The all-too-ordinary kind of lead poisoning

Every great drama has a hero, a villain, and a victim. Perhaps that is why the lead contamination of the Flint, Mich., water supply has captured the nation's attention.

Dr. Mona Hanna-Attisha is the noble pediatrician credited with battling bureaucracy to expose the haunting truth, the government is the wrongdoer accused of malfeasance and a cover-up, and thousands of innocent children have been put in harm's way. In the aftermath, celebrities and politicians are speaking out about this newly discovered social injustice, and money is flowing in.

But don't be misled by the current frenzy: Lead poisoning has been harming children for more than a century, and deteriorating lead house paint remains the greatest threat.

I take care of plenty of lead's victims. Most are poor, and many are minorities.

Recently, I spoke to the mother of a young child with anemia, behavioral problems, and a blood lead concentration higher than 50 micrograms per deciliter - more than 10 times what is considered acceptable. The dust inside the family's house and the soil outside are laden with lead.

This is not unusual in Philadelphia - or in Baltimore, Boston, or any other city with a lot of old housing. Paint used on the interiors and exteriors of homes contained large concentrations of lead through 1950. (In fact, it was often advertised as "white lead," which was up to 80 percent lead carbonate.)

Lead was removed from house paint almost entirely by 1978. It was also removed from U.S. gasoline. These public-health measures were important and powerful. During the period from 1976 to 1980, 88 percent of preschool-age children were found to have blood lead concentrations greater than 10 micrograms per deciliter; by 1994, less than 4 percent of children did. We've come a long way!

Still, in 2011, an estimated 37 million U.S. housing units still contained lead-based paint. And during the period from 2007 to 2010, approximately 2.6 percent of preschoolers were found to have blood lead concentrations greater than 5 micrograms per deciliter, according to federal data.

The latest reports are that the proportion of children with high lead levels in Flint has doubled, to 4 percent, and reached 6 percent in certain neighborhoods. But let's compare this with the long-standing environmental injustice across the United States. A startling 8 percent of Detroit preschoolers had high blood lead levels in 2013, Michigan's Childhood Lead Poisoning Prevention Program found, but there was little outrage in the national media about the cognitive and behavioral harm inflicted on them. Meanwhile, 20 percent of children tested in Allentown and Altoona in 2014 had high blood lead levels, according to state data, but celebrity sightings were few in these communities, as were resources and solutions.

Across America, lead tends to burden poor and minority families who often lack the financial resources to escape. Removal of lead from the environment and primary prevention of the harms of lead poisoning are challenging propositions requiring creative thought and serious investment.

The Flint tragedy never should have happened, and it merits careful examination. But let's not be complacent about the most dangerous lead villain lurking among us. Deteriorating paint and contaminated dust remain the greatest lead threat to American children, deserving at least as much notoriety and concern as the water in Flint.

Kevin C. Osterhoudt, M.D. is the medical director of the Poison Control Center at the Children's Hospital of Philadelphia. osterhoudtk@email.chop.edu