Removing lead pipes: A once-in-a-generation opportunity

In Flint, Mich., parents still bring their kids to the Hurley Children’s Hospital clinic, worried about the long-term consequences of the city’s lead in the water crisis on their children’s  development, learning and health. But while Flint was a signature environmental disaster of our time, it was not the first, the last nor the worst lead-in-water crisis. There are an estimated 9 million to 12 million lead service lines threatening the health of residents of all 50 states, but we now have a once-in-a-generation opportunity to prevent what happened in Flint from happening again, by meeting President Biden’s call to remove 100 percent of these underground ticking time bombs.

It is well established in medical literature that there is no safe level of lead exposure, whether it’s in drinking water, paint, soil or the air. We know that lead harms brain development in fetuses and children; causes loss of intelligence, behavioral and attention deficits and developmental delays; may be linked to early dementia; and even low-level exposure has been linked to higher rates of cardiovascular disease and death. We also know that it hits some of us harder: children of color, especially Black children, and low-income kids shoulder a greater burden of lead exposure. And studies show that drinking water violations, like many environmental health threats, disproportionately plague lower-income communities and communities of color. 

The good news is that we can solve this preventable health inequity if we invest the $45 billion needed to remove all these lead lines. The bipartisan Senate infrastructure deal would fund one-third of that need, or $15 billion. The forthcoming reconciliation bill should meet the rest of the need by investing the remaining $30 billion. The benefit of removing these lead pipes makes economic sense. Not only will the project create tens of thousands of good-paying jobs, but the health and resulting economic benefits will be enormous. 

Studies indicate that the societal benefits of lead service line removal range from a minimum 30 percent to 40 percent return on investment, and according to more comprehensive analyses, from 5 to 10 times the costs. A Pew Charitable Trusts analysis found that lead service line removal was among the most cost-effective actions for lead exposure reduction that can be made. 

A recent op-ed in The Hill by Robert Verbruggen unfortunately muddies the water. The author acknowledged that lead is bad for health even at low levels, that 40 to 60 percent of the lead exposure for bottle-fed infants comes from the tap water used to make their formula, and that on average 20 percent of lead exposure comes from drinking water. But he misses the mark and misjudges the political moment by arguing the problem of lead in drinking water should be left to local authorities to solve, and that infrastructure legislation shouldn’t fund lead pipe removal because exposure to lead from paint is bad, too. 

Local authorities have failed to make water safe from lead for decades; only a few cities have replaced their lead pipes, and a recent study found 40 states have no idea where their lead pipes are even located. This fails to inspire confidence that localities will act with the necessary urgency. Additionally, the need to address other sources of lead does not justify a refusal to fund action on lead in drinking water. Any public health professional would agree that all sources of lead must be eliminated. You can bet we would support such funding and legislation like the Environmental Justice Legacy Pollution Cleanup Act that would do so. 

The time to remove lead drinking water pipes is now. President Biden’s proposal not only affords an opportunity to upgrade the infrastructure of our drinking water delivery systems, but it also affords an investment in our nation’s most critical and foundational infrastructure — our children and their potential. We look forward to conversations and clinic visits — hopefully in the near future — where we can confidently reassure parents that the drinking water coming out of their taps and filling their babies’ bottles is safe. 

Mona Hanna-Attisha, MD, MPH, FAAP, is director of the Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative in Flint, Mich. A pediatrician, professor and public health advocate, her research helped expose the Flint water crisis. She is the author of “What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City.”

Erik D. Olson is senior strategic director, Health and Food, Healthy People & Thriving Communities Program at the NRDC (National Resources Defense Council Inc.), where he directs advocacy initiatives on health, food and agriculture, including campaigns on drinking water protection and toxins in products and the environment.