Lead Pipe Cinch – The Health Care Blog


The term “lead pipe cinch” means something that is very easy or certain. Here’s two things that are lead pipe cinches: first, that ingesting lead, such as from the water or the air, is bad for us. It’s especially bad for children, whose cognitive abilities can be impaired. Second, that the Biden Administration’s latest proposal to reduce the lead in our drinking water is not going to accomplish that.

The new proposed rules would require that lead service lines be replaced within ten years; there are estimated to still be some 9.2 million such lines in the U.S. The trouble is, no one really knows how many there are or where exactly they are, making replacement difficult. So step two of the rules is for an initial inventory by next October. The “acceptable” parts per billion would drop from 15 to 10. Utilities would also have to improve tap sampling and consumer outreach.

“This is the strongest lead rule that the nation has ever seen,” Radhika Fox, the E.P.A.’s assistant administrator for water, told The New York Times. “This is historic progress.”

Erik Olson, an expert with the Natural Resources Defense Council is also hopeful, telling NPR: “We now know that having literally tens of millions of people being exposed to low levels of lead from things like their drinking water has a big impact on the population. We’re hoping this new rule will have a big impact.”

The EPA estimates the replacement will cost $20b to $30b over the next decade; the 2021 Infrastructure Act allocated $15b, along with $11.7b available from the Drinking Water State Revolving Fund. Of course, the cost will be much higher.

Chicago alone claims it will cost $10b to replace its estimated 400,000 lead pipes. The Wall Street Journal reports: “David LaFrance, CEO of the American Water Works Association, a trade group, said the total cost could “easily exceed” $90 billion. He said the average cost to replace a single lead service line is more than $10,000, nearly double the EPA’s estimate.”

If the federal funds aren’t enough, Ms. Fox says: “We strongly, strongly encourage water utilities to pay for it,” but you should probably expect customers will end up paying – or that some of those pipes won’t be getting replaced.

It’s not like any of this is catching us by surprise. You probably remember the 2014 scandal with the Flint (MI) water crisis, with all those people lining up for bottled water. You may not remember similar crises in Washington D.C., Newark (NJ), or Benton Harbor (MI). “The Washington, D.C., lead-in-water crisis was far more severe than Flint in every respect,” Yanna Lambrinidou, a medical anthropologist at Virginia Tech and co-founder of the Campaign for Lead Free Water, told AP.

The EPA issued a set of rules around lead pipes in 1991, but those rules were watered down, and little progress has been made since. Ronnie Levin, an EPA researcher at the times, also told AP: “But, you know, we’ve been diddling around for 30 years.”

Because, you know, that’s what we do, especially when fixing a problem costs too much money.

The water companies may replace their water lines but not the ones that go under private property, and the pipes inside homes or offices — well, you should start thinking about a water filter (ones certified for lead, of course).

You wouldn’t buy a house that you knew had lead paint or had asbestos, but most people don’t know if any part of their water supply comes through lead pipes. Dr. Lambrinidou told Fast Company: “We know that the majority of homes, if not all, have lead-bearing plumbing. And we know from the science that as long as you have lead-bearing plumbing, you are at risk of exposure.”

It shouldn’t be a surprise that the problem is worst in cities and in older housing stock. “This a public health concern that has, unfortunately, spanned generations and an issue that has disproportionately impacted low-income and minority communities,” EPA Administrator Michael Regan said at the EPA briefing. “Everyone in this country should be able to turn on their tap for a glass of water and know that it’s safe to drink.”

“We’re trying to right a longstanding wrong here,” Radhika Fox, head of the EPA Office of Water, echoed. “We’re bending the arc towards equity and justice on this legacy issue.”

Experts estimate some 500,000 children have high levels of lead in their blood; that number may be overstated, or wildly low. Adults are at risk as well, especially pregnant women. The EPA believes its rules would generate between $9.8b and 34.8b in economic benefits each year, making it a good return on the replacement investments. But the rub is that those economic benefits are from less cognitive impairments and health disorders, in populations we tend to neglect anyway, and so are much “softer” than the direct budget hits of replacing the pipes.

“We have failed generations of children by not eliminating lead,” Mona Hanna-Attisha, the Michigan pediatrician whose research helped to exposed the 2014 Flint water crisis, told NYT. True, but we’ve been failing generations of kids for generations in many ways, such as child poverty or infant mortality. We have generations of “lost Einsteins,” kids who never had a chance to reach their full potential due to their surroundings while growing up, whether from lead in their water, insufficient food, polluted air, or failing public education.

We’re the champs at failing kids. And at addressing structural issues like infrastructure.

The new rules now have a waiting period, and final rules aren’t expected until next fall. Then there will be a waiting period before they go into effect. By the time the lobbyists and the politicians – we can’t afford it! – have their say, I’m not optimistic how much impact the final rules will have.

I’m freaked out that there might be lead in my water lines. I’m saddened that there are perhaps hundreds of thousands, if not millions, of children who will never reach their full potential due to having adsorbed too much lead. And I’m furious that we allow our public goods, like clean water or air, to be compromised by politicians whose only concern is reelection.

We can do better, Sadly, it’s a lead pipe cinch that we probably won’t.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and now regular THCB contributor

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