Centers for Disease Control

and Prevention

National Institute for Occupational 

Safety and Health

Reducing Workers’ Lead Exposure 

during Water Service Line Removal 

and Replacement 

Introduction 

Workers who replace lead water service 

lines may be exposed to lead pipes and 

lead-contaminated soil while removing 

the old water lines and replacing them 

with lead-free lines. The United States 

Environmental Protection Agency (EPA) 

estimates that there are between 6 and 

10 million lead water service lines in 

the United States [EPA 2019]. Lead water service lines may be in the walls of 

structures or underground [EPA 2022; 

Lee and Lunney 2021] and may supply 

water to businesses, schools, childcare 

facilities, and residential homes. Infrastructure legislation has made funding 

available to improve municipal water 

systems and protect public health by replacing lead pipes [White House 2021]. 

Increased efforts to replace these lines 

may result in an increased risk of worker exposure to lead-contaminated pipes 

and soil. This document provides information about occupational lead exposure and recommendations for protecting workers’ health during lead pipe 

replacement.

Lead Exposures 

during Replacement 

of Service Water Lines

Workers potentially exposed to lead 

during replacement of lead water service lines include managers, line supervisors, and field workers who service 

water utilities (such as from plumbing companies, water utilities, and 

construction firms). Workers may be 

exposed to lead if they work in excavated pits, cut and handle lead pipe 

and equipment, or prepare to pull the 

lead line or disconnect the service line. 

Workers may also be exposed to leadcontaminated soil during excavation using heavy equipment such as a backhoe 

or manual digging using shovels [NIOSH 

2021c].

Replacing a lead residential or commercial service water line may involve 

the following steps [NIOSH 2021c]:

 Excavate soil and create trenches using a backhoe and shovels. 

 Use the trenches to find the connections between the main line, the curb 

stop (shut off valve), and the home 

or business.

 Shut off water supply to the home or 

business and disconnect/cut the lead 

service line. This may generate lead 

dust [Koh et al. 2015].

 Connect a new copper service line 

to the old lead line and pull the line 

through the soil. 

 Disconnect and remove the old lead 

line and reconnect the new copper 

line to the water main line. Test for 

leaks. On occasion, a steel cable is 

threaded through the inside of the 

lead line and pulled (using the backhoe bucket) to remove the line. The 

rope is then attached to the steel cable and pulled through. The process 

is repeated until the line is removed, 

and a new copper line is in place. A 

licensed plumbing contractor makes 

the final connection to the home or 

business. 

 When the line replacement is complete, backfill soil and gravel into each 

excavation and repair the road surface/curb/sidewalk. This last step may 

expose workers to lead if the soil is 

contaminated. 
2

In some communities, it may be acceptable to install a new 

service line adjacent to the old lead line and leave the old 

line in its original location undisturbed. This will minimize 

worker exposures to lead. However, the acceptability of this 

installation technique may vary regionally, and is often dependent on soil type, the presence of existing underground 

structures (e.g., other pipes, electrical conduits), and concrete streets and sidewalks in urban municipalities.

Lead Health Effects

Lead is considered toxic to all organ systems and serves no 

useful purpose in the body. The routes of exposure for lead 

are inhalation, ingestion, skin, and/or eye contact. Lead particles or fumes could be inhaled (breathed in) during certain 

work operations; swallowed if they are on a person’s hands 

while a person is eating, drinking, or smoking; or absorbed 

through the skin [NIOSH 2023c]. 

Long-term exposure to lead at work can affect the nervous 

system and has resulted in decreased performance in some 

tests that measure nervous system function. Lead exposure 

may also cause weakness in fingers, wrists, or ankles. Lead 

exposure may also causes small increases in blood pressure, 

particularly in middle-aged and older people. Lead exposure 

may also cause anemia. At high levels of exposure, lead can 

severely damage the brain and kidneys. High levels of exposure can result in decreased fertility in men and women, and 

miscarriage [ATSDR 2020a].

For more information about the health effects of lead, see 

the public health statement and toxicological profile on lead 

from the Agency for Toxic Substances and Disease Registry: Public Health Statement for Lead and Health Effects of Lead 

[ATSDR 2020a,b]. 

Take-Home Lead Exposures

Take-home lead exposure occurs when workers are exposed 

to lead at the work site and unknowingly carry the lead into 

their homes on their skin, clothes, shoes, and personal items 

(keys, phones, or lunchboxes) [NIOSH 1997b; 2019b; Piacitelli et al. 1997; CDC 2012]. Personal vehicles can also become contaminated with lead. Exposure to take-home lead 

is hazardous to children and other household members. No 

safe blood lead levels (BLLs) have been identified for children [CDC 2022b], and the Centers for Disease Control and 

Prevention (CDC) considers a BLL of 3.5 μg/dL or higher 

in a child to require public health action [CDC 2022a]. Depending on the BLL and the jurisdiction, public health action 

might include giving information about sources of lead exposure, investigations to identify and address sources of exposure, or clinical care and intervention. In children, lead exposure has been associated with developmental and neurological 

disorders [CDC 2022a]. Visit Lead in Jobs, Hobbies, or Other 

Activities for a list of jobs and tasks that may result in lead exposure [CDC 2022c].

Lead Occupational Exposure 

Limits and Reference Levels

To protect workers from lead exposures and reduce related 

health effects on the job, both the NIOSH recommended exposure limit (REL) and the Occupational Safety and Health 

Administration (OSHA) permissible exposure limit (PEL) 

are 50 micrograms per cubic meter of air (50 μg/m3) as an 

8-hour time-weighted average (TWA). 

Lead exposure is also covered in the OSHA lead construction standard, which applies to all construction work where 

a worker may be exposed to lead: 

 Demolition or salvaging of structures where lead or materials containing lead are present

 Removal or encapsulation of materials containing lead

 New construction, alteration, repair, or renovation of 

structures, substrates (or portions thereof), that contain 

lead, or materials containing lead [29 CFR 1926.62]

An OSHA action level (AL) refers to worker exposure 

(whether or not respirators are used) to an airborne lead 

concentration of 30 μg/m3 calculated as an 8-hour TWA. If 

an exposure reaches the AL, the employer must take action 

and implement exposure control measures. 

Recent research has indicated adverse health effects in adults 

at levels that are lower than those previously documented 

[NTP 2012; ATSDR 2020b; OSHA (Lead Health Effects page)]. 

Measuring lead in blood is the most effective method to detect and assess exposure. The most up to date BLL for workers is the value used by the NIOSH Adult Blood Lead Epidemiology and Surveillance (ABLES) program. The ABLES 

program defines an elevated BLL as 5 μg/dL. For more information about BLLs, see the BLL Reference Guide [NIOSH 

2021b].

Case Study of Lead Exposures 

from Water Pipe Replacement 

In 2019, NIOSH conducted a Health Hazard Evaluation 

(HHE) (Exposure to Lead during Residential Water Line 

Replacement Activities) among city water department employees who were replacing lead water lines servicing residential homes. The evaluation identified potential lead exposures via inhalation and ingestion among these employees 

(see Figure 1).
3

Figure 1. Photo taken at the HHE site.

Before the NIOSH evaluation, workers underwent BLL testing through their employee health services program. Two 

workers’ blood test results indicated they had elevated BLLs 

(a BLL ≥ 5 μg/dL, the reference BLL for adults in the United States) [NIOSH 2021b,c]. NIOSH staff performed an exposure assessment among eight workers on two crews that 

worked 8-hour shifts. NIOSH collected personal air samples 

from workers and collected wipe samples from some workers’ hands and various surfaces (truck cab components, handheld equipment, etc.). Lead was found on workers’ hands, inside work gloves, and on surfaces inside trucks and inside 

the locker room. None of the air sampling results were above 

the occupational exposure limits for lead (NIOSH REL and 

OSHA [AL/PEL]). NIOSH also conducted medical interviews and observed work practices. They learned about and 

observed inadequate hand hygiene practices, improper use 

of lead removal wipes, and incorrect respirator use. These 

findings illustrate the significance of minimizing routes of 

exposures other than inhalation. 

Recommendations to Reduce 

Lead Exposure in Workers

Employers and workers should take the measures outlined 

below to reduce occupational exposure to lead during water 

pipe replacement. 

Reducing Lead Exposure 

The hierarchy of controls states that the most effective ways 

of controlling a hazard are elimination or substitution (with 

a less hazardous substance) [NIOSH 2023a]. Although removing lead water pipes eliminates the hazard for future exposures, the process of removing the lead water lines has 

the potential for lead exposures. Since eliminating or substituting the lead during service line removal is not possible, the next most effective method is controlling the hazard 

at its source through engineering controls. Worker exposure 

can also be reduced through administrative controls (e.g., 

limiting the length of exposure). Lastly, personal protective 

equipment (PPE) is at the bottom of the hierarchy of controls and is used when a hazard cannot be controlled by other means.

What Employers Can Do

Employers should reduce workers’ exposure to lead through 

the following [NIOSH 2019b, 2021c, 2023b; 29 CFR 

1910.132(d)(1); OSHA lead overview]:

 Develop a written lead-monitoring and control program, 

a hazard communication program, and a job-hazard analysis for tasks that may involve exposure to lead. 

 Monitor airborne exposures and ensure compliance with 

the OSHA lead standard.

 Engineering controls: 

— Provide portable high efficiency particulate air 

(HEPA)-filtered vacuums to clean up vehicles in 

the field, in addition to regular cleaning of work vehicles. 

— Provide and use tools that produce less dust. 

 Work practices:

Training

— Provide proper training regarding lead hazards 

and work practices when hiring a new worker. Provide refresher training annually for all workers including maintenance, cleaning staff, and others 

who may come in contact with lead-contaminated 

equipment, vehicles, or work areas. 

— Train workers on methods to keep hands clean. For 

example, wear appropriate disposable gloves (e.g., nitrile) and use a lead-removal soap or wipe, or hand 

cleaner after working with lead pipes.

— Train workers on the use of cutting techniques that 

produce less dust (e.g., using a pipe cutter versus a 

saw).

— Train workers on methods and PPE necessary to 

handle HEPA vacuum filter changeouts and disposal of contaminated vacuum contents.

Photo by NIOSH
4

Hygiene and housekeeping

— Require workers to follow hygiene practices pertaining to lead.

— Inform workers about potential take-home lead contamination and the risks associated with lead exposure among household members.

— Ensure that lead-removal wipes and handwashing 

stations are available onsite (e.g., in the field and at 

the water department facility) for all workers especially before eating, drinking, or smoking.

— Ensure that bathroom facilities include sinks and 

lead-removal soap.

— Provide a locker room (or lockers), showering facilities for workers, and laundry facilities or services when possible. 

— Provide lead-removal soap (or lead-removal wipes 

when no lead-removal soap and water are available) 

in the employee locker room, as standard soap is not 

adequate to remove lead residue [NIOSH 2023b].

— Prohibit the use of contaminated equipment on 

other jobs/tasks not related to water line replacement.

— Stock work vehicles with proper materials for decontamination and exposure control in the field. 

Include appropriately labeled waste bags, cleaning 

materials, and disposal-collection bins for workers 

to use at the work site.

— Develop and implement clean-up procedures that 

prevent lead dust from contaminating the workplace, 

work or personal vehicles, and equipment:

» Wipe down surfaces using wet methods while 

wearing appropriate PPE (gloves) to prevent dermal absorption.

» Clean cable tools and equipment that have been 

in direct contact with lead pipe using an appropriate lead removal solution. 

» Develop a cleaning schedule to clean “highcontact” surfaces (e.g., locker handles, doorknobs, 

truck cab surfaces, tools, etc.) using lead-removal wipes or lead-removal soap.

» Prohibit the use of compressed air to remove lead 

from any surface unless it is used in conjunction 

with a system to capture airborne lead [29 CFR 

1926.62(h)(5)].

Testing

— Provide lead exposure surveillance monitoring (BLLs) 

for workers and monitor the results in accordance 

with the OSHA lead construction standard. The Association of Occupational and Environmental Clinics and 

American College of Occupational and Environmental Medicine have additional recommendations for testing 

and managing lead-exposed workers.

— Consider purchasing colorimetric wipe test kits and 

periodically test hands, surfaces, and tools for lead. 

Periodic tests will help identify potential sources of 

exposure and provide an indicator of the effectiveness of decontamination techniques, equipment, and 

personal hygiene cleaning efforts, as well as workers’ 

use of PPE.

 PPE

— Provide training for workers on how to properly 

use, store, and maintain PPE, including respirators 

(if they are required). 

— Provide appropriate PPE (such as gloves, coveralls, 

eye protection, and respirators) at no cost to workers [29 CFR 1910.132 and 29 CFR 1926.95; OSHA 

2017].

— Encourage frequent exchange of work gloves, especially if they are worn or heavily soiled.

— Ensure that nitrile gloves are replaced if they become torn or loaded with soil or other debris. 

— If a job hazard assessment indicates that respiratory protection is required, implement a respiratory 

protection program that complies with the OSHA 

construction respiratory protection standard, 29 

CFR 1926.103, including training, fit testing, and 

medical clearance. 

What Workers Can Do

Workers should take the following steps to reduce their exposure to lead:

 Work practices: 

— Through your employer or physician, take a test each 

year to monitor your BLL, or as frequently as required by OSHA. 

— If your family may have been exposed to lead from 

your job, contact their healthcare provider [CDC 

2022c].

— Clean surfaces (truck cab surfaces, tools, doorknobs) 

and equipment periodically throughout the workday 

and at the end of the shift. Use lead-removal wipes or 

lead-removal soap.

— Avoid bringing personal items such as keys, water bottles, or phones into lead-contaminated areas. 
5

— Avoid visiting office areas while wearing potentially 

contaminated clothing/footwear.

— Use lead-removal soap (or lead-removal hand wipes 

if soap is not available) after completing work and 

clean-up activities, before eating, drinking, or smoking, and before getting into a vehicle.

— If showers are available, shower to remove residual 

lead dust before leaving work.

» If showers are not available at work, wash as 

much of your skin as you can with lead-removal 

soap before going home.

— Change into clean clothes and boots before leaving 

work. Leave soiled clothing at work for laundering.

— If clothes are not washed at the workplace, follow 

these steps:

» Store work clothes in a closed plastic bag away 

from all other clothes.

» Wash and dry work clothes alone and not with 

any other clothes. Use a lead-removal detergent.

— Store street clothes separately from work clothes, both 

at work and at home.

 PPE: 

— When the job hazard assessment requires the use 

of a respirator, wear a respirator properly and in 

accordance with the OSHA respiratory protection 

standard when working directly with lead-contaminated soil or pipes. (Filtering facepiece respirators 

and elastomeric half mask respirators with N95 level protection are examples [NIOSH 2019c]*

.)

— Wear nitrile gloves under work gloves when cutting or handling lead pipes and change both sets of 

gloves frequently, especially if either set of gloves 

becomes heavily soiled.

— Replace nitrile gloves if they become torn.

Acknowledgements

The authors would like to acknowledge the external reviewers of this document, including the American Water Works 

*

Elastomeric half mask respirators are also referred to as elastomeric half 

facepiece respirators. The selection of N-, R-, and P-series filters depends 

on the presence or absence of oil particles, as follows: if no oil particles 

are present in the work environment, use a filter of any series (i.e., N-, R-, 

or P-series). If oil particles (e.g., lubricants, cutting fluids, glycerin, etc.) 

are present, use an R- or P-series filter. Note: N-series filters cannot be 

used if oil particles are present. If oil particles are present and the filter is 

to be used for more than one work shift, use only a P-series filter [NIOSH 

1997a].

Association, for their helpful reviews of an earlier draft of 

this document.

The basis for this document is the NIOSH Health Hazard Evaluation Report entitled Exposure to Lead during Residential Water Line Replacement Activities (investigators: Mark Methner, 

PhD, CIH, Marie de Perio, MD). 

Suggested Citation

NIOSH [2023]. Reducing workers’ lead exposure during water pipe removal and replacement. By Hughes SE, Methner 

M, de Perio MA, Afanuh SE. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease 

Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2023-

141. https://doi.org/10.26616/NIOSHPUB2023141

Resources for Medical 

Management of BLLs in Workers

These resources provide a definition of lead-exposed workers who should be considered for monitoring:

 Recommendations for Medical Management of Adult Lead Exposure: Association of Occupational and Environmental 

Clinics

 Workplace Lead Exposure: American College of Occupational and Environmental Medicine

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For More Information

More information about workers’ lead exposure and 

the HHE program is available on the NIOSH website: 

https://www.cdc.gov/niosh/topics/lead/default.html

https://www.cdc.gov/niosh/hhe/default.html

Find NIOSH products and get answers to workplace safety 

and health questions:

1-800-CDC-INFO (1-800-232-4636) 

TTY: 1-888-232-6348

CDC/NIOSH INFO: cdc.gov/info | cdc.gov/niosh

Monthly NIOSH eNews: https://www.cdc.gov/niosh/enews/

Mention of any company or product does not constitute 

endorsement by NIOSH. In addition, citations to websites 

external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or 

products. Furthermore, NIOSH is not responsible for the 

content of these websites.

This document is in the public domain and may be 

freely copied or reprinted. NIOSH encourages all 

readers of the Workplace Solutions to make them 

available to all interested employers and workers.

As part of the Centers for Disease Control and Prevention, 

NIOSH is the Federal agency responsible for conducting 

research and making recommendations to prevent workrelated illnesses and injuries. All Workplace Solutions

are based on research studies that show how worker exposures to hazardous agents or activities can be significantly 

reduced.

DOI: https://doi.org/10.26616/NIOSHPUB2023141

DHHS (NIOSH) Publication No. 2023-141

September 2023