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62–945 PDF 2010

LEAD EXPOSURE IN D.C.: PREVENTION,

PROTECTION, AND POTENTIAL PRESCRIPTIONS

HEARING

BEFORE THE

SUBCOMMITTEE ON FEDERAL WORKFORCE,

POSTAL SERVICE, AND THE DISTRICT

OF COLUMBIA

OF THE

COMMITTEE ON OVERSIGHT

AND GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED ELEVENTH CONGRESS

SECOND SESSION

JUNE 15, 2010

Serial No. 111–92

Printed for the use of the Committee on Oversight and Government Reform

(

Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html

http://www.house.gov/reform

(II)

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

EDOLPHUS TOWNS, New York, Chairman

PAUL E. KANJORSKI, Pennsylvania

CAROLYN B. MALONEY, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

JOHN F. TIERNEY, Massachusetts

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

JIM COOPER, Tennessee

GERALD E. CONNOLLY, Virginia

MIKE QUIGLEY, Illinois

MARCY KAPTUR, Ohio

ELEANOR HOLMES NORTON, District of

Columbia

PATRICK J. KENNEDY, Rhode Island

DANNY K. DAVIS, Illinois

CHRIS VAN HOLLEN, Maryland

HENRY CUELLAR, Texas

PAUL W. HODES, New Hampshire

CHRISTOPHER S. MURPHY, Connecticut

PETER WELCH, Vermont

BILL FOSTER, Illinois

JACKIE SPEIER, California

STEVE DRIEHAUS, Ohio

JUDY CHU, California

DARRELL E. ISSA, California

DAN BURTON, Indiana

JOHN L. MICA, Florida

JOHN J. DUNCAN, JR., Tennessee

MICHAEL R. TURNER, Ohio

LYNN A. WESTMORELAND, Georgia

PATRICK T. MCHENRY, North Carolina

BRIAN P. BILBRAY, California

JIM JORDAN, Ohio

JEFF FLAKE, Arizona

JEFF FORTENBERRY, Nebraska

JASON CHAFFETZ, Utah

AARON SCHOCK, Illinois

BLAINE LUETKEMEYER, Missouri

ANH ‘‘JOSEPH’’ CAO, Louisiana

RON STROMAN, Staff Director

MICHAEL MCCARTHY, Deputy Staff Director

CARLA HULTBERG, Chief Clerk

LARRY BRADY, Minority Staff Director

SUBCOMMITTEE ON FEDERAL WORKFORCE, POSTAL SERVICE, AND THE DISTRICT OF

COLUMBIA

STEPHEN F. LYNCH, Massachusetts, Chairman

ELEANOR HOLMES NORTON, District of

Columbia

DANNY K. DAVIS, Illinois

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

WM. LACY CLAY, Missouri

GERALD E. CONNOLLY, Virginia

JASON CHAFFETZ, Utah

BRIAN P. BILBRAY, California

ANH ‘‘JOSEPH’’ CAO, Louisiana

——— ———

WILLIAM MILES, Staff Director

(III)

C O N T E N T S

Page

Hearing held on June 15, 2010 ............................................................................... 1

Statement of:

Arias, Ileana, Ph.D., Principal Deputy Director, Centers for Disease Control and Prevention; Thomas P. Jacobus, general manager, Washington

Aqueduct Division, U.S. Army Corps of Engineers; George S. Hawkins,

general manager, D.C. Water and Sewer Authority; Christophe A.G.

Tulou, acting director, District Department of the Environment; and

Ellen Silbergeld, professor, Johns Hopkins Bloomberg School of Public

Health ............................................................................................................ 12

Arias, Ileana .............................................................................................. 12

Jacobus, Thomas P. ................................................................................... 28

Hawkins, George S. ................................................................................... 34

Tulou, Christophe A.G. ............................................................................. 43

Silbergeld, Ellen ........................................................................................ 51

Letters, statements, etc., submitted for the record by:

Arias, Ileana, Ph.D., Principal Deputy Director, Centers for Disease Control and Prevention, prepared statement of ................................................ 15

Chaffetz, Hon. Jason, a Representative in Congress from the State of

Utah, prepared statement of ........................................................................ 7

Connolly, Hon. Gerald E., a Representative in Congress from the State

of Virginia, prepared statement of .............................................................. 85

Hawkins, George S., general manager, D.C. Water and Sewer Authority,

prepared statement of ................................................................................... 36

Jacobus, Thomas P., general manager, Washington Aqueduct Division,

U.S. Army Corps of Engineers, prepared statement of ............................. 30

Lynch, Hon. Stephen F., a Representative in Congress from the State

of Massachusetts, prepared statement of ................................................... 3

Silbergeld, Ellen, professor, Johns Hopkins Bloomberg School of Public

Health, prepared statement of ..................................................................... 53

Tulou, Christophe A.G., acting director, District Department of the Environment, prepared statement of .................................................................. 45

(1)

LEAD EXPOSURE IN D.C.: PREVENTION, PROTECTION, AND POTENTIAL PRESCRIPTIONS

TUESDAY, JUNE 15, 2010

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON FEDERAL WORKFORCE, POSTAL

SERVICE, AND THE DISTRICT OF COLUMBIA, COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM, Washington, DC.

The subcommittee met, pursuant to notice, at 2:09 p.m., in room

2154, Rayburn House Office Building, Hon. Stephen F. Lynch

(chairman of the subcommittee) presiding.

Present: Representatives Lynch, Norton, Cummings, and

Chaffetz.

Staff present: Jill Crissman, professional staff; Aisha Elkheshin,

clerk/legislative assistant; William Miles, staff director; Rohan

Siddhanti, intern; Dan Zeidman, deputy clerk/legislative assistant;

Lawrence Brady, minority staff director; Jennifer Safavian, minority chief counsel for oversight and investigations; Adam Fromm,

minority chief clerk and Member liaison; Seamus Kraft, minority

director of new media and press secretary; Justin LoFranco, minority press assistant and clerk; Howard Denis, minority senior counsel; Hudson Hollister and Marvin Kaplan, minority counsels; Mark

Marin, minority senior professional staff member; and Molly Boyl

and James Robertson, minority professional staff members.

Mr. LYNCH. Good afternoon. The Subcommittee on Federal Workforce, Postal Service, and the District of Columbia hearing will now

come to order. Welcome, Ranking Member Chaffetz, members of

the subcommittee, hearing witnesses and all those in attendance.

In light of the District of Columbia’s ongoing efforts to minimize

the amount of lead in its water, particularly since the 2000 to 2004

lead-in-the-water crisis, I have called today’s hearing to look into

how the District and the Federal Government can reduce the

amount of lead that D.C. residents are exposed to and to learn

what steps, if any, should be taken to identify children exposed to

lead during the lead-in-the-water crisis.

The chair, the ranking member and the subcommittee members

will each have 5 minutes to make opening statements, and all

Members will have 3 days to submit statements for the record.

I now yield myself 5 minutes for my opening statement.

Ladies and gentlemen, again let me welcome you to the subcommittee’s oversight hearing entitled, ‘‘Lead Exposure in D.C.:

Prevention, Protection, and Potential Prescriptions.’’ From a health

and safety perspective, today’s hearing provides the subcommittee

with an important opportunity to take a prospective look at issues

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of lead and lead exposure in D.C. and to discuss what the District

and Federal Government can do to help protect the more than

600,000 District of Columbia residents and the millions of people

that visit our Nation’s Capital every year.

There is an old saying that the only good lead is no lead, and

although we may never actually meet the objective standard, given

the various sources of lead that exist, I do believe it is critical that

we continue to work to limit and reduce the level of exposure of

D.C. residents, particularly of infants and children, particularly

susceptible populations, as well as to fully inform the public about

their options if exposure to lead does occur. Today’s hearing is also

intended to look at what steps, if any, should be taken to identify

and assist those previously exposed to lead during the District’s

lead-in-the-water crisis.

As many of you are aware, from 2000 to 2004, the D.C. lead-inthe-water crisis threatened the District’s drinking water with an

estimated 4,000 District of Columbia homes having lead in their

water that exceeded the Federal limit of 15 parts per billion. While

a host of work has been performed since the early 2000’s to limit

the District residents’ exposure to lead, the seriousness of the previous crisis warrants ongoing oversight and examination, which is

why I believe today’s hearing is one of the most important proceedings this subcommittee will hold during the 111th Congress.

It is my hope that today’s hearing will examine a myriad of topics and questions, ranging from current practices to treat and deliver high-quality drinking water to residents of the District, to recent improvements in agency coordination and the dissemination of

accurate and timely information to the public about whether or not

their homes are at risk to exposure to lead, and to look into what

actions can be taken to ensure the prevention of another crisis.

I would like to thank my colleague, the Honorable Congresswoman Eleanor Holmes Norton, for her years of work on this issue.

Please know that the subcommittee looks forward to continuing to

work with you and others who are concerned about this problem

as we collectively look for ways to prevent, protect and prescribe

possible solutions for those who may have been or are exposed to

lead in the District of Columbia.

Again, I thank all of those in attendance this afternoon, and I

look forward to hearing the testimony of our witnesses.

[The prepared statement of Hon. Stephen F. Lynch follows:]

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Mr. LYNCH. I would like now to take a moment to introduce the

ranking member, Mr. Chaffetz, for 5 minutes for his opening statement.

Mr. CHAFFETZ. Thank you, Mr. Chairman. I stand by your assertion. You are correct that one of the basic tenets here, one of the

basic things we should do is make sure that the water is safe for

our people and for the people who are going to consume it from all

over the world as they visit the District of Columbia. People expect

their drinking water to be safe, abundant and inexpensive. Sadly,

here in the Nation’s Capital the safety of our drinking water has

been an ongoing concern.

Clearly there is a major Federal role in the quest for safe drinking water in the Washington region. Congress has done extensive

oversight, and legislation has been enacted. Our goal is to basically

make sure that the lead is out.

Though not one of the leading tourist attractions in the Washington, DC, area, the Blue Plains Advanced Wastewater Treatment

Plant is the largest such facility in the world. On the banks of the

Anacostia, it is the key to having a healthy Potomac River and

Chesapeake Bay.

I recognize that I am still a freshman here, but I do understand

that not too many years ago there would be pitchers of water with

drinking glasses supplied to Members and witnesses at congressional hearings. I notice that today we have bottles of water on the

table. Back then there were boil water alerts in Washington and

signs in this very building cautioning people against drinking the

water from the water fountains. Yet now, as we pointed out, we

have bottled water.

So the Water and Sewer Authority was created as a quasi-regional entity, and as recently as 2008, Congress enacted legislation

to preserve its independence. WASA operates Blue Plains. As of

April 2009, WASA has a new general manager, who is with us

today, and we appreciate you being here.

WASA supplies wholesale wastewater treatment for over 2 million local residents and millions of visitors and has over 500,000 retail, commercial and Federal customers. The Washington Aqueduct,

the Pentagon, the Reagan National Airport are all closely linked to

WASA.

In 2004, the WASA board hired a leading law firm, Covington

and Burling, to investigate its management of lead-monitoring activities from July 2000 to January 2004 due to elevated lead levels

in the local water supply. That investigation, interestingly enough,

was conducted under the direction of now-U.S. Attorney General

Eric Holder.

Some of our witnesses today testified before our predecessors on

this subcommittee and before the full committee. It is shocking

that a congressional investigation recently concluded that the Centers for Disease Control and Prevention made ‘‘scientifically indefensible’’ claims in 2004 relative to the dangers some local residents

were exposed to by drinking public water. That is something we

would like to hear about more in this committee and hopefully here

today.

Mr. Chairman, I thank you again for calling this hearing and

look forward to hearing from our witnesses. I appreciate you all

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being here and look forward to your testimony and the question

and answer afterwards.

I yield back the balance of my time.

[The prepared statement of Hon. Jason Chaffetz follows:]

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Mr. LYNCH. The chair will now recognizes the gentlelady from

the District of Columbia, Ms. Eleanor Holmes Norton, who has

been a driving force behind this hearing and trying to correct a

very difficult situation.

Ms. NORTON. Thank you very much, Mr. Chairman. I particularly appreciate your quickly holding a hearing on this important

public health issue.

The hearing is, I believe, important for its national implications

as well because of the effects of lead on children and pregnant

women in particular. Just as the earlier lead-in-the-water crisis

from 2000 to 2004 resulted in national attention on the issue and

the introduction of legislation in Congress, this hearing will take

a broad-prospective look at lead in D.C. to learn not only about reduction of lead exposure in the District, but also what steps, if any,

can and should be taken to identify and treat children and adults

who were exposed to lead during the District’s lead-in-the-water

crisis.

This crisis became public in 2004 and caused considerable concern in the city. At my request the Committee on Oversight and

Government Reform held hearings on this issue, and a number of

other congressional committees did as well. Two months ago, the

lead-in-the-water crisis reemerged in public consciousness when

the majority staff of the House Science and Technology Subcommittee on Investigations and Oversight released a critical investigation

report making out the case that the Centers for Disease Control

and Prevention had misrepresented the harm caused to D.C. residents during the lead-in-the-water crisis.

This hearing is a followup to the S&I Subcommittee report, and

I think, Mr. Chairman, it is necessary because the emergence once

again of this issue has caused D.C. residents to be concerned about

lead in the water, that whole crisis, and what are its implications

for today.

We called to the attention of residents that for the past several

years, however, lead in the water has been below the U.S. Environmental Protection Agency action level of 15 parts per billion. However, the subcommittee report raised questions about whether public officials misled, intentionally or otherwise, and continue to mislead the public about the lead-in-the-water crisis. These questions

need clarification, and the CDC has indicated, too, that mistakes

were made.

But the more urgent goal of today’s hearing, I believe, Mr. Chairman, is to look forward at what we should do about the children

and the pregnant women who may have been exposed during the

lead-in-the-water crisis, and what steps we can take to ensure that

D.C. residents are safe now from lead in the water, lead in paint,

and from other sources.

The D.C. Water and Sewer Authority [WASA], first became

aware of the high levels of lead in the water in 2002; however, it

was only when the Washington Post ran a story in early 2004 that

the public became aware of the full scope of the problem. At that

time it was estimated that 4,000 District homes had lead in the

water that exceeded the EPA action level of 15 parts per billion,

and that the city had 23,000 homes with lead service lines. Fear

spread through the District.

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In response to the lead-in-the-water crisis, and pursuant to Federal law, the District sought to replace all of the approximately

35,000 known utility lead service lines in the District of Columbia

by 2016.

At congressional hearings in 2004 and 2008, I questioned

WASA’s response to the lead-in-the-water crisis of proceeding with

partial lead pipe replacements. There was no evidence at the time,

and to my knowledge there is no evidence today, that such a measure would reduce lead in drinking water. In fact, CDC’s own research suggests that partial lead pipe replacements actually may

increase the amount of lead in the water. However, WASA spent

$100 million on partial pipe replacement in the District.

We are very concerned that while WASA has considerably reduced the number of such partial replacements, it continues to perform them. We need to look for new science-based approaches to rebuild confidence in the agencies responsible for preventing lead

contamination.

Most of our witnesses today are charged with the task of improving public health here in the District and nationally. The subcommittee, I am sure, will be interested to learn how they are

meeting this charge today, particularly as it relates to the reduction of lead exposure here, what progress has been made, and, looking toward the future, what changes are needed.

Though the focus of this hearing relates to the specific example

of the District of Columbia, its findings, in my judgment, could

have far-reaching consequences. The lessons learned from the leadin-the-water crisis here in the District already have been instructive to health professionals elsewhere.

Again, I thank you, Mr. Chairman, for the hearing. I think it is

as important outside of the District as much as it is in the District

itself.

Mr. LYNCH. I thank the gentlelady.

It is the committee’s policy that all witnesses to testify must be

sworn, so may I please ask you to rise and raise your right hands.

[Witnesses sworn.]

Mr. LYNCH. Let the record show that all of the witnesses have

answered in the affirmative.

What I would like to do is begin by offering a brief introduction

of each of our witnesses on this panel, and then we will invite the

witnesses each to offer a brief opening statement as well.

On panel one, I would like to begin by introducing Ileana Arias.

Am I pronouncing that correct?

Ms. ARIAS. You are.

Mr. LYNCH. OK. That was luck.

Currently Ileana Arias currently serves as Deputy Director at

the Centers for Disease Control and Prevention. In 2005, she was

also appointed as the Director of the National Center for Injury

Prevention and Control. Prior to joining the Centers for Disease

Control and Prevention in 2000, she was the director of clinical

training and a professor of clinical psychology at the University of

Georgia.

Mr. Thomas Jacobus has been the general manager of the Washington Aqueduct since 1994. He is responsible for overseeing one of

the largest municipal water-treatment operations in the Nation.

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Prior to his arrival at Washington Aqueduct, Mr. Jacobus, a registered professional engineer, spent more than 25 years with the

Army Corps of Engineers in military assignments around the

world.

Thank you for your service.

Mr. George Hawkins has been the general manager of the D.C.

Water and Sewer Authority since September 2009. In this position

Mr. Hawkins oversees all of the D.C. Water and Sewer Authority’s

operations and is responsible for carrying out the strategic plan for

the utility. Prior to this Mr. Hawkins served for 21⁄2 years as the director of the District Department of the Environment, an $80

million agency with 300 employees.

Mr. Christophe Tulou was named acting director of the District

Department of the Environment in May of this year. Mr. Tulou has

over 10 years of experience in government, including his position

as cabinet secretary for the Delaware Department of Natural Resources and Environmental Control. He also worked as an adviser

on the Clinton Climate Initiative’s Carbon and Poverty Reduction

Project.

Dr. Ellen Silbergeld is currently a professor and editor in chief

of environmental research at the Johns Hopkins Bloomberg School

of Public Health. She received her Ph.D. from Johns Hopkins in geography and environmental engineering and a postdoctoral fellowship in environmental health sciences. She has served as a scientific adviser to the Centers for Disease Control, Environmental

Protection Agency, Department of Energy, Occupational Safety and

Health Administration and the World Bank.

Welcome.

Ms. Arias, you are welcome to offer an opening statement for 5

minutes. Let me just explain that small box in front of you will

flash green while your time is active, it will flash yellow when you

should begin to wrap up, and then obviously it will show red when

your time has expired. But welcome, and, please, you are welcome

to offer your opening statement.

STATEMENTS OF ILEANA ARIAS, Ph.D., PRINCIPAL DEPUTY DIRECTOR, CENTERS FOR DISEASE CONTROL AND PREVENTION; THOMAS P. JACOBUS, GENERAL MANAGER, WASHINGTON AQUEDUCT DIVISION, U.S. ARMY CORPS OF ENGINEERS;

GEORGE S. HAWKINS, GENERAL MANAGER, D.C. WATER AND

SEWER AUTHORITY; CHRISTOPHE A.G. TULOU, ACTING DIRECTOR, DISTRICT DEPARTMENT OF THE ENVIRONMENT;

AND ELLEN SILBERGELD, PROFESSOR, JOHNS HOPKINS

BLOOMBERG SCHOOL OF PUBLIC HEALTH

STATEMENT OF ILEANA ARIAS

Ms. ARIAS. Thank you, Mr. Chairman, and thank you to the subcommittee for inviting me to testify today on what we consider an

incredibly important issue for D.C. and for the country as a whole.

I am Dr. Ileana Arias, the Principal Deputy Director of the Centers for Disease Control and the Agency for Toxic Substances and

Disease Registry, as has been mentioned. In that role I am primarily responsible for advising the Director, Dr. Thomas Frieden,

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on all scientific and programmatic activities at CDC and the

ATSDR.

We are here to talk today about lead. Lead is an incredibly dangerous substance. It leads to, unfortunately, a number of

neurobehavioral effects, and young children are particularly susceptible to the effects of exposure to lead.

Lead exposure in the child’s environment must be controlled and

eliminated as much as possible. At CDC essentially we adopt a zero

tolerance for lead, even though we recognize that removing all

traces of lead in the environment may not be possible. However, we

are committed to driving those numbers down as much as is feasibly possible and that we can.

For nearly three decades CDC has spearheaded an effective national lead prevention campaign. When we began about 30 years

ago, 88 percent of American children tested had blood levels above

10 micrograms per deciliter. Today we are testing children and

showing that less than 1 percent have those high levels of lead in

their system.

The changes that have taken place in the 30 years essentially

constitute one of the greatest public health success stories in the

United States. CDC has worked tirelessly in order to accomplish

this, and we haven’t done it alone. We have partnered with other

agencies who are equally committed to making a significant difference, such as the EPA, HUD, State and local health departments and others. CDC recognizes the potential to eliminate childhood lead exposure, and although we have made significant strides,

we are not giving up in trying to make even greater differences.

Lead is a common but dangerous substance, and exposures can

occur in many different ways, as already has been mentioned;

paint, dust, soil, toys. We even know now some imported candies,

unfortunately, have traces of lead. We have been successful in the

past in fighting it. Important pervasive sources of lead, like leaded

gasoline, have been eliminated. Eliminating childhood lead exposure will require, however, targeting the most at-risk, and unfortunately that means the hardest-to-reach, populations. We need to remain vigilant for current sources and identify new sources of lead

and make sure that we address those exposures appropriately.

CDC continues to work with D.C. to protect its children from

lead exposure. Today the D.C. Program is a very effective program

at reducing childhood lead exposure, screening at-risk children, and

ensuring that exposed children get effective case management.

The D.C. Council has adopted and implemented a lead poisoning

prevention law that is one of the strongest in the Nation. It requires universal screening of all 1- and 2-year-olds in D.C., who are

at highest risk for the negative effects of lead exposure. It also requires screening once prior to the age of 6 years and also screening

of children prior to daycare and school enrollment.

The D.C. lead program continues to address compliance and enforcement. D.C. drinking water has been in compliance with EPA’s

Safe Drinking Water Act standards for lead since 2006. CDC works

with D.C. to reduce the number of D.C. children exposed to lead

and to ensure that children who have been exposed receive appropriate case management.

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Children who test positive are enrolled in case management,

which includes actions such as clinical followup, that includes medical assessment of neuro development, chelation for excessive levels

of blood lead, referrals for childhood development educational service. It also includes environmental followup, including assessment

of potential sources of lead exposure and enforcement of lead hazard mitigation in homes and in the environment of the children.

It also involves parent and guardian education in the form of

home visitation programs to not only educate parents and caregivers, but also to address the hazards, to assess and mitigate hazards in the home and the households where children and other atrisk populations live. Enriched educational services and intellectual

development programs in the D.C. Public Schools also have been

incredibly helpful in responding to children who have been exposed

and characterized by high levels of lead in their systems.

Moving forward, our focus must be on how best to protect children from lead poisoning. The CDC Director, Dr. Tom Friedman,

and I have met with D.C. leaders already, and I am testifying

today to underscore our intention and commitment to eliminate

lead poisoning in children.

In D.C., we are working very closely with the lead program. We

are also engaging in a number of broad national activities to improve our knowledge of the state of affairs and our ability to respond very quickly to make a difference.

Thank you.

Mr. LYNCH. Thank you.

[The prepared statement of Ms. Arias follows:]

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Mr. LYNCH. Mr. Jacobus, you are now recognized for 5 minutes

for an opening statement.

STATEMENT OF THOMAS P. JACOBUS

Mr. JACOBUS. Thank you.

Mr. Chairman and members of the subcommittee, I am Tom Jacobus, general manager of Washington Aqueduct. Thank you for inviting me to testify today concerning strategies for reducing lead

exposure via drinking water.

Washington Aqueduct is committed to ensuring that we produce

safe, high-quality drinking water for our customers. Every action

we take as an organization is focused on achieving this. We have

an exceptional record of producing and delivering safe, reliable and

cost-effective water service for our customers.

Washington Aqueduct is regulated by EPA Region 3, and even

though we are Federal in nature, we operate like every other regulated water utility.

The elevated levels of lead in drinking water in some homes in

the District of Columbia that were reported in the media in January 2004 were caused by a treatment change we made in November

2000. That change was made to be more protective of chronic exposure to disinfection by-products, while at the same time keeping

the water free from harmful bacteria. However, it resulted in an

unforeseen change as to the corrosion control measures being used.

As a result, the water in contact with the lead service lines was

too reactive, and the lead was leached from those lines.

A technical solution to restore affected corrosion control was researched and tested and then applied to the treatment process and

delivered to the entire distribution system in August 2004. By adding orthophosphate as the corrosion inhibitor, lead levels measured

at the tap in accordance with the Safe Drinking Water Act Lead

and Copper Rule began dropping, as predicted. The use of a chemical additive as a corrosion inhibitor in the Washington Aqueduct

treatment process will continue indefinitely.

Lead gets into the drinking water after the water has been produced at the treatment plants. Nothing in the treatment process

adds lead to the water, and the network of public water mains that

transport the water to the homes does not add lead. Lead can only

be introduced to the drinking water if lead service lines connect the

residents to the water main, or if there is a galvanized pipe in a

residence which has had a lead service line, if there is lead in solder joints in home plumbing, or if there is lead in plumbing fixtures in the homes.

However, if the treatment plants have optimal corrosion control

techniques, the possibility of lead leaching into the drinking water

in the home can be very significantly reduced because the corrosion

inhibitor creates a nonreactive surface inside the pipes and fixtures.

To confirm analytical calculations and bench tests of corrosion

control chemistry, Washington Aqueduct built an array of lead pipe

loops and set it up at the water treatment plant to mimic home

water use conditions. Looking forward, this lead pipe loop array

will be a test bed for analysis of the effects of any future change

to water chemistry or treatment techniques. We will investigate

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thoroughly what happens to corrosion control. All of this will be

evaluated by our consultants and then by the Environmental Protection Agency before any future treatment change is made.

We have followed this review procedure with the ongoing change

in the form of the disinfectant we use. Instead of having chlorine

gas delivered to the water treatment plants, we are converting to

the use of an aqueous form of chlorine known as sodium hypochlorite.

We are confident that through precise water chemistry control,

our customers can maintain compliance with the Lead and Copper

Rule. That confidence is based not only on science, but also only

corroboration with our customers. We have the very best equipment for analyzing lead concentrations, and we share the data with

our wholesale customers. We have regular meetings to discuss

water quality, and we get excellent feedback.

Even with optimum corrosion control chemistry in a system that

is fully compliant with the Lead and Copper Rule, as long as there

are homes with lead service lines, lead solder or plumbing fixtures

containing lead, the water delivered to those homes may pick up

some concentration of lead. However, by following the directions

that the District of Columbia Water and Sewer Authority has communicated to its customers, everyone living and working in the

District of Columbia can confidently drink the water.

Mr. Chairman, thank you for the opportunity to offer this testimony. I look forward to responding to any questions you or other

members of the subcommittee may have.

[The prepared statement of Mr. Jacobus follows:]

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Mr. LYNCH. Mr. Hawkins, you are now recognized for an opening

statement for 5 minutes.

STATEMENT OF GEORGE S. HAWKINS

Mr. HAWKINS. Mr. Chairman, Congressman Chaffetz, and my

Congressman, Congressman Norton, it is a delight to be here

today. My name is George Hawkins.

For 16 years you would have heard the name D.C. WASA for the

enterprise I run. Just this morning we changed the name to D.C.

Water. Our new logo and new phrase can be seen here on the shirt.

It is ‘‘Water is Life.’’ I will come back to that. But it is not just a

change in name, it is embodying a commitment we have to step forward and take proactive steps not only for the health and welfare

of every customer, every citizen, every resident, every visitor in this

city, but every living thing in this city, because water is the fundamental of live.

Just to clarify and to recap, we purchase our water from the aqueduct. Our friend Mr. Jacobus’ Federal agency, treats the water.

We purchase the water and distribute it to every building in the

city through 1,300 miles of pipes, 36,000 valves, a pump system

that is complicated throughout the city. I would love to show you.

Then, once it is used and goes down the drain, it goes through

1,800 miles, because it includes sewage coming from our suburban

jurisdictions to the Blue Plains, what I consider a water recycling

plant, and we return over 300 million gallons of cleansed water

every single day to the Potomac from whence it originally came.

Now, to clarify here, previously I was the director of the District

Department of the Environment. We are joined by Christophe

Tulou. We are very lucky to have you. He is an excellent addition

to service here in the District.

While I was at the Department of the Environment—I have

many of my prior colleagues with me, behind me—we were very

proud to have consolidated and coordinated the lead program for

the District. What used to take five agencies to work we narrowed

to two. What use to be a responsive system—we waited until a

child was poisoned by lead until we could act—now is a proactive

system where we can go out and test and monitor and act in areas

where we think there may be a problem before it happens. That

has been a very positive step, and I know that has continued under

Director Tulou’s leadership at the Department of Environment.

I had the great pleasure of joining what is now D.C. Water in

December 2009. I believe that addressing the threat of lead in

drinking water is one of our absolute top priorities. Make no mistake, lead in water is a public health problem, and we must be active in its solution.

The issues of 2000 to 2004 severely undermined customer confidence in our system and our enterprise, and it is up to us to demonstrate that there should once again be D.C. water here on this

table and everywhere else, because I would argue that it is cleaner

than what we know is in this bottle. But I need you to believe that

more than I need me to believe that. The recent investigation and

studies about CDC suggest that these problems still linger.

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Most important to us is that lead in water and lead as a threat

is preventable. This is a problem we can solve, and this enterprise

that I have joined and am pleasure to be part of is committed.

What about our responses? Initially in 2002, it has been mentioned about the partial lead service replacement. That was not an

optional program. That was a required action by the U.S. Environmental Protection Agency under the Lead and Copper Rule. We

were required to replace 7 percent of the public service lines in any

given year.

The question has always been partial service line replacements.

As information has come forward, we have determined, really all

of us, that partial lead service line replacement does not only not

drop lead in the system in the long term, in the short term can actually cause a spike in lead in the water, in fact, because when the

lead lines are replaced, there is a lot of agitation to the pipes themselves which can dislodge lead into the system and cause a surge.

So as lead in the water, in fact, was reduced because of the

change to orthophosphate in 2004, it became clear that we were no

longer required to do partial lead service line replacements. So we

have eliminated that program. Where we were doing more than

several thousand partial lead service line replacements in a year,

they are still done in the several hundreds in a year. But I want

to emphasize, there are no lead service lines that are replaced for

that reason on the partial basis.

When a water main is replaced in the street, the lines that come

from our customers are no longer the right length because the

water main is not put in exactly the same place. Some will be too

long; others will be too short. So we have replaced those lines not

because they are lead, they just don’t fit the system. So we have

put new lines in.

In some cases if the older line was a lead line, that has the effect

of being a partial lead service line replacement. That is not why

it is done. However, in those situations we communicate with that

customer 6 months in advance, we provide ample information we

believe about what risk there is involved, we offer to do a full lead

line replacement, and will offer funding to lower-income residents.

We will provide free certified-for-lead-removal water filters for

those customers for at least 6 months or until the lead numbers

have gone down below the 15 part action level.

So we have changed our response and are being very proactive

in our protections for our customers.

Thanks so much.

Mr. LYNCH. Thank you.

[The prepared statement of Mr. Hawkins follows:]

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Mr. LYNCH. Mr. Tulou, you are now recognized for 5 minutes for

an opening statement.

STATEMENT OF CHRISTOPHE A.G. TULOU

Mr. TULOU. Thank you Mr. Chairman, Ranking Member

Chaffetz, and my Congresswoman Ms. Norton. Thank you very

much for this opportunity to testify before you today. My name is

Christophe Tulou. I am the acting director of the District Department of the Environment [DDOE].

Lead is among our most nefarious environmental toxins. It steals

our most valued treasure, our children’s potential. Because of that,

there is no safe level of lead in children’s blood, and I can assure

that you getting lead out of their bodies and their environment is

a top priority for Mayor Adrian Fenty and for DDOE.

I would like to take a moment to reflect back on the period 2000

to 2003 and D.C.’s lead-in-the-water crisis. As you know, the House

Science Subcommittee recently completed a report that questioned

the discrepancy between the number of blood lead screenings in

2003 and the numbers in the adjacent years.

Prior to that report, DDOE undertook its own rigorous review of

the data to determine the extent to which children with elevated

blood levels might have slipped through the cracks. I am pleased

to say that we did receive those screening reports and, most importantly, determined that the overwhelming majority of children with

elevated blood levels did indeed receive District services.

Originally we determined that 10 children had blood levels above

15 micrograms per deciliter who may not have been tracked, but

after further analysis we found that 5 had either received the service, did not need the service because their blood levels indeed were

not elevated, or actually their levels had been recorded in our lead

track data base.

Nonetheless, we inspected all 10 properties involved, notified

owners that failed inspection, and we have given those folks 30

days to correct the violations.

Much has happened since 2003. Most importantly, in 2008,

Mayor Fenty signed into law a Nation-leading measure that makes

prevention of lead poisoning a front-burner District policy, building

on our efforts to respond effectively to high lead levels when we

find them.

The District’s new lead law, which has been implemented for just

over a year now, creates vigorous new enforcement programs that,

among other things, makes chipping and peeling paint in a pre1978 home a presumptive lead hazard enforceable by DDOE, thus

shifting the burden to the landlord to prove that deteriorating conditions are safe.

The law consolidates lead enforcement in one agency, that is

DDOE, allowing quick action when a hazard is identified, and it requires landlords to test their property for lead hazards and document the property is cleared before renting that property to a tenant who is pregnant or who has children under the age of 6.

DDOE is also expanding its complaint response for reports of unsafe work practices and property conditions. It is minimizing data

problems by requiring testing labs to submit their results, but also

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to a separate read-only back-up server. By comparing data in these

two places, we will provide improved data integrity.

We are also joining two other jurisdictions around the

country——

Mr. LYNCH. Mr. Tulou, I am not sure what happened to your

audio there. We are losing you.

Mr. TULOU. I am back in service.

We are also joining two other jurisdictions around the country to

include water testing as part of its followup investigation of a

poisoned child’s home, allowing inspectors to advise parents on

ways to reduce risk from lead in the water supply.

We are also reaching out to families with children whose blood

levels are below the usual action level of 10 micrograms per deciliter, and in this case between 5 and 9, to teach them how to reduce home lead levels.

We are targeting proactively the highest-risk areas around the

city for enforcement. So, for example, if a child with an elevated

blood level lives in a multifamily property, the owner-manager of

that property is contacted to ensure lead-based compliance for all

their units.

We are collaborating with local Medicaid officials on data sharing

to ensure that Medicaid children are screened for lead poisoning on

time, a strategy that has lead to double-digit jumps in screening

rates in other jurisdictions.

We are participating in monthly meetings with community members and multiple District agencies to find and implement better

ways to prevent lead poisoning.

Finally, the agency is strengthening its relationship with the District’s Office of Attorney General, resulting in greater focus on and

stronger actions against those who violate the law.

In closing, the District’s leadership on lead issues is truly a community effort, ranging from concerned parents to knowledgeable

and passionate advocates, and enlightened city council members,

and an engaged and forceful Mayor, and, of course, a team of expert and committed DDOE staff, several of whom are with me

today, for whom this is not only a mission, but also their life’s

work.

Thank you again for this opportunity. I will be glad to answer

any questions you may have.

Mr. LYNCH. Thank you.

[The prepared statement of Mr. Tulou follows:]

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Mr. LYNCH. Dr. Silbergeld, you are now welcome to make an

opening statement for 5 minutes.

STATEMENT OF ELLEN SILBERGELD

Ms. SILBERGELD. Thank you very much. Thank you for giving me

the opportunity to provide testimony on this topic and on the

broader context in which this topic arises. As has been noted, I am

professor of environmental health sciences, environmental health

engineering and epidemiology at the Johns Hopkins Bloomberg

School of Public Health in Baltimore, but I am appearing as a private citizen.

I want to cover three specific topics: our current understanding

of health hazards of lead to young children and others; the contribution of lead in drinking water to exposures and toxicity; and

the importance of interventions after exposure to mitigate toxicity

to children.

As you know, there is extensive scientific consensus now that

lead is associated with significant risks to health at blood levels

well below the guidance level set by CDC in 1991, some 20 years

ago.

For adults there are also significant health impacts of exposures

below 10. And I want to stress this, that it is very important to extend our public health purview to adults in light of the serious

health effects of lead exposure that occur after childhood. For children we know that these exposures are associated with problems

in neuro development in children, but in adults they are associated

with increased risks of cardiovascular disease, including increased

risks of death due to stroke at the same levels. We also recognize

that lead-induced impairments in neuro-development in children

that are measured early in life are followed by highly significant

risks expressed in adolescents and young adults, which speaks of

the importance of intervention.

In terms of drinking water, lead exemplifies the importance of

cumulative risk; that is, the importance of considering all exposures in evaluating the significance of any specific exposure. In

fact, as our understanding of lead toxicity increases, we really are

impelled to reevaluate guidelines and standards for all media and

all potential sources of lead. For example, it has been calculated

that a child drinking 2 liters of water per day at the current action

level of 15 parts per billion would exceed a blood lead level of 5

micrograms per deciliter within a year under conditions of frequent

consumption.

Moreover, if we accept the conclusions of research on the toxicity

of lead and reset our guidance to 5 micrograms per deciliter or

lower, we can no longer assume that housing is the main source

of elevated lead exposures, and the risk metric that has been developed by CDC and by a committee that I was part of is no longer

reliable for preventing lead exposure or even prioritizing preventative actions.

As you may know, EPA is currently recognizing the importance

of reconsidering many standards and guidance related to environmental concentrations of lead, most recently with the National Ambient Air Quality Standards for lead in air. I was a member of the

SAB panel for EPA that reviewed the scientific justification for the

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current drinking water standards. The enforceable standard was

set at 15 parts per billion, but it is my scientific opinion that given

what we know now, this current standard is not acceptable, nor is

the current strategy for intermittent sampling and most certainly

the recommendations to consumers that flushing the waterline will

prevent exposure to drinking water lead an acceptable way to prevent exposure.

Now, on the last point, in terms of interventions, lamentably

many children in the United States, particularly, but not only, in

our Nation’s Capital, as well as in other major cities, including my

own, continue to be exposed to lead. Thus, we cannot ignore the importance of considering interventions that can mitigate the shortand long-term impacts of these unprevented exposures.

Clinical and experimental researchers have examined the efficacy

of educational and behavioral interventions for children, expressing

the characteristic impairments of lead toxicity, including

neurocognitive delays, impulsivity, attention deficit disorder and

heightened aggressiveness. Some of this research has been conducted by my colleagues at Hopkins, such as the Kennedy Krieger

School. In fact, this is an approach that has been adopted by parents and in school systems, and, in fact, is one of the focal points

of the CDC lead poisoning program; that is, the delivery of interventions to children with elevated lead exposures. And I am a

member of the advisory committee for the CDC that considers this

topic.

This is a very important response, and if we fail to meet the

needs of lead-exposed children, this will increase the risks of school

failure, learning disabilities and sociopathic behaviors in the next

generation of young adults.

Thank you for your attention. I am ready to answer any questions that I can.

Mr. LYNCH. Thank you, Doctor.

[The prepared statement of Ms. Silbergeld follows:]

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Mr. LYNCH. I now yield myself 5 minutes for a first round of

questioning.

Ms. Arias, thank you very much for your willingness. I know you

had to pinch hit at the last minute when your Director Dr. Frieden

was out of the country, and I appreciate your testimony here today.

To begin, you mentioned in your testimony that as a result of the

lessons learned during the 2000 to 2004 lead-in-the-water crisis,

that the Center for Disease Control instituted an automated surveillance reporting system and required that all data be reported

directly to CDC.

I must confess I was not in place at that time, and I am curious

to know how much of a change that presented to what was going

on previously, and how is that working today? And can you point

to any enhancements or changes that might bring improvement to

that whole system?

Ms. ARIAS. Thank you very much for that question.

The system is not fully implemented yet. We are expecting that

by the end of December of this year, we will have 15 programs who

are submitting their information on a very timely basis directly to

CDC. And by ‘‘timely’’ I mean quarterly reports as opposed to reports on an annual basis, and maybe even longer than that, that

unfortunately in the past had the potential, as it did in D.C., leading to a lag between what was going on in a jurisdiction and our

knowledge of it to be able to intervene.

In addition to the fact that the information is coming in directly

to CDC and more quickly, it is also coming in in raw form, so we

are actually doing the analyses as opposed to having the local programs do the analysis of the data and then submit those summary

results to us. What that means is that we again will have the raw

numbers more quickly and available to detect any significant

changes in a jurisdiction that may require a significant response.

Mr. LYNCH. Let me ask you, what data are you actually collecting?

Mr. ARIAS. Well, we are collecting the results of testing of the

water and then the blood levels in children that are being tested

primarily. So what we are interested in tracking is are there any

changes that are being reported or that are being detected in blood

levels of kids who are being tested in those areas.

Mr. LYNCH. And let me ask you further, the level—there has

been a number of witnesses on the panel as well that have talked

about the standard, how many parts per billion, and there is some

direct testimony that the old standard should be revised to recognize a greater danger, and that the old standard—is it 15 parts per

billion?

Ms. ARIAS. In the water, 15 parts per billion, yes.

Mr. LYNCH. I think Dr. Silbergeld testified that was unacceptable, if I can quote you. Are we still testing at that 15-parts-perbillion level, which was, I think, instituted back in the 1990’s?

Ms. ARIAS. We are testing at that level. There are two levels that

are of particular concern to the CDC. One is the level in the water,

and then the other is the blood level as well, so the 10 micrograms

per deciliter. One of the things that we are going to be—and Dr.

Frieden has already charged the leadership of the National Center

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for Environment Health in ATSTR to work with the advisory committee on lead to revisit both of those levels.

In the case of the 15 per billion, it is a recommendation that we

would make to EPA and others, and then they would have to essentially take that information and make the final recommendation

of what it is, what the standard ought to be.

In the case of the sort of level of concern of blood levels, we are

again sort of going to work with the advisory committee to determine, No. 1, what is the best language to use so that we do not

confuse people and misrepresent or lead to confusion about the fact

that no level of lead is safe. So we are working on both of those.

Mr. LYNCH. Given the timing of this, we are talking about the

crisis that was identified as 2000 to 2004, I also understand that

you are only testing children until age 6. At least that is what I

read. If that is not the fact, you can educate me on that.

Given the nature of the problem here in D.C. and the long time

period, and we are still not getting full compliance with the reporting requirements, wouldn’t it be helpful to continue the testing beyond age 6 to catch maybe some children beyond that age that

might have been exposed earlier?

Ms. ARIAS. The recommendations speak to those ages because

they are at highest risk for the negative health consequences of exposure to lead. However, CDC would be supportive of testing all

kids to make sure that all kids are equally protected from exposure

to lead, and not just those who are at highest risk, along with pregnant women and women who may be breast feeding because of the

infant issues.

Mr. LYNCH. Thank you. I notice my time has expired.

I now recognize the gentleman from Utah Mr. Chaffetz for 5 minutes.

Mr. CHAFFETZ. Thank you, and thank you all for being here.

Ms. Arias, are you familiar with this report by the majority staff

of the Subcommittee on Investigations and Oversight of the Committee on Science and Technology, subcommittee chairman Brad

Miller?

Ms. ARIAS. Yes, I am.

Mr. CHAFFETZ. Dated May 20, 2010. This is such a damning report. It is pretty shocking, the accusations that they throw around

in here at how inept the CDC was. What is your response to this

report?

Ms. ARIAS. As followup to today, we can provide you a more detailed sort of account and side-by-side of what was in the report

and then the actions that we took either prior or in response to the

criticisms that have been raised to improve our work.

One of the things—in general, I think it is the case that we regret the fact that we did not become knowledgeable of the situation

in D.C. any earlier than we did. However, what we have been very

clear about is how we are still confident of the response that we

did when we did become aware of the issue, that it was an appropriate response, it was an adequate response, and it was a response that maximized the safety of children and all others in the

home at that time.

Mr. CHAFFETZ. I am sorry, my time is so short, I have to move

from subject to subject here.

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This is page 2. ‘‘The CDC cannot produce the raw data used in

the cross-sectional study. Both CDC and the District Government

claim they have no records containing the raw scientific data to

substantiate the basis for this study.’’

Ms. ARIAS. The cross-sectional study was not a CDC study; the

longitudinal one was. Both studies were presented in the same dispatch, in the MMWR. So we never had the data for the cross-sectional study. We have tried to get those in order to look at the

analyses that were done and compare and see if they were accurate, but we do not have that.

Mr. CHAFFETZ. ‘‘The subcommittee’s investigation has found that

the number of D.C. children with elevated blood levels in 2002 and

2003 was at least three times greater than the CDC claimed in

2004.’’ Is that accurate?

Ms. ARIAS. That is on the basis of cross-sectional data.

Mr. CHAFFETZ. ‘‘The CDC failed to provide reliable public health

guidance when it published the emergency dispatch based on

known, missing data.

Ms. ARIAS. I will have to provide you with followup information,

because there are a number of different discrepancies that have

been alluded to or that have been pointed out in that report, and

so I will have to look into the exact one that you are referring to

and get you that information in followup.

Mr. CHAFFETZ. Part of it, it says later on page 8, ‘‘There was a

mysterious drop of almost 6,000 in the number of children tested

in 2003 compared to the year 2000.’’

Ms. ARIAS. In the longitudinal study that CDC did conduct, we

did find that there were a number of cases that were missing. We

have since collected that information and done the reanalyses to be

able to provide more accurate information. All of that information

has been then corrected in the MMWR and all the materials that

CDC makes available to the public and other professionals.

Mr. CHAFFETZ. In the conclusion of this report, ‘‘It is inexplicable

that the CDC, the Nation’s premier public health agency, promoted

as credible a report that countered every single piece of research

that outside scientists, the agency and its own advisory committee

had previously issued on dangers of elevated lead levels,’’ and it

continues on.

It can’t get any more aggressive in saying how bogus this is. I

guess we don’t have time to go through the details of this, but this

certainly warrants a very thorough explanation and a side-by-side

analysis. If you are willing to provide that, we would appreciate it.

The contrast in what you are saying and what this report says is

huge. This is not like one little minor difference here. It basically

says the whole report is something we shouldn’t believe in.

Mr. ARIAS. We will provide that to you.

Mr. CHAFFETZ. Thank you. I appreciate that.

Mr. Hawkins, welcome. I like the new logo. I will get one of those

patches for my suit, I guess.

Mr. HAWKINS. Say the word.

Mr. CHAFFETZ. There you go.

Mr. HAWKINS. You said it.

Mr. CHAFFETZ. I will call you. I will call you, yes.

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Let me ask you here, there was an analysis done where there

were 20 different recommendations. Can you give me a sense of

how thorough these recommendations have been implemented?

This was back from the report from Eric Holder. This is a summary

of the investigation reported to the board of directors of the District

of Columbia Water and Sewer Authority, July 16, 2004. There were

20 recommendations. Have they been implemented, not implemented?

Mr. HAWKINS. I will have to get back to you about that specifically, because we can answer 1 through 20, exactly what we have

done on each.

In short, the Water and Sewer Authority—which, by the way, the

legal name has not changed, so that is still the name. This is just

as D.C. Water, as we are doing our part——

Mr. CHAFFETZ. I can appreciate that, yes.

Mr. HAWKINS [continuing]. Has adopted a very aggressive strategy across the board. So the partial lead service line replacements,

as I mentioned, was a required step. We, in fact, are doing advanced monitoring. Any one of our customers that is concerned

about lead in the water can ask for a testing kit, which we will

send them. We will analyze the result. If there are results that

indicate——

Mr. CHAFFETZ. Can you send me one of those?

Mr. HAWKINS. We will send you one of those as well.

Mr. CHAFFETZ. I would love to see the water that is coming out

of the sink in my office, what that looks like.

Mr. HAWKINS. OK. We would be delighted. And if there is an

issue, we will also advise you on what steps to take in response.

Mr. CHAFFETZ. Believe me, I will call you.

Mr. HAWKINS. From soup to nuts. The monitoring we do, in fact,

because we have been under the action level of 15 parts per billion,

we could seek from EPA to reduce the level of monitoring we are

required to do. We have not done that. We think the expanded

level of monitoring that you put in place when there is a problem

is warranted to continue, because we want to make sure we can

demonstrate to our customers that which we believe is true but

want to make sure the numbers demonstrate.

You can see the water monitoring that we do on our Web site,

so we release the monitoring that is done. We are working with advocates to look at all of our materials and communications to make

sure that which we are describing to the customer is true or is as

carefully worded as possible.

As I mentioned, in partial lead service line replacements, if we

believe there is an issue in your home, we will provide you with

the certified lead removal filters for your home for at least 6

months or until we are both convinced that the numbers have gone

below the action levels.

We work with the aqueduct to make sure that from the distribution system, on research, this is board-initiated as well with the

support of the enterprise. Last year, at the end of last year, we did

our own research that revealed a connection between lead in water

and galvanized pipes. That is something we did on our own, we released to the public and are taking steps.

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So one for one on the Holder report, we can absolutely go one for

one. But the story is—this is a serious question. There is more research to be done to know what the level is, the right number. In

our view, the statement the chair said from the beginning, the only

good lead is no lead, and the question is how can it be done in a

cost-effective, thoughtful manner? It is a public health threat, and

we want to be proactive in our response.

Mr. CHAFFETZ. Thank you. I appreciate it.

Thank you, Madam Chair. I yield back.

Ms. NORTON [presiding]. Thank you.

For reasons that are perfectly obvious, I am taking the chair,

pending the full vote for the residents of the District of Columbia.

It will come.

Dr. Arias, just to clear up, before we get to prevention, it is my

understanding that the position of the CDC is the public misinterpreted the 2004 mobility weekly findings. Now, if there was a misunderstanding, what steps has CDC taken to clear up this misunderstanding?

Ms. ARIAS. There are two sets of steps that have been taken. One

is to address the information provided in that document and how

it is that then that information can be used, or how we are encouraging that it be used.

And the other is what we’re doing to rectify processes that led

to those difficulties. On the first hand, what we have done is,

again, identified the information that was not available to us at

that time, have gotten that information and redone the analysis to

make sure that the most accurate information is available. As a result of that, then we have made all the corrections and have put

special notices on all the documents in the MMWR and on our

Internet pages that refer to the original 2004 article and so have

the corrected information there.

We also then contacted all the lead programs in the country with

the updated information to make sure that they understood what

the correct information was.

In terms of processes, again, what we’re doing is improving those

surveillance systems so that we do not find ourselves in a situation

again where we find out about potential or actual increases in either water levels or blood levels of lead from the media or accidentally, after a long period of time of exposure. So that we’re making

sure that we are aggressive both in collecting the information and

then having the program work with the programs and the State

and locals to make sure that the information is being submitted

and that we then analyze it in a timely basis and act appropriately.

Ms. NORTON. Mr. Hawkins, I have a question for you in light of

Dr. Arias’ testimony.

First, I note that you eliminate the word ‘‘sewer’’ from your title.

You’re marketing your agency a little differently, I guess. I can understand that, although I think it could create some confusion with

Mr. Jacobus’ work. And some of us consider your work on sewers

to be of exquisite importance.

So I know sewer can sound like a dirty word, but the fact is that

it is that part of your jurisdiction that some of us up here, especially me, because I am the prime sponsor of the Anacostia River

bill, the comprehensive bill, the first that the Congress has ever

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passed to clean up the river, there are some of us who like the notion of calling attention to the sewers, particularly considering

their effect on the Anacostia River and ultimately on water. But,

you know, I just want you to know that some of us aren’t fooled

by your eliminating sewer from your title.

I’d like to know when CDC first informed you or, for that matter,

Mr. Tulou, of the new findings that children in the homes with partial lead line replacements had four times the likelihood of elevated

blood test levels. When did that occur?

Mr. HAWKINS. My recollection—I’ll have to check, so I can go get

a more specific answer—was 2009. But I can confirm that.

Ms. NORTON. Yes, Mr. Tulou.

Mr. TULOU. And we’re not aware of exactly what that time is either.

Ms. NORTON. Well, we have—that’s the date that’s been given to

us.

And, Ms. Arias, I have to ask you what took CDC so long. You

knew before September 2009, about this misinformation, shall we

call it. Why wasn’t the District notified immediately?

Ms. ARIAS. On the partial line replacement issue?

Ms. NORTON. On lead in the water in 2004.

Ms. ARIAS. CDC was informed of the problem in 2004 by EPA.

As soon as we were informed——

Ms. NORTON. Well, why did the District only learn about this

matter in 2009?

Ms. ARIAS. I’m sorry.

Ms. NORTON. I’m talking about partial line replacements.

Ms. ARIAS. The line replacements.

Ms. NORTON. Yeah—were four times as likely than children in

homes with lead service lines, so that Mr. Hawkins would know

that.

Ms. ARIAS. We did not have that information until much later,

and it was information that—or data through 2006. So it was in

2007 when we did the initial analysis, and then we were

waiting——

Ms. NORTON. You mean CDC only recently had the view that

partial line replacements can, in fact, increase exposure to lead?

You didn’t know that before 2009?

Ms. ARIAS. No, that was a longitudinal study that we did after

the MMWR.

Ms. NORTON. When did you do that study? I remember that in

the early 2000’s there was testimony in this committee precisely of

that matter, that even while WASA was proceeding, there was no

explanation given as to why that would help and why that might

not indeed exacerbate the situation. And you were unfamiliar with

the fact that partial replacement might, indeed, exacerbate lead in

the water?

Ms. ARIAS. I can send you, as a followup, a full detailed chronology of when it is that information became available.

Ms. NORTON. Has CDC informed jurisdictions around the country

about the possible effects of partial line replacement?

Ms. ARIAS. Yes, we have.

Ms. NORTON. When did you do that?

Ms. ARIAS. I can get that information to you.

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Again, there was an initial communication, and then there’s been

a more recent one. I think the first one was in 2009. And then

more recently we have reached out and again and again posted information on our Web and sent out letters to our lead programs informing them of the findings.

Ms. NORTON. Let me ask you, Ms. Silbergeld, and you, Ms. Arias,

is there anything that can be done now that these households have

knowledge that they may have been exposed? Is there anything

that can be done that can remedy the situation as far as they’re

concerned?

Ms. ARIAS. What we are recommending in D.C. specifically is

making sure that children—No. 1, that the water is tested and

making sure that it’s in compliance with the Lead and Copper

Rule.

Ms. NORTON. I want to know—we know the preventative work is

very important, and maybe this is all a case of prevention. I want

to know, if I was pregnant—2 months pregnant in 2002 and I now

have that child, what is it that I should do?

Ms. ARIAS. Contacting a medical professional and getting testing,

No. 1, not only to look at current lead levels in the blood but then

also looking at any potential developmental problems associated

with lead that may be present either in that child or in that adult

woman herself.

Ms. NORTON. Suppose lead is found? Then what? What can do

you to get the lead out? Can you?

Ms. ARIAS. Then some case management, depending on the level,

that would determine the response of exactly what would be done.

But it certainly then would be case management and then continuing to do a very careful assessment of the home and removing all

possible sources of lead.

Ms. NORTON. Ms. Silbergeld, are these parents and children just

out of luck or is there something you know of that could be done

after the fact for such families?

Ms. SILBERGELD. Well, in my testimony I reviewed this in somewhat more detail than I did in speaking. But very briefly, to summarize, I think that it is the opinion of professionals in education,

child psychiatry, etc., who have been dealing with this problem of

children who were exposed to lead, in fact, for most of these children you can’t get the lead out of the body. NIH sponsored a large

clinical trial, of which Hopkins was a participant, to see whether

pharmacologic treatment at lower levels of lead would, in fact, do

anything to reduce lead in the blood and to improve the status of

the child. The answer was no. So what we’re looking at now are

interventions that are targeted at what we know to be the at-risk

outcomes for children with early lead exposure.

And there have been schools and researchers, including the Kennedy Krieger school in Baltimore, which is affiliated with Johns

Hopkins, which have developed specific curricula which speak to

the particular behavioral and cognitive problems that have been

widely described in children with these exposures.

So I would support Dr. Arias’ statement of having a very early

assessment, as early as possible. Because we know, in general, for

developmental disabilities that the earlier that an accurate diagnosis is made and a program is developed that fits the needs of the

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child, the more likely we are to mitigate and potentially remediate

the effects of those earlier exposures. So I think that is an issue

of very high priority; and, in fact, it is a focus of the lead poisoning

prevention program at CDC.

Ms. NORTON. Well, I know Mr. Tulou can perhaps answer this.

There is some kind of targeting focus on homes presumed to perhaps be more vulnerable, have children more vulnerable to lead. I’d

like to know how those homes are selected.

For example, my family and I have lived in a—what we on Capitol Hill call a historic house. You can’t do certain things to these

houses because it was built so long ago. Why wouldn’t the targeting

simply be every child under a certain age, whatever you choose, in

the District of Columbia? And if it is not that, how do you decide

which children should be tested?

Mr. TULOU. Well, actually, the requirement is that every child

under the age of two must be blood tested.

Ms. NORTON. So that means that today, if you—whether you go

to a private physician or deliver as a Medicaid patient, you get

those results, 100 percent results.

Ms. Silbergeld is shaking her head. You say that you don’t.

Ms. SILBERGELD. Well, unfortunately not. That has been the recommendation of the American Academy of Pediatrics, by the CDC

and others, that we should have universal screening. Because, as

you rightly say, there’s kind of a diffuse picture of risk. And living

in an old house such as yours—and I, too, had children in an old

house in Baltimore. I can tell you that there’s lead paint present

and that in any house that has lead paint present there are higher

levels of lead and dust than in a house that does not have lead

paint present, no matter how well maintained it is. Those are studies that we have actually published.

Ms. NORTON. Are you saying that the Federal law does not require universal testing?

Ms. SILBERGELD. The Federal law has been softened so that priority is given to Medicaid children and to other children receiving

services. And, as I mentioned in my testimony, there has been a

risk assessment which was well designed by CDC in 1991 which

focused really on priority to prevent exposure to lead-based paint.

And so then——

Ms. NORTON. All right. Lead from any place it would detect,

though, from any source.

Ms. SILBERGELD. Well, but what happened was the children that

received the priority for screening were, I think as Mr. Tulou mentioned, primarily based on the assumption that the major source of

risk to produce a blood lead in excess of 10 or even 15, which is

the action level in many cities, that was more often than not associated with the presence of lead-based paint.

However, if we become—as I suggested, if we become concerned,

as I think we should, about levels down to the level of five, then

that metric and that risk assessment is no longer fully predictive;

and at that point lead in drinking water, lead in other sources, perhaps, as well become major contributors to the blood lead elevation.

And this is going to be something that I’m sure that Dr. Arias, Dr.

Frieden, and others are going to have to take into account as they

develop new guidance and new recommendations.

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Ms. NORTON. And I understand they’re doing that. They’re developing new guidance.

I don’t understand the screening notion. I can understand the

Medicaid for those who get their health services through the public.

But I don’t understand, since we learned during the health care

crisis—sorry, the health care bill debate, that most people have

health insurance. I don’t understand why you wouldn’t simply say,

just like every child has to be vaccinated, every child has to be tested. Let us say a child below two has to be tested.

Ms. SILBERGELD. That has been said under EPSDT and other

programs, but it has not been enforced as a universal requirement,

to the best of my knowledge.

Ms. NORTON. Dr. Arias, why in the world doesn’t CDC simply

mandate or recommend or whatever you do that every child in the

United States, whether seen by a private physician or through

some other source, be tested for lead? If—particularly if, as I’ve

heard it, prevention is the only cure here.

Ms. ARIAS. Sure. We don’t have the authority to do that. What

we do, however, is make sure that we educate medical professionals to make sure that they do engage in testing parents, etc.

Ms. NORTON. OK. I get sick of CDC. Every time you ask them

something, they tell you, well, they can’t mandate something. I understand that. We’ve been with CDC through a lot of things in this

town, I must tell you. Does CDC make recommendations to public

health authorities as to what should be done? I’m just trying to get

a straight answer.

Ms. ARIAS. Yes, we do; and we do recommend universal testing

for children up to the age of two.

Ms. NORTON. This is, it seems to me, very, very important. This

notion of universality is very important. I don’t know whether you

keep record of it, how often you do it. When’s the last time you

made such a recommendation and looked to see whether or not

people were doing that? Dr. Arias.

Ms. ARIAS. We work with the lead programs to make sure that

they are aware and that they are aware of our recommendations

and work with their coalitions to make sure that then those recommendations get adopted in those local jurisdictions.

Ms. NORTON. I have to tell you, I’m very concerned. Because I

needed to hear, and I have heard, let no lead in the water now, at

least if we use your standard, and I can understand you’re working

on that standard. But if you were pregnant or if you were a young

child, the most we can tell you is to get tested. That means that

a very heavy, a very heavy burden is on the CDC not only to make

a recommendation once in a blue moon but to check to see if this

is being done. And so I would urge in your protocols that you are

preparing that something other than a recommendation that may

be made a moment in time occur.

Yes, Ms. Silbergeld.

Ms. SILBERGELD. Out of respect for my good colleagues at CDC,

who I think have been heroic in these recommendations over the

past 20 years, I think there would be room for some investigation

and oversight of the private insurance sector and some of the State

health programs that are not funding this.

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Ms. NORTON. And who would you suggest do that oversight? Do

you think CDC has any role in that?

Ms. SILBERGELD. No, I think that’s something that has to come

from the Congress.

Ms. NORTON. The Congress can have hearings.

Ms. SILBERGELD. That’s what I mean.

Ms. NORTON. But if, in fact, CDC says there should be universal

testing, well, surely CDC doesn’t say something that it then can’t

ask the jurisdictions to give them some information back up on.

Ms. SILBERGELD. Well, they do; and they do collect data on prevalence of testing. I know my State reports on this, and I think

again that the results are very discouraging. But just as CDC——

Ms. NORTON. Ms. Arias, do you publish these results? Dr.

Silbergeld says that in fact they do give their results to CDC.

Ms. ARIAS. Yes. For example, we know that in D.C. only 45 percent of 1- and 2-year-olds have been tested.

Ms. NORTON. How often do you publish these results?

Ms. ARIAS. I have to see what reports we actually do send out.

I want to make sure that we’re accurate in that.

Ms. NORTON. I wish you’d, within 30 days, tell us how often.

It does seem to us, particularly since, of course, CDC is not an

enforcement agency, it would be important, it seems to me, to make

jurisdictions know they’re on the list by knowing, for example, that

annually these results will be posted. You now have an increasingly aware population, and once they see they’re not on list of people I think they will do our homework for us.

I wanted to make sure I understand Mr. Hawkins and the partial line replacement. This is something that has bothered me for

some time. You gave a very intelligent and rational explanation.

I didn’t understand, though, are you saying that the public portion of the pipe is in any case exposed so you’ve got to replace it

when you are doing other work underground? Is that why you’ve

just got to do it?

Mr. HAWKINS. Right. That essentially is true. When we’re replacing a water main in the street, the new main is very rarely put in

exactly the same place that the old main was located. So if you

think of the street and the main being 2 feet to the left of where

the previous main had been, that means all the lines coming from

either side of the street are no longer the right length to connect

into the main because it’s too close on one side and farther away

on the other. So we have to replace those public lines just to make

them the right length to connect into the system.

For that reason, when we replace a water main—and we’re going

to be doing more water main replacements, not for lead. They’re

old, and they’re breaking, and we need to improve the infrastructure in the city. When we do that, we will replace the lines because

of this location question. When we replace the lines, some of those

lines are lead, which yields a partial lead service line.

Ms. NORTON. I understand that, Mr. Hawkins. And if I understand you to say there’s no way around it, there’s no way around

it. I’m very bothered by the fact that a remedy could have such an

effect. And, of course, you have indicated there are a number of

steps, and I commend you for the steps you have taken. I just wonVerDate 11-MAY-2000 13:52 Feb 23, 2011 Jkt 000000 PO 00000 Frm 00075 Fmt 6633 Sfmt 6633 C:\KATIES\DOCS\62945.TXT KATIE PsN: KATIE
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der whether or not people pay attention, I suppose, is my great

problem.

When it comes to water, there are assumptions made. They

turned out not to be true in 2000 to 2004, and you had the Nation’s

Capital really ridiculed for having a water crisis. We wouldn’t like

to see that happen again, largely because we wouldn’t want families to be put in the position they were. There was something close

to panic in this city at the time, and then they were put to rest.

And now, of course, there’s concern again.

That makes me want to ask Mr. Jacobus about the new chemical

that made us feel more comfortable, orthophosphate. And in light

of Mr. Hawkins’ testimony and the fact that orthophosphate is supposed to be an inhibitor, a corrosion inhibitor, I wonder how effective you think orthophosphate has been since 2004 on what Mr.

Hawkins is doing with respect to partial replacement or, for that

matter, on ordinary lines as they exist today.

Mr. JACOBUS. Sure. Let me just borrow his microphone as a

water line. If this was the water main where my left hand is, the

water that comes from the treatment plant has this chemical,

orthophosphate. What orthophosphate does is, when it passes

through the water line that goes into a house and into the house

plumbing and comes to the tap, a chemical reaction occurs on the

inside of that pipe, and it physically—the chemical and the

orthophosphate compound physically integrates into the wall of the

pipe.

So if that pipe was lead, after the orthophosphate has taken hold

in there and the chemical reaction has accomplished itself, and

that will take a matter of months, and since we’ve been doing it

since 2004, it’s well established in there. From the water’s point of

view, the water going through the pipe, even though the pipe is

lead, the water doesn’t see lead. The water sees this protective film

which is a phosphate coating, and that is the mechanism by which

we can protect the public from having a lead pipe, by changing the

chemical composition of the inside of pipe.

And that has worked extremely well. It works as it goes through

the copper pipes. If you had lead solder in the older homes where

copper pipes are soldered together, it coats those junctions, and it

even coats the inside of faucets which could have some amount of

lead in the machining of those or in the metal fabrication. So that

process working extremely well, as we knew it would. And so we’re

happy with that.

But if you come for a partial service line replacement and you

clip the line here, as Mr. Hawkins said, in the process of doing that

you can shake off this film and you can get little pieces of lead coming through. So you have to take good precautions to the people

using that for several weeks. But then that film will re-establish

itself. So over time you have now a copper pipe or some other metal

that’s joined with the lead. The corrosion inhibitor will repair that,

and it will be OK.

That’s why I said in my statement that we commit—because it’s

the right thing to do for the chemistry and for the public health—

that we will continue to use a corrosion inhibitor indefinitely. So

that as things happen in the distribution system, people jostle

things around or things change or even if someone were to have

73

some illegal solder and solder connections together, we can take

care of that through the water chemistry. So that’s, I think, a good

news story on the technical side.

Ms. NORTON. And, Mr. Hawkins, you do say you inform people

and you inform them a long time in advance. It just makes me very

nervous to think that there is a 1-year-old child or a pregnant

woman, who, during that time when orthophosphate is taking hold,

may, in fact, be contaminated. It’s very bothersome. Although I

must say the only thing that saved the hearings we had before was

that we learned about orthophosphate.

I’d like to know if you’re still using the chloramine to treat drinking water here in the District of Columbia. That was what was corroding, I understand.

Mr. JACOBUS. Right. The chloramine is a secondary disinfectant

that lowers this class of chemicals called disinfection byproducts.

Those are chronic potential carcinogens.

Just to quickly review what we found out after the fact. We did

not know this ahead of time or, obviously, we never would have

done it. Chloramine was a very effective chemical used widely in

the United States to lower the level of disinfection byproducts.

Under the Lead and Copper Rule in 1991 when it was promulgated, by 1994, between Washington Aqueduct and EPA Region 3

had decided upon a technique which would give optimal corrosion

control treatment, and that would be the use of lime to control the

Ph of the water. What we did not know and what nobody knew except looking back a year or so after this was that the chlorine itself

in the distribution system was acting as a corrosion inhibitor, and

when we changed that to chloramine it started chemically eating

away at the chlorine film that had been put there. And until we

could establish a phosphate film, we had that period of time when

we had unknowingly disrupted the corrosion control that had existed on behalf of chlorine. And, obviously, we never would have

done that if we knew the chemistry; and out of all of this came a

lot of thought and a lot of concern. The Lead and Copper Rule was

changed nationally to be more protective. And I think that a very

unfortunate situation. We did react quickly, but there was a period

of time when people were exposed.

Ms. NORTON. So chloramines are or are not still——

Mr. JACOBUS. They are still used.

And what is a little bit confusing about this, ma’am, is that in

the late winter, early spring, annually, we will change the distribution system chemistry to be more effective at killing bacteria that

may have grown in the distribution system, biofilm, if you will, and

by letting it see chloramine followed by chlorine for a period of couple months, it will, sort of like spring cleaning. That again is a very

common practice in the industry.

But throughout all of that we are now using a corrosion inhibitor. Had we been using a corrosion inhibitor, an orthophosphate

corrosion inhibitor in 2000, we wouldn’t be sitting here today.

Ms. NORTON. Yeah. Are there other chemicals used to treat the

city’s water?

Mr. JACOBUS. Yes, ma’am. We add fluoride to the water for dental prophylaxis. We use, well, of course, lime to help change the Ph

of the water to make it less reactive to the orthophosphate. To

74

make the water coagulate, we use aluminum sulfate and, of course,

the disinfectant, the chlorine. We use various versions of

polyaluminum chloride. We use various polymers.

These are all done to either enhance the coagulation and sedimentation or to improve filtration or to do good solid Ph control.

Caustic soda is another agent that we use. All of these chemicals

are certified by EPA for water treatment use.

But back to the couple of comments in my testimony, we have

set up these lead pipe loops. We have pipes that have been harvested from the District of Columbia distribution system. There are

arrays of these in the basement of the water treatment plant on

McArthur Boulevard. We run water through those, and we measure it as simulating the water in a house. And we can see the effectiveness of the day-to-day treatment, but we can also use various

versions of those loops, various—we have seven—actually, 21

pieces of pipe, but that’s OK—that, if we want to change chemistry,

if we anticipate a change, we will run that water in the proposed

chemistry through those pipes and analyze it for a period of time,

look at those results with our own consultants, and then go to EPA

with those results to then have a very high assurance that any

change we make in the future will have been tested on pipes that

water would be expected to see in the District of Columbia so that

there would be no unexpected outcome of a future water treatment

change.

Ms. NORTON. So, please make me understand. Who monitors the

water supply in the District of Columbia?

Mr. JACOBUS. EPA Region 3 is responsible for enforcement of the

Safe Drinking Water Act.

Ms. NORTON. Yeah, but who monitors the water on a monthly

basis?

I mean, for example, Mr. Hawkins, WASA was on the hot seat,

frankly, for not, in fact, informing residents about lead in the

water. And I am confused still about whose job it is to offer this

information. I mean, is it Mr. Tulou’s job? You know, whose job is

it to tell the public the real deal here and how often?

Mr. JACOBUS. I misunderstood what you said about monitor. I

mean, we send the results to EPA, and they look for compliance.

Washington Aqueduct, as do all water utilities, we are responsible

for our own process control.

Ms. NORTON. You sent it to the EPA in 2000 as well and 2001

and 2002 and 2003 and 2004. I’m trying to find out who is responsible for monitoring the water in the District of Columbia and if

there is an issue informing residents about that issue.

Mr. JACOBUS. We share that responsibility here.

Mr. HAWKINS. Yes, Congresswoman, my answer to that is that

both the aqueduct and DC—now DC Water—would share that responsibility.

As you know—and this is part of our proactive strategy—twice

since I’ve been on this job we’ve had to do a limited boil water

alert. We did it as a precaution, but that’s because the monitoring

that we do, which is in addition to the monitoring the aqueduct

does, we now take an—almost an extremely proactive look. If we

see something that we believe could be a threat, we will release

that information. We will take whatever protective steps are necVerDate 11-MAY-2000 13:52 Feb 23, 2011 Jkt 000000 PO 00000 Frm 00078 Fmt 6633 Sfmt 6633 C:\KATIES\DOCS\62945.TXT KATIE PsN: KATIE
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essary. We will go to the public. We will walk door to door, which

we did in both instances. So the aqueduct does actually more physical monitoring events than we do, but we do thousands as well.

It is on our Web site so you can see it.

Ms. NORTON. So WASA would once again have the task of informing residents if, in fact there was some reason, something for

them to know.

Mr. HAWKINS. Yes. We believe we have the responsibility, as the

distributor of the water, to inform our customers. There may be occasions where the aqueduct does as well. But we take that responsibility very seriously on our part and will do it in every way we

can to make sure the citizens know exactly what’s happening as

soon as we know.

Mr. JACOBUS. There are very strict rules in the Safe Drinking

Water Act that require utilities to coordinate with EPA within

hours of any treatment or other event that falls into a whole range

of categories, and then a decision is made very quickly of what kind

of notice should be made.

Ms. NORTON. Mr. Jacobus, I’m not concerned, frankly, that people didn’t find out. I know one thing they didn’t find—the public

didn’t find out for 4 years. I’m concerned about public information;

and Mr. Hawkins has said, as was the case before, it is the job of

WASA. WASA, which had a marvelous reputation, because the

agency had to be rebuilt, until that time, really did much to spoil

its reputation by taking actions that could only be called cover-up

actions.

Now, Mr. Tulou, the public needs to know why it is you, for example, are the lead agency on the lead prevention work and not,

as is usually the case, the public health agency in a local jurisdiction. How did that happen? And what is your——

Mr. TULOU. Well, the key response in terms of dealing with prevention that came out of this experience in 2003 was the realization that we had too many agencies of the District government involved in the process. So if there was a problem it took forever to

actually get some response.

The old way is the Department of Health would receive a report

from a blood test screen. They would make a report to DDOE,

which would followup to check to see whether or not there was a

cause of concern within the home of the child that had the elevated

blood level. And then, if that was the case, then DDOE would send

a report over to DCRA, which is the consumer regulatory administration, to actually enforce.

So what has happened in 2008 with the law that the Council

passed and the Mayor signed is to consolidate all those responsibilities within DDOE. One of the primary reasons for that is that this

is indeed an environmental threat.

Ms. NORTON. And a public health threat.

Mr. TULOU. Well, it’s a public health implication, but if you have

peeling paint in a home or you have lead in the water, then, in essence—and you know there’s no real reason it would have to be an

environmental agency. It just needs to be an agency that is willing

to step up, realize that there’s a problem and take action. We have

been designated that agency.

76

I have to give Mr. Hawkins a great deal of credit for having

made DDOE the kind of agency that can respond as well as it does

to these sorts of things and to the folks sitting behind me who have

made it their life’s work to make sure that we discover where the

problem is and we take action to deal with it.

Ms. NORTON. Dr. Arias, I have another question for you. In light

of your testimony, at page 7, where you say that the rate of elevated blood levels was actually lower when the CDC included the

new evidence, evidence that was not available to you before, did

these findings account for the residents or the households who

knowingly, knowing perhaps that they had lead service lines or

high levels of lead in the water, had switched, therefore, to drinking bottled or filtered water?

There were people who didn’t know. Those were the people who

were particularly panicked. There were others who had switched

because a lot of people were switching during that period to drinking water that we’re told often is the same water that comes to us

out of the pipes.

Were you able to account for those who had switched and therefore might be in the sample as well?

Ms. ARIAS. The information that we added when we did the reanalysis was information back from the initial exposures. We did

have information about who was drinking tap water, but we did

not have information about who had switched to bottled water or

was drinking bottled water.

Ms. NORTON. And there was no way to find that out? I mean, are

those people perhaps in the sample?

Ms. ARIAS. I would have to check with—we would have to check

the raw data. I’d have to check with my colleagues back at CDC

and look at that more closely.

Ms. NORTON. I would appreciate your doing that and providing

information to the subcommittee within 30 days.

Looking again at your testimony, page 8, you indicated that

among the data that was missing in 2004 were results from 100

children, you say, who had elevated blood levels in 2003. How

many of these children were tested for poisoning in 2003, and how

many of them had elevated blood levels?

Ms. ARIAS. The 100 are the ones who, according to those tests,

appear to have elevated blood levels that is above 10. When we

then followed up with the Department in the District, it turns out

that there were five children, I think it was—I don’t remember if

it was—I’m sorry. There were three children who actually had

lower levels than that, were below 10. Ninety-five of the children

did have elevated blood levels between 16 and 28 micrograms per

deciliter. Those 95 children have received appropriate services and

case management so that it was documented that they had received appropriate case management.

There were two children who—one was a resident of the embassy, and we don’t have information about them, although we assumed that they got the appropriate services through their contacts

and their providers, and then there is one child who the Department has not been able to locate and find out what the followup

was after the positive test.

Ms. NORTON. How many total tests of children were taken?

77

Ms. ARIAS. I would have to get that information to you.

Ms. NORTON. Would you, within 30 days, to the chair of the subcommittee.

Some have suggested that—indeed, this is why I asked the earlier question about who monitors, it sounds like it’s self-monitoring.

Is there any reason to believe that there should be some independent oversight of water in the District of Columbia? Independent of

the people who are in charge of delivering it? Dr. Arias. I mean,

would that be a good practice to do in any case?

Ms. ARIAS. All of our lead programs are required to create coalitions of all of the agencies and then interested parties in those districts who have a role and have an interest in the quality of water

and in the whole issue of lead. So we are in favor of providing that

sort of type of oversight. The coalitions essentially are responsible

for reviewing the programs, the activities.

Ms. NORTON. Who’s responsible? I’m sorry.

Ms. ARIAS. The coalitions that are created by the lead programs.

They’re responsible for then essentially overseeing the programs,

making recommendations about changes, working with us in doing

that as well.

Ms. NORTON. Mr. Hawkins, how many partial lead replacements

have taken place in the District of Columbia this year, for example?

Mr. HAWKINS. I will get you the exact number this year. In fiscal

year 2009, the number was about 350.

Ms. NORTON. 350 in 2009.

Mr. HAWKINS. 2009. 2010, I can get you the number.

By way of contrast, when the program was full steam, it was

doing 2,500 partial lead lines a year; and those were done on purpose for the reason of replacing the lead lines, as opposed to as incident with a water main replacement.

Ms. NORTON. You keep saying that Mr. Hawkins, but, in light of

what we know, it doesn’t matter the reason. Because, whatever the

reason, as you earlier testified, you’re going to tell people what to

do——

Mr. HAWKINS. Absolutely.

Ms. NORTON [continuing]. To mitigate the lead issue. So I understand that you at least weren’t doing them in order to control the

lead in the water. Could I ask if, after our hearings in 2004, WASA

continued to do these partial replacements on the theory that it

would control lead in the water?

Mr. HAWKINS. WASA continued doing partial lead replacements.

I actually do have the letter from the CDC informing us of the

study you mentioned. It was in September 2009—it was September

2008 when the Board of Trustees, because there had been a board

level resolution to do—to support this program which had initially

been a requirement of the Lead and Copper Rule by U.S. EPA. So

the initial response——

Ms. NORTON. You regard it as a requirement today?

Mr. HAWKINS. It is not a requirement today. Once the sampling

that had been done showed that the numbers of lead in water had

gone below the action level for a period of time, then EPA removed

the requirement that we had to do partial lead service line requirements. When they removed the requirement, we had all this new

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information showing that it was not working, in fact was not

achieving its desired goal.

Ms. NORTON. Well, what made EPA think it was working?

Mr. HAWKINS. Pardon me?

Ms. NORTON. If EPA was mandating partial replacement, on the

basis of what scientific evidence were they proceeding?

This is very troublesome. We had some problems on the national

level with CDC. Now you tell me the EPA said do partial lead replacements, which is something that almost common sense would

have told you if you knew anything, as, of course, as professionals

do, might lead to leaching or leaking of lead. Can anyone tell me

what the source of that recommendation was in the first place, to

do partial lead replacement—I mean partial pipe replacement.

Mr. JACOBUS. Well, I can speak not to the theory behind it, but,

in fact, in the Lead and Copper Rule, if a system exceeds the 90th

percentile of 15 parts per billion, which is the action level threshold

on the Lead and Copper Rule, in addition to public notification it

must begin a partial system replacement of 7 percent, I think, of

the lines per year until the system achieves compliance of the hundred samples taken in a 6-month period, the 15 parts per billion.

So it was a formula worked out in the Lead and Copper Rule to

cause a system to begin to replace service lines, if only partially

and, at the same time, to re-establish corrosion control.

Now, the scientific theory behind that I cannot speak to.

Ms. NORTON. Ms. Silbergeld.

Ms. SILBERGELD. Yes, I was on the SAB committee, and I’m

afraid it was a political science consideration more than an engineering science. It had to do—and I think you spoke to this as well.

Part of this problem is because the sources of lead can be within

private property and within public property. And at the time of the

evaluation of recommendations to EPA for the Safe Drinking Water

Act in the Lead and Copper Rule there was a reluctance to try to

engage the political issues that would arise if recommendations

were made that the private sector of the lead line might have to

be replaced as well.

Ms. NORTON. If I could just finish this question, but did they

know at the time that if you did only replacement of one part of

the line that would perhaps be harmful and therefore why recommend any replacement?

Ms. SILBERGELD. I don’t think that it was clearly known that

partial replacement would potentially actually increase levels.

There was some sense that any reduction of lead in the system

would tend to reduce levels of lead overall. So that was not an

issue of scientific knowledge or assumption. But the main driver,

I would have to tell you, based on my recollection, was political

rather than scientific.

Ms. NORTON. Thank you very much, Mr. Chairman.

Mr. LYNCH [presiding]. I thank the gentlelady. I appreciate you

taking over the responsibilities of the chair during votes. It helped

us, I think, utilize our time well.

I had a number of questions here, but I think in my absence we

were able to ask a few of them, so I don’t want to—is this OK? All

right.

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Based on testimony that was given earlier today, as I understand

it, the CDC has taken issue with the fact that the District only

tests approximately 38 percent of children so far. And this sort of

relates to my earlier question about is it smart, given the history

here, to only test children up to age six? Obviously, given the history, we’d like to see 100 percent of the kids tested, children tested.

How do we get there and how close are we to getting where we

need to be?

Ms. ARIAS. As I mentioned earlier, we know that only about 45

percent of the kids even between the ages of one and two, who are

at the highest risk, are being tested. One of the things that we’re

doing is working very closely with the District to make sure that

enforcement of that law for universal screening in that age group,

No. 1, is being conducted. The reason for starting with the highrisk kids is the obvious reason. We want to make sure that they

are optimally protected.

However, in addition to them making sure that kids who are at

the highest risk are tested, we want to make sure that others as

well. So even going up to the age of three, especially a child who’s

3 years old and has never been tested, making sure that child is

tested, catching them again before they enroll either in daycare or

at school and making sure that they get tested at that time.

Mr. LYNCH. Ms. Arias, what puts a child into a high-risk category?

Ms. ARIAS. The age, No. 1. And given that they are most likely

to suffer significant health effects as a result of even low exposures

or any exposure associated with lead, again, because their brains

are still developing so rapidly during that time.

Mr. LYNCH. I understand. I guess it’s the risk of exposure is what

I’m getting at. Prior to being a Member of Congress, I actually did

a lot of volunteer legal work for—in public housing. Basically, I

grew up in the housing projects and ended up representing a lot

of the families that I used to live with, you know, and they had

lead paint. They had asbestos on the pipes. Some of the housing

was substandard, to say the least. And are we targeting any populations like people, families that are in public housing, older public

housing developments that might be at greater risk?

Ms. ARIAS. We are targeting them through various—in various

ways. One of the things that we are working very hard to do is

making sure that those homes get assessed very carefully, looking

at all sources of lead. So looking at water, looking at air quality,

looking at other kinds of things that also may increase exposure to

lead in those homes.

Mr. LYNCH. OK. But, right now, we’re only getting 38 percent.

So do we have a plan in place? Is that a goal? Are we testing 38

because we’re looking for a sampling?

Ms. ARIAS. No, the only reason 38 are being tested is because we

have to step up and make sure that individuals who should be

doing the testing are going to do it, children who should be tested

are going to be tested. So it’s a matter of providing both the education and the oversight to make sure that the laws that are in

place, the regulations that are in place are being enforced and are

being carried out.

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Mr. LYNCH. OK. Let me ask, Dr. Silbergeld, you raised some concerns around this same area. What’s your read on this in terms of

our inability to really get a more complete assessment of the risk

to these children?

Ms. SILBERGELD. That is a very complicated question. I’m glad

you’re pursuing it.

As pointed out, CDC has consistently made the recommendation

for universal screening; and I also would note that I think your

questions about extending the point of screening beyond six is

something that should be taken under advisement by CDC as well.

The problems really arise that this is actually implemented on a

State level. The funding through national health programs is limited and, therefore, its decisions that are made on the basis of

health priorities by various States. At present, relatively few

States, I believe, Dr. Arias, have actually legislated universal

screening. My State is one of them. We’re not achieving that yet

either. And a lot of it does involve speaking with the health care

community, private and public, in terms of insuring that this message goes out. But this is an issue, I think, of the very highest priority, and anything that can be done to stimulate more attention

to this, I think, would be very welcome by everyone in public

health.

Ms. NORTON. Mr. Chairman——

Mr. LYNCH. I’m just about done, so I would yield to the

gentlelady.

Ms. NORTON. I just have a question just to followup your question.

While you were gone I don’t think I had heard that 38 percent

number. The chairman’s question about 38 percent made me wonder why in the world the District has such a low number, especially

in light of the fact that it was here that you had a national leadin-the-water crisis where you would have expected us to have a

larger number tested for paint and for water and wherever lead

comes from.

Ms. SILBERGELD. Well, actually, I must say, taking a national

view—and one of my students has just reviewed this. I’m sorry to

say this as an American, but that’s at the upper end of prevalence

of testing in the United States. There are some States where we’re

down around 10 or 15 percent.

Ms. NORTON. Well, this is what I want to know. We’re supposed

to have universal testing here, and we can only get to 38 percent.

Ms. SILBERGELD. Well, we’re supposed to have universal vaccination, and we don’t get that either. So we have, you know, these are

the problems of delivering health.

Ms. NORTON. Mr. Tulou, we had the crisis, and we got 38 percent. I think it sounds awful—I don’t care compared to whatever—

and I’d like to know why we don’t have a higher figure than that.

Mr. TULOU. And I think the point’s very well taken.

We in the District, by the way, do have a law that requires testing twice of young children before they’re the age two.

One of the things I mentioned in the testimony that we’re doing

is working with Medicaid officials on some data sharing, which will

help us to make sure that Medicaid children are at least getting

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their testing on time which in other jurisdictions has led to very

significant increases in that screening rate.

But it’s like a lot of other mandates. If there is a reluctance on

the part of the health providers to do this, for whatever reason, you

would think the health officials would be the first ones to want to

test their patients for these things. It creates somewhat of a problem, and it’s obviously something we’re aware of, and we’d like to

improve those numbers as well.

Ms. SILBERGELD. Just one other point. I believe that the city of

Providence instituted a program whereby children had to present

evidence of having been tested for lead prior to school entry, including preschool. And that has had a dramatic effect on increasing the

rates of testing. So there are other actions that can be taken by jurisdictions. Again, not something that CDC mandates but ways of

linking this in a very real way to the risk of school failure.

Mr. LYNCH. That may be the answer right there. Thank you.

That’s very helpful.

Madam Chairman, I’ll yield 5 minutes to you, if you like.

Ms. NORTON. Mr. Chairman, I’ve gotten to ask all of my questions and even some of yours. Thank you very much.

Mr. LYNCH. And again, Mr. Tulou, the lack of compliance, if

we’re looking for universal testing, where is the logjam here? If

we’re at 38 percent, is it because we’re not making families aware

or we’re not making providers aware? Where are we falling down

on this?

Mr. TULOU. I think it’s—we have a fairly considerable amount of

effort going on to make the health care providers aware. What we

have found in our experience is that they sometimes, for whatever

reason, don’t particularly want to listen to us in this regard.

I think there is general authority under the law for the District

to enforce against those who are not providing the screening. I

don’t think that has been rolled out and has not been used. Certainly we’re open to other ideas to find ways to encourage these

tests to happen.

If it relates to entry into school, I think part of the downside of

that is that kids are already well beyond their second year of age

by the time that they’re looking for entry onto school or preschool

programs. But certainly that would be a way down the line to find

out whether or not that testing had occurred.

Mr. LYNCH. You would think, though, that newborns, you know,

just checkups in those very early months and years, that, given the

circumstances here, we had a crisis from 2000 to 2004, so this isn’t

just a general population. This is a population that we’ve already

identified as having some considerable risk, and the exposure possibilities are there. So now we’re responding to that by trying to

institute this testing.

You would think there would be a greater urgency among providers to make sure, whether it’s a health center, community health

centers, you know, see a lot of these children, whether or not

they’re aware of this and are taking the opportunities to test these

kids when they do come in. You know, I’m just not sure where the

gap is.

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Mr. TULOU. Well, Mr. Chairman, I’m dumbfounded, given the experience that D.C. had back in that period of time, that this isn’t

much higher on providers’ list of concerns.

I have to say, for kids who tend to be at highest risk, there are

a lot of other health issues that providers are dealing with them

and their families on. But I can assure you that we’re going to go

back, and we’re going to take a look at those numbers, and we’re

going to find a way to bring those numbers up.

Mr. LYNCH. Yeah. You know, I do agree with the doctor that

making it a condition of enrollment in school is one way. But, as

you pointed out, considerable time goes by that there may be damage being done.

Mr. TULOU. Let me say just another thing that I mentioned in

my statement is we are being very proactive. We are identifying,

through a combination of GIS and places where we’ve noticed high

blood levels in the past, to find hot spots in the District; and we

are going to those properties and making sure that those owners

and managers of those properties are inspecting their units for hazards.

Also, now, we are, when we respond to an elevated blood level

and we’re inspecting a home, we’re also checking the water.

So, in other words, the bottom line here is there are a lot of different ways that a child’s blood level could be high for lead. We

don’t want any of those opportunities and any of those ways of introducing lead into their systems to go unchecked.

Historically, of course, peeling and flaking paint was an obvious

one. The law now says that if that is happening in a pre-1978

home, it is assumed that is a hazard and so it’s up to that property

owner and that manager of that property to prove to us that it’s

not. So we enforce against them and we make sure that those

cleanups are done.

But by adding the water monitoring to the other environmental

checks that we do within those homes it’s going to give us a helpful

check to what the aqueduct and what George is doing at WASA on

whether and to what extent water is a part of that situation.

Ms. NORTON. And, Mr. Chairman, could I——

Mr. LYNCH. Please.

Ms. NORTON. Just following up on your 38 percent question,

when my children were born and you have to take children to the

hospital—I mean, to the doctor all the time in those years, it’s

mandated and people do it. I didn’t remember knowing to ask the

doctor what things John and Catherine Norton should have to immunize them. That wasn’t from me. It was from him.

He would say, Ms. Norton, you are due in 2 months for this child

to have X, Y and Z vaccination.

Why does the District of Columbia Act solve this problem by saying to health professionals, this is on your list to tell a family it

is required. Now, we know you can refuse certain kinds of vaccinations, and we get in a lot of trouble for that. But why isn’t that

simply added to the list of shots—shall I call them—like the polio

shot, all the rest of them, diphtheria, all of that, and lead in the

water, particularly because the District of Columbia has had an

issue on that?

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Mr. TULOU. And it is on the list, and that is why I am mystified.

I don’t know why the physicians aren’t requiring those tests to be

done for those children.

Ms. NORTON. I guess you don’t know then whether the other

tests are being done either, because if it is on the list, you now

scare me.

Mr. TULOU. I think that is right. And if I were a parent of a child

going to a doctor, I would want to know what is on the list, and

then I would ask the provider.

Mr. LYNCH. Reclaiming my time, now may I ask Mr. Hawkins

and Mr. Jacobus if you could just amplify around this point that

we are talking about? Was there any effort to do a public communications campaign, radio, TV, on the Metro or anything, to say you

need to be testing your child; given the history we have had here,

you need to be making sure that your child within these ages needs

to be tested for lead levels?

Mr. HAWKINS. We have done very extensive outreach about lead

in water and what is the risk factors. One of the areas that we

share with the department of environment is trying to be proactive

in profiling where the problem is most likely to exist so we can

focus our resources most intently; identifying either neighborhoods,

streets, types of buildings, age of buildings, where should we focus

our time. But to all of our customers, in all of what we distribute,

we have information about the risk of lead in water.

I don’t think, although I will check, that we have included recommendations on getting tested lead in blood for children, and that

is something that is a good idea that we could add, because we do

regularly communicate, unlike many other agencies—because we

send a bill, we communicate with our customers every month; that

we can add that, and that is a good idea.

Mr. LYNCH. That would be helpful. If you could make sure you

communicate with the committee and Ms. Holmes Norton on what

we are going to do on that. I would like to redouble our efforts and

see if we get that number up from 38. I know ironically, Doctor,

you are probably right; it is higher than elsewhere, but not nearly

where we need to be.

Mr. Jacobus, anything you could add on this?

Mr. JACOBUS. I would add, sir, that our role is to make sure that

the treatment of the water is meeting the standards that we have

set for ourselves. We meet with our customers, the District of Columbia Water and Sewer Authority, Arlington County and Falls

Church, regularly in various forums. We have a monthly water

quality meeting, and we review the treatment chemistry, we review

the data back and forth so we are aware that the quality of water

getting to them is meeting a specific standard.

We do not speak directly to the retail customers, but we are very

active in making sure that amongst the wholesale customers, everybody knows where the water is. If anybody has any concerns,

we discuss those to make adjustments to make sure they are getting exactly what they want and stuff that exactly meets the drinking water standards. So we are very much open, proactive, and

communicating all the time with our customers.

Mr. LYNCH. Thank you.

Doctor, I know you wanted to add something.

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Ms. SILBERGELD. I think it would be useful for someone to survey

insurance companies to find out how many of them actually reimburse for lead testing.

Mr. LYNCH. That is a great point.

All right. Well, I think you have suffered enough. I want to

thank you for your willingness to appear before the committee and

help us with our work. As normal, we have several hearings going

on at the same time, so I am going to leave the record open for 5

legislative days so that Members, if they would like, can submit

questions to you all.

Thank you very much for your help in addressing this problem.

We will continue to be in touch with each of you. I want to thank

you for your testimony here today, and I wish you good day. Thank

you.

This hearing is now adjourned.

[Whereupon, at 4:09 p.m., the subcommittee was adjourned.]

[The prepared statement of Hon. Gerald E. Connolly and additional information submitted for the hearing record follow:]

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