10
David A. Stroud
The onset of industrial
exposure to lead
Hernberg (2000) and Needleman and Gee (2013) summarise the
rise of human exposure to lead over the last millennium. Lead
continued to be used in alcohol production, with one of the
earliest public health laws in 1498 prescribing the death penalty
in some German states for those adding lead sugar to wine.
Later US legislation banned the use of lead condensing coils for
rum distillation in 1723.
Needleman and Gee (2013) recount the case of the physician
Sir George Baker who, in 1768, correctly diagnosed the cause of
annual epidemics of colic (with a high case fatality rate), each
autumn in Devon, as arising from acute poisoning derived from
lead keys within the millstones used to press acidic cider juice
(Baker 1772). Yet,
“Rather than receiving praise for his incisive work, Baker
was condemned by the clergy, the mill owners and by fellow
physicians: cider was Devon’s main export. Baker suffered the
fate of many ‘early warning’ scientists whose inconvenient
truths are not welcomed by supporters of thestatus quo.”
(Needleman and Gee 2013).
Whilst Ambassador to France (1776-1785), Benjamin Franklin
correctly diagnosed different routes of lead exposure amongst
different trades and their medical consequences. He concluded:
“This mischievous effect from lead is at least 60 years old;
and you will observe with concern how long a useful truth
may be known and exist, before it is generally received and
practiced on.”
(Franklin 1818).
An epidemic of acute population exposure to lead came with
the Industrial Revolution not least owing to the ubiquity of
lead use in diverse manufacturing processes. Indeed Hernberg
(2000) noted that “a comprehensive list of exposed jobs would
be too extensive” to develop.
The nineteenth century saw growing clinical understanding
of the causes and consequences of acute lead poisoning, and
the wide extent of acute, often fatal, poisoning lent urgency
to the need for regulation (Legge and Goadby 1912, Hernberg
2000). Recognising poisoning risks from use of lead glazes,
Josiah Wedgewood pressed government for legislative controls
through extension of the 1833 Factories Act from textile
industries to the potteries. However, opposition from other
pottery manufacturers led to a 30 year delay until statutory
controls on lead were eventually included within the 1867
Potteries Regulations (Needleman and Gee 2013).
The need to reduce levels of lead poisoning was central to the
development of early occupational and public health initiatives
from the second half of the nineteenth century as documented
by Hernberg (2000).
The histories of regulation to remove lead from paint and from
petrol are typical of initiatives to reduce lead exposure from
other sources.
Lead in paint
The risks from exposure to paint containing white lead
carbonate, or yellow lead chromate additives was first recognised
in 1892 and the death of a child from consumption of flakes of
leaded paint was diagnosed and reported in 1914 (Thomas and
Blackfan 1914). Leaded paint was widely withdrawn in Europe
and Australia between 1909 and the 1930s, although with a
motivation to prevent occupational exposure to decorators
rather thanhome owners and their children (Needleman andGee
2013). Many such national initiatives were driven by the national
implementation ofWhite Lead (Painting) Convention adopted by
the International Labour Organisation in 1921 (Hernberg 2000).
This prohibited the use of white lead in indoor painting.
In the UK, Sir Thomas Legge became the first Medical Inspector
of Factories in 1898 and did much to focus attention on, and
reduce the extent of, industrial lead poisoning (Legge and
Goadby 1912). However, he resigned in protest at the British
government’s refusal to ratify the Convention in 1926. In the
USA, the Lead Industries Association managed to block the US
government from signing the Convention, such that federal
legislation prohibiting indoor uses of leaded paint only came
into force in 1972 (Jacobs 1995, Needleman and Gee 2013,
Kessler 2014):
“The consequences of this delay have been disastrous”
(Hernberg 2000).
Lead in paint continues to be manufactured, sold and used in
many countries. A recent analysis by Kessler (2014) showed
use of leaded paints to be legal in 40 countries, many being
developing countries, although also including the major
emerging economies of Brazil, Russia, India, China, South Africa
STOP PRESS: A global review of the status of phasing out of lead paint was
published by SAICM in September 2015: