If Dr. Bruce Lanphear had been in charge of environmental policy in the United States over the last few decades, my daughter Katherine may never have developed leukemia and died.
Dr. Lanphear, or Bruce, as he prefers to be called, is an illustrious physician and revered expert on children’s environmental health now working at Simon Fraser University in Vancouver, BC. He has dedicated his career to protecting children from an array of toxic chemicals – lead, pesticides, PFAS – to prevent everything from cancer to autism to asthma. Perhaps even more important, he has been willing to take this message into the public sphere, to share his knowledge with ordinary people. This public message is so valuable to parents who are trying to protect their children and to activists who are trying to change the way we regulate chemicals. While remaining objective – he refuses to take money for testifying as an expert witness, for example – he has harshly critiqued the chemical industry and our business-as-usual acquiescence to their pressures. He points out the utter folly of systematically poisoning our children – triggering cancer, ADHD, and autism – and shifting the entire bell curve of IQs downward several points, resulting in more children with disabilities, and fewer children who are gifted.
As part of his work to raise awareness about how we are harming whole generations of children, he was kind enough to spend nearly two hours with me so that I could share his views with you. I have been a fan for years, so it was a delight to converse with him – and as enlightening as the very best master class imaginable. This interview has been lightly edited for length and clarity.
INTERVIEW WITH DR. BRUCE LANPHEAR, November 6, 2023
JMK: Thank you so much for giving me this time. Also, I want to say at the outset that, as the mother of a child who died of environmental illness, I am so personally grateful to you for all the work you have done over all these years.
BL: Thank you so much. I appreciate that.
JMK: Your name comes up very often, of course, in my work with the CHPAC right now, and elsewhere. My first question is really about you and how you got interested in this area of expertise. Is there some story from your childhood or your early training that got you to this place?
BL: Yes, it was roundabout. I was training to do global health or tropical medicine, and then, my fiancée came down to New Orleans, and she started her internship in pediatrics. After about two or three months she said, this isn't working out – not me and her – but her training – because there was so little academic training. There were very few nurses and orderlies, so the interns were doing all the orderly work, all the nursing work. And so, after a few months, she said, “Look, I've talked to some people in Cincinnati,” where she had done some training as a medical student. It was a world-class hospital, and they agreed to take her in her second year. So she said, “So I'm going. Are you going to follow me? Or what?” And so I ended up in Cincinnati.
It was hard to do tropical medicine in Cincinnati. So I worked in a STD clinic and an employee health clinic for health care workers studying bloodborne pathogens. That worked out for a while, but I ran into two problems. One was I felt ineffective; this was the early part of the AIDs epidemic, mid- to late-1980s, and I couldn't convince the hospital administrators to purchase needleless devices. So we had 300 to 400 exposures to blood and body fluids every year. All we had to do was prevent one conversion, and it would have been cost effective. They ended up buying needleless devices two years after I left, but I just didn't feel like I was very effective. The second reason was I had 15 people from environmental services – the janitorial employees – who told me they were trading sexual favors to work more hours. The reason they were wanting to work more hours was not only because they could get paid more, but then they could get health insurance. This troubled me: a university hospital that received public funding was using that strategy to keep their costs down. I took that to the Vice President of the University, and basically, I was told, how long did I want my job, boy? [laughs] So I decided I didn’t want to do that anymore.
The Holy Grail for public health is to eliminate poverty; that would eliminate half of all disease. During some of my course work, I realized that there was another strategy to help people. I had an opportunity to work with Michael Weitzman in Rochester and prevent lead poisoning, to reduce a barrier that kept children from succeeding. This time my wife followed me, although she had a better job than I did when we got there. And I started to study how to prevent lead poisoning; the first study I did was based on a Congressional mandate. The impetus for the Congressional mandate was interesting. Do you remember Millie, the dog?
JMK: I do – yes!
BL: So Millie the dog, George H.W. and Barbara Bush's Cocker Spaniel, was lead poisoned from renovations in the White House in 1990. It made front-page headlines in the Washington Post. Louis Stokes, a Congressman from Cleveland, said, “you know, we hope the best for Millie. But Mr. President, do you know, there are 3 to 4 million children poisoned every year?” That incident led to the 1992 Lead-Based Paint Hazard Reduction Act. And in that act, Congress mandated for a study to be done to identify what levels of lead and house dust were dangerous. So, when I was a postdoc at the University of Rochester, that study was put out as an RFA (Request for Applications). Few people applied because we were applying in April or May of 1994 and the study had to be completed by Thanksgiving of 1994. The timeline was daunting. We ended up getting the study on July first, 1994. By August fifteenth, we had hired 30 people and developed the questionnaires and the protocols, and figured out we were going to measure dust three different ways: a high-flow expensive vacuum that EPA had used; a low-flow vacuum sampler; and then a wipe sample. So then we had to figure out, “Okay, how the hell are we going to do this?” Several of my colleagues tried to convince me that we needed a random sample of children, and I said, it's a great idea, but I don't have any idea how we're going to even get 200 kids. How are we going to do a random sample in such a short time? How could we even begin to do that? Because most studies that I knew of at the time, and even today, they're convenience samples – I mean, not NHANES – but most other studies. You take whoever comes. So what we ended up doing, which turned out to be very successful, is we got all the birth certificates of children living in the city of Rochester. That was the first eligibility criterion. The second eligibility criterion is that they had to be between 12 and 30 months of age. They had to have lived in the same house since 6 months of age. They couldn't be taking iron therapy for iron deficiency for anemia. They couldn't have a history of blood poisoning. And their parent couldn't be involved in an occupation or hobby involving lead. So we got all the birth certificates for kids who were born between the relevant dates. We randomly permuted them in a computer. And then we hired three people to call all of these families up to eight times before we gave up. So we ended up calling 2,500 families before we found the 205 families that ultimately were eligible, and completed the study. And then we had to go into the homes, and we took 39 dust samples, 12 soil samples, two water samples, and a blood sample from the kid. We measured paint lead, and about an hour and a half questionnaire. So we had all of those things, and we finished it by Thanksgiving. So that's how I got involved in environmental health research and children's health.
JMK: Yes. That must have been a really formative time. And then you branched out. You do all kinds of exposures besides lead: organophosphates and all the pesticides, PFAS, air pollution, etc. You don't just stick to one disease, either. I've heard you talk about autism and IQ, as well as cancer and other diseases. It seems like you've really gotten around in the field.
BL: Yes. And I think it speaks to my particular role. Some scientists like me whom I've worked with are very quantitative. I'm not. And I've always relied very heavily on statisticians or epidemiologists who are very quantitative. I'm a physician, and what I've tried to do is build on the strengths that I have. Because of my early training, I can do everything from exposures to outcomes like IQ or autism. But I'm not really an expert in anything. I could say I'm an expert in children's environmental health. But you know, David Bellinger is an expert in neurodevelopment and IQ. I'm not. Ryan Allen, whom I work with here, is an expert in exposure science. Rick Hornung is an expert in statistics, and on and on and on. So I guess if I do have expertise, it's in trying to synthesize data across different disciplines.
JMK: I think that's so important because rarely do the experts in silos look at the whole picture.
BL: Yes, it can be hard. But of course, then, you know, it's all about how you assemble all the expertise that is necessary.
JMK: Wonderful. I saw someplace that you have published more than 250 journal articles. And I especially appreciate the public outreach you've done. Is there one thing that you're proudest of?
BL: Well, I don't know if there's one thing. I'm proudest of the work I've done that has an impact on policy. The residential dust lead standards took 25 years – but the work we did showing that there's no safe level of lead had an impact on all the lead standards, ultimately – not just in the United States, but elsewhere. Aimin Chen led our research on PBDEs, and some of that showed quite definitively that higher levels of PBDEs led to IQ deficits and ADHD. Ryan Allen led the Ulaanbaatar Gestation and Air Pollution Research Study (UGAAR) study – a randomized, controlled trial of HEPA air cleaners in Ulaanbaatar, Mongolia, a heavily polluted city in the winter. It's nestled in a valley surrounded by mountains, so you get inversion. But there are also over a million inhabitants living in gers or yurts – and everyone has their own coal stove that pumps out smoke. And there are four coal power plants in the valley. In the winter, it's extraordinarily polluted. We conducted a randomized trial of HEPA air cleaners and pregnant women – about 540 at baseline – and we showed that miscarriages dropped by 50% in the group that got air cleaners, and IQ scores increased by three points at four years of age among the kids who got cleaners in their home.
Our most recent study showed that lead in adults was the leading risk factor for coronary heart disease deaths in the United States. Most of my colleagues didn't believe it. In September, the World Bank used that and one other study to estimate that the global burden of disease for lead is 5.5 million deaths every year and 765 million IQ points lost in kids. One out of 3 kids worldwide are lead-poisoned, with a blood lead level above 5 µg/dL blood, and the overall economic cost is 6 trillion dollars a year, which is equivalent to 7% of GDP. It's huge. And so, even if you just look at lead and say, what are we doing to ourselves? Right? There's tremendous profit that was made from lead. But by and large, the companies that polluted the planet and polluted us have contributed almost nothing to its decline or control. Most of us probably thought this was a problem of the past, 30 years ago. It's still causing 5.5 million deaths every year. It's humbling.
JMK: I know that air pollution is usually estimated at 7 to 10 million deaths per year globally, but I had no idea that deaths from blood lead levels would be that high.
BL: If you add up deaths from air pollution, lead, and smoking – which is just another form of air pollution and metal pollution – metal contamination, and other toxic chemicals, it's at least one out of five deaths. But the amount of funding that goes to it pales in comparison to things like HIV or TB that cause much less death. I don’t mean to pit one disease against another one, but just to provide a kind of perspective.
JMK: Absolutely. By the way, I shared the short video you put on Little Things Matter with my students. They had never thought that we should be investing so much more in prevention instead of cures. It’s a very effective video.
BL: Good. Thank you.
JMK: Thank you. So the next question is, it's very tough to be a parent raising kids in a world with toxic chemicals. I know you're also a parent and a grandparent. So if you could communicate one thing to parents about the implications of your work, what would that be?
BL: I only get ONE? [he exclaims in wry protest ]
JMK: No! You can talk as much as you want! I’m getting it all down! [We both laugh.]
BL: All right. Most of the chronic diseases in children and adults are man-made. Most are preventable. And the way to prevent them is through population strategies, not expensive drugs, not stem cells, not genetics. Population strategies could be vaccines; it could be taking lead out of gasoline; it could be reducing air pollution; or it could be shifting away from pesticides – with organic agriculture and organic diets. That’s going to be the way we solve our problems.
There's a story I like to share. Nobody has asked parents whether they prefer to prevent disease or to treat it. But I did do a hand-raising survey of pediatricians around North America, about a thousand pediatricians at New York University, The Canadian Pediatric Society in Vancouver, University of Wisconsin Madison, and seven other places. And about the same percent answered the question the same way at every one of those places. The question I asked them was, if you could vote to increase funding for childhood leukemia, arguably the poster child for finding a cure for cancer, would you increase funding to enhance the cure for childhood leukemia? Or would you increase funding to find ways to prevent childhood leukemia? So what percent of pediatricians do you think voted to increase funding to enhance the cure?
JMK: I think they all should have said increase the funding for prevention. But I bet 90% said, increase the funding to produce a cure – am I right?
BL: So you'll feel good about pediatricians today. [Smiles broadly] Five pediatricians, only half of 1%, voted to increase funding to enhance the cure. Virtually all of them said that they would vote to increase funding to enhance prevention. But then, if you've seen the video, you know what percent of the National Cancer Institute's (NCI’s) funding for childhood cancer goes to prevention.
JMK: One percent.
BL: Yes. So what is that about? Whose interests are they serving? It's not – I don’t think – the public. Now, I said we don't know what parents would vote for. We've never surveyed them, at least not about cancer. My guess is that they would be with the pediatricians, not with the NCI budget.
JMK: I am heartened. I was afraid there was going to be a zinger. I'm glad to know that pediatricians voted the right way, because what I read – and what I experienced doing my MPH internship – is that very few physicians are equipped to talk to patients about causes of cancer and other diseases.
BL: Do you know Mark Miller or Catherine Metayer?
JMK: I know a lot of people who know them, but I don’t know them personally. It was bittersweet for me, in 2016, when they came out with that article saying that childhood leukemia was preventable. YES! Finally, someone used the word, because no one was using the word prevention, although it was obvious. So yes, they're wonderful.
So here's a follow-up question. There's so much fear and guilt surrounding environmental contamination and sick children. Has it been difficult for you personally, to address these topics over the years? And do you have any advice about how to present this topic, which is so dire?
BL: Yes. And when you say guilt, what do you mean? Parents’ guilt, or what?
JMK: Parents’ guilt, fear…. When you're communicating things like this, a lot of people are worried about scaring parents and creating guilt in parents. And it's very anxiety-producing to learn these things. My poor students – I'm the first one to tell them these things, that they will none of them have a child who's completely immune from these exposures. And how do you communicate this issue?
BL: Yes. I don't worry too much about parents’ guilt. Parents have relatively little control over these things. Joel Bakan wrote the book The Corporation, and then a follow-up book about protecting children from Big Business. He was interviewing me for his second book about environmental chemicals and how they impact children. And I was going through a litany: there's lead; there's PBDE, and after about five or ten minutes, he says, “Stop, stop! Stop! Wait a minute.” He says, “you have kids right?” And I said, “Yes.” “And you do this for a living?” He just asked, “can you protect your kids from these chemicals?” I said, “Absolutely not.” I mean, yes, maybe I can keep up on five or ten of them. But you know there are hundreds of chemicals – no way – and so I don't worry about making parents feel guilty, because for the most part, it's out of their control. Now I say that. And then, of course, as you noticed in the videos, we do say, here are some things you can do, right? These are short-term things. And the reason I offer those short-term solutions is when I first started doing talks like this to the public, maybe 20 or so years ago, invariably, people would come up afterwards and say, “Okay, you scared the shit out of us. Now, what do we do about it?” And it wasn't very satisfying to say, “well, you’ve got to advocate for better regulations, which will take 10 or 20 years.” So in the end, what I ended up doing was hopefully informing them more than scaring them, but making clear that this is an urgent problem. Here are some things you can do in the short term to help reduce your family's exposures to chemicals. And in the long term, the only real solution is better regulations. So advocate to your political leaders and representatives that we need to do a better job protecting children and the rest of us from these toxic chemicals. The other reason I didn't feel guilty is that these problems, these toxic chemicals, are too important to leave up to the experts.
So I just got back from this really fascinating retreat. It's called the Warrior Monk Retreat.
JMK: Wow! Love it!
BL: Yes. It's about how you live in today's world spiritually. That's the monk. But you are active in the world. That's the warrior. It incorporates Buddhist philosophy and meditation, but also poetry by Mary Oliver – so it was not religious. Well, one of the things that came to me in the midst of all this meditation and guided work was a confession, a poem – and it was called “Confession of a Toxicologist.” It started out, “I am guilty.” I am guilty for adopting this indoctrination that chemicals are acceptable, that chemical exposures to children, pregnant women, and the rest of us – into all life forms really – are acceptable until they are repeatedly shown to be toxic.
Now, maybe 50 or 60 years ago, that was a reasonable assumption. The assumption was made, however, not because there was evidence it was safe. There was no evidence that they were safe at low levels. In fact, we knew that many of them were poisons. It just was a question of at what level do they cause harm, but not whether they did cause harm. The assumption was made so as not to impede economic progress. The sacrifice was made so as not to impede economic progress.
And you know, I feel like I'm stepping out of this indoctrinated priesthood or something in order to say that; but when you do step out of it, when you aren't indoctrinated, but instead, you say, why are you doing this? And how did we get to this place? If the system was working, fine – if in fact, chemicals weren't causing problems. But every year, we find yet more that do cause harm. We have a hard time acknowledging them.
You mentioned a 2016 paper: one in four cases of leukemia in children can be attributed back to these four or five toxic exposures. But when you go to the cancer foundations, when you go to the oncologists, they don't talk about any of those. It's all about, we’ve got all these drugs, and that's what we're going to focus on – more and more drugs. And I'm not in any way being critical of the oncologist or the pediatrician. They are doing their job.
JMK: Yes.
BL: But then, who's failing? Well, we can certainly blame the chemical industries. And they should bear the brunt of the blame because we consistently find that they've misrepresented the science, whether it's atrazine, paraquat, or chlorpyrifos. Whether it's lead, tobacco, or some other chemical. So they deserve the brunt of the blame. But, on the other hand, the government is failing to regulate these toxic chemicals.
Inadvertently, my colleagues and I have supported that assumption, supported a regulatory system that is failing to protect the public. Until we have consistent evidence from laboratory studies and epidemiologic studies, we say we don't have adequate data to say it is toxic, that it needs to be taken off the market.
So that gets back to this other assumption. The first one was that low levels of chemicals are safe. The other one was started by Robert Kehoe around lead and tetraethyl lead in petroleum in 1925, when there were no laws that allowed the U.S. Government to regulate lead or other toxic chemicals. He said if there is no evidence that a chemical or metal like lead is toxic, then you have no right to regulate it. You have no right to keep industry from using it. Now, most people wouldn't say that that is operating today, but in a way, it is – because once chlorpyrifos was on the market, getting it off the market becomes extraordinarily difficult. Right? It's like a seal of approval.
Well, a troubling and fascinating thing about chlorpyrifos is that Lianne Sheppard and a couple of her colleagues a few years ago went back and looked at the statistical analysis that some industry-funded scientists used for the approval study of chlorpyrifos. Oh! They made a mistake. If they had used the right study, it likely wouldn't have been approved. So not only was the initial study flawed. Not only was there no check on that for 50 years. Once it was approved, getting it off the market took dozens and dozens, maybe hundreds of studies. So we've set up this system that protects the chemical industry. It doesn't protect the public.
JMK: Yes, you know this is why I want to write my book. I want to put a face to this. My daughter is one of those who – I have every reason to believe – died because of this decision. And I hope to be able to say that on the CHPAC. You know, I told them my background, and they still put me on there. But I also really respect that you got off the Canadian Advisory Committee in protest. And I noticed you said you respect people who are serving, but you thought you would have a bigger impact quitting.
BL: I didn't want to give the illusion that my presence as the co-chair on that committee meant that Canadians were being protected. Because I don’t think that they are.
JMK: I always think of Canadians as doing so much better than we are, partly because of the bans on cosmetic pesticides in Canada. But yes.
BL: They are better protected in some ways. The interesting thing is, we don't have regulations. We have guidance. So they're not enforceable. And yet, amazingly, the cities do seem to step up and try to do the right thing. So that's nice. But we should have enforceable standards for these, and the PMRA is using the same obsolete regulatory system that the U.S. EPA is using.
JMK: Yes, absolutely. Did you publish your poem?
BL: No – it was just four days ago. I probably will modify it a little bit, but I probably will at some point. This year is my sixtieth rite of passage, and I did one when I was 50, and that, too, was very similar in the sense that I was recognizing that it was time for me to shift more towards being a scientist advocate. And you know, up until maybe ten or so years ago, even today, probably, many scientists, if you say you're an advocate, think that's a bad thing. But as a physician, I have no problem being an advocate for my patients. Why would I have a problem being an advocate for populations of patients? I think it's important to number one, stay as objective as possible. Stay pure of heart. Don't take funding. I think that contaminates the process. I think it does alter your biases in a way that's really important. So I don't personally take payment for things. I'll do consulting gigs. I'll testify as an expert witness. But I don't take the money. I either do it pro bono, or I put it into a research and teaching fund at the University. But I don't take money. That's important. The other is to recognize that even with good intentions, you can cause harm. and so that to me is the final safeguard. Fortunately for me, most chemicals aren't essential, right? It's not like we need lead for the synthesis of something in our bodies, right? Now, people might say, well, pesticides, we need pesticides. Actually, we don't. That has been a misconception that has been promoted by, guess who?
JMK: Monsanto.
BL: Yes – and other pesticide companies. In 2013, the UN came out and said, no, um actually, we don't need pesticides to feed the world. And yet our regulatory agencies are still operating from that misconception. So this is a problem, because scientists are supposed to be skeptical. But once you've got something approved, once you have a belief adopted or accepted, now, the evidence to overturn it – whether it's chlorpyrifos or whether it's the idea that we need pesticides to feed the world – becomes monumental. And of course, the industries that promoted those misconceptions have figured that out. And the scientists? Too many of us have been duped.
JMK: I could not agree more. So my next question is about U.S. policy. But you should feel free to speak about Canadian policy. If you could single-handedly have the power to create new policy, what would you do? What would it look like?
BL: Well, the first thing I would do would be to mandate a living wage for everybody. And then, for the two or three percent of people who can't work for one reason or another, some other kind of mechanism. Poverty is a man-made problem. It's not inevitable. It's not genetic.
The second thing I would do is figure out how to require testing of chemicals before they're put on the market that is even a little stronger than the way we evaluate drugs. For example, we rarely look at long-term effects with drugs. We take advice from people who have vested interests. We should not allow industry representatives or industry consultants serving on advisory committees or committees approving the use of chemicals. We're going to have to get rid of campaign contributions. There's no other way around it. Because as long as we have those campaign contributions, the politicians do the bidding of the chemical industry. So it's hard for me. I can't limit it to one. [He laughs]
JMK: No, of course not…that's wonderful. But in this scenario, you are God, so you can have it all. [We both laugh.]
You have already addressed quite a bit – in our conversation and in other things that you've published – about the central question that I'm curious and occupied with, which is, how can we be this stupid? How can we allow climate change to occur and environmental degradation to kill our children? I mean, in other ways, we seem like sensible creatures. How is this happening?
BL: Yes. I think there are a couple of things. But if you look at where the power is today and has been for the last century or more, it's in the mega corporations. And Joel Bakan had an interesting way of talking about corporations. They're sociopaths. They're not people. They're sociopathic. You know to the extent that they believe – and I don't think this is true, but they use this – that their legal obligation is to make a profit for their shareholders, then they're going to do things that are not necessarily in the best interest of people or the environment. They're going to do what's in the best interest of their shareholders, the short-term, quarterly interest. Not 5-year, not 10-year, not 20 years. They're not that smart. They're idiot sociopaths. They can't think beyond the next three or six months, maybe a year. So I think that is the root of so much of the problem. Some of the robber barons of the 1900s that were involved with the lead industry, the Guggenheims, Rockefellers, Dupont, Alfred Sloan, and General Motors were the big money makers in the 1900s. And it was almost like they couldn't help themselves. There's so much money to be made. I think that is the root problem that we've got to come to grips with.
If you accept that analogy, that you can begin to understand all the idiotic policies that exist in the United States, including the ones we're talking about around toxic chemicals and the lack of universal health care. The United States is being run like a corporation by the mega corporations. If you extend that analogy out a bit, the challenge we have is that you and I and most U.S. citizens are minority shareholders. We each have one vote. The mega corporations and the very wealthy are majority shareholders; they have a lot of votes. And if we want to change things in the best interest of children and families, we have to figure out how to get all the minority shareholders together – 70% or more – and vote together, and that’s why one of the key strategies that these mega corporations use is to perpetuate polarization, because as long as they perpetuate the polarization in the United States, they can do whatever they want.
JMK: Yes, absolutely. A lot of people agree. And I think that's just true.
The next question is, I suppose, how hopeful are you that we will improve – what do you think the status of children's health will be in the year 2050?
BL: 2050. I have a lot of optimism, and the reason I have optimism is that the system is broken in so many ways. You've had firsthand experience. Have you heard the story about Ella, the 9-year-old who died of asthma in England in London?
JMK: No….
BL: Ella was a bubbly and happy nine-year-old kid with asthma. And when she was nine, she died. And on her death certificate, the pathologist listed severe asthma as the cause of death. Her mother refused to accept it. It took six years, but she finally convinced a pediatrician and the judge that air pollution was a contributing cause on her death certificate. Now, the challenge, as you know, is that you can't say it caused Ella's death, right? No more than we can say a pesticide caused your child's death. But we can certainly say it contributed, and we can certainly say that it contributes to the death of children overall from asthma and from leukemia.
My dad died of ALS. Well, as best I can gather, he died of a combination of lead exposure that began during childhood; pesticide exposure by living near a golf course and doing work as a horticulturist; and head trauma: all three of those contributed. And because he had all three and not just one, he was more likely to develop ALS, right? So we have to come up with ways to attribute cause. But we can't negate the causes of death.
And so I think with Ella and her mom, they basically were able to say, look: Ella died from asthma, induced at least in part by air pollution. And until we start doing that, we're going to continue to focus on treating asthma or treating childhood cancer. And so I think we've got to get to the point where first, mothers, parents, the public appreciates that. Most disease is man-made, and I do use man-made intentionally, as opposed to human-made – because those in power have been driving this, and historically that was mostly men.
I was at Broken Hill, Australia about ten years ago. It's a mining town out in the outback. It was named Broken Hill because there was this chunk of lead sticking out of the ground. And I was invited there by city council, and I gave a talk on lead and saved time for people in the audience to talk. And almost immediately, a grandmother who was carrying a pile of dog-eared articles wrested the mic away from me. She knew more about lead poisoning than 99% of pediatricians and toxicologists. And she started talking. She said, “I'm pissed at industry for poisoning our kids, and I'm pissed at the Government for failing to protect us.” And then she kept going on and on, and you could see people who are starting to lean away from her. I'm sure she'd done this before. I was finally able to get the mic back from her, and I wanted to acknowledge what she said, because I think she was right. I didn't want people to sideline her. So I said, “two things are necessary to make progress in public health. First, we need good science. And second, we need Mums to get pissed off.” And that was the headline in the paper the next day.
JMK: I want to gather together the pissed-off moms. I'm certainly one of them. I would say furious. Hell has no fury like the mother of a child you’ve killed.
BL: Yes. If you look at it historically, the first major public health bill with money was passed in 1921, just after women won the right to vote.
JMK: Yes!
BL: Right?! There is a transcript that I came across of Congressmen talking in the cloakroom closet, that said, we better pass this, or the women are going to come after us. So you can see evidence like that, evidence like mothers against drunk driving (MADD). The early efforts to prevent lead poisoning work were community efforts with a few physicians thrown in. As early as 2003, 2005, we knew that there were no safe levels of lead. Now the public health departments, the CDC dismissed it, ignored it. By 2012, they finally did something, but even once their Advisory Board acknowledged it, it still didn't make its way into the public. That took the Flint disaster, and mothers getting pissed off about their children being lead poisoned. And nobody was listening, and then from that disaster, now we can see that Biden has really pushed through the lead service line program. So it does take both good science and mothers getting pissed off. This is another reason I say, these things are too important not to get parents involved.
JMK: Absolutely. And I think the attitude that you shouldn't tell parents the truth because it will make them feel guilty or fearful – I actually encountered that among some physicians – they didn't want to share information with parents – they feel like it’s too much information – I think that's patronizing. I think most parents are working so hard to protect their kids, and for that, they need information.
BL: Absolutely, it is patronizing. It's very similar to what was happening in the 1960s: “Doctor, don't tell my dad he's got cancer. It may make him feel bad.” Right? Well, you couldn't get away with that anymore. Well, why do we get away with this? Back in the early 2000s, there was this big controversy among us doing children's environmental health research. About half of us thought we should report results of biomarkers back to parents. And the other half said, absolutely not. About half of the ethicists said absolutely not, because there's nothing that can be done about it, nothing clinical. Well, what we learned was, there are things that can be done about it. Families can make choices to reduce their exposure to most things, not always based on randomized, controlled trials, but oftentimes they are, in fact based on randomized, controlled trials.
So we asked our Community Advisory Board for our children center, should we report results back? They said yes. Then we asked a National Advisory Committee, and they said, absolutely report the results back. Well, even then, we were asking, “Well, okay, we could do that. But really, these committees, these national and local committees are really just proxies for what the moms might want. Right? Why don't we ask the moms?” So we asked the moms in our cohorts, and all but two of them said, “Yes, I'd like to know.” So we reported them. Now, we also took it upon ourselves – we got no funding to do any of this – to provide them a hotline where they could call a physician who did know about some of the chemicals, and they could talk it through: “What does this mean? What do I do?” So we provided that information, and we felt obligated to do it. But why is reporting on results of studies of chemicals, or biomarkers of chemicals [not done]? Why? Why are we okay scaring the shit out of people about terrorism, but not toxic chemicals? Right? It doesn't make any sense to me. The other thing that I'd say is, you know, you go back to polio during the 1940s and 1950s. Polio, relatively speaking – and I'm not trying to say we shouldn't have a vaccine or anything else like that – caused relatively few deaths. There were more deaths because of the baby boom, and so that there were more vulnerable children. Now it's the March of Dimes, but the National Foundation for Infantile Paralysis had a strategy to raise money. You know what it was.
JMK: Scare people.
BL: Absolutely. Now, I'm not suggesting we scare people. I'm trying to suggest that we need to raise awareness that it's an urgent problem and that there are things that can be done about it. We don't have a vaccine, but we don't need one. We know that there are things that our governments can do to reduce these exposures. The problem is if we scare people, and they can't do anything – if we don't know what to do. But we do know what to do. So I just don't buy that argument.
JMK: Yes, I agree. Well, people have reasons to want to scare people about terrorism, right? And there are a lot of interests in not scaring people about chemicals. But you know, all of the testing of people's blood and finding what's in us, that did come to a lot of attention, I think. It’s very motivating to know that chemicals are in everyday people whom you know.
BL: And we keep finding more chemicals, and we keep finding that more chemicals are toxic. And we keep finding more problems and more downstream costs associated with toxic chemicals. One of the more recent ones is the PFAS, the forever chemicals. We did a study of firefighters in Australia, and we found if you donate blood three to four times a year, or if you donate plasma four to six times a year, you could reduce your levels of PFAS. Well, the firefighters said, this is great. We should recommend people go out and donate their blood. Wait a minute. Number one, there are still some questions about whether there's clinical benefit. But who's going to get the blood?
JMK: Right – vulnerable people!
BL: That’s right. Now the Red Cross. They don't want to touch this. You're raising questions about the safety of the blood supply, and they're already having enough problems getting people to donate blood. I understand that. But here is yet one more downstream cost of poorly regulated toxic chemicals that we haven't even really begun to grapple with, as if we needed another one.
JMK: I am looking for experts, but I am also looking for angry mums and I am looking for asthma, birth defects, autoimmune disease, heat deaths, climate change, etc. – and so lots of different environmental topics. I’m really trying to look at the big picture of total environmental impact on children's health because I think it all matters.
BL: Okay. So one other person that comes to mind. And this is somebody who's fighting to change things. And so that's nice because it's, as you know, it can be kind of tiring to focus all the time on, this is bad, and that's bad. And so one of the things like we've done with our social media is, we've started a little theme called Little Steps, Big Impact. Look at the positive stuff that's happening. One person is Kim Konte, Non-Toxic Neighborhoods. Have you come across her name or organization before?
JMK: No, I don't think so.
BL: Kim is a mother. She was in Orange County at the time, and she and a couple other parents were hanging around watching their kids play on a sports field or playground and saw that they were applying pesticides and felt kind of troubled, like this really didn't make sense. And then Kim reached out to me because she found our video. And she said, and then we saw your video, and we knew using pesticides where our children play didn't make sense. So she contacted me, and since then started NonToxic Neighborhoods, first by working with her City Council – to get them to stop using pesticides at school playgrounds, sports fields, and public playgrounds. and then she's worked with them to get rid of the pesticides that are needed along highways by focusing on planting indigenous plants as opposed to, non-native species. So that's how she started. But now she's worked with over 200 cities, counties, and even a couple countries. And so I think she would be a great person to talk with and interview, and again, in part because it's positive.
The other person I’d contact is Ella's mom. The Guardian has written several articles written about her, so she'll be relatively easy. Her name will be easy to find. I haven't tried to contact her personally. But I think that would be a powerful story to add around asthma. Rob McConnell is at University of Southern California, and he's been involved in their center now for probably 20-25 years, and they've been focusing on childhood asthma. They do some interesting things like new evidence showing no safe levels of air pollution. I don't remember if that was focused on children, how you can reduce asthma rates based on zip codes or neighborhoods, where a higher proportion of the cars are electric as opposed to gasoline. And he's very keen on translation.
Richard Finnell at Baylor University: his focus is on neural tube defects, but he's gotten involved in some other birth defects, like in China, for example – he was doing a lot with neural tube defects in China. I just heard a talk by a scientist at Harvard. She's been looking into arsenic as a cause of neural tube defects in Bangladesh. Rick has been looking at that in China, and I think he was looking at in relationship to air pollution. It’s Maitreyi Mazumdar, and I think she's Bangladeshi.
JMK: Okay. Last question. You've been so generous with your time. Do you have any questions you'd like to ask me about my experiences or my project?
BL: Hmm. What do you hope to come out of this? This is a book project. Is that right?
JMK: Yes. I had tried for a popular book contract some years ago, but it’s very difficult to break into that market. I just sent out the book proposal yesterday – Poisoning Children: Ethnography of Environmental Health. And it’s wonderful so many people are doing popular books. But I want to have this message everywhere, including in academia. I hope that this might be a book that would get into classes. And so I feel that I have a skill set that's unusual, so I'm not sure many other people could do this particular project.
BL: And so what is your hope by writing this book?
JMK: I want plenty of angry people to change policies. That's the main thing. When I distribute flyers that offer 10 Things You Can Do to Prevent Cancer, Autism, ADHD, and Lower IQs, the last one is always make your voice heard; vote the environment. Because I agree completely with you that it has to be systemic to really make a difference. And I do teach, and I feel like on that level, I'm able to change a lot of students’ minds. And I'm able to say things like, “this should be our biggest public health success.” My son read that, and he said, “Ha! That's a funny way to say we stop killing people and save the planet.” But so I try to put the positive spin on it as well. But I do agree, there's a role for scaring people, making people aware how bad this problem is. And in my global environmental health class, I try to put together a lot of these pieces. And what I'm trying to do in the book is to put together the pieces so people get some idea of the magnitude of this problem.
BL: So how old is your son?
JMK: My son is now 26.
BL: So he gets this in ways that most people don't, and that is most of these diseases we experience are man-made. And it's really when we conquer lead poisoning or bring down the rates of lung cancer or asthma from air pollution. It's really not progress. It's adaptation.
JMK: Absolutely. Yes, you know, he lost his sister. He watched her get sick and die, and so, of course, he's right there with me. My other son is an environmental science major. I never twisted his arm, but he must have been listening. So….
BL: It does seem to be changing. I think more people are receptive to some of the messages we've been talking about compared to say, 25 years ago, when I was first getting involved in this area. I think that's quite positive. It's unfortunate that there's much more distrust of governments, but unfortunately, they deserved it. And there's more distrust of corporations, and I think that's an important part of changing the policies.
JMK: Yes, I completely agree. I am hoping that after I do the academic book, maybe I'll come back to something popular, because I agree in some ways people have to be receptive enough to the message to even be able to say it. And you know, the scientists have to say it first.
BL: All right, wonderful!
JMK: Thank you so much! I'm very grateful for all you have done to help.
