from that point onwards, a lot of countries were like, no, you cannot use lead in winemaking anymore.

And so that probably in some ways lowered chronic lead exposure, but obviously it was still around. It was just like one tiny little area of life. So in cosmetics, for example, people used to use it as like a paste to hide smallpox scars and just to make themselves prettier. Oh gosh. But the problem with topical lead application is that it poisons you. Yes, it does.

So many people who wore this lead-based concealer would end up with ruin skin and hair loss. and this led to a fad in Elizabethan times of shaving the front of your hairline. Are you serious? I'm serious. That's because of lead? Yeah. You've seen all the pictures of them with like no hair. Oh, my gracious.

Yeah. According to this book I read, yeah. Wow. Okay. And so even though the dangers of lead were known, cases of acute lead poisoning continued to occur. Apparently, lead poisoning from rum could be quite an issue, depending on where the rum was aged. And the Industrial Revolution basically ensured that everyone, everyone, whether you worked with lead or not,

would be exposed to lead. And this period marks a kind of shift in the history of lead poisoning. So up to this point, acute lead poisoning was definitely recognized, but low levels of lead poisoning weren't really thought to be harmful, even though they very much are. In the late 1800s and into the 1900s, the focus on at-risk populations for lead poisoning shifted from people who worked with lead to children, who, as you mentioned for all of those reasons, are high risk. Yeah.

Chronic lead poisoning and children was first recognized in the late 1800s in Australia, but it was met with complete disbelief. Yeah. Lead had been around. People have been using it for ages. Can't be bad. Yeah. It would take until the 1920s for lead-based paint to be

banned in Australia and in much of Europe and another 50 to 60 years after that for it to be banned in the U.S. Wow. So doing great. Doing great. Okay, for the last bit of this history section, I wanted to focus on childhood lead poisoning in the U.S. because it's really well documented sort of the history and the politics surrounding it.

And I think it's such a perfect example of how politics and public health are intertwined. Oh, Aaron, this is going to be a political episode. Just wait until the epidemiology. Oh, here we go. Okay, so first I want to set the stage a little bit because the presence and persistence of lead poisoning throughout today is just part of a long-held trend in ignoring the systemic problems in pollution, poor housing, water infrastructure, etc. That cause huge health disparities. Over the past, let's say 200 years, there have been huge improvements. improvements in the overall health of the world, due in part to the advancements in knowledge about

how infectious diseases are transmitted and how chronic diseases can be caused or worsened by some environmental contaminants. But it was really public health efforts focusing on groups of individuals or improving infrastructure that led to those improvements rather than physicians treating the individual. So things like vaccine campaigns and improved housing and workers' rights and clean food and water legislation. Yeah. These things treated the underlying cause of many illnesses rather than the illness itself. Yeah.

And prevention saves much more than treatment after the fact. An ounce, an ounce a pound, etc. Yeah, exactly. And for a long time, from the late 1800s to the mid-1900s around there, maybe these systemic improvements really did help improve overall health. But at some point, that focus sort of switched from treating groups of people or treating the underlying issues to treating the individual who is diseased and reducing overall exposure, but not prevention in terms of like there was not a lot of push for improving housing quality

or water purity. And those were the things that disproportionately affected people living at or below the poverty line. Yeah. Okay, lead. So even though it was known that lead was bad, the use of lead actually increased in the 20th century. It was added to gasoline to give the cars more power. It was in paint to help the walls shine. Throughout the mid-20th century, the U.S. Interstate Highway system greatly expanded, which allowed for the deposition of lead in soils basically all over the country. And it's not like people hadn't thought of the potential danger of the leaded gasoline. As early as the 1920s, people had expressed their concern. But the lead Industries Association funded scientific research specifically to come to the conclusion that lead

was a natural part of the human environment. And since humans had been working with lead for thousands of years, it was safe. People have been working with lead for thousands of years. People have been dying from lead for thousands of years. Oh my gosh. The 1920s. That was, yeah. I mean, as early as the 1920s, the dangers were known, but there was already pushback from the lead industries association. Yeah. Oh, my gracious. And so this was their line. This was their stance for the next four decades, basically, actually beyond that, until it was overturned by the overwhelming evidence that any lead exposure at all was harmful.

But by then, so much damage had been done, and it's still being done. So around the 1940s, physicians and researchers in the U.S. started to become aware that lead poisoning, both chronic and acute, could lead to long-term damage. so that children who presented with signs of acute lead poisoning and then recovered would probably never recover completely, but would always carry effects like developmental delays, behavioral problems, learning disabilities, and so on. Citywide epidemics of lead poisoning and children in the 1950s were seen in places like Chicago, Baltimore, New York City, Cincinnati, and St. Louis. And these brought greater attention to the issue that lead-based paint caused, but the lead industry's association fought against these negative portals. trails of lead. They embarked on or continued their propaganda machine about how much better lead was than any other material for pipes and paint and gasoline. They downplayed or outright

denied the reports of widespread lead poisoning, often making fun of the victims or putting the responsibility on the parents and the child who had lead poisoning, saying, well, they should have been watching the kid more. Oh, my gracious. They took the line that if it didn't affect the health of the average person, then it wasn't worth changing. And their definition of the average person is going to be a wealthy person who's above poverty line, white person, exactly. And so this resistance to do anything about lead obviously slowed down the social reform that was needed to actually help fix the issue of lead everywhere.

In 1967, a physician named Jane Lin-Fou published a widely circulated booklet that discussed the issue of lead, particularly lead-based paint. And it did largely ignore the effects of gasoline and other exposures, which weren't as recognized. That was sort of the standard of the time. But she framed this lead poisoning, this chronic lead exposure, as a public health issue, which some public health officials took exception to, saying that no, this is a housing issue, not a matter of public health. And this was this unnecessary divide that would slow down progress for a really long time. Oh, my God. That's infuriating. Well, it's just it's a difference of labeling and it's a difference of we don't want to be responsible for this.

This isn't on us. Yeah. And so even though people clearly recognize that low levels of lead posed a health problem by the 1970s, the magnitude of the problem wasn't as well known. Erin, so you know the N. Haynes survey? Yes, I do. Okay. So N. Haynes stands for National Health and Nutrition Examination Survey. And basically its purpose is to document the health of the American people.

So they measure all kinds of things. It's been amazing in terms of like monitoring exposures, health, status, whatever. In 1976, blood lead levels were included in the survey for the first time, and they revealed that one out of every 25 kids between the age of six months and five years had blood lead levels greater than 30 micrograms per deciliter. Whoa. Yeah. Based on the U.S. population at that time, that calculated.

to around 780,000 children under six years old that had lead poisoning. 30 at 30. And that's really high. That's very high. And then there were enormous racial, locational, economic differences in terms of the rate of lead poisoning as well. So while only 2% of white children had elevated blood lead levels, 12.2% of black children had elevated blood lead levels. and urban children fared worse than rural children, 11.6% to 2.1%. In families whose combined income was $15,000 or more, which is like, I don't know, around $35 to $40,000 in nowadays money, 1.2% of children were affected, while in families who, with a combined income of less than $15,000 in 1976,

less than $35,000 to $40,000, in those families, families, 10.9% of children had elevated blood lead levels, lead poisoning, basically. Yeah. So, okay. The early 1970s also saw the emergence of another big lead researcher, Herbert Needleman, whose pioneering work on low lead level exposure would revolutionize our understanding of the risk. All right. In one study, he compared the lead level in baby teeth from children in suburban homes and in poor

communities, and he found that those in the poor urban communities had almost five times the amount of lead compared to the ones in the suburbs. I also will say it's so genius to start using baby teeth as the level because, like I said earlier, the levels in your blood can change much more rapidly than the levels in your teeth. And often you're testing kids that are older when the exposure happened when they were a lot younger. So it was very genius to use baby teeth. Yeah, this research was groundbreaking. because it also showed that even at low levels of lead exposure, levels that were considered safe by the CDC, there were still observable long-term effects of lead exposure. Yeah.

Obviously, the lead industry did not like this. Oh, shocking. And they brought on basically just like paid money to a prominent lead researcher whose primary purpose, it seems, was to discredit Needleman studies and any other study showing that low-level lead exposure was dangerous. This seat of doubt actually had an influence on government decisions and regulations by the EPA, which is hugely worrying, but also not surprising, especially considering climate change and stuff today. So this is a great example of how politics and public health become enmeshed, especially when the government gives equal forum to both the industry whose livelihood depends on the

outcome of these studies, so this enormous conflict of interest, in the scientists who are reporting their findings as objectively as humanly possible. Oh, gracious. Even when a conflict of interest is clearly declared, it can still be hugely damaging once that seed of doubt is planted. All right. So because lead poisoning was labeled as a housing problem, back to this issue, it became inherently politicized, especially in the 1980s and into the 1990s, where proposed lead elimination or prevention policies were labeled as leftist politics and social engineering. By this time, the scientific consensus was clear. There was no safe level for lead exposure. Leaded gasoline was no longer used and lead-based paint had been banned as of 1978,

but the risks of exposure were far from over. It wasn't like, oh, we ban these, so now no one's going to get exposed. Soil was chalk full of lead around highways. Lead-based paint is still, you have to sign waivers any time you move into a house that was built before 1978. My house was built in 1929, so geez. Yeah. Yeah. Millions and millions of houses or buildings had lead-based paint, and abatement was extremely expensive and carried its own risks.

So the dust created during the abatement process and even during everyday living by opening a window with lead-based paint trim could reach poisoning levels. Conservative estimates for the complete removal of lead-based paint from the 64 million federally owned housing units was around $10,000 per unit in 1990. Ooh, wow. So many landlords and the government also basically was like either going, we're either going to abandon ship or we'll just ignore the problem completely. It's a lot easier than fixing it.

Yeah, it's a lot easier than fixing it. And it's a lot cheaper because if you, let's say you were a landlord and you were required to do lead-based pain abatement and you didn't do it, you could be taken to court. which could take months or years, and then you're like, oh, here's a $400 fine. I'm sorry, $400 fine. I don't know if that's exactly what it was, but it wasn't $10,000. Right. And so seeing this huge task in front of them, the public health approach switched from risk prevention to risk reduction.

How can we most cheaply do lead-based pain abatement was like the bottom line. And it's sort of putting a price tag on the health of the American children. It's outrageous. Okay. And in Wox, the Kennedy Krieger Institute study on lead-based paint. Have you heard of this? No, I haven't. Okay.

In 1991, this institute began a study that would eventually be compared to the Tuskegee syphilis experiment that I talked about in our syphilis episode, where poor black men were preyed upon by researchers to study the effects of untrade syphilis. This lead-based paint study, which began in 1991, Oh, no. 1999. Oh, no. Involved 108 families of single mothers with young children.

The researchers placed these families in houses with varying levels of lead, from no lead to lead levels just within Baltimore's legal limit. I'm sorry, they put people in houses with lead. Lead? Yes. In 1991. Yes. Single moms.

Okay. Single moms. Great. And then they would try out. different kinds of lead-based paint abatement while periodically monitoring the blood-led levels in the families. Their goal was to find the most cost-effective way to reduce lead-based paint, so how cheaply could you achieve lower lead levels in the blood, using children as biological monitors? Oh, oh, my God. Oh, my God. Oh, my God. I know. The researchers, of course,

acknowledge that no lead-based paint would be the best level, but they argue that most landlords would abandon the houses if required to shell out a bunch of money on lead-based paint abatement. And so then these people would continue to live at dangerous levels. So their argument was, well, we're taking them out of houses with potentially worse lead conditions and hoping to use this knowledge to, you know, help everyone everywhere. Just some tiny children guinea pigs. No big deal. Yeah.

It's appalling. So this was human experience. experimentation, and despite their intentions, the researchers knowingly placed children in homes where they knew they could be exposed to potentially dangerous levels of lead. Because any lead exposure is dangerous. Yep, and this was well known by the 1990s. Of course it was. Are you? Oh, my.

Erin, I'm raging. I know. I know. Me too. So when this study came to light in the late 1990s, the researchers were taken to court, and the court found that they had engaged in unethical research that defied many aspects of the Nuremberg Code and bore similarities to Nazi experimentation, which are, it's strong language. Yeah.

But it is still appalling. What IRB approved this, quite honestly? Well, right. I mean, but they did get IRB approval. Of course they did. It was the 90s. It's very concerning. It's very concerning.

Yeah. And these, the two people who led the study were renowned lead researchers and children's health advocates. It's, yeah, there's much more discussion about this case, this experiment itself and the court battle and so on in the book Lead Wars. So I encourage people to look into it. But still the bottom line is that in this experiment and as it continues today, children are being used as like canaries in the mind or these biological monitors for lead content. and a society is measured by its treatment of its children.

So the first-hand account features a boy who experienced acute lead poisoning, which was treated by the doctors and nurses that he saw. But they could only help treat him, not the underlying problem. The hospital had no ability to intervene with the landlord's failure to repair the home. This is something that still happens today. And in the words of the authors of Lead Wars, John, who was the kid from the first-hand account was suffering from more than an environmental exposure to a known neurotoxin caused by shoddy landlords and peeling paint. He suffered from a social and economic system that condemned his

family to poverty and racial discrimination, as well as to the urban decay that put him in harm's way. What John experienced was acute lead poisoning, which fortunately has been largely controlled in the U.S. over the past century, but chronic lead poisoning caused by long-term exposure to low levels of lead is still a huge problem. Look at the Flint, Michigan water crisis, for example. Look at many cases of this all over the U.S., all over the world. There have been so many large-scale lead poisoning epidemics, often associated with like lead smelters. There was one, for instance, in Nigeria in 2010, that has caused the deaths, the deaths of at least 400 children. It's still ongoing this issue.

My God. Yeah. Ugh. It's so infuriating because it's so preventable. Yeah. And the problem of lead exposure can't be solved with just a medical intervention. If there's going to be any lasting change, there has to be reform at a systemic level. The issue of lead exposure and other environmental or occupational hazards is a perfect example of how politics and public health have to go hand in hand.

The people who are in power and can make these changes, are elected officials, they're not the ones at risk for lead poisoning. And they'll never be because they can afford not to be. And then to get any movement on that front, public health officials might push for more easily digested regulations, like redefining what an acceptable level of exposure is. But that undermines the credibility of public health. When presented with the suggestion that complete abatement of lead-based paint

was the only way to end the issue of lead poisoning, many elected officials dismiss it out of hand as a utopian. dream. This viewpoint just perpetuates the cycle of poverty. Erin, on that note, tell me where we stand with lead poisoning today. Oh, let's talk about it, Aaron. I need a quick break after that. Yep. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry,

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Okay. First off, did you know that elevated blood lead levels were the first non-infectious, notifiable condition in the U.S.? No, I didn't know that. I didn't either. 1995 or 96? Oh my God, that seems really late. It is very recent.

Even like my youngest brother was born by then. So, yeah, it's, mm-hmm. Wow. So, yeah, anyways, it used to be that elevated blood levels of lead were only considered when you had a blood level over 60, since that's when the clinical symptoms are most commonly seen. Right. But at some point, I think it was in the 1970s, that level was decreased to 10, and that was considered the safe limit. But since 2012, the way that it works is there is no safe. limit. I mean, we knew this from before, but since 2012, there is no longer anything considered a

safe limit or even a level of concern. Right. So now what they use, the CDC uses, a blood-led reference value. So what that means is that they look at the blood, using the N. Haines data that you talked about, they estimate the average blood-led level among children in the U.S. and the highest 2.5% of children, that cutoff value is what they use to consider elevated. Does that make sense? Yes. So right now in 2019, that level is five. Five micrograms per deciliter is considered, quote, elevated. That's what the elevated lead level is considered now. The CDC's push is every four years, they reevaluate that and they want to get it down to as low as humanly possible, right? That's the goal.

Yeah. So that no child is exposed to any level of lead. That's the goal. Worldwide, according to the WHO, which cited the Institute for Health Metrics and Evaluation. I hadn't heard of that institute before. But they estimated that in 2017, lead exposure across the globe accounted for one million deaths in 2017 and 24.4 million. years of healthy life lost. I just got chills.

Yeah. That is so, that is such an incredible loss of life and life years. Yeah. Wow. The highest burden, unsurprisingly, is in low and middle income countries. They estimated that in 2016, led exposure accounted for 63% of the total burden of intellectual disability across the globe. Oh my gosh. 10% of hypertensive heart disease, which nobody thinks about being associated with lead. But like we talked about, the effects of lead on your kidneys

can have major effects on your blood pressure. And blood pressure just destroys your heart having high blood pressure. Yeah. And then also 5% of the global burden of ischemic heart disease. So that's when you have clots in your blood, that means your blood, your heart isn't getting enough blood, and 6% of the global burden of strokes as well. Wow. Wow. From lead exposure. Yeah.

That's worldwide. And this is something that, like, it's not getting any better. Not fast enough, that's for sure. Yeah. Yeah. It's going to take decades. Because, like you said, I'm still stuck on the whole leaching out of your bones over time. like a slow drip of poison.

Right? Yeah. It's terrifying. So in the U.S., of course, it was Flint, Michigan that brought lead poisoning back to the front page news. We can't have an episode about lead poisoning and not talk about the situation in Flint, Michigan. Yeah. In 2014, if you don't know the story of Flint, maybe you don't live in the U.S. Because I feel like I don't know how you could live here and not have heard about this, right?

Yeah. In 2014, the city of Flint. decided to switch from using Lake Huron and the Detroit River as their water source to the Flint River because it was going to be a lot cheaper. However, the water in the Flint River was more corrosive, and they did not take that into consideration whatsoever. And most of the pipes in Flint were lead pipes, the pipes that led into people's houses, water pipes made of lead. So, first of all, I mean, this was such a disaster. It's too big of a topic to even talk about in a lot of detail because the situation

in Flint was managed horribly. It was so severe. Tens of thousands of homes were affected. And it took literally years for people to gain access to safe water again. Even though many people now have access to safe water, the effects of that lead exposure is still lingering in a huge way. Exactly. Like children in Flint are going to be affected for the rest of their lives because of this. It was and remains a terrible, horrible situation.

But here's the thing. It's not just Flint. Oh, no. A study in 2017 estimated that 1.2 million cases of blood lead levels over 10 micrograms per decilator, which is twice what's considered elevated today. Right. If you shifted that to five, what would that? Right. Yeah. One point two million cases occurred in children between the years 1999 to 2010. Wow. However, only 600,000 of those were reported. So that means that half potentially of children who have elevated blood levels of lead, no one

is reporting that, which means we don't know, which means they're not getting treatment. Yeah. Or having their exposures reduced because we don't know about their exposures. Oh, my gosh. And like you said, that's at an elevated blood level of 10 micrograms. Five is considered elevated. So who knows what that number is if you consider it to be five micrograms? Yeah.

The problem, there's many problems. But a large part of it is that most children are never tested. for their blood-led levels. It's not required by the federal government or by state governments. Huh. It is only required to test children who are Medicaid beneficiaries. But in reality, less than half of those children are even actually tested. So those are the children that we know are likely the most vulnerable,

and only half of them are being tested. And the rest of the children in the U.S., not even tested. Wow. So people sometimes tell us to stop being so political and stick to science on this podcast. There's no such thing. There is absolutely no such thing. There are at least two big risk factors that we know that massively increase the risk of lead exposure in children.

The age of the house in which they live, right? Because that's lead paint exposure. And poverty, because poverty is the biggest risk factor. Right. there are some really great maps, Vice and Vox, both the news outlets, Vice and Vox, made maps. So the Vox map especially is every census tract in the entire country. It was Vox plus the Washington Department of Health. They estimated the risk of lead exposure based on those two risk factors, the age of houses and the level of poverty in the area,

to estimate the level of lead exposure risk across the whole country. Okay? We'll put a link to those maps on our website. They're really interesting. You should check them out. Here's the thing about when you look at those maps. Aaron, we're going to roll reverse and I'm going to tell you some history. Oh, great. In the 1930s, after the Great Depression, the homeowner's loan corporation was requested to make maps of cities to assess the riskiness of mortgages for lenders, to try and get lenders back to lending to, to people to buy homes to like fix the Great Depression or whatever. Okay. Mm-hmm. These maps are outrageously racist. Of course. So what they did was outline in red, hence the term redlining, the most undesirable

or hazardous neighborhoods from a mortgage lending perspective. Guess what neighborhoods were redlined? Neighborhoods where black people lived, period. And the descriptions of why certain neighborhoods were redlined. Like you can read these descriptions. They were labeled as high risk if a single black person lived in that neighborhood. Oh, my God. That was it.

So, guess who didn't get home loans, people who lived in those neighborhoods, aka black people. Okay? So this led to continued impoverishment of those areas that persist today. If you look at maps today of areas that are still where the media, household income is lower than what is average for the country, it's still those red-lined areas. Wow. Now, if you overlay the maps of current lead exposure risk and the red line maps from the 1930s, they match up. Of course they do. The areas where people are still being exposed to major

health risks are directly because of systemic outright racism in this country. This is why there's no separation of public health and politics between science and politics. Like, it's inherent to this. And I mean, I wish that it weren't. I wish that it would be, here's this problem. We have the money to fix it. Let's fix it. But it's not that because there are the interests of the industries at play. There's these political parties who are backed by the industries. It's, everything is so interwoven that it's impossible to talk about it in a vacuum. Yep. And it's not effective to talk. to talk about it in a vacuum. No, it's useless.

There's no context. You have to have the context, the historical, the political, the social context, to understand why disease happens where it happens. Yep, exactly. So that's the state of lead poisoning in the world, and especially in the U.S. today. While we have seen major reductions overall in the blood-led levels of children in the U.S., the health disparities cannot be ignored. People who live at less than 130% of the federal poverty level

are more than twice as likely to have elevated blood levels. Black children are more than twice as likely to have elevated blood-led levels than white children. Like, it's very bad. It's not a problem that is isolated to just one city. It is not a problem that is isolated to just a few areas. It's rampant across the country no matter where you live. Yeah, it is.

So that is lead poisoning, Aaron. Wow. Yeah, it is. Well, then. So, yeah, this was a very heavy episode, heavy metal episode. Sorry, that was funny. But it is. I mean, it's a hugely important topic.

Yeah, I think a lot of. of people think that lead poisoning, like Flint, Michigan made the news because it was so egregious. The water that was coming out of people's taps was clearly contaminated and people were being exposed to levels of lead dozens of times the, you know, there is no safe level, but extremely high levels of lead, right? Yeah. And so that's, I think, why it made such news because it was massive and thousands of children and adults. They haven't even tested the levels of blood in adults. In Flint, which is atrocious. Right.

Hundreds of thousands of people are likely affected from this, and that deservedly made the news, but children are being affected by this every day, and people don't even realize that it's still a thing outside of these headline-grabbing situations. Mm-hmm. It's a huge thing, and it's not going to go away anytime soon. Right. But it's such a problem because the people who are the most affected by it don't have a voice to do anything about it.

And that's just part of, you know, the disenfranchisement of entire groups of people because they live below, at or below the poverty line, systemic racism, all of these things. Yeah. Yeah. Yeah. But, you know, let's not get political, Aaron. Let's stick to our lane. Do you have any sources?

Yeah. We're scientists, not politicians. So we should only talk about science. Okay. Sources. I read a couple of books. One is called lead and lead poisoning in antiquity. So that's where I got a lot of the ancient Roman stuff.

And then Lead Wars, the politics of science and the fate of America's children by Gerald Markowitz and David Rosner. This book was great. I highly recommend it. And then I also read some papers that I'll post a few by Needleman, of course. And we'll post all of these on the website. Yeah. If you would like links to the Vox map, that was not.

made by both Vox and the Washington Department of Health, we will post that link as well as if you're interested in those redline maps. The University of Richmond has online interactive all of the maps that were made during that redlining time where you can see exactly what areas were redlined and the descriptions on why they were redlined. I need to read this. I need to see this. It's very horrifying. So as always, we'll post the links to all of our sources on our website. This podcast Will Kill You.com. Just click on episodes and you can see the sources from this episode and all of our episodes.

Thank you to Bloodmobile for providing the music for this episode and all of our episodes. And thank you, dear listeners, for listening to this podcast, allowing us to make it and getting righteously angry right along with us. Heck yeah. Well, with that, wash your hands. You filthy animals. This is Bethany Frankel from Just Be with Bethany Frankel. Listen, I have a bone to pick with these dog food brands calling themselves fresh, natural, healthy. Sounds great, but a lot of these, quote, unquote, fresh dog foods in your fridge are not even 100% human grade,

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