Life without Lead: Contamination, Crisis, and Hope in Uruguay

Life without Lead

CRITICAL ENVIRONMENTS: NATURE, SCIENCE, AND POLITICS

Edited by Julie Guthman, Jake Kosek, and Rebecca Lave

The Critical Environments series publishes books that explore the political forms of life and the ecologies that emerge from histories of capitalism, militarism, racism, colonialism, and more.

1. Flame and Fortune in the American West: Urban Development, Environmental Change, and the Great Oakland Hills Fire, by Gregory L. Simon

2. Germ Wars: The Politics of Microbes and America’s Landscape of Fear, by Melanie Armstrong

3. Coral Whisperers: Scientists on the Brink, by Irus Braverman

4. Life without Lead: Contamination, Crisis, and Hope in Uruguay, by Daniel Renfrew

Life without Lead

CONTAMINATION, CRISIS, AND HOPE IN URUGUAY

Daniel Renfrew

UNIVERSITY OF CALIFORNIA PRESS

University of California Press, one of the most distinguished university presses in the United States, enriches lives around the world by advancing scholarship in the humanities, social sciences, and natural sciences. Its activities are supported by the UC Press Foundation and by philanthropic contributions from individuals and institutions. For more information, visit www.ucpress.edu.

University of California Press

Oakland, California

© 2018 by Daniel Renfrew

Library of Congress Cataloging-in-Publication Data

Names: Renfrew, Daniel, 1974- author.

Title: Life without lead : contamination, crisis, and hope in Uruguay / Daniel Renfrew.

Description: Oakland, California : University of California Press, [2018] | Series: Critical environments: nature, science, and politics | Includes bibliographical references and index. |

Identifiers: LCCN 2018010667 (print) | LCCN 2018013589 (ebook) | ISBN 9780520968240 (Ebook) | ISBN 9780520295469 (cloth : alk. paper) | ISBN 9780520295476 (pbk. : alk. paper)

Subjects: LCSH: Lead poisoning—Uruguay—20th century. | Environmentalism—Uruguay—20th century.

Classification: LCC RA1231.L4 (ebook) | LCC RA1231.L4 R39 2018 (print) | DDC 615.9/2568809895—dc23

LC record available at https://lccn.loc.gov/2018010667

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To my parents, John and Ileana Renfrew

CONTENTS

List of Illustrations and Maps

Acknowledgments

Introduction: Saturn’s Nightmare

1 • To Live, Not Only Survive

2 • This Is Not a Game

3 • La Teja Shall Sing

4 • The Two Fires of ANCAP

5 • New House, New Life

6 • We Are All Contaminated

Conclusion: Contamination, Crisis, and Hope

Notes

Bibliography

Index

ILLUSTRATIONS AND MAPS

PHOTOGRAPHS

1. Carlos Pilo in his barraca

2. Industrial effluents flow into a pool in La Teja

3. CVSP poster: This Is Not a Game

4. Riding in the truck with the La Reina de La Teja murga

5. FANCAP counterrally

6. Inlasa street protest

7. Víctor and Lucía’s former home in the Rodolfo Rincón squatter settlement

8. New houses in Barrio Pilo

All photos by author

MAPS

1. Uruguay

2. Montevideo

Maps produced by William L. Nelson

ACKNOWLEDGMENTS

I started researching lead poisoning fifteen years ago, including a total of over two years living in Uruguay. My fieldwork and writing have spanned from predoctoral and doctoral research at Binghamton University–SUNY (2003–7) to postdoctoral work while living in Baltimore (2007–8) and West Virginia (2008 to the present). That makes for a long list of people to whom I want to offer my humble and deepest gratitude.

Starting in Uruguay, I must begin by thanking the dozens of individuals whose voices and perspectives animate this book. Some of you must remain anonymous, others I can name. The activists of the Live without Lead Commission (Comisión Vivir sin Plomo, or CVSP) graciously accepted me into their activist worlds and lives, and for this I will be forever touched and transformed. Carlos Pilo, tender lion of the movement, merits particular gratitude. In many ways, his life and perspective drive this story, and his inspiration has been immeasurable. Dr. Elena Queirolo, itinerant insider and companion to the movement: her tireless and principled dedication to the children and families of lead poisoning’s scourge serves as an example to all and, quite frankly, often leaves me awestruck. To the other members of the CVSP and their allies, Carlos Amorín, José Camarda, Milka Pereira, Javier Cáceres, Julio Brunini, Chiquillo Larramendi, and so many more: you have all served as invaluable support and inspiration to this project, and I find myself fortunate to have spent time with all of you. I would also like to thank the broad range of government officials, municipal workers, social workers, state enterprise employees, industry representatives, union officials, journalists, scientists, medical doctors, academics, and others with whom I had extensive contact and whose generous time and insights contributed to a more complicated and nuanced story. I would like to highlight in particular Nelly Mañay, Mabel Burger, Darío Pose, Sonnia Romero, Alicia Pereira, Verónica Bittencourt, José Radesca, Enebé Linardi, and Julio López.

Fieldwork of course necessitates other kinds of behind-the-scenes support, friendship, and intellectual engagement to sustain it. In the project’s early stages, it would have been impossible without the personal, family support of Isabel Mendietta. I also would like to acknowledge the importance of my lifelong friendships with mi hermano Salvador Malagrino as well as Javier Díaz (y la barra). Since 1997 I have had the fortune to forge deep friendships and share invaluable intellectual spaces with anthropologists and students of the University of the Republic, in particular Rafael Bazzino, Carlos Serra, Valeria Grabino, Carlos Santos, and Javier Taks. Within and beyond anthropology, Majo Techera, Tania Bo, Victoria Calvo, and Verónica Olivera have been dear friends. For brief times, I had the pleasure to share overlapping fieldwork experiences with María José Álvarez-Rivadulla, Julienne Corboz, Michelle Switzer, and Victoria Evia. Hugo Lalanne and Blanca and Luis Loureiro, within my extended family, and the Veljaciks and the late Gladys Curbelo, part of my fictive kin network, stand out as Uruguayan experts in leftist politics, society, culture, and the arts who have always enriched and stimulated me. To this, I need to acknowledge the joy of spending time with Julio and Zully Calvo, dear family friends and hosts of one of the best picadas in Uruguay.

Binghamton, New York, is where I became an anthropologist and where this project first spread its wings. I will forever be grateful to my dissertation supervisor, Carmen Ferradás, for her mentorship, guidance, and rigorous academic training and for always pushing me to be a better and ever-critical anthropologist. Carmen’s seminar in political ecology opened up a new intellectual world for me, and it has, at least indirectly, birthed three published ethnographies, by Peter C. Little, Thomas W. Pearson, and me. Other professors at Binghamton who directly or indirectly shaped this project and to whom I am indebted include Thomas Wilson, Douglas Holmes, Nancy Appelbaum, Anthony D. King, and Ann Stahl. Fellow graduate students became lifelong friends, and with them I worked and struggled through so much of the intellectual challenge and the emotional roller coaster of fieldwork and writing. Rolf Quam, Tom Besom, Kari Colosi, Bill Pavlovich, Tanya Miller, Susan Pietrzyk, Stacy Tchorzynski, Alberto Morales, Jeff Howison, Verónica Venegas, Marina Weinberg, and the late Mariana Grajales, who left us way too soon: I am forever grateful for your support and friendship. A note apart goes to Pete Little and Tom Pearson, great friends with whom I have continued to exchange ever-stimulating intellectual spaces and dialogue at professional meetings and beyond. With Pete, our intellectual journey has often developed in parallel, and I am always inspired by our conversations and friendship. Tom, one of the best editors I know, scrupulously and constructively gave me invaluable feedback on nearly the entire manuscript.

This project received generous funding from multiple agencies and institutions over the years. During my time at Binghamton, these included the Fulbright Commission, the Wenner-Gren Foundation for Anthropological Research, and the Rosa Colecchio Dissertation Enhancement Fund. I want to thank Patricia Vargas of the Uruguay Fulbright Commission for her amazing support. At West Virginia University, summer travel to Uruguay was supported through a Faculty Senate Research Grant, as well as small grants and funding through the Office of International Programs, Faculty Development Grants from the Eberly College of Arts and Sciences, and the Department of Sociology and Anthropology. I would also like to thank various professional colleagues who have supported this project through intellectual engagement and personal support. These include Matthew Durington, Samuel Collins, Doug Pryor, Whitney Garcia, and Mike Masatsugu, from my memorable one-year visiting position at Towson University in Baltimore. At West Virginia University, my colleagues Joshua Woods, Walter DeKeseredy, James Siekmeier, María Pérez, and Bradley Wilson have been extremely supportive. I thank Josh for inviting me to give a Social Science Café talk on my book project. Bradley has been a dear friend and intellectual brother while at WVU. I thank him for inviting me to present my book introduction in his political ecology graduate seminar. But he has done so much more, reading drafts of my work, cheerleading my progress, and being a pillar of inspiration in this university community. Some undergraduate students (at the time) closely read, commented on, and followed my work, particularly Andrés Romero, Derek Stemple, and Jacob Matz. Finally, I benefited greatly from the undergraduate research assistance at the beginning and end stages of this book project, respectively, from Alexandra Agosta and Christopher Scheffler.

I can’t thank enough Derek Krissoff of WVU Press for putting the University of California Press’s Critical Environments series on my radar and getting me in touch with the editors. I am grateful to Julie Guthman, Jake Kosek, and Rebecca Lave for taking on this project, and particularly to Rebecca for cheerfully believing in it and steering me through the proposal process. The manuscript benefited enormously from the generous and constructive feedback of five anonymous reviewers who chose to shed their anonymity: Javier Auyero, Donna Goldstein, Gerald Markowitz, Susanna Rankin Bohme, and Paul Blanc. I think the book is notably improved due to each of your interventions. I take sole responsibility for the areas where it may have fallen short. The editorial guidance of Kate Marshall and Bradley Depew at UC Press has been superb, and I could not have asked for a better and kinder set of guides to help steer me through the sometimes mystifying terrain of the book-publishing process. I thank cartographer Bill Nelson for making two great maps on a quick turnaround. I would also like to thank Erica Soon Olsen for her masterful copyediting work and Cynthia Savage for her expert indexing skills. Finally, I acknowledge UC Press production editor Emilia Thiuri and marketing manager Tom Sullivan for all of their valuable assistance and guidance through the final stages of the publishing process.

I dedicate this book to my parents, John and Ileana Renfrew. It is hard to put into words what my parents mean to me and how they have specifically shaped and supported this project. Both retired academics, they graciously served as my first readers, as excellent editors, and as parents, unwavering and committed supporters. My American psychologist father always pushed me toward enhancing clarity and the use of concise language. My Uruguayan literary critic mother was my first expert consultant in all things Uruguayan, and her humanistic sensibility and our years of intellectual engagement animate this text in ways conscious and beyond. My brother, Nicholas Renfrew, whether through an asado and a mate, hiking, camping, or whitewater rafting, has always been an unfailing companion and supporter throughout my life, and through key moments of research and writing as well.

When I started this project, it was just me. And then I had a family. And then it grew. Having children made me empathetic to the devastation and weight of pediatric lead poisoning in ways I could have never imagined. To my now college student Madeline, I’m so proud you are my daughter and so grateful you came into my life. Now you see what I was doing all those years during your long hours of gymnastics practice in Fairmont, where I read and reflected and wrote big chunks of this book at Fairmont State University, the Joe & Throw coffee shop, or my favorite of all, Prickett’s Fort State Park. Mi amor, little seven-year-old Stella, my passion and my muse: I think everything I do now is in some way for you. You were also a handy research assistant during our 2017 summer visit to Uruguay (and yes, I am finally done with the book!). To my wife, my friend, my colleague, and my companion, Genesis Snyder, the emotional rock, the MacGeever and Gen Vila of the house who keeps it all together: I am forever grateful for your support, for your companionship, for your love. This book would not have been possible without you.

Introduction

Lead is more sinister, maybe because of its color, hue or weight. Lead communicates something special to us about matter, our existence in matter. . . . And it isn’t the Grand Inquisitor’s universal anthill that we have to worry about after all, but something worse, more Titanic—universal stupefaction, a Saturnian, wild, gloomy murderousness, the raging of irritated nerves, and intelligence reduced by metal poison, so that the main ideas of mankind die out, including of course the idea of freedom.

SAUL BELLOW, The Dean’s December (1982, 249)

JOAQUÍN’S BODY TREMBLED IN PAIN. It hurt everywhere, from his bones and joints to his crushing migraines.¹ The six-year-old boy was pale and weak, a shadow of the formerly vibrant and playful kid from La Teja, western Montevideo’s gritty and proud working-class neighborhood. Along with his sharp and chronic pain, he was severely anemic. His parents, Nancy and Gabriel, led him through an exhausting and frustrating battery of doctors, specialized clinics, and medical tests, but his affliction remained a mystery. When hospitalized in August 2000, one of Joaquín’s doctors considered lead poisoning for the first time and ordered x-rays and blood tests. The x-rays revealed lead embedded in Joaquín’s bones and joints. His first blood lead level analysis read 31.2 µg/dL (micrograms of lead/deciliter of blood), over three times the World Health Organization and U.S. Centers for Disease Control and Prevention (CDC) medical intervention action threshold at that time.² No one knew for certain the cause of Joaquín’s lead poisoning, though the family and Public Health Ministry authorities suspected the many factories or clandestine workshops near their La Teja home.

Joaquín’s entire family tested positive for lead poisoning. Even the dog demonstrated lethargy and erratic behavior. Word began to spread, and other families in the neighborhood recognized a toxic slew of related symptoms among their own children: bone, joint, head, and stomach pains; tremors and convulsions; loss of appetite; stunted growth; attention deficits and learning disabilities; hearing loss; lethargy; irritability and aggression. Many parents sought in vain medical treatment and diagnoses for their children. Others attributed some of the seemingly milder symptoms to simple character traits or a passing phase or misdiagnosed the more serious ones. Parents later recalled the learning problems and constant disciplinary issues their hyperaggressive kids would face at school and described other kids as apagados, simply tuned out.

Similar testimonies circulated throughout the barrio. Shortly after moving to La Teja, a mother and her twelve-year-old boy found their tendons stiffening, their toes curling up involuntarily, frequent body tremors, and convulsions in their arms and legs. The boy, formerly an avid tae kwon do practitioner, grew weak to the point where he couldn’t even peel a fruit: I noticed he was distant, his mother recounted, and he started to fall down a lot . . . and he told me he couldn’t remember a thing they were teaching him in school (Amorín 2001, 33).³ Nicolás, an eight-year-old from another part of La Teja, suffered from terrible head- and stomachaches, vomiting, and joint pain. A pediatrician, in tune to growing public concern, suggested a blood lead analysis, but his mother, a maid with poor medical coverage, could not afford the test. Nicolás’s grandmother declared, we, because we’re poor, [they treat us like] we just have to die (Morales 2001, 46).

Stories such as these exemplify the alarming and sudden afflictions that struck the neighborhood’s children and the difficulty families faced not only in getting proper diagnoses but in affording medical care. Lead poisoning was discovered against the backdrop of growing poverty and a looming economic crisis, with the working class and poor experiencing the real and perceived devaluation of their lives and bodies. While some residents maintained faith in medical professionals and Public Health authorities, many others felt abandoned, particularly as officials seemed to display more concern with avoiding a public panic or denied the scope and severity of the problem altogether.

Families were also troubled that they could not determine the sources of contamination. In the early days, most residents and authorities focused on a single potential cause. Suspicions ranged from clandestine smelting and battery-recycling plants, to the noxious black smoke emitted from the BAO soap and detergent factory in the heart of La Teja, to the iconic state-owned ANCAP oil refinery along Montevideo Bay in La Teja’s southern edge, to the leather tanneries and wool dyers upstream from La Teja’s crisscrossing rivers and canals, to the ubiquitous leaded gasoline combustion in this densely populated area, or to the leaded water pipes and connections found in its many old homes. Only later did the full scope of the contamination become clear. Many of those identified sources played a role in contamination, but the causes and pathways were multiple and cumulative. Lead contamination emanated from industrial pollution, urban vehicular emissions of tetraethyl leaded gasoline, an increasingly elaborate informal economy, consumer products, urban infrastructure, and landfill laced with heavy metals and toxics. Rather than a sudden and acute burst of exposure, lead contamination had been accumulating slowly and surreptitiously through the multiple pathways of air, soil, and water. La Teja would become only the tip of the iceberg of a geographically dispersed and devastating urban epidemic.

Joaquín’s illness signaled the beginning of a long and dramatic story, one with a mostly occluded history, establishing Uruguay as another recognized site in lead poisoning’s 2,500-year global trail of silent suffering (Hernberg 2000). Originating through the lonely and desperate efforts of a few concerned parents and seemingly emerging out of nowhere, awareness of lead poisoning quickly captured the popular imagination. Neighbors of La Teja first organized collectively through popular assemblies. In early 2001, the assemblies coalesced into an environmental justice–style movement dubbed the Live without Lead Commission (Comisión Vivir sin Plomo, or CVSP), with lifelong La Teja resident Carlos Pilo as its informal leader. The same year, the state established the Inter-Institutional Commission on lead under the orbit of the Public Health Ministry to direct interventions and set regulatory norms and policies. In addition to commissioning blood and environmental lead testing, soil remediation, and housing relocations, one of the Inter-Institutional Commission’s most notable actions was to open the nation’s first health clinic for pregnant women and children exposed to environmental toxics (known widely as the Lead Clinic). By 2003 the CVSP turned from ad hoc activism responding to unfolding events and became a loosely affiliated activist group engaged in public outreach and social movement building. Its organizing power largely dissipated by 2006, however, coinciding with the rise to national power of the center-left Frente Amplio coalition. Since then, the CVSP turned back to ad hoc actions as new developments arose, while the Lead Clinic continued to treat hundreds of children. The lead issue would fade in and out of the media’s fickle spotlight.

Nevertheless, Joaquín was the index case of what would become Uruguay’s first mass contamination event, affecting upward of tens of thousands of children in neighborhoods across Montevideo and cities of the interior. It was the first environmental problem to reach mass popular awareness, gain extensive media coverage, and mobilize all three branches of state power. Carrying along a deep sense of urgency, the discovery and unfolding of lead contamination raised broad-ranging questions about the nature of urban environmental risk, the fraught and changing relationship between citizens and the state, and the transformative social, economic, and political landscape of a country in crisis.

My research follows anthropological approaches to environmental and industrial disasters in analyzing how public concern about lead poisoning constituted a totalizing phenomen[on] . . . subsuming culture, society, and environment together (Oliver-Smith and Hoffman 2002, 6). I argue that lead poisoning took on the status of a publicly conscious, media-propelled event by linking up with larger stories affecting Uruguay and in this sense acted as a prism and social surrogate for broader social and political concerns (Fortun 2001, 78, 195; see also Button 2010). I approach disasters as dynamic and processual phenomena that reinforce place attachments while revealing the inner working of society. Lead contamination, like other forms of toxic exposure, is deeply expressive of and constituted by material processes and effects, but it is equally pregnant with symbolism and meaning. It is to the deeper social grammar revealed through the material and social worlds (Oliver-Smith and Hoffman 2002, 6, 24) of lead contamination that Life without Lead is dedicated.

SATURN’S NIGHTMARE

Once the cause of the quintessential disease of antiquity, lead became the twentieth century’s mother of all industrial poisons (Markowitz and Rosner 2002, 137) and has now been reinvented and transformed yet again through globalization. Humans have mined and used lead, a versatile heavy metal, for over six thousand years (Hernberg 2000, 244). Through lead-silver mining, lead poisoning became one of the earliest occupational diseases contracted by humanity (Nriagu 1983, 309). Hippocrates described lead colic in 370 B.C., and by the first century A.D., Dioscorides recognized a connection between lead exposure and toxicity (Hernberg 2000, 244). Leaden pipes for transporting water were used in ancient Ur, Mesopotamia, and Persia, and they were the mainstay of the Roman water-distribution system through its vast network of aqueducts (Nriagu 1983, 240). Roman architect Vitruvius, writing two thousand years ago, advocated for the use of clay rather than lead pipes out of concern for the effects of leaching white lead on human health (Blanc 2009, xviii). In addition to piping, the Romans used large quantities of lead in pottery, writing tablets, and weights, and they used lead as a sweetener to neutralize the acidity of wine tannins (Nriagu 1983, 399), producing a yearly average of sixty thousand tons of lead for over four hundred years (Hernberg 2000, 244). Lead poisoning reached pandemic proportions in ancient Rome, particularly affecting the patrician class, and resulted in widespread stillbirths, miscarriages, sterility, and infant mortality, leading some historians to hypothesize a link between lead poisoning and the fall of Rome (Gilfillan 1965; Nriagu 1983, 402).

Saturnismo, the old Spanish term for lead poisoning, is derived from Saturn, the Father of the Gods, who was associated with lead, the first of the seven metals of antiquity (Nriagu 1983, 35). In pre-Columbian America, lead had a name in Quechua and Náhuatl, and the chronicler Sahagún referred to it as the excrement of the moon (Nriagu 1983, 185). Lead was used in mortuary practices across the ancient world and is linked to the history and origins of writing (Warren 2000, 19). For over 2,500 years, lead was used in body and face painting in places such as Greece, West Africa, and China, and it is still used in East Asian cosmetics and medications, for ceramic glazes in Mexican pottery (Pérez 2007; Warren 2000, 21), and in South Asian herbal remedies (Frith et al. 2005). A wide range of consumer and household products have utilized lead for centuries, including interior plasters and paints, soaps, glass and crystal, tooth fillings, medications, munitions, and fishing weights (Warren 2000, 21–23). Art historians have linked lead exposure to the genius, madness and art of great painters such as Goya and Van Gogh, who ate the sweet leaded paint straight off the brush (Warren 2000, 23). Among the first public health–related laws of the American colonies was the prohibition in 1723 of the use of lead in the distillation of molasses for rum (Bellinger and Matthews 1998). In the nascent United States, Benjamin Franklin referred to the mischievous Effect of lead in a letter to a friend in 1786 (Warren 2000, 8).

Environmental lead levels increased exponentially through industrialization. Studies have correlated peaks in environmental lead levels and the rise of medieval metallurgy, the industrial revolution, the postwar period of industrial production, and increased tetraethyl leaded gasoline use (Patterson 1965; Renberg, Bindler, and Brännvall 2001). A measurement of the bones of preindustrial humans revealed a natural background level of lead in human blood of 0.016 µg/dL (Flegal and Smith 1992, 129). The current U.S. level of concern of 5 µg/dL, therefore, would represent 1,250 times the natural lead level in humans.

What does it mean to live with lead? At low doses of exposure, lead interferes with various biochemical processes and impairs psychological and neurobehavioral functioning. At high levels, lead damages almost all organs and organ systems. Lead exposure in adults has been linked to renal dysfunction, hypertension, dementia and other psychiatric disorders, cardiovascular disease, reproductive disorders, and possibly cancer (Gulson et al. 2004; NIOSH-CDC 2001; Rhodes et al. 2003). Extreme levels of exposure may result in coma and death.

Children and adults differ in terms of exposure pathways, how the body metabolizes lead, and the ways toxicity is expressed. A child exhibits more hand-to-mouth activity than an adult, and children’s gastrointestinal absorption rates are up to five times that of adults (NIOSH-CDC 2001; UNICEF-UNEP 1997). At the fetal and newborn stages, the child is already at a disadvantage through the transfer of the mother’s blood lead through the placenta and by means of a burst of lead through pregnancy and birth-related bone mobilization. Children born with elevated lead levels commonly have lower birth weights, and their growth and stature are inhibited.

Clinical intoxication in children occurs at around 60 µg/dL, at which point manifested symptoms may include abdominal pain, colic, arthralgia, headaches, clumsiness and staggering, stupor, alterations of consciousness, convulsions, and early encephalopathy (Needleman 2004, 212). Severe cognitive, attention, and behavioral impairments are common at this stage, and anemia may develop. Studies have shown behavioral and attention deficits among lead-exposed children at subclinical or asymptomatic levels, as well as difficulties in language processing, auditory capability, fine motor skills, neuropsychological and cognitive functioning, and nerve conduction (Canfield, Gendle, and Cory-Slechta 2004; Needleman 2004). Subclinical lead exposure is also associated with various forms of antisocial behavior, including depression disorders, aggression, violent crime, and delinquency (Bellinger 2004; Bouchard et al. 2009; Dietrich et al. 2001; Montague 2004; Needleman et al. 1979; Needleman 1998; Nevin 2000). In the past fifteen years, there has been a sea change in scientific understandings of the negative impacts of low-dose lead exposure (Canfield et al. 2003), suggesting that there may be no threshold for the adverse consequences of lead exposure, and that lead-associated impairments may be both persistent and irreversible (Koller et al. 2004).⁴ In response to these new developments, in 2012 the U.S. CDC lowered its official level of concern to 5 µg/dL.

Individual harm from lead exposure is compounded at the population level. In the diminishing of IQ, for instance, a loss of a few IQ points may be detrimental to an individual child, depending on his or her rearing, environment, or individual biopsychological responses. The loss of a few IQ points on a society-wide scale, however, has potentially devastating effects. As Rogan and Ware (2003, 1516) put it: Relatively small changes in the mean IQ of a large number of children will dramatically increase the proportion of children below any fixed level of concern, such as an IQ of 80, and decrease the proportion above any ‘gifted’ level, such as 120.

By consequence, the intellectual bell curve at chronic low-level lead exposure is collectively shifted to the left, with more resources needed for remedial education and other services. If we also take into account the collective costs of the increase in antisocial and delinquent behavior, the benefits of primary prevention and a widespread lead phaseout become paramount.

Recognition of the negative effects of environmental and pediatric exposure began only during the past century, though medical knowledge of occupational exposure has a longer history. In each case, the tangled web of science and politics worked to progressively revise officially recognized levels of safety and hazard in different national contexts and internationally through the World Health Organization (Markowitz and Rosner 2002, 2013). Despite its long global history, lead poisoning has alternated between recognition and silencing, made visible or invisible depending on a complex set of factors largely unrelated to the status of medical and scientific knowledge at any given time. Bellinger and Matthews (1998, 310) note the curious pattern of the past two thousand years, whereby the toxicity of lead was seemingly discovered, forgotten, then rediscovered in a different context or with respect to a different risk group. The factors involved in these recurrent discoveries include the relative power of economic actors and interests, including their influence over public health decision-making or the funding of scientific research; cost/benefit calculations in relation to an identified risk group; broader sociopolitical contexts that are more or less sensitive to issues of individual and collective suffering; prevailing medical theories of disease etiology; social theories of the relationship between bodies, culture, and poverty and/or race; and the comparative strength of social movements or scientific advocacy groups on behalf of lead’s victims (Bellinger and Matthews 1998; Fassin and Naudé 2004; Markowitz and Rosner 2002, 2013; McGee 1999; Moore 2003; Richardson 2005; Sullivan 2013; Warren 2000). As I discuss throughout the book, all of these factors played a role in defining the scope and nature of the epidemic and ultimately in breaking the silence surrounding lead poisoning in Uruguay.

By the late twentieth century, roughly one million tons of lead were dispersed into the biosphere each year (Bellinger and Matthews 1998, 308). Lead consumption in the global South had almost tripled, while increasing only slightly and being phased out in many industries, products, and infrastructure in countries of the global North (Tong, von Schirnding, and Prapamontol 2000, 1069). For these reasons, researchers often treat lead contamination as a legacy pollutant in the global North (Schell and Denham 2003), found in peeling and flaking old house paints, in urban sediment layers from decades of tetraethyl leaded gasoline use, or in the leaded water pipes and connections of decaying deindustrialized cities like Flint, Michigan. In the global South, meanwhile, lead exposure is most often associated with either traditional folk practices like the use of lead ceramic glazes or with cottage industries of the informal economy such as battery, metals, or e-waste recycling (Hernández-Avila et al. 1999).

While true to an extent, treating processes of lead contamination in the global North and South as responding to fundamentally different social and political-economic dynamics obscures the far-reaching interconnections between North and South and between formal and informal that characterize the globalized economic system today (Nordstrom 2007; Tsing 2005). As transnational corporations outsource production and pressure suppliers to provide ever-cheaper labor and resources, lead mining and recycling operations have proliferated across the world, with devastating and sometimes deadly consequences. To offer one well-known example, in the severely polluted town of Guiyu in southern China’s Guangdong Province, the world’s preeminent electronic waste recycling center, recycled lead was used in the paints of millions of toys shipped around the world and was later subject to mass recalls in the United States (Blanc 2009, xiii; Huo et al. 2007; Lipton and Barbosa 2007). Cases such as these underline the progressive transfer of toxic industries to the global South to satisfy the consumer needs of the middle and upper classes of the global North and South alike (Little and Lucier 2017), leaving a toxic trail of contamination that laces the far-flung corners of the global commodity system.

Ethnographic research is well positioned to grasp these global articulations. Understanding lead poisoning’s broader effects among individuals, communities, and societies provides an important complement to conventional biomedical and environmental studies. And compared to the voluminous medical, toxicological, and epidemiological literatures on lead poisoning, perhaps the world’s most studied environmental pollutant (Bellinger 2004), the disease has received comparatively little attention from the social sciences.⁵

Life without Lead addresses the broad-ranging social, political, and environmental dimensions and consequences of a multimodal and multisited lead-poisoning epidemic in the global South. My research situates the Uruguayan lead case in relation to major regional and global processes involving globalization, neoliberal reform, the restructuring of the state, and the resurgence of the political Left in Latin America. It is grounded through an ethnographic analysis of grassroots social-movement formation and in relation to transformational experiences related to class, space, and place in barrios like La Teja. The book examines the social and material consequences of lead contamination through the productive entanglements of large-scale transnational capital and public enterprises, small-scale domestic formal industry, and informal or backyard cottage industries. It ties together the material effects and symbolic dimensions involved in the slow violence (Nixon 2011) of environmental health exposures and chronicity (Manderson and Smith-Morris 2010) and individual and social suffering (Kleinman, Das, and Lock 1997). The book also follows the local and transnational circulation of environmental ideologies and paradigms, and of contested scientific expertise. Throughout, it traces the dynamics of power and agency within and across the social and political spectra of victims, activists, industrialists, state bureaucrats, health providers, and scientists. In short, Life without Lead traverses the realms of material reality and experience, of disputed claims to truth, and of the symbolic and power-laden terrain of collective identities, meaning, and action.

A POLITICAL ECOLOGY OF LEAD

My work draws broadly from a political ecological perspective on urban environmental health and justice. Political ecology combines neo-Marxist and poststructuralist approaches to the human-nature nexus, bringing political economy to bear on environmental processes, with careful attention to issues of power and inequality, as well as the discursive constructions of nature (cf. Escobar 1996, 2008; Harvey 1996; Heynen et al. 2007; McCarthy and Prudham 2004). In this way it is a fluid and ambivalent space that lies among political economy, culture theory, history, and biology (Biersack 2006, 5). The structural changes and effects associated with neoliberal reform and the subsequent crisis of the neoliberal model make up the principal historical and political economic context of this study.

Neoliberalism constitutes a set of government policies and principles that aim to privatize and deregulate the economy, encourage foreign investment, and intensify export production (Harvey 2005). Lead contamination as a material and embodied threat was closely tied to the crisis of the neoliberal order that had dominated Uruguayan political economy in the latter decades of the twentieth century. The crisis reflected a failure of the economic system itself, evidenced graphically by soaring poverty rates, social exclusion, and unemployment, as well as macroeconomic instability (Olesker 2001). As in other Latin American contexts, the state, acting for years as neoliberalism’s booster, faced a profound crisis of representation and accountability (Sawyer 2004, 15; see also Edelman 1999; Goldstein 2004; Gregory 2007; Petras 1999; Wolford 2010). In many ways, however, Uruguay’s economy was the least neoliberal and an exception to other Latin American regimes’ wholehearted embrace of the model during the 1990s (cf. Babb 2001; Gill 2000; Paley 2001). While the Uruguayan state followed neoliberal precepts during the 1980s and 1990s by promoting privatization, labor flexibilization, and industry deregulation (Finch 2005; Moreira 2004), full-scale neoliberal reform was resisted by an entrenched state-centered political culture and was repeatedly defeated at the polls by a series of popular referenda and plebiscites in the 1990s and 2000s that reversed privatization measures and protected public enterprises (Moreira 2004, 107–13; Santos et al. 2006; Taks 2008). The crisis of legitimacy of the established order gave rise in 2005 to the center-left Frente Amplio coalition, part of Latin America’s so-called Pink Tide of anti-neoliberal leftist governance. Uruguayan neoliberalism then, similar to what Shever (2012) argues in the case of Argentina, has taken on a hybrid character and should be understood through its local inflections and dynamics rather than as a carbon copy of an idealist model.

The lead issue in Uruguay unfolded within the political and historical juncture of the deep long-term social effects of neoliberal economic restructuring and reform, the economic and political crisis of the neoliberal model, and the rise of the post-neoliberal Left to national power. Starting from this political economic context and the political ecological approach outlined above, Life without Lead engages with the crosscutting themes of environmental justice, knowledge and power, and governance and resistance.

Environmental Justice

The toxic environments that create environmental injustices carry both disabling and enabling tendencies (Edelstein 2004). They are disabling for individuals and communities through processes of environmental suffering and the stigmatization of victims, and because the causes of environmental risk and harm often remain uncertain (Auyero and Swistun 2009; Checker 2007; Goldstein 2017; Nixon 2011). Toxic exposure can also become enabling, however, when it fosters a sense of community and collective solidarity that turns into political action (Little 2014; Mah 2012). Environmental justice movements draw media attention and gain political traction if they emerge from meaningful and morally charged realms of symbolic violence—for instance, when children, mothers, neighborhoods, or socially vulnerable groups are threatened (Harvey 1996, 386). These movements, Schlosberg (2003) argues, advocate for a robust understanding of justice oriented around equity, recognition, and participation. Justice is conceived of as the fair and equitable distribution of social goods; as the recognition of collective identity, group needs, and difference; and as procedural equity that promotes more authentic public participation (Schlosberg 2003, 79–84).

In Uruguay, the antilead movement pushed an already pervasive social and political critique of neoliberalism in new directions by redefining popular understandings of urban environmental health and risk and by linking the socioeconomic crises of deindustrialization, poverty, and social exclusion to the environmental degradation and embodied suffering borne of toxic exposure. The movement was strongly rooted in La Teja’s combative histories of militancy and solidarity, building from and contributing to its formidable working class and place identity. As Carruthers notes in the case of Latin America, environmental justice struggles there tend to fuse environmental issues with broader community struggles, thereby linking up with rich and dense networks of popular movements often working beneath the surface (2008a, 2, 8). Studies of urban-based environmental justice movements in Latin America and the global South remain rare, however (Auyero and Swistun 2009; Carruthers 2008b; Sabatini 1998). Most environmental justice research continues to focus on the dynamics of grassroots responses to environmental racism in the urban global North,