Faced with a decision many parents have in common—finding a childcare center—RTI senior environmental health scientist Jennifer Hoponick Redmon thought of something many parents would overlook: water quality.
Specifically, she was concerned about exposure to lead, which is well known for its negative effects on children’s health. Most water consumers in the United States think that if their water were unsafe, “someone” would warn them. But for North Carolina childcare centers, there is no one to send out the warning. Centers aren’t currently required to test for lead in their water. With no information on the quality of the water, there’s also no way to fix it. As more than 250,000 North Carolina children spend much of their day in childcare centers, this lack of information about a crucial safety issue demanded action.
Centers currently only conduct water tests if a child is found to have elevated levels of lead in his or her blood, which spurs the state health department to investigate the cause. Unfortunately, this means that children are often “detecting” lead, even though health effects from lead exposure are irreversible. Lifelong deficits in IQ, behavioral difficulties and more are associated with any lead exposure.
Redmon’s intuition led RTI to fund Clean Water for Carolina Kids, a pilot project that tested water in childcare centers across four counties in the North Carolina Piedmont. She combined her environmental health expertise with the expertise of her colleague in laboratory sciences, Dr. Keith Levine, to pilot the first study of childcare water quality in North Carolina. To our knowledge, this is also the first study globally to train childcare administrators as citizen scientists to collect water samples, communicate findings and mitigate the risks of lead in drinking water.
In 2017, the project enrolled more than 100 childcare centers in the region surrounding our headquarters. RTI staff and parents in central North Carolina were invited to recruit their own childcare centers, knowing the results could help protect their children and other members of their community. The project surfaced alarming results about the prevalence of lead in childcare centers. We found that:
- 97 percent of centers had a measurable level of lead in at least one tap
- 16 percent of centers—about one out of six—had at least one sample that exceeded 15 parts per billion, which is the level at which public utilities are required to take treatment action
- the tap with the most lead in our study, a kitchen sink, had a level of 121 parts per billion of lead, three orders of magnitude greater than any other tap in the same center.
Our study results showed that lead is indeed present in childcare centers, and the level at which it is present varies greatly from tap to tap, even within the same center. Lead enters the water supply through piping and plumbing. Lead levels can vary from one building to the next, or from one faucet to another within the same building, based on a variety of factors. Even if water looks, smells or tastes good, people can still be exposed to lead—it has no color, odor or smell. Even newer buildings and faucet fixtures can have detectable levels of lead. The only way to know for sure is to test it at the tap.
Advanced Laboratory Testing
With our state-of-the-science advanced laboratory capabilities, we quantified lead down to 0.1 parts per billion (ppb), 30 times lower than lead is detected at most public utilities. This is important because the American Academy of Pediatrics recommends that an enforceable health-based standard is set for lead at 1 ppb, and the U.S. Environmental Protection Agency has a goal for lead exposure in drinking water of zero. It is necessary to detect lead at or below health-based standards to take necessary steps to get the lead out.
Community Outreach and Citizen Scientists
Training childcare personnel to be citizen scientists makes it feasible to collect water samples at lower cost, and empowers childcare centers to understand how to monitor their water quality moving forward. For this project, we helped turn employees of 103 centers into citizen scientists. The tests generated data that gives an unprecedented look at lead exposure among our state’s youngest residents. Most importantly, our study integrated water testing with ways to communicate and mitigate risks to get the lead out of drinking water in childcare centers now using no-cost and low-cost solutions. It is easy to detect and easy to mitigate by practicing clean water habits and, in some cases, installing inexpensive equipment that removes lead from water at the tap. The solution is well within reach, and the goal of protecting children’s health is worth the effort.
Spotlight on Children’s Exposure to Lead
Clean Water for Carolina Kids is part of a greater movement to reduce children’s exposure to lead from drinking water. Redmon and Levine, in conjunction with academic researchers, governmental scientists, children’s advocacy groups, childcare administrators and parents, have banded together based on the belief that children should have access to clean water, and that water itself rather than children’s blood should be tested to prove that the water is safe to drink. RTI has shared study protocols and findings with the state of North Carolina Department of Health and Human Services, the NC Childcare Commission, Duke University, the University of North Carolina at Chapel Hill, and NC Child. Based on the need for testing and feasibility documented in our pilot study, the North Carolina Commission for Public Health is taking steps toward lead-free drinking water in childcare centers by childcare sanitation guidelines for all licensed childcare centers. The new rule was approved in September 2019 and requires childcare centers and elementary schools with pre-K Head Start programs to test water used for drinking and food preparation, to communicate findings to parents, and to mitigate any sources that exceed state action levels.
In early 2019, an environmental advocacy group gave North Carolina an “F” grade for its lead testing policies. A bill before the North Carolina legislature, if passed, would extend similar requirements to schools. We are hopeful that our study helps pave the way for expanded testing, interventions when needed, and a healthier future for North Carolina children.