Changes in blood lead and water lead in Edinburgh. An eight year follow-up to the Edinburgh lead study

This study aimed to measure changes in household water lead and blood lead in young people living in Edinburgh over a period of 8 years. Two hundred and twenty-three families were eligible and 207 (93%) agreed to participate. A half-hour stagnation sample of kitchen cold water was taken from each household, and 171 young people (aged 14–17 years) provided a blood sample for lead analysis. Information on plumbing changes, exposure to other sources of lead and factors which might influence blood lead was collected by questionnaire. Edinburgh is supplied with water treated in one of two treatment plants. There was a different programme of water treatment in each plant. In one (A) lime and orthophosphate was introduced in the interval between the original and follow-up studies. In the other (F) lime treatment began before the original study and orthophosphate was introduced subsequently. In water from treatment plant A, mean water lead levels fell from 34 to 4.3 gL-1 (87%). In water supplied from treatment plant F the corresponding values were 9.3 to 3.6 gL-1 (61%). These reductions were due to both water treatment and removal of lead plumbing. Houses with no lead plumbing have water lead levels 89% lower than houses with lead tanks, and 47% lower than houses with lead pipes. About one-third of households with lead tanks are predicted to have water lead levels above the current EC limit of 50 gL- 1, though only 3% or less of the remaining households would exceed this limit. If the proposed 10 gL-1 limit were introduced, 34% of households supplied from plant A and 25% from plant F would breach the limit. Blood lead levels fell from an average of 11.0 gdL-1 to 4.0 gdL-1. Males had higher values than females and the main factors influencing levels were water lead and age of house. Our results show substantial reductions in household water lead and blood lead in our sample over a period of 8 years and represent an important achievement in public health. However, more progress will be required if the proposed new limit of 10 gL-1 for water lead is to be met. There is a need for the continuing surveillance of household water lead and blood lead levels in representative samples of the population.