The Hand-in-Hand Spread of Mistrust and Misinformation in Flint

2017 January-February. For American Scientist. "The water crisis not only left infrastructure and government agencies in need of cleaning up; the information landscape was also messy."

Reproduced from American Scientist.

In the wake of the water crisis in Flint, Michigan, countless Americans are asking: Can I trust my tap water? High lead levels in water are being found in homes, schools, and daycares across the country; recent investigations by USA Today, CNN,and the Natural Resources Defense Council(NRDC) revealed that more than 5,300 public water systems had lead violations last year. The NRDC warned in a June 2016 report that “millions of Americans could be drinking contaminated water—and not even know it.” This statement agrees with a 2015 article in the Journal of American Water Works Association that declared up to 96 million Americans could be at risk from lead-laden water. This number is not surprising considering the 6 million to 10 million lead pipes and the legion of leaded plumbing materials in our water infrastructure, all of which can leach lead despite optimal treatment. In his 2006 book, The Great Lead Water Pipe Disaster, historian Werner Troesken called the misguided decision to install lead pipes across the United States between the mid-1800s and 1980s “a long-running environmental and public health catastrophe.”

After the water crisis, Flint resident Darlene Long (second from left) and her family go to a hotel outside the city once a month to bathe for longer time periods with peace of mind. Many residents in Flint continue to distrust the water’s safety, even after government and independent scientists have tested the water and confirmed that it is safe for bathing. Photo: Brittany Greeson.

The Flint water crisis began when a Michigan state-appointed emergency manager decided to change Flint’s public water source to the Flint River in April 2014, and then the Michigan Department of Environmental Quality (MDEQ) did not mandate federally required corrosion-control treatment. This oversight led to increased corrosion of lead pipes and fittings. Consequently, the blood lead levels in Flint’s children doubled after the water switch. As the chlorine that sanitizes water interacted with corroded pipes and so was removed, the city also witnessed one of the worst legionnaires’ disease outbreaks in modern U.S. history, causing 12 deaths. This environmental injustice that endangered families for 18 months was prolonged because the city and MDEQ cheated on water tests, was hostile to outside researchers sounding the alarm, and betrayed the public’s trust by repeatedly insisting the brown, smelly, lead-laden water was safe to consume.

The U.S. Environmental Protection Agency (EPA), as per its Office of Inspector General investigation, had sufficient knowledge of imminent and substantial endangerment to Flint residents from lead-contaminated water as early as June 2015. Instead of taking decisive action, the agency silenced its own whistleblower, regulations manager Miguel Del Toral, and did not issue an emergency order until seven months later in January 2016.

The exploitation of loopholes in federal regulations and the use of faulty water-sampling methods that minimize the lead collected is not unique to Flint. A recent investigation by The Guardian found that at least 33 major cities east of the Mississippi River were cheating on such testing by, for example, flushing pipes the night before sample collection to temporarily hide lead-in-water issues. Residents of Philadelphia sued the city not long ago because of such practices. New York City vowed to retest water in its public schools after my advisor, Marc Edwards, called out their and others’ sampling practices in The New York Times. Regrettably, they have agreed to only partially fix these problems. EPA expert Mike Schock warns that such testing allows for “wanton experimentation on the public.”

Flint citizens understandably wanted to test the water for themselves rather than rely on the word of scientists. As they and concerned citizens in other towns turned to online sources and social media for support and information, some of the content they found was harmful.

In light of such exposés, it is no wonder that many citizens are worried about tap water. Agencies, including the U.S. Centers for Disease Control and Prevention (CDC), have continued to put innocent lives at risk as they have periodically dismissed the seriousness of lead exposure from drinking water, while the water industry has taken cover under a weak Lead and Copper Rule so that they may avoid their obligation to protect public health. The Lead and Copper Rule allows 10 percent of homes on a public water supply to dispense any amount of lead if the rest are below 15 parts per billion. Ten percent! If a water utility is out of compliance, they are required to “optimize” water treatment, begin citywide lead pipe replacement that often costs millions of dollars, and inform residents that their tap water is unsafe to drink. Unfortunately, efforts have often been directed toward achieving compliance rather than minimizing public health risk, so many Flints are likely out there.

Beginning in August 2015, our Flint Water Study research team, led by Edwards, along with Flint residents, led the early efforts to document the city’s lead contamination—and subsequent related water-quality issues. Since then, we have spent more than a year monitoring the response. The city switched back to treated Lake Huron water (from Detroit) in October 2015, and the state and the EPA are now working to improve the overall water quality. When Flint’s children were finally protected after Governor Rick Snyder’s emergency declaration in early 2016, we announced the end of our investigation.

Soon thereafter, Flint residents spray-painted “The Block,” a prominent concrete slab that residents use as a community bulletin board, on a cold morning in January to send a message to the government: “YOU WANT OUR TRUST??? WE WANT VA TECH!!!” Because of this demand, later that month Edwards was invited to serve on Governor Snyder’s Flint Water Interagency Coordinating Committee, and our team was hired to continue water testing in collaboration with residents, supported by state and EPA funds. This declaration of trust by Flint residents was priceless and is illustrated by Flint Bishop Bernadel Jefferson’s comments to National Public Radio (NPR): “We trust them [the Flint Water Study]. We don’t trust nobody else.”

Since President Barack Obama declared Flint a federal emergency in January 2016, more than $600 million in healthcare, nutrition, and infrastructure aid became available. Civil servants and consulting firms have been indicted, and lead pipes are being replaced across the city. Progress has been slow for Flint citizens: After 30 months, unfiltered water in Flint is still not safe to drink.

As the Flint water crisis unfolded in 2015 and early 2016, the decline in public trust was palpable: People distrusted the city’s water, the distributed lead filters, and any messaging from government agencies. As resident Kenneth Glover told the New York Times, “I don’t even give [the water] to my dog…. I don’t care how many filters they give us. I don’t care what they say. How can I trust them again?” This atmosphere enabled misinformation campaigns that spread harmful falsehoods about the water’s quality—for example, that the distributed lead filters do not work or that lead aerosolizes in the shower and can harm one’s lungs—to briefly gain momentum. Consequently, a few residents who had previously been betrayed, turned against scientifically valid advice no matter who offered it.

The Public’s Search for Answers

The imperfect nature of scientific knowledge was encountered in the water crisis and sometimes even exploited. At other times, there were legitimate concerns. For example, the lead filters that the State of Michigan and the U.S. Federal Emergency Management Agency (FEMA) distributed around the city are rated to remove up to 150 parts per billion of lead, whereas several Flint homes had lead levels that were sometimes 10 or even 100 times higher than that in their tap water. Citizens and relief groups were apprehensive for many months, and a May 2016 poll by Target Insyght/MIRS News found that 70 percent of residents did not trust government assurances that the filtered water was safe. The EPA stepped up to this challenge by testing filters at more than 200 taps—some of which were dispensing lead levels as high as 4,080 parts per billion—and found that the filters effectively brought lead below 1 part per billion every time, which matched the findings of our previous research.

Although the scientific uncertainty here was resolved, has this information increased public trust in the filters? In the absence of accurate survey data, public trust is hard to quantify. Local media outlets, however, emphatically communicated the safety of lead filters with mixed results. Some residents have repeatedly told us and the media that they don’t trust filtered water.

The lifetime risk of contracting cancer due to chronic exposure to some regulated disinfection byproducts such as trihalomethanes is much lower than the recent risk of Flint residents contracting legionnaires’ disease, a serious waterborne illness, when they were being served by the Flint River (April 2014–October 2015). The lifetime risk calculated for total trihalomethanes here is based on several inherently conservative assumptions, and likely overestimates individual risk. (Data from the Flint Water Study, Institute for Highway Safety, CDC, and engineer Joe Goodwill of Saint Francis University. For more information, see <a href="" target="_blank"></a>.) <strong>Barbara Aulicino.</strong>
The lifetime risk of contracting cancer due to chronic exposure to some regulated disinfection byproducts such as trihalomethanes is much lower than the recent risk of Flint residents contracting legionnaires’ disease, a serious waterborne illness, when they were being served by the Flint River (April 2014–October 2015). The lifetime risk calculated for total trihalomethanes here is based on several inherently conservative assumptions, and likely overestimates individual risk. (Data from the Flint Water Study, Institute for Highway Safety, CDC, and engineer Joe Goodwill of Saint Francis University. For more information, see Graphic: Barbara Aulicino.

Scientists also stepped in to develop safety information when residents reported incidences of skin rashes even after Flint switched back to Detroit water. There is a dearth of studies specifically tying environmental, genetic, psychosomatic, and placebo factors to such skin problems. As per the CDC, the prevalence in school-aged children of atopic dermatitis, the most common type of rash, is at most 20 percent. A CDC-led dermatologic investigation concluded in August 2016 that rash incidences were indeed high, clinically severe, and chronic when Flint was served water from the Flint River but were lower after the switch back to Detroit water, and that these later rash cases were less severe and acute and in some cases were probably unrelated to the water. This uncertainty about the rashes’ cause led to a scenario in which we only could be compassionate and share residents’ frustrations but could not provide a scientifically robust answer.

Some Flint residents didn’t know who to trust and understandably wanted to test their water for themselves rather than rely on the word of scientists or government agencies. As they and concerned citizens in other towns turned to online sources and social media for support and information, some of the content they found was harmful. For example, several YouTube and Facebook videos misuse a common water measurement—total dissolved solids (TDS)—and claim that it shows that water filtered using certified lead filters is still not safe or that even bottled water distributed in Flint has high lead levels. TDS meters cannot measure lead in water, which requires sophisticated analytical equipment, and they are not a standard for water safety in general or lead in particular. Instead, they quantify water conductivity or net concentration of dissolved solids, such as essential minerals, salts, and metals.

These videos spread quickly on social media among citizens. One video viewed more than 17,000 times since January 2016 strangely asserts that the higher the number displayed on this “water tester,” the worse the water is. Considering that the World Health Organization classifies water with TDS under 300 parts per million as “excellent,” the video, which states that water with TDS of 103 parts per million is “horrible,” is both alarmist and profoundly misleading. Although these hoaxes were addressed online and in the news, the videos often circulate again among worried citizens.

Xuyen Mai and Joe Goodwill of the University of Massachusetts, Amherst, sample water in homes in Flint, Michigan, with Virginia Tech’s Flint Water Study to make sure disinfection byproducts were below federally regulated thresholds. Photo: Siddhartha Roy.

A mod actor Mark Ruffalo’s nonprofit Water Defense: Their opportunistic, irresponsible intervention in Flint, in which commercialization of a new product was cloaked as humanitarian science, preyed on an already traumatized population’s fears and impaired efforts to rebuild public trust in the safety of the city’s water for bathing and showering. After President Obama’s emergency declaration, Ruffalo’s group arrived in Flint in February 2016, armed with a green sponge. Because the sponge indiscriminately absorbs disinfection chemicals reacting with organic matter in the water, air, and its own material, measurements from it are not reliable. Such measurements about disinfection byproducts (DPBs) are not comparable to any established health standards for measuring them. DBPs (such as chloroform) are an unavoidable consequence of chlorine disinfection; they form when chlorine, which is routinely added to water to kill microbes, reacts with naturally occurring organic matter. They are found in tap waters across the United States. DBPs are suspected carcinogens and are heavily regulated as an acceptable chronic exposure risk in public water because, although they are undesirable, the alternative of not chlorinating water would increase the acute risks of sickness and death from waterborne diseases (such as cholera and legionnaires’ disease). Indeed, the World Health Organization emphasizes in their manual, Guidelines for Drinking Water Quality, that “disinfection should not be compromised in attempting to control disinfection byproducts.” High levels of DBPs were a legitimate problem when Flint’s water source was the Flint River, but their levels have dropped well below federal standards after the switch back to Detroit water.

Measuring DBPs is much more complicated than tossing a sponge in the bathtub. It requires expensive lab equipment and precise sampling protocols to prevent contamination. Because of the unexplained skin ailments that some Flint residents were suffering, many were worried that the water was not safe for bathing. An explanation and the ability to find their own answers were rightfully attractive to people. This drive can be good: It is what led residents to collaborate with our team and sample their own tap water in August 2015—the results of which, as one resident told me, were “empowering.” But trust voids are often a perfect breeding ground for groups such as Water Defense to capitalize on rampant fears. In a YouTube video, Water Defense’s Scott Smith began making outrageous claims that Flint’s water was worse than 62 disaster sites he had visited, including oil spills. We were dumbfounded when Ruffalo claimed on CNN that DBPs in Flint’s water could originate from corroded lead and galvanized iron pipes, which defies the laws of chemistry. There are still gaps in the current knowledge of DBPs, including which specific contaminants are formed and which should be regulated based on greatest health risk. There are no legitimate grounds, however, for this group to take up disinfection byproducts specifically in Flint.

Water Defense’s false explanations for the skin rashes gave many mistrustful and traumatized Flint families an explanation that, no matter how flawed, was satisfying. But avoiding bathing because of Water Defense’s misleading claims has had serious consequences for Flint residents. Indeed, a spike in gastrointestinal diseases, which is often symptomatic of poor sanitation, was witnessed in May 2016 and could be attributed in part to Water Defense’s false warnings about the dangers of bathing or showering.

Ironically, this increase in easily preventable disease underscores the value of chlorine disinfection for public water systems. Nonetheless, the fear of the water is still real for residents. Students at Northridge Academy in Flint, for example, told us during an outreach visit in November 2016 that they still avoid taking showers because they are scared. The local media’s initial lack of scrutiny of scientific-sounding claims from nonscientists gave the potentially dangerous misinformation some credibility. Because our team related to the public’s exasperation with the government after the water crisis, and because our attempts to privately reason with Water Defense proved futile, we felt we had the moral obligation to call them out publicly on our website.

The Price of Impugning Pseudoscience

One of the bizarre experiences of wading into the mists of misinformation is that bad actors and conspiracy theorists usually respond to suggestions that their messages are misguided with accusations about the ethics or credibility of those who question them, even if they lack the evidence for such claims. The media, especially The Huffington Post and Slate, eventually fact-checked both sides, conducted independent investigations into Water Defense’s opportunism, and published opinions from credible outside scientists. In contrast, prior coverage had portrayed Water Defense’s claims as scientifically legitimate. People’s distrust in the government was so high that a few in turn mistrusted us because some of our measurements showing the improvement in Flint’s water were funded by the EPA, even though we had also self-funded the earlier water testing in Flint that originally exposed the agencies involved in the crisis.

Our team then enlisted the help of Dave Reckhow, a pioneer in disinfection byproduct research, and his exceptional team from the University of Massachusetts Amherst. They orchestrated independent testing in May 2016 in Flint and found disinfection byproduct levels to be “pretty average” with “nothing out of the ordinary.” Their findings were corroborated by testing from the EPA, the CDC, and researchers at Wayne State University. All these efforts ultimately discredited Water Defense. No major media outlet has covered their sponge claims since then.

Even so, such damages are difficult to repair and can exacerbate downward spirals in mistrust. Many Flint residents have altered their bathing habits (for example, some have found alternate bathing locations such as hotels and portable showers, and others have reduced bathing times or are only using bottled water, shower-head filters, and so on) because they cannot bring themselves to trust the water. One family described to us the sheer joy of taking 30-minute showers while out of town, drawing a sharp contrast to their cumbersome bathing at home using bottled water. Personal experiences with, and fears of, the water trump all scientific studies. The road to rebuilding trust is long and hard.

Staying Vigilant

The government at all levels failed the people of Flint. A resident told us she believes her family had been “left to die.” Others have expressed perpetual guilt over having given their children contaminated water. Many continue to work with the laudable conviction that they will not rest until justice and reparations have been served. Laura Sullivan, a professor of mechanical engineering and Flint resident and activist, summarized the current problem to the New York Times: “It’s difficult to convince people once they’re aware that it has been unsafe that it is now safe…. The messenger that says the water is safe can’t come from the state government. They’ve already ruined their potential to be someone who can be trusted.”

If there are more Flints out there, as many suspect, we will need to continue building and sustaining trust between scientists and local communities.

How can scientists contribute to building informed publics and empowering them to differentiate between facts and fiction? Our scientific work and advocacy in Flint, alongside residents, showed how science can be used for the public good and conceivably garner their trust. Based on my experiences in Flint, I can testify that community-engaged science requires, first and foremost, a commitment to respecting the public, their experiences, and knowledge. An unassuming openness in addressing scientific queries, sharing data, and mentoring citizen groups (both online and in community meetings) will ensure a sustained partnership in which both parties can mutually benefit and build trust in one another. During a sampling trip to Flint in November 2016, a family was wary of letting us into their home for water testing because they mistook us for the EPA, but once we explained who we were they could not have been more kind and welcoming.

Although scientists are justifiably wary of being seen as advocates, I contend that they should stop considering their work as inherently neutral, but instead see their broader societal contexts and make central to their scientific endeavors principles of ethics, transparency, and service to humanity. Training scientists in disciplines such as community engagement, science communication, and ethical conduct alongside sound science will help them quickly and successfully navigate these tricky situations. In the aftermath of an environmental disaster, it’s not just the environmental problem that needs to be cleaned up. The information landscape can also become messy, and keeping it clean takes vigilance.

If there are more Flints out there, as many suspect, we will need to continue building and sustaining trust between scientists and local communities. The Flint model of collaborative and community-engaged research can be modified and incorporated into contemporary academic training. These skills and strategies can empower scientists to demonstrate their competence and restore trustworthiness, thereby earning the trust necessary to thwart future misinformation campaigns, such as those seen in Flint.

DOI: 10.1511/2017.124.22