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  • The Great Lead Water Pipe Disaster
  • Damon Yarnell (bio)
The Great Lead Water Pipe Disaster. By Werner Troesken . Cambridge, Mass.: MIT Press, 2006 Pp. x+318. $29.95.

In 1893, a pregnant nineteen-year-old entered a hospital in northern England with a high temperature, rapid pulse, and kidney failure. Physicians diagnosed eclampsia and administered potassium bromide, laxatives, and diaphoretics. Despite these treatments, the patient suffered increasingly violent seizures and fell into a coma. Doctors delivered her child by forceps, but the infant stopped breathing shortly after birth.

In the 1890s, a number of theories competed to explain eclampsia. Some attributed the illness to infection, others to poor nutrition, and still [End Page 285] others to poisons produced by the placenta itself. Current medical opinion holds that lead exposure is a likely factor. Late in pregnancy, a woman's body harvests stores of calcium, magnesium, iron, and zinc that are in her bones. Depending on the mother's history, however, the process that releases these beneficial nutrients can also flood her system with enough lead to overwhelm her kidneys and poison her unborn child.

In this important, accessible book, Werner Troesken argues that eclampsia and a host of other health problems can be traced to a heretofore unrecognized source: lead water pipes. Lead pipes were common in the nineteenth and early twentieth centuries, particularly in urban centers. Troesken estimates that more than 85 percent of large American cities used them in 1900. (Until 1936, Chicago actually mandated that residents install lead pipes, a fact that raises intriguing questions about the agency of municipal infrastructure "consumers.") Here, Troesken also uncovers a devastating irony. Over time, hard water coats lead pipes with a mineral lining that minimizes lead seepage. Soft water does not. Because soft water is more corrosive than hard water, however, and because lead is an especially durable metal, residents in soft-water regions tended to choose lead pipes. Thus, municipalities and households were most apt to opt for lead pipes in exactly those geographic locations where they would cause the most harm.

In fact, Troesken's research indicates that lead pipes produced a significant rate of water "plumbism" (lead poisoning) in the general populations of the United States and England. The rigorous statistical analysis that stands at the core of his work shows that 10–12 percent of residents of Massachusetts suffered from water plumbism in 1923. Since pregnant women are more vulnerable to lead poisoning than other adults, they and their children suffered disproportionately. Troesken attributes up to 25 percent of infant mortality in turn-of-the-century Massachusetts to lead in the drinking water. Such figures lead him to join the fray of the contentious McKeown debate: Troesken argues that demographers should add lead eradication to the list of likely causes of the mortality transition.

This is provocative stuff. The Great Lead Water Pipe Disaster will force scholars interested in public health, water and waste technology, and urban history to reconsider long-held assumptions about sanitary infrastructure. The fact that water supply, one of the great success stories of nineteenth-century municipal governance, may have poisoned a large portion of the population is a finding of enormous consequence. The sanitary city may have rescued the population from a cesspool of infectious disease only to plunge it into a well of inorganic poison.

Troesken is trained in economic history, and this field probably represents his most natural constituency. He emphasizes how nineteenth-century medicine (the "doctrine of protective power"), politics ("municipal socialism") and law (nineteenth-century legal standards applied a form of caveat emptor to water supply) made lead a reasonable choice for period [End Page 286] actors, but the way he frames the development of scientific and technical knowledge will raise more questions than it answers for STS specialists. Instead, his strength lies in explaining current medical theories of lead poisoning (chapter 2 provides an exceptionally clear explanation of the health problems associated with protracted, low-grade exposure to lead—an issue about which definitive research has emerged only in the last decade) and in presenting statistical data in a clear, comprehensible form: he confines extended statistical explanation to a series of informative appendixes.

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