Snapshot Peril in the Pipes and Paint: Protecting the Public From Lead Exposure

Lead is toxic to human health. Lead poisoning can be harmful to human health, especially to children. Children under the age of six are at high risk of long-term health effects, including damage to the brain and nervous system. Even low-level lead exposure to children can delay cognitive growth and impair physical development.

Americans are still being exposed to lead. As of 2022, 1 in 40 children ages 1-5 years old have unsafe blood lead levels. Additionally, researchers have estimated that over half of the U.S. population, more than 170 million people, were exposed to high lead levels in early childhood.

There are various sources of lead exposure. Some examples include contaminated paint, water, dust, old toys and soil. Despite the bans on lead-based paint and lead water service lines in the U.S., these remain the primary sources of lead exposure. There are about 38 million homes (40% of all housing units) with lead-based paint, normally under layers of newer paint, and an estimated 9.2 million lead service lines provide water to properties around the country. 

A simple blood test can detect lead poisoning. Although there is no safe level of lead, doctors use 3.5 micrograms per deciliter of blood to identify a blood lead level of concern.

Significant federal funding is available to state and local governments. The U.S. Environmental Protection Agency awards non-competitive grants through the Voluntary School and Child Care Lead Testing and Reduction Grant Program. This program assists states, territories and tribes with voluntary lead testing and reduction in drinking water at schools and childcare programs. These grants have provided more than $150 million since 2019. Additionally, the U.S. Department of Housing and Urban Development offers grants to communities to clean up lead-based paint hazards. 

In 2023, Delaware amended its’ Childhood Lead Poisoning Prevention Act (HB 227), requiring primary healthcare providers to report lead poisoning screening results on electronic forms for children’s visits at 1 and 2 years of age. Delaware also enacted SB 9 (2023), which creates a process to identify and remediate homes that contain exposed lead paint, including screening every property where a child received a test result showing an elevated blood lead level. 

Maine and Washington require routine testing of school building water outlets for lead contamination. Washington’s HB 1139 (2021) requires water outlets in schools built before 2016 to be tested for lead contamination every five years and the test results shared with the school community. Maine passed SB 40 in 2019, requiring all schools to test water used for drinking or culinary purposes using water sample kits or by sending samples to the state. 

Michigan passed legislation in 2023 requiring physicians to test minors for lead poisoning (SB 31), as well as entering the testing on the minor’s immunization certificate. The bill also requires that every minor is tested at 1 and 2 years of age. Michigan’s HB 4200 requires immunization records to note lead poisoning testing and notify the parent or guardian of their right to object to the reporting requirement. Michigan also passed HB 4437, providing funds for lead testing through a children’s health care access program. 

Passed in 2022, New York’s “Dakota’s Law” (SB 5024) was established to create a comprehensive system to prevent childhood lead poisoning. The bill requires lead screenings at every routine primary health care visit from the age of 6 months to 6 years, physicians to provide information on lead poisoning prevention to the parent or guardian, and pre-kindergarten and kindergarten institutions to check if their enrolling students have been screened for lead exposure. The state also appropriated (AB 3003) $5 million each year from 2019 to 2024 for services and expenses related to lead testing and remediation of child day care facilities.  

Pennsylvania and Utah are both preventing childhood lead exposure through testing and public education. Pennsylvania’s Blood Lead Test Act (SB 522, 2021) provides for blood lead assessment and testing of children between the ages of 2 and 6 years and requires a public information campaign for parents. Utah’s blood lead epidemiology program, (HB 259, 2021), encourages lead tests and creates a program on preventive measures for parents with children under the age of 2.