Published in the Coeur d'Alene (Idaho) Press on April 19, 2002
Doctor: Lead mafia misinforms
By DAVID BOND
Staff writerEverything you and the EPA know about the risk of childhood lead poisoning in the Spokane/Coeur d'Alene Basin is bunk.
So says the former Chief of Pediatrics at Kaiser Permanente. And he has substantial academic support.
Dr. Edgar J. Schoen, of the Regional Perinatal Screening Program at Kaiser's Department of Genetics in Oakland, says cases of symptomatic childhood lead poisoning haven't been seen in his profession for two decades.
The government squanders billions pursuing what may well be a nonexistent problem here and elsewhere because of a "lead mafia running on government grants," Dr. Schoen said.
"In my view, they get people all excited, and we spend billions tearing homes down and moving lead from Point A to Point B. At Vail (Colorado, another mining-related Superfund site) they were going to tear up a beautiful town like the Israelis are doing in the Mideast right now."
Schoen sees a parallel in the Spokane/Coeur d'Alene Basin.
He said he saw his share of childhood lead poisoning cases in his early days of medical practice in Boston, but because lead in household paint and gasoline have been removed, childhood lead poisoning has gone the way of polio.
"Put your priorities elsewhere, into infectious diseases, nutritional diseases, poverty, alcoholism," he said. "With lead, you are chasing your tail with a disappearing problem. Lead will be even lower 10 years from now than it is now. Let it go away."
Schoen, 76, has published more than 100 peer-reviewed papers in scientific literature in his 50 years as a practicing pediatrician. He is a clinical professor at the University of California and founder of the Lawson Wilkins Pediatric Endocrine Society. Among his specialties is environmental health for babies.
He was also chief of pediatrics for Kaiser Permanente and chairman of the American Pediatrics Task Force.
"Government agencies are telling people that childhood lead poisoning is often named as the leading environmental threat to our children. This conclusion is not accepted by most practicing physicians, who almost never see a case of symptomatic lead poisoning," Dr. Schoen said in a 1999 peer-reviewed paper published in the periodical Technology. The article's title is "Childhood Lead Poisoning and Tainted Science."
"Most pediatricians who practice in a large medical group in an urban environment see environmental threats daily. These include poverty, violence, homelessness, family dysfunction, abuse, teenage pregnancy, drugs and alcohol - but they have not included symptomatic lead poisoning," he said
"Most physicians do not accept current (EPA) proclamations about the importance of childhood lead poisoning," he continued in his paper.
And in an interview this week with the Coeur d'Alene Press, Schoen said, "A pediatrician that has been trained within the past 20 years has never seen a symptomatic case of lead poisoning."
Before 1970, lead levels were a major threat to the health of thousands of children, particularly urban poor. Schoen said that as a house doctor in Boston between 1949 and 1951, he routinely saw children brain-damaged from ingesting house paint containing lead. Fatal lead poisoning occurred at blood-lead levels of 300 micrograms per deciliter of blood - astronomical even by blood-lead levels in Kellogg children taken during and immediately after the infamous 1974 bag-house fire at the Gulf Resources & Chemical Corporation smelter, when Silver Valley children's blood-lead levels reached their peak.
Blood-lead levels in the Spokane/Coeur d'Alene Basin children run about 5 micrograms per deciliter - closely tracking the trend of a 60-fold decrease in childhood blood-leads nationwide since the late 1940s, Schoen said, and close, within the margin of error, to the national level of 3 micrograms.
EPA claims credit for blood-lead reductions in the Silver Valley. Schoen says the reason for blood-lead reductions nationwide was the result of eliminating lead from household paint and gasoline.
Even in 1976, in its Shoshone Lead Health Project, the Centers for Disease Control found no impairment of IQ in Kellogg children who had been living or attending school in the shadow of the smelter smokestacks. Blood-lead levels had reached an average of about 60 micrograms among the 200 or so children tested right after the bag-house fire.
About the same time, according to citations in Schoen's article, pediatricians determined that children were out of danger with blood-leads of less than 100 micrograms. The CDC ratcheted that figure down to 60 micrograms, even as a 20-year follow-up study of Kellogg children reaching maturity determined that so long as childhood blood-leads were held to 80 micrograms, "socially and educationally, these adults did at least as well as their community peers."
Schoen carries no cross for the lead-mining industry at Kaiser Permanente.
"As for my connection to the lead industry, I have none. I even drink unleaded coffee," he said. "However, I do confess that I have gazed through leaded glass windows, and on special occasions have drunk champagne from leaded crystal.
"Does that violate my lead purity?"
So why did EPA's standards for lead - standards upon which its $1.3 billion "remediation" of the Spokane/Coeur d'Alene Basin are predicated - fall so far below what practicing doctors believe are cautionary?
The answer is that EPA bases its assumptions about childhood lead on "controversial studies" that long since have been discredited by the scientific community, he said.
One member of the alleged "lead mafia" - a fellow pediatrician in the Bronx, Dr. John Rosen - "is completely humorous," said Schoen.
"He is terrible. He is a complete fanatic. It's empire-building for them. It's a career. There's no conflict of interest that he goes out and preaches on government grants."
Rosen is a frequent government-funded public speaker on behalf of the Kellogg-based Peoples Action Coalition Corporation, headed by Cataldo native Barbara Miller. Miller did not return calls for comment this week. Attempts to reach Rosen also were unsuccessful.
Critics say that key among EPA's flaws in its Basin science was a study by Herbert Needleman and colleagues published in 1979 connecting even low blood-lead levels to reduced IQ levels, and a subsequent CDC study in 1991.
EPA predicates its actions in the Spokane/Coeur d'Alene Basin essentially upon Needleman's 1979 article. Europe has rejected the Needleman study, and maintains an acceptable blood-lead level for children five times the amount (25 micrograms) as pursued by EPA in its proposed cleanup work here.
The Needleman paper caused quite a fracas in the scientific community. A 1983 critique of Needleman's work by Dr. Claire Ernhart raised subsequently "unresolved" questions about the Needleman article; these questions were raised again by pediatrician Ernhart and by Sandra Scarr, a psychology professor at the University of Virginia.
"In spite of (Ernhart's original critique), Needleman, with support from federal grants and environmental advocacy groups, assumed an increasingly influential role as chairman and member of the CDC advisory committees and as consultant to government agencies - including the EPA," said Schoen.
In 1990, Needleman testified on behalf of the EPA in an EPA suit against a steel company. His testimony brought Ernhart and Scarr out firing. Their criticism of his work compelled the University of Pittsburgh, which originally had published his work, to review it.
The University of Pittsburgh's Hearing Board found Needleman's studies to consist of a "pattern of errors, omissions and contradictions" going back many years.
That same board ruled that Needleman's 1979 article, had it "contained all the caveats it should have contained regarding subject selection and model selection, it might not have been published, and it certainly should not have been a basis for federal policy."
A subsequent review of the science used by EPA to establish lead cleanup policy in the Spokane/Coeur d'Alene Basin also found a "pattern of errors, omissions and contradictions."
Needleman then was ordered by the University of Pittsburgh to submit a correction to the New England Journal of Medicine - which had published his original article - setting the record straight and admitting that his studies "were not as originally reported and did not meet scientific standards of reproducibility."
An environmental activist organization Needleman had helped found - the Alliance to End Childhood Lead Poisoning - leapt to his defense, and Needleman claimed he was the target of a Salem-style witch hunt by the academic and scientific communities.
Needleman then published another paper frequently cited by the EPA linking elevated bone-marrow lead levels to higher truancy rates among school children. However, he paradoxically found that the truants had a greater mean IQ than kids who attended school.
Literature cited by the EPA this year in defense of its $1.3 billion cleanup plan for the Basin goes back to 1998 and includes in its three citations the two contested Needleman papers, but does not address Schoen's 1999 peer-reviewed study.
"If you just got these people out of poverty, you wouldn't have a problem," said Schoen. "If you just took kids who were abused, you'd find their lead levels 20 times higher than the norm. They just came from bad environments. Lead is not the cause of their problems; it's the marker."
Schoen's remarks come on the heels of a Thursday decision by the National Academy of Sciences to review the federal blood-lead level standard of 10 micrograms, which is six times lower than where Schoen and the Europeans see any symptomatic problems. The NAS review of EPA's entire standard-setting regimen is expected to take 18 months, and will not involve any lead-advocacy scientists on either side of the controversy.
Schoen said he will continue to put to the test "conventional wisdom" on what EPA and the "lead mafia" say is a necessary blood-lead standard for children.
"I'm kind of an adversarial guy," he said. "If I see something bad, I have a hard time letting it go."
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