Old Paint: A Medical History of Childhood Lead-Paint Poisoning in the United States to 1980
Brush, Barbara L., Nursing History Review
Old Paint: A Medical History of Childhood Lead-Paint Poisoning in the United States to 1980 By Peter C. English New Brunswick, NJ: Rutgers University Press, 2001) (255 pages; $69.00 cloth)
In the prologue of Old Paint, author Peter English describes the history of childhood lead poisoning as a "dynamic epidemiological evolution" (p. 2) that tied physicians, public health officials, and the lead paint industry in a web of responses and counter-responses that lasted throughout the twentieth century. Portraying the lead industry and public health community as "collaborators" against the hazardous effects of lead paint in children, he argues, in effect, that the lead industry, through its insistence on exacting evidence to support claims of lead poisoning, actually facilitated medical and public health initiatives around diagnosis, prevention, and treatment of lead paint poisoning in children. This thesis casts a new, if not controversial, light on a subject steeped in litigation.
Comprised of five major pans with fifteen chapters, the book documents the evolution of lead paint poisoning in children in the United States and the host of measures aimed to eradicate the problem. In Part I, English chronicles the discovery of lead poisoning in children before 1920. At the turn of the century, lead poisoning was primarily an adult disease contracted through occupational exposure to lead dust in factories. Telltale signs and symptoms of "plumbism" such as abdominal cramps or colic and upper and lower peripheral neuropathies were common fare among lead workers. It was quite remarkable, therefore, when four cases of childhood lead poisoning were described at Baltimore's Harriet Lane Home in 1914. Drs. Henry Thomas and Kenneth Blackfan were among the first to suggest that children could be poisoned through lead paint consumption at home rather than inhalation of lead dust in the workplace. As further evidence of their theory, Blackfan cited the 1914 lead poisoning epidemic in Philadelphia where four children perished after eating pastry laden with lead chromate, used by the baker as a yellowing agent to make his wares more palatable.
But even as a case was being made for the hazard of poisoning by consumption, an epidemic of lead poisoning among Australian children in Queensland pointed the finger of causality squarely back on panicles of lead dust. Homes in Queensland were painted with lead paint, which under the heat of day turned to powder, coating the surfaces upon which children played. Children in large numbers displayed classic symptoms of lead poisoning along with ocular neuritis. The contrast in potential transmission between American and Australian children was lost as the magnitude of cases in the latter country dramatically outweighed the former. Thus, it is little wonder that thoughts of lead paint chips and cracking windowsill panes at the mouth level of roaming American toddlers took a back seat to the management of lead dust accumulation and exposure in American workplaces.
Not until three deaths and seventeen other pediatric cases of potential lead poisoning were reported by Dr. Charles McKann in 1926, did the notion of lead paint consumption and its hazard to children resurface. In "Gnawing Toddlers," English explores the initial stigmatization of children with pica as mental "deficients" raised in economically poor and unsupervised homes where they could gnaw on lead-painted cribs and toys to their heart's content. According to English, as these cases became public, the newly formed Lead Industries Association (LIA), organized in 1928 to promote the lead industry and its projects, became an active player in the "discovery of the hazard from peeling and flaking paint" (p. 72). Indeed, notes English, LIA secretary Felix Wormer became increasingly concerned that claims of causality were not evidence based. The LIA funded lead physiology studies at Harvard University in an effort to exact "proof" and compile standards about purported cases of lead poisoning. …