But no one’s had it as bad as the 1,200 residents of the West Calumet Housing Project in East Chicago, Indiana — whose homes are actually located within the boundaries of the USS Lead Superfund site — and who have been told to relocate their households on short notice, due to critically unsafe levels of lead in neighborhood soil.

It’s been reported that two-thirds of those residents are children. Many of them are now lead-poisoned children. Nearly all of them have brown skin. I scroll through article after article, photos of black kids sitting on front steps, next to big EPA yard signs warning, “DO NOT play in the dirt or around the mulch.” With an illustration of a brightly-colored ball on fresh green grass, just to make the message clear.

What is it, exactly, that I want to say about all this?

My first impulse, just an echo of what has already been said: This never should have happened. Of course it shouldn’t have happened. We (they) should have known better.

Except that the West Calumet neighborhood was developed in the 1960s and 1970s, when the EPA was in its infancy, and before Superfund even existed. And I can tell you from personal experience in environmental remediation that stupidity was a pervasive problem in historic land use decisions. (Who builds a residential neighborhood on a former lead smelting site? The same type of planners who build a school and residential neighborhood over a filled, toxic canal that has been purchased for a dollar.)

But there’s more to this case than just the 20-20 hindsight of spackling over industrial blight. What I’m trying to say, is that when I read about 29 children with blood lead concentrations significantly over the CDC’s level of concern, all because they are living and playing in yards with lead levels containing as much as 227 times the lead limit allowed by the EPA, and then I think about how long this hazard has resided in the soils of this community, and how long that soil has been kicked up into dust by Goodwill-purchased sneakers, and tracked into hallways and wiped onto hand-me-down shirts tossed onto the backs of kitchen chairs before those children rifle through the pantry for something good to eat — when I think about what has happened here, and how long it’s really been happening, it triggers the same visceral anger I felt when I first started learning about PFOA.

Here’s why: Because both public health catastrophes reveal the same dysfunctional premise upon which our environmental health practices seem to rely (especially in low-income areas). Which is to say: Action need not be taken until harm has already been caused.

The EPA is quick to mention that action has, in fact, been taken. And yes, approximately 90 of 1,200 properties in the neighborhood were sampled during a three-year investigation started in 2003. Roughly half of the sampled properties contained lead-contaminated soil above the EPA’s standards, and 15 of those were contaminated enough to require time-critical removal action by the agency in 2008. These data were used to justify the neighborhood’s designation as a Superfund site in 2009, and an additional time-critical removal action was taken in 2011 for 16 additional properties. So yes, action was taken for some properties… sporadically, over a long period of time. My oldest daughter was born in 2003. A lot of childhood development happens during a 12-year period.

So one wonders what action was taken for those whose properties weren’t tested, or whose soil was tested but didn’t meet the threshold for emergency removal. A flimsy pamphlet on how to reduce your lead exposure? A recommendation that you wash your children’s hands and toys when they come inside from play? And one wonders how much action was taken to educate new residents of the neighborhood and housing project over that 10+ year period. A public notice for a public meeting?

Widespread testing to determine which soils needed removal was not initiated until 2014. In response to the shock and outrage recently expressed by residents of the West Calumet Housing Project over the sudden urgency of lead contamination in their neighborhood, Robert Kaplan, acting administrator for the EPA’s Great Lakes Region, told The New York Times that EPA “had in fact warned West Calumet residents for at least a decade to avoid the soil with public notices and community meetings.” Clearly a statement in the agency’s defense, but one which also implies that not only should residents have known about the lead, but that their ignorance about the matter may have played a role in their family’s health effects.

I can think of no greater insult beyond the trespassing of an industrial contaminant across the boundaries of my own cells and those of my children, than the suggestion that its preventable harm was solely my responsibility.

Kaplan’s remarks stink of a patriarchal you-should-have-known-better mentality, a scorn typically reserved for a scantily-clad sexual assault victim found in her pitiful shredded clothes.  What did you expect, living in the projects? You knew that there was lead.

Let us be clear. They were warned for at least a decade to avoid the soil. Not “We regret that it has taken this long to take full action on this issue.” Or simply, “We’re sorry, we didn’t know it was this bad. We are working on fixing the problem.” The sad irony of Kaplan’s subtle judgment is this: Even if West Calumet residents had been scientifically knowledgable enough to deduce the hazards in which they lived, or civically savvy enough to be fully engaged in the Superfund public process, what could they have done? Where would they have gone? The state and federal government certainly wouldn’t have footed any bills on the possibility that they might be harmed. They would have certainly wanted some proof.

Proof which requires routine blood lead testing and consistent funding of such programs — an issue in Indiana, I suspect, considering its less-than-stellar commitment to public health funding. It’s quite the lesson in environmental injustice, on the interconnectedness of environmental degradation, public health, race, politics, and urban American culture. An ugly, despicable lesson, but one that must be dragged into the light.

Photo credit: nbcnews.com

Works consulted: Final Feasibility Study Report, U.S. Smelter and Lead Refinery (USS Lead) Superfund Site

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Blood testing results ranged from 0.3 micrograms/liter (or ppb, parts per billion) to 1,125.6 micrograms/liter or ppb, and the geometric mean of PFOA in blood among the sampled residents was 10 ppb — five times higher than the geometric mean of PFOA believed to be present in the blood of most Americans (which is 2.1 ppb, a figure likely resulting from our ubiquitous exposure to Teflon chemicals that were present in everyday consumer products: nonstick coated cookware, stain-resistant carpets and upholstery, water-resistant clothing, paper and cardboard food packaging, and fire-fighting foam). The health advisory went on to list the known health effects reported with exposure to PFOA, and requested of my husband: “If you have a patient that you think is experiencing health effects due to PFOA exposure, please call us at 1-800-439-8550.”

In general, the higher the PFOA concentrations in drinking water, the higher the PFOA concentration in blood. Some studies have even shown that PFOA levels in blood serum can be up to 100 times higher than the levels found in drinking water — meaning that if someone has 2,000 ppt (parts per trillion) in their drinking water, the anticipated level of PFOA in their blood might be as high as 200,000 ppt (or 200 ppb), an order of magnitude difference.

Why? Because PFOA is like, well, Teflon… resistant, persistent, hard-to-break-down. The half-life of PFOA is between 2-4 years, which means it takes up residence in the body and accumulates faster than the body can expel it — doing what exactly, we’re still not sure, except perhaps, as suggested by the limited epidemiological evidence compiled so far, wreaking havoc on the thyroid, the kidneys, the intestines, the liver. In other words, a baby born with PFOA in its blood has essentially become a chemical harbor until it grows up to be a toddler, or even a preschooler, before PFOA can be completely evicted from its system. Assuming, of course, that the exposure has been removed.

When my husband was first studying to become a physician, he was required to take a class on the history of medicine. I can remember him showing me a graph of total fatalities mapped over time, and pointing to a distinct drop in the curve — a place where something had caused some miraculous reduction in deaths from infectious disease. What was it? Antibiotics? Vaccines? Nope. It was sanitation. Removal of waste from drinking water resources. According to an article on longevity published in Slate.com, “Clean water may be the biggest lifesaver in history. Some historians attribute one-half of the overall reduction in mortality, two-thirds of the reduction in child mortality, and three-fourths of the reduction in infant mortality to clean water.” The discovery of penicillin appeared to yield but a relative blip on the graph my husband showed me, as did the proliferation of vaccines (not to diminish the importance of either to the improvement of public health), but nothing impacted public health with such magnitude as the removal of waste from water. “The garbage man does more to save lives than I ever will,” my husband said.

In Parkersburg, West Virginia, a place considered by many to be ground zero for PFOA-related contamination and injury, DuPont dumped thousands of tons of PFOA into the Ohio River, unlined ponds and beyond, causing widespread contamination of surface and drinking water resources in Parkersburg and surrounding communities. In Hoosick Falls, New York, mishandling of PFOA at the Saint-Gobain plastics facility around the corner from the water supply well on Water Works Road has resulted in contamination of the community water supply. Investigation of the former ChemFab facility will do doubt yield similar findings about disposal of PFOA materials, and during my latest trip to Pownal, Vermont, I was shocked to see that the proximity of the former Mack Molding plastics site to one of the community’s water supply wells was a mere 1,000 feet.

Contamination of drinking water from industrial waste is not a new issue, but these latest developments with PFOA raise the issue yet again, that in this day of modern medicine and sophisticated cancer treatment technologies, we continue to ignore the basic, most fundamental premise of medicine: that the most significant positive impact on human health is the separation of waste from water.

Of course, the implementation of Superfund laws and clean-up programs, and the cradle-to-grave hazardous waste regulations provide some measure of protection, but the exemptions are plenty and the funding is not. Too many waste disposal sites are left festering due to insufficient funds and political commitment for investigation and remediation, and too many water supplies remain in harm’s way.  I keep wondering, after each new discovery of contaminated drinking water wells, of impacted populations whose ailments will likely be traced back to what they drank — I keep wondering if we are ever going to wake up to this fundamental premise of public health.

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