Johns Hopkins faces further criticism over experiments

BMJ 2001; 323 doi: (Published 08 September 2001) Cite this as: BMJ 2001;323:531
  1. Deborah Josefson,
  2. San Francisco

    The Johns Hopkins University Medical Center, in Baltimore, Maryland, is facing fresh criticism over its research methods and ethics—this time in relation to a study of different ways of getting rid of lead paint in homes, during which children were knowingly exposed to high levels of lead.

    The centre temporarily lost its licence for research on humans recently after a previously healthy woman died in an asthma study (28 July, p 186).

    Now two families have won the right to pursue a court case against the Kennedy Krieger Institute, which is affiliated to the Johns Hopkins University Medical Center, claiming that in the study it allowed their children to sustain lead poisoning and brain damage by failing to inform them that they lived in housing with dangerous levels of lead dust. The Kennedy Krieger Institute, located on the university's campus, is nationally recognised in the field of lead poisoning and childhood neurological disorders.

    The study, which ran from 1993 to 1995, was conducted in 100 homes contaminated with lead paint. In Baltimore city more than 100000 homes have lead paint and over 4000 children annually test positive for raised serum lead levels.

    The aim of the study was to find a cheaper and less hazardous way of removing lead paint than stripping the paint off the walls. The work was funded largely by a government grant.

    Landlords were paid from $1650 (£1178) to $7000 to partially remove lead by scraping off peeling paint, to paint over existing paint, or to add coverings. Residents were allowed, and in some cases encouraged, to remain in their homes while these removal techniques were going on. Lead levels of children living in the homes were periodically tested to monitor the efficiency of the various techniques.

    Maryland Court of Appeal ruled 7 to 1 to allow the lawsuit to move forward, using the occasion to tighten safety precautions in research involving children and to restrict such research further. They also criticised Johns Hopkins' institutional review board for allowing the study to proceed.

    Judge Dale Cathell compared the Kennedy Krieger study to Nazi experiments on concentration camp victims and to the Tuskegee experiment, in which syphilis in black men with the disease was allowed to progress (rather than be treated with penicillin) so that the natural course of syphilis infection could be studied

    The appeal court's indictment of the Kennedy Krieger study has also resulted in an investigation into the study by the Department of Health and Human Services' Office of Human Research Protections.

    But Don Ryan, executive director of the Alliance to End Childhood Lead Poisoning, in an article in the Baltimore Sun newspaper (2001; 28 August) defended the lead research, saying: “The reality is that this research made homes safer, not only for the children in Baltimore but for hundreds of thousands of others across the nation. Children do not live in lead-burdened houses because researchers want to ‘experiment’ on them but because so much of our housing is contaminated by lead.”

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