No Safe Level: Old pipes and paint threaten the health of America’s children

Sarah Vogel, Ph.D., is Vice-President for Health.

Since the crisis in Flint hit the national headlines, the problem of lead exposure from drinking water has come under greater scrutiny. And for good reason. Seven to ten million American homes have water delivered through service lines made of lead pipe – the primary source of lead in drinking water. But the events in Flint also highlight the fact that despite decades of decline in the levels of lead in the blood of American children, we still have a lead problem in this country. Given that there is no safe level of exposure to lead, we have a lot of work to do. The current crisis offers a new opportunity to make significant progress, and we have a record of past achievement to learn from and build upon.

Forty years ago over 13 million young children in American had blood lead levels at or above 10 micrograms per deciliter (µg/dL). By 2000, that number had decreased to just under a half a million. The greatest reductions made were among low income and children of color who had the highest blood lead levels. As a result of such significant progress, many declared victory and organizations, including EDF, shifted their focus to other environmental health issues leaving considerable work still to be done on lead.

While blood lead levels were declining, scientific evidence was mounting to show there is no safe level of exposure to lead in infants and young children. Studies showed that adverse neurological effects were happening at lower and lower levels of lead exposure. In 2012, the Centers for Disease Control and Prevention reduced the level of lead in blood used to identify those with elevated exposure to 5 µg/dL. Today, approximately 500,000 children have levels at or above 5 µg/dL.

Despite the major declines in children’s blood lead levels at or above 10 µg/dL and decreases in racial and income disparities since the mid-1970s, progress has stalled over the past decade. And still disparities persist. Children living in poverty remain at the greatest risk. Indeed, children in poor households are three times more likely, and African-American children are twice as likely as white children, to have elevated blood lead levels.

As we consider how we can resume progress in reducing children’s blood lead levels and closing the gaps in disparities, it’s important to reflect on what can be attributed to the progress made earlier. It is clear that the sharp declines in blood lead levels over the past four decades came about through a deliberate national strategy focused on four areas:

1. Progressively limiting sources of exposure by setting strong standards for gasoline, paint, plumbing, food cans, and children’s products.
2. Better managing the lead already in place through careful maintenance of paint in homes with lead-based paint, setting stricter standards for lead-based paint hazards in low-income housing, and, for lead in drinking water, using corrosion control to create a protective coating in lead pipes and plumbing.
3. Replacing major sources of lead exposure that are particularly difficult to safely manage—such as lead-based paint windows.
4. Maintaining a surveillance and public health infrastructure to identify and manage lead hazards by testing children for elevated blood lead levels and intervening to identify and remove sources of exposure.

This was a smart strategy, but if we are to make further progress in reducing blood lead levels, significant improvements and fixes are needed.

1. Regulatory standards need to reflect the latest research that demonstrates there is no safe level of lead exposure. This includes updating standards for lead-based paint at the Environmental Protection Agency (EPA) and Department of Housing and Urban Development (HUD) and overhauling EPA's lead in drinking water rule. Tighter controls are also needed on lead from remaining uses such as leaded gas allowed to be used in airplanes and in automobile wheel weights, as well as on exports of lead in batteries and lead-based paint and in electronic waste.
2. Resources drained from the federal and state systems for lead exposure surveillance need to be restored and expanded. The public health and medical communities serve on the front lines of this effort. They need resources to identify children at risk as well as the sources of lead exposure in those children’s homes.
3. We need to step back from a flawed strategy for managing lead in pipes used to deliver drinking water: replacement of the pipes needs to be the priority prevention measure, with corrosion control used as an interim and ongoing control measure. This is a reversal of our current approach for dealing with lead in drinking water. Failures of corrosion control can happen not only in predictable ways, such as when the water supply was changed in Flint, but also in unpredictable ways due to factors such as physical disturbances of the lines. With as many as ten million homes still having lead drinking water service lines, too many children are at risk.

We recognize that lead-based paint remains the biggest contributor to lead exposure in children, and we strongly support the expansion of federal, state and local efforts to reduce the threat from this source. Currently, EDF is primarily focused on accelerating the replacement of lead service lines because of the significant change in policy that is needed and the opportunity to permanently remove a substantial lead hazard. Importantly, we see this work as part of a broader effort to strengthen the lead exposure prevention strategy and to expand the nation’s collective efforts to protect children from lead.

For decades, this country made tremendous progress in reducing the serious threat that lead exposure poses to our children’s health. If we are going to make further progress in reducing children’s exposure to lead, we’ll need an “all of the above” strategy that builds off of our past successes and fixes major problems. Today, there is a unique political opportunity to restore and expand these efforts to better protect millions of Americans from lead hazards.

In an upcoming series of blogs, we will be describing in greater detail some of the policy improvements and opportunities at hand to strengthen the lead poisoning prevention system, including but not limited to removing lead drinking water service lines.