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A new working paper found that the lead-poisoned water the city of Flint, Michigan started drawing from as its public water supply in 2014 caused the local fertility rate to drop dramatically the following year, the Washington Post reported on Thursday.

The sapped fertility rate was attribute in large part to a “horrifyingly large” increase in fetal deaths and miscarriages, and the paper estimates that “between 198 and 276 more children would the been born [of those conceived between November 2013 and March 2015] had Flint not enacted the switch in water.”

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The paper’s authors note that, though there is plenty of literature detailing the harmful effects of lead exposure on children (impaired cognitive function, damage to the brain, kidneys, and liver), not as much is known about the effects of lead exposure on fetal health, although a 2013 study suggested it can result in fetal death.

 

In Flint, the fetal death rate increased by 58 percent within the time parameters of the study, a number the authors say is probably low because: “(1) They do not include abortions; (2) they do not include miscarriages that occur before 20 weeks of gestation; and (3) they are restricted to hospitals reporting these events.”

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By the end of 2016, 10 percent of Flint homes still relied on water with a lead concentration that, though safe to drink according to the Environmental Protection Agency, still contained three times the lead levels observed in Detroit’s water system, and given that “there is no known level of lead exposure that is considered safe,” according to the World Health Organization, perhaps those EPA guidelines are not so solid.

Mother Jones published an article on Thursday pointing out some possible discrepancies in the study, and suggests that perhaps something else in the contaminated water other than lead caused the drop in fertility rates.

The Washington Post also included some helpful 2016 Census data in its report, which indicates that Flint is the nation’s poorest city. Forty-five percent of its residents are impoverished and 53 percent of them are black.