This is the accessible text file for GAO report number GAO-04-974T 
entitled 'Drinking Water: Safeguarding the District of Columbia's 
Supplies and Applying Lessons Learned to Other Systems' which was 
released on July 22, 2004.

This text file was formatted by the U.S. General Accounting Office 
(GAO) to be accessible to users with visual impairments, as part of a 
longer term project to improve GAO products' accessibility. Every 
attempt has been made to maintain the structural and data integrity of 
the original printed product. Accessibility features, such as text 
descriptions of tables, consecutively numbered footnotes placed at the 
end of the file, and the text of agency comment letters, are provided 
but may not exactly duplicate the presentation or format of the printed 
version. The portable document format (PDF) file is an exact electronic 
replica of the printed version. We welcome your feedback. Please E-mail 
your comments regarding the contents or accessibility features of this 
document to Webmaster@gao.gov.

This is a work of the U.S. government and is not subject to copyright 
protection in the United States. It may be reproduced and distributed 
in its entirety without further permission from GAO. Because this work 
may contain copyrighted images or other material, permission from the 
copyright holder may be necessary if you wish to reproduce this 
material separately.

Testimony: 

Before the Subcommittee on Environment and Hazardous Materials, 
Committee on Energy and Commerce, House of Representatives: 

United States Government Accountability Office: 

GAO: 

For Release on Delivery Expected at 9: 30 a.m. DST: 

Thursday, July 22, 2004: 

Drinking Water: 

Safeguarding the District of Columbia's Supplies and Applying Lessons 
Learned to Other Systems: 

Statement of John B. Stephenson, Director, Natural Resources and 
Environment: 

GAO-04-974T: 

GAO Highlights: 

Highlights of GAO-04-974T, a statement to the Subcommittee on 
Environment and Hazardous Materials, Committee on Energy and Commerce, 
House of Representatives 

Why GAO Did This Study: 

Concerns have been raised about lead in District of Columbia drinking 
water and how those charged with ensuring the safety of this water have 
carried out their responsibilities. The 1991 Lead and Copper Rule 
(LCR) requires water systems to protect drinking water from lead by, 
among other things, chemically treating it to reduce its corrosiveness 
and by monitoring tap water samples for evidence of lead corrosion. If 
enough samples show corrosion, water systems officials are required to 
notify and educate the public on lead health risks and undertake 
additional efforts. The Washington Aqueduct, owned and operated by the 
U.S. Army Corps of Engineers, treats and sells water to the District of 
Columbia Water and Sewer Authority (WASA), which delivers water to D.C. 
residents. EPA’s Philadelphia Office is charged with overseeing these 
agencies. 

GAO is examining (1) the current structure and level of coordination 
among key government entities that implement the Safe Drinking Water 
Act’s regulations for lead in the District of Columbia, (2) how other 
drinking water systems conducted public notification and outreach, (3) 
the availability of data necessary to determine which adult and child 
populations are at greatest risk of exposure to elevated lead levels, 
and what information WASA is gathering to help track their health, and 
(4) the state of research on the health effects of lead exposure.

The testimony discusses preliminary results of GAO’s work. GAO will 
report in full at a later date.

What GAO Found: 

This statement discusses GAO’s preliminary observations and highlights 
areas of further examination.

One of the key relationships in the effort to ensure the safety of the 
District’s drinking water is the one between WASA, the deliverer of 
water, and EPA’s Philadelphia Office, which oversees WASA’s compliance 
with drinking water regulations. Recent public statements and 
corrective actions by these parties clearly indicate that coordination 
and communication between them could have been better in the years 
preceding the current lead controversy. GAO’s future work will examine 
(to the extent appropriate) the interrelationships among other key 
agencies (such as the Aqueduct and the D.C. Department of Health); how 
other water systems in similar situations interacted with federal, 
state, and local agencies; and what the experiences of these other 
jurisdictions may suggest concerning how improved coordination can 
better protect drinking water in the District of Columbia.

Other water systems facing elevated lead levels used public 
notification and education practices that may offer lessons for 
conducting outreach to water customers. For example, some of the 
practices of the two water systems we have begun to examine – the 
Massachusetts Water Resources Authority and the Portland (Oregon) Water 
Bureau – include tailoring their communications to varied audiences in 
their service areas, testing the effectiveness of their communication 
materials, and linking demographic and infrastructure data to identify 
populations at greatest risk from lead in drinking water.

WASA faces challenges in collecting the information needed to identify 
District citizens at greatest risk from lead in drinking water. 
Specifically, WASA has partial information on which of its customers 
have lead service lines, and is in the process of obtaining more 
complete information. GAO’s future work will examine the efforts of 
other water systems to go one step further by linking data on at-risk 
populations (such as pregnant mothers, infants, and small children) 
with data on homes suspected of being served by lead service pipes and 
other plumbing fixtures that may leach lead into drinking water.

Nationally, much is known about the hazards of lead once in the body 
and how lead from paint, soil, and dust enter the body, but little 
research has been done to determine actual lead exposure from drinking 
water, and the information that does exist is dated. In our future 
work, we will examine the plans of EPA and other organizations to fill 
this key information gap.

www.gao.gov/cgi-bin/getrpt?GAO-04-974T.

To view the full product, including the scope and methodology, click 
on the link above. For more information, contact John Stephenson at 
(202) 512-3841 or stephensonj@gao.gov.

[End of section]

Mr. Chairman and Members of the Subcommittee: 

Thank you for the opportunity to discuss our work to date on the issues 
surrounding elevated levels of lead in Washington, D.C. drinking water. 
At the request of this Subcommittee, we are examining issues concerning 
lead in drinking water generally and the situation in Washington, D.C., 
in particular. Our testimony today lays out our preliminary 
observations on these issues and highlights areas of further 
examination.

Although rarely the sole cause of lead poisoning, lead in drinking 
water can significantly increase a person's total lead exposure. EPA 
estimates that drinking water is the source of about 20 percent of 
Americans' lead exposure, but that it may be as high as 60 percent for 
infants who drink baby formulas and concentrated juices that are mixed 
with water. Adults who drink water with high lead concentrations could 
develop kidney problems or high blood pressure. Developing fetuses, 
infants and young children are more vulnerable to lead from all 
sources, including drinking water. Their exposure to lead may delay 
their physical or mental development.

The delivery of safe water to residents requires that water systems and 
regulators work cooperatively in fulfilling the requirements of the 
Safe Drinking Water Act.[Footnote 1] In most cases, states have primary 
oversight and enforcement authority under the Act. Lead in drinking 
water is regulated under the Act's 1991 Lead and Copper Rule.[Footnote 
2] The rule requires water systems to treat their water to limit its 
corrosiveness, monitor tap water samples for evidence of elevated 
levels of lead, and report this information to their state. In 
addition, drinking water systems may consult with state health agencies 
when communicating with their customers about health risks from 
drinking water.

The relationship between regulators and water systems is more 
complicated in the District of Columbia, where the Washington Aqueduct, 
owned by the U.S. Army Corps of Engineers, draws and treats water from 
the Potomac River. The Aqueduct sells the treated water to the District 
of Columbia Water and Sewer Authority (WASA), which distributes it to 
District residents. The Environmental Protection Agency's (EPA) 
Region III Office in Philadelphia, Pennsylvania, has primary oversight 
and enforcement authority for the District's public water systems. The 
District of Columbia's Department of Health, while having no formal 
role under the Safe Drinking Water Act, is responsible for educating 
District residents on potential health risks.

In the District, the Washington Aqueduct treats drinking water and 
monitors for most contaminants, while WASA monitors tap water samples 
for lead and reports these results to EPA's Philadelphia Office. Tap 
water monitoring is important because, unlike most drinking water 
contaminants, lead is not generally introduced to drinking water 
supplies from source water. Rather, lead leaches into drinking water as 
it travels through lead service pipes, over pipe joints connected with 
lead-based solder, and through brass plumbing fixtures that contain 
lead. According to EPA, its Philadelphia Office is responsible for 
providing technical assistance to the Aqueduct and WASA on how to 
comply with federal regulations; ensuring that they report the 
monitoring results to EPA by required deadlines; taking enforcement 
actions if violations occur; and using those enforcement actions to 
return the water systems to compliance in a timely fashion.

Significant concerns were raised in early 2004 about how federal and 
local agencies were carrying out their responsibilities under the Safe 
Drinking Water Act. At that time, the local media reported that a 
number of tap water samples showed elevated levels of lead.

You asked that we (1) examine the current structure and level of 
coordination among key government entities that implement the Safe 
Drinking Water Act's regulations for lead in the District of Columbia, 
and identify any improvements to increase efficiency and 
accountability, (2) determine how other drinking water systems that 
exceeded the EPA action level for lead have conducted public 
notification and outreach, (3) assess the availability of data 
necessary to determine which adult and child populations are at 
greatest risk of exposure to elevated lead levels, and what information 
WASA is gathering to help track their health, (4) evaluate the state of 
research on lead exposure, and how this information could help inform 
other drinking water utilities of potential problems in their systems.

To respond to these questions, we are interviewing key officials and 
staff with the federal and local agencies responsible for managing 
drinking water and monitoring health for lead exposure in Washington, 
D.C., including officials at EPA's headquarters and in its Philadelphia 
Office, WASA, the Washington Aqueduct, and the D.C. Department of 
Health. We are also (1) reviewing records documenting key activities 
and interactions among these agencies, and examining their current 
responses to the lead problem, (2) contacting academic and non-
governmental experts in lead contamination, and (3) examining how other 
water systems facing similar circumstances notified and educated their 
customers on lead health risks, and how they interacted with federal, 
state, and local agencies to respond to the problem. Many of the facts 
and circumstances surrounding the District's lead controversy are the 
subject of active litigation. Accordingly, we do not take a position on 
these issues and on how they bear on the question of interagency 
coordination and communication, and instead report them only as stated 
by the affected parties.

We are here to present our preliminary observations on these issues. We 
will report our final findings and any recommendations we may develop 
at a later date. In summary: 

* Providing safe drinking water requires that water systems, 
regulators, and public health agencies fulfill individual roles, yet 
work together in a coordinated fashion. It is particularly important 
that these entities report and communicate information to each other in 
a timely and accurate manner. Recent public statements and corrective 
actions by the responsible entities, particularly EPA and WASA, clearly 
indicate that coordination could have been better in the years 
preceding the current controversy. As our work continues, we will seek 
to examine (to the extent appropriate) specific ways in which improved 
coordination between EPA and WASA could help both agencies better 
fulfill their responsibilities. We will also examine interrelationships 
among other key agencies (such as the Aqueduct and the D.C. Department 
of Health); how other water systems in similar situations interacted 
with federal, state, and local agencies; and what the experiences of 
these other jurisdictions may suggest concerning how improved 
coordination can better protect drinking water in the District of 
Columbia.

* Other water systems facing elevated lead levels used public 
notification and education practices that appear to offer lessons for 
conducting outreach to water customers, including those in the District 
of Columbia. For example, some of the practices of the two systems we 
have begun to examine--the Massachusetts Water Resources Authority and 
the Portland Water Bureau--include tailoring their communications to 
varied audiences in their service areas, testing the effectiveness of 
their communication materials, and linking demographic and 
infrastructure data to identify populations at greatest risk from lead 
in drinking water.

* WASA faces challenges in collecting the information needed to 
identify District citizens at greatest risk from lead in drinking 
water. Specifically, it has partial information on which of its 
customers have lead service pipes, although it is currently in the 
process of obtaining more complete information. In our future work, we 
will examine the efforts of other water systems to go one step further 
by linking data on at-risk populations (such as pregnant mothers, 
infants, and small children) with data on homes suspected of being 
served by lead service pipes and other plumbing fixtures that may leach 
lead into drinking water.

* Much is known about the hazards of lead in the human body and about 
how lead from paint, soil, and dust enter the body. However, little 
research has been done to determine actual lead exposure from drinking 
water, and the information that does exist is dated. In our future 
work, we will examine the plans of EPA and other organizations to fill 
this key information gap.

Background: 

Lead is unusual among drinking water contaminants in that it seldom 
occurs naturally in source water supplies like rivers and lakes. 
Rather, lead enters drinking water primarily as a result of the 
corrosion of materials containing lead in the water distribution system 
and in household plumbing. These materials include lead service pipes 
that connect a house to the water main, household lead-based solder 
used to join copper pipe, and brass plumbing fixtures such as faucets.

The Safe Drinking Water Act is the key federal law protecting public 
water supplies from harmful contaminants. The Act established a 
federal-state arrangement in which states may be delegated primary 
implementation and enforcement authority ("primacy") for the drinking 
water program. Except for Wyoming and the District of Columbia, all 
states and territories have received primacy. For contaminants that are 
known or anticipated to occur in public water systems and that the EPA 
Administrator determines may have an adverse impact on health, the Act 
requires EPA to set a non-enforceable maximum contaminant level goal 
(MCLG) at which no known or anticipated adverse health effects occur 
and that allows an adequate margin of safety. Once the MCLG is 
established, EPA sets an enforceable standard for water as it leaves 
the treatment plant, the maximum contaminant level (MCL). The MCL 
generally must be set as close to the MCLG as is "feasible" using the 
best technology or other means available, taking costs into 
consideration.

The fact that lead contamination occurs after water leaves the 
treatment plant has complicated efforts to regulate it in the same way 
as most contaminants. In 1975, EPA set an interim MCL for lead at 50 
parts per billion (ppb), but did not require sampling of tap water to 
show compliance with the standard. Rather, the standard had to be met 
at the water system before the water was distributed. The 1986 
amendments to the Act directed EPA to issue a new lead regulation, and 
in 1991, EPA adopted the Lead and Copper Rule.

Instead of an MCL, the rule established an "action level" of 15 ppb for 
lead in drinking water, and required that water systems take steps to 
limit the corrosiveness of their water. Under the rule, the action 
level is exceeded if lead levels are higher than 15 ppb in over 10 
percent of tap water samples taken. Large systems, including WASA, 
generally must take at least 100 tap water samples in a 6-month 
monitoring period. Large systems that do not exceed the action level or 
that maintain optimal corrosion control for two consecutive 6-month 
periods may reduce the number of sampling sites to 50 sites and reduce 
collection frequency to once per year. If a water system exceeds the 
action level, other regulatory requirements are triggered. The water 
system must intensify tap water sampling, take additional actions to 
control corrosion, and educate the public about steps they should take 
to protect themselves from lead exposure. If the problem is not abated, 
the water system must annually replace 7 percent of the lead service 
lines under its ownership.

The public notification requirements of the Safe Drinking Water Act are 
intended to protect public health, build trust with consumers through 
open and honest sharing of information, and establish an ongoing, 
positive relationship with the community.[Footnote 3] While public 
notification provisions were included in the original Act, concerns 
have been raised for many years about the way public water systems 
notify the public regarding health threats posed by contaminated 
drinking water. In 1992, for example, we reported, among other things, 
that (1) there were high rates of noncompliance among water systems 
with the public notification regulations in effect at that time and (2) 
notices often did not clearly convey the appropriate information to the 
public concerning the health risks associated with a violation and the 
preventive action to be taken.[Footnote 4] The 1996 Amendments to the 
Safe Drinking Water Act attempted to address many of these concerns by 
requiring that consumers of public water supplies be given more 
accurate and timely information about violations and that this 
information be in a form that is more understandable and useful.

Drinking water is provided to District of Columbia residents under a 
unique organizational structure: 

* The U.S. Army Corps of Engineers' Washington Aqueduct draws water 
from the Potomac River and filters and chemically treats it to meet EPA 
specifications. The Aqueduct produces drinking water for approximately 
1 million citizens living, working, or visiting in the District of 
Columbia, Arlington County, Virginia, and the City of Falls Church, 
Virginia. Managed by the Corps of Engineers' Baltimore District, the 
Aqueduct is a federally owned and operated public water supply agency 
that produces an average of 180 million gallons of water per day at two 
treatment plants located in the District. All funding for operations, 
maintenance, and capital improvements comes from revenue generated by 
selling drinking water to the District of Columbia, Arlington County, 
Virginia, and the City of Falls Church, Virginia.

* The District of Columbia Water and Sewer Authority buys its drinking 
water from the Aqueduct. WASA distributes drinking water through 1,300 
miles of water mains under the streets of the District to individual 
homes and buildings, as well as to several federal facilities directly 
across the Potomac River in Virginia. From its inception in 1938 until 
1996, WASA's predecessor, the District of Columbia Water and Sewer 
Utility Administration, was a part of the District's government. In 
1996, WASA was established by District of Columbia law as a 
semiautonomous regional entity. WASA develops its own budget, which is 
incorporated into the District's budget and then forwarded to Congress. 
All funding for operations, improvements, and debt financing come from 
usage fees, EPA grants, and the sale of revenue bonds.

* EPA's Philadelphia Regional Office has primary oversight and 
enforcement responsibility for public water systems in the District. 
According to EPA, the Regional Office's oversight and enforcement 
responsibilities include providing technical assistance to the water 
suppliers on how to comply with federal regulations; ensuring that the 
suppliers report the monitoring results to EPA by the required 
deadlines; taking enforcement actions if violations occur; and using 
those enforcement actions to return the system to compliance in a 
timely fashion.

* The District's Department of Health, while having no formal role 
under the Act, is responsible for identifying health risks and 
educating the public on those risks.

Coordination Among Agencies Is Critical To Ensure Safe Drinking Water: 

Providing safe drinking water requires that water systems, regulators, 
and public health agencies fulfill individual responsibilities yet work 
together in a coordinated fashion. It is particularly important that 
these entities report and communicate information to each other in a 
timely and accurate manner. In the case of drinking water in the 
District of Columbia, one of the key relationships is the one between 
WASA, the deliverer of water to District customers, and EPA's 
Philadelphia Office, the regulator charged with overseeing WASA's 
compliance with drinking water regulations. Of particular note, one of 
WASA's key obligations is to monitor the water it supplies to District 
customers through a tap water sampling program, and to report these 
results accurately and in a timely manner to EPA's Philadelphia Office. 
As EPA itself has noted, one of the Philadelphia Office's key 
obligations is to ensure that WASA understands the reporting 
requirements and reports monitoring results by required deadlines.

It is noteworthy that WASA and EPA have taken or agreed to take steps 
that are clearly intended to improve communication and coordination 
between the agencies. For example: 

* Under the Consent Order signed by EPA and WASA on June 17, 2004, WASA 
agreed to improve its format for reporting tap water samples by 
ensuring that the reports include tap water sample identification 
numbers, sample date and location, lead and copper concentration, 
service line materials, and reasons for any deviation from previously 
sampled locations. The monitoring reports are also to include the 
laboratory data sheets, which contain the raw test data recorded 
directly by the laboratory. Under the Order, WASA also agreed to submit 
to EPA for comment a plan and schedule for enhanced information, 
database management, and reporting. The plan is to describe how 
monitoring reports will be generated, maintained, and submitted to EPA 
in a timely fashion.

* EPA's Philadelphia Office has altered the way in which it will handle 
compliance data from WASA and the Washington Aqueduct. According to the 
office, compliance data from both water systems will now be sent to 
those in the Office responsible for enforcing the Safe Drinking Water 
Act, so as to separate the enforcement/compliance assurance function 
from the municipal assistance function.

Aside from the tap water monitoring issue, EPA's Philadelphia Office 
acknowledges that its oversight of WASA public notification and 
education efforts could have been better, noting that "In hindsight, 
EPA should have asked more questions about the extent, coverage and 
impact of DC WASA's public education program, and reacted to fill the 
public education gaps where they were evident."[Footnote 5] To address 
the problem, the Philadelphia Office reported on its website that it 
will have to make some improvements in the way it exercises its own 
oversight responsibilities.[Footnote 6] Suggested improvements include 
obtaining written agreement from WASA to receive drafts of education 
materials and a timeline for their submission, reviewing drafts of 
public education materials for compliance with requirements, as well as 
effectiveness of materials and delivery, and acquiring outside 
expertise to assist in evaluating outreach efforts.

As our work continues, we will seek to examine (to the extent it does 
not conflict with active litigation) other ways in which improved 
coordination between WASA and EPA could help both agencies better 
fulfill their responsibilities. We will also examine interrelationships 
that include other key agencies, such as the Aqueduct and the D.C. 
Department of Health. We will also examine how other water systems in 
similar situations interacted with federal, state, and local agencies. 
These experiences may offer suggestions on how coordination can be 
improved among the agencies responsible for protecting drinking water 
in the District of Columbia.

Experiences of Other Water Systems Highlight Effective Ways to Inform 
and Educate the Public: 

WASA is not the first system to exceed the action level for lead. 
According to EPA, when the first round of monitoring results was 
completed for large water systems in 1991 pursuant to the Lead and 
Copper Rule, 130 of the 660 systems serving populations over 50,000 
exceeded the action level for lead. EPA data show that since the 
monitoring period ending in 2000, 27 such systems have exceeded the 
action level.[Footnote 7] As part of our work, we will be examining the 
innovative approaches some of these systems have used to notify and 
educate their customers. I would like to touch on the activities of two 
such systems, the Massachusetts Water Resources Authority and the 
Portland, Oregon, Water Bureau. Each of these systems has employed 
effective notification practices in recent years that may provide 
insights into how WASA, and other water systems, could improve their 
own practices.

Massachusetts Water Resources Authority: 

The Massachusetts Water Resources Authority (MWRA) is the wholesale 
water provider for approximately 2.3 million customers, mostly in the 
metropolitan Boston area. Under an agreement with the Massachusetts 
Department of Environmental Protection, monitoring for lead under the 
Lead and Copper Rule occurs in each of the communities that MWRA serves 
and the results are submitted together. Initial system-wide tap water 
monitoring results in 1992 showed a 90th percentile lead concentration 
of 71 ppb (meaning 10 percent of its samples scored at this level and 
above). According to MWRA, adjustments in corrosion control have led to 
a reduction in lead levels, but the 90th percentile lead concentration 
in MWRA's service area has still been above the action level in four of 
the seven sampling events since early 2000.

According to an MWRA official, the public education program for lead in 
drinking water is designed to ensure that all potentially affected 
parties within MWRA's service area receive information about lead in 
drinking water. He noted, for example, that while the Lead and Copper 
Rule requires that information be sent to consumers in their water 
bills, the large population of renters living in MWRA's service area 
often do not receive water bills. Therefore, MWRA included information 
about lead in its consumer confidence report, which is sent to all 
mailing addresses within the service area. Additionally, MWRA uses 
public service announcements, interviews on radio and television talk 
shows, appearances at city councils and other local government agency 
meetings, and articles in local newspapers to convey information. MWRA 
also conducted focus groups to judge the effectiveness of the public 
education program and continually makes changes to refine the 
information about lead in drinking water.

An MWRA official also noted that MWRA focuses portions of its lead 
public education program on the populations most vulnerable to the 
health effects of lead exposure. For example, MWRA worked with 
officials from the Massachusetts Women, Infants and Children 
Supplemental Nutrition Program (WIC) to design a brochure to help 
parents understand how to protect their children from lead in drinking 
water. Among other things, the brochure includes the pertinent 
information in several foreign languages, including Spanish, 
Portuguese, and Vietnamese. The WIC program also includes information 
on how to avoid lead hazards when preparing formula.

Portland Water Bureau: 

The Portland Water Bureau provides drinking water to approximately 
787,000 people in the Portland metropolitan area, nearly one-fourth of 
the population of Oregon. Since 1997, the city has exceeded the lead 
action level 6 times in 14 rounds of monitoring. According to Bureau 
officials, the problem stems mainly from lead solder used to join 
copper plumbing and from lead in home faucets. Portland's system has 
never had lead service lines, and the Water Bureau finished removing 
all lead fittings within the water system's control in 1998.

The Portland Water Bureau sought flexibility in complying with the Lead 
and Copper Rule. The state of Oregon allowed the Water Bureau to 
implement a lead hazard reduction program as a substitute for the 
optimal corrosion control treatment requirement of the Lead and Copper 
Rule. Portland's lead hazard reduction program is a partnership between 
the Portland Water Bureau, the Multnomah County and Oregon State health 
departments, and community groups. According to Portland Water Bureau 
officials, the program consists of four components: (1) water treatment 
for corrosion control; (2) free water testing to identify customers who 
may be at significant risk from elevated lead levels in drinking water; 
(3) a home lead hazard reduction program to prevent children from being 
exposed to lead from lead-based paint, dust, and other sources; and (4) 
education on how to prevent lead exposure targeted to those at greatest 
risk from exposure.

As the components suggest, the program is focused on reducing exposure 
to lead through all exposure pathways, not just through drinking water. 
For example, the Water Bureau provides funding to the Multnomah County 
Health Department's LeadLine--a phone hotline that residents can call 
to get information about all types of lead hazards. Callers can get 
information about how to flush their plumbing to reduce their lead 
exposure and can request a lead sampling kit to determine the lead 
concentration in the drinking water in their home. The Water Bureau 
also provides funding for lead education materials provided to new 
parents in hospitals, for billboards and movie advertisements targeted 
to neighborhoods with older housing stock, and to the Community 
Alliance of Tenants to educate renters on potential lead hazards. Each 
of these materials directs people to call the LeadLine if they need 
additional information about any lead hazard. The Water Bureau 
evaluates the results of the program by tracking the number of calls to 
the LeadLine, and by surveying program participants to determine their 
satisfaction with the program and the extent to which the program 
changed their behavior.

In January 2004, the Portland Water Bureau sent a targeted mailing to 
those residents most likely to be affected by lead in drinking water. 
The mailing targeted homes of an age most likely to contain lead-
leaching solder where a child 6 years old or younger lived. 
Approximately 2,600 postcards were sent that encouraged residents to 
get their water tested for lead, learn about childhood blood lead 
screening, and reduce lead hazards in their homes. Water Bureau 
officials said that they obtained the information needed to target the 
mailing from a commercial marketing company, and that the commercial 
information was inexpensive and easy to obtain.

WASA Faces Challenges in Identifying At-Risk Populations: 

In an ideal world, a water utility such as WASA would have several 
different types of information that would allow it to monitor the 
health of individuals most susceptible to the health effects of lead in 
drinking water. The utility would know the location of all lead service 
lines and homes with leaded plumbing (pipes, solder and/or fixtures) 
within its service area. The utility would also know the demographics 
of the residents of each of these homes. With this information, the 
utility could identify each pregnant woman or child six years old or 
younger who would be most likely to be exposed to lead through drinking 
water. These individuals could then be educated about how to avoid lead 
exposure, and lead exposure for each of these individuals could then be 
monitored through water testing and blood lead testing.

Unfortunately, WASA and other drinking water utilities do not operate 
in an ideal world. WASA does have some information on the location of 
lead service lines within its distribution area. Its predecessor 
developed an inventory of lead service lines in its distribution system 
in 1990 as part of an effort to identify sampling locations to comply 
with the Lead and Copper Rule. According to WASA officials, identifying 
the locations of lead service lines was difficult because many of the 
records were nearly 100 years old and some of the information was 
incomplete. According to this 1990 inventory, there were approximately 
22,000 lead service lines. WASA updated the inventory in September 
2003, and estimated that it had 23,071 "known or suspected" lead 
service lines. WASA subsequently identified an additional 27,495 
service lines in the distribution system made of "unknown" materials. 
Consequently, there is some uncertainty over the actual number and 
location of the lead service lines in WASA's distribution system. The 
administrative order that EPA issued in June 2004 requires WASA to 
further update its inventory of lead service lines.

Regardless of the information WASA has about the location of lead 
service lines, according to WASA officials, WASA has little information 
about the location of customers who are particularly vulnerable to the 
effects of lead. The District's Department of Health is responsible for 
monitoring blood lead levels for children in the District. Officials 
from the Department of Health told us that they maintain a database of 
the results of all childhood blood lead testing in the District, and 
have studied the distribution of blood lead levels in children on a 
neighborhood basis. However, according to a joint study by the D.C. 
Department of Health and the Centers for Disease Control and Prevention 
(CDC) published in March 2004, it is difficult to discern any effect of 
lead in drinking water on children's blood lead levels because the 
older homes most likely to have lead service lines are also those most 
likely to have other lead hazards, such as lead in paint and dust. This 
joint study also described efforts by the Department of Health and the 
United States Public Health Service to conduct blood lead monitoring 
for residents of homes whose drinking water test indicated a lead 
concentration greater than 300 ppb. None of the 201 residents tested 
were found to have blood lead levels exceeding the levels of concern 
for adults or children, as appropriate.

Researchers Face Gaps in Knowledge Regarding the Risks Posed by Lead in 
Drinking Water: 

A good deal of research has been conducted on the health effects of 
lead, in particular on the effects associated with certain pathways of 
contamination, such as ingestion of leaded paint and inhalation of 
leaded dust. In contrast, the most relevant studies on the isolated 
health effects of lead in drinking water date back nearly 20 years--
including the Glasgow Duplicate Diet Study on lead levels in children 
upon which the Lead and Copper Rule is partially based.[Footnote 8] 
According to recent medical literature and the public health experts we 
contacted, the key uncertainties requiring clarification include the 
incremental effects of lead-contaminated drinking water on people whose 
blood lead levels are already elevated from other sources of lead 
contamination and the potential health effects of exposure to low 
levels of lead. As we continue our work, we will examine the plans of 
EPA and other organizations to fill these and other key information 
gaps.

Lead is a naturally occurring element that, according to numerous 
studies, can be harmful to humans when ingested or inhaled, 
particularly to pregnant and nursing women and children aged six or 
younger. In children, for example, lead poisoning has been documented 
as causing brain damage, mental retardation, behavioral problems, 
anemia, liver and kidney damage, hearing loss, hyperactivity, and other 
physical and mental problems. Exposure to lead may also be associated 
with diminished school performance, reduced scores on standardized IQ 
tests, schizophrenia, and delayed puberty.

Long-term exposure may also have serious effects on adults. Lead 
ingestion accumulates in bones, where it may remain for decades. 
However, stored lead can be mobilized during pregnancy and passed to 
the fetus. Other health effects in adults that may be associated with 
lead exposure include irritability, poor muscle coordination and nerve 
damage, increased blood pressure, impaired hearing and vision, and 
reproductive problems.

There are many sources of lead exposure besides drinking water, 
including the ingestion of soil, paint chips and dust; inhalation of 
lead particles in soil or dust in air; and ingestion of foods that 
contain lead from soil or water. Extensive literature is available on 
the health impacts of lead exposure, particularly from contaminated air 
and dust. CDC identified in a December 2002 Morbidity and Mortality 
Weekly Report the sources of lead exposure for adults and their 
potential health effects.[Footnote 9] In a September 2003 Morbidity and 
Mortality Weekly Report, CDC identified the most prevalent sources of 
lead in the environment for children, and correlated high blood lead 
levels in children with race, sex, and income bracket.[Footnote 10] The 
surveys suggest that Hispanic and African-American children are at 
highest risk for lead poisoning, as well as those individuals who are 
recipients of Medicaid. Dust and soil contaminated by leaded paint were 
documented as the major sources of lead exposure. Children and adults 
living in housing built before 1950 are more likely to be exposed to 
lead paint and dust and may therefore have higher blood lead levels.

Articles in numerous journals have reported on the physical and 
neurological health effects on children of lead in paint, soil, and 
dust. The New England Journal of Medicine published an article in April 
2003 that associated environmental lead exposure with decreased growth 
and delayed puberty in girls.[Footnote 11] In 2000, the Journal of 
Public Health Medicine examined the implications of lead-contaminated 
soil, its effect on produce, and its potential health effects on 
consumers.[Footnote 12] Lead can also enter children's homes if other 
residents are employed in lead contaminated workplaces. In 2000, 
Occupational Medicine found that children of individuals exposed to 
lead in the workplace were at higher risk for elevated blood lead 
levels.[Footnote 13] The EPA has aided in some similar research through 
the use of its Integrated Exposure Uptake Biokinetic Model for Lead in 
Children (IEUBK). This model predicts blood lead concentrations for 
children exposed to different types of lead sources.[Footnote 14]

According to a number of public health experts, drinking water 
contributes a relatively minor amount to overall lead exposure in 
comparison to other sources. However, while lead in drinking water is 
rarely thought to be the sole cause of lead poisoning, it can 
significantly increase a person's total lead exposure--particularly for 
infants who drink baby formulas or concentrated juices that are mixed 
with water from homes with lead service lines or plumbing systems. For 
children with high levels of lead exposure from paint, soil, and dust, 
drinking water is thought to contribute a much lower proportion of 
total exposure. For residents of dwellings with lead solder or lead 
service lines, however, drinking water could be the primary source of 
exposure. As exposure declines from sources of lead other than drinking 
water, such as gasoline and soldered food cans, drinking water will 
account for a larger proportion of total intake. Thus, according to 
EPA, the total drinking water contribution to overall lead levels may 
range from as little as 5 percent to more than 50 percent of a child's 
total lead exposure.[Footnote 15]

Mr. Chairman, this completes my prepared statement. I would be happy to 
respond to any questions you or other Members of this Subcommittee may 
have at this time.

Contact and Acknowledgments: 

For further information, please contact John B. Stephenson at (202) 
512-3841. Individuals making key contributions to this testimony 
included Steve Elstein, Samantha Gross, Karen Keegan, Jessica Marfurt, 
and Tim Minelli.

FOOTNOTES

[1] 42 U.S.C. 300f-300j.

[2] 40 C.F.R. pt. 141, subpart I. The Lead and Copper Rule established 
an action level of 15 parts per billion (ppb) for lead in drinking 
water. Under the rule, the action level is exceeded if lead levels are 
higher than 15 ppb in over 10 percent of tap water samples taken. For 
each monitoring period, a system must report the lead level at the 90th 
percentile of homes monitored. For example, if a system monitors 100 
homes, it sorts its results from the lowest to the highest 
concentrations and reports the concentration it observed in the 90th 
sample.

[3] Public Notification Handbook, EPA Office of Water (EPA 816-R-00-
010, June 2000).

[4] U.S. General Accounting Office, Drinking Water: Consumers Often Not 
Well-Informed of Potentially Serious Violations, GAO/RCED-92-135 
(Washington, D.C. June 1992).

[5] Letter from William C. Early, Regional Counsel, EPA Region III, to 
Eric H. Holder, Jr., Covington & Burling (June 25, 2004) attaching 
EPA's Response to May 13, 2004, letter from Covington & Burling, 
Response #26.

[6] http://www.epa.gov/dclead/pep_recommendations.htm.

[7] EPA Office of Ground Water and Drinking Water, Summary: Lead action 
level exceedences for medium (3,300-50,000) and large (>50,000) public 
water systems (Updated as of June 1, 2004).

[8] Lacey R.F., et al. Lead in Water, Infant Diet and Blood: The 
Glasgow Duplicate Diet Study. The Science of the Total Environment, 41 
(1985) 235-257.

[9] Centers for Disease Control and Prevention. Morbidity and Mortality 
Weekly Report: Adult Blood Lead Epidemiology and Surveillance - United 
States 1998-2001. 13 December 2002.

10] Centers for Disease Control and Prevention. Morbidity and 
Mortality Weekly Report: Surveillance for Elevated Blood Lead Levels 
Among Children - United States 1997-2001. 12 September 2003. 

[11] Sherry G. Selevan, Deborah C. Rice, Karen A. Hogan, Susan Y. 
Euling, et al. "Blood lead concentration and delayed puberty in girls." 
The New England Journal of Medicine. Boston: Apr 17, 
2003. Vol. 348, Iss. 16; pp. 1527-1536.

[12] Prasad LR, Nazareth B. "Contamination of Allotment Soil with Lead: 
Managing Potential Risks to Health." Journal of Public Health Medicine. 
22(4) December 2000: 525-30.

[13] Chan, J, et al. "Predictors of Lead Absorption in Children of Lead 
Workers." Occupational Medicine. Vol 50, Issue 6, 398-405, 2000.

[14] U.S. Environmental Protection Agency. The IEUBK Model 
http:www.opa.gov/superfund/programs/lead/ieubk.htm 16 April 2004.

[15] U.S. Environmental Protection Agency. Lead and Copper Rule. The 
Federal Register. Vol. 56 NO. 110, 7 June 1991.

GAO's Mission: 

The General Accounting Office, the audit, evaluation and investigative 
arm of Congress, exists to support Congress in meeting its 
constitutional responsibilities and to help improve the performance and 
accountability of the federal government for the American people. GAO 
examines the use of public funds; evaluates federal programs and 
policies; and provides analyses, recommendations, and other assistance 
to help Congress make informed oversight, policy, and funding 
decisions. GAO's commitment to good government is reflected in its core 
values of accountability, integrity, and reliability.

Obtaining Copies of GAO Reports and Testimony: 

The fastest and easiest way to obtain copies of GAO documents at no 
cost is through the Internet. GAO's Web site (www.gao.gov) contains 
abstracts and full-text files of current reports and testimony and an 
expanding archive of older products. The Web site features a search 
engine to help you locate documents using key words and phrases. You 
can print these documents in their entirety, including charts and other 
graphics.

Each day, GAO issues a list of newly released reports, testimony, and 
correspondence. GAO posts this list, known as "Today's Reports," on its 
Web site daily. The list contains links to the full-text document 
files. To have GAO e-mail this list to you every afternoon, go to 
www.gao.gov and select "Subscribe to e-mail alerts" under the "Order 
GAO Products" heading.

Order by Mail or Phone: 

The first copy of each printed report is free. Additional copies are $2 
each. A check or money order should be made out to the Superintendent 
of Documents. GAO also accepts VISA and Mastercard. Orders for 100 or 
more copies mailed to a single address are discounted 25 percent. 
Orders should be sent to: 

U.S. General Accounting Office 441 G Street NW, Room LM Washington, 
D.C. 20548: 

To order by Phone: Voice: (202) 512-6000 TDD: (202) 512-2537 Fax: (202) 
512-6061: 

To Report Fraud, Waste, and Abuse in Federal Programs: 

Contact: 

Web site: www.gao.gov/fraudnet/fraudnet.htm E-mail: fraudnet@gao.gov 
Automated answering system: (800) 424-5454 or (202) 512-7470: 

Public Affairs: 

Jeff Nelligan, Managing Director, NelliganJ@gao.gov (202) 512-4800 U.S. 
General Accounting Office, 441 G Street NW, Room 7149 Washington, D.C. 
20548: