Correspondence from Reynolds to Needleman with Draft Declaration

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Natural Resources 
Defense Council 

617 South Olive Street 
Los Angeles, CA 90014 
213 892-1500 

BY FAX Fax 213 629-5389 

May 13, 1991 

Dr. Herbert L. Needleman 
University of Pittsburgh 
Western Psychiatric Institute and Clinic 

Dear Dr. Needleman: 

Enclosed for your review is a draft of the declaration that 
we discussed by telephone today. As you can see, it is rough, 
but I hope accurate and minimally sufficient to give you 
something with which to work. Please edit, rewrite, add, cut, or 
otherwise modify what I've started. Your background and the 
description of your program obviously need further discussion, 
but I do not yet have a copy of your Curriculum Vitae. 

For the substance, I have attempted to draw as much as 
possible from the CDC's March 1991 Draft Statement and from your 
May 1989 article "The Persistent Threat of Lead: A Singular 
Opportunity." You will undoubtedly want to rework the draft -- 
in particular, paragraphs 4, 5, and 8-11 -- but it is intended to 
reflect the substance of your views as I understand then. 

Unfortunately, the federal judge assigned to the case has 
established a very tight timetable. Our summary judgment papers 
must be filed by May 24. Although the declaration need not be 
final until just before filing, we will be relying heavily on 
your expert opinions in drafting our brief. Therefore, it would 
be very helpful if you could review the draft during the next 
several days and tell me whether we are on the right track. 

Once again, thank you very much for your help. I look 
forward to talking with you later this week. 

Sincerely, 

Joel R. Reynolds 
Senior Attorney 

40 West 20th Street 1350 New York Ave., N.W. 71 Stevenson Street 212 Merchant St., Suite 203 
New York, New York 10011 Washington, DC 20005 San Francisco, CA 94105 Honolulu, Hawai'i 96813 

212.727-2700 202 783-7800 415 777-0220 808 533-1075 

Fax 212 727-1773 Fax 202 783-5917 Fax 415 495-5996 Fax 808 521-6841 

 



  

DRAFT 

DECLARATION OF DR. HERBERT L. NEEDLEMAN 

I, Dr. Herbert L. Needleman, declare and say: 

1. The facts set forth herein are personally known to me 

and I have first hand knowledge of them. If called as a witness, 

I could and would testify competently thereto under oath. 

2. I am currently a Professor of ... [INSERT OCCUPATION AND 

CV HIGHLIGHTS] During the past 20 years, I have conducted 

research, written, and consulted extensively on matters relating 

to lead poisoning, and I currently am a member of the Centers for 

Disease Control's ("CDC") Advisory Committee on Childhood Lead 

Poisoning Prevention. [EXPAND?] A copy of my Curriculum Vitae 

is attached. 

3. [INSERT DISCUSSION OF PRINCIPAL LEAD-RELATED WORK] 

4. Childhood lead poisoning is one of the most common and 

preventable pediatric health problems in the United States today. 

According to the CDC, lead poisoning is the number one 

environmental health hazard for children in the United States. 

No socioeconomic group, geographic area, or racial or ethnic 

population is spared, but the poor and minorities are exposed to 

a great deal more lead than anyone else. Between three and four 

million children -- one in six -- have levels in their blood high 

enough to cause significant impairment of their neurologic 

development. Experts have estimated that over 67% of black 

inner-city children and 17% of all children in the United States 

under the age of six have been contaminated by excessive levels 

of lead. 

 



  

5. These astonishing levels of exposure are due to the 

ubiquitous nature of lead in the human environment -- in lead- 

based paint and gasoline, drinking-water and pipes, printing inks 

and pigments used in toys, fertilizers, lead-soldered food cans, 

and soil and dust. And, because of their tendency to hand-to- 

mouth activity and because their neurologic systems are 

developing, children are particularly susceptible both to 

exposure and to lead's toxic effects. Although all children are 

at risk for lead poisoning, poor and minority children are 

disproportionately affected because they are more likely to (1) 

live or visit in homes with peeling or chipping paint; (2) live 

or visit in homes built before 1950 with planned or ongoing 

renovation; (3) have a brother, sister, or playmate with 

confirmed lead poisoning; (4) live with an adult whose job or 

hobby involves exposure to lead; or (5) live near industry likely 

to release lead (e.g., a lead smelter, battery recycling plant, 

etc.) . 

6. Recent studies of lead toxicity have both lowered the 

perceived threshold for observed health effects and demonstrated 

toxic effects in new areas. Epidemiological studies have now 

shown IQ changes of four to seven points in children at blood 

levels as low as __ug/dL. When cumulative distributions are 

compared, a six point shift in the median results in a four-fold 

increase in the rate of severe IQ deficit (IQ less than 80). In 

addition, intrauterine and early infant exposure to lead at low 

dose interferes with growth on the infant during the first year 

of life. Blood lead levels are inversely correlated with linear 

 



  

height and chest circumference. Hearing deficits have been 

measured in association with blood lead levels; no threshold was 

found. 

7. These studies draw a convincing picture of lead's broad 

impact on children's intelligence, growth, ability to hear and 

perceive language, and to focus, maintain, and shift attention. 

They certify, to the satisfaction of all but representatives of 

the lead industry, that lead is a potent, versatile, and widely 

distributed toxicant. Lead poisoning produces hyperactivity and 

aggression, and studies of low dose exposure show an increased 

incidence of those behaviors subsumed under the attention deficit 

syndrome. Attention deficit and learning disorders are well 

established risk factors for antisocial behavior. Whether there 

is a causal link between lead and delinquency has not been 

subject to systematic study, but the clues are a subject for 

troubled conjecture. 

8. Because most poisoned children have no symptoms, the 

vast majority of lead poisoning cases go undiagnosed and 

untreated. Because of this and the fact that early lead toxicity 

is reversible, monitoring of blood lead levels of young children 

through periodic screening is critical. Once detected, lead 

poisoning and related health effects can often be treated and, in 

many cases, measures can be undertaken to detect and eliminate 

the source of exposure. Screening programs have had a tremendous 

impact on reducing the occurrence of lead poisoning in the United 

States. 

 



  

9. Measuring blood lead content is the most accurate and 

reliable method of screening for lead exposure. Although perhaps 

more invasive than an oral assessment of history, blood testing 

for other conditions (iron deficiency, anemia, etc.) is typically 

part of a standard medical examination for children. More 

important, blood lead level testing is essential to an adequate 

lead screen because no oral assessment of risk factors is 

foolproof. In my opinion, periodic screening by blood lead 

measurement should be conducted at least once per year for any 

poor or minority child under the age of six because all such 

young children are at risk for lead poisoning. For children 

considered to be at high risk for lead exposure due to positive 

testing results or environmental or other factors, blood lead 

testing should be conducted every three to six months months. 

10. This conclusion is consistent with the United States 

Health Care Financing Administration ("HCFA") standards for 

implementation of the federal Medicaid Act. Those standards, 

which appear in HCFA's State Medicaid Manual, require that all 

Medicaid eligible children ages 1-5 be tested for lead poisoning. 

In my opinion, this requirement is reasonable, medically 

appropriate, and an essential part of even a minimally adequate 

and medically effective lead screening program. 

11. It is also economically sensible given the longterm 

societal costs associated with failure to treat and prevent lead 

poisoning. As the United States Department of Health and Human 

Services recently recognized in its Strategic Plan For the 

Elimination of Childhood Lead Poisoning (February 1991), lead 

 



  

exposure in U.S. children is estimated to cost society billions 

of dollars a year in medical care, special education and 

institutionalization, and lost productivity and lifetime earnings 

due to impaired cognition. By contrast, the estimated cost of 

increased screening are minimal. According to HHS, the cost of 

increased screening through EPSDT, WIC, and Head Start is only 

$1.25 million over the next five years. 

Executed at , Pennsylvania this __ day of May 
  

1991. 

I declare under penalty of perjury that the foregoing is 

true and correct. 

  

DR. HERBERT L. NEEDLEMAN