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On September 27, 2021, we published a story on widespread lead exposure in kids across the country. Then in October, the CDC reduced its lead reference value from 5.0 ug/dL to 3.5 ug/dL, making more children eligible for interventions and follow-up testing. In this report, we follow up on federal policy changes aimed at rectifying this "silent epidemic."

The bipartisan Infrastructure Investment and Jobs Act (IIJA), signed into law in mid-November by President Biden, allocates $15 billion for mapping and replacing lead pipes across the U.S. This amount is one-third of the initially proposed $45 billion that Biden wanted in order to replace all lead pipes in the country.

"It's going to create jobs replacing ... lead water pipes so every American, every child can drink clean water, improving their health and putting plumbers and pipefitters to work," Biden said during a press brief. "How long have we been talking about that? It's a gigantic issue."

The IIJA is a "once in a generation investment," said Erik Olson, senior strategic director of health at the Natural Resources Defense Council (NRDC).

"It includes the largest single investment in water infrastructure, and the largest investment ever in removing lead pipes," he said. While the Act is an important step, it is not enough to remove all lead pipes in the U.S., Olson said.

Replacing a single lead pipe costs approximately $4,700, according to a . Based on the number of lead pipes in the U.S. and the EPA's cost estimate, the current infrastructure act only provides enough funding for 15 states to replace all of their lead pipes, .

The Build Back Better Act, which is currently stalled in Congress, includes a proposed additional $10 billion to address lead in drinking water. That additional funding would bump the number of states that could replace all of their lead pipes to 24, the Environmental Policy Innovation Center estimated.

Water contamination due to lead came to national focus in 2016 due to the crisis in Flint, Michigan. However, lead can be found in many different aspects of a child's environment, not just in water, . It can be found on toys, jewelry, and imported products, as well as near airports.

"Lead-based paint and the dust that forms when lead paint erodes is the predominant source of lead exposure, and lead poisoning for American children accounts for the overwhelming majority of lead poisoning cases in this country," said Phillip Landrigan, MD, MSc, of Boston College. "We therefore need a national lead paint removal program to complement the removal of lead water pipes," he said, echoing his editorial published with David Bellinger, PhD, of Boston's Children's Hospital, in earlier this year.

Even small amounts of lead exposure can impact a child's development. It can impede neurodevelopment and cause hearing and learning problems, . According to by Bellinger, lead exposure in the U.S. has resulted in a cumulative loss of nearly 23 million full-scale IQ points.

There are somewhere between 9.7 to 12.8 million pipes across all 50 states, including those that claim to have no lead pipes, . The 23 states that do not track lead pipes make it not only difficult to estimate the number of lead pipes in the country, but also are unlikely to be following the EPA's 1991 Lead and Copper Rule, which requires water systems to be tested for lead, according to an NRDC report.

"[The] EPA needs to establish an updated Lead and Copper Rule that will require these lead pipes to be removed within 10 years," Olson said.

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