“Our children should not have to be worried about the water they’re drinking in American cities. That’s not something that we should accept.”

— President Barack Obama, January 21, 2016 (CNN)


“Nobody listened to the mom, to the activist, to the water expert. But when the pediatrician spoke, that’s when the game changed.”

— Flint, Michigan pediatrician, Mona Hanna-Attisha, M.D., M.P.H. FAAP (AAP News)


Pediatrician Mona Hanna-Attisha had heard enough stories from the families of her patients about the color, smell, and taste of their tap water. 100,000 mostly African-American and poor (40% live below the poverty line) residents of Flint, Michigan were getting sick — rashes, diarrhea, hair loss — even as local officials were saying the water supply was safe. Dr. Hanna-Attisha, a mother of two young children herself, wasn’t having any of it. She had seen results from Virginia Tech water expert and professor, Marc Edwards, that Flint’s water supply — sourced since early 2014 from the Flint River — was 19 times more corrosive than it’s previous water source, Lake Huron. Corrosive water coursing through old city water pipes, Dr. Hanna-Attisha knew, was bad, bad news, especially for the children of Flint who drank the water.

In April, 2014, Flint’s governor-appointed emergency manager made a very bad decision. In an effort to save money, it was decided that the decaying pipeline supplying drinking water to Flint needed to be replaced. That clean, relatively pure water came from Lake Huron, the third largest freshwater lake in the world. The plan was to shut down that old pipeline until a new one would come on line late in 2016 and, instead, source water from the Flint River — a notoriously polluted body of water that was used as an open sewer by the thriving automobile industry and others decades before. Although most of the prosperous-but-polluting industries left the area long ago in search of higher profits (leaving Flint dirty, poor, and abandoned), the discharged toxics continue to this day to leach into the flowing river water, making it highly corrosive and unfit for drinking or bathing. (It should be noted that there are other, additional reasons why Flint River water is so corrosive, including natural mineral leaching from the river bed, as well as the use of de-icing road salts in winter which adds to the abrasive chloride load.) The result could be smelled, tasted, and felt immediately by the city’s residents, whose complaints and protests  were “poo-pood” and ignored by those in charge.

Corrosive water in old city pipes meant one thing to Professor Edwards and Dr. Hanna-Attisha: lead in the water supply. Unless river water — especially water from a polluted source — is meticulously treated, lead will be stripped from old pipes and enter the drinking water. As we learned yesterday on The PediaBlog, drinking lead-contaminated water is a recipe for lead poisoning — a devastating and permanent condition for children to acquire. Madeline Sturgeon says Dr. Hanna-Attisha figured as much and went to work to prove it:

She compared routine blood lead test results for 1,746 kids in Flint before and after April 2014. The percentage of kids in Flint with elevated blood lead levels of 5 micrograms per deciliter or more had doubled since the switch. In certain ZIP codes, it had tripled…

“When we saw the results, we weren’t surprised because it made sense based on the water chemistry and infrastructure,” Dr. Hanna-Attisha said. “But we were still angry and saddened because this could have entirely been prevented.”


Flint’s disaster was also entirely predictable, except that the people who were put in charge of making the fateful decision to change the water source received no scientific input — no public health risk-benefit analysis — to advise them. Nor did they seek out a rapid scientific response when residents, doctors, and other scientists questioned that decision. In fact, Sturgeon says, the political noise machine of know-nothings went into overdrive to deny the science:

Dr. Hanna-Attisha released her data on Sept. 24 [2015], but officials refused to accept the findings. They called her work “unfortunate” and said it fueled public discontentment in a time of “near hysteria.”


In the end, and as usual, science won the day:

Despite a “constant nauseous feeling” and minimal sleep, Dr. Hanna-Attisha stood her ground. Her team had checked and double-checked the data, run p-values over and over again. They knew they were right.

Dr. Hanna-Attisha asked Eden Wells, M.D., the state’s chief medical executive, to take a closer look. The two doctors, who had worked together on immunization promotion earlier in the year, compared Dr. Hanna-Attisha’s results with the testing performed by state epidemiologists. They noticed the state’s sample included children who would not normally drink Flint water.

After reanalyzing their data, state epidemiologists confirmed Dr. Hanna-Attisha’s findings: The water supply was contaminated with lead. Finally, the children of Flint had been heard.

“Kids cannot speak up and say, ‘Hey, pass stricter immunization regulations, or I want to be rear-facing (in a car seat) until the age of 2 or I want to wear my helmet,’” said Dr. Hanna-Attisha. “We have to be their voices.”


The children of Flint, Michigan drank and bathed in polluted Flint River water for a year-and-a-half before the people in charge of the public’s health — people who were appointed, not voted for, and should have known better — recognized this predictable and preventable disaster. Trucking in bottled water, or reestablishing Flint’s water supply to Lake Huron, isn’t going to instantly help the children who have been exposed:

“Now we have an entire cohort of children… that have been exposed to lead,” said Dr. Hanna-Attisha. “And this is a population that is already battling every single toxic stress indicator that you can think of…

“Kids with lead poisoning are asymptomatic… We’re not going to see the impact until in five years when the kid needs special education, or in 10 years when they have ADHD or in 15 years when they’re in the criminal justice system.”


As the news cycle peels away from this debacle and onto the next disaster, we all should learn a few things and keep them in mind for the future:

  1. Emissions of smoke and chemicals don’t magically disappear. Air pollution goes up, gets diluted by cleaner air, but doesn’t disappear; water pollution doesn’t just wash away. Eventually, toxic particles will either enter our lungs in the air we breathe, fall into the soil we grow our food in, or settle into our streams, rivers, and lakes where we get our drinking water. Some people will adapt; others will get sick.
  2. Politicians: listen to scientists! They are smarter than you, are generally not beholden to special interests, and know what they are talking about. Environmental crises and their public health consequences, like lead in Flint’s drinking water, are all predictable by science and, therefore, preventable.
  3. Good health for all children is in everyone’s best interest.


One more thing: When it comes to their children, listen to mothers when they say something is wrong! They know.

They always know!