The Singer with a Sore Throat

CASE STUDY 1 – THE CHILDREN WITH LEAD POISONING

A physician working for the US Public Health Service moves to Los Angeles to assume the directorship of an inner-city health care facility for the disadvantaged. Over a period of time, she notices that an unusually large number of children brought to clinic are experiencing joint pain, difficulty walking and excessive salivation. Some have had seizures. Also many of their parents note that the children’s personalities have changed, with normally outgoing children becoming shy and withdrawn.

The physician decides to investigate the situation and contacts the CDC, which sends an epidemiologist to assist her. They obtain more complete medical histories for 15 children, ranging from 6-15 years of age and perform blood and urine tests on each. In addition to the signs and symptoms already noted, the children frequently report numbness and tingling in their limbs; they perform poorly on hearing, vision and intelligence tests; their lab results how reduced RBC counts and traces of lead in blood and urine.

All of these children live in the same housing project, play together in the same neighborhood and contribute a little to the family finances by salvaging scrap metal from a closed manufacturing plant nearby and selling it to recyclers. When the epidemiologist inspects the site, he finds paint peeling from the factory walls and dust on the floor composed in large part of pulverized paint chips. Analysis of the paint chips and dust reveals a high lead content. Lead and other heavy metals are also found in soil samples taken around the factory yard.

Suspicious of lead poisoning, the physician initiates a broader campaign of medical examination. Among children under 16 living in the area she finds a very high prevalence of lead poisoning. Specifically, of the 112 children examined during the course of the study, over 70 show at least some signs and symptoms. By contrast, she finds relatively little evidence of lead...