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Committee on Public Works and the Environment
Public roundtable on the lead service replacement program of 2004-2005
February 4, 2004

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Councilmember Carol Schwartz Glenn S. Gerstell, Chairman of WASA Board of Directors
Glenn S. Gerstell, Chairman of WASA Board of Directors, testimony at continuation of hearing on February 10, 2004 Jerome A. Paulson, Mid-Atlantic Center for Children's Health and the Environment
Paul Schwartz, Clean Water Action Walter Faggettt, Interim Chief Medical Officer

Councilmember Carol Schwartz
Committee on Public Works and the Environment
Wednesday, February 4, 2004

Statement for Public Roundtable on the "Lead Replacement Program of 2004."

Good afternoon my name is Carol Schwartz and I am Chair of the Council's Committee on Public Works and the Environment. The time is now ___  p.m. and I would like to call to order this emergency meeting of the Committee. I would also like to acknowledge the presence of Councilmembers _____ and _____.

The Committee is holding this emergency roundtable on the Water and Sewer Authority's (WASA) management of its Lead Replacement Program. WASA apparently has uncovered a significant problem with elevated levels of lead in DC tap water, and apparently has been aware for some time that the problem could be widespread. It was only when the Washington Post called last Thursday did I become aware of the magnitude of the excess lead problem.

I did not receive one E-mail, one phone call, one letter or one drop-in visit from a constituent about lead contamination. This is highly unusual when something like this happens. The usual routine is countless E-mails, phone calls, letters and drop-in visits. Why didn't this happen? Because constituents did not know about it. WASA kept them, and us, in the dark.

Not until after the articles appeared in the Post, which then lead to news stories on TV and radio, did the e-mails, phone calls, and letters start to arrive.

(February 2003 letter???)

In June 2003 -just this past summer - WASA issued a "Water Quality Report" for 2002 to all D.C. consumers that prominently stated on the cover that "Your Drinking Water Is Safe." (Hold up report).

This report has 7 pages of text, with topics ranging from a brief article about the Potomac River being the area's main water supply source to information about water treatment procedures to a list of helpful phone numbers. In a one paragraph summation on what I guess to be page 3 of this report, the "Lead and Copper Monitoring Programs" are briefly discussed. The paragraph is seven sentences. The last three sentences state:

"WASA regularly monitors for elevated lead and copper concentrations by collecting water samples at consumer taps. During 2002, concentrations found in these sampling programs exceeded (the Environmental Protection Agency's) action level based on analysis of 53 samples collected with the assistance of customers. WASA has embarked on remedial programs to meet EPA's requirements. Infants, young children and pregnant women tend to be more vulnerable to lead than the general public."

On another page of the report is a chart with a list of possible drinking-water contaminants, including lead. In the introduction to the chart, the reader is told, "Note that the concentration of all detected contaminants in IBC's drinking water were considerably below EPA-established maximum limits. "

However, we now know that 26 of the 53 samples taken from customer taps in 2002 tested above acceptable EPA levels for lead, but apparently not at "established maximum limits." And we also know that further testing by WASA has indicated that the problem is, indeed, widespread. The information was buried, minimized, or de-emphasized in such a way to make it look insignificant - and, I must say with disappointment that it appears that this was WASA's intent.

WASA, while probably good intentioned, did include a newsletter in its August 2003 bills which devoted two whole pages to the issue of Lead in Drinking Water. (Hold up newsletter). 

Still though, the information failed to disclose the magnitude of the problem saying only, "although most homes have very low levels of lead in their drinking water, some homes in the community have lead levels above the EPA action level of 15 parts per billion or 0.015 milligrams of lead per liter of water. "

Truly, how many of us actually take the time to read the inserts in our monthly bills, unless it says LIFE OR DEATH in big bold red letters? At the very least this information should have come in a separate letter from WASA, and the information certainly should have been conveyed with some sense of urgency.

With all that said, I was surprised - to say the least - when I received a call from a reporter seeking comment about the 4,075 District households (out of 6,118) that had excessive lead in samples of water tested by WASA.

Over the months that this testing was conducted, the major issues that the management of WASA has brought to my attention had nothing to do with excess lead levels. I have been hearing from WASA about its $1.3 billion storm water management program which includes the replacement of 125,000 water meters. Obviously, this issue is related to lead issues, but not specifically to the matter before us today.

Now, I worked with WASA to ensure that the federal government bear its share of the long range capital improvement project to our antiquated stormwater runoff system, which contributes mightily to the pollution in our waterways. In each of the past two years, I have personally helped to secure $50 million (for a total of $100 million) for the improvement of our stormwater management system. So, see... when I have knowledge any knowledge I try to help.

In 2002, when the water meter replacement program started, WASA launched a comprehensive public relations campaign to tell us that the new meters would end billing errors and save money by allowing meters to be read electronically. During a hearing on the matter that I convened, print material was shared with the Committee that clearly explained the purported benefit of the new meters. We were told that the new meters could generate reports giving us a daily reading of our use of water. WASA was able to replace the 125,000 water meters, which indicated to me that when the agency commits to something, they get the job done.

Bottom line, WASA is clearly capable of advertising what and when it wants to.

However, in the urgent matter before us today - the excessive lead levels in our tap water - I have not seen yet seen the type of commitment from WASA that I believe is merited, deserved and paid for, and that is what we are going to be discussing today.

The law that established WASA created it as a quasi-independent agency. The Mayor chooses the District representatives on the WASA board and they are confirmed by the Council. Neither the Mayor nor the Council can change the budget of WASA. By law this Committee has only legislative oversight of the operation of WASA.

While the Council's control is limited to oversight, this control can have quite an impact because we are able to conduct hearings before the public, which are aired on local Cable Channel 13 and can be viewed by WASA's customers. We already had a regularly scheduled hearing to perform oversight of the WASA's budget and performance during Fiscal Year 2003 and thus far in 2004, and we will still be conducting that hearing as scheduled at 2:30 on Tuesday, February 10, 2004. Needless to say, finding lead in our city's drinking water is a very grave concern of this Committee, and that is why I scheduled this emergency roundtable in addition to the hearing I am convening next week. Holding these hearings is my way of exercising the limited control I have, and my way of following up on the concerns off the constituents I represent, a number of whom have contacted me after news of the excess lead reached the media.

Needless to say, many of these individuals have families with young children or pregnant women. One call in particular deeply troubled me because it shows the dramatic impact this issue is having on our residents. This constituent's wife is six months pregnant, and now the family is worried that their child may have physical or mental disabilities due to the apparent excessive levels of lead in their water. This family must now worry about the potential consequences of lead contamination in their water. Worrying about what is or is not in their drinking water should be the very last thing a couple worries about during what should be a very joyous time for them.

I find this reprehensible. I want and intend to get answers. 

Now, before we start with questions, I would like to turn to my colleague(s) for their opening statements. Councilmember ____?

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Statement by Glenn S. Gerstell

Chairman of the WASA Board of Directors
To the
Committee on Public Works and the Environment
Council of the District of Columbia
On
Questions on Lead in Our Water Supply 

February 4, 2004 

Good Afternoon Madam Chairman, Committee Members and Members of the Council:

The District of Columbia Water and Sewer Authority has four simple points we want to tell our customers and the Council:

  • one, the safety of our water supply is our top priority;

  • two, the drinking water we process and send through our pipes throughout Washington IS safe;

  • three, we pledge every effort to try to understand why there has been an increase in lead levels in samples we have taken from some homes in the District; and

  • four, we will continue to be completely open and candid with the Council and the public about what information we have and what our plans are.

That has been and will continue to be our policy. We have tried to publicize this but it is obvious from the news of the past few days that our message didn't get through. We will redouble our efforts to make sure our citizens get the information they need and deserve. The Authority can and will do a better a job in communicating with the public and government officials. I and the other volunteer board members live here too; our families drink the water and we want our questions about water quality answered to our full satisfaction just as you do.

While I know we can improve in the communications area, there shouldn't be any doubt that all of us at the Authority regard the safety of the water supply in our homes, our schools and our offices as our number one priority. We are absolutely committed to ensuring safety and that at all times we are in full compliance with all federal and local rules.

And I am pleased that we can say that we are, and have continuously for years now been, in full compliance with rules on water quality. That fact is very important and needs to come through to our citizens. I don't say that to pat ourselves on the back, but to reassure the public about the safety of our water supply system. The Authority and the US Army Corps of Engineers run hundreds of tests every week on our drinking water throughout the 1,300 miles of water pipes under DC streets. Those tests show we are meeting and surpassing federal standards as to biological contaminants and have no sign of contamination by lead or copper or other inappropriate elements.

But our drinking water system consists of more than just the Authority's water mains - it includes service lines to buildings and the privately owned pipes and fixtures inside buildings. For the vast majority of the public who drink our water in offices, schools, hospitals, apartment houses and private homes, the water that comes out of the faucet is safe. But for some 15% of our customers, we need to look at this more closely. We know that samples of water from some homes in the District showed elevated levels of lead. We are concerned about this and take it very seriously. We need to do more to find out what is causing these high readings.

When some samples in 2002 showed higher lead levels, after years of showing low results, the Authority decided last year to obtain thousands of more samples than were required by federal rules because we wanted to try to understand the scope of the potential problem. Last year we dug up and replaced almost 400 old lead pipes connecting homes to our water mains. We are going to continue that lead pipe replacement program. We are complying with the rules of the Environmental Protection Agency regarding lead pipe replacement. Let's be very clear on the scope of this issue - what we know right now is that the problem seems to involve only the 15% of our customers - some 23,000 single-family homes - connected to lead service lines. Most of those homes were built in the early 1900's, in the 1930's or during the World War II copper shortage, when lead was a popular choice for small-diameter water pipes.

Most importantly, we want to provide information and answer your questions. After elevated lead readings were noticed in 2002, we distributed a brochure as an insert to the Washington Post and the Washington Times and issued an announcement encouraging testing. In March and May of 2003 we had community meetings and meetings with local ANC commissioners about our lead service pipe replacement program. We can improve these communications and make them even more specific.

Over a year ago, we set up a lead hotline, at (202) 787-2732, for citizens to call and we want to publicize that again. We want our customers to call that number and we will tell you if our records show whether your home is one of the 23,000 homes in the District that are connected to our water mains by a lead service line. If it is, the Authority will provide you within two days a free test kit for your home tap water, we'll pick it up and analyze it for free and give you the test results within 30 days. Or you can email us at wgp2003@-dcwasa.com. This free testing isn't anything new but again, we want to make sure the word gets out. We'll continue to publicize this and give you updates in mailings and on our website at DCWASA.COM.

We appreciate this opportunity to tell the Council and the people who live and work in Washington about the safety of our water supply. Thank you.

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Testimony of Glenn S. Gerstell

Chairman of the Board of Directors
District of Columbia Water and Sewer Authority

Before the Committee on Public Works and the Environment
Carol Schwartz, Chairman
Council of the District of Columbia

Tuesday, February 9, 2004
Council Chambers, The John A. Wilson Building

DISTRICT OF COLUMBIA WATER AND SEWER AUTHORITY
5000 OVERLOOK AVENUE, S. W., WASHINGTON, D. C. 20032

Good afternoon Madam Chairman, and other members of the Council. Thank you for this opportunity to help the public better understand the issue we are confronting with respect to elevated lead concentrates in some District properties. The subject of water quality is of wide spread interest and I would like to take this opportunity to tell you what we are doing to address this issue. I am announcing five steps the Water and Sewer Authority is taking.

I want to assure you that providing safe and clean water to our community is our highest priority and this is particularly true with regard to our children, who can be especially sensitive to exposure to lead. We live in the District of Columbia, our children are here, and we are vitally concerned with taking the necessary actions to assure public safety and our children's safety.

First, we are working closely with the District of Columbia public schools and beginning this Saturday, February 14th, we will test all of the District's public schools. We are taking the extra precaution even though we believe the pipes leading into the schools are lead free. Results of those tests will be back by the end of the month and we will share those results with the public as soon as we have them.

We will also cooperate with private schools in the District that wish to have their water tested.

Second, we will increase the number of lead service pipes that we replace this year by more than 50 percent. When tests of drinking water at houses in the District showed higher lead levels in 2002, we immediately began compliance with federal rules requiring the replacement of old lead service pipes. It's believed that those pipes - typically connecting the city's water mains to single-family homes built before 1950 - are the most likely cause of the problem. We've replaced about 400 pipes so far and are doing everything that federal law requires. But we are doing more.

I have conferred with the other members of the Board of Directors and they support management's recommendation to reallocate already approved funds from other projects adding $7 million to the Lead Service Line Replacement Program budget. These additional funds will be targeted to replace service pipes in homes with the highest lead readings, where a pregnant woman or where children under the age of six live.

Third, we will send sample water testing kits upon request to homes with known lead service pipes. And if it's requested and we don't know whether the service pipe is made of lead, we will still send a testing kit. In all of these cases, WASA will pay for the testing.

Fourth, the District's Health Department (DOH) has begun canvassing door-to-door at those homes where tests showed lead levels exceeding 300 ppb (there are about 150 of these already identified.) The Health Department will conduct free blood tests for people at risk in these homes.

Fifth, in addition to the guidance from the Health Department, we are working to obtain the advice and counsel on this issue from the George Washington University School of Public Health. We welcome their cooperation and look forward to working with both the Health Department and George Washington University to get accurate, up-to-date information about the health impact of lead in drinking water to the public.

A week ago, I told you we would make every effort to improve our communications with the public on the issue of lead in drinking water. That has begun. We have tripled the number of phone lines devoted to the lead services hotline and staffed them with additional trained customer service representatives. I am pleased to tell you we have responded to every one of the more than 4000 calls we've received. We have also responded to over 1600 e-mails and more than 100 web site inquiries.

Today, for most callers to the hotline there is no wait to speak to a customer service representative and calls received overnight are promptly returned the next business day. We have been extending the hotline hours from 7:00 a.m. to 7:00 p.m. daily and 9:00 a.m. to 5:00 p.m. on weekends.

Another important step we have taken is to send a letter in both English and Spanish, with accompanying information about this issue, to every resident of the District. We will also continue to inform the public about lead in water through both print and broadcast media. A copy of the letter and other informational material is in your press kit.

We are considering other measures to address lead in water including use of filters. We are also working with the District government to pursue funding assistance options for the replacement of privately owned portions of lead service lines. As we have said, the Water and Sewer Authority has the responsibility and right to replace only the portion of the pipe that lies under the streets and public property; the part that lies underneath private property is the responsibility of the homeowner. We will work with homeowners to replace their portion of lead service pipes at cost if they ask us to.

In addition, we are briefing District and Federal government officials about our progress and answering their questions about the issue of lead in water. We will continue to meet with them and keep them informed.

Getting at the root of the problem, conducting research on the question of why there is an increase in levels of lead in some homes will continue to be a priority for WASA. We are aggressively researching this subject with EPA, the Army Corps of Engineers and respected scientists and academic experts. We will continue to do so until we get answers. We expect a preliminary report from this investigation in 30 days. We will use this information to guide our actions on behalf of the public.

Finally, I would appreciate your assistance in providing good advice to our customers and your constituents. Please advise anyone concerned about the possibility of lead in their water supply to follow a simple two-step process. It is likely that lead is getting into the tap water when that water sits for a long period of time in the lead service pipe or is otherwise in contact with lead joints. So the way to minimize it is to run some water through your home system. First, when you get up in the morning or anytime water has been sitting unused for six hours or more, flush the old water out of the system by using some water in the home for showering or bathing. Second, run water from the tap for about one minute before using for drinking or cooking. It is a simple, inexpensive measure any one can take.

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The Mid-Atlantic Center for Children's Health & the Environment
A Pediatric Environmental Health Specialty Unit
Affiliated with the George Washington University School of Public Health & Health Services
and the Children's National Medical Center

2100 M Street, NW
Suite 203
Washington, DC 20052
202-994-1166    www.health-e-kids.org   1-866-330-1200

Co-Directors Benjamin Gitterman, MD 
Tee L Guidotti, MD, MPH
Jerome A. Paulson, MD

Testimony of

Jerome A. Paulson, MD

before the City Council of Washington DC
on the matter of Lead in Drinking Water
4 February 2004.

Councilmember Schwartz and other members of the Washington, DC City Council. Thank you for the opportunity to present this testimony today. I am Dr. Jerome A. Paulson. I am a pediatrician and one of the Co-Directors of the Mid-Atlantic Center for Children's Health & the Environment. We are one of eleven Pediatric Environmental Health Specialty Units in the US and we are based at the George Washington University School of Public Health and Children's National Medical Center. I am the Medical Advisor for the Children's Environmental Health Network. I also practice primary care pediatrics here in the District of Columbia.

The Mid-Atlantic Center for Children's Health and the Environment, which serves the District of Columbia and the five states in the Mid-Atlantic region, has two goals: 1) the education of health professionals and others about the scientific and medical aspects of environmental health problems effecting children, and 2) providing advice to physicians, nurses, public health officials, parents, school professionals and others about children who have been, or may have been, exposed to environmental health hazards.

The Children's Environmental Health Network is a national multi-disciplinary, non-profit organization, based in Washington, DC whose mission is to protect the fetus and the child from environmental health hazards and promote a healthy environment.

Lead in the drinking water in some homes in the District of Columbia is a public health problem and the Washington DC Water and Sewer Authority (WASA) needs to resolve this problem as soon as possible. On the other hand, this is not a public health emergency for all of the residents of the District of Columbia who receive their water from WASA.

I will first talk about the toxicity of lead, then the specific issue of lead in water, then the problem of lead in drinking water confronting the District of Columbia and then the overall, and sorely neglected, problem of lead poisoning in the District.

Lead Toxicity

People are exposed to lead through ingestion or inhalation of lead contaminated food, water, or air. When lead enters the body, either via the lungs or the gastrointestinal tract, it moves into the blood stream. Because it is chemically similar to the ubiquitous chemical calcium, it replaces calcium in various bodily processes. Lead then exerts its toxic effects by inactivating crucial enzymes and so halting biochemical pathways essential to normal functioning. The enzymes most sensitive to the effects of lead are in the organ system where we most commonly see symptoms of lead poisoning: the brain. Other organ systems are also at risk from lead toxicity due to enzyme inhibition and impaired iron uptake and processing. These systems include the kidneys, the auditory system, the reproductive system, and red blood cell production.

It is important to recognize that children drink more water per pound of body weight per day than do adults; therefore, if the water is contaminated, they get a larger dose of the contaminant.1 In addition, children absorb a larger proportion of the lead that they ingest than do adults.2

The greatest potential for harm from lead occurs in the immature brain; i.e., in children prior to birth and during the first several years of life. Therefore, the offspring-of-pregnant-women and young children who have been drinking lead tainted water are particularly at risk. However, the
risk cannot be directly related to the concentration of the lead in the water. The risk is related to how much lead builds up in a child's body.
Blood lead levels above 80 mcg/dL, which would be exceedingly unlikely from exposures to lead in drinking water alone, have been associated with coma,, convulsions and death. Intermediate blood lead levels, which I also would not expect to occur from this type of exposure, are also associated with significant health effects. Recent research indicates that even children with blood levels below 10 mcg/dL, the level of concern as defined by the US Centers for Disease Control and Prevention sustain a small loss of IQ points. In addition, it is very important to note that many children with elevated lead levels develop attention deficits, language problems, reading difficulties and other learning problems as a result of their exposure to lead. Some children have hearing deficits, short stature, and/or significant behavior problems as a result of their exposure to lead. The behavior problems may be severe enough to result in involvement with the juvenile justice system. These problems may have a greater impact on long-term outcome than the IQ loss. It is lead levels in this range, particularly if the children are also exposed to other sources of lead in their environment, such as lead-based paint, that I believe may occur as a result of drinking lead-tainted water.

Measurable central nervous system injury from lead poisoning does not occur in every instance of exposure. However, if it occurs, it is irreversible. There is no approved medical treatment for children with blood lead levels in the range that we are discussing. Some of the lead will be stored in the body and some will be slowly. excreted, but there is no medication or other intervention that will safely remove the lead from the body or reverse any damage that might have been done.

There is at least one case report in the literature of a child sustaining elevated lead levels as a result of lead in water used to dissolve powdered baby formula.3

Lead in Water

Lead is going to be a problem in drinking water, if it is present in the source water; but that is not the situation here. In our situation, lead is present in the pipes that carry the water or some of the joints of those pipes or the faucets and other fittings. When lead is present in the pipes, joints, faucets, or fittings then the lead can dissolve into the water as the water sits in the pipes. How much dissolves depends on various chemical characteristics of the water and the amount of time that the water remains in contact with the pipes, joints, faucets, or fittings. The most common cause is corrosion, a reaction between the water and the lead pipes or solder. Dissolved oxygen, low pH (acidity) and low mineral content in water are common causes of corrosion. Presumably, it is one or more of these factors that have changed and have caused the increase in the number of homes showing elevated tap-water lead levels in the WASA sampling.

Lead in Water in the District of Columbia

WASA indicates that "[a]pproximately 23,000 properties, about 15% of our customer households, have lead service lines ..." It is these homes that are likely to be at highest risk of elevated lead levels in the drinking water coming out of the tap. It is these homes that should be targeted for intervention.

Recommendations for managing medical aspects of the problems of lead-contaminated drinking water in the District of Columbia

Because irreversible Prevention of further problems should be the primary means of dealing with this problem from hear on out. That means reducing the amount of lead present in the water that comes out of the tap. There are methods for chemically treating water to decrease its corrosive potential and thereby decrease that amount of lead that will dissolve in the water. WASA should be required to implement those changes if it has not already done so.

Replacing lead water lines will also reduce this problem in the future, but it will not be a rapid solution to the problem. WASA is required by US EPA regulations to replace 7% of the lead water lines per year. At that pace, in 10 years, there will still be thousands of lead service lines in use. In addition, WASA is only required to replace the line from the street to the property margin. The homeowner is responsible for the remainder. That is going to be a very expensive proposition for some District homeowners. To help homeowners, the District Government should consider developing a system to provide financial aid to enable them to afford to replace these lead lines. Consideration should also be given to whether the District can require a more rapid replacement off lines than is required by the federal government.

WASA should be required, within the next month, to test water samples from all remaining places with known lead service lines. This should not be a passive exercise with WASA relying on homeowners to get test kits, mail them in and interpret the results. Rather, this should be an active program. WASA needs to collect the samples, insure quality control, notify the homeowner of the specific results and publish the overall results.

WASA should be required, within the next 2-3 weeks to directly communicate with all of the properties that it knows to have lead service lines. Those living in the properties should be instructed that they should: 1) run their water for several minutes before using it for drinking or cooking and 2) only use cold water for drinking and cooking. They should be instructed that boiling water will not remove lead and will, in fact, increase the concentration of lead in the water. They should be instructed not to make baby formula with water directly from the tap until the water has been documented to be safe. Those living in the properties should be told that there are water filters that will remove lead and be supplied with a list of those filters certified by NSF International to remove lead.

Probably the most important question from a health perspective is whether there is anything that needs to be, and can usefully be, done now to assess the potential health impact of this lead exposure on the offspring of women who have been pregnant while consuming lead contaminated water or on children who have been consuming lead contaminated water. The US Environmental Protection Agency has published The Integrated Exposure Uptake Biokinetic Model for Lead in Children (IEUBK) ( http://www.epa.gov/superfund/programs/lead/ieubk.htm). This computer model attempts to predict blood-lead concentrations (PbBs) for children exposed to lead in their environment. Using this model and entering concentrations of lead in water at the levels that have been reported by WASA, it is obvious that it is unlikely for children to sustain blood lead levels in the 20s and above from the water alone (See appendix). It is also obvious that the children are at risk for sustaining blood lead levels for, the single digits into the teens.

There would be particular concern about children who are at risk of having elevated blood lead levels from other reasons, most likely lead based paint in their homes. The elevation of their blood lead level from the water would be on top of the elevation of their blood lead level from paint. In these children, who live in older homes, the homes more likely to have lead service lines, the incremental increase in their blood lead levels may be sufficient to increase their risk of permanent brain damage from the lead exposure.

Unfortunately, it is also important to recognize that there is no approved medical treatment for children with blood lead levels in the range that we are discussing. Some of the lead will be stored in the body and some will be slowly excreted, but there is no medication or other intervention that will safely remove the lead from the body or reverse any damage that might have been done.

Given these facts, should any of the people who have been exposed to lead in drinking water see their physician, have medical tests or any medical interventions? I would recommend that the following criteria be used to decide the answer to this question.

  1. Only people living in, or spending many hours per day in, homes with lead service lines should be considered for further evaluation. WASA needs to notify everyone whose home is of concern.
  2. Of those people, only those living in, or spending many hours per day in, homes that are known to have had elevated tap water lead levels should be considered for further evaluation. Therefore, it is very important for WASA to complete the water analyses as rapidly as possible as indicated above.
  3. Of those people, the greatest risk will be to the children who were born to women pregnant during this episode who consumed WASA water during their pregnancy and children, in the first several years of life, who themselves consumed WASA water.
  4. Of those people, based on the information from The Integrated Exposure Uptake Biokinetic Model for Lead in Children I would recommend that
    1. children under 6 who lived in homes with water lead levels greater than 300 ppm have a blood lead level done
    2. children under 6 who lived in homes with water lead levels less than 300 ppm and greater than 100 ppm and who live in a home built prior to 1950 or some other significant risk factor such as a neurologic problem or developmental delay have a blood lead level done
    3. other children not have a blood lead level done.
    4. children who have had blood lead levels within the last six months, or who are scheduled to have a blood lead level done within the next one to two months do not need to have a blood lead level done at this time, but should have a blood lead level when next scheduled
    5. all blood lead levels should be drawn as venous blood samples.

There are a number of caveats that need to accompany these recommendations:

  1. They have not been peer reviewed for scientific soundness
  2. Different inputs into The Integrated Exposure Uptake Biokinetic Model for Lead in Children (IEUBK) will lead to different results, and perhaps, different recommendations.

Lead Poisoning in the District of Columbia

I realize that this is a hearing about lead contamination of drinking water in the District of Columbia. However, I cannot let this opportunity go by without reminding the members of the Council that there are thousands of homes in the District of Columbia that contain lead-based paint. As a result, there are hundreds of children every-year in the District of Columbia who sustain brain damage as a result of exposure to this paint.

At the present time we have an inadequate law in the District of Columbia that requires screening of children from 6-9 months of age and again in the second year of life. Screening at 6-9 months is too early to identify children with elevated lead levels.

Moreover, and more importantly, screening children means that we are using children to identify. unsafe homes in the District of Columbia. Since there is no known safe level of lead, identifying children with elevated lead levels means identifying children after the damage may have been done.

The District of Columbia needs to work to identify and repair, or have repaired, dwellings that are unsafe for children before the children are harmed. There are ways to do this. The federal government will predicate its future funding for lead programs on this type of approach.

The District needs to change its current law and stop the unethical process of using children to identify unsafe housing. The City Council should convene hearings in the near future to review the entire issue of lead poisoning in the District of Columbia. Major changes need to be made in the way the District and the private sector operate so that children are protected from a problem which is preventable and about which children and their parents have very little control. Council members need to be aggressive and forceful leaders on this issue.

Deciding on further medical evaluation of individuals who may have been exposed to lead-tainted water.

Does the home a lead water pipe?
Yes   No - no further evaluation

Does the home have an elevated water lead level?
Yes   No - no further evaluation

Are there children in the home who are under 6 years of age or a woman who is pregnant?
Yes   No - no further evaluation

Is the lead level in the water greater than 300 ppm?
Yes - have a venous blood lead level done on No - see below the child or the infant born to the mother.

Is the lead level in the water greater than 100 ppm but less than 300 ppm?
Yes - determine if there are other risk factors (Other risk factors include a home built prior to 1950, a child with a neurological or developmental problem)

Are there other risk factors?
Yes - have a venous blood lead level done on No - no further evaluation the child or the infant born to the mother.

Is the lead level in the water less than 100 ppm?
Yes - no further evaluation

Appendix to the testimony of Jerome A. Paulson, MD before the City Council of Washington DC on the matter of Lead in Drinking Water, 4 February 2004.

The material in this appendix was generated by Dr. Paulson using The Integrated Exposure Uptake Biokinetic Model for Lead in Children (IEUBK). This software is available at httv://www.epa.Rov/superfund/programs/lead/ieubk.htm. Each page represents portions of the results generated by the software. Each page differs in the amount of lead that was assumed to be in the drinking water. Particular attention should be paid to the columns headed Blood (ug/dL).

Alternate Water Values Used

Values:
Percent of Total Consumed as First Draw: 50.000% 
Concentration of Lead in First Draw: 4.000 ug/L 
Concentration of Lead in Flushed: 1.000 ug/L 
Percentage of Total Consumed from Fountains: 0.000 
Concentration of Lead in Fountain Water: 10.000 ug/L

CALCULATED BLOOD LEAD AND LEAD UPTAKES: 

Year Air (ug/dL) Diet (ug/day) Alternate (ug/day) Water (ug/day)
.5-1 0.021 2.557 0.000 0.231
1-2 0.034 2.655 0.000 0.574
2-3 0.062 3.009 0.000 0.603
3-4 0.067 2.926 0.000 0.621
4-5 0.067 2.869 0.000 0.656
5-6 0.093 3.046 0.000 0.697
6-7 0.093 3.373 0.000 0.711
 
Year Soil+Dust (ug/day) Total (ug/day) Blood (ug/dL0
.5-1 4.067 6.876 3.7
1-2 6.417 9.681 4.0
2-3 6.479 10.153 3.8
3-4 6.551 10.165 3.6
4-5 4.940 8.532 3.0
5-6 4.475 8.311 2.6
6-7 4.239 8.415 2.4
 

Alternate Water Values Used

Values:
Percent of Total Consumed as First Draw: 50.000% 
Concentration of Lead in First Draw: 15.000 ug/L 
Concentration of Lead in Flushed: 3.000 ug/L 
Percentage of Total Consumed from Fountains: 0.000 
Concentration of Lead in Fountain Water: 10.000 ug/L

CALCULATED BLOOD LEAD AND LEAD UPTAKES: 

Year Air (ug/dL) Diet (ug/day) Alternate (ug/day) Water (ug/day)
.5-1 0.021 2.540 0.000 0.827
1-2 0.034 2.622 0.000 2.042
2-3 0.062 2.977 0.000 2.146
3-4 0.067 2.897 0.000 2.215
4-5 0.067 2.843 0.000 2.342
5-6 0.093 3.020 0.000 2.487
6-7 0.093 3.346 0.000 2.538
 
Year Soil+Dust (ug/day) Total (ug/day) Blood (ug/dL)
.5-1 4.041 7.429 4.0
1-2 6.340 11.038 4.6
2-3 6.408 11.593 4.3
3-4 6.488 11.666 4.1
4-5 4.896 10.148 3.5
 

Alternate Water Values Used

Values:
Percent of Total Consumed as First Draw: 50.000% 
Concentration of Lead in First Draw: 100.000 ug/L 
Concentration of Lead in Flushed: 10.000 ug/L 
Percentage of Total Consumed from Fountains: 0.000 
Concentration of Lead in Fountain Water: 10.000 ug/L

CALCULATED BLOOD LEAD AND LEAD UPTAKES: 

Year Air (ug/dL) Diet (ug/day) Alternate (ug/day) Water (ug/day)
.5-1 0.021 2.432 0.000 4.837
1-2 0.034 2.420 0.000 11.516
2-3 0.062 2.768 0.000 12.198
3-4 0.067 2.715 0.000 12.685
4-5 0.067 2.677 0.000 13.476
5-6 0.093 2.853 0.000 14.355
6-7 0.093 3.171 0.000 14.701
 
Year Soil+Dust (ug/day) Total (ug/day) Blood (ug/dL)
.5-1
3.868
11.158
6.0
1-2
5.851
19.822
7.9
2-3
5.960
20.988
7.7
3-4
6.080
21.547
7.4
4-5
4.611
20.831
6.9
5-6
4.192
21.493
6.5
6-7
3.986
21.951
6.2
 

Alternate Water Values Used

Values:
Percent of Total Consumed as First Draw: 50.000% 
Concentration of Lead in First Draw: 200.000 ug/L 
Concentration of Lead in Flushed: 20.000 ug/L 
Percentage of Total Consumed from Fountains: 0.000 
Concentration of Lead in Fountain Water: 10.000 ug/L

CALCULATED BLOOD LEAD AND LEAD UPTAKES: 

Year   Air   Diet   Alternate   Water
(ug/dL)   (ug/day)   (ug/day) (ug/day) ------------------------------------------------------------------------------

Year Air (ug/dL) Diet (ug/day) Alternate (ug/day) Water (ug/day)
.5-1 0.021 2.316 0.000 9.215
1-2 0.034 2.226 0.000 21.179
2-3 0.062 2.563 0.000 22.591
3-4 0.067 2.533 0.000 23.662
4-5 0.067 2.509 0.000 25.254
5-6 0.093 2.681 0.000 26.982
6-7 0.093 2.990 0.000 27.725
 
Year Soil+Dust (ug/day) Total (ug/day) Blood (ug/dL)
.5-1 3.685
15.237
8.1
1-2
5.380
28.820
11.3
2-3
5.518
30.735
11.2
3-4
5.671
31.933
10.9
4-5
4.320
32.149
10.5
5-6
3.939
33.696
10.1
6-7
3.758
34.567
9.6
 

Alternate Water Values Used

Values:
Percent of Total Consumed as First Draw: 50.000% 
Concentration of Lead in First Draw: 300.000 ug/L 
Concentration of Lead in Flushed: 30.000 ug/L 
Percentage of Total Consumed from Fountains: 0.000 
Concentration of Lead in Fountain Water: 10.000 ug/L

CALCULATED BLOOD LEAD AND LEAD UPTAKES: 

Year Air (ug/dL) Diet (ug/day) Alternate (ug/day) Water (ug/day)
.5-1 0.021 2.215 0.000 13.215
1-2 0.034 2.068 0.000 29.522
2-3 0.062 2.394 0.000 31.656
3-4 0.067 2.379 0.000 33.345
4-5 0.067 2.365 0.000 35.717
5-6 0.093 2.534 0.000 38.254
6-7 0.093 2.834 0.000 39.415
 

Year Soil+Dust   Total   Blood
(ug/day)   (ug/day)   (ug/dL) --------------------------------------------------------------

Year Soil+Dust (ug/day) Total (ug/day) Blood (ug/dL)
.5-1 3.523 18.974 10.0
1-2 5.000 36.625 14.2
2-3 5.155 39.268 14.2
3-4 5.328 41.119 13.9
4-5 4.073 42.222 13.6
 

Alternate Water Values Used

Values:
Percent of Total Consumed as First Draw: 50.000% 
Concentration of Lead in First Draw: 400.000 ug/L 
Concentration of Lead in Flushed: 40.000 ug/L 
Percentage of Total Consumed from Fountains: 0.000 
Concentration of Lead in Fountain Water: 10.000 ug/L

CALCULATED BLOOD LEAD AND LEAD UPTAKES: 

Year Air (ug/dL) Diet (ug/day) Alternate (ug/day) Water (ug/day)
.5-1 0.021 2.124 0.000 16.899
1-2 0.034 1.938 0.000 36.890
2-3 0.062 2.253 0.000 39.716
3-4 0.067 2.249 0.000 42.022
4-5 0.067 2.242 0.000 45.140
5-6 0.093 2.407 0.000 48.443
6-7 0.093 2.698 0.000 50.027
 
Year Soil+Dust (ug/day) Total (ug/day) Blood (ug/dL)
.5-1 3.379 22.423 11.7
1-2 4.686 43.549 16.8
2-3 4.851 46.882 16.8
3-4 5.036 49.373 16.6
4-5 3.861 51.310 16.3
5-6 3.536 54.479 16.0
6-7 3.391 56.209 15.4

1. For example, when an infant drinks six ounces of formula or breast milk per kilogram of body weight daily, it is equivalent to an adult male drinking 35 cans of soda in a day.

2. Children 0-2 years absorb about 50% of the lead they ingest. Children 2-6 years absorb about 35% of the lead they ingest. Childrne 6-7 years absorb about 20% of the lead they ingest. Adults absorb about 10% of the lead they ingest. 

3. Shannon M. Graef JW. Lead intoxication from lead-contaminated water used to reconstitute infant formula. Clinical pediatrics. 28(8):380-2 1989 Aug.

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CLEAN WATER ACTION

4455 Connecticut Avenue, NW ∎ Suite A300 ∎ Washington, DC 20008-2328
(202) 895-0420 ∎ FAX (202) 895-0438 ∎ E-MAIL: CWA@cleanwater.org

Testimony of Paul Schwartz
National Policy Coordinator
Clean Water Action

Committee on Public Works and the Environment
Oversight Hearing on DC WASA & Lead in Drinking Water
February 4, 2004

Good Afternoon. Thank you for the opportunity to testify before the Committee on Public Works and the Environment on the topic of lead in the District of Columbia's drinking water. My name is Paul Schwartz, Clean Water Action's Water Policy Coordinator. Clean Water Action is a public health and environmental advocacy group with two dozen offices and 700,000 members nationwide. We represent thousands of members who live and work in Washington DC, many of whom are DC WASA ratepayers.

DC WASA was born out of a crisis of confidence in how the District government was handling its responsibilities to protect our community's health and environment. Today we see a new crisis of confidence. WASA's communications consistently reassure residents and consumers that DC water meets all federal regulations and that they did not have to be vigilant. We now know how wrong that assumption was.

Pregnant women, parents of small children and others are wondering about irreversible harm being done right now and are wondering about the costs of WASA's behavior to their families and children's future. Many people, who may or may not have a lead problem in their home, are abandoning City drinking water by turning to costly and possibly less protective alternatives such as bottled water and point of use and point of entry household filtration devices. I live in the 4th Ward in the old neighborhood of Takoma DC. wo of my close neighbors are in their second trimester of pregnancy; four of my neighbors have kids up to three years old who are especially vulnerable to drinking water contamination.

Particularly since the 1993 "boil water" alert, Clean Water Action has worked with allies like the Natural Defense Council and others in the public health and environmental community to find solutions to Washington DC's drinking water issues. WASA, Region III EPA, the Army Corps of Engineers which runs the Washington Aqueduct and the DC Department of Health need to do a better job of protecting our drinking water sources, upgrading our out of date water filtration plant and repairing, replacing and maintaining our old and broken system of reservoirs and distribution pipes. Some progress has been made, but we often encounter resistance on these fundamental issues as well as on issues of communication with the public.

The problem of lead in DC's water is not new. At a national press conference last June 11, 2003, Clean Water Action noted that DC WASA continued to have problems with a range of contaminants including lead. We noted that inclusion of the drinking water consumer should not be an afterthought, and lack of action to address the problems would result in increasing health problems for the District's residents and workforce. It is imperative that consumers be informed about and involved in solving DC's drinking water problems. The situation we find ourselves in today might have been avoided with better communication and more timely action.

Beyond our concerns about other contaminants regularly found in the District's drinking water, there are other problems, including the lack of funding, an inadequate source water protection effort, no waterborne disease surveillance program, an aging and out of date filtration and disinfection system, aging and failing pipe and little inclusion of the rate payer/drinking water consumer. How can we change this picture and address some of these long standing problems?

We ask this committee to use its authority to take a number of steps to address the current situation and to put in place structures to ensure clean, safe and affordable water over the long term:

  1. DC WASA should share all relevant information about the extent of the lead problem in DC's drinking water;
  2. DC WASA should reveal all of its lead testing data to the public;
  3. DC WASA should notify all homeowners of any positive lead tests;
  4. DC WASA should publish a map showing the distribution and amount of lead found throughout the city;
  5. DC WASA should notify all homeowners who have been identified as having lead service lines:
  6. DC WASA, along with the Washington Aqueduct (WA), should investigate and re-tune their corrosion control program;
  7. DC WASA should make permanent the free lead testing program it has recently established and extend the service to any household that requests a test;
  8. DC WASA should end the practice of including prominent, unqualified and misleading statements about the water's safety in its annual Water Quality or "Right to Know" Report;
  9. The DC City Council and Mayor should appoint and convene a panel of experts, consumers and advocacy organizations to do a through review of DC WASA and the WA's conduct regarding lead and numerous other pressing drinking water, storm water and sewage issues;
  10. The DC City Council should enact a bill authorizing the creation of a DC Water Citizen's Utility Board (DC CUB), an ongoing, independent, citizen advocate review panel with express oversight authority over DC WASA and the WA, and the Mayor should sign into law.

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Dr. Walter Faggett

Committee on Public Works and the Environment
Carol Schwartz, Chair
Public Roundtable
The Lead Service Replacement Program
Wednesday, February 4, 2004
1:00 pm
The Wilson Building
Room 412

Good Afternoon Chairman Schwartz, Members of the Committee and the Environment and other Council Members. Thank you for convening this important forum to discuss the Water and Sewer's Authority's management of the lead service replacement program.

I am Dr. Walter Faggett, Interim Chief Medical Officer, District of Columbia Department of Health and a practicing pediatrician in the city. My remarks today will focus on potential health risks of lead exposure. 

Lead Poisoning: Health Risks

  • Children: In regard to the potential health risks to children in the District of Columbia There is a difference of opinion on the risks of elevated lead in water for small children and developing fetuses. There is a general consensus that extremely large amounts of water would have to be consumed to have a clinical impact on the health of our residents. The Medical Community has evidence that lead intoxication can lower IQ scores and cause behavior problems such as ADHD and behavioral problems such as aggressive behavior, school problems and adolescent adjustment disorders.
  • Information on the health risks of lead poisoning.
    Lead in the water is less of a hazard that peeling lead paint, which small children eat. The levels in those children would be predictably much higher than those children exposed to water with high levels of lead. The EPA does estimate that drinking water can make up 20% of a person's total exposure to lead.

    Lead can cause damage to the many body systems with high exposure and moderate or low but chronic exposure can affect the developing nervous system of young children ( <6yo) in subtle but clinically significant ways.

    Signs and symptoms associated with toxicity of ongoing lead exposure vary from asymptomatic at low levels of exposure ( <10 mcg ) to ADHD seizures, paralysis and brain damage at extremely high

    Blood levels (150mcg and above). The American Academy of Pediatrics has published screening, prevention and treatment guidelines which the DOH recommends to DC providers serving our residents.

    Excessively large amounts of water with lead levels 15 parts per billion would be required to reach the toxic levels resulting in Severe signs and symptoms

I repeat that Children exposed to lead may be asymptomatic and concerned parents should have their children tested. Likewise, pregnant women, senior citizens or anyone with concerns should be tested as well.

Dr. Janelle Goetchus of Unity Clinic reports no recent increase in lead levels in that patient population in areas of elevated water levels to date.

The current lead levels in the water are cause for concern. However, anyone with concerns should visit their doctor for a lead test.

DOH Contact Information:

The DC Department of Health can provide more information about the health effects of lead and how you can have your child and family tested. For general information please call 202-671-0733: For information on screening please call 202-535-2690 or 202-535-2626.

New information brochures have been prepared by the Department of Health to educate DC residents about the risks of lead exposure and steps
to take to lower the risk of exposure. DOH fact sheet is submitted as part of testimony.

Thank you for your continued

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