Lead in Drinking Water Poses Danger for Children, Pregnant Women
Lead in drinking water, which has ignited a public health crisis in Flint, Michigan, is largely ignored as a potential contributor to elevated blood lead levels in thousands of Wisconsin children, records and interviews show.
Nearly 4,000 children in Wisconsin were diagnosed with elevated levels of lead in their blood in 2014, though the number has fallen over the years thanks in part to bans on lead in paint and gasoline. Unlike in Flint, however, it is not known to what extent lead in the drinking water contributes to elevated blood lead levels in Wisconsin.
The percentage of lead-poisoned children among those tested in Wisconsin — 4.5 percent — is similar to the 4.9 percent of children diagnosed in 2015 in the Flint region, where state and federal officials have declared a state of emergency over the spike in lead in drinking water and children’s blood.
In Milwaukee, the percentage is even higher: 8.6 percent of children tested in 2014 had blood lead levels above 5 micrograms per deciliter, the level at which children are known to suffer health problems, according to the Wisconsin Department of Health Services.
Even those percentages likely understate the magnitude of the problem, said Marc Edwards, the Virginia Tech professor whose team helped identify the lead problem in Flint’s water. Standard testing for lead in blood begins around age 1, a time when children become mobile and may be exposed to lead paint or dust — ignoring infants on formula who may be ingesting large amounts of lead-tainted tap water.
“Neither in Flint nor in Wisconsin is the greatest at-risk group being tested,” Edwards said.
Lead’s effects are severe and permanent. Reduced intelligence, learning disabilities and developmental delays have all been attributed to lead exposure in young children, particularly those under age 6 whose developing brains are most vulnerable.
Some studies have linked childhood lead poisoning to disruptive behavior at school and a greater likelihood of violent crime in adulthood. Lead exposure in pregnant women has been associated with an increased risk of fetal death.
The U.S. Environmental Protection Agency acknowledged the contribution of water to the nation’s lead exposure in 1991 when it estimated that drinking water accounts for about 20 percent of average lead exposure, but as much as 85 percent of exposure for infants consuming formula made with tap water.
Because of the dangers of lead, the United States started phasing out leaded gasoline in 1973 until it was virtually eliminated in 1988. The use of lead-based paints steadily decreased after 1950 until the additive was banned from the market in 1978. The use of lead for plumbing was outlawed in 1986, although until January 2014, “lead-free” indoor plumbing components could legally contain up to 8 percent lead.
Officials at the nation’s Centers for Disease Control and Prevention and Wisconsin’s Childhood Lead Poisoning Prevention Program attribute childhood lead exposure almost exclusively to deteriorating lead-based paint and lead dust in older homes.
But lead paint is not the only hazard of old housing stock. For decades beginning in the late 1800s, lead was a commonly used material in the pipes that carry drinking water from the water main to individual homes, also known as lead service lines. There are an estimated 176,000 such lead pipes in Wisconsin.
Yanna Lambrinidou, a researcher and instructor at Virginia Tech, said the CDC and public health community are “doing tremendous damage” by failing to require testing for lead in drinking water when a child is lead poisoned.
“It’s putting generations of kids in harm's way for absolutely no good reason,” she said.
A study led by Dr. Mona Hanna-Attisha, the Flint pediatrician who sounded the alarm about elevated blood lead levels among children in her community, described the crisis as a warning to other communities with aging water infrastructure and limited budgets.
“The situation in Flint, Michigan,” Hanna-Attisha and her research colleagues concluded, “may be a harbinger for future safe drinking-water challenges.”
Thousands of children affected in Wisconsin
In 2014, 3,922 Wisconsin children under age 6 had blood lead levels of 5 micrograms per deciliter or higher. About 20 percent of Wisconsin children are tested in a typical year.
The Wisconsin Childhood Lead Poisoning Prevention Program provides technical assistance, funding and consulting to health providers to prevent, detect and treat childhood lead poisoning. It projects lead-poisoned children “will likely cost Wisconsin billions of dollars in reduced intelligence quotient (IQ), lifetime earning losses and the associated societal costs for health care, education and correctional services.”
Almost 60 percent, or 2,244, of the state’s lead-poisoned children in 2014 were from the city of Milwaukee.
Ramona Jensen, lead liaison for Milwaukee’s Social Development Commission, wonders when Wisconsin officials will finally begin investigating tap water as a potential contributor to lead poisoning.
Jensen’s organization, which plans, coordinates and provides human service programs to the poor in Milwaukee County, is wrapping up work on a multi-year, $3 million U.S. Department of Housing and Urban Development-funded project to identify and remove lead hazards from 231 low-income housing units. Yet drinking water is not part of the program, she said.
“We just quite honestly don’t consider the water,” she said. “If you’re not testing the water when you’re doing a (lead) investigation, how do we know if it is or is not an exposure route?”
Blood lead level lowered, water standard same
In recognition of lead’s high toxicity, in 2012 the CDC cut in half the amount at which a child’s blood lead level requires reporting and possible intervention from 10 micrograms per deciliter to 5.
But the nation’s standard for lead in public drinking water has not been updated since 1991 when the EPA’s Lead and Copper Rule took effect. The federal law aims to keep lead levels in water below 15 ppb, while standards for lead in Canada and the European Union match the World Health Organization’s guideline of 10 ppb.
Public water utilities are required to take remedial action under the Lead and Copper Rule only if more than 10 percent of household tap water samples exceed 15 ppb. No remediation is required for even exceedingly high readings if the 10 percent threshold is not met.
In Wisconsin, 725 tap water samples, or 3.5 percent of almost 21,000 household samples tested between January 2010 and April 2015, exceeded 15 ppb, according to a DNR database analyzed by the Wisconsin Center for Investigative Journalism.
Applying the 3.5 percent estimate to the 176,000 known lead service lines in the state suggests that some 6,200 Wisconsin households may drink public water that exceeds the federal standard. That does not account for the unknown number of homes with lead fixtures.
In addition, an estimated 940,000 Wisconsin homes get their water from private wells. Private wells are largely unregulated, meaning those property owners are responsible for the safety of their own water.
In 2013, the Department of Health Services analyzed almost 4,000 private well samples and found that 1.8 percent of them exceeded 15 ppb of lead. Applying this estimate to all homes on private wells adds nearly 17,000 households to the at-risk total.
When public and private well calculations are combined, they suggest that residents in roughly 23,000 homes in Wisconsin may be consuming unsafe levels of lead in their water.
In some Wisconsin communities, the percentage of public water samples that tested above 15 ppb was much higher than 3.5 percent, such as Lake Mills (20 percent), Columbus (18 percent) and Mount Horeb (16 percent). The state’s highest value was recorded in 2012 in Mount Horeb: 9,370 ppb.
Source investigations ignore water
In July 2013, Crystal Wozniak of Green Bay learned that her 9-month-old baby Casheous had 18 micrograms per deciliter of lead in his blood — more than three times the federal threshold. The finger prick test that Casheous received is mandatory for children, generally beginning at age 1, who are covered under BadgerCare, Wisconsin’s health care program for low-income families.
“When (the nurse) broke the news to me,” Wozniak said, “I was devastated. My heart broke, I cried. I was very worried for him and had no knowledge of what to do next.”
The Brown County Health Department identified multiple sources of deteriorating lead-based paint in Wozniak’s home, built in 1900. Eventually, the house was gutted, and Wozniak moved elsewhere.
But she wondered why nobody talked about lead pipes or urged her to get her tap water tested.
A source investigation triggered in Wisconsin by a case of childhood lead poisoning does not require testing the tap water in the child’s home or daycare, despite the documented link between water lead and blood lead levels. The CDC guidelines also do not specifically recommend examining drinking water.
Later testing of Wozniak’s tap water found no lead, but even EPA officials acknowledge that “the existing regulatory sampling protocol … systematically misses high lead levels and potential human exposure.”
Lambrinidou, the Virginia Tech scientist, said regulatory agencies fail to examine lead in water or alert homeowners of ways to protect themselves, including installing filters costing as little as $40.
“Lead in drinking water has been pushed under the rug by almost every single agency,” she said. “Lead particles (in water) can contain far more lead than lead paint chips and can spike a child's blood lead level literally overnight, and cause irreversible brain damage from one glass of water or one bowl of pasta.
“The outrage,” Lambrinidou added, “is that for many households, the prevention of miscarriages and of irreversible brain damage is $40 away.”
This story was produced as part of The Confluence, a collaborative project involving the Wisconsin Center for Investigative Journalism and University of Wisconsin-Madison School of Journalism and Mass Communication reporting classes. The nonprofit Center (www.WisconsinWatch.org) collaborates with Wisconsin Public Radio, Wisconsin Public Television, other news media and the UW-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by the Center do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.