December 2022 • Journal of Environmental Health 47 BLL data. These surrogate indicators are largely based on data from the U.S. Census and American Community Survey. For example, U.S. EPA’s EJScreen Lead Paint Index (www.epa.gov/ ejscreen) and a recent statistical model (Schultz et al., 2017) are based on housing age, race, and income variables. The U.S. Department of Housing and Urban Development’s (HUD) Deteriorated Paint Index predicts risk based on pre-1980 homes with large areas of deteriorating paint based on microdata from the American Community Survey and the American Housing Survey (Garrison & Ashley, 2021). U.S. EPA, HUD, and CDC recently collaborated on a state-of-science summary of publicly available methods, data, and maps for identifying lead hotspots in the U.S. The summary provides descriptions and references for currently available lead indices, BLL data, and environmental data. It also identifies environmental data gaps and data accessibility needs to improve our ability to identify these hotspots (Zartarian et al., in press). Removing Lead From Drinking Water The Lead and Copper Rule Revisions (U.S. EPA, 2022a) require water systems to establish service line (i.e., water supply lines to homes and businesses) inventories and proactively replace lead and galvanized service line pipes. U.S. EPA scientists in the Oce of Research and Development (ORD) have developed noninvasive methods based on sampling tap water to help speed up identifying these pipes (Hensley et al., 2021; Lytle et al., 2018). In addition, ORD scientists provide technical support to states, consultants, and water system operators to help them reduce the release of lead from pipes and plumbing fixtures. The ORD Small Drinking Water Systems Webinar Series (www.epa.gov/water-research/smalldrinking-water-systems-webinar-series) and Annual U.S. EPA Drinking Water Workshops provide state of the art training on lead service line identification, optimizing corrosion control, and evaluating the e- cacy of point-of-use water filters (Doré et al., 2021; Harmon et al., 2022; Liggett et al., 2022; Schock et al., 2021). ORD also recently reviewed field analyzers used for rapidly quantifying lead in drinking water samples and provided recommendations for their use (Doré et al., 2020). Remediating Lead in Soil Contaminated soil remains a critical driver of elevated BLLs, especially for young children who are exposed by hand-to-mouth contact and by ingestion of dust and soil (Özkaynak et al., 2022; Zartarian et al., 2017). Remediating soil lead is associated with declines in BLLs in children (Klemick et al., 2020; Mielke et al., 2019; Ye et al., 2022), therefore understanding soil lead levels and various remediation approaches is critical for environmental health practitioners. ORD has developed rapid and cheap methods to estimate how much lead at a particular site can be absorbed when ingested by people or taken up by plants (Bradham et al., 2016, 2017; Griggs et al., 2021; Misenheimer et al., 2018). The integrated biokinetic exposure and uptake model can be used by environmental professionals to estimate specific site cleanup levels (U.S. EPA, 2022b). ORD has also shown that the addition of soil amendments like phosphate can be used to form long-lasting insoluble mineral complexes that help to sequester the lead in the soil, and that new ways to lock up the lead in soil might help reduce removal cleanup e¤orts and costs (Bradham et al., 2018; Karna et al., 2020; Sowers et al., 2021). Moving Onward In many ways, lead is the opposite of emerging chemical contaminants—it is a well characterized developmental and adult toxicant that a¤ects multiple human organ systems. Lead sources in the environment are also well known; one indicator of this understanding is the myriad laws and rules that regulate lead (President’s Task Force, 2016). Yet repeatedly, it is the legacy chemical that draws our attention to public health emergencies in places (e.g., Flint, Michigan; Syracuse, New York; and East Chicago, Indiana) where exposure resulting from lead in drinking water, old housing, and contaminated soil still a¤ects children and their families. Example of Mapping Locations With a High Prevalence of Elevated Blood Lead Levels (EBLLs) Mapping locations with a high prevalence of EBLLs helps public health practitioners target remediation, outreach, and educational resources and provides a compelling way to visualize success in lead exposure reduction actions. Reproduced with author permission from Xue et al., 2022. FIGURE 1 OEPA % EBLLs (�5 µg/dl) by Census Tract for Children 0 to <6 years 0–5 >5–10 >10–20 >20–40 >40–70 A C Threegak Stephtnson Muskegon .. Lansing B D Byron 2008 �"'2/10 a {S e' ).§J: f5� ,,.., "[l J OJ fa j ., '� � -�\� -... r->., . �" '-- L, Muskegon ''t ,- Belding 01
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