The notorious American Academy of Pediatrics, a political organization masquerading as a scientific organization, is mounting a furious effort to stop Congress from amending its baby, the misconceived and defective CPSIA. Consistent with its previous output, the current campaign is filled with half-truths, misleading statements and innuendo. Facts and science take a back seat.
Here is their first blast email - with my replies noted. I will post more of their pap as it arrives.
As the Energy and Commerce Committee considers issues related to the safety of children's products, the American Academy of Pediatrics is pleased to provide background information about lead and its effect on child health. For more information, please contact Cindy Pellegrini (cpellegrini@aap.org) or Kristen Mizzi (kmizzi@aap.org) at the American Academy of Pediatrics at 202/347-8600.
Lead: Frequently Asked Questions
Lead is a soft, heavy and malleable metal that occurs naturally in trace amounts throughout the environment. Due to its abundance and easy workability, it has been used for thousands of years in plumbing, production of glass and crystal, and the manufacture of a wide range of consumer products. Following are some common questions about lead and its impact on children’s health.
What are the effects of lead exposure on children’s health?
Lead is well-established as a potent neurotoxin and a particular threat to the developing brain of the fetus, infant, and young child, with documented negative effects on behavior and permanent loss of IQ points. Lead causes permanent, irreversible brain damage. Even at very low levels, lead is known to cause loss of IQ and intellectual function. Children with elevated lead are more likely to have problems with attention deficit and reading disabilities, and to fail to graduate from high school. Investigators have identified associations between lead exposure and increased aggression, commission of crime and antisocial or delinquent behaviors. At high levels, lead exposure can be lethal.
@@@@RW - Lead is a known neurotoxin, yes, but exposure to lead does NOT erase IQ points inevitably or permanently. Common experience indicates this, and so does science. Here, the AAP is emphasizing that lead CAN do this, not that it WILL do so as a result of each exposure under all circumstances. The AAP cannot prove that lead ALWAYS has this effect nor can they link lead poisoning to the regulatory issue currently before Congress - namely, lead-in-substrate. Lead-in-paint is NOT at issue here. Elevated lead levels have NEVER been linked to lead-in-substrate - NEVER EVER ANYWHERE. Here the AAP is IMPLYING that lead can do this via lead-in-substrate, and relying on fear of the unknown (and a general societal ignorance of science) to achieve their political goal. Lead exposure from house paint, leaded gasoline and industrial pollution are the only sources of lead poisoning addressed or cited by the EPA or CDC.
Notably and shamefully, the AAP ignores or distorts its own scientific evidence in its venomous public relations campaign against the CPSIA amendment. As you will see from their later press releases, the AAP cites the following article: Chen A, Dietrich KN, Ware JH, Radcliffe J, Rogan WJ. IQ and blood lead from 2 to 7 years of age: are the effects in older children the residual of high blood lead concentrations in 2-year-olds? Environ Health Perspect. 2005;113(5):597-601. They do not provide a link, but I have it for you here. In this article, the AAP's assertion that lead inevitably erases IQ points is exposed as conjectural, not a universal truth. The Abstract of the article makes it clear that no declarative statement linking lead-in-substrate to loss of IQ points can be made other than that it is theoretically possible:
“Increases in peak blood lead concentrations, which occur at 18–30 months of age in the United States, are thought to result in lower IQ scores at 4–6 years of age, when IQ becomes stable and measurable. Data from a prospective study conducted in Boston suggested that blood lead concentrations at 2 years of age were more predictive of cognitive deficits in older children than were later blood lead concentrations or blood lead concentrations measured concurrently with IQ. Therefore, cross-sectional associations between blood lead and IQ in school-age children have been widely interpreted as the residual effects of higher blood lead concentrations at an earlier age or the tendency of less intelligent children to ingest more leaded dust or paint chips, rather than as a causal relationship in older children. [Ed. Note - In other words, the lower IQs found in children may be due to the fact that it may effectively be a self-selecting group. Hmmm, interesting finding.] Here we analyze data from a clinical trial in which children were treated for elevated blood lead concentrations (20–44 μg/dL) at about 2 years of age and followed until 7 years of age with serial IQ tests and measurements of blood lead. We found that cross-sectional associations increased in strength as the children became older, whereas the relation between baseline blood lead and IQ attenuated. Peak blood lead level thus does not fully account for the observed association in older children between their lower blood lead concentrations and IQ. The effect of concurrent blood level on IQ may therefore be greater than currently believed.” [Emphasis added]
The study notes later: "In neither analysis did we see evidence in the overall group or in the placebo group that blood lead at 2 years of age determined IQ at 7 years of age. . . . Thus, although it is attractive to look at change in IQ by change in blood lead when considering the effect of an intervention, modeling those changes simultaneously is complex and can produce results that are difficult to interpret." [Emphasis added] In other settings, this might be labeled an ADMISSION. Don't expect any such thing from the AAP.
I am sure the AAP never expected anyone to actually read their footnotes . . . .
What happens to lead in the human body?
The human body treats lead like calcium. Once ingested, lead is absorbed into the bloodstream and travels throughout the body, including across the blood-brain barrier. Lead is bioaccumulative; a percentage of absorbed lead may be stored in the bones, where it is bound tightly and may be released over the course of many years. A portion of lead will also be excreted from the body. The amount of lead absorbed, excreted or stored in the bone may depend on a number of variables.
@@@@RW - This is a critical point, and again, the AAP relies on innuendo and fear to sell an implication as an accepted fact. Common experience, even among children with elevated lead levels, indicates that it is the persistence of high blood lead levels that put children at material risk of lead poisoning and IQ loss. Here's another quote from the above article CITED by the AAP: "Among children with both prior and concurrent blood lead concentrations below the corresponding medians as the reference group, those with prior blood lead concentrations at or above median but concurrent blood lead concentrations below the median did not have a decrease in school-age IQ score. In contrast, children with concurrent blood lead concentrations at or above the median had roughly similar IQ decreases, irrespective of their prior blood lead concentration." [Emphasis added]
In other words, studies show that children with high blood lead levels that are later reduced to the normal range do NOT have reduced IQ levels. HOWEVER, if the high blood lead levels are allowed to persist in school age children, lower IQ levels can be anticipated. Who are these kids with high blood lead levels at school age? That begs MANY questions. Don't expect the AAP to address them.
While it is undeniable that some lead accumulates in some form in the body, the real question is how much and what is the lasting impact of that lead. On that question, the AAP is silent and certainly makes no effort to carefully consider and translate its own cited studies. Taking the opposing position to the AAP is not the same thing as touting lead as a health food. Lead is dangerous - the question is how is it dangerous and in what forms. In this case, we are dealing with lead-in-substrate; it would be helpful to only present data relevant to that topic.
Are some children more vulnerable to lead and its effects?
Yes, but it may be difficult to identify an individual child’s risk. Lead absorption is known to vary based on factors like a child’s age and nutritional status. At least one gene has been identified that appears to raise a child’s risk. Scientists are still working to identify sensitive windows of development where lead exposure may be particularly damaging.
@@@@RW - For the sake of argument, let's assume this is unambiguously correct - kids vary in their susceptibility to lead poisoning. Some are more susceptible, some are less. [The AAP provides no data on this point here.] Then consider how many children are currently living on Earth (more than 2 billion). And then consider the effect of mortality rates and "aging out" on the total population of children in the regulated age group over a period of decades.
If kids fall along a spectrum of susceptibility to lead poisoning and therefore some are very sensitive to it, and taking into account the MANY billions of children in the regulated age group worldwide over the past 50 years, WHY aren't there any documented cases of lead poisoning from lead-in-substrate anywhere at any time under any living conditions or otherwise? Four Members of Congress asked consumer group representatives this question at the April 7th hearing - and didn't get an answer. It's a good question. The absence of victims suggests that the range of susceptibility is not as great as the AAP wants you to believe (as a result of its innuendo and implications). It also suggests (proves?) that lead-in-substrate is not a health hazard in children's products.
How does lead enter the body?
Lead can be ingested or inhaled. Children may swallow paint chips, small parts, or other items that contain lead. In addition, lead can be released from products when they are mouthed, sucked, or licked. Lead may be found in dust and soil, and is present in measurable quantities in our air. Lead cannot be absorbed through the skin, but it can be ingested if it gets on a child’s hands and he or she then puts their hands in their mouth.
@@@@@RW - A mixture of undeniable facts and misleading innuendo. The AAP mixes up known and serious sources of bio-available soluble lead (paint, dust and dirt) and immaterial and unproven sources pf insoluble lead (substrates). Their narrative is designed to manipulate you into reaching the unsupported conclusion that it's all the same by providing only half the story. If the AAP were restricted to talking JUST about lead-in-substrate, this paragraph might not be as powerful or fear-inducing. This is the basic error in the original CPSIA panic - lead-in-paint was equated with lead-in-substrate by reactive people like Dick Durbin. At that point, all was lost.
Does it matter how lead gets into the body?
No. Once lead enters the human body, its behavior is consistent.
@@@@RW - This is patently UNTRUE. Bio-available lead, namely soluble lead that can be absorbed into the bloodstream, has a very different effect than lead bound into substrate. Lead-in-substrate has never been linked to health problems but soluble lead (lead-in-paint, lead-in-dirt from leaded gasoline, lead-in-air from industrial pollution) has a clear linkage. This misstatement is either carelessness by the AAP or a flat out effort to mislead. Draw your own conclusion.
Will the size of a product, or the concentration of lead in it, have an effect on how much lead is absorbed?
Very small items can have high lead content, such as paint chips or dust. Trace amounts of lead, enough to cause measurable brain damage, are invisible to the naked eye. Exposure to higher concentrations of lead will, however, more quickly lead to higher blood lead levels in children.
@@@@RW - Again, the AAP uses lead-in-paint and dust to make a point in a question about lead-in-substrate. This is irrelevant and misleading. They want you to believe it's all one-and-the-same. The final sentence is also unsupported. A very high concentration of lead in hard plastic will NOT lead more "quickly" to higher blood levels than a lower concentration of SOLUBLE LEAD in another form (say, dust or lead-in-paint). This is plain baloney and is not supported by scientific findings or common experience. The AAP should be embarrassed.
What’s considered a high blood lead level?
Blood lead level is measured in micrograms per deciliter (mcg/dL). In general, research currently indicates that 1 IQ point is lost every time a child’s blood lead level rises 1 mcg/dL at levels in the range of 3 to 10 mcg/dL. Above a level of 10 mcg/dL, IQ loss occurs somewhat more slowly, but other health consequences may appear, such as interference with iron metabolism. The Centers for Disease Control and Prevention recommends that the source of lead exposure be investigated for any child with a blood lead level of 10 mcg/dL or higher.
@@@@RW - The AAP does not correlate actual data and science with their declarative statements and misleading remarks. Consider their claim that "[in] general, research currently indicates that 1 IQ point is lost every time a child’s blood lead level rises 1 mcg/dL at levels in the range of 3 to 10 mcg/dL" with the above-referenced scientific study cited by the AAP. The AAP's statement over-promises by a wide margin. Their clear implication is that high blood lead levels are like an IQ ratchet wrench but the literature speaks more carefully and notes many problems with reaching black-and-white conclusions. This may be why you did not seem to lose too many IQ points fastening lead fishing lures with your teeth as a kid. Someone once left a comment in my blog that they must have lost thousands of IQ points from lead over the years. This is what they meant.
I urge you to be suspicious of the assertions of pseudo-scientists who don't back up their big claims. If the claims are true, then there should be no reason not to trade in data. Hey, AAP, where are all the victims? Can you hear me yet???
What are current average blood lead levels in the United States?
The removal of lead from gasoline and paint in the 1970s resulted in a precipitous drop in child blood lead levels. Between 1976 and 1980, the average blood lead level for children age 1 to 5 years was 14.9 mcg/dL and blood lead levels over 40 mcg/dL were not uncommon. Today, the average blood lead level for children age 1 to 5 years is 1.5 mcg/dL (CDC NHANES, 2007-8). However, about one percent of children still have blood lead levels 10 mcg/dL or higher.
@@@@RW - This is the point Rep. Bono-Mack made at the February hearing. The last sentence is meant to scare Congress into believing that we do not know how children today come to suffer high blood lead levels - leaving the dark impression that it may be the fault of children's products. We do know the answer to this question, however - the EPA and CDC tell us that the causal agents are house paint, the consequences of leaded gasoline use and industrial pollution. It's certainly NOT lead-in-substrate. If it were, there might be at least ONE victim they could trot out. Those victims don't exist.
What is the treatment for elevated blood lead levels?
There is no treatment available for low to moderate blood lead levels. At levels of 45 mcg/dL and higher, physicians may recommend chelation, which involves administering a drug that binds to lead in the bloodstream. Chelation is not, however, effective at lower blood lead levels, and it carries risks of its own. Chelation does not reverse the damage done by lead to the developing brain.
@@@@RW - Interesting but irrelevant. This law is about lead-in-substrate. The AAP is not talking about a problem caused by lead-in-substrate here, so it's completely irrelevant to the matter at hand. It sounds creepy, however, so I can understand why they felt it necessary to mention it.
What is a safe level of lead?
Scientists have not been able to identify a safe level of lead in the human body. Research shows that lead causes harm down to very low levels, below which the science remains unclear.
@@@@RW - Whether there is or is not a safe level for lead is not relevant here. What is relevant is whether lead-in-substrate can harm children. The AAP has never proven it, just asserted it. There is no evidence that lead-in-substrate can harm children in any material or detectable way. Until the consumer groups can offer up something more persuasive than their usual declarative statements, they should be kept out of the room.
For more information, please contact Cindy Pellegrini (cpellegrini@aap.org) or Kristen Mizzi (kmizzi@aap.org), at the American Academy of Pediatrics, 202/347-8600.
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