Introduction to Public Health Final Exam

Explain why lead is considered to be the single most harmful environmental threat to the health of children in the U.S.

Children are in double jeopardy from the ill effects of lead, because their highest potential for exposure occurs due to their behavioral patterns: children engage in more hand-to-mouth activity than adults, and therefore ingest more contaminants in dust or dirt. This high exposure comes at a time when children's bodies are building their vital organs and bones and lead is particularly toxic to their developing nervous systems. In addition, children's bodies are not as efficient at depositing circulatory lead into their bones, and thus a higher percentage of the total lead in their bodies becomes available to exert toxic effects on their internal organs.

The American system of food production and consumption has been characterized as a disaster for the environment and public health. The investigative journalists Eric Schlosser and Michael Pollan (both highlighted in the movie "Food, Inc.") have demonstrated a strong connection between industrial food - particularly meat and corn - and the obesity and diabetes epidemics. Explain how our modern food system (production and consumption) damages public health and the environment. (see Food, Inc. documents in Industrial Food System folder on Blackboard. Here is the link to watch Food, Inc.: http://vimeo.com/29575879)

- The American system of food production and consumption damages public health because fast food and processed foods are often less expensive than healthier foods like fruits and vegetables because many of the ingredients come from crops subsidized by the federal government. -Families with lower incomes are at a higher risk for obesity because they are more likely to eat cheaper, processed foods rather than more expensive healthier alternatives.

Describe four to six social determinants of health.

-Education -Access to/quality of Health Care -Socioeconomic Status -Neighborhood/Built Environment -Age -Culture -Social Behavior (smoking/not smoking)

Explain what actions are necessary to prevent climate catastrophe, that is, by holding global temperature increases to 2°C and global CO2 levels to about 400 ppm.

-Global Warming Education (of public and elected officials) -Creating a political will to implement a transition away from greenhouse gas emissions -Hold temperature increases to 2C and global C02 levels to about 400 ppm to slow down climate change by creating a low-carbon economy and increasing energy efficiency

Explain why mental illness is one of our most pervasive public health problems in the United States. What evidence is there for this claim? What mental health care problems are still considerable in the United States today? Explain the relationship between mental health/mental illness and life in American advanced capitalist society. Explain how our current mental health care challenges can be traced back to "deinstitutionalization" and the forces that led to "deinstitutionalization." In particular, explain the relationship between deinstitutionalization, homelessness and mass incarceration.

-Mental illness is one of the country's most prevalent public health problem because not much focus is placed on it such that mental illness is the leading cause of disability in the U.S. today and the country has no nationwide program to combat it. -Evidence to back up this claim: 5 million Americans experienced a mental illness last year; 22-23% had a mental disorder in the last year; 28-30% had a substance abuse problem; nearly 30,000 suicides each year; In 2001, homicides and suicides were 2nd and 3rd leading causes of death in ages 15-24; one in five marriages is disrupted within five years, one in three marriages within ten years; in 2002, 29% of high school senior drank 5 drinks in a row during previous 2 weeks, 25% had used drugs in previous 30; widespread abuse of drugs, alcohol, and tobacco in U.S. -Mental health care problems considered in the United States today: how to provide services to the homeless, resolving problems of those with mental illness who are incarcerated, improper treatment and prevention of children and adults (a.k.a. the U.S. likes to overmedicate), lack of comprehensive national program, and serious problems in mental health programming at the local level. -Mental health/mental illness and life in American advanced capitalist society = STRESSSSSSSS (ahhhhhhh!); overexposure to high levels of stressors may result in diseases of adaptation (i.e. ulcers, high BP, impaired immune system function); chronic exposure to stress may result in mental illness; but then if entire communities are living under stress, this may result in a seemingly irrational behavior (i.e. rioting). -Mental health and de-institutionalization: after World War II, there was a large scale discharging of people to less restrictive community housing with some patients (elderly) moved to nursing homes. Forces that led to deinstitutionalization: economics, idealism, legal considerations, and development of antipsychotic drugs. In terms of the relationship between deinstitutionalization, homelessness, and mass incarceration, people who were kicked out from institutions ended up homeless or placed in a position such as using or selling drugs that led them to be incarcerated (relate back to mental health problems of the United States today).

Explain the impact of changing the environment on individual health.

-More effective than trying to change individual behavior -Change focus from blaming the victim -Pioneered in injury control programs -Effective in tobacco control programs -Now thinking of how to apply it to improving diet and physical inactivity

Musculoskeletal injuries (repetitive stress injuries) are the most prevalent form of workplace injury in American workplaces today. Explain how musculoskeletal injuries occur, using the epidemiological model for injuries (agent, host, environment), and considering how energy causes injuries. Give examples of how such injuries occur, including from health care sector.

-Musculoskeletal disorders can be both acute and chronic injury to muscles, tendons, ligaments, nerves, joints, bones, and supporting vasculature. The leading type was repeated trauma disorders (e.g. carpal tunnel syndrome, noise-induced hearing loss). Using the epidemiological model for injures, the agent would be the likelihood that the musculoskeletal disorder would happen (energy). The host would be us, the workers; the environment would be our workplace. Therefore, from an interventionist perspective, it is important that rules are set in place, so the workers avoid suffering from this disorder. -In terms of energy causing injury, "energy that causes injuries can be in several forms, including kinetic, chemical, or thermal. For example, kinetic energy causes motor-vehicle-related injuries, and thermal energy causes burns. Lack of metabolic energy that occurs through external forces, such as during drowning or suffocation, can also be included in the definition of injuries. Energy can be transferred to a human host through vehicles (inanimate objects such as motor vehicles) or vectors (animate objects such as another human). Some injuries require both a vehicle and a vector, such as a gunshot wound that requires a firearm and ammunition (vehicles) and someone to shoot it (vector)." -Specifically, in the healthcare sector, injuries are common. More musculoskeletal injuries are suffered by orderlies, attendants, nurses and nursing aides than workers in any other industry. Back injuries in the healthcare industry are estimated to cost over $7 billion every year. Ironically and unfortunately, the healthcare industry has twice as many workers in the field yet are inspected less. The injuries suffered most often are back pain (usually from helping a patient off a bed), falls, trips, slips, workplace violence, TB, and bloodborne pathogens.

Describe 3 or 4 expected impacts on health from increasing global temperatures of 2°C to 4°C or more.

-Oceans rise = Flooding -Increase in number and severity of heat waves and droughts = increased risk of dehydration/harder to sustain crops = less food -Storm/Weather Changes (Hurricanes Could become more lethal with increasing ocean temperatures)

Explain the importance of achieving parity between mental health care and physical health care in the U.S. What should be done to achieve parity?

-Parity = equal. So, it is EXTREMELY important that mental health care and physical health care in the U.S. are equal because you could have the healthiest heart (physically) in the world but that won't matter if your heart aches emotionally because you are depressed. Also, mental and physical health care play off with each other in that if you are feeling low mentally, you won't take care of your physical self. -First off, funding should be allocated equally so that the amount of money we spend on physical health care is equal to the funds on mental health care! Funding is most definitely one of mental health's biggest problem. Second, mental health should be seen as an illness; this is a hard task to do since this requires changing people's mindset. For example, if someone breaks their arm, chances are people would say to go to the hospital. However, if someone is having a panic attack, the knee-jerk reaction shouldn't be to "get over it."

In each fatality (4,500 in 2012) and injury (4 mill. to 8 mill. in 2012) or work-related illness, the General Duty Clause of the OSH Act was not followed. What are the reasons (social, economic, and political) for the fact that 4500 people die each year on the job? Explain what should be done to better prevent occupational fatalities, illnesses, and injuries. What should Congress and the Obama Administration do to improve worker health and safety, and prevent death and injury at work? What should be done so that employers (and employees) follow the General Duty Clause of the OSH Act and fatalities and injuries are prevented?

-Social: employers give the problems to society when it comes to work-related illness such that it is not being documented and workers are not paid through workers' compensation when it does happen to them; economic: some companies don't bother upgrading their equipment that may come at the expense of the worker when it is much more expensive to deal with a worker that has is ill or injured; political: socializing losses is very common in that when large losses occur for speculators or businesses, they are able to successfully lobby government for aid rather than face the consequences of said losses. It is also important to note that there is a lack of enforcement (not enough inspectors to go to workplaces), low fines, and the consequences for employers are nothing compared to the event that happened. -Um, people need to start following the rules from the employers that need to provide a safer workplace to the employees that need to follow the rules in the first place! However, this is what the slides say: Safety and health programs: hire and maintain healthy workers. Pre-placement exams. Disease prevention programs: control diseases. Safety programs: reduce injuries. Health promotion programs: boost morale and productivity, reduce medical costs. Employee Assistance Programs: assist employees in overcoming personal problems. -What should be done under Congress and Obama Administration as well as how do we make sure employers and employees are following the General Duty Clause is followed? Raise the amount of workers so that more places are inspected in a short amount of time; this can prevent SOOOOOOOOO much work-related problems from machines and equipment that needs to be upgraded or just seeing what could be improved. Make it so that employers (especially the elite) can't just lobby their way out of this; this is NOT FAIR and it goes back to Intro to Public Health's main theme of social justice vs. market justice. A side note of this is that it is important too that the violations and fines that employers get are actually what they deserve to get - you know? Employers can't simply brush a miniscule fine for something so great as a life of a worker. Increase OSHA's budget so that it can do what it does; OSHA's budget increased 7.68% from 2009 to 2010, and the Obama administration has asked for another 2.5% increase for 2011. Increased inspections at companies with patterns of safety negligence, conducted mandatory follow-up inspections, and inspected other workplaces under the same ownership as those where severe problems have been found. Peace, guys ✌

Explain the role of stigma in diagnosing, treating and preventing mental illness. How important is stigma and what should be the role of public health in addressing stigma of mental illness?

-Stigma prevents people from getting diagnosed and therefore from getting treated for mental illness. A stigma is a mark of disgrace associated with a particular circumstance, quality, or person; stigma most definitely need to be addressed and the way that can be done is by opening the conversation on mental illness. Those who suffer from mental illness ought to not be afraid that they will be judged for seeking treatment. -This is really sad guys :(

The U.S. is ranked 27th in the world in infant mortality rate, despite having a declining infant mortality rate over the past four decades. What helps explain why the U.S. rate is significantly higher than the rest of industrialized world? What are the causes of infant mortality in the U.S.? What are the social factors in infant mortality? What is the leading cause of infant mortality among black Americans?

-The U.S. infant mortality rate is significantly higher than the rest of the industrialized world because of poverty. Poverty creates dire environmental, behavioral, nutritional, medical, and social consequences for the unborn child and mother. With that, maternal behaviors such as smoking, drinking, and use of illegal drugs are also observed reasons as to why the U.S. is ranked higher. -Causes of infant mortality rate in the U.S. are the following: birth defects (leading cause overall), premature and low birth weight (leading cause among black Americans), and sudden infant death syndrome (SIDS). -Social factors in infant mortality: poverty, environmental hazards, poor nutrition, maternal behaviors (said above), young maternal age, violence, stress, lack of social support, and lack of prenatal care (or access to one).

The "war on drugs" has helped make the mass incarceration rates in the U.S. the highest in world, with 2.6 million people in prison. Michelle Alexander has described the impact of the "war on drugs" on black communities in the U.S. Name three impacts of the "war on drugs" on black communities in this country. What are implications for the overall health of black communities in the U.S. of the "war on drugs"?

-Three impacts of the "war on drugs" on black communities: a. our Fourth Amendment protections against unreasonable searches and seizures have been eviscerated (completely ignored). stop and-frisk operations in poor communities of color are now routine. b. the arbitrary and discriminatory police practices the framers aimed to prevent are now commonplace. c. the drug war, though, has been waged almost exclusively in poor communities of color, despite the fact that studies consistently indicate that people of all races use and sell illegal drugs at remarkably similar rates. d. more than two million African Americans are currently under the control of the criminal-justice system -- in prison or jail, on probation or parole. e. so, since most of those who are mass incarcerated are african americans, they are often restricted from doing many things such as casting a vote, getting a job, finding housing, etc. -It's important to note that due to the impact of "war on drugs" on black communities, we have managed to create a massive system of control that locks a significant percentage of our population -- a group defined largely by race -- into a permanent, second-class status.

Describe 3 public health interventions to change unhealthy behaviors.

-Tobacco Regulation -Prohibition -Efforts to reduce inactivity and promote healthy eating to decrease obesity

Explain the purpose of the Occupational Safety and Health Act of 1970. What is the OSHA General Duty Clause and how does it relate to the purpose of the OSH Act? What is the responsibility of the employer? What is the responsibility of the worker (employee)?

-purpose: to ensure that employers in the private sector provide employees with a working environment free of recognized hazards that can cause death or serious harm. -General Duty Clause: employer must provide a work environment free of recognized hazards; relates to the purpose of the OSH Act because the employer must provide a safe workplace. -The employer is ultimately responsible for providing a safe workplace (sounds repetitive, I know). Employees must work safely and must follow the rules that are implemented.

List the leading 3 to 4 actual causes of death in the U.S.

According to the CDC website: Heart Disease Cancer Respiratory Disease Accidents

Explain the reasons for the rise in obesity and across a broad spectrum of Americans, particularly younger Americans, over the past 25 years. What role do the built environment (how cities and neighborhoods are laid out) and our American capitalist system (our economy and society, including our food system) play in the rise of obesity?

Built environment: -Past few decades: Shift to motor vehicles as a mode of transportation instead of walking -Kids are spending more time watching tv and playing video games and less time exercising -Quality/lack of sidewalks (parents might prefer to drive their kids rather than let them walk due to any potential safety hazards) -Availability of recreational facilities -Rural/urban areas where unhealthy food options (fast food) are prevalent over healthier alternatives Capitalist System: -Emphasis on unhealthy foods in the Food industry, cheap processed foods are cheaper and sold more often than healthy foods.

Explain what should be done (policies, programs, practices) to reverse the surge in obesity and prevent it in the future. Think as broadly as possible about confronting factors of the built environment and the American capitalist system in order to prevent obesity in the future.

Built environment: -Make sidewalks safer to encourage walking -Increase availability of recreational facilities/healthy food options Capitalist: -Organized campaign to educate the public about nutrition -Individual and collective efforts to buy healthier food (the food system responds to consumer demand (wal-mart switched to rBST-free milk as a result of consumer pressure) -Gov't programs/laws to prevent food companies from providing misinformation about food products -Gov't regulation of the food industry similar to regulation of the tobacco industry -Media campaign to provide incentives for eating healthy foods and discourage unhealthy foods

Explain how corporate power works against public health and environmental regulations, as illustrated in "Kids and Chemicals."

Corporations have a long record of avoiding responsibility to the public. They use their vast resources to fight environmental regulation, to fight public health research findings, and to fight compensating communities for the harm they have caused. They essentially just do everything in their power to avoid responsibility of the incidents that occur under their jurisdiction.

Who is Lois Gibbs and what role did she play in environmental health?

Homemaker in Niagara Falls, NY In 1977-78 fought to have her neighborhood cleaned up and relocated after devastating toxic contamination from a Love Canal waste dump. Successfully fought for federal and state funding of cleanup of hazardous waste sites in U.S., the Superfund law (1980).

Explain the different levels in the socio-ecologic model of health behavior.

Individual Level: Knowledge, attitude, skills Interpersonal Level: Social Network (family, friends) Organizational Level: Environment Community Level: Cultural Values, Norms Public Policy Level: local, state, national laws/policies

Explain possible sources of high blood lead levels in young children.

Lead water pipes - infecting the water. Lead in house paint in homes built before 1978 - inhaling/eating chips of paint. Imported items such as clay pots and house remedies. Consumer products such as certain candies, make-up, and jewelry.

Explain the effect of socioeconomic status on health. Why does socioeconomic status (SES) have an impact on health and healthy behavior.

Low SES=Less Health Care Access + less access to healthy food = Greater risk for diseases High SES=Greater Health Care Access + More access to healthy food = less risk for diseases

The film "Unnatural Causes" (episodes called "When the Bough Breaks" and "Place Matters") demonstrates that there are significant health disparities along racial lines in the United States. Explain why there is such a disparity between the health status of white Americans and the health status of black and Hispanic Americans. What are the fundamental economic and social reasons for the racial gap in health? In particular, what role does stress play in racial health disparities? (see www.unnaturalcauses.org, and the related documents in the Maternal Health and Health Behavior folders on Blackboard)

Many people of color experience a wide range of serious health issues at higher rates than do whites, including breast cancer, heart disease, stroke, diabetes, hypertension, respiratory illness and pain-related problems. Class certainly plays a role. Because of historical discrimination and structural racism, people of color are likely to be less wealthy, to have less education and to live in segregated communities with underfunded schools, insufficient services, poor transportation and housing, and higher levels of exposure to toxic and environmental hazards. It is hypothesized that black and Hispanic Americans are subjugated to "subconscious racism" such that people that are of this race are in constant alert to be discriminated against. This creates constant stress in the body and affect long term health. This constant stress might be at such a low level that it can't be detected, but it is hypothesized to be happening in these specific races. This creates racial disparity because those that are under chronic stress are more likely to fall for chronic diseases such as cancer and hypertension; AND, since many don't have the resources in the first place, then it creates this vicious cycle! 👎

Explain the impact of prohibition (e.g. drugs, alcohol) on promoting good health.

Prohibition was the U.S. government's way of banning the use of alcohol, lol, by passing a constitutional amendment in 1919. It was repealed (uhh taken down) because the amendment BACKFIRED on the government with the rise of organized crimes and underground bars. In terms of promoting good health, the implementation of Prohibition did convince many people to cut down on or quit their use of alcohol; also, the rate of liver cirrhosis (prevalent in alcoholics) declined in half because of this! Also, our attitude towards drugs now is the same attitude many had during the implementation of Prohibition. That's why many people argue that the impact of prohibition in terms of drugs is creating a society that is vulnerable to corruption and "lost hope" mentality.

How do pesticides threaten human health? Who is most at risk for pesticide poisoning?

Pesticides are, by nature, used to kill organisms on plants, crops, etc. Therefore, a human who exposed to even the least toxic of these chemicals can develop health problems or be poisoned. The people who are most at risk for pesticide poisoning are the people working with it if they are not properly geared up to prevent the pesticide from entering their bodies. Children, pregnant women, and the elderly are also especially susceptible.

Explain the impact of regulation on protecting health and promoting good health.

Regulation is done by passing and enforcing laws. It is effective but often unpopular. For example, there are laws against murder and assault (well obviously) to protect the people; but there are traffic laws such as stopping at red lights and not overspeeding aimed to achieve the same goal. The problem is people don't really follow this one (i.e. many go beyond the speed limit and drive while intoxicated, to name a few). Overall, regulation has a good impact in protecting health and promoting good health BUT ONLY WHEN IT IS FOLLOWED BY THE PEOPLE.

In the "Kids and Chemicals" video, CDC epidemiologist Richard Jackson states that environmental epidemiology - finding the environmental risk factors for non-communicable diseases such as cancer - is more difficult than infectious disease epidemiology. Explain what he means.

The causes of disease in environmental epidemiology are often much slower and more long term when compared to the causes of disease in infectious disease epidemiology, making environmental exposures harder to detect than infectious exposures.

Describe the impact of psychological factors such as stress and social support on health. How does stress impact health? How does social support impact health.

Stress: -Prolonged stress can lead to mental illness (depression) -Prolonged stress can lead to a weakened immune system Social Support: -Increases ability to cope with stress -Boosts an individual's well-being/increases mental health -Strengthens immune system

What is Superfund? What is RCRA? What is SARA? How do they all relate to hazardous waste? (see power point file "Environmental Health and Safety Lecture")

Superfund is the fight to clean up waste sites. Superfund law (Comprehensive Environmental Response Compensation and Liability Act) passed in 1980 RCRA = Resource Conservation and Recovery Act of 1976 - waste management act: source reduction, product reuse and recycling, disposal, composting, sanitary landfills (leachates), combustion (incineration). SARA: Superfund Amendment and Reauthorization Act 1986 Worker and Community Right-to-Know (part of SARA, 1986) Emergency Planning and Community Right-to-Know Act, 1986 (part of SARA) Emergency notification Toxic Release Inventory

Explain the importance of community activism in the PBS video "Kids and Chemicals." (here's the video link: http://vimeo.com/64088351).

The importance of community activism is clear. If only a few people are aware and fighting, not much can be accomplished. If the whole community is aware and fighting, the government and corporations are much more likely to listen in fear of being exposed for being negligent or doing something wrong.

Explain the differences between federal exposure limits (acceptable risk) and a precautionary approach. For each approach: What are the guiding questions? Who has the burden of proof?

The permissible exposure limit (PEL or OSHA PEL) is a legal limit in the United States for exposure of an employee to a chemical substance or physical agent. They have not been updated since 1970. Guiding question is how much exposure is safe for workers? The workers or whoever is harmed has the burden of proof. The precautionary principle or precautionary approach to risk management states that if an action or policy has a suspected risk of causing harm to the public or to the environment, in the absence of scientific consensus that the action or policy is not harmful, the burden of proof that it is not harmful falls on those taking an action. (Guiding questions are implied here)

What is sick building syndrome?

The term "sick building syndrome" (SBS) is used to describe situations in which building occupants experience negative health and comfort effects that appear to be linked to time spent in a building, but no specific illness or cause can be identified. The complaints may be localized in a particular room or zone, or may be widespread throughout the building.

Explain the scientific consensus about the connection between human activity and global warming.

There is scientific consensus that global warming is occurring and that human activity is contributing to it. Heat-trapping greenhouse gas emissions from fossil fuel burning has been a large contributor to the earth's warming over the last 50 years

To what extent do people choose their own health?

Uhh, this is a pretty subjective question. I think we decided in class on a decent 7.5. It is important to note that people are born with genetic conditions, in which they have no control over that might affect their health. Also, the video Place Matters showed the importance of the environment on our health. For example, those people living in a food insecure place do not have access to nutritional foods that could greatly help their health status. It is up to our control, however, the lifestyle choices we make that can affect our health (e.g. getting enough exercise, drinking moderately, living a positive outlook - link between physical and emotional health, etc). Hope this question was answered..?

Explain why workers are considered to be "guinea pigs" when it comes to exposure to harmful chemical substances.

Workers are considered to be "guinea pigs" when it comes to exposure to harmful chemicals because employers have been known to take safety short-cuts in order to save time and money. This essentially leaves workers to monitor their health on their own. Even when someone is hurt or killed, the companies keep it quiet and hide the incident by not reporting it. They do this because it is cheaper this way.

Name two important treatment options for children and adults suffering from a mental illness or mental disorder.

a. Psychotherapy -face to face interviews -cognitive behavioral therapy - involves stress management, relaxation, and training to change behavior b. Medications (a.k.a. psychopharmacology)

Nearly 50% of all Americans experience one mental illness in their lifetime. Name three risk factors that this experience might be associated with.

a. biological - genetic factors (i.e. schizophrenia, bipolar disorder, autism) b. psychological - dysfunctional family or environmental factors c. sociocultural - cultures that make people of certain gender identity feel inferior or place taboos on mental disorders such as depression

What are the most common ways to get lead poisoning?

house paint from before 1978 toys and household items painted before 1976 toys made and painted outside the United States bullets, curtain weights, and fishing sinkers made of lead pipes and sink faucets, which can contaminate drinking water soil polluted by car exhaust or chipping house paint paint sets and art supplies jewelry, pottery, and lead figures other types of art hobbies and projects storage batteries Kohl or kajol eyeliners(used more in other countries) Some traditional ethnic medicines

As mentioned in the film "Kid and Chemicals," environmental epidemiology (as opposed to communicable disease epidemiology) is extremely challenging. Explain the challenges of environmental epidemiology. (See file on "Kids and Chemicals" in Environmental Health folder on Blackboard)

•"Environmental epidemiology, doing investigations of epidemic things in the environment, has been held back by good measures of what's in people. It is much more difficult than infectious disease epidemiology. Environmental exposures are often much lower, much more long term. It's a different kind of investigation." •Environment health is complicated: there are often several, even many, interacting causal factors.

Explain why some companies continue to release dangerous chemicals into the environment above the limits allowed by federal law, as illustrated in the Herraclanium, Missouri example in "Kids and Chemicals," and as illustrated by the process of fracking (hydraulic fracturing).

•Industry and government lied, doctors said nothing to parents. •Community included workers ---> hard to speak out. •People can't sell homes. Why? •Company didn't understand why lead contamination became an issue. Why? •Community demanded answers, help from government, and cleanup of contamination. •Community leader. Leslie Warden, town alderwoman, organized the community to demand that industry and government take action. •Doe Run Company representative: "People become more aware or tolerate less risk than 10 years ago." •Company escaped regulation for years. Government allowed high levels of pollution as long as company was improving. •Finally, Federal government action. Congressman Gephardt demanded Heruclanium be put on Superfund priorities list for hazardous waste cleanup.

Explain the role of industry in federal efforts to ban leaded gasoline, as illustrated in "Kids and Chemicals."

•Industry blocked the ban on lead in gasoline for a long time •Europe banned lead in paint in 1920s. •U.S. ignored the science, promoted lead in paint for 40 years. •Lead put in gas in 1920s, against scientists' objections that it would lead to lead poisoning epidemic. •EPA phase-out of lead in gasoline, 1973-1996. Average blood lead levels in kids dropped from 16 (1970s) to 2 micrograms per deciliter since lead taken out of gas. •Lead industry attacked Needleman's research à called it junk science, scientific misconduct. They said only high levels would do harm. Propaganda worked for a while. •Industry shown later to be wrong. They paid their "independent" scientists who had challenged Needleman --- industry science.