The Big Idea: Don't Drink the Water

by Claudia Dreifus Published Summer 2016
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Photograph by Diane Bondareff

David Rosner, Columbia’s Ronald H. Lauterstein Professor of Sociomedical Sciences and the codirector of the Mailman School’s Center for the History and Ethics of Public Health, is known for his work on occupational disease and industrial pollution. An expert on lead poisoning, he helped bring the water crisis in Flint, Michigan, to national attention, and he regularly serves as an expert witness in lawsuits against the lead industry. We asked him to explain what went wrong in Flint, and how we might prevent future public-health catastrophes.

Columbia Magazine: How did you first learn of the situation in Flint?
David Rosner: I got an inquiry from an editor at the American Journal of Public Health, asking if I’d peer-review an article on poisoned drinking water in Michigan.

The paper under review had been written by Mona Hanna-
Attisha, a pediatrician at a hospital in Flint. By crosschecking the medical records of her patients, she’d observed that the lead levels in their blood had spiked after Flint stopped buying clean water from Detroit in 2014 and started using the Flint River as its primary source of drinking water. This doctor, I could see, had documented a major public-health failure.

Of course I recommended publication. At the editor’s behest, I also wrote an accompanying editorial, “Flint, Michigan: A Century of Environmental Injustice.” In coupling Dr. Hanna-
Attisha’s report with my editorial, the journal’s editors were putting their prestige behind her. They were signaling to the public-health community: “Pay attention — this isn’t hype.”


What was your initial reaction to her findings?
I was upset and angry. Anyone who knows the history of Flint knows that beginning in the 1920s, and for roughly the next fifty years, the automotive industry used that river as an open sewer. We’re talking about acid from batteries, remnants of lead paint, plastics, and solvents being dumped into it. The history of that river is a history of pollution, which is probably why in the 1960s, the municipality’s leaders stopped using it for drinking water and started buying clean, properly treated Lake Huron water from the City of Detroit.

So what was my reaction? It was outrage. This disaster was entirely preventable. Why hadn’t this city’s leaders carefully checked the water for heavy metal and bacterial contamination? Why would anyone allow children to drink from that river?


What’s your guess on that?
Money. That’s the surface reason. As more information emerges, we are also learning about leadership failures, cover-ups, and what seems like a bureaucratic indifference to the fate of the city’s residents. Flint is a bankrupt town. Once a bustling hub of factories, it has lost much of its tax base since the decline of the American automotive industry. It’s a very poor place, with a shrinking and impoverished population.

Given this genuine financial crisis, the city’s leadership announced they would stop buying water from Detroit and use treated water from the Flint River. Five million dollars could be saved.

What was unforeseen was that the very old pipes connecting the municipal water supply to many homes were made of lead. Once the highly corrosive water was released into the water mains, it ate at the lead in the pipes, interacted with it, and allowed it to leach into the drinking water.

Photograph by AP Photo / Carlos Osorio


Why is lead so dangerous?
It’s a neurotoxin. It can harm people of all ages, and when ingested by children, it can lower IQ, make for behavioral problems, and create permanent neurological damage. The damage is mostly irreversible.

The thing that’s so troubling is that we don’t have any idea what a safe level of lead exposure might be. With children especially, it has become clear that you don’t need a lot. In recent years, the medical community has come to recognize that even small amounts can be toxic.

But what happened in Flint isn’t small. Among public-health experts, there are consensus guidelines suggesting that fifteen parts of lead per billion parts of water is the upper level for “acceptable” drinking water. In Flint, levels were sometimes at eleven thousand parts of lead per billion parts of water. I recently saw a report about one Flint home where the contamination was at fifteen thousand!

Photograph by AP Photo / Jake May


Has anything good emerged from the Flint water crisis?
Flint has put lead poisoning back into public discussions, where it badly needs to be. When I was an undergraduate in the late 1960s, people talked a lot about lead poisoning. The issue was seen as symbolic of all that was wrong and all that needed fixing in society, because it was so devastating to the poor.

Over the decades, the threat has slipped from public consciousness. Yet the Centers for Disease Control and Prevention tell us that about a half million American children have elevated blood lead levels, mostly because of contact with lead-based paint in dilapidated older housing. Until the 1950s, lead was a key ingredient in house paint. About fifteen pounds of lead were in every gallon. In many older homes, layers of lead paint are still on the walls. When it disintegrates, lead dust and chips can fall to the floor, where curious toddlers will sometimes handle them. If they eat the chips or ingest the dust, the children could be sick for the rest of their lives.

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