Lead is a naturally occurring metal applied in the production of products such as batteries and pipes. However, it is also toxic to the human body; thus, lead contamination is a critical public health issue in the U.S. due to the policies that impact healthcare delivery systems. Lead poisoning happens when an individual is exposed to lead by breathing contaminated air or dust, drinking contaminated water, or eating contaminated foods (American Public Health Association, 2020). According to the Environmental Protection Agency (EPA), 20% of lead exposure is through contaminated tap water. The most affected population is people from a racial and ethnic minority; African Americans and Hispanics live in under-resourced neighborhoods.
The most significant contributor to the increase in exposure is the old lead water service pipes, where lead leaches into the water through the pipes’ corrosion. The installation of lead pipes in the U.S. accelerated during the 1920s in commercial buildings and homes. The pipes are still in service, thus increasing the population’s susceptibility to lead contamination. The policy issue is multilevel, with the local, state, and federal governments creating policies and implementing programs. Flint, Michigan, is an example of public health concerns caused by lead-contaminated water. Flint’s water system primarily used lead pipes, similar to many U.S. urban areas (Bellinger, 2016). Housing practices in Flint forced minorities and low-income families into older homes with older lead plumbing. Additionally, 42 percent of Flint children live in poverty, thus limiting water supply options depending on tap water. The city switched its water source to the Flint river for Detroit river leading to increased corrosion of the lead pipes, thus contaminating the water, exposing thousands of people to lead poisoning.
Approximately 78 percent of freshwater consumed in the U.S. is derived from surface waters, such as reservoirs, lakes, and streams. Overall, 25 percent of all water contaminants are point source pollutants coming from diffuse sources. Point-source pollutants enter the water supply in locations such as chemical waste sites or lead water pipes. In 1978, the Occupational Safety and Health Administration (OSHA) banned the use of lead in paint and gas, leading to a drop in lead-related illnesses in children.
However, lead poisoning through drinking water has increased due to the old water system infrastructure’s corrosion. Congress banned the use of lead pipes in 1986 but allowed the 10.2 million existing lead piping system to remain. Over 20 million Americans still cook use water running through lead service lines. Water utilities use corrosion-control chemicals to reduce the amount of lead in tap water based on the Reduction of Lead in Drinking Water Act. The government monitors and limits lead contamination in water through the EPA guideline of lead and copper rule. However, the testing methods used are faulty as they do not detect the highest concentrations of lead, thus providing false results to the general population regarding their health (Katner, Pieper, Lambrinidou, Brown, Hu, Mielke, and Edwards, 2016). Prolonged exposure can lead to severe effects affecting all generations.
Most water system damage is preventable with the enforcement of proper regulatory safeguards. Water systems using lead piping are always susceptible to having traces of lead toxins. Many of these are difficult to remove during conventional water treatment; thus, tighter regulations of lead pipes should be implemented, and also adopt the removal of all lead service lines. The lead and copper rule review requires EPA officials’ approval as they are charged with providing safe water to American citizens. Extensive scientific research must provide factual evidence of the new system’s benefits compared to the predecessor to convince the government agency to review the obsolete guidelines.
Policy change to encompass the complete removal of lead pipes is through lobbying. Lobby groups pressure the administration to review its law allowing utilities to replace lead lines as a last resort to mandatory replacement of the pipes (Harclerode, Lal, Vedwan, Wolde, and Miller, 2016). The stakeholders involved include the federal government and local authorities in changing and implementing the law. Local governments claim lead service lines that run under the private property are the responsibility of homeowners. Replacement of all private lead lines is costly, thus requiring substantial capital investment. Funding can be through increased government spending and enacted state policies to increase user utility rates to fund the program.
Impact on Health Care Delivery System
The primary effects of lead contamination on humans range from diseases to socioeconomic issues affecting people of all ages. Children are mostly exposed to the household environment through the consumption of paint chips containing lead. Children are also exposed through the consumption of contaminated soil and infant formulas mixed with lead-contaminated water, where approximately 4 million children are exposed to high lead levels. The risk of children’s exposure is high due to their fondness for putting hands and objects in their mouths. Both the Environmental Protection Agency (EPA) and Centre for Disease Control (CDC) maintain no safe blood lead level in children whose bodies absorb ingested lead at 40 to 50 percent, compared with 3 to 10 percent in adults. Adults are most often exposed to occupational hazards, contaminated food, and water. Pregnant women represent a critical population regarding occupational lead exposure since the mother and fetus are adversely affected. The fetus is affected as lead can cross the placenta and be passed through breastmilk. Lead poisoning causes many health risks in children, including decreased cognitive skills, learning difficulties, and retardation. It also leads to reproductive issues, heart defects, and kidney malfunctioning (Rosen, Pokhrel, and Weir, 2017). Contaminated water also leads to the outbreak of Legionella disease from droplets of water from old buildings. The contamination of the water used for consumption can be avoided through effective water management to reduce diseases.
Bellinger, D. C. (2016). Lead contamination in Flint—an abject failure to protect public health. New England Journal of Medicine, 374(12), 1101-1103.
Harclerode, M. A., Lal, P., Vedwan, N., Wolde, B., & Miller, M. E. (2016). Evaluation of the role of risk perception in stakeholder engagement to prevent lead exposure in an urban setting. Journal of environmental management, 184, 132-142.
Katner, A., Pieper, K. J., Lambrinidou, Y., Brown, K., Hu, C. Y., Mielke, H. W., & Edwards, M. A. (2016). Weaknesses in federal drinking water regulations and public health policies that impede lead poisoning prevention and environmental justice. Environmental Justice, 9(4), 109-117.
Rosen, M. B., Pokhrel, L. R., & Weir, M. H. (2017). A discussion about public health, lead, and Legionella pneumophila in drinking water supplies in the United States. Science of The Total Environment, 590, 843-852.
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