Health & Medicine / Genes & Health

DISCOVER previously published a condensed version of this interview.

Philip Landrigan doesn’t look like a tough guy. With his nest of white hair and vibrant blue eyes, he seems more like an amiable country doctor than a Harvard-trained physician who has fought the world’s most powerful corporations and bullied bureaucrats to protect the public from poisonous pollutants for nearly 30 years.

In the early 1970s, as a newly minted pediatrician, he was dispatched to El Paso, Texas, by the Centers for Disease Control (CDC) to investigate lead poisoning in children living near a lead smelter. His medical sleuthing revealed that even minuscule levels of lead caused profound damage to health and cognition, a discovery that helped propel the phaseout of lead in gasoline in 1976.

It would set the pattern for his career. In the forefront of battles to eliminate environmental toxins ever since, the Boston native has helped show the relationship between asbestos, pesticides, and benzene and human disease. From 1988 to 1993, Landrigan was chairman of the National Academy of Sciences committee whose chilling report showed that children in the United States were steeped in pesticides from a host of environmental sources, resulting in the Food Quality Protection Act. More recently, his cavernous, sparsely furnished office at the Mount Sinai School of Medicine in New York has served as nerve center for tracking the environmental impact of the 9/11 terrorist attacks.

Currently a professor of pediatrics and director of the Mount Sinai Center for Children’s Health and the Environment, Landrigan is hardly ready to hang up his hat. Instead, the 65-year-old scientist is gearing up for his most ambitious project yet: the National Children’s Study, a landmark field investigation that will follow 100,000 American children from as soon as possible after conception to age 21. He hopes the research will identify factors in the environment—cultural, genetic, social, physical, and chemical—that make us more susceptible to disease. He also hopes it will shed light on why rates of birth defects, childhood cancers, asthma, obesity, violence, ADHD, autism, dyslexia, and other learning disabilities are skyrocketing.

Once headed for a career as a surgeon, Landrigan talked with DISCOVER about why he traded in his scalpel for a stethoscope, why he is unafraid of wading into battle against entrenched corporate interests, how he navigates hostile political waters, and what propelled him to become a champion of children’s environmental health.

You planned to become a surgeon. Why the switch to children’s health?
I had an uncle who was an ophthalmologist who did a lot of surgery. I had scrubbed in on operations with him when I was in college, and I had always thought I was pretty good with my hands. But as I went through medical school, pediatrics appealed to me more, both intellectually and emotionally. I like kids, and I thought it was a fascinating exercise to think about how you diagnose and treat disease in small people who can’t talk to you. It taxes your skills to the utmost.

You joined the Epidemic Intelligence Service, essentially the CIA of the CDC, and they sent you to El Paso to sleuth a case. In the process you changed history. What happened?
In winter 1971 the El Paso health department had a director named Bernard Rosenblum who was a transplanted New Yorker. He was concerned about a smelter’s putting out sulfur dioxide that was causing respiratory irritation in children, and so, along with the city attorney, he started a court case against the smelting company, Asarco. In the course of the case, they requested papers through legal discovery, and that’s when they learned that Asarco had released 1,000 tons of lead, 500 tons of zinc, and smaller amounts of cadmium and arsenic into the city’s air over the preceding three years, an amount that was vastly greater than anybody in the health department had imagined. There weren’t any cases of obvious lead poisoning [that is, blatant damage to the brain or other vital organs], but there was an exposure situation and so they asked us to come down and investigate. We reviewed their data and began a small pilot survey of some children who attended a nursery school within a mile of the smelter. It was an economically upscale neighborhood, but it was very much in the polluted zone. You know, usually pollution falls most heavily upon the poor, but it turns out that the University of Texas at El Paso was right beside the smelter and so there was a neighborhood where a lot of university professors lived, and that’s where the nursery school was located. We went in and took blood samples from 30 or 40 little children in the nursery school, and all but two or three had blood levels that were strongly elevated. In those days, an elevated blood lead level was anything greater than 40 micrograms. Today the limit is 10 micrograms, but back then we didn’t know as much.

With all the untested chemicals in the environment, we’re conducting a vast uncontrolled experiment and children are the guinea pigs.

How could you be sure the smelter was to blame?
On the basis of those findings, we went back that summer to do a more systematic survey. We divided El Paso into three concentric circles with the smelter at the center. We went door to door. As you moved away from the smelter, the levels declined so that the pattern corresponded precisely to the levels of lead in the air. We found heavy contamination of dust in people’s homes and heavy contamination of the yard soil. We reckoned that kids were exposed by several routes at the same time. They were directly inhaling the lead that was in the air, and they were certainly transferring lead from dust and soil into their bodies through their mouths.

And yet the children weren’t stuporous or blatantly sick with the kinds of symptoms often associated with lead poisoning. How did you prove the lead was harming them?
I was becoming friends with Herb Needleman, the University of Pittsburgh pediatrician celebrated for his work on lead poisoning. Needleman had not yet published his landmark paper on loss of IQ in children who had lead exposure in the absence of symptoms, but he was already thinking along those lines, and we conversed. I said to myself, well, we have a great opportunity to test that proposition at El Paso. So we went back in the summer of ’73, a year after we did the field studies, and did IQ testing and testing of peripheral nerve function in a group of the kids there. We found that the kids who had the higher lead levels had significant slowing in their motor skills and significant reduction in their IQs—an average of eight points.