The New England Journal of Medicine has a few choice words for officials responding to the Flint water crisis, and they aren’t pretty.

Yesterday, the Journal posted a lengthy editorial piece titled “Lead Contamination in Flint – and Abject Failure to Protect Public Health” by Dr. David Bellinger. There is an interview with Dr. Bellinger attached to the article.

Dr. Bellinger chronicles historical treatment of lead and lead poisoning, demonstrating that its damaging effects have been public knowledge for millennia – well prior to the Flint water crisis. He outlines efforts on part of the U.S. federal government to reduce public exposure to lead through tight regulation on paint and gasoline additives. As a result, lead levels in blood have been significantly reduced in the American population through decisive, preventative action.

Detailing the background on Flint, Dr. Bellinger laments on the tragi-comedy of errors which went into the making of the city’s present day water woes. Sourcing water from the Flint River instead of Lake Huron; removing EPA-mandated corrosion-control treatments; the addition of ferric chloride to the water. He states: “The water reaching consumers was therefore 19 times as corrosive as it had been when the source was Lake Huron. The more corrosive water is, the more readily it can dissolve metals such as lead. So the lead concentration in Flint’s water began to rise.”

Dr. Bellinger goes on to discuss the socio-economic and health fallout from the “cost-saving” decision of city and state officials. Rising lead levels in Flint hit children the hardest, he says. The children of economically disadvantaged families are particularly vulnerable. “In Flint, 4 in 10 families live below the poverty line, unemployment is high, and the majority of the population is black. In general, disadvantaged children are exposed to more lead than their wealthier counterparts because they are more likely to live in houses in poor repair that still harbor deteriorating lead paint, to live in urban neighborhoods with greater soil and dust lead concentrations from traffic and industrial activities, and to have nutritional deficiencies that increase lead absorption.”

He points out that proactive prevention is cheaper than reactive scrambling. “Although the cost of repairing Flint’s water infrastructure is uncertain, estimates range as high as $1.5 billion. The cost of reducing the corrosivity of the Flint River water at the time of the change would have been minimal, perhaps $100 per day — proving again that prevention is generally cheaper than remediation and treatment.” He suggests that money and time being currently allocated to fight lawsuits could have been spent instead on a number of beneficial social programs for Flint residents.

The article ends with damning words for public officials who are handling Flint’s water crisis.

“It is notable that the Flint contamination might never have been brought to light had citizens not persisted in efforts to force local, state, and federal officials to take action. This is not the way public health protection should work, and the crisis appears to reflect failures at every level of government. In 1969, environmentalist René Dubos warned that the problem of childhood lead poisoning “is so well-defined, so neatly packaged, with both causes and cures known, that if we don’t eliminate this social crime, our society deserves all the disasters that have been forecast for it.”5 We have yet to fully respond to Dubos’s admonition.

We have the knowledge required to redress this social crime. We know where the lead is, how people are exposed, and how it damages health. What we lack is the political will to do what should be done.”

To see the NEJM article full text, click here.

Click here to listen: interview with Dr. Bellinger on Flint, MI.