Lead exposure is a serious and widespread public health concern in the United States that has been highlighted recently through the tragedy in Flint, Michigan. Even small amounts of lead can have serious developmental effects, particularly children and pregnant women, and lead exposure can negatively affect nearly every bodily system. The CDC reports that despite the fact that there are no safe blood levels of lead there are approximately 4 million households across the country where children are being exposed to high levels of lead through their drinking water.

The Flint story should never have happened. The health dangers of lead exposure are well known and the Federal Government has a series of legislative instruments specifically designed to try and ensure accountability for the testing and treatment of drinking water. The Safe Water Drinking Act and the associated Primary Regulations are the enforceable legislative tools that require the Environmental Protection Agency (EPA) to set and enforce standards for public drinking water, outline maximum contaminant levels, treatment techniques, monitoring and reporting requirements. Under the regulations, states have delegated authority to meet a range of criteria that includes; establishing regulations at least as stringent as those recommended by the EPA, inventory the state’s public water system, conduct sanitary surveys and analyze water samples and have enforcement authority to compel water systems to comply. While the Act gives the states delegated regulatory authority, it also provides the EPA with authorization to act when agencies fail to comply and in emergency situations where there is an ‘imminent and substantial endangerment to the health of persons’.

While the story of Flint is a cautionary tale it is one that has already plagued many cities across the U.S. The city of Baltimore found elevated levels of lead in schools in 1992 and in 2007 the district changed to only using bottled water which the city considered a more cost-effective solution than replacing all lead-bearing pipes. In 2004, Washington DC faced a public health crisis when it was reported that lead-based utility lines servicing approximately 11.5 million people had levels of lead in the water exceeded EPA lead standards. In 2008, schools in Los Angeles were found to have levels of lead hundreds of times above EPA standards. Schools implemented a range of tactics to try and reduce lead exposure and in September of 2015, the district allocated $19.8 million to remove drinking fountains that were a lead threat. These are just a few examples of how widely issues of lead exposure have reached.

The failings in accountability at each level of the governmental system in Flint were highlighted in the final report of an independent task force appointed in October 2015 to investigate the cause of the crisis, assign accountability and prescribe recommendations on how to rectify the situation and prevent similar situations from occurring. The recommendations of the Flint Task Force point to the need to strengthen and empower existing authorities, especially the EPA, to ensure that required measures are clear, unambiguous and rigorously followed with clear consequences and accountability mechanisms at every level of government. Accountability measures alone will not be enough to counter the problem of a national infrastructure with approximately 7.3 million lead service lines. The EPA National Drinking Water Advisory Committee Working Group has recommended removal of all lead service lines as a public health priority, a mammoth undertaking logistically and financially. It will require investment in infrastructure, political will to enforce safety standards and a multi-sectoral commitment to address the widespread issue that runs beneath the surface of our cities and towns.