By Greg Barnes
It has long been known that elevated lead exposure in children can damage their nervous systems and cause learning disabilities, stunted growth, hearing loss, low IQ, increased aggression, and impaired formation and function of blood cells
What hasn’t been known until now is that nearly one in 10 licensed child care centers in North Carolina have tested above the state’s poison hazard threshold for lead in at least one of their faucets used for drinking or cooking.
The finding comes after the N.C. Commission for Public Health approved a rule in the fall of 2019 requiring licensed child care centers to have all of their taps tested for lead. Previously, licensed centers served by public water systems were not required to test their water for lead at the point of use. The new rule requires the centers to test all of their taps for lead every three years and to take remedial action when levels are found at or above 15 parts per billion.
Working with the centers’ administrators, RTI International and the N.C. Division of Public Health have tested 2,129 of the state’s 4,409 licensed centers since July 2020. Of those tested, 8.5 percent were found to have lead levels at or above the state’s 15 parts per billion lead poisoning hazard level in at least one of their taps, said Jennifer Hoponick Redmon, a senior environmental health scientist and chemical risk assessment specialist with RTI.
Using the 8.5 percent figure means an estimated 20,000 children have potentially been exposed to high levels of lead at their child care centers, Hoponick Redmon said.
She said an additional 4 percent of the centers tested had a lead concentration of 10 parts per billion or more — but less than 15 parts per billion. The centers have until Sept. 30 to get their taps tested, a deadline that was extended because of the pandemic.
Bill seeks lower lead level
The 10 parts per billion threshold is important. A bill introduced in March in the state House of Representatives by Rep. Harry Warren (R-Salisbury) seeks to lower the lead hazard level from 15 parts per billion to 10 parts per billion. The House Environment Committee voted unanimously in favor of the bill on April 20 and sent it to the House Health Committee for further review. House Bill 272 would have to successfully complete its trip through committees and pass a vote in one of the legislature’s chambers by May 13 or else be dead for the rest of the biennial General Assembly session.
At one time, scientists believed that children could tolerate small amounts of lead in their bodies, but more recent research has shown the dangers of even small amounts. The U.S. Environmental Protection Agency and the Centers for Disease Control and Prevention now say no levels of lead are safe for children.
Hoponick Redmon said lowering the lead standard to 10 parts per billion would help protect an additional 30,000 children against lead in the state’s licensed day care centers. More than 236,000 children attend those centers.
Hoponick Redmon said testing has found that it’s rare for the facilities to have multiple taps out of compliance with the lead rules. Of the more than 13,000 tap samples taken so far, she said, only 2.1 percent have come back with lead concentrations of 15 parts per billion or higher.
“We have a lot of variability in lead levels among taps within the same building,” she said. “So oftentimes we find that a center will have one elevated tap, and there are more centers — about four times more centers — they’re having one elevated tap compared to the sample counts.
“We very rarely are finding centers that have like three, four or five elevated taps.”
That makes mitigation a lot easier, Hoponick Redmon said. Oftentimes, she said, elevated lead levels can be remedied by simply replacing a faucet that had used lead solder or by installing a low-cost filtration system that is certified to remove lead.
Centers doing a “good job” getting tested
The testing is being done through Clean Water for Carolina Kids, a partnership between the state Department of Health and Human Services’ Division of Public Health and RTI, a nonprofit research institute in Research Triangle Park. The testing is being funded through an EPA grant.
“The centers have been doing a good job, especially with this undue pressure associated with COVID, on completing the testing,” Hoponick Redmon said.
The state now requires centers that test at or above the 15 parts per billion hazard level to inform parents and staff and shut off access to those taps immediately. They have five days to remediate the excessive lead levels.
Center coordinator response
Hannah Bradshaw, coordinator of seven pre-K child care centers in Onslow County elementary schools, said she didn’t hesitate to have problems fixed when tests showed that taps at the Thompson Early Childhood Center had lead levels exceeding the 15 parts per billion threshold.
The center replaced those faucets and drinking fountains and any others that showed elevated levels of lead, even though they weren’t above the hazard level, Bradshaw said. The school was built in the 1940s, long before a federal rule banned lead use in pipes and fittings in 1986. Bradshaw said the other pre-K centers she oversees had no lead problems.
“The Clean Water for Kids and the testing kits, they were a great resource for us to be able to know what we needed to do to make sure that the kiddos in our building were safe,” Bradshaw said. The testing kits and other resources provided by Clean Water for Kids are free to the centers.
Before the Commission on Public Health passed the new testing requirements, child care administrators typically had no way of knowing whether their taps contained excessive lead.
Center administrators as “citizen scientists”
North Carolina is viewed as a leader in lead reduction efforts. What makes its new testing unique from other states, Hoponick Redmon said, is that the administrators of the child care centers become “citizen scientists,” personally performing the tests, taking action to remove the threat of lead, and communicating with staff, parents and children about water quality improvements.
Hoponick Redmon said RTI does not oversee whether steps have been taken to resolve lead issues, and the state can only take action when taps are found to be at or above the 15 parts per billion threshold.
RTI has created an Internet mapping site where parents can go to check the lead levels at the centers their children attend. Hoponick Redmon said the site can also be used by center administrators to update the risk mitigation their centers have taken.
“Some centers have listed their mitigations, but over time more centers will have that up,” she said, adding that RTI has started webinars and created a video explaining how to list mitigation efforts on the website.
“Some centers are mitigating with very low levels, because they want to be proactive and do so,” Hoponick Redmon said. “But others, for example there could be a center that is at 14.9 parts per billion in a kitchen sink and right now they’re not required to mitigate it. We’re strongly recommending that they mitigate it and providing recommendations for how to do so, but we’re not confirming that, and they could choose that they do not want to.”
The pandemic has caused some child care centers to temporarily close. Testing found elevated lead levels in some of those centers after they reopened because tap water sat in pipes and fixtures where lead was present, Hoponick Redmon said.
“So one thing we have been telling centers and schools to do is to flush their water for a prolonged period of time prior to opening.” she said. “Then to flush it again on that Monday morning, and then to really make a habit anyways of flushing the water during periods that it’s not used, like holidays or weekends, and even in the morning if you find that you have a tap that has some lead in it. Flushing in the morning before use can be effective in some cases.”
The value of 10 parts per billion
Warren’s bill to reduce the lead levels defined in the N.C. Childhood Lead Poisoning Prevention statute to 10 parts per billion would give state regulators more teeth to ensure children are protected. It would also align the state’s lead threshold with federal standards.
The bill says lowering the threshold “would extend lead exposure protection to an additional 30,000 young children in child care settings, resulting in measurable benefits to children and society in the form of reduced crime, health care cost-savings, special education cost-savings, and avoided losses in lifetime earnings.”
In December, the EPA lowered its lead hazard level defined in the Lead and Copper Rule from 15 parts per billion to 10 parts per billion for public water utilities. For the first time, community water systems are required to test for lead in drinking water in the elementary schools and child care centers they serve. It was the first major update to the rule in nearly 30 years.
Hoponick Redmon said Clean Water for Carolina Kids plans to start testing the state’s 1,353 licensed family home child care centers next. If grant funding continues, she said, testing will be done at elementary schools that don’t have pre-K programs.