| Changes in Blood Lead Levels Associated with Use of Chloramines in
Water Treatment Systems Marie Lynn Miranda, Dohyeong Kim, Andrew P. Hull, Christopher J. Paul, and M. Alicia Overstreet Galeano Nicholas School of the Environment and Earth Sciences, Duke University, Durham, North Carolina, USA Abstract
Background: More municipal water treatment plants are using chloramines as a disinfectant in order to reduce carcinogenic by-products. In some instances, this has coincided with an increase in lead levels in drinking water in those systems. Lead in drinking water can be a significant health risk. Objectives: We sought to test the potential effect of switching to chloramines for disinfection in water treatment systems on childhood blood lead levels using data from Wayne County, located in the central Coastal Plain of North Carolina. Methods: We constructed a unified geographic information system (GIS) that links blood lead screening data with age of housing, drinking water source, and census data for 7,270 records. The data were analyzed using both exploratory methods and more formal multivariate techniques. Results: The analysis indicates that the change to chloramine disinfection may lead to an increase in blood lead levels, the impact of which is progressively mitigated in newer housing. Conclusions: Introducing chloramines to reduce carcinogenic by-products may increase exposure to lead in drinking water. Our research provides guidance on adjustments in the local childhood lead poisoning prevention program that should accompany changes in water treatment. As similar research is conducted in other areas, and the underlying environmental chemistry is clarified, water treatment strategies can be optimized across the multiple objectives that municipalities face in providing high quality drinking water to local residents. Key words: blood lead levels, chloramines, GIS, lead risk, water quality. Environ Health Perspect 115:221–225 (2007) . doi:10.1289/ehp.9432 available via http://dx.doi.org/ [Online 7 November 2006]
Address correspondence to M.L. Miranda, Nicholas School of the Environment and Earth Sciences, Duke University, Box 90328, Levine Science Research Center Room A134, Durham, NC 27708 USA. Telephone: (919) 613-8023. Fax: (919) 684-3227. E-mail: mmiranda@duke.edu We thank A. Bauer, J. Davis, S. Edwards, E. Norman, and T. Ward for their work on this project. We also thank the Wayne County GIS Department for facilitating this analysis by providing access to tax parcel and water district shapefiles. This research was made possible by funding from the Centers for Disease Control and Prevention (through a subcontract with the North Carolina Department of Environment and Natural Resources) and the National Institute of Environmental Health Sciences Superfund Basic Research Program (3 P42 ES010356-07) . The authors declare they have no competing financial interests. Received 18 June 2006 ; accepted 7 November 2006.
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