
Low-level lead exposure and mortality in US adults - dzdt
http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30025-2/fulltext
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merricksb
Same study discussed here:

[https://news.ycombinator.com/item?id=16611099](https://news.ycombinator.com/item?id=16611099)

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portofcall
From the study, _Deaths from cardiovascular disease have declined strikingly
in the USA over the past 50 years, but this disease is still the leading cause
of death.1 In 2013, cardiovascular disease accounted for more than 800 000
deaths in the USA (about one in every three deaths), with total costs
exceeding US$300 billion annually.1_

To be clear then, this study is claiming that half of all cardiovascular
deaths in the USA per year are the result of lead exposure? That seems very
unlikely given rates of obesity, smoking, and other cardiovascular risk
factors.

I’d also like to know what if any interest the hedge fund listed as a funding
source would have in this. Plus this...

 _We declare no competing interests. BPL serves as an expert witness in
plaintiff cases of childhood lead poisoning in Milwaukee and Flint, MI, USA,
but he receives no personal compensation._

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gwern
And extremely small lead exposure levels at that, too. Not to mention
accounting for much of the SES/mortality correlation - who knew it was so
simple and easy and definitely didn't involve any confounders like genetics?
If you believe that, I have a lead-free bridge I'd like to sell you.

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phyzome
There is no safe (measurable) level of lead in the bloodstream.

Used to be considered safe below 30 µg/dL. Then 10. Now 5, last I heard. I
have no reason to believe the action level will not continue dropping further.

What amount of lead would you consider acceptable in your bloodstream?

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portofcall
Very little, but the question raised by this study is how much lead leads to
death. They’re claiming the answer is very _very_ little, and further claiming
that it accounts for more deaths than COPD, infections, and accidents
combined. They did this based on a survey and blood levels, without taking
many (if any) confounding factors into account.

As to why they’d do this, the lead author’s role as an expert witness for
plaintiffs in cases of lead poisoning seems suggestive.

~~~
pointAndCall
Considering the primary adverse effect of lead poisoning is neurological, and
psychiatric conditions are its fallout, if poor lifestyle choices are the
result of bad decisions, perhaps low-level lead exposure fuels a simmering
sub-clinical hopelessness that defies treatment, and provokes poor self care.

Everybody is such a big fan of LSD microdosing, and maybe this is the other
side of that coin.

~~~
portofcall
Most poeple aren’t a fan of LSD microdosing, including me. I’m a fan of
studies which honestly account for confounding factors and draw a line between
causation and correlation. This ain’t that.

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gshubert17
Wow, that seems high -- 412,000 is 15% of the total number of American deaths
in 2015 which was 2,712,630.

[https://www.cdc.gov/nchs/nvss/deaths.htm](https://www.cdc.gov/nchs/nvss/deaths.htm)

But that seems to be what they're claiming:

> Population attributable fractions were calculated to show the proportional
> reduction in all-cause mortality, cardiovascular disease mortality, and
> ischaemic heart disease mortality that would occur if recorded
> concentrations of lead in blood were reduced to 1·0 μg/dL or lower (≤0·048
> μmol/L). The adjusted population attributable fraction for all-cause
> mortality was 18% (95% CI 10·9–26·1), equivalent to 412 000 (95% CI 250
> 000–598 000) deaths each year (table 2). Adjusted population attributable
> fractions were 28·7% (95% CI 15·5–39·5) for cardiovascular disease mortality
> and 37·4% (23·4–48·6) for ischaemic heart disease mortality, equivalent to
> 256 000 cardiovascular disease deaths and 185 000 ischaemic heart disease
> deaths annually (figure 3).

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dzdt
Its amazing how little of a splash this report made in the media. I guess it
is because it doesn't fit much of a narrative. The biggest sources of lead
exposure were leaded automotive gas and lead-based paint, both of which were
phased out decades ago. There isn't any obvious current event to tie the
reporting to. But the ongoing effect is HUGE as far as medical effects go;
basically second only to smoking.

~~~
phyzome
There's still ongoing exposure from lead paint, which was only phased out in
the US around 1979. And the soil in cities is loaded with lead. People grow
stuff in that dirt and eat the plants, not realizing the risk. Dust gets
tracked in and ends up ingested in various ways as well.

It's a slow burn, and like you said, not linked to well-defined current
events. The most you can say is "government continues not to do much about
pervasive poisoning of population".

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brador
> Dust gets tracked in and ends up ingested in various ways as well.

What's this about? Is dust bad if ingested?

~~~
trav4225
(dust contaminated with lead)

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calibas
By the way, "lead-free" plumbing contains as much as 8% lead, and only in the
past decade were the regulations tightened so that "lead-free" plumbing must
be a weighted average of 0.25% lead or less.

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chiph
> Baseline data in NHANES-III were gathered between 1988 and 1994

They didn't really talk about where the lead came from, but adults living then
grew up during the period when leaded gasoline was in common use (banned by
the EPA in a five year phase-out period starting in 1995). As well as when
lead-based paint was used in homes (it's use was banned in the US starting in
1978). I'd like to see another study in a few years for people born after
2000.

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jaclaz
This seems to me like "weasel wording":

> Although reducing the amount of lead in blood might cut a patient's risk of
> cardiovascular disease mortality, it is more accurate to view this study as
> estimating how many deaths might have been prevented if historical exposures
> to lead had not occurred.

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aculver
Is anyone familiar with any other research that would allow us to compare this
to other developed nations?

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strictnein
Wouldn't almost all developed nations have utilized and then phased out lead
paints?

~~~
stevenwoo
There was some thread yesterday that brought up that all small propeller
driven planes/GA in the world use leaded fuel still because it was simpler to
keep that instead of forcing a changeover. So not only is it constantly spewed
out but also in miniscule quantities in every farm product that gets crop
dusted in the USA.

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gwbas1c
Is there a laymen's summary?

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epistasis
The current headline, "lead kills 412k/year" is an inaccurate representation
of the linked paper. That type of statement is not in the paper.

Keeping that type of phrasing, saying something like "Lead _might_ kill up to
412k/year" would be in the realm of reasonable.

This type of headline manipulation is how the media turns good science into
bad science.

~~~
dzdt
The paper says: "The adjusted population attributable fraction for all-cause
mortality was 18% (95% CI 10·9–26·1), equivalent to 412 000 (95% CI 250
000–598 000) deaths each year."

My opinion is still that translates better to "kills 412k per year" than "
_might_ kill _up to_ 412k per year."

I could see "might kill up to 598k per year" or "kills at least 250k per year"
from their confidence interval.

Why do you think it should say "might" and "up to"?

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dang
The site guidelines ask you not to editorialize in titles:
[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html).
Cherry-picking one detail and putting it in the title is not just
editorializing, it's the leading form of it.

If you want to say what you think is important about an article, please do so
in a comment. Then your view is on a level playing field with everyone else's.

