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Academy Historian Christian Warren, PhD, Has Op-Ed Piece on Lead-Tainted Toy Recalls Published in the Washington Post

An op-ed piece authored by Academy Historian Christian Warren, PhD, regarding the massive recall of lead-tainted toys and the need for stricter testing of imported products appeared recently in the Washington Post (see below text). The article discusses the turbulent past of lead-based paint and the more recent discovery of high lead levels in paint used in toys produced in China, which triggered a recall of 2.5 million toys in June and August. Dr. Warren’s articles call attention to the U.S. Consumer Product Safety Commission’s recall of Thomas & Friends wooden railway toys and collectible Elmo figures, among others, and focuses on the global changes needed to prevent continued use of lead based paint by other nations that export toys to the United States. “If we really want our kids to tickle a lead-free Elmo, we'll find a way to think and act globally,” writes Dr. Warren, who is also author of the book, "Brush With Death: A Social History of Lead Poisoning."

Poison Me Elmo

-by Christian Warren

In June, 1.5 million lead-tainted Thomas and Friends toys headed back across the Pacific. This month, Fisher-Price announced that it was recalling nearly a million toys for the same reason. As with past discoveries of lead hazards, consumers should expect more toy recalls and more calls for heightened vigilance by U.S. companies regarding their overseas suppliers. Chastened companies and their wary competitors are likely to proclaim robust new quality-control measures, but don't expect a meaningful increase in federal oversight.

Each of these is a positive step toward reducing one source of lead for American children. But they are secondary steps at best, slowing an epidemic's spread rather than eliminating the underlying cause. Each is also likely to be somewhat forgotten once the media coverage subsides. For Thomas and Elmo, as with Ethyl and the Dutch Boy before them, primary prevention requires purging the offending heavy metal completely — and globally. There's an instructive parallel between current proposals to curtail toxic imports and the decades-old split over the most expedient approach to preventing childhood lead poisoning in general: the medical approach, which focuses on case-finding and treatment, and the environmental approach, which focuses on detoxification. The first method includes policing the borders by sampling imported toys for lead content; this can be likened to mandatory blood tests for American children. Properly implemented, product testing will find offensive products quickly and get them out of children's hands, just as blood tests will identify those who need treatment and help prompt the elimination of lead in their homes. Yet these steps, while helpful, are merely reactive. They are costly in dollars and in children's health. Ultimately, neither will solve the problem.

In public health and product safety, primary prevention is the gold standard. For lead — a far more pervasive danger than the toys being recalled in recent months — primary prevention entails the costly and politically challenging process of actually removing lead from the environment. It means not merely covering over but safely removing layers of heavily leaded paints in millions of homes, and finding and detoxifying child-accessible lead dust from old paint and leaded gasoline. This is not the simple remedy of not adding new sources; it is the removal of the detritus of our nation's century-long lead binge.

The process is just as expensive and politically challenging for imports — getting our trade partners to remove lead from all their consumer products, not merely those headed for the United States. No doubt Fisher-Price and RC2 Corp., which sold the Thomas and Friends toys, had clear rules banning lead pigments. Apparently, their suppliers chose to see those mandates more as guidelines than actual rules (and reached for the nearest bin of cheap red lead paint when pressed by cost-cutting pressures or simple expedience). True prevention removes that temptation by eliminating any legitimate reason for manufacturers to have red lead around in the first place.

Primary prevention does not make China a scapegoat. Instead, it values the health of Chinese workers and children in other countries who play with lead-painted toys. Nor does it stop with Chinese factories; it sees the threat to workers in India, Ecuador or Mexico as an extension of the threat to American children.

In the final 25 years of the 20th century, Americans made enormous strides in purging lead from the environment and their bodies. Most of this progress came through measures such as eliminating leaded gasoline and banning lead paint. The biggest strides came when lead was seen as a universal threat, endangering wealthy and poor, white and non-white alike. Instrumental, too, was the catalyst of wide-ranging, often surprising, partnerships and shared interests. Activists for many causes — the environment, civil rights, labor, medical care and public health — as well as bureaucrats, academics, concerned companies and lawyers both litigious and civic-minded found common cause in primary prevention.

Companies such as Fisher-Price and RC2 can ramp up economic pressures, making broader and more verifiable demands on their contractors. Americans can demand a more substantial government role in product testing. But if we can also back off the isolationist rhetoric the recent recalls have prompted, and raise the flag of universality, we will find there are many allies ready to work toward making the world lead-free. Organizations such as Barro Sin Plomo in Mexico and Occupational Knowledge International in San Francisco are already finding culturally sensitive, cooperative approaches around the world. If we really want our kids to tickle a lead-free Elmo, we'll find a way to think and act globally. ####

Posted on August 14, 2007

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The 2012-2013 Duncan Clark Lecture - The Affordable Care Act: An Insider’s View

The 2012-2013 Duncan Clark Lecture - The Affordable Care Act: An Insider’s View

Featured Speaker: Sherry Glied, PhD, former Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services

November 19, 2012 - The NYAM Section on Health Care Delivery welcomes Sherry Glied, PhD, former Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, who will deliver the 2012-2013 Duncan Clark Lecture on "The Affordable Care Act: An Insider's View."
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NYAM Report - Federal Health Care Reform in New York State: A Population Health Perspective

The New York Academy of Medicine with support from the New York State Heath Foundation released a new report, Federal Health Care Reform in New York State: A Population Health Perspective.

This report identifies opportunities that build on both the Patient Protection and Affordable Health Care Act (ACA) and New York’s ongoing efforts toward improving the health of its 19 million residents.

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