Community aspects of childhood lead poisoning

Boundary networks and Rochester's "smart" lead law: the use of multidisciplinary information in a collaborative policy process

The Rochester, New York, Coalition to Prevent Lead Poisoning formed in 2001 with the goal of eliminating childhood lead poisoning by 2010. The Coalition recruited diverse community stakeholders into a collaborative process committed to using the best available science. The Coalition successfully infused the debate about a new lead poisoning law with local data, national analyses, and the latest medical research. We argue that this was facilitated by a boundary network of individuals who provided technical input throughout the process. As a result of the Coalition's advocacy, in 2005 the Rochester City Council unanimously passed an ordinance that has been hailed as one of the nation's "smartest" lead laws. Many communities are looking to Rochester's new lead ordinance as a model. Both the process and outcome of this case provide valuable lessons for collaborative efforts to promote scientifically sound local environmental health policy.

Lead poisoning in a historical perspective

Lead poisoning existed and was already known in Antiquity but was forgotten, at least in the literature, until the end of the Middle Ages, where it was mentioned sporadically. In the 19th century this disease, which reached epidemic dimensions during the period of industrialization, was "rediscovered." Several comprehensive clinical articles appeared in the literature. The clinical picture deepened during the beginning of the 20th century, and preventive efforts were started. However, the concept of poisoning remained strictly clinical. During the latter half of the 20th century a new concept emerged: subclinical and early forms became recognized as undesirable effects. This led to a substantial lowering of hygienic standards. Pediatric poisoning has also been a serious problem during the 20th century. After the 1920s, environmental pollution by lead caused by the introduction of tetraethyl lead in gasoline became an alarming public health problem. The use became restricted in the 1980s; its effects on blood lead levels are now evident. Today's research focuses on the effects of low exposure, often with the aim of defining noneffect levels for different types of effects.