New US Lead Pipe Regulation Could Protect Nearly a Million Infants from Low Birthweight
Meeting in Nepal for the International Lead Poisoning Prevention Week 2024
A lead poisoning prevention workshop in Kathmandu, Nepal organized by the Ministry of Health and Population (MoHP) and WHO Country Office for Nepal.

The US Environmental Protection Agency (EPA) recently announced a new ruling that requires drinking water systems to replace lead pipes within 10 years

The rule also strengthens requirements to locate lead pipes, improve testing for lead in water, and ensure that exposure is minimized while lead pipe replacement efforts are underway.

“Families like yours, exposed to lead in the water–they deserve better… We’re finally addressing an issue that should have been addressed a long time ago: the danger lead pipes pose to our drinking water,” said President Biden earlier this month

The EPA estimates that up to nine million US homes are served through legacy lead pipes across the country, many of which are located in lower-income communities and communities of color, “creating disproportionate lead exposure burden for these families,” the agency said in a press release.   

To remove the millions of lead pipes still in use, the EPA has tapped $2.6 billion from the Bipartisan Infrastructure Law. The agency estimates that the public health and economic benefits of the final rule are estimated to be up to “13 times greater than the costs,” including protecting 900,000 infants from low birthweight, preventing 2,600 cases of ADHD, and reducing 1,500 cases of premature death from heart disease each year following the ruling. 

Sources of lead in drinking water
The EPA’s new ruling could over two thousand cases of ADHD and protect nearly a million infants from being born with low birthweight each year.

The Biden Administration’s announcement came just two weeks before International Lead Poisoning Prevention Week, which highlighted the persistent threat of lead for the world’s children population. 

“Lead continues to be one of the greatest public health concerns,” said Dr Maria Neira, World Health Organization (WHO) environment director. “Urgent action is required from member states to prevent exposure to lead.”

The United Nations Children’s Fund (UNICEF) estimates that one in three children have blood lead levels at or above 5µg/dl – levels that can cause lifelong neurological, behavioral, and health problems like anemia, hypertension, and toxicity to reproductive organs. “The science is clear,” noted an EPA statement, “lead is a potent neurotoxin and there is no safe level of exposure.”

Both the EPA and US Centers for Disease Control and Prevention (CDC) recommend having children tested for lead as the best way to determine exposure, especially if living in a house built before 1978.  

High risk of elevated lead in South Asia 

Lead exposure hot spots
South Asia, Africa, and parts of South America are lead exposure hotspots.

UNICEF’s landmark 2020 lead poisoning report exposed the scale at which children are exposed to high levels of lead. Of the 815 million children estimated to have elevated blood lead levels, nearly half live in India, Pakistan, Nepal, and other South Asian countries. 

The reasons for higher exposure, the UNICEF report notes, comes from a high prevalence of unsafe lead-acid battery recycling, and contaminated spices, ceramics, and toys. Children can also be exposed to lead in soil, dust, air, and water.  

Fewer regulations and enforcement leaves industries lacking environmentally safe practices, and the absence of blood lead screening make it difficult to protect children from lead hazards. The report also cites poor nutrition as a risk factor for higher lead absorption in lower-and middle-income countries. 

Brochures for healthy homes and lead prevention
Educational materials in Rochester, New York, for people at higher risk for lead poisoning.

“With few early symptoms, lead silently wreaks havoc on children’s health and development, with possibly fatal consequences,” said Henrietta Fore, UNICEF’s Executive Director at the time, at the report launch.

“Knowing how widespread lead pollution is — and understanding the destruction it causes to individual lives and communities — must inspire urgent action to protect children once and for all.” 

“Since the 1970s, efforts to reduce lead in paint, gasoline, water, yards and even playgrounds have resulted in considerable success in reducing blood lead levels among children in the United States,” wrote the report authors.

“The issue of lead poisoning is not new, but our understanding of the scope and scale of its impacts and feasible solutions has never been better. Proven solutions exist for low- and middle-income countries, those most burdened by this challenge. Those solutions can be implemented today.”

Image Credits: S. Samantaroy/HPW, WHO, EPA, UNICEF.

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