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Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 Commentary Lead: The Relevance Of History By David Rosner and Gerald Markowitz [Editor's Note: This article is adapted from the forthcoming book "Deceit and Denial: the Deadly"?olitics of Industrial Pollution," (Berkeley: University of California Press/Milbank Fund) by Gerald Markowitz and David Rosner due out in Fall 2002. Mr. Rosner is Professor of History and Sociomedical Sciences at Columbia University and is also the Director of the Center for the History and Ethics of Public Health at Columbia's Mailman School of Public Health. Mr. Markoivitz is Professor of History at John Jay College of Criminal Justice and the City University of Neiu York Graduate Center. Together, Mr. Rosner and Mr. Markoivitz have zvritten extensively about the history of occupational and environmental health. Some of this material ivas gathered ivhile the authors were researching an affidavit for the Nezv York City Law Department. Copyright 2001 by the authors. Responses to this commentary are welcome.] From the mid-19th to the mid-20th Century, lead was the most ubiquitous poison for American workers. It was at the heart of production in a wide range of industries. Almost every trade associated with America's emerging industrial empire -- foundry work and steel production, automobile and gasoline production, painting and battery making -- exposed workers to danger ous levels of this age-old poison. Lead caused workers to suffer tremors, kidney damage, miscar riage, birth defects, and horrible deaths. Even at the turn of the 20th Century, lead was consid ered so dangerous that women and children were generally excluded from the "lead trades." Managers accepted, with little debate, that poisoning was an intrinsic risk of these trades. Begin ning in the early 1900s in Australia, and by the middle of the second decade of the 20th Century in the United States, a literature developed which linked this age-old occupational toxin with new environmental dangers including deaths and physical damage to children from ingesting lead paint. Today the legal debates over culpability for childhood lead poisoning revolves in part around historical issues. First, it is important to understand the development of the lead paint industry. Second, the question of what information regarding lead paint's dangers was available at what point in time is critical. Third, what information did the lead industry itself possess is also important. Finally, it is important to examine the industry's response to the growing literature on childhood lead poisoning. Here, primarily using the documents of the Lead Industries Asso ciation (LIA), the trade association for the industry after 1928, and medical articles throughout the 20th Century, we examine these historical issues. By the turn of the 20th Century, corporations like National Lead and Eagle-Picher emerged as the dominant producers of lead products including pigments for paint.1 National Lead, the largest of these companies and by far the most powerful, was founded in 1891 as a holding company created following the break-up of what was called the Lead Trust. (The Sherman Anti-Trust Act of 1890, passed largely to prevent collusion among manufacturers, was responsible for the break up of the lead trust.) The Lead Trust was a group of 31 lead firms organized by a group of financiers to secure "intelligent cooperation in the business of smelting, refining, corroding, manu facturing, vending, and dealing in lead and all its products."2 By 1890 the Trust "controlled the manufacture of 80 percent of white lead, 70 percent of red lead, 15 percent of linseed oil [used to [ Vol. II, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 mix paint], and 9 percent of lead pipe produced in the United States."3 It brought together all but three of the largest lead producers.4 By 1893, the newly formed National Lead Company was the most powerful of the lead companies and lead pigment was its signature product. It manu factured 65,000 tons of white lead annually, compared to a total production of 25,000 tons by the other nine American producers combined.5 National Lead, like other pigment manufacturers, such as Eagle Picher and Anaconda, was a vertically integrated company, owning everything necessary for the production of lead products, including smelters, factories, and paint companies. Thus it had a tremendous stake in encouraging the use of lead pigment in paints. But since there were hundreds of paint companies. National Lead, even though it controlled the market for lead pigments by 1900, could not control the amount of their product that any individual paint pro ducer used. Most of these companies produced "mixed paints," paints that contained both lead carbonate and lead sulfate, but also other pigments such as titanium and zinc.6 The Identification Of Lead Poisoning In Children The medical literature on lead poisoning and children can be traced back to the work of Tanquerel des Planches in 1848. In his treatise he remarked on children placing lead painted toys in their mouths and developing lead colic.7 As early as 1887 medical authorities in the United States noted cases of children coming down with lead poisoning. David Stewart, for example, reported in Medical News that nine members of a single family developed lead poisoning from lead chro mate used to dye bread yellow.8 In the 19th Century lead chromate was often added to lead sulfate to form what was called "chrome yellow," a substance used by bakers and candy makers as a coloring agent. In 1889, an article in Science reported on the deaths of two children from the ingestion of baked confectioners' products that contained chrome yellow.9 In 1892, J. Lockhart Gibson and A. Jefferis Turner reported that many of Brisbane's lead poisoned children were "re markably fond of sweets and chewing things." One boy chewed the foil covering chocolates "to make pellets to pelt other boys." Others were so delighted by the taste of the foils that covered sweetmeats that they chewed them with the foil still on them.10 In the United States, a physician, noting that toys were often made of lead and painted with lead paint, wondered how important it might be to guard against its use if "infants and older children, [and] especially young babes, refer all objects to the mouth . . . ."n In the late 19th and early 20th centuries, the literature on lead poisoning among children contin ued to accumulate in Australia, England, and the United States. In 1896 the American MedicoSurgical Bulletin, for example, reported on a 9-month old baby poisoned by painted lead soldiers. It hypothesized that the paint was a possible source of poisoning.12 In Australia, in 1897, A. Jefferis Turner documented "lead poisoning among Queensland children." He listed a series of cases and noted that lead poisoning cases were widespread among children between the ages of 3 and 12.13 J. Lockhart Gibson's article "A Plea for Painted Railings and Painted Walls of Rooms as the Source of Lead Poisoning" in the Australian Medical Gazette in 1904, which was based on evidence he gathered as a clinician in Queensland, was among the first in an English-language publication to directly link lead-based paint to disease in children.14 A year later, Gibson re ported on cases of ocular neuritis in children, and held that poisoning was due to paint powder that came off of verandahs, and urged that "the use of lead paint within the reach of children should be prohibited by law."15 In 1907 American physicians could learn of the Queensland studies from David Edsall, of Harvard, who noted their significance in a chapter he contributed to the textbook, Modern Medicine.16 The Australians continued to document the role of lead paint in the poisoning of children, publishing in medical journals in their own country and also in the prestigious British Medical Tournal.17 The first American documentation of cases of childhood lead poisoning from paint came in 1914 when Henry Thomas and Kenneth Blackfan, physicians at the Harriet Lane Home, a children's facility affiliated with Johns Hopkins Hospital, detailed a case of a boy from Baltimore who died of lead poisoning from white lead paint bitten from the railing of his crib. Five days before admission, the child began to complain about "pain in his face and head, to be restless at night Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 23 Voi. n, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 and to look ill." He began vomiting and rapidly deteriorated. He then began to convulse and went into a coma and when he entered the hospital he was comatose with his head thrust for ward "and his arms and legs . . . extended and spastic."18 In 1917, Blackfan published an article that reviewed the extensive English-language literature on lead poisoning in children. In his case histories he noted that children were poisoned by gnawing on lead and concluded his review with the recommendation that children should be prevented from eating or mouthing painted articles. He described children who first became "fretful, peevish and often very restless at night." Their appetite was poor and their gums began to bleed, and soon pain shot up and down their legs. Their stomachs began to ache and they became constipated. Their muscles became "so painful as not to permit the weight of the bed-clothirig." They developed a waddling gait, only walking on the "outside of the feet." They dragged their toes and their legs swung out sideways as they walked. Soon, seizures occurred and some died.19 In the 1920s, clinicians produced a drumbeat of articles that linked lead-based paint to lead poi soning among children.20 These early casualties were signs of a much deeper problem that was not being addressed. Isaac Abt argued in his standard text on pediatrics that childhood lead poisoning was "more common in children than generally supposed,"21 a point that was echoed over and over in the coming years. In 1924 the lournal of the American Medical Association published an article by John Ruddock that showed that the true extent of lead poisoning in chil dren was understated because there were "many mild cases . . . manifested by spasms or colic, the true nature of which are never suspected."22 In 1926, Charles F. McKhann, a Harvard physi cian, detailed 17 case studies, concluding that lead poisoning was "of relatively frequent occur rence in children" and was usually associated with the ingestion of lead paint.23 At the time (and even in some cases to the present), the lead industry argued that the real "cul prit" where .lead poisoning was concerned was the child.24 They were able to do so because in the 1920s some viewed a child's lead poisoning as the result of pathological behavior oh the part of the child. A number of the physicians reporting cases of lead poisoning in children described the poisoning as a consequence of another condition, pica, often considered an abnormal craving for non-edible substances; to make such a diagnosis put the child's own behavior in question, for pica was often associated with mental retardation. Others argued, however, that the problem was not the child's behavior but the fact that there were too many opportunities for children to put lead in their mouths. For these physicians, pica, when the term was used, was a normal habit, not a pathology. This distinction had enormous social and political implications for the lead industry: if the ingestion of lead was defined as due to the pathology of a small number of individual children, then the lead industry could justify the continued use of lead. But, if this gnawing and mouthing were a habit normal in children, then the number of potential victims of poisoning would be increased astronomically, and the industry's responsibility less easily skirted. Today, defenders of the lead industry argue that the medical literature was long dominated by the view that only certain children engaged in the "perverse" behavior of sucking on objects and were thus at risk. However, even a cursory review of the articles that reported on childhood lead poisoning reveals no such clear-cut understanding of the term "pica." In most cases it was described as part of children's normal behavior or a mild habit. Holt's Diseases of Childhood, a standard pediatrics text published in 1934, noted that pica was a habit that was not confined to mentally deficient children; the 1940 edition noted that "[mjost of the children who acquire [lead poisoning] do so during the first two years of life when it is natural for them to put things in the mouth. The abnormal persistence of this trait, pica, in older children may be followed by lead poisoning"25 Others echoed the view of pica as a habit, rather than a pathological condition. Charles McKhann and Edward Vogt, in a 1933 article in the loumal of the American Medical Association argued that there were different forms of pica and that "[i]n the majority of cases of lead poisoning due to ingestion of paint, the pica has apparently been merely a pernicious habit, unrelated to any underlying abnormal condition."26 McKhann and Vogt note that "the incidence of lead poison- Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 24 Vol. II, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 ing is highest in infants and small children in whom teeth are erupting and in whom there is a great tendency to put things into the mouth."27 For the most part, sucking on fingers covered with lead dust, placing toys and other objects in one's mouth, biting nails and chewing cool, sweet objects like painted windowsills or lead sol diers were understood as normal behavior for young children. In the evolving field of psychol ogy, developmental theorists and psychoanalysts identified a variety of stages of child develop ment; the early years were viewed as a stage when children tended to put any object they could grasp into their mouths. For Freudians, this was deemed the "oral" stage. Many who observed children simply noted that, in the normal act of teething, children would chew and gnaw on objects. Childhood lead poisoning was a condition arising both from a set of behaviors typical of young children and the opportunity to ingest a poison. From the very beginning of the literature on lead poisoning, it was clear that this was an unusual condition, one that could not simply be attributed to abnormal behavior, but an environmental disease in that it was related to the wide spread availability of the poison itself. Unlike arsenic or other toxic substances, which had only limited availability and were distributed with warning labels or skull-and-crossbones to let people know their danger, lead was everywhere and there was no warning as to its hazards. As John Ruddock put it, "a child lives in a lead world."28 Lead Pigment Manufacturers' Awareness Of Lead Paint's Dangers To Children Whatever the cause of children's ingesting lead, the fact that such ingestion caused poisoning was well established by the time the lead industry organized the Lead Industries Association (LIA) in 1928.29 The meeting at New York's Roosevelt Hotel was attended by representatives from the National Lead Company, St. Joseph's Lead Company, and several other, smaller, lead companies. In some respects this was a traditional trade association that sought, in its own view, "to combat the substitution of other metals and products for lead," to expand the market for lead so that "old uses of lead might be increased and new uses found," and to gather "better statisti cal information regarding lead than is now available."30 The LIA was a vertical trade association, representing "the various links in the chain from mine to finished product as represented by mining companies!,] smelting and refining companies, and corporations fabricating the multitu dinous lead products." They banded together because "what affects one link in the chain is apt to influence others."31 While some industry groups, like the National Safety Council sincerely concerned themselves with specific occupational safety and health problems (as well as non-industrial issues such as highway safety), the LIA devoted much of its energy and resources to creating a safe and health ful image for its deadly product.32 Unlike the National Safety Council which promoted "Safety First" with billboards, posters and educational campaigns within and outside the factory, the LIA did everything in its power to obscure the health dangers associated with lead. Although the stated purposes of the trade association were "to decrease the prevalence of occupational dis eases due to lead in industry,"33 promoting a positive image for its toxic product soon became one of its leading objectives. As the LIA's president Edward Cornish (the past president of Na tional Lead)34 put it in 1933, it was "important to remember that the lead industries must have the good-will of the public for it is more often subjected to unfavorable comment than other metal industries. Publicity which shows the important work our metal is discharging in the world helps to build up good-will and respect for lead."35 The industry knew that further evidence of the dangers from lead in paint could undermine public confidence in lead and ultimately destroy the industry's market. It was necessary for the industry to mount a counteroffensive. Felix Wormser, the LIA's Secretary, led the industry's battle against negative publicity from 1928 through 1947.36 With the LIA's founding, Wormser made combating lead's growing negative image a prime focus of his career, calling for an "impartial investigation which would show once Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 25 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 200! and for all whether or not lead is detrimental to health under certain conditions of use."37 The LIA contracted with Harvard University's young lead researcher. Dr. Joseph Aub, who had al ready worked with the National Lead Company, to continue his "medical research on lead poi soning" and lead metabolism in adults,38 studiously avoiding questions about lead's impact on children. In 1921 National Lead's president, Edward Cornish, presented Harvard Medical School with a check of almost $14,000 as part of a coordinated contribution of the lead industry to fund "a thorough study of lead poisoning." Cornish wrote to David Edsall, then the Dean of Harvard's Medical School, that lead manufacturers, as a result of "50 to 60 years" experience, agreed that "lead is a poison when it enters the stomach of man -- whether it comes directly from the ores and mines and smelting works ... as well as the ordinary forms of carbonate of lead, lead oxides and sulfate and sulfide of lead."39 Aub's work centered on lead metabolism among adults subject to occupational exposures, never on childhood lead poisoning. Aub purported to show that a certain amount of lead absorption was harmless, and questioned the legitimacy of individual allegations of workers' deaths or illnesses from lead poisoning, thus earning Aub the trust of the lead industry.40 Even in the midst of the Depression, when a steep decline in lead prices reduced the industry's revenues, the LIA continued to provide financial support for Aub's efforts. In Wormser's mind, the unrelenting attacks on lead as a toxic substance made it crucial that the industry "emphasize the question of the general health hazard of lead." Speaking for the lead industry, "we should always be in the forefront so far as medical knowledge of lead is concerned."41 As late as 1942, when the LIA gave Aub $3,500,42 Wormser would describe Aub's work as "[o]ur medical re search at Harvard Medical School."43 But in the early years of the Depression, the lead industry faced another problem besides sagging revenues. Information about the dangers of lead which had appeared in professional journals was beginning to find its way into the popular press. In 1930, the United States Daily (a news paper "Presenting the Official News of the Legislative, Executive and Judicial Branches of the Federal Government and of Each of the Governments of the Forty-Eight States") ran a front-page story stating that "Lead poisoning as a result of chewing paint from toys, cradles and woodwork is now regarded as a more frequent occurrence among children than formerly thought, and all children's hospitals, realizing the extent of the dangers from this source, are coming to use a lead-free paint on their beds, toys, furnishings and interior decorations. . . ." The story quoted a United States Public Health Service official who said that "small amounts of lead which may cause only chronic lead poisoning in an older person may be of sufficient quantity to produce acute poisoning, leading to death, in an infant.''44 This information did not lead Wormser and his Association to consider addressing the very real problems of lead poisoning in children. In stead, at an LIA Board of Directors meeting three weeks later, Wormser, in response to the article and another in the New York Daily News, complained that "of late we have received much undeserved publicity in newspapers damaging to lead products." Renewed energy would be needed to "counteract" what Wormser called "such unfair and unfavorable publicity." The LIA would take "any remedial steps if necessary," along with its on-going medical research but would, in the meantime, initiate "a program of vigorously investigating each alleged case that arises." This meant that any time reference was made to a case of lead poisoning, the industry would raise questions about the accuracy of the diagnosis and its link to lead ingestion. Further, the LIA would publish "literature showing the useful role of lead in industry. . . ." Together, these acts "may help to improve the situation''45 -- that is, improve lead's image in the public mind. Also in 1930, the Metropolitan Life Insurance Company issued a report stating that "Chronic lead poisoning occurs much more frequently among infants and young children than has been gener ally supposed. It would be a more prominent item in both morbidity and mortality records but for the fact that the condition is often unrecognized by physicians."46 Prompted by the revelations in the U.S. Daily and the Metropolitan Life report, the Lead Indus tries Association took actions that, while giving the appearance of addressing the danger of lead Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 26 Vol. II' #3 MEALEY'S LITIGATION REPORT: Lead | November 1, 2001 in consumer products, were intended only to alliy' fears of pediatricians and mislead doctors about the extent of the danger that children were 'exposed to. In November 1930, the L1A sent out a short note, which it later portrayed as a "survey." The survey said: "We are conducting an investigation to ascertain if any lead paint is being used to paint or decorate cribs, children's beds or furniture. Will you therefore, kindly let p's know if it is your practice to use any white lead in painting this type of furniture. A return envelope is enclosed and a simple notation at the bottom of this letter will suffice. Thanking [sic] you for your cooperation.''47 They received replies from only 12 companies, all but one of whom said they did not use lead paint on their products.48 Although the LIA had no sense of whether these companies were representative -- or whether their replies were truthful -- they proceeded to use this "survey" in the most selfserving way, assuring medical researchers that although children had been poisoned by lead paint on toys and cribs in the past, "the lead industry and the manufactures of cribs and toys . . . have cooperated by substituting other types of pigments formerly used."49 It soon became clear, however, that the reality was quite different. In 1935 the Children's Bureau surveyed various toy companies about their use of lead and the presence of lead in their prod ucts. The Schoenhut Company described how they received a large order from Macy's in 1932, and how Macy's returned one quarter of the order saying it contained lead. Schoenhut had these toys tested and found that this was true. Subsequently they "took this question up with quite a number of paint manufacturers and everyone was willing to sign an agreement that the paint furnished would be non-poisonous, but only a few agreed that they would furnish materials that were entirely free of lead."50 Similarly, the Newark Varnish Works "found that lead in the form of Lead Chromate was being used extensively in colored finishes."51 Even painters in the industry appear to have been unaware of the potential hazard to children posed by lead paint. In a 1933 issue of Painters Magazine, an article about painting wooden toys ignored any mention of a lead paint hazard: "A priming coat of linseed oil and red lead . . . works well on most of the toy woods. If a light colored finish is to go on, enough white lead can be used, in lieu of red lead, to lighten this first coat. The paint on toys in these times has to be regarded for exterior as well as for interior use, because of the extensive use of the toy in yards and on the sidewalks."52 Given that parents were often not aware of the dangers from lead paint, it is not surprising that children continued to be diagnosed with lead poisoning. In 1931, Charles F. McKhann delivered a paper before the American Neurological Association in Boston53 and Edward Vogt, from the Children's and Infants' Hospitals in Boston, delivered a paper, later published in the Journal of the American Medical Association, in which he noted that "the most frequent source of lead . . . is from paint off the furniture, woodwork and toys."54 Evidently, the work of McKhann and Vogt was worrisome to the Lead Industries Association. In the spring of 1931 Wormser "visited Boston for the purpose of discussing the subject of lead poisoning in infants with some of the medical profession there who have caused us to receive some unfavorable publicity about lead. . . ." He would later report to his board of directors that "the visit was worthwhile."55 We do not know what transpired in these meetings, but their tenor can be gleaned from a 1933 correspondence between Ella Oppenheimer of the United States Children's Bureau and Louis Dublin of Metropolitan Life. When Oppenheimer asked for infor mation from Metropolitan Life's survey cited above, Dublin wrote back: "Please be advised that our Bulletin article received a great deal of publicity against which there was strong remon strance by the Lead Industries Association. You will readily understand that we wish to avoid any controversy with the lead people. Please, therefore, do not mention the Metropolitan in connection with whatever releases you may make. We have the entire case in our files and if you wish to see all the correspondence ... it will be placed at your service."56 Given that one of the most respected and established insurance companies in the United States was intimidated by the LIA, it is no wonder that lead poisoning among children received so little publicity in the years between World War I and World War II. Copyright 2001 Mealey Publications, King of Prussia, PA * www.mealeys.com 27 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 `Disposing Of Each Situation As It Arises' Throughout the 1920s and 1930s, physicians continued to identify as hazardous the lead paint on woodwork, windowsills, doorframes, toys, and cribs. But the lead industry maintained that the sole concern about lead poisoning in children during the inter-war years related to the problem of lead painted toys and cribs that children would gnaw or suck on. Once industry had "re solved" that problem by sending out the "survey" to reassure public health officials that there were no leaded paints on children's toys and cribs, they regarded the problem as so much his tory. The industry failed to warn parents of the dangers or to make sure that their paint with lead was not promoted for interior use. While publicly the industry maintained that the toy manufacturers themselves had solved the problem, privately, the industry worried that its at tempt to control the issue was failing.57 More and more information about lead's harmful effects was appearing in the medical literature. "Hardly a day goes by but what [sic] this subject re ceives some attention at the headquarters of the Association," Wormser told the LIA's annual meeting in 1935. "We are constantly investigating alleged cases of lead poisoning and endeavor ing to correct misstatements about lead poisoning to calm misapprehension about the toxic prop erties of the metal. . . So serious was the threat of negative publicity that Wormser told the members that "if all other reasons for the establishment of a cooperative organization in the lead industries were to disappear, the health problem alone would be sufficient warrant for its estab lishment."58 By the 1930s and 1940s, even defenders of the lead industry began to question the LIA's position. Robert Kehoe, who had been the primary defender of the safety of lead in gasoline, declined to defend lead paint when presented with evidence of its dangers to children. He acknowledged to physicians that "the preventive aspect of this problem should ... be greatly stressed" since poi sonings occurred "at the period when children are most likely to eat abnormal things and to chew various objects in their environment." Kehoe argued that "strenuous efforts must be de voted to eliminating lead from their environment."59 It is difficult for us to understand what small amounts of lead were capable of killing children. The proceedings of the American College of Physicians, published in the Canadian Journal of Public Health, included the report of a study done in a Toronto hospital from 1919 to 1933. The authors, John Ross and Allan Brown, were adamant that the prevention of lead poisoning in children required "the elimination of these paints from the immediate environment of the child during the second and third years of life. . . ." This idea had been percolating throughout the medical community for at least 15 years by this time. But Ross and Brown added a new dimen sion to the problem by attempting to quantify the startlingly small amounts of lead a child needed to ingest to develop symptoms or even die. "The amount of lead per unit of painted surface has recently been estimated. . . . On one square foot of a surface painted with ordinary house paint of the lead-zinc oxide type there would be 5.8 grams of metallic lead, while on a similar area painted with yellow toy enamel (lead chromate) there would be 1.86 grams Pb. A fatal case of lead poisoning in our series was found to have ingested not more than two-thirds of a gram of metallic lead," or approximately a two-inch-by-two-inch chip of one coat of paint. Given this, "it would seem advisable to prohibit the use of lead containing paints for toys, children's furniture, and for interior work."60 By the early 1930s lead poisoning remained primarily a concern to a few physicians and public health professionals. To the extent that the general public was aware of the danger represented by lead paint, a huge advertising and promotion campaign assuaged their fears, leading them to believe that lead was safe and paint, even containing lead, was benign and wonderful for deco rating your home.61 But the industry still had reason to worry. New, non-toxic zinc and titanium based pigments became more readily available during the 1930s. If it became public knowledge that lead was killing children to the extent that physicians were documenting, the competing pigments, some of which were already displacing lead as the leading pigment, could devastate the industry. A prohibition of lead in paint became more feasible as alternatives were devel- Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 28 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 200! oped. In 1931 the American Toumal of Public Health published an article stating that substitut ing zinc for lead in paint would protect children. Since children were being poisoned because of eating "paint on cribs, woodwork and toys, it seems obvious that the simple precaution of using zinc paints in these cases should be resorted to."52 Titanium based pigments could also replace lead, and in fact an increasing share of the market was being taken over by companies selling paint with non-lead pigments. National Lead itself, despite continuing to produce and market lead carbonate, its signature product, had acquired the Titanium Pigment Company and a sig nificant interest in the Titan Company, a Norwegian pigment manufacturer during the 1920s, thereby broadening its product line, and protecting itself against the erosion of the lead pigment market.63 Even the National Safety Council noted that "the most obvious method of preventing lead poi soning is to substitute for lead and its compounds other materials that are non-toxic."54 Feeling extremely threatened, the industry was vigilant about challenging those who dared to propose substitutes, particularly when their proposal was offered as a means of preventing lead poison ing. President Edward Cornish bragged to LIA members: "Wherever we have detected com petitors of lead materials using the argument of lead poisoning as a means of furthering their sales, we have protested this practice."65 The Association continued to use its tried and true approach. "We have continued privately to investigate any attacks on lead that have appeared in the press and which have the semblance of being merely wishful thinking. Our vigilance pays dividends in enabling us to correct many inaccurate statements about lead that would ordinarily go unchallenged."66 Meanwhile, the LIA continued to fight against any regulation, legislation or action by the states that would restrict the use of its paint on walls. In 1934, when the Massachusetts Department of Labor sought to regulate the "use of white lead in painted buildings," Wormser went to state officials and reached what he called "a satisfactory adjustment." He told the LIA that "It was particularly important to obtain a hearing and settlement in Massachusetts otherwise we might have been plagued with an extension of similar restrictive painting legislation in other States, affecting the use of white lead" because it was then "the most important outlet for pig lead metal."67 This was in keeping with their broader attempts to derail government regulation. "The Association has continued to act for its members in legislation affecting the lead industries, such as, . . . miscellaneous contacts with numerous Government Departments on health legislation, standards and other matters," the LIA reported to its members.68 `Unpleasant Reading For The Lead Producer' By late in the Depression, industry's success in controlling information through sponsorship of research, challenges to the accuracy of reports of lead poisonings, and even intimidation had begun to diminish. The popular press began picking up on the medical reports about lead poi soning that were reported in professional journals. In 1939 and 1940 Wormser regularly reported to the members that "the large amount of space given to lead by medical columnists in the daily press by the medical profession, by consumer organizations and by authors of scientific subjects has increased the amount of attention that we have had to give to the subject of lead toxicology. . . ,"69 In January 1941, "Lead poisoning matters continue to absorb a large amount of time of the Association. . . ." Yet, the Association continued to make it a policy "to protect our interests from unwarranted attacks and undeserved publicity on lead poisoning. . . . The greatest attacks on lead now occur among so-called 'consumer organizations' who make statements about lead that are decidedly unsupportable from a scientific standpoint."70 By June 1943, Wormser was complaining that meeting "attacks on lead due to its toxic qualities ... is apparently endless. . . ."71 The LIA felt bombarded from all sides by articles and opinions that cited lead paint as a deadly poison for children. Yet, America's leading pediatricians were shocked to note that despite the accumulating body of scientific knowledge, no regulations were in place to protect children from lead. L. Emmett Holt's textbook. Diseases of Infancy and Child- Copyright 2001 Mealey Publications, King of Prussia, PA * www.tnealeys.com 29 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 200! hood, concluded that "Lead poisoning is one of the common and most serious forms of intoxica tion recognized in childhood." Holt lamented that "In spite of the rather high incidence of cases of lead poisoning there are no laws in this country to prevent the use of lead paint in children's toys and furniture." He urged that paint be labeled "so that one may ascertain that lead is an ingredient."72 In December 1943, Time magazine discovered the issue of children poisoned by lead from paint making it national news, the first time that lead paint became a broad public issue. The basis for Time's report was an article published by Drs. Randolph Byers and Elizabeth Lord of Boston's Children's Hospital in the American lournal of Diseases of Children that noted that the lack of awareness among parents of the dangers of lead based paint led many to use it on toys, cribs, "windowsills and other places." Children, it was pointed out, then chewed the objects leading to a variety of physical and nervous disorders. "All but one child, Dr. Lord discovered, were school failures. Only five had normal I.Q.s, and four of the five were so erratic that they could not learn easily."73 In a preliminary report on the Time piece, the LIA maintained that the assumption regarding the relationship between lead poisoning in early infancy and later mental retardation was not proven and that "many of the alleged cases of lead poisoning were probably nothing of the kind."74 Wormser believed that the paper was "open to serious criticism on many important points, both from the economics of the situation and the medical aspects. ..." and that the case was "far from proven." He took solace in a conversation he had with Joseph Aub, who told him that "he felt that children that have sub-normal appetites, or the disease known as 'pica' which caused them to chew on inedible articles, were sub-normal to start with!"75 The Time article, which Wormser concedes was "unpleasant reading for the lead producer," was simply another example for him of where "lead has been unfairly attacked in the public press."76 He visited Dr. Byers in Boston and had a discussion with him that Wormser characterized as "frank and friendly."77 Byers would remember the meeting differently. In 1980 he recalled that following the publication of his article, "Dr. Lord's and my results were challenged at once by the Lead Industries and their lawyers."78 Christian Warren, author of the authoritative study of lead poisoning. Brush with Death, writes: "According to Byers, the Lead Industries Association threatened to sue him for a million dollars, but this threat could have been nothing more than the stick to complement the carrot they planned to extend," which was money to support Byers' research for up to ten years. Warren concludes that "Felix Wormser had to come up to Boston to do damage control in the time-honored way he had dealt with Harvard's researchers since the 1920s: by buying their cooperation with research funds."79 The Time magazine article was a turning point for the industry. Not only did it bring lead paint poisoning to national attention, but it shifted the terms of the lead poisoning discussion. Before Byers and Lord, the medical community had focused its attention on the dramatic effects of acute lead poisoning -- namely convulsions, coma and death. But Byers and Lord documented subtler and perhaps more devastating long-term effects of lead poisoning upon children who appeared to be recovered from a first acute episode. The study, then, was the first that documented that lead's effects were not due only to the death of brain tissue, but also to the interference of children's neurological development.80 As Warren puts it, "the simple epidemiological and statistical tools employed by Byers and Lord would never cut mustard today," but few could not "acknowledge the fundamental impact of [their] study."81 Wormser, to be sure, was one of those few; but by the mid-1940s even his natural allies in the leaded gasoline industry were privately urging the LIA to abandon its long-held policy of protecting lead paint at all costs. The tetraethyl lead defenders came to believe that the unyielding defense of lead in paint could harm portions of the industry that produced lead for other uses than lead paint. J.H. Schaefer, a senior official at the Ethyl Corporation, which manufactured tetraethyl lead for gasoline, worried that the LIA's at tempt to deny lead paint's toxicity to children could ultimately backfire. In a June 1944 letter to Wormser, Schaefer urges him to quit stonewalling the public, "because certainly there are a suf ficient number of legitimate cases of lead poisoning of children. . . ,"82 Robert Kehoe, Director of the Kettering Laboratories of the University of Cincinnati and a firm defender of the innocuous ness of leaded gasoline, also argued that the paint industry's position was indefensible. Shortly Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 30 Voi. n, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 after the publication of the Byers and Lord article in the American lournal of Diseases of Chil dren. and the Time piece, Wormser wrote to Kehoe critiquing Byers and Lord's work. He wor ried that "other doctors will accept as authoritative this paper of Byers and Lord and probably build upon it still more fantastic assertions." But he acknowledged that "if what this article describes is correct, then we have indeed a most serious public health hazard."53 Kehoe wrote back that "I fear that you will be disappointed by my answer, for I am disposed to agree with the conclusions arrived at by the authors, and to believe that their evidence, if not entirely ad equate, is worthy of very serious consideration." He informed the head of the LIA that in his own work he had seen "serious mental retardation in children that have recovered from lead poisoning. . . ."w Throughout the 1930s and 1940s, Kehoe argued strenuously, in private, for the avoidance of lead on any surface a child could come in contact with. In 1945 he wrote to the Colorado health department to advise that people should "be careful to avoid the use of lead compounds in any large extent on surfaces within the environment of small children. Small children crawl about on the floor and contaminate themselves pretty generally with any kind of dust or dirt that is within their environment. Eventually everything they get on their hands goes into their mouths, and therefore considerably greater opportunities exist for the dangerous exposure of small children of a variety of materials that have no important influence on the adult with more circumspect per sona] habits. ... It is well known that children are more susceptible to the effects of lead absorp tion than are adults and also that clinical lead poisoning as seen in the child is a more serious disease than it is in the adult, generally speaking."85 The LIA continued during the World War II years to portray this growing body of scientific literature as "prejudice against lead" rather than the documentation of a serious public health concern.86 The LIA still sought to cast doubt on virtually every report of lead poisoning, focus sing on the reports' methodological problems rather than the underlying reality.87 In December 1945 the LIA became more deeply alarmed by the detrimental effect anti-lead reports could have on their market and stepped up their efforts to depict these reports merely as propaganda. They called for a concerted effort to undercut the existing literature. "If it can be demonstrated . . . that the production of various lead articles can be attended with no detriment to health of the worker even though, as is well known, exposure may be of a high order, then public alarm over public exposure to lead, which is of a much lower order, should subside." Further, the LIA sought to continue to proselytize the public: "The dissemination of accurate publicity about lead to newspapers, magazines and radio should be organized specifically through a professional agency such as our own advertising agency. . . ."88 Wormser's relentless denials in the face of a constant barrage of information about the dangers of lead in paint began to make him look foolish. Robert Kehoe, meanwhile, let it be known to his Ethyl contacts that Wormser was dead wrong about the benign impact of lead on children. "I cannot fail to be somewhat critical of the comments of Mr. Wormser on various phases of the subject of lead poisoning in children. Whatever he may wish to think about this matter lead poisoning in children is all too frequent. When it occurs, it is usually a very serious disease, and for this reason the warnings given to the public through various avenues are likely to be useful, and therefore should not be unduly criticized, even if they do contain some misinformation."89 When Wormser claimed that toy and crib manufacturers had ceased using lead based paint on these items,90 Kehoe responded that he could "show him records of a number of cases that are fully authenticated even to his satisfaction. Mr. Wormser takes the position that since reliable manufacturers do not supply playpens and the like that have been painted with lead paint, that all this [concern] is a tempest in a teapot."91 By the mid-1940s physicians began to directly challenge Wormser in a way they never would have done before. At a 1946 conference on lead poisoning, in Boston, sponsored by the American Medical Association where Wormser gave the opening address, one doctor brushed aside Wormser's assurances that children were no longer getting lead poisoning from nibbling on cribs: "The next Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 31 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 time Mr. Wormser comes to Baltimore, I will show him a re-painted crib which caused at least three cases of lead poisoning."92 A representative of Consumers Research wrote to Wormser objecting that "no one could possibly know that" lead paint is not used for interiors because that "would imply a knowledge of the behavior of builders and just ordinary people all over the country, which no human being could possibly have."93 In fact, in the following years National Lead itself continued to market leaded paint to painters, trumpeting its use on "interior plaster and wallboard [and] enamel undercoats."94 At the 1946 conference on lead poisoning sponsored by the American Medical Association where Felix Wormser gave the opening address Kehoe in directly challenged Wormser: "More lead poisoning in children has occurred than we would like to think about. The number that are actually reported in medical literature have very little rela tionship to the number that actually occur. Lead poisoning in a child is a serious disease."95 In 1948 Manfred Bowditch, former Director of the Division of Occupational Hygiene of the state of Massachusetts, became the Director of Health and Safety of the LIA, succeeding FelixWormser as that association's chief spokesperson on health-related issues.96 (Wormser had rejoined St. Joseph Lead Company, becoming Vice President in 1948. In 1953 Wormser would become Assis tant Secretary of the Interior for Mineral Resources under Eisenhower and serve there until 1957, when he would return once more to St. Joseph.97) Kehoe wrote to congratulate Bowditch and encourage him to break with the denials of the past and confront forthrightly the problems lead was causing. He should pay attention to "more effective control of lead exposure, both in the community at large, but more particularly in the lead trades. My impression is that these indus tries, by and large, have not taken full advantage of the available information that now enables satisfactory control to be achieved."98 In the late 1940s, sensing that popular opinion seemed to be turning against the industry's posi tion and pressure for regulatory activity was increasing, the LIA, like many corporations since the 1920s, sought to reshape its image.99 For the first time it acknowledged that it could play a role in educating the public about the dangers of lead. The LIA collaborated with the Metropoli tan Life Insurance Company to educate parents about "the soundest approach to the problem of preventing childhood lead cases."100 But at the same time, it was still seeking to protect its declining market by assailing charges of lead's deleterious impact on health; agreeing in April 1948 to join with the American Zinc Institute "to cease explicit or implicit attacks" on each other's products arising because of issues of "toxicity."101 But the damage had already been done. Over the next several years the popular press highlighted the havoc that lead paint wrecked on children's lives. Soon action would finally be taken by the federal government to prevent the use of lead paint on interior surfaces. The ability to mass-produce lead carbonate for use as a pigment in paint helped create an indus try that would, for the next century, depend upon a poison and its distribution throughout the environment for its profitability and its survival. The industry's success could be measured by the tons of the toxin it could mine, process and distribute. Happily for the industry, the reorga nization of American society during the century increased the demand for lead. But at the same time the dangers from lead were becoming more apparent. The lead industry had to find ways to neutralize the popular idea which emerged from the factory that lead killed people and create a positive image that would allow consumers to buy and use this deadly material on the walls of its homes where its children would come into close and deadly contact with it. The tension between creating a healthful image for the toxin and addressing the public health concerns of the professional community would ultimately prove too intense for the long-term solvency of the lead pigment industry. The industry ultimately phased out lead for use in interior paint. But, in the meantime, for approximately half a century, the industry succeeded in deflecting attention from the dangers of its product, thereby perpetuating, in Christian Warren's words, a "silenced epidemic."102 The story of lead in paint is that of a guerilla war fought by small groups of individuals -- mostly doctors and a few public health officials -- against the giant lead corporations. As evi- Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 32 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 dence emerged of the dangers of lead in paint the industry made it its business to frustrate the efforts of any individuals or groups to publicize the dangers of lead, to warn people of those dangers or to regulate lead in consumer products. As part of that effort the lead industry con trolled the overwhelming amount of the research that was conducted about the toxic effects of lead. The most cynical response of the lead industry to reports on the dangers of lead was a fifty year advertising campaign to convince people that lead was safe, and the most insidious part of this campaign was the industry's marketing to children. This elaborate and decades long public relations campaign was intended to shape the public image of lead, emphasizing its "healthful" qualities and suggesting that it was essential for the social and economic progress of the nation. In the 1950s and 1960s new groups began to challenge the hegemony that the lead industry had over lead research and the definition of lead poisoning. As a result, the war against the lead industry finally succeeded in forcing the removal of lead in paint and gasoline in the 1970s and 1980s, as activist groups were able to enlist federal agencies in this effort.103 ENDNOTES 1. Christian Warren. Brush with Death: A Social History of Lead Poisoning. fBaltimore: Johns Hopkins University Press, 2000), p. 46. Douglas Knerr, Eagle-Picher Industries: Strategies for Survival in the Industrial Marketplace. 1840-1980. (Columbus: Ohio State University Press, 1992). 2. Hans Thorelli, The Federal Anti-Trust Policy: Organization of an American Tradition. (Stockholm, 1954), p. 79, quoted in Douglas Knerr, Eagle-Picher. (Columbus: Ohio State University Press, 1992), p. 33. 3. Quoted in Douglas Knerr, Eagle-Picher. (Columbus: Ohio State University Press, 1992) p. 33. 4. Warren, p. 46. 5. See Douglas Knerr, Eagle-Picher. (Columbus: Ohio State University Press, 1992), p. 36. See Douglas Knerr, Eagle-Picher Industries: Strategies for Survival in the Industrial Marketplace. 1840-1980. (Co lumbus: Ohio State University Press, 1992), p. 2. 7. See, Samuel L. Dana, trans. Lead Diseases: A Treatise from the French of L. Tanqueral des Planches. Lowell, 1848. 8. David Dennison Stewart, M.D. "Notes on Some Obscure Cases on Poisoning by Lead Chromate Manifested Chiefly by Encephalopath," Medical News. 1 Qune 18, 1887), 676-681. 9. William Glenn, "Chrome Yellow considered as a Poison," Science. 13 (January 1, 1889), 347-349. 10. Lockhart Gibson, Wilton Love, David Hardie, Peter Bancroft, A. Jefferis Turner, "Notes on LeadPoisoning as Observed Among Children in Brisbane," Intercolonial Medical Congress of Australia (1892), pp. 78-83. 11. R. Abrahams, "Acute Lead Poisoning in an Infant With Report of Other Interesting Cases," Ameri can Medico-Surgical Bulletin. 10 (November 7, 1896) p. 531-532. 12. R. Abrahams, "Acute Lead Poisoning in an Infant, with Report of Two Other Interesting Cases," American Medico-Surgical Bulletin. 10 (November 7, 1896) p. 531-532. 13. A. Jefferis Turner, "Lead Poisoning among Queensland Children," Australian Medical Gazette. 1897, p. 475-479. 14. J. Lockhart Gibson, "A Plea for Painted Railings and Painted Walls of Rooms as the Source of Lead Poisoning Among Queensland Children," Australian Medical Gazette. 23 (April 20, 1904), 149-153. Copyright 2001 Mealey Publications, King of Prussia, PA www.tnealeys.com 33 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 15. J. Lockhart Gibson, "The Importance of Lumbar Puncture in the Plumbic Ocular Neuritis of Chil dren," Australian Medical Congress Transactions. 11(1905). 16. David L. Edsall, "Chronic Lead Poisoning," Modern Medicine. 1907, ed. William Osier, v. 1, pp. 87, 92, 108. Edsall noted the "wholesale poisoning in the Queensland children" by "ingestion of lead from painted wood work of houses. . . ." 17. A. Jefferis Turner, "Lead Poisoning in Childhood," Australasian Medical Congress. 1908, pp. 2-9. J. Lockhart Gibson, "Plumbic Ocular Neuritis in Queensland Children," British Medical lournal. 2 (No vember 14, 1908), pp. 1488-1490; J. Lockhart Gibson, "Plumbic Ocular Neuritis in Queensland Chil dren," British Medical lournal. 2 (November 14, 1908). Even before the first documented cases of lead poisoning among children in America, Henry Gardner, who headed the Educational Bureau of the Paint Manufacturers Association, a trade group of manufacturers of both leaded and non-leaded paint, suggested that the lead paint that was being placed on interior surfaces represented a hazard "Should we not exercise similar care in guarding against lead dust in our public buildings? The many tons of corroded white lead flatted with turpentine once applied to the walls and ceilings of school rooms and hospitals would, gradually disintegrate and cause the formation of dried particles of white lead dust very dangerous to those who breathed it. Fortunately," he erroneously asserted, "the use of flatted white lead has been largely abandoned for wall and ceiling decoration, and its place has been taken by the more sanitary leadless Flat Wall Paints." He predicted "with the adop tion of preventive measures . . . lead poisoning will be done away with almost entirely." Henry A. Gardner, The Toxic and Antiseptic Properties of Paints (Philadelphia: Educational Bureau, Paint Manufacturers' Association of the U.S., (Feb. 12, 1914), 11-12. 18. Henry Thomas and Kenneth Blackfan, "Recurrent Meningitis, Due to Lead in a Child of Five Years," American Tournal of Diseases of Children. 8 (November 1, 1914), 380, 377. A. Brent, W. J. Young, "The Occurrence of Lead Poisoning Amongst North Queensland Children," Annals of Tropical Medicine and Parasitology. 8 Qanuary 1, 1914), 575-590. 19. Kenneth D. Blackfan, "Lead Poisoning in children with Especial Reference to Lead as a Cause of Convulsions," American Tournal of Medicine. 153 (1917), 877-887. 20. See, for example, Robert Strong, "Meningitis Caused by Lead Poisoning in a child of Nineteen Months," Archives of Pediatrics. 37 (January 1, 1920); L. Emmett Holt, "General Function and Nervous Dis eases," in The Diseases of Infancy and Childhood for the Case of Students and Practitioners of Medicine. Chapter 11, 8th ed., (New York: D. Appleton, 1923), pp. 645-694; L. Emmett Holt, "Lead Poisoning in Infancy," American Tournal of Diseases of Children. 25 (March, 1923); Council of Queensland Branch . . . , "An Historical Account of the Occurrence and Causation of Lead Poisoning Among Queensland Children," Medical Tournal of Australia. 1 (February 11, 1922). Stafford McLean and Ruston McIntosh, "Studies of the Cerebral Spinal fluid in Infants and Young Children," in The Human Cerebrospinal Fluid New York, 1924, pp. 299-300; Carl Vernon Weller, "Some Clinical As pects of Lead Meningo-Encephalopathy," Annals of Clinical Medicine. 3 (1925), 604-613; Joseph Aub, Lawrence Fairhall, A.S. Minot, Paul Reznikoff, and Alice Hamilton, Lead Poisoning (Baltimore: The Williams and Wilkins Company, 1926), p. 70 and preface; L. Emmett Holt and John Howland, The Diseases of Infancy and Childhood. (NY: D. Appleton & Co., 1926), p. 542; Frederick L Hoffman, Deaths from Lead Poisoning. U.S. Department of Labor, Bureau of Labor Statistics, Bulletin No. 426. (Washington, D.C.: GPO, February 1927), pp. 33-34; Boston, Health Department, "Lead Poisoning in Early Childhood," Monthly Bulletin. 16 (Nov. 1927), 266. 21. Issac Abt, ed. Pediatrics. Vol. VII, Philadelphia, 1925, 246-7; 315. 22. John Ruddock, "Lead Poisoning in Children with Special Reference to Pica," Tournal of the Ameri can Medical Association. 82 (May 24, 1924) p.1682. In 1926 another American researcher, in an article entitled, "Lead Poisoning in Children," noted that lead paint was dangerous to children and that "many cases of lead poisoning are overlooked" by physicians and parents, suggesting that the first thing to do was to make parents aware "of the hazards of painted articles to little children." See, L. W. Holloway, "Lead Poisoning in Children," Tournal of the Florida Medical Association. 13 (1926) 94-100; Frederick Hoffman, Deaths from Lead Poisoning. U.S. Bureau of Labor Statistics, Bul letin No. 426. in which he lists eleven boys and eight girls under the age of eighteen who died from lead poisoning, a number of whom were poisoned from eating the paint from windows, walls, toys and cribs. Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 34 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 23. Charles F. McKhann, "Lead Poisoning in Children," American journal of Diseases of Childrpn. 32 (1926), 386-392. 24. See, "Affidavit of Peter C. English," City of New York, et al. Against Lead Industries Association, Inc., et al. Index Number 14365/89, 1999. 25. Emmitt Holt and John Howland, "Neuroses of the Alimentary Tract," Holt's Diseases of Infancy and Childhood (New York: D. Appleton, 1934), p. 764; 1940 edition, p. 1368. 26. Charles McKhann and Edward Vogt, "Lead Poisoning in Children," IAMA. 101 (1933), 1131. See also, Charles F. McKhann, "Lead Poisoning in Children," The Archives of Neurology and Psychia try. 27(February, 1932), 294-295. He acknowledged that .some children chewed paint because they were anemic, or had "certain intestinal parasites," or were prone to pica as a result of mental de fects, but that most "do not fit into any of these groups, but appear normal children who have merely a pernicious habit." 27. Charles McKhann and Edward Vogt, "Lead Poisoning in Children," TAMA. 101 (1933), 1131. 28. John Ruddock, "Lead Poisoning in Children with Special Reference to Pica," Tournal of the Ameri can Medical Association. 82 (May 24, 1924) p. 1682. Carl Vernon Weller, "Some Clinical Aspects of Lead Meningo-Encephalopathy, "Annals of Clinical Medicine. 3 (1925), 604-613; See also Stafford McLean and Rustin McIntosh, "Studies of the Cerebrospinal Fluids in Infants and Young Children," in The Human Cerebrospinal Fluid. New York: Paul Hoeber, 1924, pp. 299-300; T. Suzuki and J. Kaneko, "Serious Meningitis in Infants Caused by Lead Poisoning from White Powders," Tournal of Oriental Medicine. January 1, 1924. 29. See Roland Marchand, Creating the Corporate Soul: The Rise of Public Relations and Corporate Imagery in American Big Business. (Berkeley: University of California Press, 1998). 30. Memo to William J. Donovan, Sept. 21, 1928, National Archives, Federal Trade Commission Docu ments, in Papers of the Lead Industries Association and Associated Companies, New York City Law Department, Affirmative Litigation Division, New York, NY, (hereafter LIA Papers). See also, "Con stitution of the Lead Industries Association," for Article II, "Objects," of the LIA. While the "welfare of those engaged in the lead industries" is one objective, there is no specific mention of industrial disease or the need to "combat the substitution of other metals." See also. First and Organization Meeting of the Members of the Lead Industries Association," November 14, 1928, FTC Records, LIA Papers. 31. Wormser to Edward McCready, Esq., Grand Rapids Store Equipment Corporation, July 7, 1930, LIA Papers. 32. See John C. Burnham, John E. Sauer, and Ronald Gibbs, "Peer-Reviewed Grants in U.S. Trade Asso ciation Research," Science. Technology & Human Values. 12 (Spring 1987), 42-51 in which they point out "much of the trade association research was defensive, designed to protect existing markets by attempting to counter bad publicity or changed conditions that could lessen the demand for the product." Most of that research was not health related, although they do cite the Meat Institute and the National Dairy Council as having "spent large sums attempting to counter the effects of new health beliefs that caused many consumers to look unfavorably upon fats of various kinds." 33. Memo to William J. Donovan, Sept. 21, 1928, National Archives, Federal Trade Commission Docu ments, LIA Papers. See also, "Constitution of the Lead Industries Association," for article II, "Ob jects" of the LIA. Sherwin Williams, Glidden, and Eagle-Picher were among the first companies to join, also in 1928. The International Smelting and Refining Company joined in 1929, LIA Papers. 34. Drugs. Oils and Paints. 48 (April 1933), 140. 35. Report of the President, LIA, Annual Meeting of the Members of the Lead Industries Association, April 12, 1933, LIA Papers. 36. "Felix Edgar Wormser," Vitae, Wormser MSS, American Heritage Center, University of Wyoming, Cheyenne. Copyright 2001 Mealey Publications, King of Prussia, PA * www.mealeys.com 35 Voi. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 37. LIA "Directors Meeting," May 29, 1929, LIA Papers. 38. LIA, "Directors Meeting," September 11, 1929, LIA Papers. 39. Edward J. Cornish to David Edsall, May 12, 1921, courtesy of Christopher Sellers. 40. Joseph Aub, "The Biochemical Behavior of Lead in the Body," IAMA. 104 (Jan. 12, 1935), 87. See also, Christopher Sellers, Hazards of the Tob. p. 197. LIA, "Director's Meeting, September 30, 1931. In 1929, Aub and the Harvard School of Public Health were awarded by the LIA an appropriation of $10,00040 for research into the physiological effects of lead; at the next year's meeting the LIA ear marked another $2,000 for "Medical Research" at Harvard. In 1931, another $5,000 was given to "Harvard College." When Felix Wormser learned that Aub "was planning to write an article on the treatment of lead poisoning for the journal of Industrial Hygiene." he urged members to develop a plan for the distribution and use of its results "at the time Dr. Aub's results become public." See, LIA, "Directors Meeting," May 28, 1930, LIA Papers. 41. LIA "Director's Meeting," June 15, 1933, LIA Papers. 42. LIA, Executive Committee Minutes, Jan. 15, 1943, LIA Papers. 43. LIA Minutes, May 11, 1942, LIA Papers. 44. "Lead-free Paint on Furniture and Toys to Protect Children," United States Daily. Nov. 20, 1930, p. 1. 45. LIA "Directors Meeting," Dec. 12, 1930, LIA Papers. 46. "Chronic Lead Poisoning in Infancy and Early Childhood," [mimeo] Metropolitan Life Insurance Company, Statistical Bulletin. October, 1930, LIA Papers; reprinted in October, 1930; quoted in "Chronic Lead Poisoning in Infancy and Early Childhood," American Tournal of Public Health, 21(1931), p. 566; See also, in "Chronic Lead Poisoning in Infancy and Early Childhood," American Tournal of Public Health. 21 (January, 1931), 18. Warren, in his recent book. Brush with Death. estimates that nationwide approximately 240 fatal plumbism cases among children occurred each year but were overlooked or misdiagnosed by physicians unaware of the scope of the problem. See, Warren, p. 33. 47. Frederick L. Hoffman, Lead Poisoning Legislation and Statistics. (Newark: Prudential Insurance Company of America), 1933, p. 19. 48. Frederick L. Hoffman, Lead Poisoning Legislation and Statistics. 1933, p. 19. 49. Charles McKhann and E.C. Vogt, "Lead Poisoning in Children," IAMA. 149(1933), 1135. McKhann and Vogt had depended upon a "personal communication to the authors of a survey of crib and manufacturers made by the Lead Industries Association, Secretary, F.E. Wormser." 50. A. Schoenhut Company to Ella Oppenheimer, April 17, 1935, LIA Papers. 51. Newark Varnish Works to Ella Oppenheimer, April 25, 1935, LIA Papers. See also Kehoe to A.J. Lanza, March 18, 1938: In the course of the past several years I have seen several fatal cases of lead poisoning in children as the result of ingesting lead from toys, play pens, and in one instance con taminated food," LIA Papers. 52. George Rice, "Painting and Gilding Wooden Toys," Painter and Decorator.47 (July, 1933), 12-14. 53. Charles F. McKhann, "Lead Poisoning in Children," The Archives of Neurology and Psychiatry. 27 (February 1932), 294-295. Norman Porritt, "Cumulative Effects of Infinitesimal Doses of Lead," Brit ish Medical Tournal. (July 18, 1931), 92-94. An article by a British physician documented lead poi soning from "the slow, subtle, insidious saturation of the system by infinitesimal doses of lead ex tending over a long period of time." 54. Edward Vogt, "Roentgenologic Diagnosis of Lead Poisoning in Infants and Children," Tournal of the American Medical Association. 98 (January 9, 1932), 125. Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 36 Vol. II, #3 MEALEY'S LITIGATION REPORT: Lead November I, 2001 55. LIA "Directors Meeting," September 30, 1931, LIA Papers. 56. Louis Dublin to Ella Oppenheimer, September 14, 1933, courtesy Christian Warren. 57. "Of late the lead industries have been receiving much undesirable publicity regarding lead poison ing," Wormser told his Board of Directors LIA, Annual Meeting of the Members of the Lead Indus tries Association, April 12, 1933, LIA Papers. In November 1933 the Massachusetts Department of Labor and Industries picked up on the issue, noting in a Bulletin focused on occupational hazards, that "many serious and even fatal cases of lead poisoning among infants have been traced to the sucking or chewing of lead-painted surfaces. Toys, cribs, furniture and other objects with which infants may come in contact should not be painted with lead colors." Massachusetts, Department of Labor and Industries, Division of Industrial Safety, Industrial Bulletin No. 13. "Revised Rules, Regu lations, and Recommendations Pertaining to Structural Painting." November 1, 1933, p. 8, LIA Pa pers. Manfred Bowditch was the Occupational Hygienist in the Division of Industrial Safety and would in the 1950s become the LIA's Health and Safety Director. Also in 1933 a paper delivered at the American Congress of Radiology by E.C. Vogt and Charles F. McKhann was abstracted in Scien tific American under the title, "If Your Children Chew Paint." It reported, "Unfortunately, infants and children very often eat or swallow enough lead to be poisoned by it and in a large percentage of cases they die. Ninety-five cases of lead poisoning have been observed at the Infants' and Children's Hospital, Boston, during the past nine years." The article continued by noting that "most children suffering from lead poisoning seem to have ingested the lead by chewing the paint from woodwork, furniture, or toys." "If Your Children Chew Paint," Scientific American. 149 (December 1933), 291. An article published in the journal of the American Medical Association noted that "in the majority of cases of lead poisoning due to ingestion of paint, the pica has apparently been merely a perni cious habit, unrelated to any underlying abnormal condition. The incidence of lead poisoning is highest in infants and small children in whom teeth are erupting and in whom there is a great tendency to put things in the mouth." Charles F. McKhann and E.C. Vogt "Lead Poisoning in Children," TAMA. 101 (October 7,1933), 1131. 58. LIA Annual Meeting, June 13, 1935, LIA Papers. Meanwhile, the information from physicians docu menting lead poisoning in children pointed more and more to lead as an even more dangerous substance than previously understood. The John Hopkins Hospital Bulletin reported on lead poi soning in Baltimore, including one child who "ate flakes of dry paint from the walls." S.S. Blackman, Jr. "Intranuclear Inclusion Bodies in the Kidney and Liver Caused by Lead Poisoning," Bulletin of the lohns Hopkins Hospital. 58 (1936), 384-397. See also, S.S. Blackman, Jr., "The Lesions of Lead Encephalitis in Children," Bulletin of the lohns Hopkins Hospital. 61 (1937), 40. 59. Robert Kehoe, abstract of discussion in Charles F. McKhann and E.C. Vogt "Lead Poisoning in Chil dren," TAMA. 101 (October 7,1933), 1135. Elsewhere, Robert Kehoe wrote, "There is every reason for suspecting the existence of significant and dangerous lead exposure in the case of children with a history of pica. The occurrence of lead-containing commodities and the use of lead paints on furniture, toys, and other objects within the reach of small children is much too common to ignore. The existence of symptoms even slightly suggestive of plumbism should result in prompt investiga tion of the child and his surroundings." See: Robert Kehoe, "The Diagnosis of Lead Poisoning in the Light of Recent Information," reprint from journal of Medicine. December 1935, pp. 3-8. See also Kehoe, "My experience, and that of my colleagues at Harvard, leads me to believe that most cases of lead poisoning in infants and children come from chewing objects coated with metallic lead and lead pigment. I am not quite sure, but I believe that every case, except one, in our list of children has had such a causative factor." In Kehoe to Hoffman, June 26, 1937, LIA Papers. 60. John R. Ross and Alan Brown, "Symposium on Common Poisonings: III Poisonings Common in Children," Canadian Public Health Tournal. 26(1935), 237-243. See: A.S. Minot, "The Physiological Effects of Small Amounts of Lead: An Evaluation of the Lead Hazard of the Average Individual." Physiological Review. 18 (1938), 554-557. 61. See Gerald Markowitz and David Rosner, Deceit and Denial: The Deadly Politics of Industrial Pol lution. (Berkeley: University of California Press/Milbank Fund, 2002) for a more comprehensive history of the effort to promote lead as a healthful, innocuous product. 62. The American Public Health Association's Tournal of January, 1931, p. 18. Copyright 2001 Mealey Publications, King of Prussia, PA * www.mealeys.com 37 voi. n, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 6. William S. Haynes, American Chemical Industry. Vol. 3, (New York: Van Nostrand, 1954), pp. 367. 64. National Safety Council, "Proposed Revision LEAD Health Practices Pamphlet No. 3 (Final Draft), [1942] LIA Papers. 65. LIA, Annual Meeting of the Members of the Lead Industries Association, April 12, 1933, LIA Papers. 66. LIA, Annual Meeting, Minutes, June 4, 1943, LIA Papers. 67. LIA, Annual Meeting of the Members of the Lead Industries Association, June 5, 1934, Report of Secretary, LIA Papers. 68. LIA, Board of Directors Meeting, "Report Summarizing the Activities of the Lead Industries Associa tion and Furnishing Data to Draft the Budget for 1937," December 23, 1936, LIA Papers. 69. LIA Board of Directors Meeting, June 6, 1940, LIA Papers, Wormser told the Board of Directors that "the lead industry received two blasts in the press recently" and that "as usual the Association investigated these attacks. See: LIA Board of Directors Meeting, May 16, 1939 LIA Papers; In Janu ary 1940 the Directors were informed that "attacks against the use of lead on the ground of lead poisoning continued to be made. . . ." See: LIA Board of Directors Meeting, January 17, 1940, LIA Papers. 70. LIA Board of Directors Meeting, January 7, 1941, LIA Papers; By 1936, some outside the professions were noting the dangers of lead. In May 1936. Consumers Union told its readers that "lead paint used on floors, porches, cribs, and other furniture sometimes causes acute lead poisoning of chil dren." See: "Lead Hazard in Toys," Consumers Union. May, 1936, p. 11. 71. LIA Board of Directors Meeting, June 4, 1943, LIA Papers. 72. L. Emmett Holt, Rustin McIntosh, Holt's Diseases of Infancy and Childhood. NY: Appleton-Century-Crofts, Inc., 1940, pp. 1368-1372. 73. "Paint Eaters," Time. December 20, 1943, p. 49. 74. LIA "Preliminary Report of Investigation of 'Time' Article 'Paint Eaters,'" "Lead Hygiene and Safety Bulletin No. 40," [December 8, 1944], LIA Papers. 75. Wormser to Members of the Lead Industries Association, Dec. 8, 1944, LIA Papers. "Lead Hygiene and Safety Bulletin, No. 40, "Exhibit A to LIA Executive Committee Minutes January 1945, LIA Papers. 76. Wormser to Members of the Lead Industries Association, Dec. 8, 1944, LIA Papers. "Lead Hygiene and Safety Bulletin, No. 40, "Exhibit A to LIA Executive Committee Minutes January 1945, LIA Papers. 77. Wormser to Members of the Lead Industries Association, Dec. 8, 1944, LIA Papers. "Lead Hygiene and Safety Bulletin, No. 40, "Exhibit A to LIA Executive Committee Minutes January 1945, LIA Papers. See also that Wormser visits a Dr. Mayer questioning his findings of lead as a factor in the death of a child in Philadelphia. He reports that the Executive Committee is providing a grant to Dr. Byers. Wormser to Aub, LIA Papers, Jan. 4, 1945, LIA Papers. 78. Randolph K. Byers, "Introduction," Low Level Lead Exposure: the Clinical Implications of Current Research, ed. By Herbert L. Needleman, New York: Raven Press, 1980), p. 2. 79. Warren, p. 150. 80. Kim N. Dietrich, "Environmental Neurotoxicants and Psychological Development," G. Taylor, K.O. Yeats, M. D. Ris, eds.. Pediatric Neuropsychology: Research. Theory and Practice (New York: Guilford Press, 1999), p. 222. 81. Warren, p. 150. Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 38 Vol. 11, #3 MEALEY'S LITIGATION REPORT Lead November 1, 2001 82. J.H. Schaefer to Wormser, June 27, 1944, LIA Papers. 83. Wormser to Kehoe, January 19, 1944 [60022-25]. 84. Kehoe to Wormser, February 7, 1944, LIA Papers. 85. Kehoe to R.L. Gorrell, September 5, 1945, LIA Papers. Kehoe's position on the danger of paint to children was consistent with statements he had made before and after this communication with the LIA. As early as 1930 Kehoe had noted lead poisoning among children who "sucked the paint from toys and beds from inside the house." He also cited the danger of "leaded" dust on windowsills from crumbling paint. See: Kehoe to Worth, September 25, 1930, LIA Papers. In 1938 Kehoe wrote to Metropolitan Life's Anthony Lanza that he had "seen several fatal cases of lead poisoning in children as the result of ingesting lead from toys [and] playpens." See: Kehoe to Lanza, March 18, 1938, LIA Papers. About this same time Kehoe noted that "There is every reason for suspecting the existence of significant and dangerous lead exposure in the case of children with a history of pica. The occurrence of lead-containing commodities and the use of lead paints on furniture, toys, and other objects, within the reach of small children is much too common to ignore." Kehoe, The Diag nosis of Lead Poisoning in the Light of Recent Information, n.d., LIA Papers. 86. LIA Annual Meeting, Minutes, May 15, 1944, LIA Papers. Felix Wormser argued that "Our industry continues to be plagued unfairly by attacks made upon lead products because of their toxicity. It seems to me that we must be losing a vast amount of business each year because of the fact that lead has such unpleasant connections in the minds of so many Americans." See also Roland Marchand, Creating the Corporate Soul: The Rise of Public Relations and Corporate Imagery in American Big Business. (Berkeley: University of California Press, 1998), for detailed analysis of the broader public relations campaigns by corporations. 87. LIA, Executive Committee, "Minutes," Jan. 12, 1945, LIA Papers. Wormers, arguing in early 1945 that "grave doubt existed as to [lead poisoning's] prevalence," suggested that "the Association contemplated an investigation of statistics of death from lead poisoning which, from a preliminary examination, were believed to be seriously faulty." He suggested to the directors that the organi zation take "a more aggressive attitude in meeting the attacks frequently made on the lead indus try. . . ." 88. LIA, Executive Committee Meeting, Exhibit D, December 28, 1945, LIA Papers. 89. Kehoe to J.H. Schaefer, January 29, 1945, Kehoe Manuscripts, Box 90. 90. Wormser, "Facts and Fallacies of Lead Exposure," p. 12 [courtesy of Warren, 100064] 91. Kehoe to J.H. Schaefer, January 29, 1945, LIA, Box 90, 100065 92. Wormser, "Facts and Fallacies Concerning Exposure to Lead," and Discussion, in "Symposium on Lead Poisoning," at 7th Annual Congress on Industrial Health, Boston, Sept. 30, 1946, also pub lished in Occupational Medicine. 3 (Jan. 1947), 13-19. 93. F.J. Schlink to LIA, June 28, 1948, LIA Papers. 94. National Lead Ad. "Versatile," in American Painter and Decorator. June 1949; National Painters Magazine. Oct. 1949. 95. Robert Kehoe, Discussion in Conference on Lead Poisoning, at the 7th Annual Congress on Indus trial Health, American Medical Association, September 30-October 2, 1946, p. 52. 96. Robert L. Zeigfield, Secretary, to Members of LIA, Jan 15, 1948, LIA Papers. 97. "Alumni Trustee Chosen by Columbia University," New York Times. October 6, 1953, p. 31; "Wormser Resumes Old Post," New York Times. June 18, 1957, p. 48. 98. Kehoe to Manfred Bowditch, February 11, 1948, courtesy of Warren, 100069. Copyright 2001 Mealey Publications, King of Prussia, PA * www.inealeys.com 39 Vol. 11, #3 MEALEY'S LITIGATION REPORT: Lead November 1, 2001 99. See Marchand, Creating the Corporate Soul. 100. LIA, Annual Meeting, Report of the Secretary, April 13-14, 1950, LIA Papers. 101. Robert L. Ziegfeld to E.V. Gent, April 9, 1948, LIA Papers; LIA, Executive Committee Minutes, April 2, 1948, and attachment, "Abstract" from minutes of meeting of the Industry Development Committee of the American Zinc Institute, Dec. 18, 1947, LIA Papers. 102. See Christian Warren, Ph.D. dissertation, "The Silenced Epidemic; A Social History of Lead Poison ing in the United States Since 1900,"Brandeis University, 1997. 103. See Gerald Markowitz and David Rosner, Deceit and Denial: The Deadly Politics of Industrial Pol lution. (Berkeley; University of California Press/Milbank Fund, 2002); Gerald Markowitz and David Rosner, "'Cater to the Children': The Role of the Lead Industry in a Public Health Tragedy, 19001955," American Tournal of Public Health. 90 0an. 2000), 36-46; David Rosner and Gerald Markowitz, "A 'Gift of God'?: The Public Health Controversy over Leaded Gasoline During the 1920s," Ameri can Tournal of Public Health. 75 (April, 1985), 344-352. Copyright 2001 Mealey Publications, King of Prussia, PA www.mealeys.com 40