In 2014, the city of Flint, Michigan switched its drinking water supply from treated Detroit water to the Flint River, in an attempt to cut back costs. The Flint River was an unofficial waste dumping site for years, and after the switch, many residents began to complain of foul-smelling and discolored water coming from their taps. City officials claimed the water was completely safe; however, about a year later, studies showed that nearly 40% of water samples taken contained above 5ppb (parts per billion) of lead (Alfonsi, 2020).
As years have passed, many Americans have forgotten about Flint, assuming that the problem has been resolved. While the city has stopped providing bottled water since 2018, suggesting that the public water is now safe to drink, we are starting to see the effects of individuals drinking lead-contaminated water for years, specifically in children. Dr. Mona Hanna-Attisha, a pediatrician in Flint, explains the grim early findings of about 14,0000 children exposed to lead from the water. "It impacts cognition...actually drops IQ levels. It impacts behavior, leading to things like developmental delays". Three years after the crisis began, it was found that the percentage of third-graders in Flint who passed Michigan's standardized literacy test had dropped from 41% to 10% (Alfonsi, 2020).
Regarding fetal exposure, lead is shown to be linked to fetal death, prenatal growth abnormalities, a reduced gestational period, and reduced birth weight (Grossman, 2019). Studies show that among white mothers, there has been a 71-g reduction in birth weight (Abouk, 2018), fertility rates have decreased by 12%, and there has been a 58% increase in fetal deaths, relative to areas not afflicted by poisoned water (Grossman, 2019). These numbers are likely undercounted, as significant research has yet to be conducted.
According to the 2016 US census, Flint is 53% African-American, and 45% of Flint's residents live in poverty (U.S. Census Bureau, 2016). Lack of government accountability and transparency led to this ongoing crisis that has affected hundreds of thousands of individuals. Cost-cutting should never supersede health and safety, yet that is exactly what happened in Flint. We still have yet to see what the long term effects of years of lead exposure will be, in addition to the effects of most of Flint's residents drinking only bottled water for the last 6 years. Regardless of the lack of media coverage, this crisis is far from over.
References
Abouk R, Adams S. Birth outcomes in Flint in the early stages of the water crisis. J Public Health Policy. 2018 Feb;39(1):68-85. doi: 10.1057/s41271-017-0097-5. PMID: 29109518.
Alfonsi, Sharon. “Early Findings Grim on the Health of Flint Kids after Water Crisis.” CBS News, CBS Interactive, 5 July 2020, www.cbsnews.com/news/flint-water-crisis-effect-on-children-60-minutes-2020-07-05/.
Grossman, D.S., Slusky, D.J. The Impact of the Flint Water Crisis on Fertility. Demography 56, 2005–2031 (2019). https://doi.org/10.1007/s13524-019-00831-0
U.S. Census Bureau (2016). Population Estimates. Flint City, Michigan. Retrieved from [https://www.census.gov/quickfacts/flintcitymichigan]
Hi Megan,
ReplyDeleteThis is a great topic to bring to light. I am from Jackson, Michigan, a city about an hour away from Flint. The statistic you shared regarding the significant drop of third graders who passed Michigan’s literacy test is astounding to me. This crisis very quickly disappeared from the media and from the attention of many, even for Michigan residents like me.
Neurotoxicity is used to describe neurophysiological changes that occur after exposure to toxic substances like lead. Exposures to toxic agents could cause cognitive changes, memory disorders, and changes in mood or onset psychiatric disturbances (Mason, Harp, Han, 2014). Some of lead can be excreted through urine and bile once it is introduced in the blood, but the remaining lead binds to red blood cells and is distributed to different soft tissues throughout the body. Eventually, this causes an accumulation of lead in the bone (Mason, Harp, Han, 2014). Interestingly, the deposited lead in the bone has a half-life of 20 to 30 years. When bone turnover occurs, the lead deposits are released back into the bloodstream (Mason, Harp, Han, 2014). The dynamic nature of bone and constant remodeling is physiologically extremely useful but can be very harmful if these bone tissues have lead deposits. During pregnancy, menopause, and lactation, bone turnover is increased. Meaning, if these individuals have lead deposits in their bone tissue, there is an increased amount of lead released into the bloodstream (Mason, Harp, Han, 2014). In a recent study, offspring exposed to lead during pregnancy had different neural connectivity patterns compared to offspring that were not exposed to lead (Thomason, et. al, 2019). Fetuses not exposed to lead had stronger age-related increases in the cross-hemispheric connectivity compared to those exposed to lead (Thomason, et. al, 2019). This connectivity is important in systems supporting high-order cognitive functions (Thomason, et. al, 2019). These alterations may be responsible for the significant cognitive and behavioral outcomes associated with lead exposure (Thomason, et. al, 2019). In conclusion, maternal lead exposure could lead to detrimental cognitive and behavioral effects for the fetus.
As I think about the catastrophic effects of the Flint water crisis, I can’t help but think about how this decision made by government officials to cut back on costs could be detrimental for Flint residents for years to come. Not only will the current children and adult Flint residents suffer, the future generations who were unknowingly exposed in utero will endure these same consequences. As healthcare providers, we ought to do no harm, non-malfeasance, and I believe it is our duty to continue to fight for Flint residents for access to clean water in order to fulfill this ethical duty.
Mason LH, Harp JP, Han DY. Pb neurotoxicity: neuropsychological effects of lead toxicity. Biomed Res Int. 2014;2014:840547. doi: 10.1155/2014/840547. Epub 2014 Jan 2. PMID: 24516855; PMCID: PMC3909981.
Thomason ME, Hect JL, Rauh VA, Trentacosta C, Wheelock MD, Eggebrecht AT, Espinoza-Heredia C, Burt SA. Prenatal lead exposure impacts cross-hemispheric and long-range connectivity in the human fetal brain. Neuroimage. 2019 May 1;191:186-192. doi: 10.1016/j.neuroimage.2019.02.017. Epub 2019 Feb 7. PMID: 30739062; PMCID: PMC6451829.