Gómez, H.F., Borgialli, D.A., Sharman, M. et al 2019. Analysis of blood lead levels of young children in Flint, Michigan before and during the 18-month switch to Flint River water Journal of Clinical Toxicology DOI: 10.1080/15563650.2018.1552003
Background: The toxicity of lead, like any xenobiotic, is directly linked to the duration of exposure and toxin concentration in the body. The elevation in blood lead levels (BLLs) in young Flint, Michigan children noted in time-periods before, and during the 18-month exposure to Flint River water (FRW) from 25 April 2014 to 15 October 2015 is well-known internationally. The length of time BLLs were elevated is unknown, yet key in understanding the potential health impact of the event. The objective of this study was to evaluate whether BLLs in Flint children were increased during the entire 18-month FRW exposure compared to similar earlier time periods.
Methods: We conducted a retrospective study analyzing BLLs from Flint children aged 5 years and under. The geometric mean (GM) BLLs and percentages of BLLs ≥5.0 μg/dL in Period I: 25 April 2006 to 15 October 2007 (earliest timeframe available for study) and Period II: 25 April 2012 to 15 October 2013 (timeframe immediately before the water switch), were compared to Period III, 25 April 2014 to 15 October 2015 (FRW exposure).
Results: There were 5663 BLLs available for study. GM ± SE BLLs decreased from 2.19 ± 0.03 μg/dL in Period I to 1.47 ± 0.02 μg/dL in Period II [95% CI, 0.64, 0.79]; p<.001 and decreased further to 1.32 ± 0.02 µg/dL during the FRW Period III [95% CI, 0.79, 0.95]; p<.001. The percentage of BLLs ≥5.0 μg/dL decreased from Period I (10.6%) to Period II (3.3%) [95% CI, 5.7, 8.8]; p<.001 and from Period I to Period III (3.9%) [95% CI, 5.0, 8.2]; p=.002. The 0.6% increase from Period II to Period III was not statistically significant [95% CI, −1.9, 0.57]; p=.30.
Conclusion: Analyses of GM and percentages ≥5.0 μg/dL of BLLs do not support the occurrence of a global increase in BLLs in young children of Flint during the entire 18-month period of FRW exposure.
Posted in Lead
Tagged Lead, Michigan
Jarvis P, Quy K, Macadam J, Edwards M, Smith M. Intake of lead (Pb) from tap water of homes with leaded and low lead plumbing systems. Sci Total Environ. 2018 Dec 10;644:1346-1356. doi: 10.1016/j.scitotenv.2018.07.064.
Methods of quantifying consumer exposure to lead in drinking water are increasingly of interest worldwide, especially those that account for consumer drinking habits and the semi-random nature of water lead release from plumbing systems. A duplicate intake protocol was developed in which individuals took a sub-sample from each measured drink they consumed in the home over three days in both winter and summer. The protocol was applied in two different water company regional areas (WC1 and WC2), selected to represent high risk situations in England, with the presence or absence of lead service pipes or phosphate corrosion control. Consumer exposure to lead was highest in properties with lead service pipes, served by water without P dosing. The protocol indicated that a small number of individuals in the study, all from homes with lead service pipes, consumed lead at levels that exceeded current guidance from the European Food Standards Agency. Children’s potential blood lead levels (BLLs) were estimated using the Internal Exposure Uptake Biokinetic model (IEUBK). The IEUBK model predicted that up to 46% of children aged 0-7 years old may have elevated BLLs (>5 μg/dL) when consuming the worst case drinking water quality (>99%ile). Estimating blood lead levels using the IEUBK model for more typical lead concentrations in drinking water identified in this study (between 0.1 and 7.1 μg/L), predicts that elevated BLLs may affect a small proportion of children between 0 and 7 years old.
Doré E, Deshommes E, Laroche L, Nour S, Prévost M. Lead and copper release from full and partially replaced harvested lead service lines: Impact of stagnation time prior to sampling and water quality. Water Research 2018 Dec 3;150:380-391. doi: 10.1016/j.watres.2018.11.076.
Partial lead service line replacement (PLSLR) results in the addition of a new galvanic connection and can increase lead concentrations at the tap. Focus has been given to minimizing lead release after PLSLR, but little information is available on the impact of lead remedial actions on copper concentrations, especially before passivation occurs. The impact of water quality (decreased chloride-to-sulfate mass ratio from 0.9 to 0.3; addition of orthoP; pH increase to 8.3) on lead and copper concentrations was investigated after stagnation (30 min-336 h) in a pipe rig comparing full lead service line (LSL), and two configurations of partial LSLs (Cu-Pb and Pb-Cu). Results show different trends for lead and copper: maximum lead concentrations were reached in 16 h while copper concentrations continued to increase over 336 h. Lead release rates were also the highest in the first 16 h of stagnation and were strongly impacted by water quality and the configuration of PLSLR (Cu-Pb vs Pb-Cu). Increasing the sampling flow rate from 5 to 15 LPM drastically increased the particulate lead release (78-fold) in Pb-Cu configurations; this effect was however not observed in 100% Pb or Cu-Pb configurations. High velocity flushing prior to 16 h stagnation decreased total Pb release by a factor of 12-fold for Cu-Pb, 1.6-fold for Pb-Cu and 2.0-fold for 100% Pb. Results support the definition of sampling protocols targeted for the detection of lead and copper sources and the proscription of flushing prior to sampling.
Another ecologic study attempting to infer associations with very weak correlations. Would nonconsumption of food be associated with a lower prevalence of elevated dental caries?
Sanders AE, Slade GD. Blood Lead Levels and Dental Caries in U.S. Children Who Do Not Drink Tap Water. American journal of preventive medicine. 2017 Nov 18. pii: S0749-3797(17)30495-6. doi: 10.1016/j.amepre.2017.09.004.
INTRODUCTION: This study’s purpose is to determine whether nonconsumption of tap water is associated with lower prevalence of elevated blood lead levels and higher prevalence of dental caries in children and adolescents.
METHODS: Cross-sectional data from the National Health and Nutrition Examination Survey 2005-2014 recorded drinking water source (n=15,604) and blood lead levels (n=12,373) for participants aged 2-19 years, and dental caries experience for the 2011-2014 subset (n=5,677). The threshold for elevated blood lead level was ≥3 μg/dL. A binary outcome indicated presence or absence of dental caries experience. Multivariable generalized linear models estimated adjusted prevalence ratios with 95% confidence limits.
RESULTS: In analysis conducted in 2017, 15% of children and adolescents did not drink tap water, 3% had elevated blood lead levels ≥3 μg/dL, and 50% had dental caries experience. Children and adolescents who did not drink water were less likely than tap water drinkers to have an elevated blood lead level (adjusted prevalence ratios=0.62, 95% confidence limits=0.42, 0.90). Nonconsumers of tap water were more likely to have dental caries (adjusted prevalence ratios=1.13, 95% confidence limits=1.03, 1.23). Results persisted after adjustment for other covariates and using a higher threshold for elevated blood lead level.
CONCLUSIONS: In this nationally representative U.S. survey, children and adolescents who did not drink tap water had lower prevalence of elevated blood lead levels and higher prevalence of dental caries than those who drank tap water.
Zartarian V, Xue J, Tornero-Velez R, Brown J. Children’s Lead Exposure: A Multimedia Modeling Analysis to Guide Public Health Decision-Making. Environmental health perspectives 2017 Sep 12;125(9):097009. doi: 10.1289/EHP1605.
BACKGROUND: Drinking water and other sources for lead are the subject of public health concerns around the Flint, Michigan, drinking water and East Chicago, Indiana, lead in soil crises. In 2015, the U.S. Environmental Protection Agency (EPA)’s National Drinking Water Advisory Council (NDWAC) recommended establishment of a “health-based, household action level” for lead in drinking water based on children’s exposure.
OBJECTIVES: The primary objective was to develop a coupled exposure-dose modeling approach that can be used to determine what drinking water lead concentrations keep children’s blood lead levels (BLLs) below specified values, considering exposures from water, soil, dust, food, and air. Related objectives were to evaluate the coupled model estimates using real-world blood lead data, to quantify relative contributions by the various media, and to identify key model inputs.
METHODS: A modeling approach using the EPA’s Stochastic Human Exposure and Dose Simulation (SHEDS)-Multimedia and Integrated Exposure Uptake and Biokinetic (IEUBK) models was developed using available data. This analysis for the U.S. population of young children probabilistically simulated multimedia exposures and estimated relative contributions of media to BLLs across all population percentiles for several age groups.
RESULTS: Modeled BLLs compared well with nationally representative BLLs (0-23% relative error). Analyses revealed relative importance of soil and dust ingestion exposure pathways and associated Pb intake rates; water ingestion was also a main pathway, especially for infants.
CONCLUSIONS: This methodology advances scientific understanding of the relationship between lead concentrations in drinking water and BLLs in children. It can guide national health-based benchmarks for lead and related community public health decisions.
Deshommes E, Laroche L, Deveau D, Nour S, Prévost M. Short- and Long-Term Lead Release after Partial Lead Service Line Replacements in a Metropolitan Water Distribution System. Environ Sci Technol. 2017 Aug 9. doi: 10.1021/acs.est.7b01720.
Thirty-three households were monitored in a full-scale water distribution system, to investigate the impact of recent (<2 yr) or old partial lead service line replacements (PLSLRs). Total and particulate lead concentrations were measured using repeat sampling over a period of 1-20 months. Point-of-entry filters were installed to capture sporadic release of particulate lead from the lead service lines (LSLs). Mean concentrations increased immediately after PLSLRs and erratic particulate lead spikes were observed over the 18 month post-PLSLR monitoring period. The mass of lead released during this time frame indicates the occurrence of galvanic corrosion and scale destabilization. System-wide, lead concentrations were however lower in households with PLSLRs as compared to those with no replacement, especially for old PLSLRs. Nonetheless, 61% of PLSLR samples still exceeded 10 μg/L, reflecting the importance of implementing full LSL replacement and efficient risk communication. Acute concentrations measured immediately after PLSLRs demonstrate the need for appropriate flushing procedures to prevent lead poisoning.
Trueman BF, Sweet GA, Harding MD, Estabrook H, Bishop DP, Gagnon GA. Galvanic Corrosion of Lead by Iron (Oxyhydr)oxides: Potential Impacts on Drinking Water Quality. Environmental science and technology. 2017 May 30. doi: 10.1021/acs.est.7b01671.
Lead exposure via drinking water remains a significant public health risk; this study explored the potential effects of upstream iron corrosion on lead mobility in water distribution systems. Specifically, galvanic corrosion of lead by iron (oxyhydr)oxides was investigated. Coupling an iron mineral cathode with metallic lead in a galvanic cell increased lead release by 531 µg L-1 on average-a nine-fold increase over uniform corrosion in the absence of iron. Cathodes were composed of spark plasma sintered Fe3O4 or α-Fe2O3 or field-extracted Fe3O4 and α-FeOOH. Orthophosphate immobilized oxidized lead as insoluble hydroxypyromorphite, while humic acid enhanced lead mobility. Addition of a humic isolate increased lead release due to uniform corrosion by 81 µg L-1 and-upon coupling lead to a mineral cathode-release due to galvanic corrosion by 990 µg L-1. Elevated lead in the presence of humic acid appeared to be driven by complexation, with 208Pb and UV254size-exclusion chromatograms exhibiting strong correlation under these conditions (R2average = 0.87). A significant iron corrosion effect was consistent with field data: lead levels after lead service line replacement were greater by factors of 2.3 – 4.7 at sites supplied by unlined cast iron distribution mains compared with the alternative, lined ductile iron.