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.
It doesn't appear to control for other confounding factors. There are large correlations between lead exposure and socioeconomic status (inner cities are the most polluted), and between socioeconomic status and life expectancy (healthcare is expensive).
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.
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?
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.
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.
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.
You are begging the question. The claim 'there is no safe level' is based precisely on dubious epidemiological results like this, and this study is already being used to push exactly that claim. I am fine with <10ug in my blood because I am not yet aware of any natural or randomized experiments showing benefits from decreases in that level, as makes sense with any kind of plausible dose-response curve - the last few ug should matter the least.
This "extremely small" argument falls flat, as is well known, pre-industrial levels were < 0.05 ug/dl. That said, I agree the result is suspiciously strong.
> 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).
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.
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".
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.
> 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.
> 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.
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.
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"?
The site guidelines ask you not to editorialize in titles: 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.
These are associations, not causal implications. "Lead kills" is a causal statement, and even "lead associated with X deaths" is a bit leading, and I think that the authors were careful to not say that directly.
Given the experimental evidence mentioned in the introduction of the paper, it's likely that some or many of these deaths could be due to lead, but they could also be due to shared causes. There could be other things that lead to both greater lead exposure and greater cardiac death, for example.
One has to be very very careful with drawing conclusions from surveys such as this one. The standard in epidemiology is usually, association + one potential mechanism, but even with that it doesn't mean that the one potential mechanism is an explanation for all the observed association.
https://news.ycombinator.com/item?id=16611099