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When leaded gasoline was first developed in the 1920s, medical experts were quick to warn of the public health catastrophes it would cause. Yet government regulators did not heed their advice, and for more than half a century, nearly all cars used leaded gasoline, which contributed to a nationwide epidemic of lead poisoning. By the 1970s, 99.8% of American children had significantly elevated levels of lead in their blood. Unleaded tells the story of how crusading scientists and activists convinced the U.S. government to ban lead additives in gasoline. It also reveals how, for nearly fifty years, scientific experts paid by the oil and mining industries abused their authority to convince the public that leaded gasoline was perfectly harmless. Combining environmental history, sociology, and neuroscience, Carrie Nielsen explores how lead exposure affects the developing brains of children and is linked to social problems including academic failure, teen pregnancies, and violent crime. She also shows how, even after the nationwide outrage over Flint’s polluted water, many poor and minority communities and communities of color across the United States still have dangerously high lead levels. Unleaded vividly depicts the importance of sound science and strong environmental regulations to protect our nation’s most vulnerable populations.

An increasing body of research has linked the geographic distribution of lead with various indicators of criminal and antisocial behavior. The current study, using data from an ongoing project related to lead exposure in St. Louis City, MO, analyzed the association between aggregate blood lead levels and specific indicators violent crime within the city. Ecological study. St. Louis, Missouri. Blood lead levels. Official reports of violent crimes were categorized as 1) crimes involving a firearm (yes/no), 2) assault crimes (with or without a firearm), 3) robbery crimes (with or without a firearm), 4) homicides and 5) rape. With the exception of rape, aggregate blood-lead levels were statistically significant predictors of violent crime at the census tract level. The risk ratios for each of the outcome measures were as follows: firearm crimes 1.03 (1.03-1.04), assault crimes 1.03 (1.02-1.03), robbery crimes 1.03 (1.02-1.04), homicide 1.03 (1.01, 1.04), and rape 1.01 (0.99-1.03). Extending prior research in St. Louis, results suggest that aggregated lead exposure at the census tract level predicted crime outcomes, even after accounting for important sociological variables. Moving forward, a more developed understanding of aggregate level crime may necessitate a shift toward studying the synergy between sociological and biological risk factors such as lead exposure.

Lead exposure has been associated with psycho-neurological disorders. Elevated blood lead levels have been found in shooters. This study assesses the association between the blood lead levels of shooters and their levels of aggression. An analytical cross-sectional study was conducted in Gauteng, South Africa. Participants were recruited from four randomly selected shooting ranges with three randomly selected archery ranges used as a comparison group. A total of 118 (87 shooters and 31 archers) participants were included in the analysis. Aggressiveness was measured using the Buss-Perry Aggression Questionnaire. Shooters had significantly higher blood lead levels (BLL) compared to archers with 79.8% of shooters versus 22.6% of archers found to have a BLL ≥ 5 μg/dL (p < 0.001). Aggression scores were significantly higher in shooters (p < 0.05) except for verbal aggression. In the bivariate and regression analyses, shooters with BLLs ≥ 10 μg/dL were significantly associated with the hostility sub-scale (p = 0.03, adjusted odds ratio (OR) 2.83, 95% confidence interval (CI) 1.103–7.261). Shooters have a significantly higher BLL and aggressiveness compared to archers. However, elevated blood lead levels were significantly associated with hostility only. Interventions need to be put in place to prevent continued exposure and routine screening of populations at risk should be implemented.

Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2–7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5–7·0]), and household air pollution from solid fuels (4·3% [3·4–5·3]). In 1990, the leading risks were childhood underweight (7·9% [6·8–9·4]), household air pollution from solid fuels (HAP; 6·8% [5·5–8·0]), and tobacco smoking including second-hand smoke (6·1% [5·4–6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2–10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4–1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, Andean Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, most of Latin America, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. Bill & Melinda Gates Foundation.

Objectives. To highlight contextual factors tied to increased blood lead level (BLL) risk following the lead-in-water contamination in Flint, Michigan. Methods. Using geocoded BLL data collected in 2013 and 2015 and areal interpolation, we predicted BLLs at every residential parcel in the city. We then spatially joined social and built environmental variables to link the parcels with neighborhood-level factors that may influence BLLs. Results. When we compared levels before and during the water crisis, we saw the highest estimates of predicted BLLs during the water crisis and the greatest changes in BLLs in neighborhoods with the longest water residence time in pipes (μ = 2.30 µg/dL; Δ = 0.45 µg/dL), oldest house age (μ = 2.22 µg/dL; Δ = 0.37 µg/dL), and poorest average neighborhood housing condition (μ = 2.18 µg/dL; Δ = 0.44 µg/dL). Conclusions. Key social and built environmental variables correlate with BLL; such information can continue to guide response by prioritizing older, deteriorating neighborhoods with the longest water residence time in pipes.

Childhood lead exposure is a purported risk factor for antisocial behavior, but prior studies either relied on indirect measures of exposure or did not follow participants into adulthood to examine the relationship between lead exposure and criminal activity in young adults. The objective of this study was to determine if prenatal and childhood blood lead concentrations are associated with arrests for criminal offenses. Pregnant women were recruited from four prenatal clinics in Cincinnati, Ohio if they resided in areas of the city with a high concentration of older, lead-contaminated housing. We studied 250 individuals, 19 to 24 y of age, out of 376 children who were recruited at birth between 1979 and 1984. Prenatal maternal blood lead concentrations were measured during the first or early second trimester of pregnancy. Childhood blood lead concentrations were measured on a quarterly and biannual basis through 6.5 y. Study participants were examined at an inner-city pediatric clinic and the Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio. Total arrests and arrests for offenses involving violence were collected from official Hamilton County, Ohio criminal justice records. Main outcomes were the covariate-adjusted rate ratios (RR) for total arrests and arrests for violent crimes associated with each 5 microg/dl (0.24 micromol/l) increase in blood lead concentration. Adjusted total arrest rates were greater for each 5 microg/dl (0.24 micromol/l) increase in blood lead concentration: RR = 1.40 (95% confidence interval [CI] 1.07-1.85) for prenatal blood lead, 1.07 (95% CI 0.88-1.29) for average childhood blood lead, and 1.27 (95% CI 1.03-1.57) for 6-year blood lead. Adjusted arrest rates for violent crimes were also greater for each 5 microg/dl increase in blood lead: RR = 1.34 (95% CI 0.88-2.03) for prenatal blood lead, 1.30 (95% CI 1.03-1.64) for average childhood blood lead, and 1.48 (95% CI 1.15-1.89) for 6-year blood lead. Prenatal and postnatal blood lead concentrations are associated with higher rates of total arrests and/or arrests for offenses involving violence. This is the first prospective study to demonstrate an association between developmental exposure to lead and adult criminal behavior.

Inequality between and within populations has origins in adverse early experiences. Developmental neuroscience shows how early biological and psychosocial experiences affect brain development. We previously identified inadequate cognitive stimulation, stunting, iodine deficiency, and iron-deficiency anaemia as key risks that prevent millions of young children from attaining their developmental potential. Recent research emphasises the importance of these risks, strengthens the evidence for other risk factors including intrauterine growth restriction, malaria, lead exposure, HIV infection, maternal depression, institutionalisation, and exposure to societal violence, and identifies protective factors such as breastfeeding and maternal education. Evidence on risks resulting from prenatal maternal nutrition, maternal stress, and families affected with HIV is emerging. Interventions are urgently needed to reduce children's risk exposure and to promote development in affected children. Our goal is to provide information to help the setting of priorities for early child development programmes and policies to benefit the world's poorest children and reduce persistent inequalities.

Objectives This study uses UCR and NCVS crime data to assess which data source appears to be more valid for analyses of long-term trends in crime. The relationships between UCR and NCVS trends in violence and six factors from prior research are estimated to illustrate the impact of data choice on findings about potential sources of changes in crime over time. Methods Crime-specific data from the UCR and NCVS for the period 1973–2012 are compared to each other using a variety of correlational techniques to assess correspondence in the trends, and to UCR homicide data which have been shown to be externally valid in comparison with other mortality records. Log-level trend correlations are used to describe the associations between trends in violence, homicide and the potential explanatory factors. Results Although long-term trends in robbery, burglary and motor vehicle theft in the UCR and NCVS are similar, this is not the case for rape, aggravated assault, or a summary measure of serious violence. NCVS trends in serious violence are more highly correlated with homicide data than are UCR trends suggesting that the NCVS is a more valid indicator of long-term trends in violence for crimes other than robbery. This is largely due to differences during the early part of the time series for aggravated assault and rape when the UCR data exhibited consistent increases in the rates in contrast to general declines in the NCVS. Choice of data does affect conclusions about the relationships between hypothesized explanatory factors and serious violence. Most notably, the reported association between trends in levels of gasoline lead exposure and serious violence is likely to be an artifact associated with the reliance on UCR data, as it is not found when NCVS or homicide trend data are used. Conclusions The weight of the evidence suggests that NCVS data represent more valid indicators of the trends in rape, aggravated assault and serious violence from 1973 to the mid-1980s. Studies of national trends in serious violence that include the 1973 to mid-1980s period should rely on NCVS and homicide data for analyses of the covariates of violent crime trends.

We use data on intergenerational social mobility by neighborhood to examine how social and physical environments beyond concentrated poverty predict children’s long-term well-being. First, we examine neighborhoods that are harsh on children’s development: those characterized by high levels of violence, incarceration, and lead exposure. Second, we examine potential supportive or offsetting mechanisms that promote children’s development, such as informal social control, cohesion among neighbors, and organizational participation. Census tract mobility estimates from linked income tax and Census records are merged with surveys and administrative records in Chicago. We find that exposure to neighborhood violence, incarceration, and lead combine to independently predict poor black boys’ later incarceration as adults and lower income rank relative to their parents, and poor black girls’ teenage motherhood. Features of neighborhood social organization matter less, but are selectively important. Results for poor whites also show that toxic environments independently predict lower social mobility, as do features of social organization, to a lesser extent. Overall, our measures contribute a 76% relative increase in explained variance for black male incarceration beyond that of concentrated poverty and other standard characteristics, an 18% increase for black male income rank (70% for whites), and a 17% increase for teenage motherhood of black girls (40% for whites).