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Reducing Lead in Air and Preventing Childhood Exposure Near Lead Smelters: Learning from the U.S. Experience

NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 2015, Vol. 25(1) 78–101 ! The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1048291115569027 new.sagepub.com

Marianne Sullivan1

Abstract Childhood lead exposure and poisoning near primary lead smelters continues in developed and developing countries. In the United States, the problem of lead poisoning in children caused by smelter emissions was first documented in the early 1970s. In 1978, Environmental Protection Agency set National Ambient Air Quality Standards for lead. Attainment of this lead standard in areas near operating lead smelters took twenty to thirty years. Childhood lead exposure and poisoning continued to occur after the lead National Ambient Air Quality Standards were set and before compliance was achieved. This article analyzes and discusses the factors that led to the eventual achievement of the 1978 lead National Ambient Air Quality Standards near primary smelters and the reduction of children’s blood lead levels in surrounding communities. Factors such as federal and state regulation, monitoring of emissions, public health activities such as blood lead surveillance and health education, relocation of children, environmental group and community advocacy, and litigation all played a role. Keywords childhood lead exposure, smelting, NAAQS, lead industry

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Department of Public Health, William Paterson University, Wayne, NJ, USA

Corresponding Author: Marianne Sullivan, Department of Public Health, William Paterson University, Hunziker Wing, Room 149 300, Pompton Road, Wayne, NJ 07470, USA. Email: [email protected]

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Introduction Childhood lead exposure and poisoning near primary lead smelters continues to occur in developed and developing countries.1–5 In the United States, childhood lead exposure and poisoning attributable to primary smelting was first documented by federal researchers over forty years ago—near the El Paso smelter in Texas in 1971 to 1972.6 Subsequently, lead exposure was documented in children near all primary lead smelters studied in the United States.7 Blood lead levels (BLLs) above 10 mg/dL in children living near an operating primary lead smelter were last documented in the United States in 2006 near the Herculaneum smelter in Missouri.8 The Herculaneum smelter closed in 2013, ending primary lead smelting in the United States. Even with no primary lead smelters currently operating in the United States, exposure and poisoning from contaminated soil and dust in former smelting communities remains a public health concern. Superfund and Resource Conservation and Recovery Act cleanups are occurring around many former primary lead smelting sites, including Bunker Hill, Idaho; El Paso, Texas; and Herculaneum, Missouri. The primary purpose of this article is to discuss the factors that led to achievement of the 1978 National Ambient Air Quality Standards (NAAQS) near the three U.S. primary lead smelters that continued to operate after the 1980s (the Glover and Herculaneum smelters in Missouri and the East Helena smelter in Montana) and the eventual reduction of children’s blood lead levels in smelting communities. The article considers the role of factors such as regulation, monitoring of emissions, public health activities (such as blood lead surveillance, health education, and relocation of children), advocacy by environmental groups and community members, and litigation, in contributing to improvement in this chronic problem in the United States. In addition to discussing the three lead smelters mentioned above, historical context on long-standing pollution control problems in the lead smelting industry is provided, along with background on the discovery of childhood lead poisoning caused by smelters in the United States. This research shows that lead poisoning near smelters has a long and well-documented history in the United States. Also well understood are ways to prevent childhood lead poisoning near these facilities. It is critical that governments, industry, regulators, and researchers learn from past experiences to ensure that children currently living near smelters are no longer lead exposed and/or poisoned.

Lead and Children’s Health Since the early 1970s, a large body of scientific literature has documented risks to children from lead exposure.9,10 Lead is a developmental neurotoxin that causes harmful cognitive, behavioral, and nervous system effects. Recent evidence suggests that even at low levels lead may have adverse effects on the cardiovascular,

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immune, and endocrine systems. In January 2012, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Lead Poisoning recommended that the BLL at which public health intervention and clinical counseling begins be lowered to 5 mg/dL, a recommendation that was subsequently adopted.11

Global Lead Production and Consumption and Childhood Lead Poisoning Despite advances in science and growing public health concerns about exposure to lead, production and consumption of lead worldwide continues to increase. Therefore, the potential for environmental contamination and human exposure during mining, transport, smelting, refining, consumer use, recycling, and disposal remains an important public health concern. Lead production is classified as either primary—from the smelting of mined ore—or secondary—produced by melting down and recycling lead that is already in use. Global primary lead production has steadily increased over the past fifteen years, topping four million tons in 2010.12 Global consumption of lead was expected to be as high as eleven million tons in 2013.13 The lead industry is predicting that the demand for primary lead production will continue to grow, due to its use in lead acid batteries for vehicles worldwide.12 In addition, lead can still be found in paints for household use currently on the market in at least forty countries.14 For decades, the United States was a leading producer of lead. Since the mid1980s, however, U.S. primary production has declined.15 Particularly since 2000, there has been a dramatic change in where primary production of lead occurs, with production declining in the West and much of the rest of the world and climbing steadily in China. In 2010, 67 percent of primary production occurred in China and only 8 percent occurred in North America, compared to 20 percent in 2000.12 Other important locations for lead mining and smelting include Australia, Mexico, Peru, India, and Russia.13 Despite efforts to decrease emissions from primary smelters over the past several decades, particularly in developed countries, global emissions of lead from primary nonferrous smelters and refineries (this category includes copper, nickel, lead, and zinc production) are still significant. These emissions were recently estimated to range from 25,830 to 30,800 tons per year, with approximately one-third of emissions occurring in China.5 Shifting lead production from North America and developed countries to China and developing countries is problematic because of the potential for lower regulatory standards for community and occupational exposure and/or lack of enforcement of such standards. For example, China has regulatory standards for lead in ambient air, but a recent case study of a lead smelting community in Yunnan province, China, found that there was “no routine

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monitoring performed to check for lead in the ambient air in the study area—that is, in the area near the smelter.16(p.14) Without monitoring, enforcement of environmental standards is not possible. In developing countries there may also be fewer resources for public health surveillance of BLLs, medical treatment for people who are exposed, and environmental remediation. People in developing countries are often more likely to rely on their local environment for subsistence activities. Toxic metal pollution from smelters may expose people through multiple pathways in addition to inhalation of lead in ambient air, such as eating home-grown or locally grown food, drinking contaminated water, and ingesting soil or dust. A recent study highlighted the problem of soil and crop pollution as well as human health effects in several provinces in China due to lead/zinc mining and smelting.17 Incidents of childhood lead exposure and poisoning in overseas communities located near primary nonferrous smelters (and some secondary smelters) have been reported on in both the United States and international media in recent years.18–21 Human Rights Watch identified eighteen episodes of lead poisoning in four provinces in China between 2009 and 2011, some involving hundreds of children.2 Some industrial lead facilities in China have closed after public outcry about damage to children’s health.22 A study that mapped “lead exposure hotspots” worldwide (places where average BLLs equaled or exceeded 10 mg/ dL) found that the majority of such “hotspots” were near lead smelters or foundries.23 For communities affected by industrial lead poisoning, particularly from lead smelters, there may be useful lessons from the U.S. experience. In the United States, the problem was long-standing, and once documented in the early 1970s, took several more decades to effectively remedy. This article describes and analyzes the key factors that led to eventual improvement in both ambient lead levels and childhood lead exposure near lead smelters and makes recommendations based on this analysis of the U.S. experience.

Methods The article relies on historical research, which analyzes and synthesizes many primary and secondary sources on lead smelting in the United States. Primary sources include records and reports from environmental and health agencies including the U.S. Environmental Protection Agency (EPA), the Agency for Toxic Substances and Disease Registries, CDC, and state agencies. Other primary documents include scientific papers, media reports, and documents obtained from court records. Secondary sources include the literature on the primary nonferrous smelting industry in the United States and abroad. The collected documents were organized into a timeline to develop a chronology and to facilitate document analysis. The analysis relied on a close reading of the primary sources. Secondary sources were used to provide historical and

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regulatory context. Assertions and arguments were developed based on a close reading of the primary documents in an iterative process. Excerpts from documents and interviews are reproduced verbatim in the text to provide support for key arguments.

Findings Large-scale primary nonferrous smelting began in the United States in the late 1800s. Early U.S. smelters had significant uncontrolled toxic metal emissions. Near lead smelters, particulate lead emissions were a major problem from the inception of the industry and often resulted in protests from nearby residents, particularly if lead smelters were located close to grazing lands for livestock or near farms. Farmers and ranchers, scientists, industry, and government recognized in the early years of the twentieth century that fine lead particles discharged from smelters could accumulate on grazing land and contaminate streams and result in poisoning deaths of livestock. Conflicts between farmers, ranchers, and industry in smelting regions were not uncommon.24–27 These early twentieth century conflicts were sometimes litigated and sometimes turned over to court-appointed commissions to solve, which led to the increased use of technology for controlling lead and other heavy metal emissions from smelters.28 Baghouses were used in lead smelters to filter lead particulates from the smoke stream before they exited the stack.29 In 1907, the Cottrell electrostatic precipitator, which uses electrical charges to capture particulates from smoke streams, was first installed at the Selby smelter near the San Francisco Bay.28 By the end of the first decades of the twentieth century, most lead smelters were using one or both of these particulate control measures, either because they were required to by the courts or because they found that capturing heavy metals from their smoke stream could increase profits.24,28 These technologies substantially reduced lead and other toxic metal emissions from smelter smokestacks; however, some portion of the toxic heavy metals in the smoke stream still escaped. The technology, which controlled stack emissions, did not address “fugitive emissions” (emissions that do not go through the stack), which are caused by activities such as transporting, dumping, and storing ore; and slag dumping, leaks, or other uncontrolled discharges—and which could be significant. Fugitive emissions have proven to be more challenging to control and a persistent problem for many smelting facilities. Though people who lived near smelters have had concerns about their health for decades, health concerns were not rigorously investigated around U.S. smelters until the early 1970s. Also, prior to the establishment of the U.S. EPA in 1970, there were few estimates of the magnitude of heavy metal emissions from U.S. nonferrous smelters. Murozumi et al.30 estimated that about 2000 tons of lead was emitted from lead smelters as aerosols in the Northern Hemisphere

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in 1966. Based on their data, the National Academy of Sciences estimated that in 1968, smelters in the Northern Hemisphere put 985 tons of lead into the air.31 Quantitative data on lead emissions from a U.S. smelter first became public as a result of legal discovery in an early 1970s lawsuit by the city of El Paso and the state of Texas over air pollution from ASARCO’s El Paso smelter. Company data revealed that 1100 tons of lead was emitted from the stack between 1969 and 1971; annual figures were 292 tons in 1969, 511 tons in 1970, and 313 tons in 1971.6 Subsequent investigations established that ambient concentrations of lead could be high in El Paso’s air; annual average samples close to the smelter showed concentrations of 92 mg/m3 in 1971 and 43 mg/m3 in 1972 to 1973.6 At the Bunker Hill smelter in Idaho, following a fire in the baghouse, lead emissions from the plant were 37 tons in January 1974 and 96 tons in March of the same year.32 Over some eighteen months, up until the summer of 1974, the lead smelter emitted approximately 720 tons of lead into the environment.33 Ambient concentrations of lead approximately two miles from the smelter stack ranged from 7 mg/m3 in 1971 to 17 mg/m3 in 1973.34

Initial Discovery of and Response to Childhood Lead Poisoning Near Smelters Surveillance of children’s blood lead conducted by CDC and health officials in both El Paso and near the Bunker Hill smelter established in the early to mid1970s that lead poisoning in children living near both sources was substantial and widespread. The El Paso study, published in 1973 and based on a random sample, estimated that 2700 El Paso residents aged one to nineteen within four miles of the smelter had BLLs of 40 mg/dL or above.6 The highest BLL measured in El Paso was in a child who lived close to the smelter (94 mg/dL),35 and a number of children were hospitalized.36 Within approximately one mile of the Bunker Hill smelter, only two children out of 172 had BLLs under 40 mg/dL and thirty-eight children had BLLs over 80 mg/dL. Of over 919 children tested within thirty-two kilometers of the stack, approximately 40 percent had BLLs over 40 mg/dL. Children’s BLLs decreased with distance from the stack.37 CDC researchers conducted follow-up studies on the health effects of lead exposure in both communities. Findings from El Paso pointed to lower scores on tests of “nonverbal cognitive and perceptual motor skills”.38 Near the Bunker Hill smelter, more highly exposed children were found to have anemia and decreases in nerve conduction velocity.37 CDC’s studies in El Paso and Bunker Hill established that both ingestion of lead-contaminated dust and inhalation of airborne lead were important routes of exposure in smelting communities.37,39 The smelting/lead industry generally contested the role of airborne lead and current emissions in raising children’s BLLs and blamed children’s exposure in smelting communities largely on ingestion of lead that had accumulated in soil over time.40

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Environmental Organization Lawsuits to Compel EPA to Set an Ambient Lead Standard CDC’s early to mid-1970s studies on lead exposure and children’s health in smelting communities were taking place at the same time as a national debate over regulating airborne lead, which was due primarily to the use of leaded gasoline. EPA had determined in the early 1970s that lead was an air contaminant that threatened public health and estimated that ambient concentrations higher than 2 mg/m3 could result in elevated BLLs.41 To address lead in air, EPA’s healthbased regulatory approach was to focus on lowering concentrations of lead in gasoline over time rather than setting an ambient standard for lead.42 In the mid-1970s, the Natural Resources Defense Council filed a lawsuit to compel the EPA to list lead as a Criteria Air Pollutant under the Clean Air Act, which would force EPA to set the NAAQS, or ambient standard, for lead.43 In March of 1976, a U.S. District Judge ordered the Agency to make the listing. EPA appealed the court’s decision but lost.44 In 1978, EPA set the ambient standard at 1.5 mg/m3. The smelting industry had five years to meet the standard. At the time the standard was announced, EPA publicly discussed its concerns about what an ambient standard would do to the U.S. primary lead industry. EPA Administrator Douglas Costle was quoted as saying, “We don’t believe that a major disruption of this industry [lead smelting] is an acceptable consequence” of the ambient lead standard. He promised to “drop or alter the new rule” if it resulted in “significant disruption” of the lead smelting industry.45 The Lead Industries Association, an industry trade group made up of producers and users of lead, and the Bunker Hill Company challenged the standard through the courts but failed.46 In the 1980s, EPA considered revising the 1978 lead NAAQS to make it more protective of health. Extensive work was done reviewing the scientific evidence and writing a criteria document. The criteria document acknowledged ongoing violation of the NAAQS in smelting communities.47 The LIA opposed tightening the standard, arguing that the population that would benefit would be small, a stricter standard would be costly for industry, possibly leading to smelter closures, and exposure in smelting communities was mostly from lead in soil and household dust, not from air, due to existing emission controls.40,48,49 Though under the Clean Air Act, EPA is required to review the NAAQS in light of evolving scientific evidence every five years and revise if appropriate; the 1.5 mg/m3 standard was in place for thirty years, until 2008, despite criticisms that it was not stringent enough to protect children’s health. It took a lawsuit by an environmental advocacy group, the Missouri Coalition for the Environment, to cause the standard to be reviewed and eventually tightened in 2008.50 In those thirty years, thousands of studies had been conducted on the public health impacts of low-level lead exposure. The lead NAAQS set in 2008 is 0.15 mg/m3 and is measured on a three-month rolling

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average basis.51 This standard was set to attempt to protect children from a variety of harms from low-level lead exposure, including intelligence quotient loss.52

Failure to Achieve the Lead NAAQS in a Timely Fashion through State Implementation Plans Of the six primary lead smelters operating in the United States when the 1978 ambient lead standard was set, three closed without meeting the standard—Bunker Hill, El Paso, and the Buick smelter near Bixby, Missouri. Bunker Hill closed completely in 1981, the El Paso lead smelter closed in 1985 but the company continued to operate its copper smelter, and Buick/Bixby was converted to a secondary lead smelter in 1991.53–55 The air around the other three primary lead smelters that remained open (East Helena in Montana and Glover and Herculaneum in Missouri) continued to violate the NAAQS for lead for many more years. EPA estimated that in 1984, 1150 tons of lead were still being released from U.S. lead smelters, and that within two kilometers of lead smelters ambient lead concentrations could range from 5 to 15 mg/m3.47 Therefore, not only was EPA reluctant to set an ambient standard, the agency also showed reluctance to enforce the standard for many decades in smelting communities. States have primary responsibility for developing and implementing measures to meet NAAQS and are required to submit detailed plans to EPA called State Implementation Plans (SIPs). Smelting states moved slowly on developing lead SIPs—the plans were due to EPA by July of 1979 but few states met the deadline.56 There was significant industry push back on the lead NAAQS, and many in the smelting industry contended that old smelters simply would not be able to meet the standard. For example, when the standard was announced, the chief executive officer of St. Joe’s Minerals said the standard was “far more stringent than necessary to protect public health and technologically infeasible at any cost at most of the nation’s lead smelters and recycling plants”.45 Though they did not meet the federal deadline, states eventually submitted SIPs to EPA for approval. Generally, however, the SIP process proved to be lengthy and largely ineffective at achieving compliance with the lead NAAQS in smelting communities in a timely fashion. For example, Montana submitted a SIP for the East Helena lead smelter in 1983 and EPA approved it in 1984. By the end of 1986, with the emission controls outlined in the SIP in place, the air around the plant did not meet the NAAQS for lead.57 Five years later, at the end of 1991, the area was classified as in nonattainment. A new SIP was due in 1993, but revisions were submitted in 1995, 1996, and 1998. The revised SIP was still under EPA review in 2000.58 East Helena closed in 2001. According to the Superfund Record of Decision, the area around East Helena achieved the NAAQS between 1998 and 1999, twenty years after the standard was set.59

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A long process of SIP approvals, failures to attain the NAAQS, and SIP revisions also played out at the Herculaneum smelter in Missouri. Specifically, in 1986, EPA asked for a revision to the SIP because of nonattainment in the area around the smelter, and the state submitted the revision four years later, in 1990. EPA approved the SIP and set 1995 as the date that the lead NAAQS would be achieved. However, this did not occur, and after more revisions to the control plan, the area near the smelter was to meet the NAAQS by 2002.60 This compliance date was also not met. It was not until 2008 that EPA determined that the area around the Herculaneum smelter was consistently meeting the lead NAAQS set in 1978.61 In 2008, the smelter still put 20 tons of lead into the air, down from approximately 140 tons in 2000.16 Also located in Missouri, the area around the Glover smelter exceeded the lead NAAQS until 1997. Prior to that, quarterly averages near the plant in 1993 and 1994 were 10 mg/m3 and 9.3 mg/m3, respectively. Some 24-hour average samples at two monitoring sites were also quite high (e.g., 102.2 mg/m3 in 1993, 61.3 mg/m3 in 1994, and 8.71 mg/m3 in 2003).62 Since the 1978 lead NAAQS are based on a quarterly average, these types of exceedences could occur and the standard could still be attained. Glover closed in 2003. The area around the Glover smelter was officially designated as in attainment for lead in 2004, after closure.63 During the 1980s, ambient lead concentrations declined nationwide, and by 1991, the lead NAAQS were being met in all parts of the United States, except near primary and secondary smelters and metal refineries—these communities continued to be outliers.64 Even in the late 1990s, near the Herculaneum Smelter, the Broad Street monitor, which was close to a residential area, showed a quarterly average reading of 11.6 mg/m3 in 1998 and 6.8 mg/m3 in 1999.65 In 1991, the level of concern for lead in blood in children was lowered from 25 to 10 mg/dL66 and EPA published a Lead Strategy document, primarily focused on children, which set forth a national plan for addressing persistent lead exposure and poisoning. Exposures of most concern were lead in paint, urban soils, and water. Communities living near lead smelters were briefly considered, though none were mentioned by name. Though EPA recognized that high blood lead in children could be caused by industrial sources, the Agency characterized affected communities as “small” and “local”.64 EPA estimated that enforcement of the 1978 NAAQS could halve the number of children with BLLs over 10 mg/dL (from eight hundred to four hundred children), and that even greater public health gains could be achieved with more stringent NAAQS; however, EPA continued to worry that enforcement or revision of the NAAQS would shut down the primary lead smelting industry.64

Other Regulatory Efforts Regulation under the Clean Air Act (NAAQS) was one approach to bringing smelters into compliance with the ambient standard, but other U.S.

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environmental regulatory programs also contributed. For example, at the East Helena smelter, regulatory actions under the Comprehensive Environmental Response, Compensation, and Liability Act, or Superfund, were used to reduce emissions from the plant. The area near the East Helena smelter was placed on the National Priorities List in 1984, which triggered remedial investigations to characterize contamination. Under Superfund, EPA sets goals in 1991 for reducing children’s BLLs near the East Helena smelter—goals that required further lead emissions reductions from the plant along with soil cleanup in residential areas. Both the NAAQS and Superfund actions at East Helena focused largely on reducing fugitive emissions. For example, the state required in the 1983 SIP that ASARCO, the smelter owner, pave roads and unload ore in an enclosed building. The Superfund remedial investigation determined that 35 percent of lead particulates in East Helena’s air was coming from outdoor ore storage areas. Ore storage and handling was moved to an enclosed building in 1989. Further emissions reductions came from ending certain slag dumping practices in 1990.59 Neither the Herculaneum nor the Glover smelter was placed on the National Priorities List in the 1980s when other smelting communities were listed. Emissions reductions from similar strategies in place at East Helena by the early 1990s, such as improvements to ore handling, unloading, paving roadways, enclosing key operations, and improved dust control, did not occur at Glover until the mid to late 1990s after a Consent Decree between the smelting company, the state, and the EPA was filed in 1996, with a strict schedule for making improvements that would lead to emissions reductions. Many of the improvements focused on reducing fugitive emissions.67 Substantial emissions reductions occurred at Herculaneum in the early 2000s when lead emissions decreased from 139.8 tons in 2000 to 113.5 tons in 2001 and further declined to 58.8 tons in 2002.16 The reductions followed concerted state and federal regulatory involvement prompted by public concerns about lead contamination in the community and elevated BLLs in children. For example, in response to a community member’s concern, regulators tested a sample of dust from a roadway in Herculaneum in 2001. Results showed that this sample of dust contained approximately 30 percent lead.68 EPA under its Resource Conservation and Recovery Act (covering solid and hazardous waste) and Superfund authority, along with the Missouri Department of Natural Resources issued an Administrative Order on Consent in 2001, which was updated several times in subsequent years, and which specified increased controls on air emissions, soil replacement in certain yards and children’s play areas, and remediation of a large slag pile.69 The Natural Resources Defense Council notes that many of the improvements that led to achievement of the NAAQS near the Herculaneum smelter were due to controlling fugitive emissions from enclosing structures, reducing emissions of lead dust from ore storage

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and handling, and reducing and controlling lead dust from vehicles and roadways.16,70

The Role of Public Health Activities Many U.S. smelting communities were essentially “company towns” where loyalty to the community’s economic engine made it difficult for some to speak out against environmental pollution and damage to children’s health. Along with this, in the 1970s and 1980s, the lead industry continued to contest the role of airborne lead in damaging children’s health in an attempt to stave off regulation. The industry also disputed findings from independent public health research regarding the level of lead in blood that could cause harm to children. In some smelting communities, the lead industry sponsored or supported studies which found that children with elevated BLLs in these communities suffered few adverse health effects, adding to confusion among residents.71,72 Public health and other officials, too, at times participated in downplaying community health risks caused by smelter emissions, particularly in Bunker Hill73 and Herculaneum.74 Australian researchers have pointed to a similar tendency on the part of government and the mining industry in Queensland, Australia to publicly “minimize” concerns about health risks associated with environmental lead exposure among children.75 Outside of the regulatory process, steps to decrease children’s exposure to lead emissions in smelting communities often followed the public release of blood lead surveillance data. These steps included relocation of children (El Paso, Bunker Hill, and Herculaneum) and the implementation of additional pollution control measures to try to decrease lead emissions. For example, in El Paso, publicity following blood lead test results from 1971 to 1972 contributed to a court order for the smelter to reduce its emissions.76 In 1977, CDC reevaluated children’s BLLs in El Paso and found there had been some improvement, in part because of relocation of children and in part because of emissions reductions. Only three children were living within 0.8 km of the smelter in 1977, whereas in 1972, 160 children had been tested. The mean BLL among the three was 17.7 mg/dL in 1977, compared to 41.4 mg/dL in children living at that distance in 1972. Farther out (0.8– 1.6 km), BLLs dropped from an average of 31.2 to 20.2 mg/dL between 1972 and 1977. The decreases in children’s BLLs were attributed to new pollution controls at the smelter—notably occurring before the lead NAAQS were set. Concentrations of lead in air were halved over the fiveyear period—from 10 to 5.5 mg/m3.77 With the exception of Bunker Hill, annual blood lead screenings in children were not conducted in U.S. lead smelting communities until the 1990s. East Helena appears to have had the most frequent screening—with screening occurring in 1975, 1983, every two years after 1991, and every year after 2005.

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The data show decreases over time from an average BLL of 28 mg/dL in 1975, down to 1.3 mg/dL in 2006, with no tested children over 10 mg/dL after 2000.78 In Herculaneum, where blood lead screening was less frequent, public health protection took longer to achieve. Eighty-seven children from Herculaneum were included in a 1975 EPA-CDC study of smelting communities, and ten were judged to have elevated BLLs (the study used 29.4 mg/dL to define elevated BLLs), according to the standards at the time.7 However, only sixteen children at highest risk (within a half mile of the smelter) were tested, and the average BLL in that group was 24.8 mg/dL.79 Doe Run, the Herculaneum smelter owner, and the state collaborated on a study in 1984, which showed an average BLL of 18.9 mg/dL in children living closest to the stack.79 A 1992 study by the local health department also found elevated BLLs in children. Between June 1992 and May 1999, results were available for fifty-two children living near the smelter. BLLs in excess of 10 mg/dL were found in fifteen children. Three children had BLLs greater than 20 mg/dL.80 Community and regulator concern increased when a 2000 county and state health department study showed that approximately 15 percent of children living within 1.5 miles of the Herculaneum smelter had elevated BLLs.81 Studies in 2001 and 2002 showed elevated BLLs in children, with the highest BLLs at 31 and 28 mg/dL, respectively.82,83 The early 2000 surveillance studies were a critically important factor in the concerted effort by federal and state officials to address ongoing smelter emissions. In fact, in 2001, the Missouri Department of Health and Senior Services took the highly unusual step of issuing a letter stating that lead contamination near the smelter posed a “clear and present” and “imminent and substantial endangerment” to the public’s health and particularly to pregnant women and children aged six and under.84 This prompted the state to promulgate an “abatement and cease and desist order” which among other things required the company to “cease and desist the use of open-backed trucks for hauling lead concentrate within 45 days,” “cease all activities that cause fugitive dust to leave the facility,” and to provide funding for interior dust cleanup.85 Doe Run was also required to offer to buy 160 homes in proximity to the smelter for “fair market value.” 85

Surveillance and Comparison to National Averages Childhood blood lead surveillance in smelting communities took place within the larger context of national blood lead surveillance that began in the 1970s. Importantly, since 1971, the Surgeon General and CDC have set federal public health guidelines for children’s BLLs, and this has facilitated the interpretation of blood lead screening data in smelting communities.86 In NHANES II (1976–1980), the mean BLL was 16.0 mg/dL in U.S. children aged six months to five years,87 and BLLs in white children in this age group showed a 42 percent decrease over the five-year study period.88 But in smelting

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communities, BLLs in children often remained dangerously high. For example, at Bunker Hill, BLLs in children closest to the smelter averaged 40 mg/dL in 1976 and 31 mg/dL in 1980. Even after the smelter stopped operating, BLLs remained higher than U.S. averages (e.g., in 1983, 21 mg/dL).89 Children living within a half mile of the stack at Herculaneum also had BLLs higher than U.S. averages in 1984 (18.9 mg/dL).79 Public health surveillance efforts helped to prove that lead in air was an important factor in children’s elevated BLLs. The 5.4 mg/dL drop in average BLLs for the U.S. population observed in NHANES II between 1976 and 1980 correlated closely with the reduction of lead in gasoline,88 striking evidence that lead in air was more important to blood lead than the lead industry had consistently argued. Smelting and lead industry leaders themselves recognized this. An internal memo between Herculaneum managers reporting on a LIA meeting from 1983 recognized the significance of the NHANES data: “The Haines II study [sic] which shows a one to one drop in blood lead with gasoline lead reduction is devastating to lead interests. Ethyl and DuPont have convincing counter arguments that explain the data based on terribly faulty sample design.”90 These type of data gained from traditional public health surveillance activities strengthened the evidence base for the importance of reducing ambient lead concentrations in smelting communities by improving controls on both stack and fugitive emissions. Surveillance data and the ability to compare the BLLs of children in smelting communities to national averages also became important for advocacy and lawsuits.

Government Agency, Environmental Group, and Individual Lawsuits Lawsuits by government agencies and by environmental groups and individuals have played a key role in addressing the lead health threat from smelters. As noted previously, it was a lawsuit by the state of Texas and the city of El Paso that led to scrutiny of the El Paso smelter’s lead emissions, touching off studies of heavy metal exposure around the United States, as well as questioning of the industry’s emissions and pollution control practices. After widespread lead poisoning in El Paso was made public in the early 1970s, ASARCO, the company which owned the smelter, participated in relocating families living nearby, reduced lead emissions to some extent, and worked to settle quickly two legal complaints covering fifty children.91 Sociologist Mary Romero contends that ultimately the company made monetary settlements ($500–$7000 per child) with the families involved with the condition that they would give up their right to sue.92 After El Paso, a lawsuit against Bunker Hill, brought by the parents of leadpoisoned children, led to two separate settlements in the early 1980s on behalf of children and adults, totaling approximately $31 million.93 This case is thought to be one of the earliest damage awards for childhood lead poisoning from

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exposure to industrial pollution. The settlement was large for its time—compared to Woburn, MA ($8 million settlement in the mid-1980s) and the estimated $35 million settlement in 2002 with families in Toms River, NJ94(pp. 428– 432) , both for childhood cancer clusters. A 1983 community lawsuit near a secondary lead smelter in Dallas, TX, where children who lived nearby were exposed to lead, was also of concern to the lead industry and seemed to signify a growing threat. The case was discussed at a LIA environmental health meeting: Werner Meyer/Jerry Cole have the charge of preparing a discussion proposal on a 3-year PR campaign to try and raise lead’s pitiful image. The Dallas situation [secondary lead smelter] is spreading where multimillion dollar community lawsuits are mushrooming, anti-lead regulations are epidemic. The message was “go home—spread the word—and budget.”90

At East Helena, in 1984, the Montana State Department of Health and Environmental Sciences filed a lawsuit against ASARCO for discharging arsenic-contaminated water, which allegedly contaminated groundwater and led to the deaths of livestock on a nearby ranch.95 Lawsuits by citizens and government publicized the concerns of smelter neighbors, raised questions about the behavior of the industry, and sometimes allowed for legal discovery that cast light on broader problems, as in El Paso and Bunker Hill. However, there are at least two examples from Herculaneum where fear of lawsuits kept smelter managers from taking responsible action to protect public health. For example, at the Herculaneum smelter, managers declined to put a lead air monitor near the northwest area of the plant in 1982, stating, “. . . our major reason for not wanting to have a public record of any data well above the standard might be the liability and the possibility of community legal action.”96,a They also determined not to do a large-scale buyout of nearby homes in the late 1980s for fear that such a buy-out would “. . . almost certainly invite a major class action lawsuit.”96,b Since the 1990s, community lawsuits against the Herculaneum smelter have been successful. For example, a mother of three children who lived near the smelter sued when her children were found to have elevated BLLs and learning problems. Her 1995 suit was settled in 2010.97 More recently, in the summer of 2011, a jury awarded $38.5 million in compensatory damages for damage to children’s health from lead exposure and $320 million in punitive damages—an unprecedented amount for community toxic metal exposure.98 Plaintiffs in another class action suit were awarded $55 million for “annoyance and discomfort” and property damage in 2012.99 Community lawsuits alleging property and health damage from lead smelters have been successful in part because plaintiffs’ lawyers have been able to rely on

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monitoring data that has documented violations of lead in air above regulatory standards, soil contamination above EPA screening values, and in the case of lawsuits over health damage, surveillance data that have documented BLLs in children over federal public health guidelines for decades. Underpinning these cases is the large body of independent science that has developed since the 1970s correlating health effects in children at specific BLLs—which eliminates the ambiguity associated with so many other types of community environmental exposure.

Discussion Regulatory efforts alone cannot be credited with eventual lowering of lead emissions from primary lead smelters in the United States and reductions in children’s BLLs in smelting communities in the decades following the discovery of widespread lead exposure and poisoning caused by these facilities. Rather, many interacting factors contributed. These included community and environmental group advocacy, litigation, independent science, public health standards for lead in blood, public health surveillance efforts, health education, relocation, and regulatory standards and activities. In fact, regulating the lead health threat from smelters was not a priority for EPA and some smelting states like Missouri at least until the 1990s, by which time the majority of primary smelters had closed and the industry’s political power at the state and federal level had diminished.100 Regulatory efforts, when they occurred, were often spurred by environmental organizations, community members, and public health advocates who pushed for environmental standards to be both set and enforced. Independent science, which advanced knowledge of health risks from smelters, lead, and the particular vulnerability of children, helped to inform the actions of environmental organizations, community members, and public health advocates. Public health activities such as surveillance of children’s BLLs near smelters, with public reporting of results, and national BLL surveillance also contributed. Surveillance efforts helped to highlight the persistence of elevated BLLs in children living near smelters even as BLLs declined across the United States after the 1970s. More concerted regulatory efforts to control lead smelter emissions often followed the public release of surveillance data on childhood lead poisoning, or public reporting of test results on environmental contamination. Lawsuits by smelter community residents and the threat of liability were also a factor in removing children from harm’s way and for changing industry practices. Access to monitoring data on lead in air has been important for regulation and for lawsuits. As primary smelters closed in the United States throughout the 1970s and 1980s, the smelting industry declined in importance in the United States. This may have also played a role in empowering community action, advocacy, and regulatory efforts. A recent Natural Resources Defense Council case study examined the factors that helped to bring the Herculaneum smelter into compliance with the 1978 lead

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NAAQS and made recommendations for overseas lead-producing facilities based on the U.S. experience. Their case study credits the application of both health-based (NAAQS) and technology-based (NESHAPS) standards for regulation of lead in air, monitoring of lead in air, fugitive dust control, public health interventions, Superfund authority, and community involvement for reducing risk to the community from this smelter.16 This analysis, which includes the three lead smelters that continued to operate after the early 1990s, largely agrees with Natural Resources Defense Council ’s findings but additionally argues that other factors were also essential for achieving emissions reductions around U.S. smelters. These include ongoing public health surveillance and health education, independent science, publicly available monitoring and surveillance data, the threat of liability and lawsuits, and advocacy by environmental groups and individuals. To protect public health and the environment in countries where lead smelters now operate, ambient lead concentrations must be continuously monitored and results publicly reported. Monitoring, along with the maintenance and release of data, should be the responsibility of government regulatory agencies. The data should be available to researchers, health officials, and community residents. A recent study in Australia examining “the ineffectiveness of regulatory authorities at protecting public health” from smelter emissions emphasized the importance of making monitoring data available to the public in a timely manner and in an understandable format.101 Ongoing public health surveillance of children’s BLLs in smelting communities is also critical. Based on the U.S. experience, the most effective approach is, at a minimum, annual blood lead surveillance (typically in summer months when BLLs may be higher) of a random sample of the population of children living within defined distances from lead smelters. Public health officials should take control of blood lead screening and should be responsible for analyzing the samples and interpreting and publicly reporting the results. Full participation of residents in blood lead screening should be incentivized. The results of annual blood lead surveillance should be accompanied by stateof-the-art public health education about the hazards of low-level lead exposure in children and should include steps that parents can take to help reduce lead exposure. However, such education should recognize that there is only so much that parents can do in a lead-contaminated environment and that reducing or eliminating lead in air, soil, and house dust will be the most effective way to lower children’s BLLs. Surveillance and health education efforts should include pregnant women. Blood lead surveillance should occur not only near smelters but also outside of zones influenced by smelters, so that there is a population to use for comparison purposes. Also important is a legal framework that allows people who are injured to seek compensation either individually or as a class. In addition to requiring strict controls on stack emissions, regulators should evaluate and address all significant sources of fugitive emissions, including ore

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transport and storage and their contribution to ambient lead levels and soil contamination in smelting communities. Experience identifying and controlling fugitive emissions has been developed in the United States at the East Helena, Glover, and Herculaneum smelters and could inform overseas regulatory efforts. If emissions from primary lead smelters are not monitored and controlled to the extent necessary to ensure protection of public health, appropriate zoning restrictions should be put into place near these facilities. Residences, schools, day care operations, parks and playgrounds, and other areas used by children should be located outside of a smelter’s zone of influence. The zone of influence should be defined by the current U.S. lead in air standard of 0.15 mg/m3, which is based on a three-month rolling average. The standard was set after an extensive review of the science of lead’s harm to children and is aimed at preventing significant intelligence quotient loss in children, neurobehavioral problems, fetal effects, and other negative health outcomes. Ideally pregnant women, families with children, and all child use areas should be located outside of areas that exceed this air lead level. This should be viewed as a partial and temporary solution to protect human health in the short run. The potential for significant childhood lead exposure through soil contamination should also be evaluated. Regulators should consider adopting the California screening level for lead in residential soil (80 mg/kg), which was set by taking into consideration harm to children from low-level lead exposure.102 In addition to their significant public health impacts, lead emissions from smelters are a multimedia environmental problem that has resulted in degradation of soil and water, impacts to agriculture, and harm to wildlife and domesticated animals. In the United States, we are now facing the costs and challenges of environmental cleanup—around the Bunker Hill smelter alone the costs of cleanup are projected to top $700 million, and remediation will take decades to complete.103 Controlling emissions to protect public health and the environment is the best solution for people living near smelters today and for future generations, as well as for protecting soil and water resources, agriculture, and wildlife.

Conclusion Childhood lead exposure and poisoning from nonferrous smelting is an unacceptable ongoing public health problem that can and should be prevented. One of the most important differences between the U.S. experience reported here and today’s context is that there is no longer meaningful debate over the harms of lead exposure for children. Today, parents, health officials, physicians, regulators, and advocates can make an unassailable case for the public health imperative of preventing exposure to lead. CDC’s 5 mg/dL standard for lead in blood underscores the harms of low-level lead exposure for children. It is technologically feasible to control both stack and fugitive emissions from lead smelters. In the United States, the primary lead industry argued that it

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would be unable to meet the 1.5 mg/m3 standard. However, the standard was met at three lead smelters, two of which were built at the turn of the twentieth century. The public health and environmental costs of not controlling industrial lead emissions are significant. Solving this problem will require collaboration among and advocacy by affected communities, environmental scientists, public health researchers, legal experts, and activists—not only within countries where smelters continue to operate but also on an international level. Acknowledgments The author gratefully acknowledges Rutgers University Press (RUP) for allowing a small amount of material adapted from the author’s book, Tainted Earth: Smelters, Public Health, and the Environment, published by RUP in 2014, to be included in this article.

Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author received no financial support for the research, authorship, and/or publication of this article.

Notes a. The quote pertains to Mr. Smoger, the plaintiff’s lawyer, referencing Exhibit 50, a letter from Vornberg to Peppers dated 21 April 1982, as reported in the trial transcript. b. The quote pertains to Mr. Smoger’s reading of Exhibit 1, a letter between Fluor executives from 1989.

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Author Biography Marianne Sullivan is an assistant professor in the Department of Public Health at William Paterson University. Her book Tainted earth: smelters, public health, and the environment is published by Rutgers University Press. Contact her at [email protected].