Update on Lead - what's going on?

2/27/17 Update: see the WNYC story here and the comment from lead expert Dr. Morri Markowitz head of the lead prevention program at Montefiore Hospital, who convincingly argues against DOE's false assurances that there has never been a case of lead poisoning at a NYC school.  How would they know spoint out ince there is no systematic testing of children above the age of 2 in NYC? I also want to that while the NY law calls for testing of lead in school water every five years,  DC schools test every year, as will NJ schools from now on. That's what this Michigan bill proposed by their Governor requires, and this bill just introduced in Massachusetts.

Last Thursday night, I gave a presentation on the capital plan to District 6 CEC.  Since many of the   parents in the district at the meeting were  understandably concerned about the high levels of lead reported in the water of some of their schools -- including a finding of 6,620 parts per billion (ppb) and 493 ppb at the building shared by Muscota and Amistad, as well as elevated levels at P.S. 98, I.S. 52  and Washington Heights Academy -- I also provided an update on this critical issue.

As I pointed out in this DNAinfo article, DOE officials had dragged their feet ever since the lead scandal erupted in Flint Michigan, which drew attention to this issue for the first time in years.   In its first round of testing last year, DOE refused to follow the recommended protocol and instead flushed out the water from pipes first before gathering samples which tends to diminish lead levels. This discredited method was also used by the government officials in Flint to minimize the problem of lead and also violated recommended EPA guidelines. 

Initially,  DOE also refused to test the water in schools built after 1986-- even though most experts advised all schools should be tested.  As we saw in the case of Muscota, new school buildings sometimes have lead levels as high or higher than older buildings. In response to the city's insistence on flushing the water before testing it,  Dr. Marc Edwards, the Virginia Tech expert who brought national attention to the crisis in Flint said, “The results should be thrown into the garbage, and the city should start over."

Then in June 2016, the NY legislature passed a new law requiring that water at all schools be tested with the “first draw”  to more accurately assess the lead levels that a child might be exposed to,  as recommended by experts and the EPA.

Though Governor Cuomo didn't sign the legislation until September, many districts started retesting the water over the summer in expectation that the law would take effect soon.  The NYS Department of Health released an memo in late August to school districts, informing them of the urgency of this issue;  and emergency regs were issued Sept. 6, letting them know that any outlets found to have water with lead at more than 15 parts per billion -- the "action level" -- would have to be shut off and the sources of lead identified and removed until lead fell below this limit.  The regulations also called for a deadline for retesting the water in all schools by October 31, 2016.  (You can check out the DOH documents here.)

Parents and others were supposed to be informed of the results within six weeks of testing, and also be told the plans to remediate the lead; districts were mandated to report all results to the state no later than November 11, 2016.

Yet even after law passed and the regulations issued, DOE refused to adopt the new protocols.  Inexplicably, NYC officials didn't begin retesting schools according to the mandated method until sometime this winter, according to a letter written by Deputy Chancellor Elizabeth Rose.  

The results? As of January 27, according to the NY State Department of Health, 96 percent of schools in state outside of NYC had finished retesting;  yet NYC had submitted results for less than one third of schools, and would not have complete results until sometime in mid-2017. So far, 9 percent of tested school faucets and fountains in NYC schools have been found to release water above the action level, according to the NY State Department of Health.  

But what has not yet been widely reported is that even earlier, in June 2016, the American Academy of Pediatrics came out with new guidelines that schools should limit the amount of lead in their water to no more than 1 part per billion, as opposed to the 15 parts per billion mandated in NY state law. Why? Because as AAP stated, ”There is no identified threshold or safe level of lead in blood…No Amount of Lead Exposure is Safe for Children.”  

Indeed, research has shown that children with blood levels even less than 5 micrograms per deciliter suffer from lower IQ , worse test scores, and higher rates of inattention, impulsivity and hyperactivity.  

Here is a post I wrote earlier, with the research evidence that there is no safe threshold -- given that any detectable blood levels of lead in children are correlated with worst outcomes.  See the charts to the right,  from a study by researchers at Yale and Brown called "Lead Exposure and Racial Disparities in Test Scores," showing that preschool children with very low levels of lead are likely to have lower test scores in later grades in math and ELA.

Accordingly, DC schools have now adopted the AAP lower guidelines of 1 part per billion for water, and have retested and installed filters in outlets at schools, recreation centers and libraries.  

The lead levels of young children under six have been declining overall, according to the NYC Department of Health,  since the NYC Council passed a strict lead paint law in 2003 over Mayor Bloomberg's veto.  Yet  2 percent of NYC children are  still found to have blood levels at or above 5 mcg per deciliter.  And children's blood levels are rarely tested again after the age of 3.

All of which makes the comments of Oxiris Barbot, the first deputy commissioner of NYC Department of Health, as quoted in DNAinfo, frankly irresponsible:

Her message to kids: “Drink more water in schools,” because, "the more you run the water through the pipes, the more you're flushing out the stale water."

 

Really? This is the remediation method recommended by a health professional, given the new recommendations of the AAP?  When the building shared by Muscota and Amistad found one outlet with lead at 6,620 parts per billion (ppb) and another at 493 ppb?     And the school at Roosevelt Island, where a sink in the weight room was found to have water with 3,430 ppb?

As Dr. Marc Edwards has said, "Frankly, a onetime exposure to even 100 parts per billion is a concern,” given the research findings on the devastating impact of even low levels of lead."  The city needs to be far more honest with parents and more scrupulous in addressing this problem than it has been in the past. 

See the NY Dept of Health report  to the Governor and the Legislature, Lead in School Drinking Water, dated Jan. 27, 2017; and the NY DOH school water data reporting pages and maps, as of today without any NYC data. Also check out this just-released report from  the Environment America Research and Policy Center, Get the Lead Out: Ensuring Safe Drinking Water for Our Children at School, February 2017.

Is DOE using the right protocols to test for lead? And new evidence about its devastating impact

Update  9/2/16:  NY Times reports that NYC will change their method of lead testing in school water but unclear if this methodology would match best practices: "In the future the city would try to conduct as many tests as possible while school was in session, and on mornings other than Mondays, and that for these tests it would abandon the pre-stagnation flushing step. But she said the city would continue doing the pre-stagnation flushing when it was necessary to collect samples on Monday mornings or over school holidays."  More here.

Update 9/1/16:  WNYC/Schoolbook reported today that the city said it will stick to its discredited method of testing for lead in school water, even though it doesn't follow EPA protocols and the foremost expert on lead contamination said their results were essentially meaningless.  The reporter, Beth Fertig, also linked to this blog for the discussion below of how even very low levels of lead in blood have been linked to lower test scores and higher rates of special needs.  For the full list of NYC schools tested in July with the discredited method, and the results, including which 509 schools were identified with high levels of lead, see here.

 Today, Kate Taylor of the NY Times reported that the method that NYC Department of Education has used to test lead in school water by flushing the pipes extensively beforehand is seen as illegitimate by the same scientific experts at Virginia Tech who first revealed the crisis in Flint:

“The results should be thrown into the garbage, and the city should start over,” said Marc Edwards, a civil engineering professor at Virginia Tech who helped uncover dangerously high lead levels in the water in Flint, Mich., touching off scrutiny of drinking water across the country.   

Yanna Lambrinidou, an anthropologist who has worked with Dr. Edwards to expose lead contamination in water in Washington, D.C., and elsewhere, and an affiliate faculty member at Virginia Tech’s Department of Science and Technology in Society, said in an email that New York City’s schools “may have just broken the national record for flawed testing.”
 
I never understood why the DOE’s procedure using pre-flushing would be an accurate way to detect how much lead there may be in the water that settles into pipes and water fountains at the point when schoolchildren actually drank from them.

A few months ago, after the Flint scandal emerged, DOE said they had already tested the water in all public schools built before 1986, and that this was all that was necessary, because that  year the use of lead piping was banned.  They added that “the vast majority are confirmed negative.”

Yet then it turned out that in the majority of cases, even for the schools built before 1986, this testing had not happened for more than ten years! 

DOE initially said they would only retest the water at these older schools, even though many experts including Marc Edwards advised that all schools should be tested regularly because of the use of lead in soldering in water fountains past that date.   

Subsequently, the DOE switched positions, and when they finally tested all 1500 schools, the results were not encouraging: a startling 509 schools were found to have elevated levels on the first or second draw, even after the flushing exercise noted above:

But the amounts did not indicate potential harm to students, Schools Chancellor Carmen Fariña said. “Families can rest assured that water in school buildings is of the highest quality and is safe for students and staff to drink,” Fariña said. “Schools are following the aggressive flushing and remediation protocols that the Department of Education has had in place for years. We continue to update families and school staff throughout the process.

More specifically, to address these problems, the DOE wrote:

For those buildings that had even one outlet with results above recommended levels (even if the test was in the past), we have been implementing a protocol, approved by DOHMH and based on EPA guidance, involving a combination of weekly flushing, equipment replacement and more, to ensure the safety of students and faculty. Flushing has been shown to be highly effective in removing lead from water because (a) flushing builds up the protective coating on plumbing pipes and (b) flushing moves old water out of the system and brings in fresh water. 

Yet the DOE did not make clear in which schools flushing would be used alone and in which would the equipment be replaced. I asked these same questions in my blog back in July, when the widespread nature of the problem was first revealed.

And while  the DOE now says they will now retest all schools every five years, Marc Edwards, the same VA Tech expert, has  recommended that schools test their water annually,

Coincidentally, yesterday I was reading two articles that I have not seen widely reported, revealing that  higher lead levels of poor and black children may be a major contributor to the test score gap.  These studies also suggest that there is no safe level of lead either in the blood or presumably in drinking water.  As the NY Times reported today:

Lead poisoning among children has declined in New York City since 2005, according to a 2015 report by the Department of Health and Mental Hygiene. In 2014, 840 children under 6 were newly identified with blood lead levels of at least 10 micrograms per deciliter — a level the C.D.C. used to use as its “level of concern” — down from 2,705 children in 2005. (The C.D.C. revised its guidelines in 2012, saying that five micrograms of lead per deciliter of blood should be of concern.)

Yet even below five micrograms, there seems to be an impact on student achievement.

In a recent NBER paper called Do Low Levels of Blood Lead Reduce Children's Future Test Scores?, written by economists at Brown and Princeton, researchers found that by looking at the blood lead levels of preschool Rhode Island children born between 1997 and 2005 and their subsequent third grade test scores, the higher their blood lead level (BLL) the lower their test scores tended to be: "Using these data, we show that reductions of lead from even historically low levels have significant positive effects on children's reading test scores in third grade.”

The students’ mean BLL was 3.1, “which is well below the CDCs threshold for medical intervention of 5 micrograms per deciliter. African American and Hispanic children both have higher mean levels, as do children who always receive free school lunch (4.2, 3.6, and 3.9, respectively.)”

The researchers found that “a one unit decrease in average blood lead levels reduces the probability of being substantially below proficient in reading by 3.1 percentage points (on a baseline of 12 percent). Moreover, poor and minority children are more likely to be exposed to lead, suggesting that lead poisoning may be one of the causes of continuing gaps in test scores between disadvantaged and other children…”.

In an earlier paper, called "Lead Exposure and Racial Disparities in Test Scores," these same researchers concluded that the the decline in racial disparities in lead explains between 37 and 76% of the decline in racial disparities in test scores over the past decade in Rhode Island.  Yet significant disparities remain, in both blood lead levels and test scores:

Among Rhode Island children born between 1997 and 2004, African American children have average lead levels of 4.8 compared with 4.2 for Hispanic children and 3.1 for white children. Likewise, children of less educated mothers have lead levels of 4.6 on average, compared to children with more educated mothers whose lead levels are 3.2. The same patterns are true if we classify children by whether they are eligible for free lunch or not (4.1 vs. 2.7), their mothers are single or married (4.2 vs. 3.0) and whether they live in a poor neighborhood ….

Not only are African American children more likely to be exposed, but they may also suffer more harm from a given level of exposure. For example, good nutrition and cognitive stimulation may be protective against the negative effects of lead poisoning, and African American children may be less likely to enjoy these protective factors (Environmental Protection Agency, 2015).

Indeed, according to the cited EPA document, "Children with empty stomachs absorb more lead than children with full stomachs. Provide your child with four to six small meals during the day."

The researchers also concluded that there was no threshold at which a child's blood lead levels did not predict his later test scores or the probability of having an IEP:

Children with an average BLL of 0 score nearly 5 points higher (42% of a standard deviation) than those with BLLs of 5. Similar patterns are observed for math test scores, as well as for the probability of having an IEP which increases from 20 percent for those with 0 BLLs, to 27 percent for those with a BLL of 5 and over 30 percent for those with a BLL of 10.

See these startling graphs, showing that the slope of the line signifying the decline in test scores and the likelihood of having an IEP was as sharp, if not sharper, between O and 5 BLL (supposedly safe levels) as between 5 and 10 BLL (dangerous levels, according to the EPA).

 

Aizer, Currie, Simon, and Vivier, “Lead Exposure and Racial Disparities in Test Scores,” Feb. 7, 2015.

 

So what will the city do now that their methodology for testing lead in schools has been denounced by perhaps the nation’s foremost authority? According to the NY Times,

On Monday, a spokeswoman for Mayor Bill de Blasio, Freddi Goldstein, initially said that while the city believed its testing procedures were sound, “out of an abundance of caution” it would abandon pre-stagnation flushing when it began retesting schools in the fall. A short time later, she rescinded that statement and said the flushing would continue.

This unfortunate dithering follows from an earlier audit, showing that the city Health Department had falsified records at many day care centers to show that they had been tested for lead when they had not.

One would hope that whatever decision is finally made by the Mayor about how to test and remediate for lead in school drinking water, it is made with input from independent experts and with the Precautionary Principle in mind:

"When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically. In this context the proponent of an activity, rather than the public, should bear the burden of proof. The process of applying the precautionary principle must be open, informed and democratic and must include potentially affected parties. It must also involve an examination of the full range of alternatives…." - Wingspread Statement on the Precautionary Principle, Jan. 1998