This lack of support could mean that individuals with mental health conditions continue to smoke, leading to negative health outcomes. The study highlighted the need for integrating smoking cessation programs into mental health treatment facilities to address this disparity.
Similarly, the guidelines for treating HIV exposure are crucial for preventing the spread of the virus and providing timely care to those at risk. Without the expertise of the CDC scientists who were laid off, the development and dissemination of these guidelines may be delayed or hindered.
The loss of these experienced professionals is a blow to public health efforts across the country. Their expertise and dedication were instrumental in identifying and addressing health threats such as lead poisoning and smoking cessation. Without them, the ability to respond effectively to emerging public health issues may be compromised.
As the Department of Health and Human Services transitions to a new administration, it is essential that efforts to prevent lead poisoning and other health threats continue unabated. The work of the CDC and its scientists is crucial in protecting the health and well-being of all Americans. It is imperative that the funding and support necessary to carry out these vital public health initiatives are maintained to safeguard the health of communities nationwide. The CDC started requiring states to focus on this population, some states used CDC money for tobacco cessation programs at mental health facilities, and the new study showed improvement, but also still gaps, especially as far as nicotine replacement therapy was concerned.
Now, for some authors, seeing that sort of paper come out was bittersweet: Gratifying, that clinicians and officials would be able to learn from it, but alarming to think it might be what extinction researchers call an endling, the last of its kind, the final MMWR to emerge from the Office on Smoking and Health, for instance, which had been eliminated, or the Childhood Lead Poisoning Prevention Program, which had been gutted, too.
That represented a loss of potential knowledge as well as the public health interventions that emerge from it. Lead in applesauce was a case in point. “What’s happening at CDC right now is jeopardizing our ability to do any of this work,” said Ed Norman, head of the children’s environmental health unit at North Carolina’s DHHS.
The routine blood testing that had first revealed the lead poisoning is often done by family doctors and paid for by Medicaid, which congressional Republicans just proposed cutting by some $700 billion, its own question mark for now. But even if some or all that testing were to continue, the three epidemiologists who collect and process those data for the state of North Carolina are 100% funded through the CDC’s childhood lead poisoning prevention program. Norman said those positions can be paid for through October, but he isn’t sure whether he can keep those employees after that. Without them, he explained, “we would never know which kids have exposures.”
Those were the people who’d pinpointed the family in Hickory, and then two other households in western North Carolina who’d turned out to be feeding their kids the contaminated applesauce. One inspector had arrived at a mobile home, where lead exposures are often harder to identify because such trailers generally don’t have the lead paint that is among the usual suspects in an old house. “When she got to the door,” Norman said, “she asked the parent about applesauce, because it was a new thing she’d just learned about. And the mother took her over to the kitchen cabinet, and there were 90 pouches.”
Those 90 pouches, it turned out, created a natural experiment. The purees came in various flavors — apple cinnamon, banana, mango — and the child was eating a number of them; the inspector took pouches of each one to send out for testing. Only the cinnamon one ended up containing lead. Once those results were confirmed, things began moving fast.
The Food and Drug Administration notified the public, and the distributor initiated a voluntary recall. The CDC scientists, meanwhile, began coordinating among state health departments, to track down just how widespread these poisonings were. They established the difference between suspected, probable, and confirmed cases, and made sure that states were following the same processes to ascertain that a poisoning was actually linked to the applesauce, rather than, say, crunching flakes of old lead-containing paint, which can taste sweet.
The CDC’s work was important, said David Nicholas, a chief epidemiologist with the New York State Department of Health. “To make sure we’re all using the same case definition, we’re all classifying cases the same way because each state may have different regulations or may see things a little bit differently, but this gives you a centralized way to collect the data and to report out on the data so you can describe the outbreak as one whole.”
Behind this research is a road map for addressing a molecular time bomb. In our bodies, lead resembles the minerals that our cells need all the time: the calcium required for our tissues’ electrical signals, the iron necessary for ferrying oxygen through our blood. Replacing those — even in small doses — with lead can impede all kinds of functions, causing organ damage and cognitive impairment. With a long enough exposure, the lead can get built into the very architecture of the bone. There, it can eventually degrade and seep back into circulation, the body poisoning itself.
An extreme enough blood level might require drugs to catch onto the toxic molecules and make them water-soluble so they can be peed out. But usually, the best and most immediate response is identifying and eliminating the source, the very work Honeycutt and his counterparts at the CDC and in other states were doing.
By now, the lead-in-applesauce story is old news. The factory in Ecuador where the contamination occurred was identified and the product pulled off shelves. A New York Times investigation from February 2024 revealed checkpoints in the food safety system that this applesauce had sailed through. The MMWR paper was a postmortem, a way for those in public health to learn from the method when other, similarly baffling issues come up. But as things stand now, that method would be wildly different if it could be applied at all.
“There’s an outbreak that no one can figure out; it’s definitely not infectious, but they don’t know what it is — this unit gets contacted,” said Erik Svendsen, the director of the division of environmental health science and practice at CDC, who was himself RIF’d on April 1. “Our team’s gone.” As the lead poisoning prevention team at the CDC faces uncertain future, many are left wondering about the implications of this decision. With the team effectively axed from the CDC, questions arise about the continuation of their important work and the impact it will have on public health.
A Health and Human Service official stated that as HHS finalizes its reorganization plans, all strategic programs and priorities will be evaluated. The fate of the lead poisoning prevention program remains unclear, leaving many in the dark about when it will resume, who will be involved, and what will happen to the funds allocated to states through the office.
Norman from North Carolina expresses his concerns, stating that it’s hard to sleep through the night with so much uncertainty looming. He had regular contact with CDC scientists who are now nowhere to be found, leaving him feeling isolated and anxious about the future.
The lack of communication and transparency surrounding the discontinuation of the lead poisoning prevention team has left many feeling abandoned and helpless. The importance of this program in preventing lead exposure and its harmful effects cannot be overstated, making the uncertainty surrounding its future all the more concerning.
As we wait for more information on the fate of the lead poisoning prevention program, it is imperative that the government prioritize public health and safety. The impact of lead exposure on individuals and communities is significant, and the absence of a dedicated team to address this issue is a cause for alarm.
It is crucial that the government provides clarity on the future of the lead poisoning prevention program and takes necessary steps to ensure that this vital work continues. The health and well-being of the public should always be a top priority, and the decision to disband this team raises serious concerns about the commitment to safeguarding public health.
