The Great Lead Water Pipe Disaster (review)

With this provocative and ambitious volume, economist Werner Troesken has made an important contribution to our historical knowledge of lead and public health prior to the twentieth century. Lead paint and leaded gasoline have gotten most of the attention in the growing historiography on lead, but Troesken examines a source of lead nearly as ubiquitous: drinking water made toxic by the solid lead water pipes installed in millions of homes.

The impact of lead on public health in the nineteenth century has yet to be adequately examined and is particularly difficult to assess for two reasons. First, as mid-twentieth-century industrial hygienist and amateur historian Carey P. McCord found, there is the absence of the kind of data historians find most useful: "Nowhere are there statistics," he complained, "just allusions."¹ Second is the ubiquity of bio-available lead from hundreds of products and environmental exposures, a constellation of toxicity quite distinct from that obtained in most of the twentieth century. Lead-painted walls were still a rarity, and ethyl lead was not yet even a twinkle in Thomas Midgley's eye. Instead, lead-adulterated alcoholic beverages tops a long list that includes sources as diverse as lead medications, food colors (!), pewter drinking and dining vessels, lead-glazed ceramics, and lead-soldered food cans. No satisfying narrative seems likely to emerge from this cacophony. Which source poisoned our nineteenth-century ancestors? Which passenger on the Orient Express really killed Mr. Rachett? The absence of statistics and the glut of vectors suggest a disconnect between lead poisoning before and after 1900, with the nineteenth century fading into "pre-history" and irrelevance.

Troesken handles both of these obstacles energetically. First he clears the field of all suspects but water pipes, chiefly those in urban settings. This choice goes a long way toward solving one side of the data problem, since the scale and centralized planning of waterworks produced systematic and copious statistics. In order to gage and compare lead exposure, Troesken collected exhaustive lists of assays of lead levels in municipal water from dozens of cities and towns in the United States and Britain. Troesken's analysis establishes convincingly that lead water pipes exposed millions of people to a routine daily dose of lead orders of magnitude above current safety standards. This is a significant achievement, and it validates the book's title.

Finding health data to measure the health costs of this exposure is far more problematic, and Troesken's attempt, while impressive in its cliometrics and frequently tantalizing in its results, is not fully convincing. Apart from occupational cases, acute or fatal lead poisoning was almost never reported; and the sort of chronic, subclinical effects likely to accrue from lead in the water pipes would be invisible even if public health experts wanted to study it. An indirect measure is required, and for this Troesken employs readily available infant mortality and stillbirth statistics. Passing the data through equations designed to account for differences in water hardness, disease environment, population, and something called a city's "health-consciousness" produces statistically significant correlations between the presence of lead pipes and negative health outcomes. But such claims as ". . . in Massachusetts and the north of England lead water pipes increased infant mortality rates and stillbirth rates by between 8 and 25 percent" (p. 15) bear a false precision, given the notorious inconsistency and inaccuracy plaguing historical health statistics across time and geography.

Still, this is an important book that should inspire new historical research into the nature and scope of public exposure to lead and other environmental poisons prior to the twentieth century. Trying to establish the numbers killed and maimed should be less central to this project than understanding the economic, scientific, and cultural factors that allowed the world to turn a blind eye to what were even then the known dangers of lead and fly headlong into the twentieth century under the flag of...