WHAT WE DO...AND WHOM WE SERVE:
A Risk Equation for Shools
REMOVING OLD PIPES-AN INVESTMENT IN CHILDREN
Is any risk acceptable when children’s health is involved? What is the cost of reducing the risk as close to zero as possible? Will taxpayers agree?
Science can inform public policy on issues such as this. Several researchers in our department have been helping the Seattle Public Schools weigh the risk of lead in the water pipes of district schools.
Young children are at particular risk for lead poisoning.
Catherine Karr, MD, PhD, a pediatrician and epidemiologist who heads the University of Washington Pediatric Environmental Health Specialty Unit (PEHSU), authored a study on the potential health implications of the lead levels in the schools.
The risk to children from lead pipes is relatively low, Karr said, but it represents a possible exposure from an overlooked source that can be prevented. As a matter of policy, the school district’s water oversight committee unanimously recommended replacing all older water pipes in the schools and adopting a formal maintenance schedule. The $11 million proposal will be considered as part of planning for an upcoming school levy.
John Scott Meschke, an assistant professor who specializes in microbiology of water, and Nancy Beaudet, an industrial hygienist with PEHSU and a district parent, serve on the oversight committee. Elaine Faustman, a professor of Toxicology, briefed a subcommittee of the school board about risk assessment, management, and communication. Dave Eaton, a professor of Toxicology, was a peer reviewer on an outside toxicology report, and Steve Gilbert, an affiliate associate professor, made presentations to parents and school board members. The university’s involvement is important, Karr said, because it is a respected, neutral party.
Karr and other child environmental health specialists typically worry about lead from paint in older houses, though Washington has less of this dilapidated housing stock than other parts of the country. But now that the nation has largely succeeded in taking lead out of paint and gasoline, water pipes have become more of an issue. Although most pipes are now lead-free, solder and drinking fountain components can introduce lead into the water.
Catherine Karr in the UW pediatric clinic.
The lead problem was brought to the Seattle school board’s attention in 2003, when parents complained about discolored water at an elementary school. The district had tested the water in 1991–1993 and not publicized the result. Unfortunately, by not sharing these earlier findings with parents, the 2003 findings created an environment of outrage and distrust, noted Karr.
The school district responded by adopting the strictest policy in the country, mandating the testing of drinking water for lead at half the EPA level and for several other metals and bacteria, which is not required for schools at all. The policy also provides for publishing all samples on its website. “Our goal is to make sure every student and staff member has access to ample quantities of safe and aesthetically appealing water, with confidence that they can rely on the district’s testing program,” said Ron English, who is in charge of the district’s drinking water quality program.
Karr got involved at a stage where little health information was being disseminated and parents were outraged. She helped explain what the lead levels meant for children’s health.
“For me, it has been challenging to try to do risk communication in that context—the history had an important influence on parents’ perceptions.”
The Seattle school issue provides an example of the importance of good risk communication, she said. “It needs to be transparent and responsive, as soon as a problem is recognized. Involving the interested parties early on is also key, so they can help guide the process.”
Karr is also working to educate fellow pediatricians, pediatricians in training, and family practice physicians about lead risks. Last year she directed a continuing education course on pediatric environmental health, one of our department’s best-attended continuing education courses.
CONCENTRATIONS OF LEAD IN BLOOD OF US CHILDREN AGES 5 AND UNDER
Source: US Environmental Protection Agency, 2003. America’s Children and the Environment. Measures of Contaminants, Body Burdens, and Illnesses.
Data: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.
FOR FURTHER READING
ATSDR Primer on Health Risk Communication
Principles and Practices http://www.atsdr.cdc.gov/HEC/primer.html.
CDC Childhood Lead Poisoning Prevention
http://www.cdc.gov/nceh/lead/lead.htm.
Gilbert, SG. A Small Dose of Lead
http://www.asmalldoseof.org/toxicology/lead.php.
Pediatric Environmental Health Specialty Unit (PEHSU)
Lead in Seattle school drinking water: A review of the health implications
http://depts.washington.edu/pehsu/reports.html.
Public Health–Seattle & King County
http://www.metrokc.gov/HEALTH/tsp/lead.htm.
Schools water quality site
http://www.seattleschools.org/area/facilities/WaterQuality/water_quality_update.htm.
Washington State Health Department
http://www.doh.wa.gov/ehp/dw/Programs/lead.htm.
US EPA Toolkit for reducing lead in school drinking water
http://www.epa.gov/safewater/schools/guidance.html#3ts.