6 ms·

Low-level lead exposure and mortality in US adults

81 points by dzdt 9y ago

aculver 9y ago
Is anyone familiar with any other research that would allow us to compare this to other developed nations?
- strictnein 9y ago
  Wouldn't almost all developed nations have utilized and then phased out lead paints?
  - stevenwoo 9y ago
    There was some thread yesterday that brought up that all small propeller driven planes/GA in the world use leaded fuel still because it was simpler to keep that instead of forcing a changeover. So not only is it constantly spewed out but also in miniscule quantities in every farm product that gets crop dusted in the USA.
gshubert17 9y ago
Wow, that seems high -- 412,000 is 15% of the total number of American deaths in 2015 which was 2,712,630. https://www.cdc.gov/nchs/nvss/deaths.htm https://www.cdc.gov/nchs/nvss/deaths.htm But that seems to be what they're claiming: > Population attributable fractions were calculated to show the proportional reduction in all-cause mortality, cardiovascular disease mortality, and ischaemic heart disease mortality that would occur if recorded concentrations of lead in blood were reduced to 1·0 μg/dL or lower (≤0·048 μmol/L). The adjusted population attributable fraction for all-cause mortality was 18% (95% CI 10·9–26·1), equivalent to 412 000 (95% CI 250 000–598 000) deaths each year (table 2). Adjusted population attributable fractions were 28·7% (95% CI 15·5–39·5) for cardiovascular disease mortality and 37·4% (23·4–48·6) for ischaemic heart disease mortality, equivalent to 256 000 cardiovascular disease deaths and 185 000 ischaemic heart disease deaths annually (figure 3).
portofcall 9y ago
From the study, Deaths from cardiovascular disease have declined strikingly in the USA over the past 50 years, but this disease is still the leading cause of death.1 In 2013, cardiovascular disease accounted for more than 800 000 deaths in the USA (about one in every three deaths), with total costs exceeding US$300 billion annually.1 To be clear then, this study is claiming that half of all cardiovascular deaths in the USA per year are the result of lead exposure? That seems very unlikely given rates of obesity, smoking, and other cardiovascular risk factors. I’d also like to know what if any interest the hedge fund listed as a funding source would have in this. Plus this... We declare no competing interests. BPL serves as an expert witness in plaintiff cases of childhood lead poisoning in Milwaukee and Flint, MI, USA, but he receives no personal compensation.
- fancyfacebook 9y ago
  This seems like a dream paper if you work in the cattle industry.
- Scaevolus 9y ago
  It doesn't appear to control for other confounding factors. There are large correlations between lead exposure and socioeconomic status (inner cities are the most polluted), and between socioeconomic status and life expectancy (healthcare is expensive).
- gwern 9y ago
  And extremely small lead exposure levels at that, too. Not to mention accounting for much of the SES/mortality correlation - who knew it was so simple and easy and definitely didn't involve any confounders like genetics? If you believe that, I have a lead-free bridge I'd like to sell you.
  - phyzome 9y ago
    There is no safe (measurable) level of lead in the bloodstream. Used to be considered safe below 30 µg/dL. Then 10. Now 5, last I heard. I have no reason to believe the action level will not continue dropping further. What amount of lead would you consider acceptable in your bloodstream?
epistasis 9y ago
The current headline, "lead kills 412k/year" is an inaccurate representation of the linked paper. That type of statement is not in the paper. Keeping that type of phrasing, saying something like "Lead might kill up to 412k/year" would be in the realm of reasonable. This type of headline manipulation is how the media turns good science into bad science.
- dzdt 9y ago
  The paper says: "The adjusted population attributable fraction for all-cause mortality was 18% (95% CI 10·9–26·1), equivalent to 412 000 (95% CI 250 000–598 000) deaths each year." My opinion is still that translates better to "kills 412k per year" than "might kill up to 412k per year." I could see "might kill up to 598k per year" or "kills at least 250k per year" from their confidence interval. Why do you think it should say "might" and "up to"?
  - dang 9y ago
    The site guidelines ask you not to editorialize in titles: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html. Cherry-picking one detail and putting it in the title is not just editorializing, it's the leading form of it. If you want to say what you think is important about an article, please do so in a comment. Then your view is on a level playing field with everyone else's.
  - epistasis 9y ago
    These are associations, not causal implications. "Lead kills" is a causal statement, and even "lead associated with X deaths" is a bit leading, and I think that the authors were careful to not say that directly. Given the experimental evidence mentioned in the introduction of the paper, it's likely that some or many of these deaths could be due to lead, but they could also be due to shared causes. There could be other things that lead to both greater lead exposure and greater cardiac death, for example. One has to be very very careful with drawing conclusions from surveys such as this one. The standard in epidemiology is usually, association + one potential mechanism, but even with that it doesn't mean that the one potential mechanism is an explanation for all the observed association.
gwbas1c 9y ago
Is there a laymen's summary?
dzdt 9y ago
Its amazing how little of a splash this report made in the media. I guess it is because it doesn't fit much of a narrative. The biggest sources of lead exposure were leaded automotive gas and lead-based paint, both of which were phased out decades ago. There isn't any obvious current event to tie the reporting to. But the ongoing effect is HUGE as far as medical effects go; basically second only to smoking.
- narrator 9y ago
  They didn't have a bill they've been trying to get passed for years that this story would have justified.
- phyzome 9y ago
  There's still ongoing exposure from lead paint, which was only phased out in the US around 1979. And the soil in cities is loaded with lead. People grow stuff in that dirt and eat the plants, not realizing the risk. Dust gets tracked in and ends up ingested in various ways as well. It's a slow burn, and like you said, not linked to well-defined current events. The most you can say is "government continues not to do much about pervasive poisoning of population".
  - brador 9y ago
    > Dust gets tracked in and ends up ingested in various ways as well. What's this about? Is dust bad if ingested?
    - trav4225 9y ago
      (dust contaminated with lead)
jaclaz 9y ago
This seems to me like "weasel wording": > Although reducing the amount of lead in blood might cut a patient's risk of cardiovascular disease mortality, it is more accurate to view this study as estimating how many deaths might have been prevented if historical exposures to lead had not occurred.
chiph 9y ago
> Baseline data in NHANES-III were gathered between 1988 and 1994 They didn't really talk about where the lead came from, but adults living then grew up during the period when leaded gasoline was in common use (banned by the EPA in a five year phase-out period starting in 1995). As well as when lead-based paint was used in homes (it's use was banned in the US starting in 1978). I'd like to see another study in a few years for people born after 2000.
merricksb 9y ago
Same study discussed here: https://news.ycombinator.com/item?id=16611099 https://news.ycombinator.com/item?id=16611099
calibas 9y ago
By the way, "lead-free" plumbing contains as much as 8% lead, and only in the past decade were the regulations tightened so that "lead-free" plumbing must be a weighted average of 0.25% lead or less.
member221 9y ago
I was not really having a problem breathing at first. My throat was burning; I thought I had strep throat. I had pain in my neck, and there was swelling around my collar bone. The first doctor I went to said he did not know why there was swelling. He gave me antibiotics and told me that if the swelling was not better to come back in two weeks. I went back in two weeks and he said he did not know what was wrong. Since I do not have insurance, I went to a hospital emergency room, and they said I have COPD, I lost touch with reality. January 2018 I started on the COPD natural herbal formula we ordered from GREEN HOUSE HERBAL CLINIC, We spoke to few people who used the treatment here in the United States and they all gave a positive response, my symptoms totally declined over a 7 weeks use of the Green House COPD disease natural herbal formula. I am now almost 70 and doing very well, the disease is totally reversed! (Visit their website www . Greenhouseherbalclinic . com) I am thankful to nature, herbs are truly gift from God. i breath much better and feel comfortable doing so, I will keep sharing more awareness!!!

81 points by dzdt 9y ago

aculver 9y ago

Is anyone familiar with any other research that would allow us to compare this to other developed nations?

strictnein 9y ago
Wouldn't almost all developed nations have utilized and then phased out lead paints?
- stevenwoo 9y ago
  There was some thread yesterday that brought up that all small propeller driven planes/GA in the world use leaded fuel still because it was simpler to keep that instead of forcing a changeover. So not only is it constantly spewed out but also in miniscule quantities in every farm product that gets crop dusted in the USA.

gshubert17 9y ago

Wow, that seems high -- 412,000 is 15% of the total number of American deaths in 2015 which was 2,712,630. https://www.cdc.gov/nchs/nvss/deaths.htm https://www.cdc.gov/nchs/nvss/deaths.htm But that seems to be what they're claiming: > Population attributable fractions were calculated to show the proportional reduction in all-cause mortality, cardiovascular disease mortality, and ischaemic heart disease mortality that would occur if recorded concentrations of lead in blood were reduced to 1·0 μg/dL or lower (≤0·048 μmol/L). The adjusted population attributable fraction for all-cause mortality was 18% (95% CI 10·9–26·1), equivalent to 412 000 (95% CI 250 000–598 000) deaths each year (table 2). Adjusted population attributable fractions were 28·7% (95% CI 15·5–39·5) for cardiovascular disease mortality and 37·4% (23·4–48·6) for ischaemic heart disease mortality, equivalent to 256 000 cardiovascular disease deaths and 185 000 ischaemic heart disease deaths annually (figure 3).

portofcall 9y ago

From the study, Deaths from cardiovascular disease have declined strikingly in the USA over the past 50 years, but this disease is still the leading cause of death.1 In 2013, cardiovascular disease accounted for more than 800 000 deaths in the USA (about one in every three deaths), with total costs exceeding US$300 billion annually.1 To be clear then, this study is claiming that half of all cardiovascular deaths in the USA per year are the result of lead exposure? That seems very unlikely given rates of obesity, smoking, and other cardiovascular risk factors. I’d also like to know what if any interest the hedge fund listed as a funding source would have in this. Plus this... We declare no competing interests. BPL serves as an expert witness in plaintiff cases of childhood lead poisoning in Milwaukee and Flint, MI, USA, but he receives no personal compensation.

fancyfacebook 9y ago
This seems like a dream paper if you work in the cattle industry.
Scaevolus 9y ago
It doesn't appear to control for other confounding factors. There are large correlations between lead exposure and socioeconomic status (inner cities are the most polluted), and between socioeconomic status and life expectancy (healthcare is expensive).
gwern 9y ago
And extremely small lead exposure levels at that, too. Not to mention accounting for much of the SES/mortality correlation - who knew it was so simple and easy and definitely didn't involve any confounders like genetics? If you believe that, I have a lead-free bridge I'd like to sell you.
- phyzome 9y ago
  There is no safe (measurable) level of lead in the bloodstream. Used to be considered safe below 30 µg/dL. Then 10. Now 5, last I heard. I have no reason to believe the action level will not continue dropping further. What amount of lead would you consider acceptable in your bloodstream?

epistasis 9y ago

The current headline, "lead kills 412k/year" is an inaccurate representation of the linked paper. That type of statement is not in the paper. Keeping that type of phrasing, saying something like "Lead might kill up to 412k/year" would be in the realm of reasonable. This type of headline manipulation is how the media turns good science into bad science.

dzdt 9y ago
The paper says: "The adjusted population attributable fraction for all-cause mortality was 18% (95% CI 10·9–26·1), equivalent to 412 000 (95% CI 250 000–598 000) deaths each year." My opinion is still that translates better to "kills 412k per year" than "might kill up to 412k per year." I could see "might kill up to 598k per year" or "kills at least 250k per year" from their confidence interval. Why do you think it should say "might" and "up to"?
- dang 9y ago
  The site guidelines ask you not to editorialize in titles: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html. Cherry-picking one detail and putting it in the title is not just editorializing, it's the leading form of it. If you want to say what you think is important about an article, please do so in a comment. Then your view is on a level playing field with everyone else's.
- epistasis 9y ago
  These are associations, not causal implications. "Lead kills" is a causal statement, and even "lead associated with X deaths" is a bit leading, and I think that the authors were careful to not say that directly. Given the experimental evidence mentioned in the introduction of the paper, it's likely that some or many of these deaths could be due to lead, but they could also be due to shared causes. There could be other things that lead to both greater lead exposure and greater cardiac death, for example. One has to be very very careful with drawing conclusions from surveys such as this one. The standard in epidemiology is usually, association + one potential mechanism, but even with that it doesn't mean that the one potential mechanism is an explanation for all the observed association.

gwbas1c 9y ago

Is there a laymen's summary?

dzdt 9y ago

Its amazing how little of a splash this report made in the media. I guess it is because it doesn't fit much of a narrative. The biggest sources of lead exposure were leaded automotive gas and lead-based paint, both of which were phased out decades ago. There isn't any obvious current event to tie the reporting to. But the ongoing effect is HUGE as far as medical effects go; basically second only to smoking.

narrator 9y ago
They didn't have a bill they've been trying to get passed for years that this story would have justified.
phyzome 9y ago
There's still ongoing exposure from lead paint, which was only phased out in the US around 1979. And the soil in cities is loaded with lead. People grow stuff in that dirt and eat the plants, not realizing the risk. Dust gets tracked in and ends up ingested in various ways as well. It's a slow burn, and like you said, not linked to well-defined current events. The most you can say is "government continues not to do much about pervasive poisoning of population".
- brador 9y ago
  > Dust gets tracked in and ends up ingested in various ways as well. What's this about? Is dust bad if ingested?
  - trav4225 9y ago
    (dust contaminated with lead)

jaclaz 9y ago

This seems to me like "weasel wording": > Although reducing the amount of lead in blood might cut a patient's risk of cardiovascular disease mortality, it is more accurate to view this study as estimating how many deaths might have been prevented if historical exposures to lead had not occurred.

chiph 9y ago

> Baseline data in NHANES-III were gathered between 1988 and 1994 They didn't really talk about where the lead came from, but adults living then grew up during the period when leaded gasoline was in common use (banned by the EPA in a five year phase-out period starting in 1995). As well as when lead-based paint was used in homes (it's use was banned in the US starting in 1978). I'd like to see another study in a few years for people born after 2000.

merricksb 9y ago

Same study discussed here: https://news.ycombinator.com/item?id=16611099 https://news.ycombinator.com/item?id=16611099

calibas 9y ago

By the way, "lead-free" plumbing contains as much as 8% lead, and only in the past decade were the regulations tightened so that "lead-free" plumbing must be a weighted average of 0.25% lead or less.

member221 9y ago

I was not really having a problem breathing at first. My throat was burning; I thought I had strep throat. I had pain in my neck, and there was swelling around my collar bone. The first doctor I went to said he did not know why there was swelling. He gave me antibiotics and told me that if the swelling was not better to come back in two weeks. I went back in two weeks and he said he did not know what was wrong. Since I do not have insurance, I went to a hospital emergency room, and they said I have COPD, I lost touch with reality. January 2018 I started on the COPD natural herbal formula we ordered from GREEN HOUSE HERBAL CLINIC, We spoke to few people who used the treatment here in the United States and they all gave a positive response, my symptoms totally declined over a 7 weeks use of the Green House COPD disease natural herbal formula. I am now almost 70 and doing very well, the disease is totally reversed! (Visit their website www . Greenhouseherbalclinic . com) I am thankful to nature, herbs are truly gift from God. i breath much better and feel comfortable doing so, I will keep sharing more awareness!!!