Is lead poisoning an overlooked epidemic in America?

At 7 months old, Avi Rubin was exposed to lead paint, but his family didn’t know the severity of its effect until they noticed changes in his behavior. After further testing, Avi was one of the millions of children in America who suffered brain damage from lead. 

Eighteen years later, Avi sat beside his mother at the CMAC studios in Fresno, watching years of childhood footage showcased in Rubin’s documentary, “MisLEAD.” Tamara filmed the documentary from 2011 to 2016. She is still finalizing the film. 

CMAC hosted a preview screening in February. 

“I have a brain injury due to lead poisoning, and I have an autism diagnosis, and so, technically, it’s more than a brain injury,” Avi said. 

Lead is a powerful neurotoxin that affects brain development and the central nervous system, according to research by the University of Pittsburgh School of Medicine. It can lead to behavioral disorders and learning difficulties. 

No level of lead exposure is safe for children, but one in three children has blood lead levels at or above five micrograms per deciliter (5 μg/dL), according to the World Health Organization. Around a million people die from lead poisoning each year. 

Tamara Rubin remembered her panic when her doctors called, saying Avi was poisoned. 

“They said we had to move out of our house immediately. ‘Leave with the clothes on your back. Don’t take anything with you. Don’t take any strollers or cribs or anything’…. So it was terrifying,” she said. 

Avi was exposed when contractors were improperly scraping and burning lead paint off Rubin’s house in Portland, Oregon. Tamara said her son’s disabilities correlate with his exposure to lead and are also causal. At that moment, she documented their experience, which sparked her activism career.

“It’s a very complex thing to grow up with because, and just like with anyone who has disabilities, it kind of changes how you are in the world,” Avi told The Collegian.

By the time he was tested, Avi had 16 μg/dL of lead in his blood. Growing up, he developed aggressive behavior, memory loss, low verbal fluency, low reading comprehension and a low attention span. 

“The biggest thing that I have dealt with is people not understanding. Because a lot of people think that lead is a problem of the past and that it’s not really an issue anymore. And they also don’t really understand what lead poisoning is; and what the fine points of the effects are,” Avi said. 

History of lead poisoning

Aric Mine is a Fresno State assistant professor in the Department of Earth and Environmental Sciences, teaching environmental science, geochemistry, biogeochemistry and environmental sampling. 

He teaches his students the history of lead poisoning in the United States. 

“Globally, lead exposure, the severity and the extent of it vary a lot. It depends on where you live and the routes of exposure. So for us in the United States, the most common exposures were through air pollution and continue to be, historically, through leaded piping,” Mine said. 

He said currently, pipes are the top lead source in the U.S. He noted how in 2016, Fresno had brown, discolored water due to poor piping, leaving thousands of residents with undrinkable water. 

Fresno County is one of the highest-ranking counties in the state for lead poisoning rates in children, according to the City of Fresno’s website.

In the documentary, Tamara pointed out that although blood lead testing is mandatory for children, it often isn’t enforced. According to California’s 2020 report on lead poisoning, children with Medi-Cal were less likely to be tested for lead. 

“In Fresno County, children at ages 1 and 2 in Medi-Cal missed nearly half of the required [blood] tests (4,408 of 9,026), despite the fact that 488 children under age 6 with elevated lead levels lived in those areas,” it said in the report. 

Since the late 1900s, lead exposure in the United States has come from four primary sources: water pipes, gasoline exhaust, smelting plants and chipping paint, according to research by UC Berkeley and Harvard. 

In 1924, General Motors and Standard Oil formed the Ethyl Corporation and sold tetraethyl lead, a compound so dangerous that it could kill a person if it was absorbed through the skin, according to the research paper.  

That next fall season, five workers died while making tetraethyl lead at a Standard Oil plant in New Jersey. Two more died at a plant in Dayton, Ohio, in the same year, and more than 60 fell gravely ill, with some suffering from terrifying hallucinations. In the research paper, Cal and Harvard quoted journalist Lydia Denworth, who reported on the lead industry in 2008. 

“Confronted with an early choice between corporate interests demanding absolute proof of harm and health experts insisting on absolute proof of safety,” Denworth wrote, “America chose business.”

In 1914, childhood lead poisoning in the U.S. was thought to only cause death or was seen as a treatable illness. But in 1943, the sentiment changed when 19 out of 20 survivors suffered from “behavioral disorders, learning difficulties and school failure,” according to the University of Pittsburgh. 

Tamara said lead poisoning is preventable, but when it comes to its effect on children, it’s irreversible. 

It took a while for researchers to figure out the effects of lead on children. 

In the 1960s, the Centers for Disease Control and Prevention’s accepted toxic threshold for lead in children was 60 µg/dl. Screening studies in eastern U.S. cities found that 10 to 20% of children in the inner cities had blood lead levels over 40 µg/dl. 

“The focus with kids is because they’re more sensitive to lead exposure, so it’s absorbed into their bloodstream more rapidly. They also put their hands in their mouth a lot more than adults do. So they’re more likely to eat paint chips that could have had lead in them or soil or something that’s contaminated with lead. So it’s for those reasons that kids are often the focus because it’s known to have significant cognitive-behavioral impacts on their development long term,” Mine said. 

Children’s guts absorb lead more readily than an adult’s, and their central nervous system is more vulnerable to toxicants, according to researchers at the University of Pittsburgh. It is affected by the “distortion of enzymes and structural proteins.” It inhibits calcium entry into cells and has a binary impact on neurotransmitter release.

“Higher lead exposure leads to more developmental and cognitive issues you will have long term: difficulty focusing in the classroom, poor performance in educational tests across the board [and] lower IQ,” Mine said. 

The University of Pittsburgh noted how one research project saw children 12 years after their initial exposure to lead. According to the research, children whose lead levels were higher compared to the other kids had more school failure, reading disabilities, lower class standing in their final year of high school and disturbances in fine motor function.

“Parents have frequently reported that after recovery from an episode of acute lead poisoning, their child’s behavior changed dramatically, and they became restless, inattentive, and aggressive,” the research paper stated. 

Mine said average blood concentration with lead dropped after the phasing out of lead in gas and paint in the 1980s. 

In response to new data, in 1991, the CDC revised its acceptable blood lead level limit from 60 to 10 µg/dl. 

Although 5 µg/dl is the current limit, Tamara said it’s still not enough to inform parents about the dangers of lead. 

MisLEAD Documentary 

The documentary started with Tamara Rubin’s activism work in Flint, Michigan, alongside Bernie Sanders. Tamara has become a leading expert in lead poisoning, speaking at multiple universities and news publications; many are archived on her website.  

For the film, she worked with multiple lead experts, from university professors, activists and social workers, and even includes an interview with Noam Chomsky, famous for his work in linguistics and political activism. 

People can also watch the film on Vimeo. The film has music donated by The Who, Maia Sharp and Tom Waits. Jon Fishman, the drummer of Phish, is also an executive producer of the project.

The documentary interviews many other families affected by lead in their homes. Tamara is known for providing free testing services, doing blood tests throughout the country and lead tests at people’s homes. She uses an XRF scanner, which tracks the concentration of lead on certain items. 

From toys, baby bottles, purses and housing structures, Tamara finds high levels of lead in people’s lives and posts what items to watch out for. 

Tamara also calls out multiple lead-based industries, such as Sherwin Williams, saying the “lead industry is deferring blame.” During the filming process, Tamara said Sherwin Williams pressured one of the documentary’s sponsors to pull their name from the film. 

The company’s website has a section warning customers about lead safety, saying exposure to lead dust or fumes “may cause brain damage.”

In response to an inquiry from The Collegian, Sherwin Williams has not commented at the time of this article, saying it is reviewing the questions.  

Tamara’s activism has sparked controversy. She was arrested in Oregon after her previous foundation, Lead Safe America Foundation, was accused of seven counts of theft in the first degree and two counts of welfare fraud. But these claims were eventually dismissed by the Multnomah District Attorney’s Office, according to court records.

 The cost and time of the trial led to the downfall of Tamara’s former nonprofit. She now owns her current business, Lead Safe Mama, and still advocates lead safety.

“My work has been challenged, and they attempted to discredit me. And it’s really hard to recover from having your mugshot easily findable on the internet. At the same time, they destroyed my nonprofit. I decided to continue in spite of all my lawyers saying no,” Tamara said. 

Sarah Lin, a Fresno native and Fresno State alumna with a degree in math and English, has followed Tamara’s work for many years. She had training in construction and remodeling homes. She learned about pre-1978 homes that may have lead-based paint. During her research, that’s when she stumbled on Tamara’s work. 

They met in person when Tamara came to Fresno back in 2021. 

“[Tamara] likes to help families when they’re worried that their homes might be a hazard to their young kids or to their pets, because it affects pets, too,” Lin told The Collegian. 

As a mother of a 4-year-old daughter, she said she’s lucky to have heard about Tamara’s work and lead safety. When she tested her older home in Fresno for lead, Lin said a lot of the house’s surfaces had high concentrations of lead. 

“There was a lot that ranges between 60 micrograms per square foot to just under 200 micrograms per square foot of lead in the dust,” she said. 

Lin said she couldn’t put her baby on the floor due to the dust, so she and her family ended up moving out. Lin noted how the documentary pointed out how costly it is to renovate a home to remove lead. 

“I was lucky to get into a house where I didn’t have to worry about lead. But as far as revamping the house, that’s really hard to do,” she said. “And that’s really costly and a lot of people who try to remodel, or they try to take the lead off, oftentimes the contractor doesn’t know and they don’t know that they can’t be at the house when that’s happening because that’s a huge dust hazard.”

According to “MisLEAD,” renovating a house can average tens of thousands of dollars. 

Lin thanks Tamara for her knowledge about lead, especially as a parent. 

“I’m very lucky because of Tamra. I knew that was an issue, and I was able to take preventative action, and [my daughter has] never tested with an elevated level of lead in her blood,” Lin said. 

Although Tamara’s son Avi was the documentary’s focal point, Tamara’s other children, AJ and Charlie, also had lead poisoning. Charlie was diagnosed with autism, like Avi, and ADHD. 

Tamara said it’s hard for her children to inform and educate others about their disabilities. 

“It is something that is hard for someone to communicate. So as a college student, [Avi] has to advocate for the services to accommodate his disability, and he doesn’t always want to do that,” Tamara said. 

Avi wanted to emphasize the importance of equal treatment for people with disabilities:

“Being a person with disabilities, in recent culture, people say that if someone has a disability, it should be assumed that there are certain things they can’t do. And I’m very opposed to that idea that it means that there’s something you automatically can’t do because people can create workarounds. When my parents talked to doctors when I was younger, they said that I would probably never be able to learn to read, and I have learned to read, and I do a lot of science reading and writing. I just want people to know that if they find that they are disabled, or they know someone who’s disabled, that doesn’t mean that there’s anything that they can’t do.”

Tamara’s documentary had a clear message at the end to test children’s blood and people’s homes for lead because prevention is critical. Mine encourages people to buy test kits at Home Depot and Lowes to test their water

Tamara encourages lead kits for surface items and parents to blood test their kids. 

For college students, Tamara said relying on science is crucial and calls on them to become an activist in their communities. 

“It’s hard to ask people to become activists because it’s challenging and you can face criticism and other challenges because of that. But in the college communities, you want to make sure that if you’re living in dorms, or campus housing that your campus housing is lead free. And there’s no law saying that campus housing for college students has to be lead free,” she said. 

It’s crucial for students and younger people to be a part of the conversation, she added. 

“When you see an object that’s in your home, that you know is toxic, that’s a great opportunity to have a conversation with your parents. And a great opportunity to have a conversation with your teachers,” Tamara said.