A Michigan health official told Congress that his department’s “initial analysis” showed blood lead levels in Flint children in the summer of 2014 were “within range of years before.” That’s false. That analysis concluded blood lead levels “were higher than usual” from July to September 2014, shortly after the city switched its water supply.
On April 25, 2014, the city of Flint began using the Flint River as its water source, as reportedin the Detroit Free Press. But the Flint River has particularly corrosive water, which led to high levels of lead leaching into the water from many of the city’s dated pipes. Soon after the water supply switch, Flint residents began complaining about the color of the water, rashes and other issues.
Then, in July 2015 the Michigan Department of Environmental Quality told Michigan Gov. Rick Snyder that issues with water contamination in Flint were limited to one house and not widespread. At the same time, the Michigan Department of Health and Human Services claimed the elevated blood lead levels in children followed a normal seasonal trend.
The link between Flint’s water switch and elevated blood lead levels in children wasn’tconfirmed until two independent researchers, Marc Edwards and Mona Hanna-Attisha, each put forth their own analyses in September 2015.
While the July 2015 report conclusively showed blood lead levels in children were above normal in the summer of 2014, Edwards and Hanna-Attisha’s combined efforts showed that kids living in areas with lead contaminated water also had elevated blood lead levels.
Using their own data, Edwards’ work found increased lead levels in water, while Hanna-Attisha’s “Hurley Report” concentrated on elevated blood lead levels in children under 5. But the MDHHS contested these findings until Oct. 1, 2015, arguing its data didn’t show the same trends.
Since then, state and city officials have come under criticism for their slow response to the crisis, which so far has resulted in charges against three public officials for official misconduct and other offenses.
According to the World Health Organization, “Young children are particularly vulnerable to the toxic effects of lead and can suffer profound and permanent adverse health effects, particularly affecting the development of the brain and nervous system.”
At an April 13 U.S. House hearing, Rep. Gene Green asked Nick Lyon, director of the Michigan Department of Health and Human Services, about a Feb. 22, 2016, letter that Green and three other House Democrats sent to Lyon. That letter cited the initial July 2015 MDHHS analysis(pages 10-11), and correctly stated that the analysis “confirmed a spike in blood lead levels” in children under 16 during the summer of 2014. Green then asked Lyon a question that was originally posed in the letter. The exchange starts at 1:03:45:
Green, April 13: Why did the Michigan Health and Human Services conclude that the spike was not related to the water supply?
Lyon: Well, I think when that initial analysis was done the staff that worked for me felt that it was, there was seasonal fluctuations within that, within the data that drove the changes over that first summer . When they compared it to prior years, it was within range of years before.
But the MDHHS’ initial analysis showed the opposite. In the next section we’ll explain how and why the MDHHS’ initial analysis of children’s blood lead levels for summer 2014 didn’t conform to seasonal variation or fall “within range of years before,” as Lyon claimed.
Can’t Blame the Seasons
Lead levels in children and water do normally fluctuate seasonally for a number reasons, researchers Edwards and Hanna-Attisha told us by email. “Warmer temperatures mean more lead leaches out of lead pipes – that’s why you should never use warm tap water,” said Hanna-Attisha, a pediatrician at the Hurley Medical Center in Flint.
In the summer, kids may also be exposed to more lead from soil because they tend to play outside more, said Edwards, an environmental engineer at Virginia Tech. There is also increased lead exposure from dust because people tend to keep their windows open in summer, both researchers noted.
Overall, it’s “[v]ery common to see a peak [in blood lead levels] in summer,” said Edwards. Still, even summer lead levels fall within an expected range — what scientists call the upper and lower control limits. If data fall outside of that range, researchers have reason to believe that factors other than the normal seasonal variation are at play.
MDHHS’ July 2015 analysis aimed to address exactly this question, namely, did blood lead levels in children under 16 fall within the normal seasonal range for July, August and September 2014 compared with the same months in 2011, 2012 and 2013?
Cristin Larder, the MDHHS researcher who conducted the analysis, concluded in her analysis memo (page 11) that among those dates, only July, August and September 2014 had proportions of elevated blood lead levels “higher than that expected from random variation over time.”
Larder told colleagues in a July 28, 2015, email (page 6) that her analysis “shows that the three months in question are the only ones that lie outside the control limit: in fact, they are the only points that lie well above the mean at all. This doesn’t say anything about causality, but it does warrant further investigation.”
Both Edwards and Hanna-Attisha agreed that the MDHHS’ July 2015 analysis of children’s blood lead levels in summer 2014 didn’t fall “within range of years before,” as Lyon claimed during the hearing. In particular, Edwards told us the “spike was scientifically conclusive” and was “a missed opportunity” to resolve Flint’s water issues earlier.
It was more than two months after Larder’s memo that the Genesee County Health Department declared a public health emergency and told residents not to drink the water.
When we contacted the MDHHS by email and asked about the discrepancy between Lyon’s claim and the July 2015 analysis conclusion, Jennifer Eisner, a public information officer at MDHHS, didn’t answer our question directly. She said, “We are looking at all aspects of this and internal and external reviews are ongoing.”
We also asked Eisner why MDHHS chose to include children under 16 in its analysis, instead of just children under 5. Both Edwards and Hanna-Attisha told us the norm is to only consider lead levels in children under 5. Similarly, the Centers for Disease Control and Prevention notes children under 6 are particularly at risk to lead exposure “because they are growing so rapidly,” among other reasons.
But Eisner didn’t directly answer this question either. She replied that the “data Dr. Larder was provided and asked to analyze was for children younger than 16.”
Why is this important? “Including kids under 16 dilutes the effect of lead in water” and “makes it harder to find the problem,” said Edwards. “But not many people know this.” Regardless, “even in their analysis which included older kids, [MDHHS] still had the proof that there was an increase” outside of the norm for summer, Hanna-Attisha told us.
We don’t know why Lyon gave the House committee information that was contrary to the July 2015 memo’s conclusion. But we can say Lyon falsely claimed this initial analysis showed blood lead levels in Flint children under 16 for the summer of 2014 fell “within range of years before.”