Marc Edwards, Civil and Environmental Engineering Professor at Virginia Tech

321 - MON DAY, MARCH 7, 2016 Marc Edwards

(Music)

Mark Masselli: This is Conversations on Health Care. I am Mark Masselli.

Margaret Flinter: And I am Margaret Flinter.

Mark Masselli: Well Margaret, the political primaries and caucuses are heating
up around the country, and it's been challen ging to swift through all of the political
noise and rhetoric, but the most recent Democratic Debate took place in the
community dealing with a major public health crisis Flint, Michigan. Residents
there were exposed to dangerously high levels of lead and other contaminants
through their public drinking water.

Margaret Flinter: At the Democratic Debate in Flint, we were able to focus on
something that is vitally important public health, and the Flint water crisis that is a
public health perfect storm. A nd you know Mark, I don’t know if I have ever seen
such a powerful backdrop during one of these debates. The audience was filled
with Flint residents who have been directly impacted by the crisis, their children
who had been exposed to high levels of lead which poses a serious risk to their
long - term health, and other major contaminants have caused additional health
problems throughout the community as well as disrupting daily life in the search
of pure water. Government officials were denying the existen ce of a problem,
and it wasn’t until our guest today came along that there was a shift in the
situation .

Mark Masselli: Dr. Marc Edwards is the person who shined a spotlight on the
crisis and is now working to fix the problem. He is a MacArthur Fellow, Civil
Engineer, and Professor of Environmental and Water Resources at Virginia
Tech. His specialty is the decaying of the nation’s crumbling water delivery
infrastructure and the threat that it poses to human health.

Margaret Flinter: And to no matter w hat the topic, you can hear all of our shows
by going to www.chcradio.com
Mark Masselli: And as always, if you have comments, please e - mail us at

[email protected] , or fin d us on Facebook or Twitter , we love hear ing from you.
Margaret Flinter: We will get to our interview with Dr. Marc Edwards in just a moment.
Mark Masselli: But first, here is our producer Marianne O’Hare with this week’s
Headline News.
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321 - MON DAY, MARCH 7, 2016 Marc Edwards

Maria nne O’Hare: I am Marianne O’Hare with these Health Care Headlines. The
political season is generating more fallout, Dr. Ben Carson no longer seeking the
republican nomination for president. The former neurosurgeon says he doesn’t
see a pathway to succes s in this contentious election season being dominated by
real estate developer Donald Trump . The White House and public health officials
st
are planning a summit April 1 on the Zika v irus that researchers in Brazil the
epic center of the Latin American out break say there may be more to worry
about. They are saying the virus link ed to birth defects in babies as well as
neurological disorders in adults maybe carried by more than one kind of
mosquito. Scientists announcing they were able to inf e ct other spec ies
especially one that’s 20 times more common in Brazil.

CTE researchers have found in almost every single former NFL player who died,
had a brain that showed signs of the neurological disorder brought on by multiple
blows to the head. But little attent ion has been paid to women’s sports . Retired
U.S. women soccer player Brandi Chastain wants to change that planning to
donate her brain to CTE research , increasingly young women playing competitive
sports are also suffering traumatic brain injuries. Chas tain is the second national
team member to decide to donate her brain after Cindy Parlow Cone, both
women and several others from the 1999 team have argued against heading in
youth soccer.

I am Marianne O’Hare with these Health Care Headlines.

(Music)

M ark Masselli: We are speaking today with Dr. Marc Edwards who is overseeing
the mitigation of the Flint Michigan Water Crisis. Dr. Edwards is the Civil
Engineer and Charles P. Lunsford Professor of Environmental and Water
Resources Engineering at Virgini a Polytech Institute where as focus es on
ensuring the protection of safe drinking water. He has earned numerous awards
and distinctions including 2008 MacArthur Foundation Fellowship for his activism.
He earned his B.S. from SUNY Buffalo and is M.S. and P h.D. from the University
of Washington in Seattle . Dr. Edwards , welcome to Conversations on Health
Care.

Dr. Marc Edwards : Thank you for having me.

Mark Masselli: It's an honor to have you join us at the time when you are so
focusing on mitigating a m ajor public health crisis unfolding in Flint , Michigan.
Tens of thousands of Flint residents have been exposed to high levels of lead
and other toxic contaminants through their public water infrastructure after the
government entities switch ed the water s ources, and then consistently denied
there was a problem, and you can't make this stuff up. But you have been also
exposed several years ago a similar matter that impacted the population of
Washington D.C., and you said there was only a matter of time for another such

321 - MON DAY, MARCH 7, 2016 Marc Edwards

crisis to emerge. Could you help our listeners understand the scope and the
context of the current crisis in Flint?

Dr. Marc Edwards : In 2001 to 2004, there was actually a massive lead and water
contamination event in Washington D.C. that was probably 20 to 30 times worse
than what currently happen ed in Flint. But that problem was completely covered
up by fraudulent U.S. Centers for Disease Control report that claim no one got
hurt from this unprecedented exposure , and there wasn’t until 2 010 that that was
exposed by a congressional investigation in our research. That said even though
th
the Flint water disaster is only 1/30 as bad as Washington D.C., the Centers for
Disease Control has actually lowered the threshold that ’ s considered a con cern
or lead poisoning in children . And as a result, even though the lead levels in Flint
water were not as bad as Washington D.C. certainly they were horribly bad, it did
elevated blood lead of many children over the current five microgram per deciliter
thresholds and then some neighborhoods that had higher water lead and lower
incomes , t he incidents of elevated blood lead rose abo ve 10% in the August of
last year , s o literally one out of every 10 children had the blood lead elevated in
some neighborhood . So there is no safe level of lead exposure and of course , in
addition to the lead, they destroy ed the pipe infrastructure probably hundreds of
millions of dollars of damage and then we have legionella deaths which are also
related to the failure to contr ol corrosion control laws. And yeah all of this
originated from the failure to federal law by civil servants both at MDQ and then a
political point at EPA who knew about it and let it happen.

Margaret Flinter: Well Dr. Edwards , I can't think of a more s itting title for of
course than the one that you teach in engineering ethics and heroism at Virginia
Tech . It seems you are surrounded by many heroes throughout the unfolding
crisis, the mom who first reach ed out to you and who became your leading
citizen scientist in this crisis, there was the physician who spoke out publically
after seeing a spike in kids with elevated lead levels. So many people try to
confront the problem, bring it to attention, but seem to be thwarted by authorities
or even publicall y excoriated, maybe you could share with us the timeline of the
Flint water crisis and what was it that made you and your team of scientists and
students decided to go all in for Flint as you said?

Dr. Marc Edwards : The switch to the new Flint River wate r source occurred in
April of 2014 , and in retrospe ct problems started right immediately . People were
noticing problems related to corrosion control which Flint forgot to install. So
people were complaining about red colored water which is iron rust , the y were
seeing pipe s breaking because they were being knocked by the water. The
General Motors plan in October of 2014 found that the water is heating their car
parts up so they had to switch the water sources. And in the meantime, the
people who forgot t o follow the law were misleading everyone . And then in early
2015, people started noticing lead in the water and in fact , one mom in Flint had
twins and she noticed one of them wasn’t growing as fast as the other and they
test it for lead and water and le ad and blood and founded both were high.

321 - MON DAY, MARCH 7, 2016 Marc Edwards

At that point, we got involved because Mr. Del Toral an EPA employee had been
working with this hero mom, me Lee - Anne Walters and so we sample d their
house and wow found literally hazardous waste levels of lead com ing out of this
family’s ta p . And Mr. Del Toral as I said he put his career on the line to raise
alarms about this that EPA should consider taking over the system to protect
people. Unfortunately , his memo that he wrote was covered up by his boss. She
a llowed this brave employee to be publically discredited and as a result to that
cover up people in Flint were told that the water was safe to drink when it wasn’t.
The thing that really angered us and made us go all in for Flint was that residents
actuall y had a meeting with these state bad actors, but civil servants laughed in
the face of Ms. Walters which I don’t see anything funny about a child being lead
poisoned. They bragged about how this EPA employee had been handled and
he would not be heard from again. So turns out they made a deal with EPA that
EPA would not intervene to help Flint residents, besides getting mad we decided
to form this team of 25 people. We provided funding and the expertise and
allow ed Flint residents to sample their water to see if it was safe or not, and they
very quickly discovered it was not safe.

Mark Masselli: Your whole set of action reveal failure of the system you ran into
this same problem in Washington D.C. and if it wasn’t for your own moral
integrity and to vali date the health concerns, there are – I am not sure any of this
would have been uncovered, and I am wondering what the message is to folks
who want to join your brigade as citizen scientist how they might help in other
parts of the country, w h ere they are worried about their own water safety?

Dr. Marc Edwards : Well, the larger message is very scaring and that’s why it's
striking such a chord and that is the government that we pay to protect us is in
some cases are enemy. They are not looking out for us. They are working
overtime to frankly hurt us if that means that they can protect their reputation. So
I guarantee you with the present culture at these agencies the truth will lose
every time. I am not putting down the employees at these organizations b ecause
I know the vast majority of them are great people they want to do their job. But
what we have created is these corrupt cultures where they are not making the
decisions. They literally care more about their reputation of their agency than
they do a bout the health of children . So that’s what’s making this – everyone so
angry about this is and everyone should be upset about this and we really need
bipartisan efforts to force a culture change at these agencies and remind them
that they work for the pu blic and not for themselves .

Margaret Flinter : Well Dr. Edwards, I – as I started my career as a public health
nurse four decades ago and we were relentless in the pursu it of lead poisoning
and elevated lead, but what was front and center always was you had to prevent
it because the damage could be irreparable. C alled Flint a perfect storm of
health complications and maybe you could tell us a little bit about what is it that

321 - MON DAY, MARCH 7, 2016 Marc Edwards

has everyone so upset and worried about the lifelong consequence s of having
lead poisoning in childhood?

Dr. Marc Edwards : Lead adversely affects every system in the human body and
as a result, it's official U.S. government policy that there is no safe level of lead
exposure that we have to do everything in our power to engage in pr imary
prevention or just to make sure laws are followed and children are not exposed
because the harm that’s been done cannot be undone, even more concern as
the way we monitor for lead in children is not how you would monitor to detect
lead and water expo sures. Specifically , the Centers for Disease Control simply
assumes that the water across the country is safe, and so what they have in
place is a lead paint and lead dust monitoring program .

Margaret Flinter : Right.

Dr. Marc Edwards : And the fact tha t the incidents of blood lead in these children
that are not the highest risk group was doubled raises concerns about what
happen ed in the risk groups that we are not even measuring. S pecifically you
know the youngest infants using formula they never test ed for blood lead and
those are the off the charts health risk. So for all of these reasons, the doubling
of the incidents of blood lead is of concern enough but when you realize the fact
that the monitoring program that detected it is not designed to fin d lead in water
risk because we have a lead in water law, you know it really raises concerns
about how deep the damage goes and that’s you know another reason people
are just so upset about this.

Mark Masselli: W e are speaking today with Dr. Mar c Edward s who is sphere
heading the effort to address the lead contamination crisis in Flint Michigan which
is his research help confirm , he is the McArthur Foundation Fellow , a Civil
Engineer and Professor of Environmental and Water Resources E ngineering at
Virgin ia Tech . You know sort of back to Flint the water supply has been switched
back to its original source but the damage has been done , the population now is
reliant on filtration systems , bottled water for the foreseeable future what are the
other challenge s that they face in terms of threat to human health?

Dr. Marc Edwards: One of the problems we are having is simply getting the
water tested to see its current status because in all likelihood Flint water is now
meeting federal standards. But unfortunate ly , Flint like many cities across the
United States has never followed [ph]. So the 25 - year - old Federal Lead and
Copper Rule Law which means they never identified the high risk homes of with
lead pipe that they were supposed to be sampling. Because they didn’t do their
homework 20 years ago, they can’t do the testing until they go in and find the
right number of homes that have lead pipe and this is proving to be a lot hard er
than anyone thought . S o we are up there right now, my students are giving up
th eir spring break and they are going all around the city with Flint residen ts and
they are re - sampling. 2 71 homes that we sample d was Flint residents in August

321 - MON DAY, MARCH 7, 2016 Marc Edwards

of 201 5 when the Flint water lead crisis was at its height. In the meantime
everyone is waiting for EPA to figure out a way to do a legitimate sampling event,
because Flint has never done one, and it's not until both of those pieces of the
puzzle are in place that anyone is going to even think about telling people that
Flint is meeting federal stand ards, so I think bottled water filters are going to be
used for the foreseeable future at least the next couple of months , and frankly
even then no one is going to trust the water anyway because they have been
betrayed so fundamentally . You know, you have the National Guard walking the
street distributing bottled water , putting filters on ta p s , neighborhoods of children
with elevated blood lead and according to EPA in the state department of
environmental quality Flint never failed the Lead and Copper Rule . You know so
it shows you which is -- what a joke EPA has allowed this to become.

Margaret Flinter: Well Dr. Edward s certainly another health care hero in this
story is the family doctor who confronted the establishment, Dr. Mona showed us
that she cou ld use just good medical research and the medical evidence that was
in front of her to stand up to the powers of be who were telling her she was
wrong and her actions really seemed to have helped turn the tide against those
who we re denying just what a cri sis they had on their hands . I wonder what your
thoughts are about what other frontline clinicians might learn from her
experience?

Dr. Marc Edward s : You know Flint is really a story of both epic villains and epic
heroes, and Dr. Mona is certainly one o f those that helped us reached that critical
mas s that was necessary to show what was happening to the kids. If we hadn’t
had this just amazing group of outside people and you know those kids would still
be drinking that water to this day. I think she ki nd of exemplify the new
generation of public health professional that probably is harkens back to a
generation ago.

Margaret Flinter: Right, right I think so.

Dr. Marc Edwards: Where really folks got into this field because they were
altruistic and i f anyone was going to hurt the children they would put it on the line
to protect them and she h a s got the right mix of s cientifics and political savvy and
is not afraid to take on evil when she sees it , the world desperate we need the
more Dr. Mona s .

Mark Masselli: You know i t was interesting to listen to the democratic
presidential debate in which both Hillary Clinton and Bernie Sanders called for
those public officials responsible for letting the crisis unfold to be held
accountable. B ased on your expe rience what kind of punishment for negligence
among public officials have you seen and what more needs to be done to ensure
that public officials are held accountable ?

321 - MON DAY, MARCH 7, 2016 Marc Edwards

Dr. Marc Edward s : Well in Washington D . C . there is no better example because
five brav e whistleblowers who put their career on the line to try to tell the public
that the lead in water was high or that the agencies were corrupt , they were fired ,
and not one of the perpetrators of this environmental crime was held
accountable , and even after they were reamed in a congressional hearing CDC
refused to say that they did anything wrong. So that’s why I knew that another
D . C . which happened in Flint was inevitable because if you cannot learn from
your mistakes you are d oo med to repeat them. I th ink in Flint, you know we
finally have seen what it takes for a federal or state employee to lose their job ,
you have to literally poison a city , destroy their infrastructure , cause death s from
legionnaires ’ disease, and at that point yeah, that does reach the threshold to
finally get a government employee fired but that you know that threshold is not
good enough to stop the next Flint from happening . W e have to change the
culture at these agency , so good, heroic people are allowed to do their jobs. We
ar e all at risk , I mean , what happened in Flint is a miracle because it got
exposed. But as I can tell you that miracle is not going to happen every time
around the country and you know for that reason we really have to get this fixed.

Margaret Flinter: W ell Dr. Edward s I want to may be pivot to the issue of getting
it fixed and are there any examples of communities or cities around the country
that have taken a proactive stan ce to really look at the quality of their water
safety and make a plan to move fo rward.

Dr. Marc Edwards: I am the biggest fan of the mission of the EPA and the CDC,
but they have to live up to their mission, they have to be worthy of the public
trust, and frankly , I don’t see an alternative but to have a trustworthy government
and n o one ever thought that people would behave this way without any profit
motive whatsoever and I think that’s what ’s so shocking. I am sure that there are
communities you know all around the country and probably the vast majority
whether water is safe but when you see something like Flint, when you see
something like Washington D . C . who is to say it's not you next. So that’s why I
trust we have to get these agencies fixed.

Mark Masselli: We have been speaking with Dr. Marc Edwards , Civil Engineer
and Pro fessor of Environmental and Water Resources Engineering at Virginia
Tech . You can learn more about his work by going to flintwaterstudy.org or you
can follow them on Twitter by going to # flintwatercrisis. Dr. Edwards thank you
so much for joining us on C onversations on Health Care today.

Dr. Marc Edwards: Thank you for having me.

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be
truly in the know when it comes to the facts about health care reform and policy.
Lori Ro bertson is an award - winning journalist and managing editor of

321 - MON DAY, MARCH 7, 2016 Marc Edwards

FactCheck.org, a nonpartisan, nonprofit consumer advocate for voters that aim to
reduce the level of deception in U . S . politics. Lori, what have you got for us this
week?

Lori Robertson: Dona ld Trump says that federal government could save a $300
billion a year by negotiating prescription drug prices. But Medicare which isn’t
allowed to negotiate drug prices now spent only $77 billion total in federal fund
on its prescription drug program in 2015 , and in a March Republican Debate , he
claims that the government could save hundreds of billions of dollars in waste by
having prescription drug companies bid properly. One of the debate moderators,
Fox News ’ Chris Wallace, accurately pointed out tha t Medicare’s entire federal
spending per year for Part D, its prescription drug component , was well under
that. Trump countered that he was talking about saving throughout the economy
but Trump has indeed claimed several times that he could save the $300 billion
per year through negotiating drug prices. According to figures from the
congressional budget office three years of spending on Medicare Part D doesn’t
even add up to $300 billion. All national spending on retail prescriptions whether
it's through Medicare , Medicaid , private insurance or out of pocket totaled nearly
$300 billion in 2014 , that’s according to the National Health Expenditure Data ,
compiled by the Centers for Medicare and Medicaid Services. So Trump would
be talking about saving all o f the money the country spends on drugs per year .
Democratic Presidential Candidate Bernie Sanders has cited a much lower
estimate for savings from negotiating Medicare drug prices between $230 billion
to $541 billion over 10 years. And that’s my fact ch eck for this week. I'm Lori
Robertson, Managing Editor of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the
country's major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact, that you would like
checked, email us at www.chcradio.com . We will have FactCheck.org's Lori
Robertson check it out for you here on Conversations on Health Care.

[Music]

Mar k Masselli: Each week Conversations highlights a bright idea about how to
make wellness a part of our communities and everyday lives. Pregnancy is
normally an exciting time for most women but according to the research it
estimated 10% of prenatal women e xperience some kind of depression s in their
pregnancy and many are reluctant to treat their depression with medication for
fear of harming the fetus.

Dr. Cynthia Battle: They are having significant symptoms that are getting in the
way of feeling good and left untreated those mild to moderate symptoms can
progress in some cases lead to a more serious post partum depressions.

321 - MON DAY, MARCH 7, 2016 Marc Edwards

Mark Masselli: Dr. Cynthia Battle is a psychologist at Brown University . S he and
her colleagues decided to test a cohort of pregna nt women to see if a targeted
prenatal yoga class might have a positive impact on women dealing with prenatal
depression.

Dr. Cynthia Battle: And we enrolled 34 women who we re pregnant who had
clinical levels of depression and we measured their change in depressive
symptoms over that period of time.

Mark Masselli: Not only were women able to manage their depressive incidents
they also bonded with other pregnant women during the program and found
additional support from their group.

Dr. Cynthia Battle: So one thing we are interested in seeing is when we provide
prenatal yoga program can it improve mood and then can we even see some
positive effects in terms of the birth outcome.

Mark Masselli: A guided non - medical yoga exercise program design ed to ass ist
pregnant women through depression symptoms , helping them successfully
navigate those symptoms without medication . Now that’s a bright idea.

(Music)

Margaret Flinter: This is Conversations on Health Care. I'm Margaret Flinter.

Mark Masselli: And I'm Mark Masselli, Peace and Health.

Conversations on Health Care, broadcast from the campus of WESU at
Wesleyan University, streaming live at www.wesufm.org and brought to you by
the Community Health Center.