Strong Association between Children's Elevated Blood Lead Levels and Lead Service Lines: A Census Tract-Level...

Area of Science:

• Environmental Health
• Public Health
• Toxicology

Background:

• Lead service lines (LSLs) are a suspected source of lead exposure in children, but quantifying their impact has been challenging due to data limitations.
• Elevated blood lead levels (BLLs) in children pose significant health risks, necessitating identification of key exposure sources.

Purpose of the Study:

• To investigate the association between the prevalence of lead service lines (LSLs) and elevated blood lead levels (EBLLs) in children.
• To compare the predictive power of LSL prevalence against other established lead exposure risk factors.

Main Methods:

• Address-level LSL data were aggregated to the census tract level and linked with EBLL prevalence data for two large water systems.
• Statistical analyses, including linear and weighted quantile sum (WQS) regression, were employed to assess the relationship between LSL prevalence and EBLLs.

Main Results:

• A strong positive correlation was found between LSL prevalence and EBLLs in both the Grand Rapids Water System (GRWS) and Greater Cincinnati Water Works (GCWW).
• LSL prevalence demonstrated stronger predictive power for lead exposure risk compared to EPA's Random Forest Models and HUD's Deteriorated Paint Index.
• In WQS models, LSL prevalence received the highest component weight, highlighting its significant independent contribution to lead exposure.

Conclusions:

• Lead service lines independently contribute to children's elevated blood lead levels.
• Replacement of lead service lines is supported as an effective public health intervention to mitigate lead exposure.