Book Review: Getting the Lead Out

Troesken carefully examines the medical community’s uncertainty during this period with respect to the threat of lead in water. Some physicians feared that consumers were being poisoned, but the majority were either skeptical or certain there was no danger. In most cases, after all, the poisoning produced was not acute but chronic, developing slowly and in the early stages easily mistaken for other complaints. Furthermore, physicians were focused on the health of adults, but children and fetuses were most at risk. Drinking water in many cities in Britain and the United States supplied dosages of lead capable of inducing abortion. This threat was recognized by some physicians by the early 1900s and was taken up by adherents of the eugenics movement as a hazard that threatened to bring about “race suicide.” There is also a compelling argument made that lead in water significantly increased the incidence of eclampsia in pregnancy.

As scientists and engineers came to better understand the nature of plumbism in the early 20th century, they took a range of government-mandated steps to lower the risk of poisoning from water pipes, including chemically treating water to inhibit lead solubility and replacing lead pipes with conduits made of safer materials. The gradual introduction of polyvinyl chloride (commonly known as PVC) pipes in the second half of the twentieth century finally got the lead out of most drinking water, though as Troesken notes in his concluding chapter, lead levels still exceed EPA standards in some districts in the United States.

Troesken’s book is based on extensive research in the chemical and medical literature, government publications, court cases, and newspaper stories, as well as statistical analysis not often encountered in historical studies. The narrative nicely blends chemistry with the political and economic forces that shaped decisions about water supply and is rich in illustrative anecdotes. The book would benefit from tighter organization, and more could be said on recent developments that have brought the problem under control. Nevertheless, The Great Lead Water Pipe Disaster is a valuable addition to our understanding of the chemical health hazards associated with modernization in Western society.

James Whorton is a professor of the history of medicine in the University of Washington School of Medicine, Seattle.