Current Lead Levels in Flint Michigan Children at Historic Lows Interview with:

Dr. Hernan F. Gomez MD Department of Emergency Medicine, Hurley Medical Center, Flint, MI Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 

Dr. Gomez

Dr. Hernan F. Gomez MD
Department of Emergency Medicine, Hurley Medical Center
Flint, MI
Department of Emergency Medicine, University of Michigan
Ann Arbor, MI Why did you decide to do this study?

Response: Although the Flint water crisis drew recent, national attention to childhood lead exposure, environmental lead exposure has been a longtime, widespread problem in the United States.

I have recollections of far higher blood lead levels in children during my training as a young pediatrician in an economically challenged city with roughly the same population as Flint. As a medical toxicologist I have not seen any children with lead levels requiring medical treatment in years. The last time a child required inpatient chelation treatment for elevated lead levels in Flint was during the 1980s. What did you find? 

Response: We found that annual percentages above the CDC reference range of 5 µg/dL and annual geometric mean blood lead levels have steadily declined over the 11-year study period.  We found a similar elevation of lead levels over our 11-year study period in 2010 that was random, yet similar in magnitude and not associated with a water source change. We found that in 2016, the first full year back to the Great Lakes water source, average lead levels are currently at an historic low. Public health efforts from the perspective of the past decade to reduce lead exposure seem to be working. Why is this important? 

Response: There is no safe blood lead level, but we do know the higher the lifetime exposure to lead, the more toxic the effects in children. Knowledge of the past helps us to understand the present and more reliably anticipate future public health trends. Why is this information important for the public to know?

Response: Although the Flint water crisis drew recent, national attention to childhood lead exposure, lead exposure is a longtime, widespread problem. We now know that lead levels were far higher in Flint over the last decade, and therefore potential toxic effects of lead during the recent past were higher in comparison to the time period of the water switch. Public health efforts to reduce lead exposure in the community have been largely effective. Currently lead levels in Flint children are historically low. What are your conclusions from this study? 

Response: The study team found that since 2006, blood lead levels declined steadily and substantially in Flint children and reached an all-time low in 2016. We were also surprised to find that in the year 2010 there was random increase in lead levels that were similar in magnitude to what had occurred in Flint children during the water switch period. Do you agree that children were poisoned?

Response: We do not want our Flint children to grow up with a false stigma of thinking their brains have been poisoned. While it is true there is no known safe blood lead level, according the CDC, the reference value of 5 µg/dL is a value that is frequently misinterpreted as some sort of definitive threshold of poisoning. It is accurate to say that more children were at higher risk during the period of the water switch compared to the year 2013. What is your motivation in this work?

Response: The aim of the study was to place in historical context the elevation of lead levels during the crisis. Levels were substantially higher and declining since 2006 due to public health efforts. In fact, no lead levels in the data we examined during the Flint water switch reached the point where the CDC recommends any form of medical intervention.

Citations: Blood Lead Concentrations of Children in the United States: A Comparison of States Using Two Very Large Databases

Keneil K. Shah, James M. Oleske, Hernan F. Gomez, Amy L. Davidow, John D. Bogden
The Journal of Pediatrics, Vol. 185, p218–223
Published online: February 28, 2018 

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