The challenge of Dr. Herbert Needleman in the fight over lead toxicity

harold-needleman

Written by Thomas A. Lewis, and originally published in the National Wildlife magazine in 1995, this story chronicles the persecution against Dr. Herbert Needleman for daring to care enough to try to protect children by attempting to ban lead in gasoline. 

“Dr. Herbert Needleman discovered that lead is harmful to the human body and mind in the 1950s. Since then, he has worked towards banning lead from everyday life in hope of stemming lead poisoning.”

For Dr. Herbert Needleman, March 3, 1994, was judgment day – the day the jury would deliver a verdict on his personal integrity and on 15 years of his innovative but highly controversial research. Although Needleman was being tried by a panel of scientists rather than a court of law, he faced what was, in effect, a two-count indictment brought against him by other researchers. One count, of scientific misconduct, alleged that he had deliberately skewed the results of a 1979 study of the effects of low-level lead exposure on school-age children. The other count charged that he had made a number of errors in the study’s methodology and mathematics, errors that Needleman’s critics called shoddy science but that he termed irrelevant to the study’s conclusions.

Three times since 1979, Needleman had won from previous peer inquiries a split decision – innocent of scientific misconduct, but guilty of minor errors and misstatements that had no cumulative effect on his conclusions. The March 1994 decision, however – from the Office of Research Integrity in the federal Department of Health and Human Services – would be the scientific equivalent of a Supreme Court ruling. On the one hand, it might confirm his reputation as one of the first American researchers to discover how lead has poisoned the minds, in addition to the bodies, of generations of Americans. On the other hand, it might brand him a scientific charlatan who had misled the federal government into needless over-reaction to minute quantities of lead in such things as gasoline and house paint.

Needleman first encountered the toxic effects of lead some 40 years ago, when, to help pay his way through medical school, he took a summer job as a laborer at a DuPont chemical plant in Deep-water, New Jersey. Needleman noticed that one group of older workers kept to themselves, moving and speaking slowly and awkwardly, spending their ‘breaks staring into space. These, fellow laborers told Needleman, were the men from the “house of butterflies.”

Years before, Needleman learned, more than 300 workers involved in the synthesis of tetraethyl lead – an anti-knock compound for gasoline – had suffered lead poisoning. Four had died. Many had become psychotic. Among the deeply damaged survivors still able to work, many frequently flicked away imaginary insects – hence the mocking reference to the house of butterflies.

This was Needleman’s first encounter with the effects wrought on the human mind by one of the most pervasive poisons of the industrial age. In the 1950s, lead was everywhere in urban American life. It spouted from the exhaust pipes of cars and the smokestacks of smelters and paint factories. It leached into drinking water carried by pipes joined with lead solder. It dusted yards and bedrooms as lead-based household paint deteriorated.

Once lead enters the bloodstream, the body mistakes it for chemically similar calcium and incorporates it, like flawed building blocks, into bone and soft tissue. The effect on most organs is minimal, but in the brain lead causes small blood vessels to leak, expanding the adjoining tissue. The swelling, confined by the skull, squeezes the brain downward. If the pressure is not relieved, it can result in coma and death.

Needleman’s commitment to eliminating the effects of this deadly metal began in 1957 with his very first lead-poisoning patient. She was a 3-year-old Hispanic girl brought to the inner-city Philadelphia hospital where Needleman was a young pediatric resident. Her symptoms were classic: pallor, listlessness, headaches, stomach aches, anemia and erratic behavior. A blood test confirmed Needleman’s immediate suspicion of lead poisoning. He prescribed a drug that would help flush lead from the little girl’s blood.

In school, Needleman had learned that one instance of lead poisoning could be treated successfully, but that a second would inevitably destroy the brain. When he determined that the little girl had been poisoned by chips and dust from household lead-based paint, he told the mother that she dare not take the child home. “Where do I take her?” the distraught mother asked. “Any other house I could afford to rent has lead paint in it, too.”

That, Needleman says, is when it occurred to him that “this was an illness that was not within the reach of medicine.” He began to “obsess,” as he puts it, “about the effects of lead on children” and to ponder the means for regulating environmental lead.

After a few years in pediatrics, Needleman returned to school for a degree in psychiatry. By the mid-1960s, he was back in Philadelphia’s inner city in a community mental-health practice. His patients were children whose problems typically included mental retardation, school failure and bad behavior – symptoms Needleman recognized as the calling cards of lead poisoning.

Obviously, the great majority of these children had never suffered the clinical definition of lead poisoning. But what, Needleman wondered, if much lower levels of exposure were affecting their development? The question had been raised years before by Dr. Randolph Byers, a professor at Harvard and a pediatrician at Boston Children’s Hospital. Byers tracked the development of 20 children who in 1939 had been treated successfully for lead poisoning.

By the standards of the day, success meant that although the youngsters had suffered many of the symptoms of lead poisoning, treatment had prevented excessive swelling of the brain. But four years later, Byers found, 18 of the children were experiencing profound learning disabilities, and many showed evidence of personality disorders. The study made headlines and caused a brief flurry of national alarm that soon was forgotten in the urgency of World War II.

But Needleman had studied Byers’s work while at Harvard. Nearly two decades later, he remembered Byers’s work as, from his inner-city office opposite a Philadelphia school, he watched children steeped in lead exhaust fumes make daily treks to and from their lead-painted homes.

In 1970, he initiated his first study on lead and children. He reasoned that the best way to collect data was to examine children’s teeth, which retain permanently the molecules of lead they absorb, much as the annual rings of a tree retain evidence of severe climate conditions. Also, at the age of six years or so, baby teeth begin to drop out, offering easily collected specimens.

Needleman analyzed and compared the tooth-lead levels of two small groups of children and later backed this with a larger sample of students from two Philadelphia school districts. The results indicated that children in the inner city – where older buildings are typically caked with deteriorating, lead-based paint – were exposed to five times more lead than their counterparts in the newer houses of the suburbs, where lead-based paints were falling out of favor. The inner-city children were victims of a historical artifact: Household paint manufactured before 1950 contained as much as 50 percent lead by weight. A dime-sized chip of such paint contained enough lead to sicken a two-year-old.

In 1974, Needleman moved to Boston to teach at Harvard and practice at Boston Children’s Hospital. There he launched an even more ambitious project: “I wanted to study the relationship of lead levels and psychological change.”

He analyzed the teeth of 2,500 first and second graders from two similar Boston suburbs, then set out to compare the academic status of the students who had the highest and lowest lead exposures. Selecting 524 students representing the top and bottom 10 percent of tooth-lead levels in the sample, he gathered more information about them to eliminate any influences on their academic ability and performance other than low-level lead exposure. This process narrowed his sample to the 100 highest-level and 58 lowest-level students. Teachers unaware of the results of the lead study administered rigorous tests to measure the students’ IQ, academic achievements and behavioral problems. Then Needleman compared the chemical and behavioral assessments.

The results, published in the New England Journal of Medicine in March 1979, indicated a direct link between low, chronic levels of lead exposure and impaired mental development. The average IQ of the children with low lead exposure was 107, with 5 percent of them scoring in the mentally gifted range. The group with high lead levels had an average IQ of 102, and not one qualified as gifted. Four times as many students in the high-lead group had verbal IQ scores below 80. The higher the lead level, the more likely the child was to receive negative behavior ratings.

The paper was devastating to the lead industry and came at a critical time. A federal ban on lead in household paint had taken effect in 1977. Exposure to lead in the workplace had come under strict monitoring and remediation requirements under the 1978 Occupational Safety and Health Act (OSHA). The Environmental Protection Agency (EPA), urged on by Needleman in his capacity as a consultant to EPA’s Scientific Advisory Board, was moving toward controls on lead air pollution so strict that they could be met only by removing lead from gasoline. And Needleman’s work suggested that far more stringent regulations were needed, even though the Centers for Disease Control in 1978 already had halved the blood-lead levels that had been considered harmful to children in the 1950s.

Needleman’s emergence in 1979 as a leading exponent of the dangers of low-level lead exposure and as an influential advisor to EPA made him the target of a remarkably bitter and prolonged attack by other researchers and the lead industry. In this, he was following in the footsteps of other researchers who had reported on the dangers of exposure to lead. One of these was Dr. Byers, who in the 1940s was threatened with a $1 million lawsuit by the lead industry. Now it was Needleman’s turn.

The person who was to become his principal nemesis for the next 13 years opened fire in 1981. She was Dr. Claire Ernhart, a developmental psychologist at Case Western Reserve University in Cleveland, Ohio. In 1974 she had published a paper on a group of Long Island preschoolers in which she reported a relationship between low-level lead exposure and low IQ scores. But in 1980 she declared that by the time her subjects entered the first grade, she could find no effects attributable to lead exposure. Needleman, on the other hand, insists that her data do indicate effects. He also is quick to point out that Ernhart receives substantial grants from the industry-funded International Lead Zinc Research Organization (ILZRO). Ernhart counters, “I am not a tool of industry. My concern with Needleman’s slipshod science began before I ever heard of [the ILZRO].”

Their prickly relationship began in 1981, while both were acting as EPA consultants during revisions to the Clean Air Act. She charged that flaws in Needleman’s 1979 study should disqualify him as a government advisor. An investigating panel of six outside experts, citing three reanalyses of Needleman’s data, issued a statement “confirming the published findings.” Needleman later wrote in the journal Pediatrics that he believed that “this official statement had finally and permanently sealed the argument.”

Wrong. In 1991, Ernhart – along with Dr. Sandra Scarr, a developmental psychologist at the University of Virginia – brought formal charges of scientific misconduct against Needleman in a letter to the National Institutes of Health (NIH). They charged that Needleman had deliberately manipulated his research to emphasize the effects of lead exposure. NIH instructed the University of Pittsburgh medical school to conduct an inquiry.

The arguments were complicated, but Ernhart’s basic charges declared that Needleman had failed to take into account the ages of the children in his sample and that he had deliberately excluded certain children from the study – after he knew the results of their IQ tests – in order to maximize the perceived effects of lead exposure. Needleman responded that the IQ test he had used adjusted its results for age and that exclusions had been made by a computer according to previously established guidelines.

In December 1991, the three-person inquiry panel found “no evidence of fraud, falsification or plagiarism” in Needleman’s study, but said it was unable “to exclude the possibility of research misconduct” and recommended a further, formal, hearing. During two days of testimony in April 1992, other scientists demonstrated that when Needleman’s data were reanalyzed with the excluded children put back in and with the subjects’ ages factored in, the results were virtually unchanged.

After two months of deliberation, the full hearing board concluded that no evidence suggested scientific misconduct. However, the board also found a “preponderance of circumstantial evidence” that Needleman misrepresented his “sub-standard” methods to influence public policy on lead pollution.

Outraged, Needleman filed a lawsuit to force the university to retract the latter finding and pay him damages. The matter was referred in 1992 to the federal Office of Research Integrity (ORI) for yet another hearing. Nearly two years later, ORI found him not guilty of intentional scientific misconduct, but declared that he had made “numerous errors and misstatements,” mostly of a statistical nature that did not necessarily affect his conclusions. As a result, Needleman says, “The effect of lead on IQ is settled.” However, his suit for damages is still pending in court.

Even during the years that Needleman’s work and reputation were under fire, his influence was growing. Henry Falk, head of the environmental health division of the Centers for Disease Control, credits Needleman with forcing a fundamental change in the way the nation perceives the threat of lead contamination. Falk told In Health magazine in 1991, “Herb Needleman pushed people to think about the kinds of effects you wouldn’t notice in an individual child, but could see only if you studied a population.”

Needleman’s work made him a hero to Larry Schweiger of the National Wildlife Federation, who successfully nominated Needleman for the Federation’s 1992 Conservation Achievement Award. “Few environmental scientists have the distinction of contributing so much to humanity,” Schweiger says. “He has helped eliminate a serious threat to millions of children.”

One result of Needleman’s work was a series of changes in federal lead regulation. In the late 1970s, the government began phasing out lead as an additive to gasoline, with a complete ban slated within the next year.

In 1991, the Centers for Disease Control again lowered its action level for lead in children – to 10 micrograms per deciliter, down from 60 in the 1950s. Also in 1991, two federal departments – Health and Human Services, and Housing and Urban Development – announced ambitious strategies for eliminating the threat of lead poisoning to children in the future.

The recent series of academic confrontations and challenges brought a lot of stress into Needleman’s life and distracted him from his work. But, he says, “If you look at the blood lead levels of children today, you’ll find they have been reduced by 77 percent since 1981. That makes it all worth it.”

Source Citation: Lewis, Thomas A. “The difficult quest of Herbert Needleman.” National Wildlife 33.n3 (April-May 1995): 20(6). This article is being used by MercuryExposure.info for educational purposes only and not for profit. 

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