My favorite way to capture students’ attention about lead poisoning is to tell them about Dr. Herbert Needleman and his use of children’s baby teeth. In the late 1960’s, Needleman recruited school teachers in Chelsea and Somerville, MA to collect their young students’ deciduous teeth when they fell out. It was a non-invasive way—-no needlesticks, no bone biopsies—to get data on lead burden in children.

Needleman’s team analyzed the teeth for lead which helped them establish a population distribution of tooth lead levels. (It did not exist up to that time.)  In 1972, he published the findings as lead exposure prevalence among the school children in the journal Nature. He built on that research with his investigations of the relationship between children’s lead levels and IQ. That research also involved school teachers. The landmark paper: “Deficits in psychologic and classroom performance of children with elevated dentine lead levels,” was published in the New England Journal of Medicine in 1979.

In an interview with historians David Rosner and Gerald Markowitz, Needleman reveals his enthusiasm for scientific inquiry rich with community involvement:

“We had posters placed around the city in store windows. My secretary’s husband was a commercial artist. He drew us a tooth that looked like Mickey Mouse. It had a missing tooth, and it said, “I gave.” …We gave as a reward a little kit—toothbrush, toothpaste—and a badge.”

“The teachers were wonderful. They each had a shoe box filled with coded envelopes. On the envelope was a diagram of the human mouth with a big smile. They would look in the kids’ mouth, find the space, and then mark the space on the envelope.”

At the time of Needleman’s initial work in the late 1960’s, children with a blood lead level of 60 ug/dL of blood were considered to have lead poisoning. His work was instrumental in identifying the relationship between lead exposure and intellectual impairment, school performance, and behavior disorders. By 1980, the threshold for childhood lead poisoning was 30 ug/dL of blood. Needleman’s inquiries with colleagues continued and their findings were essential in securing greater protections for the public from lead, including action by the EPA and Congress to ban lead in gasoline, paint, plumbing, and other uses. The CDC’s current action level for blood lead in children is 5 ug/dL of blood and the recognition that no level is considered safe.

Needleman published more than 60 papers about the adverse health effects of lead. His research, however, threatened the economic viability and public image of makers and users of lead. Needleman was vigorously attacked for his work by EI DuPont, the Ethyl Corporation, and others. Assertions of scientific misconduct by Needleman were hurled by scientists on the industry’s payroll. The accusations led to investigations by the National Institutes of Health and the University of Pittsburgh where Needleman was a professor of child psychiatry and pediatrics.

Needleman discussed the professional assault in an interview with Rosner and Markowitz, in particular, the University’s practice of holding academic integrity proceedings behind closed doors. Needleman said:

“The major issue was having an open hearing. I knew that if we went in to executive session, I was through—I mean, just judging by the report that the inquiry committee wrote. I campaigned to get it open, and the university faculty senate was behind me 100%. It became a big issue here. The chancellor was challenged in public. About 400 scientists from around the country petitioned. The hearings were then declared open, at which point Sandra Scarr and Claire Ernhart [researchers for the lead industry] said they would not come. They did not want to be questioned in public.”

Needleman wrote about the experience in “Salem comes to the National Institutes of Health: Notes from inside the crucible of scientific integrity,” for a 1992 issue of Pediatrics.

Philip Landrigan collaborated frequently with Needleman. Landrigan told Sean Hamill of the Pittsburgh Post-Gazette:

“It was a terrible time in his life. The people who raised the questions used a small discrepancy to undermine him. More than 90 percent of the scientific community had long accepted his findings and the only people who didn’t were on the payroll of the lead industry.”

Historian Rosner remarked:

“He accomplished a lot. He suffered a lot. And he inspired a lot of people. His main goal was to inspire a generation of researchers, and he obviously has done that. He was just a great man.”

A testament to Needleman’s inspiration comes today from the front lines. Upon his death, pediatrician Mona Hannah-Attisha, who exposed the lead-poisoning epidemic in Flint, Michigan tweeted:

“So much of our knowledge about lead and children flows from Dr. Needleman’s work and tenacity. He was attacked, fought back, and forced change. RIP.”

Needleman’s fierce advocacy for children went far beyond lead. A tribute written by David Wallinga describes Needleman’s role on an EPA advisory committee examining exposures to pesticides.

His son, Joshua Needleman, MD, said his father’s passion for social justice grounded all of his work.

“He just couldn’t tolerate injustice and could not stop seeking the truth.”

What an appropriate motto for anyone in public health! Thank you Dr. Needleman.