These three individuals touched many lives in a good way!

Herb Needleman MD

Irving Selikoff MD

Archie Cochrane MD

As-bes-tos is the best! Only lead-based paint can protect farm equipment! 5-day hospital stays mandated even for normal deliveries

Asbestos “rip-outs” & related practices currently responsible for 200K deaths per year; Lead exposures created decades of kids’ mental slowness, neuropsychiatric problems.. Hucksters & chelationists touted phony, unproven “cures,” often victimizing farm families.

Principal & “principled” investigators

Herb Needleman MD

Irving Selikoff MD

Archie Cochrane MD

Flint, Michigan water & far beyond Shipyard & construction asbestos uses Created gold standard - medical evidence

Limit set at “40” but lowering itself to“30” & shortly morphing toward “25,” then “10” It’s now effectively zero (0) - Which was the correct answer?

Public health authorities set the blood lead (Pb) limit at 40-units (1971), amending it to 30-units five years later (1976) before dropping to 25 (1982); Childhood lead exposure, perhaps most significant for 3 year-olds, given both developmental capacity & proclivity to “find trouble;” Late in Million Dollar Speedway Brooklyn vents. “Do you know where that lead (Pb) goes, first into the air and then into little kids lungs!”

In 1989’s “Field of dreams” Kevin Costner posits ”If you build it he (..or they) will come.”

Does accepting or believing in standards ensure their correctness?

Field of Dreams finds its origins in WP Kinsella’s novel (Shoeless Joe)

If the barbed wire were only a few inches above your head how low could you go? Would you crawl this low if the lowest strand were 5-feet above the ground?

US Army training photo

35 years: same no. of “orange smokestacks,” Kids exceeding contamination benchmarks Which was (or were) health protective? Which were achievable? And then came Flint Michigan!

Source: Wm. Kincaid MD, St Louis Health Dept. Request your city’s data from local health dept.

Where is the truth? What is the “correct” answer? We aren’t the only ones experiencing difficulty in making up our minds?

For decades physicians advised patients that BP’s <140/90 (systolic/diastolic) acceptable; But more recent studies (SPRINT trial) noted fewer strokes & deaths among middle-aged pts. achieving ”stricter” systolic readings ~ 121 versus those with “moderate” attainment ~136; But dropping systolic pressures anywhere close to 120 isn’t easy, may require addition of a 2 nd or even a 3 rd anti-hypertensive Rx.

3 key questions: Where do we stand? What is needed? How realistic is attainment?

How do lead levels in St. Louis kids’ connect with three fellows - Herb, Irv & Archie?

Irv Selikoff found a remarkable common denominator in 17 shipyard-associated patients (Paterson New Jersey) suffering from asbestosis, lung cancer &(rare for time) mesothelioma. Industry spokesmen questioned Selikoff’s wartime service, his medical credentials & his motives; Herb Needleman, a pediatric psychiatrist collected “baby” or deciduous teeth, correlating elevated lead (Pb) content with both poor school performance & neuropsychiatric issues. Needleman & his laboratory were hounded by paid spokes people who disagreed with these findings; Archibald “Archie” Cochrane, WWII medical P-O-W & epidemiologist, ensured public would no longer be deceived by chelation specialists, among other hucksters. Cochrane invented, or at least strengthened, medical evidence-basing.

Why is the Red Limit Line terracing downward toward 2020? ”New” scientific data? Industry influences? Capacity to achieve a standard? So-called “Safe” lead (Pb) level in kids’ blood dropped 400% across 21-year period (71-92)

I’ve waited a lifetime to tell these stories –Heart & soul of industrial hygiene! I’ll let ProfUSMCMel have the last word here...

The jargon surrounding medicine sometimes thwarts understanding. Hence, some technical simplifications have been added to Million Dollar Speedway. Blood lead concentrations are described in simple units, corresponding to micrograms of the metal lead present in each one-tenth liter portion of blood, also termed a deciliter. Use of deciliter volumes is deeply anchored in American transfusion medicine. During the second half of the twentieth century, public health authorities successively lowered the concentration of concern, the so-called C-O-C for lead. The events described past the General Unknown chapter span 1979-81 when the pediatric C-O-C’s was set at less than 10-units. National surveys concluded as many as ninety per cent of America’s children were being lead over exposed. Corresponding 2003-08 surveys concluded fewer than one per cent of America’s children exceeded the earlier poisoned-or-no standard. Late in this tale, a questioner asks Prof Mel if he has solved the lead riddle. Mel’s response continues to be relevant for us. Thanks for asking, we're not done.