Scott Pruitt, the Oklahoma attorney general picked by President-elect Donald Trump to lead the Environmental Protection Agency, immediately drew blowback during his confirmation hearing on Wednesday for saying that he “hasn’t looked into the scientific research” on precisely how much lead exposure is unsafe for children.

Critics slammed Pruitt’s response as an uninformed and dangerously naive perspective on a critical environmental health issue. But, in fact, Pruitt’s not alone in his uncertainty on this question. There’s an ongoing debate among scientists and regulators about how much lead is too much for kids to have in their bodies.

Just this week, the Centers for Disease Control and Prevention was scheduled to hold a meeting to discuss that very question.

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That didn’t stop Democrats from using Pruitt’s quote, out of context, as a talking point:

First, here’s what Pruitt actually said:

Senator Ben Cardin (D-Md.): To continue on clean water for one moment, we’ve had significant problems with safe drinking water and clean water. Let me ask you a preliminary question: Do you believe there is any safe level of lead that can be taken into the human body, particularly a young person?

Pruitt: Senator, that’s something I’ve not reviewed, nor know about. I would be very concerned about any level of lead going into the drinking water, or obviously human consumption. I’ve not looked into the scientific research on that.

Pruitt’s statement that he would be concerned about “any level” of lead ingestion reflects the existing consensus. Both the CDC and the EPA say on their websites that there is no level of lead known to be safe in a child’s bloodstream.

But regulators have to prioritize which situations warrant a public health response; after all, barely traceable levels of lead pose a less imminent health threat to kids than higher ones. And it’s possible that the tiniest levels of lead may not be harmful for kids. Though the CDC and the EPA agree that 0.000001 micrograms of lead per deciliter of blood has not been proven safe, we don’t know that it’s unsafe, either.

So that’s why the CDC relies on a “reference level” of 5 micrograms of lead per deciliter of blood to identify which children under age 6 have an elevated level of lead. That’s been the standard since 2012. Before that, the “level of concern” was 10 micrograms of lead per deciliter of blood. The change reflects increasing awareness about the damage that can be caused by even tiny levels of lead in the blood.

And the threshold may still be shifting. Reuters reported a few weeks ago that the CDC was considering lowing the threshold by 30 percent — down to 3.5 micrograms of lead per deciliter of blood — at a meeting scheduled for earlier this week.

The CDC did not immediately respond to STAT’s request for comment Wednesday afternoon on the outcome of that meeting.

All of which is to say: Pruitt probably deserves some slack on this point. We don’t know what level of lead is safe to be taken into children’s bodies, or if there even is such a threshold. And the level that warrants regulatory action is actively being debated.

But still, the critical tweets keep coming.

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  • How dishonest can a journalist get?

    “All of which is to say: Pruitt probably deserves some slack on this point. We don’t know what level of lead is safe to be taken into children’s bodies”

    vs.

    “Both the CDC and the EPA say on their websites that there is no level of lead known to be safe in a child’s bloodstream.”

  • The establishment of “reference levels” or “levels of concern” by the government is pure black magic. One concrete example. Anyone who has ever bought a house in NJ has to have the home tested for radon levels at a cost to the buyer of couple hundred bucks. Ever wonder how the “safe” level of 4 picocuries/L was established in the first place? The inspector didn’t know so I looked it up. The way the “safe” level was established was by exposing caged rats to radon concentrations typically found in uranium mines, which are about 65 times higher than levels in the atmosphere. Whether they did an LD50 I don’t recall, but the “safe level” for humans breathing the air in their homes was based on how much of a supersaturated concentration of radon in a rat cage was required to sicken the rodents. I wouldn’t be surprised if the determination of “safe” lead levels was based on science that was just as bad.

  • I’m particularly disappointed in this journalists’ headline. The good point is lead never existed in our air or water prior to industrial activity, and no lead level is safe for humans. The debate of how much is too much will continue in the medical community to direct medical intervention. Realizing lower levels cause harm, our government has been lowering treatment thresholds for years.
    What is scary is this EPA nominee seems to be clueless about this massive issue, and this journalist chose to make his ignorance seem like he had a ‘good point’.

  • No amount of lead is safe; this is indisputable. Uncertainty exists only about when we, as doctors and as a society, need to take action.

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