CDC must do more to respond to the D.C. lead cover-up

By Dana Best and Marc Edwards
Sunday, July 4, 2010

We commend Thomas R. Frieden, director of the Centers for Disease Control and Prevention, for his careful examination of the complex history of lead in the D.C. water supply ["Lead in D.C. water: Still more to do," Local Opinions, June 27]. His commentary was a good start toward correcting the scientific record and healing the rift between District residents and the U.S. public health community. Unfortunately, the piece overlooked some key points.

First and foremost, as a result of lead-contaminated water, many D.C. children will never achieve their full potential. In 2009 we published a peer-reviewed scientific paper that showed that when water lead levels were elevated, several hundred and perhaps thousands of D.C. children were poisoned by lead because they drank contaminated tap water. Children exposed to even low levels of lead suffer permanent, irreversible harm. The neurological effects of lead poisoning can be partly abated by enriching the child's environment, but the low-income neighborhoods in which water and blood lead levels were highest are the same ones with schools facing significant challenges.

Second, what happened in the District was far more serious than this piece suggested. As soon as the D.C. Water and Sewer Authority started to note the elevated water lead levels, it began to hide problems and play down potential health effects. If it hadn't been for the work of reporters from The Post, D.C. residents might never have learned the full extent of dangers from the water supply. Once the story broke, the messages delivered to D.C. residents contained misinformation and tended to play down the risks of elevated lead in the water supply. Dr. Frieden's commentary continued in this vein by presenting a skewed version of events in which the CDC is portrayed as a victim of D.C.'s poor data collection rather than the author of an inaccurate and misleading report.

Finally, Dr. Frieden's commentary ignored the harm caused by the 2004 Morbidity and Mortality Weekly Report. That report stated "that although lead in tap water contributed to a small increase" in blood lead levels in the District, no children were identified with blood lead levels greater than 10 micrograms per deciliter, "even in homes with the highest water lead levels." Even though two addenda of the report have been published, the original erroneous conclusions stand. Decisions have been and continue to be made based on the report's conclusions.

For example, after the report was published in 2004, the D.C. Department of Health withdrew support for distribution of water filters to homes without a record of lead service lines. More recently, in 2008, the CDC findings were used by the D.C. Council to justify the elimination of all water-related language from the bill it passed to prevent lead poisoning. The impact of the report has been felt all over the United States and Canada by supporting assertions that lead in the water supply is less harmful than it is. As long as the report remains part of the scientific literature, it will continue to influence public policy and water supplies.

We understand that Dr. Frieden inherited this issue. We are not suggesting that he played any role in the CDC's handling of the data or the reporting of misinformation. Nevertheless, we are concerned about the focus of his column and the continued presence of the flawed 2004 Morbidity and Mortality Weekly Report in the scientific literature. The CDC should remove this report from the scientific record immediately. A group of concerned scientists and parents made this request on May 20, repeated the request earlier this month, and as of today have not received a reply.

A change in the culture of the CDC is an important step toward improving the health of the District and our nation. Again, we commend Dr. Frieden for reexamining the D.C. lead-in-water crisis. We remain concerned about the perpetuation of misinformation released during the crisis. While the heads of the agencies and organizations involved have changed, many people with significant responsibility for the coverup of the elevated lead and associated harm to D.C. residents remain. Dr. Frieden seems to be hearing their voices without hearing ours.

Dana Best is a pediatrician working for Children's National Medical Center and an associate professor of pediatrics at the George Washington University School of Medicine. Marc Edwards is a civil engineer and a professor at Virginia Tech.

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