CMAJ • November 4, 2008; 179 (10). doi:10.1503/cmaj.1080107.
© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Letters

Protecting children from lead in tap water

Heide B. Schneider, MD PhD

Department of Family Medicine, University of Leipzig, Leipzig, Germany

Lead in drinking water is still an important health issue in Germany. There is concern about the association of lead exposure with neurologic and intellectual deficits as described by Mark Payne1 and with hearing impairment in infants; higher levels of lead exposure have been associated with increased morbidity in adults and with cognitive decline in older people.2,3 Although the maximum allowable lead concentration in tap water will be reduced from 0.025 mg/L to 0.01 mg/L by December 2013 in Germany, a 2005 test of 237 000 random samples of tap water showed that the lead concentration in more than 5% of the samples exceeded 0.025 mg/L in several regions.4 In Germany it is recommended that pipes be flushed to reduce lead levels by running water for at least 5 minutes every morning, as also suggested by Payne.

Data from the German Federal Environment Agency suggest that even at a lead concentration of 0.01 mg/L in tap water, infants should not consume more than 0.4 L of tap water per day if the water comes from plumbing systems containing lead. As an interim solution until all lead is removed from plumbing, it has been proposed that infants should be given bottled water to avoid exposure to tap water during childhood because the threshold exposure level for lead toxicity has not yet been established.5

Most German municipalities are taking responsibility for removing lead from plumbing systems to protect infants and toddlers in particular from the health hazards associated with exposure to lead in drinking water. In Hamburg alone, all plumbing systems containing lead will be replaced for 28 000 households.

Footnotes

Competing interests: None declared.


REFERENCES

  1. Payne M. Lead in drinking water. CMAJ 2008;179:253-4.[Free Full Text]
  2. Schober SE, Mirel LB, Graubard BI, et al. Blood lead levels and death of all causes, cardiovascular disease, and cancer: results from the NHANES III mortality study. Environ Health Perspect 2006;114:1538-41.[Medline]
  3. Weisskopf MG, Wright RO, Schwartz J, et al. Cumulative lead exposure and prospective change in cognition among elderly men: the VA Normative Aging Study. Am J Epidemiol 2004;160:1184-93.[Abstract/Free Full Text]
  4. Schneider PA, Schneider HB. Risk assessment of lead in drinking water. MMW Fortschr Med 2008;21:19.
  5. Wilhelm M, Dieter HH. Lead exposure via drinking water — unnecessary and preventable. Umweltmed Forsch Prax 2003;8:239-41.




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