Reading journal assignment

After reviewing the below readings Discuss the connection between health, environment and society.  

**It is important that you use examples from the readings attached below to support your claims.**

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Bates, Diane. 2009. “Population, Demography, and the Environment.” Pp. 107-124. In Twenty Lessons in Environmental Sociology eds. Kenneth Gould & Tammy L. Lewis. Oxford University Press, Inc.

Rabin, Richard. 2008. “The Lead Industry and Lead Water Pipes ‘A MODEST CAMPAIGN.’” American Journal of Public Health 98.9 (2008): 1584–1592.

Levenstein, Charles and John Wooding. “Deconstructing Standards, Reconstructing Worker Health” in Reclaiming the Environmental Debate: The Politics of Health in a Toxic Culture edited by Richard Hofrichter. (Massachusetts Institute of Technology, 2000).

Film: Chernobyl Heart


American Journal of Public Health | September 2008, Vol 98, No. 91584 | Public Health Then and Now | Peer Reviewed | Rabin

Lead pipes for carrying drinking water were well recognized as a cause of lead poi-
soning by the late 1800s in the United States. By the 1920s, many cities and towns
were prohibiting or restricting their use. To combat this trend, the lead industry
carried out a prolonged and effective campaign to promote the use of lead pipes.
Led by the Lead Industries Association (LIA), representatives were sent to speak
with plumbers’ organizations, local water authorities, architects, and federal offi-
cials. The LIA also published numerous articles and books that extolled the ad-
vantages of lead over other materials and gave practical advice on the installation
and repair of lead pipes. The LIA’s activities over several decades therefore con-
tributed to the present-day public health and economic cost of lead water pipes.
(Am J Public Health. 2008;98:1584–1592. doi:10.2105/AJPH.2007.113555)

Disease Control and Prevention
began to establish acceptable
blood lead levels for young chil-
dren in the 1960s, the concentra-
tion at which blood lead levels
have been thought to have signifi-
cant health effects has steadily de-
clined. That concentration has
been reduced from 60 µg/dL to
the current level of 10 µg/dL,
which was established in 1991.1

Research conducted in the past
few years, however, suggests that
there are health effects below that
level, and that IQ declines at a
faster rate below 10 µg/dL than

| Richard Rabin, MSPH

public concern when more than
half the homes with lead service
pipes were found to exceed the
Environmental Protection
Agency’s (EPA’s) action level of
15 parts per billion.12 Public in-
terest in this matter is evident
from a computer search of gen-
eral interest and business publi-
cations for the period between
January 1995 and April 2007
with the terms water and lead
pipes that yielded 220 articles.13

Recent US history has been
marked by many environmental
and public health crises initiated
or exacerbated by corporate ac-
tors despite knowledge (or rea-
sonable suspicion) that an activ-
ity or chemical exposure was
particularly hazardous. Child-
hood lead paint poisoning,14,15 as-
bestos-related deaths,16,17 and to-
bacco-related diseases and
mortality18 are a few of these.
Here I review the evidence that
lead pipes for water distribution
were installed well after they
were considered a public health
threat and examine the corporate
activities and other factors con-
tributing to their continued use.

Although lead-based paint is the
single most important contributor
to elevated blood lead levels in
children, if just a few micrograms
of lead per deciliter of blood are
of concern and if we are to truly
prevent the health effects of lead
exposure in the United States,
then water, as well as other
sources of lead, must also be ad-
dressed. Water consumption is es-
timated to contribute, on average,
about 10% to 20% of a child’s
total lead intake, and for infants
fed formula, 40% to 60% of their
lead exposure.4

In the past 2 decades, legisla-
tion and regulations at the fed-
eral level have helped to reduce
water lead concentrations.5–7

Nevertheless, lead in drinking
water continues to be a public
health concern. Over the past
several years, significantly ele-
vated lead levels in many cities
have provoked public outcry.
Lead-contaminated water in
homes and schools has been de-
tected in Boston, MA8,9; Durham,
NC10; and Camden, NJ,11 among
many others. In Washington, DC,
in 2004, there was considerable

Lead Industry


Lead Water Pipes


the late 1800s to the early 1900s,
numerous journal articles and re-
ports appeared documenting the
dangers to health of lead
pipes.21–28 One published bibliog-
raphy in 1943 listed more than
100 articles and reports in English
on lead poisoning from drinking
water.29 In 1890 the Massachu-
setts State Board of Health ad-
vised the state’s cities and towns
to avoid the use of lead pipes.19 By
the turn of the century, there was
little doubt in the public health
community that lead water pipes
were to be avoided. By the 1920s,
many cities had concluded that
the engineering advantages of
lead were outweighed by the pub-
lic health risks, and local and state
plumbing codes were revised to
prohibit or limit the use of lead in
pipes for water distribution.19,30


The Lead Industries Associa-
tion (LIA) was formed in 1928 as
the lead industry’s trade organiza-
tion. Its membership encompassed
both producers and users of lead
products and included all the
major producers. Lead mining
and manufacturing was domi-
nated by just 6 companies (all
LIA members) until the 1960s:
the National Lead Company,
American Smelting and Refining,
Anaconda, the Hecla Mining
Company, Eagle Picher, and the
St Joseph Lead Company.31 The
National Lead Company was by
far the largest.32

As would be expected of an in-
dustrial trade association, a central
function of the LIA was to pro-
mote the sale of its members’
products. Lead pipe, of course,
was one of them.

We are endeavoring to keep
abreast of any impending
changes in plumbing codes. . . .

We have also been investigating
the use of lead in service pipe
and other applications. We have
been accumulating useful infor-
mation pertaining to lead and
expect soon to make it the basis
of a modest educational cam-
paign within the limits of the
current budget.33

Although most of the lead in-
dustry’s efforts to promote the use
of lead in plumbing emphasized
the positive (i.e., the advantages of
lead over other materials), there
clearly was some concern that the
potential health hazard of lead
pipes could jeopardize the market
for lead pipes. In his 1929 report
to the membership, the secretary
noted that,

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Although the use of lead pipes
for water distribution has a cen-
turies-old history, installation of
lead pipes in the United States on
a major scale began in the late
1800s, particularly in the larger
cities.19 By 1900, more than 70%
of cities with populations greater
than 30 000 used lead water
lines.19 Although lead was more
expensive than iron (the material
of choice until that time), lead
pipes had 2 significant advantages
over iron ones: they lasted much
longer than iron (about 35 years
compared with 16) and, because
they are more malleable, they
could be more easily bent around
existing structures.19

Concerns about the potential
toxicity of lead from water that
passes through lead pipes were
documented even before lead
came into widespread use. In
1859 a collection of articles was
published presenting the views of
various engineers, physicians, and
public health officials. The editor
of those articles began by noting
the objections raised by residents
of New York City and Boston to
the introduction of lead for service
pipes (the pipes that carry water
from the street main to a building)
and indoor plumbing:

In other cities of the United
States and of Europe the same
feeling has at times more or
less agitated the public mind,
without leading however, thus
far, to any serious modification
of the long established practice
[of installing lead pipes], that I
am aware of, except in Hartford,

With the large-scale introduc-
tion of lead service pipes, numer-
ous public health and newspaper
accounts of lead poisoning from
drinking water began to appear
with increasing frequency. From

Water is much more wholesome from earthen-
ware pipes than from lead pipes. For it seems
to be made injurious by lead, because white
lead paint is produced from it; and this is said
to be harmful to the human body.

Vitruvius, first-century-BC Roman architect and engineer, De architectura

Of late the lead industries have
been receiving much undesirable
publicity regarding lead poison-
ing. I feel the association would
be wise to devote time and
money on an impartial investi-
gation which would show once
and for all whether or not lead
is detrimental to health under
certain conditions of use.33

This public alarm over lead
exposure can be attributed at
least in part to reports in the
popular press. In 1924, the
New York Times reported on a
medical conference that high-
lighted nonindustrial sources of
lead, including lead paint.34

During the Depression, it was
not uncommon for poor per-
sons to use old battery casings
for fuel, and there were news-
paper reports of families being
lead poisoned.35,36


Although subsequent LIA re-
ports implied that the secretary
primarily had lead paint in mind
as the cause of this adverse public-
ity, the association also felt the
need to address the public’s con-
cerns regarding lead pipes. For in-
stance, in 1930 the LIA investi-
gated a case of lead poisoning in
conjunction with the Charleston
Water Works.37 (The findings of
the investigation were inconclu-
sive: lead service pipes had re-
cently been installed, but contami-
nation of the home was possible
because the father was a house

From its inception until at least
the early 1970s, the lead pipe man-
ufacturers and their association
used a wide variety of methods to
promote their products, including
the publication of numerous educa-
tional materials and model stan-
dards, attendance at professional
meetings, and lobbying of local,
state, and federal government agen-
cies. In 1931, the LIA prepared a
booklet and a “model” standard for
lead pipes.39 It also published the
first edition of the book, Useful In-
formation About Lead,40 which de-
scribed the many products made of
lead. The chapter on plumbing ad-
vises that “the best material in a
water service, though it may be
slightly more expensive at first, is
really an economy, and the best
material is usually lead.”40(p74) The
exception, it notes, is

when the water is very soft, or
of swampy or peaty origin, that
lead should not be used, but
under those conditions other
metals are also soluble, so lead
may be used by adding a little
sodium silicate solution to the
water, as is done occasionally–
or using tin-lined lead

The LIA’s 1934 annual meet-
ing minutes record an “intensive”
effort to reverse the downward

trend in the use of lead pipes; con-
tacts are reported with city offi-
cials, master plumbers, and
plumbing associations. Over the
next 2 decades, the LIA continued
to promote lead pipes through
contacts with plumber organiza-
tions and local boards, by lobby-
ing federal agencies, and by pub-
lishing newsletters.

The association issued a bulletin
for distribution to water works
officials. LIA members who pro-
duced plumbing supplies made
donations to the Plumbing and
Heating Industries Bureau. The
usefulness of cooperation with
that organization was clear:

As the Bureau was founded to
promote the wider use of mod-
ern plumbing, it is essential that
the role which lead plays in
modern plumbing installations
be not overlooked. Our cooper-
ation with this Bureau will in-
sure that lead receives ample
and proper consideration.41

A key part of the campaign to
boost sales of lead pipe was the
hiring of an agent to, in the words
of the LIA secretary,

work on our behalf and I am
pleased to report that the work
has more than met with an excel-
lent reception. It has grown so
quickly and so strongly that it has
reached a stage at which it is re-
ally too large a problem for one
man working in the Eastern part
of the United States alone to han-
dle. We have rekindled an inter-
est on the part of master and
journeymen plumbers in the use
of lead. We have pointed out to
municipalities the risks that they
run in advocating substitutes for
lead and have received the en-
dorsement of numerous impor-
tant State master plumbers and
journeymen plumbers associa-
tions with whom the subject has
been discussed. . . .Since the first
of the year, even greater ad-
vances have been made and we
firmly believe that in a compara-
tively short time there will be
growing evidence of the advanta-
geous results accuring [sic] to our
members from this work.41

The report of the LIA’s agent,
Robert Dick, enumerates the
year’s specific accomplishments:

(a) One code approved and put
into operation, requiring lead
wherever it is advisable to use
lead in the plumbing system.

(b) One town enforcing the use
of lead throughout plumbing
systems although not called for
by its code.

(c) Nine cities and towns with
revised codes calling for lead
throughout. These codes now
ready to be submitted to the
various councils for adoption.

(d) Forty-eight cities and towns
working on revisions to require
lead throughout, but with the
codes not yet ready for submis-
sion to council.

(e) Forty-eight cities and towns
in which no immediate action
can be taken due either to polit-
ical or financial conditions, or in
a few cases, to opposition to the
use of lead.41

Although this report does not
mention the health-related reasons
lead had been losing ground to
other plumbing materials, it does
discuss the economic pressures
brought on by the Depression:

The present time is a critical
time for this work because dur-
ing the depression years, the
plumbing industry has experi-
enced intense competition from
the installations of handymen
and others not actually engaged
in the plumbing business so
that the plumbers are now look-
ing for anything that will pro-
tect their interests against these

Dick went on to explain that re-
quiring the use of lead would be
in the interest of professional
plumbers because the installation
of lead fixtures and pipes required
a level of skill that others did not
possess. This self-interest on the
part of plumbers probably ac-
counts for the reported success
that the LIA had in persuading the

American Journal of Public Health | September 2008, Vol 98, No. 91586 | Public Health Then and Now | Peer Reviewed | Rabin


numerous plumber organizations
to endorse the use of lead. Even
into the 1940s, this economic mo-
tivation played some role in
plumbers’ desire to allow or even
require lead. In Denver in 1947,
when a proposal was made to per-
mit iron and steel for domestic
plumbing, the master plumbers
organization blamed “self-seeking
speculative builders,” and one
journeyman plumber was quoted
as attributing the proposal to an
attempt to “move ‘90-day won-
ders’ and handymen into an in-
dustry which protects the health
of the community.”42(p77)

According to the secretary,
1938 was a banner year for the
LIA. The association now had 3
representatives working on its
Plumbing Promotion Program.
Most of their time was taken up
that year by attendance at 24 state
conventions of master plumbers
and by speaking at 19 of them.
Outreach materials were produced
and distributed to plumbers who
were actively attempting to change
their local building codes. The as-
sociation’s trade publication,
Plumbers’ Forum, had a mailing list
of 22500. Plans were announced
to “work with various housing au-
thorities to have lead specified in
the plumbing of . . . large develop-
ments.”43 Plumbing code regula-
tions were changed in Pennsylva-
nia (to require lead for plumbing),
Massachusetts (removal of the 5-
foot limitation on lead), and in
dozens of other cities. In this con-
nection, the secretary reminded
the members that

It must be remembered that
adoption of laws, as above, is
slow work, but once adopted,
make a relatively permanent re-
quirement of lead. In many cities,
we have successfully opposed
ordinance or regulation revisions
which would have reduced or
eliminated the use of lead. We
have prevented elimination of

September 2008, Vol 98, No. 9 | American Journal of Public Health Rabin | Peer Reviewed | Public Health Then and Now | 1587

lead work from examinations
for plumbers’ licenses in New
York and other cities, and have
introduced license examina-
tions with a lead work require-
ment in many places where no
examinations for lead work
were formerly required.43(pp3–4)

In cities where lead had fallen
out of favor for a number of years,
there was the danger that, even if
a revised plumbing code rein-
stated lead as a permitted or re-
quired material, there would not
be a sufficient number of plumbers
trained in its installation and repair.
Consequently, the LIA expended
some effort to train a labor force
skilled in working with lead. Coop-
erating with the Federal Commit-
tee on Apprentice Training, in
1938 the LIA established classes
in several cities, including Chicago;
Pittsburgh; San Francisco; St Paul,
Minnesota; Wilkes-Barre, Pennsyl-
vania; Youngstown, Ohio; and
Phoenix. In addition, it began
preparation of the section on lead
of the Standard Text on Plumbing,
to be published by the National
Association of Master Plumbers.44

The pipe manufacturing mem-
bers of the LIA were also con-
cerned about the failure of lead
plumbing, stemming from poor
quality goods, and thereby leading
to the discontinuation of lead
products. In response, the LIA de-
veloped a series of standards for
various lead plumbing products,
including pipes and caulking. Ac-
cording to the LIA secretary, nu-
merous entities adopted these
standards, including the American
Water Works Association, New
York City, and several other cities.44

In 1940 several federal agen-
cies including the War and Navy
Departments, the Public Buildings
Administration, and the US Hous-
ing Authority were involved in
major construction projects for
“defense building.” As a result,
LIA staff expended much effort in

Washington to ensure the inclu-
sion of lead in the specifications
for plumbing. Their efforts appar-
ently met with considerable suc-
cess, because “lead plumbing is
now included in many Federal
government master specifications
where it had been excluded for
many years.”45 But because these
specifications were only optional,
association staff had to make per-
sonal visits to many of the federal
construction projects to persuade
those in charge that lead was
preferable to other materials.
These efforts were also successful,
according to the secretary.

At the same time, the LIA initi-
ated or continued several activities
that it expected would have long-
term benefits for the lead industry
by institutionalizing the use of
lead in plumbing nationwide:

A simplified standard for lead
fittings was put into effect at the
end of the year. Also the first
steps toward obtaining a Com-
mercial Standard for lead pipe,
traps and bends and calking
lead, promulgated by the Na-
tional Bureau of Standards,
were taken. It is expected that
Federal Specifications for lead
pipe, traps and bends will fol-
low soon after adoption of the
Commercial Standards.45(p6)

An initial success was the publi-
cation in 1940 by the Bureau of
Standards of a new Plumbing
Manual,46 which served as the
basis for the specification of lead
plumbing in federal construction
projects. The manual has a cau-
tionary note: “Lead piping in
water-supply lines shall not be
used unless it has been definitely
determined that no poisonous
lead salts are produced by contact
of lead with the particular water
supply.”46(p14) However, given the
numerous factors that could affect
a water supply’s plumbosolvency,
it is not clear how it could be
known for certain in advance that


American Journal of Public Health | September 2008, Vol 98, No. 91588 | Public Health Then and Now | Peer Reviewed | Rabin

“no poisonous salts” would be dis-
solved in the water.

By the 1940s, the lead industry
had become alarmed at the pub-
lic’s growing wariness of all things
lead, including lead pipes:

There is hardly an outlet for
lead to which one can turn
today without encountering, in
some measure, the question of
the lead hazard to the public. So
fundamental is this problem to
the future welfare of the lead in-
dustries and the continued man-
ufacture and use of many impor-
tant lead products, such as white
lead, red lead, litharge, sheet
lead and lead pipe that unless
some immediate attention is
paid to the problem above and

Lead Alloys, and Lead Compounds,49

the industry continued its promo-
tion of lead service lines; more
than 1500 copies were sold in the
first 2.5 months after publica-
tion.50 However, this edition did
not caution the reader (as it did in
1931) about conditions under
which lead might not be advisable.

Throughout the 1950s, the LIA
continued its outreach to plumb-
ing and related professionals.
Lead, the LIA’s trade journal with
a quarterly publication schedule
and a distribution list of more
than 50 000, carried a steady
stream of articles on plumbing.51

The textbook, Lead Work for Mod-
ern Plumbing,52 which was first
published in 1952, had by early
1956 reached a total distribution
of more than 6500.53

The theme of a continuous, se-
rious threat to the lead industry
because of the public’s alarm over
the danger of lead exposure is
again made explicit a few years
later by the LIA’s secretary:

I cannot overemphasize [the]
importance [of our health and
safety work]. The toxicity of
lead poses a problem that other
nonferrous industries generally
do not have to face. Lead poi-
soning, or the threat of it, hurts
our business in several different
ways. While it is difficult to
count exactly in dollars and
cents, it is taking money out of
your pockets every day.54(p4)

As before, he is most concerned
about lead paint, but he makes
clear that lead pipe sales are also
at risk:

There is a law suit now pending
in Milwaukee in which an apart-
ment building tenant is suing the
owner for $200,000 damages
for alleged lead poisoning from
water passing through the build-
ing’s lead service pipe. Success
of a suit like this could well
mean the end of lead services
not only in Milwaukee, but in
Chicago and many another city,
amounting to thousands of tons

of lead a year. We are working
with the defense, and although
the case does not come to trial
for some months, our latest infor-
mation is most encouraging.54(p4)

Promotional activities contin-
ued at least until 1972, when the
LIA issued the sixth printing of
its text Lead Work for Modern


Given the medical and public
health view that lead pipes were a
clear danger to the public, one
may ask how the lead industry
could persist, with at least moder-
ate success, in promoting and sell-
ing lead water pipes. Several fac-
tors contributed. One relates to
the lingering doubts among water
engineers and water authorities
about the risks of lead pipes.
Throughout the 19th century, at-
tempts had been made by some
physicians to link lead water pipes
to cases of severe illness. How-
ever, these were met with consid-
erable skepticism by water author-
ities, most of the medical
community, and the general pub-
lic: not everyone consuming water
from lead pipes became sick,
many of the symptoms of lead
poisoning mimic those of other
diseases, and the medical tests for
diagnosing lead poisoning were
not well developed. However, by
the early 20th century, publica-
tion of the many medical articles
and reports of the previous 20 to
30 years had made a compelling
case for a relation between lead
water pipes and lead poisoning.19

As indicated above, plumbers
and water works engineers and of-
ficials favored lead pipes for their
durability and other practical ad-
vantages. In addition, an extensive
discussion among water works
professionals and officials at their
meetings and in their publications

I cannot overemphasize [the] importance [of
our health and safety work]. The toxicity of lead
poses a problem that other nonferrous indus-
tries generally do not have to face. Lead poi-
soning, or the threat of it, hurts our business in
several different ways.

beyond what the Association has
already accomplished and is cur-
rently doing, the opposing forces
may grow strong enough to do
us injury which it would take
years of work to correct.47

Between 1941 and 1949, the
LIA reduced its plumbing cam-
paign field staff from three to two.
However, it continued its usual pro-
motional work around lead pipes:

The promotional work in the
plumbing and water works field
continues as in the past . . .
with master and journeyman
plumbers, plumbing inspectors,
instructors and others, to see that
lead is adequately provided for
by plumbing codes through the
country and to see that plumbers
are trained to know how to han-
dle and install lead work.48(p5)

In the LIA’s 1952 book Lead in
Modern Industry: Manufacture,
Applications and Properties of Lead,

not be installed where the water
supply was “soft” (lacking in cer-
tain minerals, primarily magnesium
and calcium) or high in carbonic
acidic (carbon dioxide dissolved in
water).55,56,59,61 The LIA’s Robert
Ziegfeld also advanced this
argument but suggested that con-
ditions that affected lead would
also attack other metals. (He ne-
glected to mention, however, that
other metals, such as iron and
copper, are not as toxic as lead.62)
Another argument in favor of the
use of lead pipes was that over
time a thin coating forms on the
interior pipe surface that prevents
further corrosion. Furthermore,
various chemicals could be added
to the water to reduce the acidity.
However, research and experience
from the mid-1800s to the early
1900s in the United States and
Great Britain provided consider-
able evidence that many other fac-
tors as well (not often discussed by
water works professionals) could
influence the plumbosolvency of a
water supply.19 In other words,
whereas a water supply that is
hard or alkaline is less likely to re-
sult in an unhealthy concentration
of lead, such a result may occur
because of other factors. An ex-
ample was provided by a 1928
study of several towns and cities
in Illinois that had very hard
water. In that study, lead levels
ranged from 0.02 to 0.50 parts
per million (1.3 to 33 times the
modern EPA standard).66

The lead industry also benefited
from the absence, at the federal
level, of the regulation of environ-
mental health hazards. As several
authors have noted, before the
1960s, the federal government did
not play an active role in protect-
ing the public from environmental
or occupational hazards.67–70 In
the Progressive Era of the first 2
decades of the 20th century, the
federal government’s legitimate

role was to investigate hazards and
recommend solutions to the re-
sponsible industry but not to legis-
late changes. In her investigations
of the occupational hazards in sev-
eral industries, including those
with lead exposure, Alice Hamilton
(a pioneer in occupational medi-
cine in the United States) high-
lighted serious health hazards and
made recommendations for their
abatement but did not suggest leg-
islative interference.67 The next 4
decades marked a period of even
less government activism, as man-
ufacturers were assumed to investi-
gate and control the hazards that
they created.67 The public health
disasters of asbestos and lead
paint, noted above, can be seen as
products of this laissez faire era.

Another factor impeding a
greater focus on lead pipes was
the much greater concern regard-
ing infectious diseases compared
with the attention paid to environ-
mental toxins in the first half of
the 20th century.71 Prevention of
water-borne diseases was a partic-
ular focus of attention for profes-
sionals who designed and installed
domestic plumbing. Some indica-
tion of this greater concern about
communicable disease can be
seen from a computer search of
American Journal of Public Health
articles. The search terms water
and cross-connection (a common
cause of infectious disease from
drinking water) yielded 20 articles
for the 1930 to 1950 period,
whereas lead pipes yielded only 3.
Indeed, at least 1 of the National
Lead Company’s advertisements
promoted lead pipes as providing
a more “sanitary” water supply.72


The year 1930 is often given
as the date after which few lead
water pipes were installed in the


clearly indicates that many of them
were not as convinced as their
counterparts in the public health
community that lead water pipes
were an unacceptable health haz-
ard.55–63 This divided opinion can
be seen in articles in professional
journals, plumbing texts, and pub-
lications of more general interest.
For example, the author of an arti-
cle in the Journal of the American
Water Works Association in 1938
believed the dangers of lead pipes
to be exaggerated:

Lead ions seem to have a bad
reputation, although some of it
is not deserved when it comes
to the traces found in most pu-
rified water supplies. If the very
small amounts which persons
ingest by drinking water and
eating food, were as harmful as
some people believe them to
be, there would be many more
cases of lead poisoning than are
known to occur.57(p248)

In 1934 and again in 1945, the
American City, a magazine report-
ing on general and technical de-
velopments in the urban environ-
ment, approvingly reported on the
installation and longevity of lead
service pipes.64,65

On the other hand, Harold Bab-
bitt, a professor of sanitary engi-
neering, strongly opposed the use
of lead water pipes:

Lead is sufficiently soluble in
water to offer a real menace to
health and for this reason its use
in contact with potable water
should be restricted if not prohib-
ited. Tests by the Massachusetts
State Board of Health have shown
lead content as high as 3 to 5
parts per million in natural waters
and an increase of 50 to 100 per
cent, and even more after the
water has been standing in lead
pipe. Since 0.5 parts per million is
considered dangerous to health,
the use of lead in water pipe or in
contact with potable water should
be prohibited.63(p267)

A common, middle point of
view was that lead pipes should

September 2008, Vol 98, No. 9 | American Journal of Public Health Rabin | Peer Reviewed | Public Health Then and Now | 1589


United States,19,30 and this down-
ward trend was almost certainly
the case. However, the reports
and meeting minutes of the LIA
cited above indicate that it had
some success in slowing, and
even in some cases reversing,
that movement. Evidence of con-
tinued installation of lead pipes
comes from other sources as well.
The plumbing codes of some
major cites, including Boston73,74

(JE Richardson, Boston Water and
Sewer Commission, personal com-
munication, January 29, 2007);
Milwaukee, WI54; Philadelphia,
PA74; Denver, CO42; and Chicago,
IL,43,75 still called for lead many
years, even decades, beyond
1930. Besides these major cities,
there is much suggestive evidence,
both direct and indirect, that the
installation of lead water pipes
continued on a significant scale
throughout the United States well
beyond 1930. Cities and states
usually based their plumbing
codes on 1 of 3 model codes: the
Building Officials and Code Ad-
ministrators’ (BOCA) plumbing
code, the International Council of
Building Officials’ Uniform Plumb-
ing Code, and the Southern Build-
ing Code Congress’ Standard
Plumbing Code. All 3 listed lead as
an acceptable material for water
distribution for several decades be-
yond 1930 (until 1981, 1988, and
1977, respectively).76–82

Of course, the listing of lead as
a permitted material in plumbing
codes does not, by itself, mean
that it actually continued to be
used on a large scale. However,
the LIA itself confirmed such use
of lead pipes for water distribu-
tion. At a 1963 symposium on
lead, the LIA’s Robert Ziegfeld
stated that one of the principal
uses of lead in construction was
pipes for water distribution. “Pipe
and extruded products” consumed
20 000 tons in 1962.83

American Journal of Public Health | September 2008, Vol 98, No. 91590 | Public Health Then and Now | Peer Reviewed | Rabin

In 1984 the EPA conducted a
survey of 153 public water sys-
tems across the country to deter-
mine the extent of the use of lead
pipes.75 Most (91) of the systems
in the survey had populations of
over 100 000. Of the municipali-
ties surveyed, 112 (73%) indicated
that they had in the past installed
lead service lines, and 5 specifically
stated that lead had been permit-
ted well beyond 1930. Seven sys-
tems answered that they currently
(as of 1984) used whatever their
code permitted. Chicago acknowl-
edged that it still sanctioned the
installation of lead service pipes.
With passage of the Safe Drinking
Water Act Amendments of 1986,5

installation of lead water pipes
was finally prohibited nationwide.

The number of lead service
lines installed in US cities since
the 1920s probably cannot be es-
timated with any degree of cer-
tainty. In the EPA’s 1984 survey,
approximately 30% of the respon-
dents could not offer any estimate
of the number of lead service lines
remaining in their cities. Neverthe-
less, it can be stated that with so
many large cities that continued to
permit the use of lead pipes, such
as Boston; Chicago; San Diego,
CA; Philadelphia; and Milwaukee
among others, the number is
likely quite significant.


Although most cities in the
United States were moving away
from lead water pipes by the
1920s, it appears that this trend
was not universal. National model
plumbing codes approved lead
into the 1970s and 1980s, and
most water systems based their
regulations on those codes. Fed-
eral guidelines and specifications
also sanctioned lead pipes at least
into the 1950s. Water system en-
gineers were debating the pros

and cons of lead at least into the
1940s. Perhaps most telling was
the active campaign carried on by
the lead and pipe manufacturers’
trade organization, the LIA. To
maintain sales of lead pipe, the
LIA lobbied the government at all
levels and targeted the people
who both designed and installed
water distribution systems with
outreach and educational material
and other resources. The associa-
tion carried on its promotional
campaign into the 1970s.

As noted in the introduction, re-
cent research strongly suggests that
lead exposure has health effects of
public health significance below the
level of concern designated by the
Centers for Disease Control and
Prevention. Indeed, no threshold
for the effects of lead on cognition
has yet been identified.84 The
number of children potentially af-
fected is quite high. More than one
quarter (25.6%) of children aged
1 to 5 years in the United States
had a blood lead level at 5 µg/dL
or higher in 1994 according to the
third National Health and Nutrition
Examination Survey.85 Several re-
cent studies also point to serious
health effects in adults at very low
blood lead levels, including can-
cer,86 cardiovascular disease,86,87

peripheral arterial disease,88 and
death from all causes.86 Therefore,
although lead-based paint is the
most significant source of child-
hood lead exposure, and occupa-
tional exposure is the main source
for adults, we will have to address
the contribution of water if we are
to make acceptable progress in
further reducing blood lead levels.

Although the number of lead
service lines and other water dis-
tribution pipes installed as a result
of the influence of the LIA and its
pipe manufacturing members can-
not be quantified, it is surely sub-
stantial. The American Water
Works Association conducted a

national survey to estimate the
cost of replacing lead service
lines.89 The average cost per re-
placement was $3200, with a
range of $750 to $16 000. The
Washington, DC, water authority
appropriated $300 million to re-
place 23 000 lead service lines,
plus some portion of 27 000 lines
of unknown material.

Despite a voluminous literature
on the dangers of lead water pipes,
and based on such knowledge, a
national trend to restrict and pro-
hibit the use of lead for water dis-
tribution, the lead industry contin-
ued its promotion and sale of lead
pipes for several decades. Note
also that the LIA and its corporate
members carried out a similar
campaign to promote lead paint
long after its hazards became
known14,15 and are currently de-
fending themselves against law-
suits by dozens of cities and
states.90,91 In fact, at least two LIA
members, the National Lead Com-
pany and Eagle Picher, manufac-
tured both lead paint and lead
pipes. Although the use of these
products has long since ended, our
cities and towns, and society as a
whole, are still paying the price.

About the Author
The author is an activist in occupational
and environmental health.

Requests for reprints should be sent to
Richard Rabin, MSPH, 8 Sawin Street,
Arlington, MA 02474 (e-mail:

This article was accepted April 25,

I thank my wife, Meryl Becker, for her
very helpful suggestions for this article.

Human Participant Protection
No protocol approval was needed for
this article.

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