Reports of lead contamination have emerged in schools and communities across the country. The focus on this issue is deserved: even at low levels, lead exposure is harmful, especially in young children.1-3 Drinking water is important for proper hydration and oral health and can serve as a substitute for sugary drinks in order to help children grow up at a healthy weight. But water must be safe to drink.
This project sought to take a closer look at states’ efforts related to testing their drinking water for lead. It involved the statistical analysis of water lead content data from state-based testing programs overall and by school and student demographic characteristics. The research team documented features of state school water quality testing programs and compared their methodologies to standard health surveillance elements.
This report describes the features of statewide initiatives in operation between January 1, 2016 and February 28, 2018 in 24 states and the District of Columbia to conduct testing for lead in school drinking water, and the prevalence of elevated lead concentrations in tap water in public schools based on available data. To identify and summarize the features of state policies and programs, researchers conducted online searches using a search engine and by scanning state legislative and department websites and existing resources from public health organizations. Researchers communicated with state government agencies to verify their policy or program and to request relevant documents and up-to-date data on water quality test results for lead.
Key findings of the study include that there is no uniformity in:
- States’ approaches to create and oversee programs to test for elevated lead in school drinking water
- States’ action levels
- States’ protocols to test school drinking water for lead and to share their findings
- States’ recommendations for school responses to testing
- States’ organization and maintenance of water quality data
In 12 states (which were those with available data on the lead content found in drinking water in schools), the research team found that:
- 12% of all water samples tested had a lead concentration at or above the state’s action level
- 44% of schools tested had one or more water samples with a lead concentration at or above the state’s action level
- Schools that collected and tested water from a greater number of taps were also more likely to identify a sample with elevated lead concentrations
- Use of lower action levels by a state program would increase the proportion of schools that would need to take steps to address the content of lead in the drinking water
Despite an uptick in awareness of and attention to the issue of lead in drinking water, many students in the U.S. attend public schools in states where not all taps are tested for lead. Additional research and consensus are needed to determine a health-based standard for regulating lead concentration in school drinking water and the optimal approaches for initial assessment and ongoing monitoring of lead content in drinking water in schools in a way that is most protective of children’s health.
- United States Government Accountability Office. Lead Testing of School Drinking Water Would Benefit from Improved Federal Guidance. Washington, DC: United States Government Accountability Office; July 2018.
- National Toxicology Program. NTP Monograph on Health Effects of Low-Level Lead. Research Triangle Park, NC: National Institute of Environmental Health Sciences; June 2012:xiii, xv-148.
- Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention. Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Atlanta, GA: Centers for Disease Control and Prevention; 2012.
The report was funded by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation.
Principal Investigator: Angie Cradock, ScD, MPE
Funder: Healthy Eating Research (HER), a national program of the Robert Wood Johnson Foundation
Funding Dates: January 1, 2018 – June 30, 2018
Contact: Angie Cradock, ScD, MPE
- Cradock AL, Barrett JL, Poole MK, Flax CN, Vollmer L, Hecht C. Lead Concentrations in US School Drinking Water: Testing Programs, Prevalence, and Policy Opportunities, 2016‒2018. Am J Public Health. 2022 Sep;112(S7):S679-S689. https://doi.org/10.2105/AJPH.2022.306961.
Research Brief & Reports
- Full report: Early Adopters: State Approaches to Testing School Drinking Water for Lead in the United States
- Healthy Eating Research brief: Early Adopters: State Approaches to Testing School Drinking Water for Lead in the United States