Under the Safe Drinking Water Act, EPA is responsible for regulating contaminants that may pose a public health risk and that are likely to be present in public water supplies. EPA may establish an enforceable standard—called a maximum contaminant level—that limits the amount of a contaminant that may be present in drinking water. However, if it is not economically or technically feasible to ascertain the level of a contaminant, EPA may instead establish a treatment technique to prevent known or anticipated health effects. In the case of lead, EPA established a treatment technique—including corrosion control treatment—because the agency believed that the variability of lead levels measured at the tap, even after treatment, makes it technologically infeasible to establish an enforceable standard. EPA noted that lead in drinking water occurs primarily as a byproduct of the corrosion of materials in the water distribution system or household plumbing, some of which is outside the control of the water systems. Figure 1 illustrates the distribution system for drinking water and potential sources of lead contamination. EPA’s lead rule also established a 15-parts-per-billion lead action level, which is based on the 90th percentile level of water samples taken at the tap. Water systems must sample tap water at locations that are at high risk of lead contamination, generally because they are served by lead service lines or are likely to contain lead solder in the household plumbing. The number of samples that must be collected varies depending on the size of the water system and the results of earlier testing. Small or medium-sized systems whose test results are consistently below the action level may be allowed to reduce the frequency of monitoring and the number of samples collected. To determine their test results at the 90th percentile level, water systems must multiply the number of samples taken during a monitoring period by 0.9 and identify the result at that level, after ranking the results of the individual samples they collected in ascending order. For example, a water system required to take 50 samples would rank the results from 1 (for the lowest result) to 50 (for the highest result); the 90th percentile level is the 45th result, 5 below the highest test result for that monitoring period. When the 90th percentile results for a water system are above 15 parts per billion, the system has exceeded the lead action level and must meet requirements for public education and source water treatment. Under the public education requirements, water systems must inform the public about the health effects and sources of lead contamination, along with ways to reduce exposure. Source water responsibilities include, at a minimum, water monitoring to determine if the lead contamination is from the water source rather than—or in addition to—service lines or plumbing fixtures. Water systems that exceed the action level may also be required to install corrosion control treatment, except for large systems that may qualify as having optimized corrosion control based on other criteria. When either corrosion control or source water treatment are not effective in controlling lead levels, the lead rule calls for water systems with lead service lines to begin replacing them at a rate of 7 percent annually (unless the state requires a higher rate). The states play an important role in ensuring that the lead rule is implemented and enforced at the local level. Among other things, they are responsible for (1) ensuring that water systems conduct required monitoring and (2) reporting the results to EPA. If the systems must take corrective action to address elevated lead levels, the states are responsible for approving or determining the nature of the treatment or other activities that will be required, ensuring that they are implemented, and periodically reporting relevant information to EPA. The Safe Drinking Water Act authorizes the states to assume primary responsibility for enforcing the drinking water program—including the lead rule—if they meet certain requirements, such as adopting drinking water regulations at least as stringent as EPA’s and having adequate procedures to carry out and enforce the program’s requirements. All states except Wyoming have assumed primacy for managing their drinking water programs. In addition to requiring the regulation of lead in public water supplies, the Safe Drinking Water Act also contains provisions to limit the extent to which materials in the water distribution system and household plumbing contribute to lead levels at the tap. Specifically, the act banned the use of solder and other materials in the installation or repair of public water systems or plumbing that are not lead-free. In this regard, the act established a material standard by defining “lead-free” to mean solders and flux containing no more than 0.2 percent lead, and pipes and pipe fittings containing no more than 8.0 percent lead. In addition, the act called for development of voluntary performance standards and testing protocols for the leaching of lead from new plumbing fittings and fixtures by a qualified third party certifier or, if necessary, promulgated by EPA. A third party certifier set such a standard in 1997, limiting the amount of lead that the fittings and fixtures may contribute to water to 11 parts per billion. To address the potential risks of lead contamination in water supplies serving schools and child care facilities, Congress passed the Lead Contamination Control Act of 1988. Among other things, the act banned the manufacture and sale of drinking water coolers containing lead-lined tanks and other water coolers that are not lead-free and required (1) EPA to publish a list of such coolers and distribute it to the states, (2) the Consumer Product Safety Commission to issue an order requiring manufacturers and importers to repair or replace lead-lined coolers or recall and provide a refund for them, and (3) the states to establish programs to assist local agencies in addressing potential lead contamination. In 1990, EPA identified six models of water coolers from one manufacturer that contained lead-lined tanks, but the agency was unable to obtain information on the number of units produced. Regarding water coolers that were not lead-free, EPA identified three manufacturers that produced coolers containing lead solder that could contaminate drinking water. The manufacturers reported producing at least 1 million of the coolers. Following the discovery of elevated lead levels in the District of Columbia’s drinking water, EPA undertook a year-long evaluation to gain insight into how states and local communities are implementing the lead rule and to determine whether the problems identified in the District of Columbia are occurring elsewhere. EPA’s activities included a series of expert workshops on key aspects of the rule (monitoring protocols, simultaneous compliance, lead service line replacement, public education, and lead in plumbing fittings and fixtures), a review of state policies and practices for implementing the lead rule, data verification audits that covered the collection and reporting of compliance data for the lead rule in 10 states, and an expert workshop and a review of state efforts to monitor for lead in drinking water at schools and child care facilities. Participants in EPA’s expert workshops included representatives of federal and state regulatory agencies, drinking water systems, researchers, public interest groups, and others. Although EPA’s data on the results of testing indicate that the lead rule has largely been successful in reducing lead levels, the reporting of these data has not been timely or complete. In addition, key data on the status of water systems’ efforts to implement the lead rule, including required corrective actions, are incomplete. EPA’s data on lead rule violations are also questionable because of potential underreporting by the states. The lack of data on key elements of lead rule implementation makes it difficult for EPA and others to gauge the effectiveness of efforts to meet and enforce the rule’s requirements. When the lead rule was first implemented, initial monitoring disclosed that several thousand water systems had elevated lead levels—that is, more than 10 percent of the samples taken at these systems exceeded the 15- parts-per-billion action level. EPA’s most recent data indicate that the number of water systems that exceed the lead action level has declined by nearly 75 percent since the early 1990s. The systems that currently have a problem with elevated lead levels represent about 2 percent of all water systems and serve approximately 4.6 million people. Figure 3 shows the results (by system size) of the initial lead monitoring, conducted from 1992 to 1994, and more recent testing from 2002 through the quarter ending in June 2005. EPA, state, and water industry officials generally see the decline in the number of systems with elevated lead levels as evidence that the lead rule has been effective and point to corrosion control treatment as the primary reason. Another indicator of success is the number of water systems approved for reduced monitoring. Under the lead rule, water systems can obtain state approval to reduce both the frequency of monitoring and the number of samples included in the testing when test results show lead levels consistently below the action level. According to EPA’s data, nearly 90 percent of all water systems have qualified for reduced monitoring. After several years of experience with the lead rule, in January 2000, EPA made significant changes to the information states were required to report for inclusion in the agency’s database. Among other things, EPA added a requirement for states to report, for large and medium-sized systems, all 90th percentile test results, not just the results for systems that exceed the action level. EPA said that it planned to use these test results to show how levels of lead at the tap have changed over time for large and medium systems and, by extrapolation, for small systems. Although the new reporting requirements took effect in January 2002, EPA’s database contained 90th percentile test results for only 23 percent of the large and medium systems by January 2004. EPA officials explained that states were still having difficulty updating their information systems to accommodate the new reporting requirements and, for EPA, obtaining the data was not a priority at that time. Following the detection of elevated lead levels in the District of Columbia, however, EPA made a concerted effort to obtain more complete information from the states, and, as of June 2004, EPA reported that it had data for nearly 89 percent of the large and medium systems (based on an analysis of test results submitted from January 2000 through May 2004). However, we also analyzed data on the results of lead testing and found that EPA’s database does not contain current information for a much larger percentage of large and medium water systems. Specifically, we found that for the period from January 2002 through June 2005, EPA’s database lacks any test results for nearly 31 percent of the large and medium water systems. We could not determine whether the data are missing because states have not reported the results or because testing has not occurred. When asked whether states have been updating test results in a timely manner since 2004, an official representing EPA said that the timeliness of recent test data is unknown; the agency has not been tracking whether states are adequately maintaining data on the results of lead testing. Regarding the information required for small water systems—which is limited to test results exceeding the action level—officials from both the Office of Ground Water and Drinking Water and the Office of Enforcement and Compliance Assurance indicated that some data are probably missing but could not provide specific estimates. An official from the Office of Ground Water and Drinking Water commented that EPA’s database likely includes most of the required small system data because action level exceedances trigger follow-up activities and states are more likely to pay attention to those cases. As part of EPA’s efforts to improve its indicators of lead rule implementation, the agency restructured its reporting requirements and reduced the number of “milestones” that states are required to report from 11 to 3. EPA established three corrective action milestones, including (1) a DEEM milestone, meaning that the system is deemed to have optimized corrosion control; (2) an LSLR milestone, meaning that the system is required to begin replacing its lead service lines; and (3) a DONE milestone, meaning that the system has completed all applicable requirements for corrosion control, source water treatment, and lead service line replacement. EPA officials told us that the vast majority of water systems should have at least one milestone in the database. They indicated that in most instances, systems should have a DEEM designation because they have installed corrosion control or qualify for meeting the milestone otherwise. However, we found that, overall, EPA has information on corrective action milestones for only 28 percent of the community water systems nationwide—and lacks any milestone data on the remaining 72 percent. Table 1 summarizes the results of our analysis. The extent to which milestone data were reported to EPA varied from state to state. We found that 22 states had not reported milestones for any of their water systems and another 8 states had reported data on about 10 percent of their systems. (See app. II for a state-by-state breakdown of reported milestone data.) EPA officials believe that most water systems have actually taken the steps necessary to meet the criteria for the DEEM milestone, at a minimum, and attribute the lack of milestone data to non-reporting by the states rather than noncompliance by the water systems. They also suggested that some of the 22 states we identified as having reported no milestone data, based on our analysis of EPA’s current data, may have reported corrective actions prior to 2000, when EPA modified the number and type of milestones. However, we reviewed archived data in EPA’s database and found that 8 of the 22 states had also not reported any milestones prior to 2000, and another 11 states had reported data on no more than 10 percent of their systems. Overall, the 50 states had reported milestone data for only 5.7 percent of their community water systems prior to 2000. Moreover, some information in EPA’s database is inconsistent with other reported data. Specifically, we found differences between the information on lead service line replacement in EPA’s database—systems having an LSLR milestone—and the information states reported in the agency’s 50- state review of lead rule implementation policies and practices. As table 2 shows, seven states reported requiring lead service line replacement in response to EPA’s June 2004 query but did not have any LSLR milestones in EPA’s database in the same time frame. In addition, after following up with state officials, we found that EPA’s database did not contain accurate data on the number of water systems required to replace lead service lines because the states were not providing timely updates or correcting erroneous information. Periodic audits by EPA—and our own analyses—raise questions about the completeness of EPA’s data on lead rule violations. To assess the reliability of its drinking water data, EPA regularly conducts data verification audits that evaluate state compliance decisions and the adequacy of states’ reporting to the national database. In addition, EPA prepares a national summary evaluation of the reliability of drinking water data every 3 years. While past data verification audits have not assessed compliance decisions under the lead rule, to the extent that states’ reporting practices are relatively consistent across regulations, the audits may shed some light on the types of problems likely to be found in the reporting of lead rule data. According to the most recent national summary of data reliability, which covered audits conducted from 1999 to 2001, the estimated error rate for health-based violations—involving maximum contaminant level or treatment technique requirements—was 35 percent, down from 60 percent in the prior national report, which covered audits conducted from 1996 to 1998. For monitoring and reporting violations, the estimated error rate was 77 percent, down from 91 percent in the prior report. The March 2004 report said that most violation errors resulted from incorrect compliance determinations by the states, meaning that the state should have cited a violation but did not. Other problems included “data flow” errors (when the state correctly identified a violation but did not report it to EPA) and errors in EPA’s database (such as violations that were incorrectly reported or not removed when rescinded). Another analysis from EPA’s March 2004 report did include the lead rule and the results also raise questions about the completeness of EPA’s data on lead rule violations. The report states that by means of a tool that tracks the number of violations reported in each state over a period of several years, EPA determined that 14 states had not reported any treatment technique violations under the lead rule during a 6-year period from 1997 to 2002. The report noted that this potential non-reporting should be evaluated further and recommended that EPA and the states conduct annual evaluations of all instances of potential non-reporting. EPA’s Office of Ground Water and Drinking Water asked the regional offices to follow up with the states regarding the potential underreporting, as recommended in the March 2004 report on data reliability. For the most part, however, the regions’ responses did not address the lack of treatment technique violations under the lead rule in the applicable states; two of the regional offices did not provide written responses. Officials from EPA’s Office of Enforcement and Compliance Assurance were not aware of the violations analysis. The officials told us that because of limited resources, they focus their efforts on helping to ensure that states address the worst compliance problems—water systems identified as significant noncompliers as a result of the frequency or severity of their violations. A lack of violations—or a relatively low number of water systems with violations—does not necessarily mean that states are not meeting reporting requirements, or that their compliance monitoring and enforcement efforts are inadequate. However, analyzing the violations data and following up on the results could provide some useful insights into the reasons for differences among the states; it could also help identify problem areas and best practices. We updated EPA’s analysis of violations and, as table 3 shows, the percentage of water systems that have had one or more violations over the past 10 years varies from state to state, particularly in the case of monitoring violations. Appendix III contains a state-by-state analysis of lead rule violations reported from 1995 to June 2005. More recently, EPA conducted data verification audits during the fall of 2004, which focused exclusively on states’ compliance determinations under the lead rule in five states and included the lead rule as part of the audit in another five states. However, the results are not yet available. EPA officials have been analyzing the data and obtaining comments on the preliminary findings from the states; they expect to issue a final report by the end of calendar year 2005. In changing its reporting requirements in January 2000, EPA recognized that it needed better indicators of the lead rule’s implementation. Regarding the 90th percentile results of lead monitoring, EPA noted that in terms of routine reporting, these data are the only measure it has for showing the lead rule’s effectiveness and said that, without such data, the agency would have no way to measure progress. Similarly, EPA maintained that having information on water systems’ corrective action milestones, along with quarterly violation and follow-up information, would provide data on the status of lead rule implementation and allow the targeting of compliance and enforcement activities. Given the reduced number of milestones, EPA indicated that it would be critical for states to report the information completely and in a timely manner, and that the agency would be following up with the states to ensure that such reporting was occurring. Despite the importance of the 90th percentile results and corrective action milestones to evaluating the lead rule’s implementation, our analyses confirmed or identified significant and longstanding gaps in the amount of information available. Although EPA attempted to ensure that it had complete data on the results of lead testing, following the publicity surrounding the incidence of lead contamination in the District of Columbia, the problems with incomplete test result data have continued and the agency has not followed up on the missing milestone data. EPA has also been slow to take action on the potential underreporting of violations. As noted earlier, following its March 2004 report on data reliability, EPA did not determine the reasons for the lack of violations reported by some states. EPA’s previous summary evaluation, which was issued in October 2000, identified similar indications of underreporting and called for targeted attention to the applicable states and regions to address the issues and develop action plans. EPA needs complete, accurate, and timely data to monitor water systems’ progress in implementing the lead rule, identify potential problem areas and best practices, and take appropriate action. In particular, not having complete or reliable data on corrective action milestones or violations makes it difficult to assess the adequacy of EPA and state enforcement efforts. However, officials from EPA’s Office of Enforcement and Compliance Assurance told us that the amount of enforcement resources devoted to the drinking water program—including enforcement of the lead rule—has declined in recent years. They also told us that while they hold monthly meetings with their counterparts in EPA’s regional offices and state officials to discuss the more significant violators, the officials have not systematically evaluated state enforcement efforts with regard to the lead rule. See appendix IV for information on EPA and state enforcement actions, by type, from 1995 to June 2005. EPA and state officials attribute the problems with lead rule data to the complicated nature of the rule, the incompatibility of EPA and state information management systems, and resource constraints. For example, EPA officials noted that it is difficult to ensure that the database contains complete information—and includes data on every system that is required to test for lead in a particular period—because the frequency of required testing can vary depending on whether a system has qualified for reduced monitoring (and maintains that status in future periods). The same circumstances also make it difficult to develop trend data. EPA and state officials indicated that the January 2000 minor revisions to the lead rule, which made significant changes in states’ reporting requirements, exacerbated existing problems with the transfer of accurate and timely data from the states to EPA. For that and other reasons, modifying the states’ data systems to incorporate the new reporting milestones has been delayed. In addition to problems with the structure of the information systems—and technical problems in actually transferring data from the states to EPA—EPA and state officials acknowledge that reporting water systems’ milestone data has been a low priority. The officials explained that since January 2004, states have been focusing their limited resources on reporting the 90th percentile test results for large and medium water systems. EPA and the Association of State Drinking Water Administrators have been working on a Safe Drinking Water Information System modernization effort that should address at least some of current data problems, according to EPA officials. Among other things, the modernization will make it easier to transfer data between states and EPA so EPA’s data will be more timely. To improve the accuracy of the data, EPA’s system will have a component designed to validate state data before it is entered into the federal database. As of October 2005, EPA had completed the transition to its modernized system for the entry of new data. Based on their experiences in implementing the lead rule, EPA, state, and water system officials have identified six aspects of the rule for which oversight could be improved or the requirements modified to increase public health protection. Specifically, their experiences indicate that (1) the sampling sites used for lead testing may no longer reflect areas of highest risk, (2) reduced monitoring may not be appropriate in some instances, (3) the homeowners who participate in tap monitoring may not be informed of the test results, (4) controls over when and how treatment changes are implemented may not be adequate, (5) data on the effectiveness of lead service line replacement programs are limited, and (6) states vary in how they apply the lead rule when water systems sell drinking water to other systems. In addition, some of the officials responsible for implementing the lead rule and other drinking water experts believe that existing standards for plumbing fixtures may be outdated. EPA is considering modifications to the lead rule that will address some of the problems we identified. Under the lead rule, water systems must select sampling sites that are considered to be at high risk for contamination. The rule defines Tier 1 sites as single-family structures served by lead service lines, and/or containing lead pipes (or copper pipes with lead solder installed after 1982). According to participants in EPA’s workshop on monitoring protocols and state officials we interviewed, one problem is that EPA has never updated its site selection criteria and at least one of the criteria is outdated. Specifically, enough time has elapsed so that lead solder in plumbing installed from 1983 to 1986 is no longer “fresh” (lead solder was banned in 1986). Experts believe that, by now, solder from that period has been coated by a naturally occurring film that prevents lead leaching. Moving the sampling sites to other Tier 1 locations—for example, homes served by lead service lines—could be problematic. In the preamble to the lead rule, issued in 1991, EPA cited a survey by the American Water Works Association which estimated that only about 20 percent of the nation’s community water systems have lead service lines. Moreover, although the lead rule required water systems to do a “materials evaluation” to identify an adequate pool of high risk sampling sites, according to EPA the evaluation did not assess pipe materials system-wide, and many systems do not have a complete inventory of their service lines. A related problem is that sampling locations have likely changed over time as sites are no longer available or appropriate, and states may not have procedures in place to ensure that these locations continue to represent the highest risk sites. In this regard, EPA requested information from the states on how they “ensure that site locations were correctly followed during system sampling rounds.” As table 4 shows, a significant number of states may not be tracking changes in water systems’ sampling locations. Another uncertainty is whether systems that are on reduced monitoring— and have been allowed to reduce the number of samples they collect—are taking samples from locations that represent the highest risk sites based on previous testing. According to the lead rule, these water systems must take their samples from sites included in the pool of high risk sampling sites identified initially. Although the systems have some indication of which sites within the pool have historically tested at higher or lower lead levels, the rule is silent on how sites within the pool are to be selected for reduced monitoring, except that they must be “representative” of the sites required for standard monitoring. In addition, the rule provides that states may specify the sampling locations. EPA requested information from the states on what role they play in selecting the sites used for reduced monitoring. We analyzed the states’ responses and found that, in most instances, the states’ role is limited; table 5 summarizes the results of our analysis. According to EPA’s lead rule, small and medium-sized water systems whose test results are consistently at or below the action level may reduce the frequency of monitoring from once every 6 months to annually and, if acceptable results continue, to once every 3 years. In addition, systems of any size that operate within water quality control parameters reflecting optimal corrosion control treatment, as specified by the state, may reduce the frequency of monitoring under the same schedule. The rule also lays out conditions under which water systems must return to standard monitoring—for example, small and medium-sized systems that have exceeded the action level. In addition, states have the flexibility to require systems to resume standard monitoring if the state deems it to be appropriate. We analyzed EPA’s compliance data and found some instances that raise questions about the states’ decisions to allow reduced monitoring. Specifically, we found that 49 large and medium water systems were exceeding the 15-parts-per-billion action level and appeared to be on reduced monitoring schedules. In addition, our analysis indicates that 104 large and medium systems with lead levels of 13-15 parts per billion also appear to be on reduced monitoring schedules. Although this is allowable under EPA’s regulations, according to some state officials, systems with lead levels just below the action level should be subject to closer scrutiny and, thus, may not be good candidates for reduced monitoring. To determine how states exercised their discretion with regard to monitoring frequency, we reviewed their responses to EPA’s information request, which asked the states to describe how they determine if reduced monitoring is appropriate. According to their responses, the states by and large adhere to the requirements of the lead rule and allow reduced monitoring whenever a water system’s test results are at or below the action level in consecutive monitoring periods. Specifically, 40 states reported that they follow the federal regulation, 6 states indicated that they may be using some additional criteria for their reduced monitoring determinations, and 4 states did not answer or provided information that was nonresponsive. EPA did not ask for the states’ views on whether reduced monitoring is appropriate when a water system’s test results are at or just below the action level or on circumstances in which states might determine that previously approved reduced monitoring is no longer appropriate—and the states did not volunteer such information. None of the states reported using other criteria, such as test results that are at or just below the action level, to delay or rescind approval for reduced monitoring. A key issue is whether water systems should be required to resume standard monitoring following a major treatment change so that the potential effects of the change can be evaluated. Given the circumstances in which lead contamination became a problem in the District of Columbia, when a change in the system’s disinfection treatment impaired the effectiveness of corrosion control, such decisions can be critical. In its information request on state implementation policies and practices, EPA asked the states whether they had ever required a system to conduct more frequent monitoring to evaluate the potential effects of a treatment change. It would have been useful to know more about the states’ policies and practices in this regard, including how often the states required additional monitoring and the criteria they used in making such determinations. However, EPA’s question was limited in scope and, as table 6 shows, the states often did not elaborate. In our discussions with 10 states, we found a variety of policies and practices regarding reduced monitoring. For example, officials from California and New York told us that they do not approve reduced monitoring—or are reluctant to do so—when water systems’ test results are close to the lead action level. On the other hand, Connecticut and Massachusetts officials indicated that they have systems that are on reduced monitoring despite test results close to the action level. Several other states indicated that, in the case of large water systems, approval for reduced monitoring is linked to whether the systems are meeting their water quality parameters—not the results of lead monitoring. On the issue of monitoring following a major treatment change, some participants at EPA’s monitoring workshop stated that standard compliance monitoring does not adequately evaluate the impact of treatment changes and that monitoring immediately after major changes should be required. Several of the states we contacted also favor increased monitoring under these circumstances; Florida and New York, for example, require systems to return to semi-annual monitoring following a treatment change. Pennsylvania officials agree that the state and water system should revisit the treatment approach when monitoring results indicate that a treatment change is affecting water chemistry. However, the officials acknowledged that they may not find out about the impact of treatment changes in a timely manner when water systems are on a triennial monitoring schedule. According to EPA’s information request on state implementation policies and practices, only two states require their water systems to notify homeowners of the results of lead testing—Texas (only when results exceed the action level) and Wisconsin. At least 17 other states indicated that notification may be occurring voluntarily to varying degrees. Table 7 summarizes the results of our analysis. In some instances, changes to other treatment processes can make corrosion control less effective. According to EPA, state, and industry officials, one of the biggest challenges in implementing the lead rule is achieving “simultaneous compliance” with other rules, including, in particular, rules related to total coliform bacteria, surface water treatment, and disinfection by-products. Changing the type of disinfectant a system uses to control bacteria, for example, can impair the effectiveness of a system’s corrosion control treatment to prevent lead contamination. Among other things, states assuming primary enforcement responsibility must have a process for ensuring that the design and construction of new or substantially modified water system facilities will be capable of meeting drinking water regulations, including the lead rule. In addition, in its minor revisions to the lead rule, EPA added a requirement that certain water systems must notify the state no later than 60 days after making a change in water treatment. However, the responses to EPA’s information request raise questions about the nature and extent of states’ reviews of treatment changes. On the one hand, 31 states indicated that they had some type of proactive process to review or evaluate treatment changes, before or after the treatment was installed, including 15 states that reported requiring some or all of the affected water systems to provide information on the potential effects of treatment changes on corrosion control. On the other hand, it appears that in at least 15 states, the plan review process may be limited, or the states may not be receiving notifications from all their water systems. For example, some states indicated that their review process only covers changes to a system’s physical infrastructure—or specifically excludes changes in the chemicals used in a process. Other states reported that they are not learning of some treatment changes until they conduct comprehensive inspections of the water systems, or that small systems in particular are not notifying the state when they change their treatment processes. Some of the participants in EPA’s May 2004 workshop on simultaneous compliance cited a need for additional regulations or guidance to help ensure that the effectiveness of corrosion control is maintained when water systems make changes to other treatment processes. For example, some participants suggested that the lead rule should better define or even specify the types of treatment changes that (1) should be reported to the state and (2) trigger additional monitoring or analysis. Along those lines, Washington state officials told us that certain changes, such as switching the disinfectant from chlorine to chloramines or making adjustments that affect the water’s pH or alkalinity, may warrant closer review because of the potential impact on corrosion control. The officials also noted that additional guidance from EPA on these matters would be helpful. Others believe that small water systems, in particular, need more guidance on the potential effects of various treatment changes, and that operator certification and training programs should be updated to address these topics. Under the lead rule, drinking water systems may be required to replace lead service lines if test results exceed the action level after installing corrosion control and/or source water treatment. Some of the participants in an EPA workshop on lead service line replacement and state officials we contacted raised questions about the effectiveness of replacement programs, in part because such programs often result in partial replacement only. Water systems are responsible for replacing only the portion of the service lines they own. While residential customers may, at their option, pay the cost of replacing the rest of the service line—typically, the portion running from the curb stop or property line to the household plumbing system—some evidence suggests that customer participation in such programs is generally low. According to workshop participants, little conclusive information is available on the extent to which removing lead service lines lowers lead levels at the tap. In a survey of water systems conducted for the American Water Works Association, 18 of 27 respondents indicated that lead service lines were not responsible for the highest levels of lead in drinking water, and 20 of 29 respondents reported no observed linkage between lead service lines and lead levels in drinking water. However, the survey did not include information on test results before and after replacement of lead service lines. The American Water Works Association Research Foundation is sponsoring a study of the relative contributions of service lines and plumbing fixtures to lead levels at the tap; the projected completion is fall 2008. The limited data on the extent and results of lead service line replacement programs make it difficult to draw conclusions about the programs’ effectiveness or the need for additional regulations or guidance. As noted earlier, EPA’s data on corrective action milestones—including the LSLR milestone—are incomplete. Moreover, few states reported requiring systems to replace lead service lines in response to EPA’s information request on state implementation policies and practices. Specifically, when asked if they have any systems that have been required to do lead service line replacement, five states answered “yes” without elaborating and seven states reported a total of 27 water systems that are (or were) replacing lead lines. In addition, although the lead rule requires testing following partial service line replacement, it appears that neither the states nor EPA are collecting and analyzing these test results. EPA asked states to describe the process they use to ensure that water systems are following the requirements for lead service line replacement. Among other things, the lead rule requires systems to collect samples within 72 hours following partial replacement and to notify homeowners and occupants of the results. States may waive the requirement that these test results also be provided to the states. Of the 12 states that reported requiring one or more water systems to replace lead service lines, only one indicated that its water systems might be required to report the results of service line testing to the state. Some of the officials we contacted raised concerns about whether the benefits of replacement are enough to justify what can be a significant investment. For example, Iowa drinking water officials commented that partial replacement is not a good use of resources because it disturbs the line, releasing lead particulate matter into the water, and still leaves half the lead line in place. In addition, officials from the Syracuse Water Department told us that they are planning to replace lead service lines at a cost of $5.3 million, although they are skeptical that the effort will significantly reduce lead levels, citing the age of the housing stock and lead contributions from internal residential plumbing. The officials attribute the city’s problem with elevated lead levels to a simultaneous compliance issue. Specifically, adding a phosphate-based corrosion inhibitor to further reduce the corrosiveness of the drinking water solves one problem but creates another: excessive phosphates in the system’s discharges to a local lake. Participants at EPA’s workshop on lead service line replacement and some of the state and water industry officials we contacted suggested measures to help ensure that water systems maximize the potential benefits of replacement efforts. For example, some workshop participants called for EPA guidance on strategies to encourage full service line replacement and motivate customers to have their portion of the line removed. Such strategies might include subsidizing a portion of the replacement cost, offering low interest loans or property tax relief, requiring disclosure of lead service lines in property sales, or providing more information on the health effects of exposure to lead in drinking water. Others suggested that prioritizing the replacement of lead service lines would help ensure that replacement activities focus on the populations most at risk from exposure to elevated lead levels. Some utilities are already prioritizing service line replacement using criteria such as locations with vulnerable populations, including schools and child care facilities, locations where test results have exceeded the action level, and lines serving 20 or more people in an 8-hour day. We found some differences among the states in how interconnected water systems—generally comprising a system that sells drinking water along with one or more systems that buy the water—are required to monitor for lead and report the results. According to EPA’s proposed definitions, these interconnected water systems are known as “combined water distribution systems.” The variations in state implementation practices create differences in the level of public information and, potentially, public health protection. Combined distribution systems account for a large and growing share of the nation’s community water systems so differences in how they implement the lead rule could have broad implications for public health protection. Overall, EPA estimates that there are currently about 2,800 combined distribution systems that encompass about 13,900 individual systems, likely accounting for a significant share of all community water systems. Under EPA regulations that establish general requirements for drinking water monitoring, states may modify the monitoring requirements imposed on combined distribution systems—typically by reducing the number of samples required within the combined system—“to the extent that the interconnection of the systems justifies treating them as a single system for monitoring purposes.” However, in the case of the lead rule, EPA strongly discouraged such modifications, commenting that they would not be appropriate because the primary source of elevated lead levels at the tap is materials within the distribution system. At least four of the states we contacted—Massachusetts, Michigan, Oregon, and Washington—approved modified sampling arrangements at combined distribution systems. For example, the Massachusetts Water Resources Authority, which supplies all of the drinking water for 30 communities, currently takes lead samples at 440 locations under its modified sampling arrangement—significantly fewer than the 1,720 samples that would be required if each of the consecutive systems tested for lead individually. On the other hand, if the combined distribution system represented a single water system, only 100 samples would be required. EPA does not have comprehensive information on the extent to which states are approving modified sampling arrangements at combined distribution systems—or the reporting practices used by such systems. As table 8 shows, we found differences in how combined distribution systems calculated and reported their 90th percentile test results. Not only do the reporting practices approved by the states affect the amount of information available to the public—they can also have implications for the corrective actions that are taken to reduce lead levels. For example, reporting one overall result for lead testing can be misleading if the 90th percentile levels at individual consecutive systems would have exceeded the action level. In the case of the Massachusetts Water Resources Authority, although EPA’s database contains the overall result for the combined system, authority officials calculated the 90th percentile results for each of the consecutive systems and determined that lead concentrations at some of them exceeded the action level. State officials in Massachusetts told us that until recently, none of the consecutive systems whose individual test results exceeded the action level were required to meet public notification or public education requirements or to replace lead service lines—as long as the result for the combined system met the action level. Although EPA regional officials concurred with such arrangements when they were first established, EPA is now considering how to ensure that the lead rule requirements will be applied to each community within a combined distribution system. Based on discussions with EPA regional officials, Massachusetts has already changed its policy and will be revisiting agreements with combined distribution systems. The standards applicable to plumbing products are important to utility managers who are responsible for ensuring the quality of water at the tap but have little control over household plumbing. However, existing standards may not be protective enough, according to some experts, because testing has determined that some of the products defined as “lead- free” under the Safe Drinking Water Act can still contribute high levels of lead to drinking water. For example, although the act prohibits the use of solder or other plumbing materials in the installation or repair of any public water system if it is not lead-free, lead-free is defined to include materials that contain small amounts of lead. That is, solders and flux may contain up to 0.2 percent lead, pipes and pipe fittings may contain up to 8 percent lead. In addition, plumbing fittings and fixtures may leach lead up to 11 parts per billion into drinking water and still be deemed lead-free, according to voluntary standards established by an independent organization and accepted by EPA. NSF International (NSF)—a not-for-profit, non-governmental organization involved in standards development and product certification—established the standard in 1997. NSF used a voluntary consensus process that included representatives from regulatory agencies, industry, water suppliers, consultants, and other users of the products governed by the standard. One problem with the current regulatory framework is that certain devices used in or near residential plumbing systems are not covered by all standards for lead-free plumbing. Table 9 shows how the standards governing lead content and lead leaching apply to specific categories of products. Some of the products that are not covered by the voluntary leaching standard have been found to contribute high levels of lead to drinking water during testing. For example, tests conducted by NSF indicate that certain meters and valves may contribute high levels of lead to drinking water. At our request, NSF compiled test results for a nonprobability sample of water meters and valves that had been submitted for evaluation. While all of the products in the sample were well below the 8 percent limit on lead content, the test results showed that the amount of lead leached from the selected water meters ranged from 0.4 parts per billion up to 39 parts per billion and, in the case of valves, ranged from a low of 4.1 parts per billion to as much as 530 parts per billion. An NSF official commented that although these products are representative of what is submitted to NSF for testing, they are probably not representative of what is available in the marketplace because some manufacturers have two product lines—a low-lead line for buyers who specify products that meet NSF Standard 61 and a higher-leaded line for other buyers. Another issue is that NSF’s testing protocol for lead leaching may not accurately reflect actual conditions and may need to be modified. One recent study identified several aspects of NSF’s testing protocol that should be reevaluated, including, for example, the chemistry of the water in which tests are conducted. After demonstrating that potentially unsafe devices could pass NSF’s test, the study concluded that the protocol “lacks the rigor necessary to prevent installation of devices that pose an obvious public health hazard.” NSF officials told us that they are aware of the concerns and have already made some clarifications and changes to the protocol. NSF has also established a task force, the Drinking Water Additives Joint Committee, which will be reviewing the protectiveness of NSF Standard 61 and related testing. Representatives of NSF, water utilities, and researchers also took issue with the standard for lead content, noting that it has not been updated to reflect current manufacturing capabilities and practices. According to the American Water Works Association, manufacturing technology in the plumbing industry has improved since the lead-free definition was established nearly 20 years ago, and today’s plumbing products contain less lead as a result. Data on the lead content of plumbing products voluntarily submitted to NSF for evaluation, shown in table 10, suggest that manufacturers can produce products with lead levels well below the 8 percent standard. According to NSF, the extent to which lead leaches from products containing lead is not directly proportional to the level of lead used in any one alloy contained in the product. NSF identified several factors that contribute to the level of leaching, including the corrosiveness of the water, lead content, the extent of the leaded surface area, and the process used to manufacture the product. However, the state regulators, water industry representatives, and other experts we interviewed generally agreed that lowering the existing standard for lead content is feasible and would provide an extra margin of safety. Both the Copper Development Association and the Plumbing Manufacturers Institute acknowledged that most plumbing products are below the 8 percent limit on lead content but prefer that plumbing standards focus on performance—the leaching of lead—rather than content. We did not attempt to determine the extent to which the standards for lead- free plumbing products are enforced. According to NSF, the use of plumbing products within a building is generally regulated at the state, county, and city levels through plumbing codes. NSF representatives also said that all model plumbing codes reference NSF Standard 61 for pipes, fittings, and faucets. NSF reports that most faucets sold at the retail and wholesale level are certified to meet Standard 61, but fewer valves and other in-line devices are certified to the standard because it is not required in model plumbing codes. State efforts to implement more stringent standards for plumbing products appear limited, based on our discussions with federal and state regulators and representatives of the water industry and plumbing manufacturers. We identified two states in which such activities have occurred: In California, the Attorney General sued 16 manufacturers and distributors of kitchen and bathroom faucets in the early 1990s, alleging that lead leaching from brass components of their faucets violated California law. The suit resulted in settlement agreements with the companies and a related court decision in which they agreed to reduce leaching levels. According to an official with the California Attorney General’s Office, the limit on lead leaching is 5 parts per billion for residential kitchen faucets and 11 parts per billion for all other faucets. According to officials with the Massachusetts Board of State Examiners of Plumbers and Gas Fitters, in 1995 the board established a 3 percent limit on the lead content of endpoint and in-line devices installed inside the home. Board officials acknowledge that enforcement of the standard is difficult because products containing more than 3 percent lead may be sold in Massachusetts stores as long as the products are not installed in Massachusetts homes. Moreover, the packaging does not indicate lead content or certification to the state standard. At the local level, some water systems are installing no-lead meters—which contain less than 0.25 percent lead—because of concerns about the potential impact of leaded brass meters on lead levels at the tap. In some instances, the water systems are targeting their meter replacement to buildings housing schools and child care facilities. Based on its year-long evaluation of the lead rule and how it is being implemented, EPA concluded that the conditions that led to elevated lead levels in the District of Columbia were not indicative of the conditions nationwide. However, in November 2004, while its evaluation was still ongoing, EPA issued a guidance memorandum to reiterate and clarify specific regulatory requirements after the agency’s review of state programs and some press reports identified inconsistencies in how drinking water systems and the states were carrying out the regulation. The memorandum focused on requirements related to collecting samples and calculating compliance. In addition, in March 2005, EPA announced a Drinking Water Lead Reduction Plan to improve and clarify specific areas of the rule and the agency’s guidance materials. The plan identifies nine targeted revisions of the regulations and updates to two guidance documents. Specifically, EPA’s lead reduction plan calls for regulatory revisions to the following: Monitoring requirements. These revisions would (1) clarify the number of samples required, (2) clarify the number of locations from which samples should be collected, (3) modify definitions of “monitoring period” and “compliance period,” (4) clarify the requirement to take all samples within the same calendar year, and (5) reconsider allowing large water systems that exceed the lead action level to qualify for reduced monitoring as long as their test results for water quality parameters are within acceptable limits. Treatment requirements. These revisions would require water systems to notify the state of treatment changes 60 days prior to the change rather than within 60 days following the change. Customer awareness requirements. These revisions would (1) require water systems to disclose test results to homeowners and occupants who participate in tap monitoring programs and (2) permit states to allow water systems to modify flushing instructions—the amount of time that homeowners are advised to run water before using it—to address local circumstances. Lead service line replacement requirements. These revisions would require water systems to reevaluate lead service lines that previously “tested out” of the replacement program as a result of low lead levels if a subsequent treatment change causes the systems to exceed the action level. In addition, EPA is considering updating its 1994 guidance on lead in drinking water in schools and non-residential buildings, along with its 1999 guidance on simultaneous compliance. So far, EPA has not released additional details on the nature of the changes being considered in some areas (e.g., number of samples and sampling locations) or what prompted its determination that revisions to the lead rule and related guidance might be warranted. An EPA workgroup, which was established when the lead reduction plan was issued, is developing the proposed rule for the regulatory changes, with a goal of releasing a proposal in late 2005 or early 2006. Revisions to the guidance documents are scheduled to be completed about the same time. While the exact nature of some changes has yet to be defined, we asked the 10 states we contacted for their views on whether the proposed revisions would improve implementation of the lead rule. For the most part, state officials were in favor of the proposed changes involving the monitoring protocols. Although they wanted more details on how the requirements would be revised, they believed the changes to be relatively minor. In particular, most state officials agreed that large water systems that exceed the action level should not be allowed to reduce the frequency of lead monitoring based solely on their ability to meet water quality parameters. Regarding earlier notification of treatment changes, officials from all 10 states we contacted supported such a revision, particularly for major treatment changes. The officials indicated that the notification requirement would not have a significant impact on their own practices because each of the states already had some type of process in place to permit or review treatment changes. Five of the states questioned whether 60 days advance notice would be sufficient to allow an adequate review. Several states suggested that EPA should require expedited monitoring of lead levels following major treatment changes—or issue guidance on when it would be appropriate for states to require such monitoring—and that EPA should issue guidance on what constitutes a major treatment change. In addition, officials from two states commented that EPA should require state approval of the treatment changes in addition to advance notification. On the proposed revisions involving customer awareness, all 10 states agreed that homeowners that participate in the tap sampling program should be informed of the test results—particularly if the results for individual homeowners exceed the lead action level—whether or not the 90th percentile result for the entire system exceeds the action level. One state was concerned about the additional resources that would be required to track the water systems’ actions. Nearly all of the states also endorsed the proposal to give states and water systems more flexibility in determining what flushing instructions are appropriate in particular situations. Some states suggested that EPA guidance on making such determinations would be useful. Regarding the proposed reevaluation of lead service lines that tested out of a replacement program, the states’ views were mixed. Although five states generally endorsed the idea, the other five states raised several concerns, including the potential cost to local drinking water systems, the administrative burden that such a requirement would impose on states, and the need for more specific information on the types of treatment changes that would trigger a reevaluation of lead service lines. Over the long term, EPA plans to examine other issues related to lead rule implementation that may need to be addressed through regulation or guidance. EPA officials have indicated that, in some instances, they need more information to determine whether changes are warranted, and they are in the process of collecting and analyzing data, or have relevant research projects underway. According to EPA officials, some of the issues they plan to review include the sampling protocol, monitoring and reporting requirements for consecutive systems, the impact of disinfection treatment on corrosion control, and the requirements for lead service line replacement. Little information exists on the results of activities initiated after enactment of the Lead Contamination Control Act (LCCA) of 1988, including the recall of lead-lined water coolers from schools and child care facilities. More recent efforts to detect and remediate lead in the drinking water at such facilities also appear limited. As a result, the extent to which drinking water may contain unacceptable levels of lead at schools and child care facilities nationwide is uncertain. In addition, no clear focal point exists at the federal or state level to collect and analyze the results of testing and remediation efforts. Moreover, state and local officials say that addressing other environmental hazards at schools and child care facilities takes priority over testing for lead in drinking water. The LCCA, enacted in 1988, laid out a number of requirements for EPA, the Consumer Product Safety Commission, and the states to address the potential risks of lead contamination in water supplies serving schools and child care facilities. Among other things, the act banned the manufacture and sale of drinking water coolers containing lead-lined tanks and other water coolers that are not lead-free, required EPA to publish a list of such coolers and distribute it to the states along with guidance on testing for and remedying lead contamination in drinking water, and required the Consumer Product Safety Commission to issue an order requiring manufacturers and importers to (1) repair or replace the coolers or (2) recall and provide a refund for them because coolers containing lead-lined tanks were deemed to be imminently hazardous consumer products. In addition, the LCCA required states to establish programs to assist local agencies in addressing potential lead contamination. While the nature and extent of state activities varied widely, the program was never funded, according to EPA officials. In 1996, the requirement was determined to be unconstitutional. To support the required recall, EPA identified six models of water coolers containing lead-lined tanks, all produced by one company and manufactured prior to April 1979. EPA could not obtain information on the number of units produced. The Consumer Product Safety Commission broadened the recall order to include all tank-type models of drinking water coolers manufactured by the company, whether or not the models were included on EPA’s list. Under the terms of the order, the manufacturer established a process under which qualified owners of the affected coolers could request a refund or replacement. The manufacturer was also required to notify appropriate officials and organizations, including state and school officials and day care centers, about the recall and the availability of refunds and replacements. Little information is available to determine the effectiveness of the recall effort in removing lead-lined water coolers from service. Not only is the number of coolers affected by the recall unknown, but the Consumer Product Safety Commission did not have summary data on the results of the recall. An agency official confirmed information in a 1991 Natural Resources Defense Council report that, as of 1990, the Commission had received approximately 1,200 inquiries about the recall, 1,373 coolers had been determined to be eligible for replacement, 514 had been replaced, and 105 refunds had been mailed to customers. However, the official also said that many more coolers were replaced after that date and that by 1993, the manufacturer had received approximately 11,000 inquiries about the recall. The official believed that the actual number of replacements was potentially 10 times greater than those reported in 1991 and the refunds four to five times greater. In addition, the recall order did not specify an end date for filing a refund or replacement request so an unknown number of coolers could have been taken out of service without the knowledge of the manufacturer or the Commission subsequent to 1993. According to several state and school officials we interviewed, virtually all of the water coolers affected by the recall have been replaced or removed, either as a result of the publicity surrounding the recall or because they had already been taken out of service. Some of the six models covered by the recall were manufactured in the 1950s and 1960s and are likely to have been retired because of their age or maintenance problems. Beyond the recall effort, little or no data are available to assess the effectiveness of other actions taken in response to the LCCA. For example, little information is available on the extent to which schools and child care facilities were inspected to check potential lead contamination from water coolers that were not lead-free. While the act did not require EPA or the states to track or report on the results of testing, EPA was responsible for publishing guidance and a testing protocol to assist schools in determining the source and degree of lead contamination in school drinking water supplies and remedying such contamination. EPA published guidance for both schools and child care facilities in 1989 and 1994, respectively. We found no information indicating how pervasive lead-contaminated drinking water in such facilities nationwide or within particular states might be, but several studies conducted in the early 1990s contained some limited information on testing efforts: In 1993, we reported on the results of a survey of 57 school districts in 10 states. We found that 47 districts were able to provide data on the results of testing, which showed that about 15 percent of the 2,272 schools tested had drinking water containing levels of lead considered unacceptable by EPA. We also contacted child care licensing agencies in 16 states to obtain information on their activities for addressing lead hazards and found that none of the agencies routinely inspected child care facilities for such hazards. A 1990 report by EPA’s Inspector General found that, of the 13 school districts surveyed, 10 conducted some testing for lead in drinking water and 8 detected contamination, with some results exceeding acceptable levels by a wide margin. According to the Natural Resources Defense Council’s 1991 study, 47 states reported some testing of school drinking water supplies, including 16 states that tested in “a few” to 25 percent of their schools, 27 states that tested from 25 percent to 82 percent of the schools, and 4 states that tested 95 percent or more of their schools. The study also found that 17 states reported testing at child care facilities. In addition to these earlier studies, in 2004 EPA asked the states to provide information on current state and local efforts to monitor and protect children from lead exposure in drinking water at schools and child care facilities. As part of that effort, seven states also reported on the results of local testing following passage of the LCCA, stating that elevated lead levels were found in at least some of the locations tested. However, the states differed significantly in the extent of their testing and how they summarized the results. In five of the states, the results generally ranged from about 1 percent to 27 percent of samples, facilities, or districts with lead levels considered unacceptable by EPA—but the other two states finding elevated lead levels used a different assessment measure. The extent of current testing and remediation activities for lead in school and child care facility drinking water appears limited. The LCCA does not require states to track or report such activities and, based on the information that EPA collected from the states in 2004 and our own contacts in 10 states, few states have comprehensive programs to detect and remediate lead in drinking water at schools and child care facilities. Figure 4 shows the nature and extent of these activities; about half the states reported no current efforts. Of the five states that reported having testing requirements, four— Connecticut, New Hampshire, South Carolina, and Vermont—require child care facilities to test their drinking water for lead contamination when obtaining or renewing their licenses. In the fifth state (Massachusetts), the testing requirement focuses on schools. Water systems must include two schools among their sampling sites in each round of lead testing, although the school data are not included in the 90th percentile calculation to determine whether lead levels exceed the action level. Massachusetts officials told us that, although the testing requirement has been in place since 1992, it has not received much attention until recently. The officials acknowledged that most water systems repeatedly used the same schools as sampling sites for the sake of convenience and said that the state has never summarized the results of the school testing. Given the renewed concerns about lead contamination following the detection of lead in the District of Columbia’s drinking water, Massachusetts now requires water systems to rotate testing among schools and child care facilities and plans to issue a summary report at the end of 2005. In addition to these requirements, Florida’s Department of Environmental Protection reported to EPA that it had established a voluntary program. Specifically, the state designated child care facilities as Tier 1, high risk sites and gave water systems the option of using the facilities as lead sampling sites and including them in the calculation of the 90th percentile lead level. (According to a Florida official, to be included as a sampling site, the child care facility must meet other Tier 1 criteria, such as being served by a lead service line.) However, when we followed up with state officials, they said that they had no way of tracking the extent to which water systems were actually including child care facilities as sampling sites. The scope of the targeted testing reported by 12 states varied widely, from a single school district in Pennsylvania to over 1,300 homes and child care facilities in Indiana. Several states indicated that they were focusing on potential high risk locations. EPA regional offices helped to initiate some limited testing in a few states, including Massachusetts, New Jersey, New York, and Pennsylvania; the testing generally focused on a few of the states’ largest school districts. The state-sponsored surveys to determine the status of testing by local agencies also varied, with some covering all schools within the state and others focusing on a smaller subset of schools. In Washington, the state recently set aside $750,000, including $400,000 from its drinking water state revolving fund, to partially reimburse school districts for the cost of monitoring for lead in elementary schools’ drinking water. EPA officials attributed the relatively low level of state activity in recent years to the aftereffects of a 1996 lawsuit brought by the Association of Community Organizations for Reform Now against the state of Louisiana for not doing enough to implement the LCCA. The case resulted in a federal circuit court decision declaring that part of the LCCA was unconstitutional. Specifically, the court ruled that the federal government did not have the authority to require states to establish a remedial action program as outlined in the LCCA. While Louisiana reported to EPA that the case “had the unintended effect of ending the lead program in schools for the state of Louisiana,” none of the 10 states we contacted cited the ruling as a factor in limiting their efforts. To obtain more information about testing and remedial actions in individual cities, we contacted five school districts—Boston, Detroit, Philadelphia, Seattle, and Syracuse. Table 11 shows the extent and results of testing within each district, and provides information on the various approaches school administrators have used to address the lead contamination. 1 F.3d 137 (5th Cir. 1996). Scope: Testing focused on kitchen facilities used to prepare food and was conducted between 2003 and 2004 at the district’s central kitchen facility and 38 schools with on-site kitchen facilities. Actions: Manual flushing for at least 1 minute each day in all kitchens and an automatic flushing program at the central kitchen and 22 school buildings with kitchen facilities. Results: Lead levels in water from 17 kitchen facilities, including the central kitchen, exceeded 20 ppb. Cost: Not available. Scope: The district tested 21 water fountains and other outlets in one middle school as of November 2002. (Testing was also conducted at one other middle school, but the number of outlets included was not available.) Actions: For the short term, shutting off outlets with elevated lead levels, doing manual flushing, and providing bottled water. For the long term, installing a water treatment system, replacing lead piping and fixtures, and re-routing a service line serving the school. Results: Lead levels in water from 16 drinking water outlets in one middle school exceeded 15 ppb. Cost: An estimated $9,000 for bottled water and $5,865 for the water treatment system, plus $800 in annual maintenance costs. Scope: As a result of consent orders in 1999 and 2000, the school district was required to test all drinking water outlets at 299 schools and other buildings, or about 30,000 outlets in total. Actions: For the short term, shutting off outlets with elevated lead levels and providing bottled water. For the long term, replacing or removing fixtures. Results: As of March 2004, the district had detected lead levels over 20 ppb in approximately 4,600, or roughly 15 percent, of the outlets tested. Cost: An estimated $6 million through February 2005. Scope: In 2004, the district tested all interior drinking water outlets considered suitable for use, about 2,400 outlets in total. Results: Lead levels at 600 of the outlets, or 25 percent, exceeded 20 ppb. Actions: For the short term, shutting off outlets with elevated lead levels and providing bottled water. For the long term, fixing or replacing fixtures, installing filters, and replacing piping for any outlet where lead levels exceeded 10 ppb. Cost: An estimated $15 million upon completion in 2007. Scope: The district tested specific interior drinking water outlets in 50 schools and other buildings, beginning in August 2003. Results: 23 of the facilities had at least one drinking water outlet with lead levels over 20 ppb. Actions: For the short term, shutting off outlets with elevated lead levels. For the long term, installing in-line carbon filters at each outlet with elevated lead levels. (Other measures such as pipe replacement and removal of fixtures are still under discussion.) Cost: An estimated $100,000 through March 2005. Boston officials told us that they focused on kitchen facilities in their most recent testing because the district had already installed bottled water at many drinking water outlets after earlier testing had disclosed elevated lead levels. Both Philadelphia and Seattle had also conducted some testing prior to the more recent efforts summarized in this table. uirement to test bathroom faucets. The cities we contacted differed in the testing protocols they used to test for lead in school drinking water. While three of the cities (Boston, Philadelphia, and Syracuse) followed EPA’s guidance, using a 250 milliliter sample and a limit of 20 parts per billion for triggering follow-up action, Seattle took a more conservative approach. Using the same sample volume, the school board established 10 parts per billion as its standard for follow- up action. Detroit, on the other hand, used the same protocol that is required for public water systems—a 1 liter sample and 15 parts per billion as the limit. Some of the remediation measures adopted by the cities we contacted were effective, including installing in-line filters, replacing pipes, and removing fixtures at outlets with test results indicating high lead levels. Other measures required more attention and others inadvertently created new issues for officials to deal with. For example, a Seattle school official noted that the district decided against instituting a flushing program in its schools because it was too difficult to ensure that staff in individual schools would follow through with the flushing every day. In Boston, a school official told us that using bottled water posed a problem because staff had to make sure that replacement bottles were always available and because it created other issues with pests, vandalism, and spillage. While a number of cities have detected elevated lead levels in school drinking water, and a few states are beginning to collect information on the status of local testing efforts, little information exists on the extent to which drinking water at schools and child care facilities nationwide may contain unacceptable levels of lead. No focal point exists at the federal or state level to collect and analyze test results or information on cost- effective remediation strategies. As a result, it is difficult to get a sense of the pervasiveness of lead contamination in the drinking water at schools and child care facilities, and to know whether a more concerted effort to address the issue—such as mandatory testing—is warranted. In addition, remediation measures such as providing bottled water, regularly flushing water lines, installing filters, and replacing fixtures and internal piping vary widely in cost and complexity, among other factors. State and local officials have expressed concern about not having sufficient information on the measures, their pros and cons, and circumstances in which particular measures might be more appropriate than others. At the federal level, EPA’s Office of Ground Water and Drinking Water sets drinking water standards and other requirements for public drinking water systems, but generally does not have any direct oversight responsibility for the quality of drinking water in schools or child care facilities. The U.S. Department of Education (Education) is responsible for, among other things, providing guidance and financial assistance to state and local education agencies for elementary and secondary schools. Education’s Office of Safe and Drug Free Schools recently signed a memorandum of understanding with EPA, the Centers for Disease Control and Prevention, and various water industry associations with the goal of reducing children’s exposure to lead in drinking water at schools and child care facilities. However, according to an Education official, the department does not have legal authority to compel schools to test for lead in the drinking water. Officials in Washington state saw a need for closer coordination between EPA and Education. The officials believe that local education officials are more likely to respond to guidance on lead and other environmental health issues if Education were to be involved in developing it. At the state level, responsibility for the environmental health of schools and child care facilities is usually fragmented among multiple agencies. According to EPA, in most states, the same agency that administers the drinking water program—generally the state’s department of environmental protection or department of health—is also responsible for implementing the LCCA. However, we also learned from EPA that the state agencies responsible for administering education programs and licensing child care facilities are usually the ones with the regulatory or oversight authority over environmental conditions in schools and child care facilities. (As noted earlier, some states also have lead poisoning prevention programs to monitor blood lead levels in children and investigate the source of lead exposure when the levels are elevated.) According to some of the states we contacted, the level of coordination among state agencies needs to be improved and the lack of a centralized authority at the state level has complicated efforts to plan and implement a testing program for lead in water in some school districts. For example, in Pennsylvania, state drinking water officials said that several other agencies, including the Departments of Health, Education, and Public Welfare, have a role in overseeing schools and child care facilities—but it was unclear which agency would be best suited to manage a testing program if one were to be required. In contrast, Connecticut officials said that having both the drinking water program and the child care licensing program housed within the same department has been an advantage because it is easier for the programs to share information and coordinate their activities. We also contacted several school and child care associations to find out if they were involved in or aware of efforts to promote testing for lead in drinking water, collect and analyze the results of testing, or set standards for the environmental health of the facilities. According to a representative of the National Child Care Association, until recently the association had not been aware of any issues regarding lead in drinking water at child care facilities or involved in any effort to promote testing. The representative commented that one challenge to distributing information on lead in drinking water to child care facilities is the fragmented nature of the child care industry. While the National Head Start Association has been involved with lead poisoning prevention in general, the organization has not done anything specifically related to lead in drinking water. The Healthy Schools Network, Inc. promotes the development of state and national policies, regulations, and funding for environmentally safe and healthy schools. Although the network has published some fact sheets that address the potential health risks from lead exposure, lead in drinking water has not been a priority compared with other environmental issues. While none of these organizations were parties to EPA’s recent memorandum of understanding, they have been actively engaged in assisting EPA as the agency revises its guidance for schools and child care facilities, according to EPA officials. According to state and local officials, children may be exposed to a variety of environmental hazards at schools and child care facilities, including asbestos, lead in paint or dust, mold, and other substances that affect indoor air quality. The officials told us that dealing with such problems often takes priority over checking for lead in drinking water because, in the case of the other problems, more information is available on the nature and extent of the potential health risks involved. For example, many of the officials we interviewed said that the most significant source of lead exposure—and thus, their primary concern—was lead in paint. Officials from two states also mentioned that lead in jewelry, toys, or pottery is a more significant source of exposure than lead in drinking water. Washington state officials told us that child care facilities also have many competing priorities and cited food handling as one of their major concerns. At the local level, officials talked about dealing with multiple health and safety issues and the difficulty of prioritizing limited resources. For example, in Detroit, one official told us that dealing with asbestos takes priority over all other environmental concerns, including lead in drinking water. Another Detroit official commented that indoor air quality is another priority because “issues related to breathing are very important to educators.” In Philadelphia, a school official noted that a major source of lead in the school district is dust, a problem that requires continuing attention from the maintenance staff, which must set aside time to scrub the areas where dust collects. A Seattle official also mentioned the difficulty posed by competing needs for limited funds. He indicated that the competition is not only among environmental issues, such as mold and asbestos, but, on a broader level, between maintenance and basic classroom expenditures. Without additional resources—or more compelling evidence that lead in drinking water should be a higher priority—state and local officials, as well as representatives of industry groups, were reluctant to support calls for mandatory testing for lead in drinking water in schools and child care facilities. Many of the officials we interviewed said that more research is needed on several aspects of the lead issue. In addition to wanting more information on the extent to which lead contamination in schools and child care facilities is a problem, some officials also wanted more information on the circumstances in which particular remediation approaches are most effective. Other officials believe that more research is needed on the relationship between children’s exposure to lead in drinking water and their blood lead levels. Ensuring that the lead rule adequately protects public health and is fully implemented and enforced should be a high priority for EPA and the states because the potential consequences of lead exposure, particularly for infants and young children, can be significant. However, EPA’s hands are tied unless states report complete, accurate, and timely data on the results of required monitoring, the status of corrective actions, and the extent of violations. Without such information, EPA cannot provide effective oversight or target limited resources where they are most needed. Similarly, inconsistencies among the states’ policies and practices for implementing the lead rule may lead to uneven levels of public health protection for consumers and thus need to be examined and corrected, as appropriate. Given the potential health effects associated with lead contamination, it is important to minimize any unnecessary exposure as a result of leaded materials in the water distribution system or household plumbing. Reevaluating existing standards for the devices used in or near residential plumbing systems would also enhance the effectiveness of the treatment provided by local water systems. In the case of schools and child care facilities, both the vulnerability of the population served by such facilities and the competition for limited resources make it essential to have better information on the nature and extent of lead-contaminated drinking water—and its significance relative to other environmental hazards. We recommend that the Administrator, EPA, take a number of steps to further protect the American public from elevated lead levels in drinking water. Specifically, to improve EPA’s ability to oversee implementation of the lead rule and assess compliance and enforcement activities, EPA should ensure that data on water systems’ test results, corrective action milestones, and violations are current, accurate, and complete and analyze data on corrective actions and violations to assess the adequacy of EPA and state enforcement efforts. To expand ongoing efforts to improve implementation and oversight of the lead rule, EPA should reassess existing regulations and guidance to ensure the following: the sites water systems use for tap monitoring reflect areas of highest risk for lead corrosion; the circumstances in which states approve water systems for reduced monitoring are appropriate and that systems resume standard monitoring following a major treatment change; homeowners who participate in tap monitoring are informed of the test states review and approve major treatment changes, as defined by EPA, to assess their impact on corrosion control before the changes are implemented. In addition, EPA should: collect and analyze data on the impact of lead service line replacement on lead levels and conduct other research, as appropriate, to assess the effectiveness of lead line replacement programs and whether additional regulations or guidance are warranted; collect information on (1) the nature and extent of modified sampling arrangements within combined distribution systems and (2) differences in the reporting practices and corrective actions authorized by the states, using this information to reassess applicable regulations and guidance; and evaluate existing standards for in-line and endpoint plumbing devices used in or near residential plumbing systems to determine if the standards are sufficiently protective to minimize potential lead contamination. In order to update its guidance and testing protocols, EPA should collect and analyze the results of any testing that has been done to determine whether more needs to be done to protect users from elevated lead levels in drinking water at schools and child care facilities. In addition, to assist local agencies in making the most efficient use of their resources, EPA should assess the pros and cons of various remediation activities and make the information publicly available. We provided a draft of this report to EPA and the Consumer Product Safety Commission for review and comment. EPA generally agreed with our findings and recommendations. Regarding the completeness of information that EPA has to evaluate implementation of the lead rule, the agency said that it will work with the states to ensure that relevant information is incorporated into the national database and will use the information, in part, to assess the adequacy of enforcement efforts. In addition, EPA agreed that aspects of the regulation need improvement. EPA said that it will address some of these areas as part of its package of revisions to the lead rule that it plans to propose early in 2006, including homeowner notification of test results and criteria for reduced monitoring. EPA also said that it needs additional information before it can address other areas, such as lead service line replacement and plumbing standards, that may warrant regulatory changes. EPA did not comment on our recommendation to reevaluate existing regulations and guidance to ensure that tap monitoring sites reflect areas of highest risk for lead corrosion. Finally, EPA did not address our recommendations regarding lead contamination and remedial actions at schools and child care facilities. We believe that, given the particular vulnerability of children to the effects of lead, it is important for EPA to take full advantage of the results of any tests that have been done, as well as to identify those remedial activities that have proven to be most effective. EPA’s comments appear in appendix V. The Consumer Product Safety Commission generally agreed with our findings as they pertain to the Commission. As agreed with your offices, unless you publicly announce the contents of this report earlier, we plan no further distribution until 30 days from the report date. At that time, we will send copies to appropriate congressional committees; the Administrator, EPA; the Chairman, Consumer Product Safety Commission; and the Director of the Office of Management and Budget. We will also make copies available to others upon request. In addition, the report will be available at no charge on the GAO Web site at http://www.gao.gov. If you or your staff have any questions about this report, please contact me at (202) 512-3841 or stephensonj@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. GAO staff who made major contributions to this report are listed in appendix VI. For information on how the lead rule is being implemented, we obtained information from the Environmental Protection Agency’s (EPA) Office of Ground Water and Drinking Water and Office of Enforcement and Compliance Assurance, eight EPA regional offices, and 10 states. We selected eight of the states—California, Illinois, Iowa, Massachusetts, Michigan, New York, Pennsylvania, and Washington—because they either had a relatively high number of water systems with test results that exceeded or fell just below the lead action level, or they added to the geographical diversity of our selections. We also included Connecticut and Florida in our review because they were identified by EPA as particularly active in addressing potential lead contamination in water supplies serving child care facilities. At the local level, we obtained information from eight water systems: the Chicago Water Department in Illinois, the Boston Water and Sewer Commission and Massachusetts Water Resources Authority in Massachusetts, the Detroit Water and Sewerage Department in Michigan, the Syracuse Water Department in New York, the Portland Bureau of Water Works in Oregon, the Philadelphia Water Department in Pennsylvania, and Seattle Public Utilities in Washington. Our criteria for selecting these systems included test results showing elevated lead levels, lead service line replacement activity, and/or the use of modified sampling arrangements for consecutive systems. We reviewed the Safe Drinking Water Act, the lead rule, EPA’s minor revisions to the lead rule, other pertinent regulations, and applicable guidance to states and water systems. To gain a national perspective on the data EPA uses for oversight of lead rule implementation, including the results of required testing, the status of corrective actions, and the extent of violations, we analyzed data from EPA’s Safe Drinking Water Information System through June 2005 for active community water systems. We assessed the reliability of the data by (1) performing electronic testing of required data elements, (2) reviewing existing information about the data and the system that produced them, (3) interviewing agency officials knowledgeable about the data, and (4) reviewing EPA’s own data verification audits and summaries of data reliability. We determined that the data on results and frequency of lead testing were sufficiently reliable to show compliance trends. However, we found that other data on corrective actions and violations were not sufficiently reliable to assess the status of efforts to implement and enforce the lead rule. For information on experiences in implementing the lead rule and the need for changes to the regulatory framework, we interviewed EPA, state, and local officials; analyzed states’ responses to an EPA information request regarding their policies and practices in implementing the rule; and reviewed other relevant studies and documents. We reviewed the results of EPA’s expert workshops on monitoring protocols, simultaneous compliance, lead service line replacement, and public education, and obtained information from several researchers and other drinking water experts. Among other things, we identified potential gaps in the regulatory framework, including oversight, regulations, and guidance, and obtained views on the modifications to the lead rule now being considered by EPA. To learn about the development and effectiveness of existing plumbing standards, we obtained and analyzed information from NSF International (NSF), the Copper Development Association, the Plumbing Manufacturers Institute, and relevant articles and studies. To assess the reliability of NSF’s data on lead content and lead leaching of plumbing fittings and fixtures, we talked with foundation officials about data quality control procedures. We determined the data were sufficiently reliable for illustrative purposes. For information on safeguards against lead-contaminated drinking water at schools and child care facilities, we interviewed officials from the Consumer Product Safety Commission, EPA’s Office of Ground Water and Drinking Water, the National Head Start Association, the National Child Care Association, and the Healthy Schools Network. We also obtained information from drinking water program offices and public health or education departments in the 10 states we contacted for the first objective as well as school districts in Boston, Chicago, Detroit, Philadelphia, Seattle, and Syracuse. We reviewed the Lead Contamination Control Act (LCCA) of 1988 and obtained information on the recall of lead-lined water coolers. For information on other actions taken in response to the LCCA, we interviewed EPA, state, and local officials; reviewed relevant studies; and analyzed information collected by EPA. We used the same information sources to determine (1) the extent of current testing and remediation activities for lead in school and child care facility drinking water, (2) the extent to which various entities have responsibility for overseeing or collecting data on such activities, and (3) the relative priorities among environmental hazards common to schools and child care facilities. We also analyzed states’ responses to an EPA information request on state and local efforts to monitor and protect children from lead exposure and attended an EPA-sponsored expert workshop on lead in drinking water at schools and child care facilities. For more detailed information on experiences at the local level, we collected information from five school districts on the extent of testing for lead in school drinking water, the results, and the approaches used to address contamination. We performed our work between June 2004 and November 2005 in accordance with generally accepted government auditing standards. Percent of total systems with Legend: TT = treatment techniue violations, including failure to install optimal corrosion control treatment, failure to meet water uality control parameters, failure to replace lead service lines, and failure to meet public education reuirements, among other things. MR = monitoring and reporting violations, including the failure to conduct reuired testing and failure to report the results. We included the most commonly used enforcement actions in this table and excluded miscellaneous actions and activities unrelated to enforcement or the lead rule. EPA files a “complaint for penalty” when the terms of an administrative order are violated. In addition to the individual named above, Ellen Crocker, Nancy Crothers, Sandra Edwards, Maureen Driscoll, Benjamin Howe, Julian Klazkin, Jean McSween, Chris Murray, and George Quinn, Jr. made key contributions to this report.

Summary: Elevated lead levels in the District of Columbia's tap water in 2003 prompted questions about how well consumers are protected nationwide. The Environmental Protection Agency (EPA), states, and local water systems share responsibility for providing safe drinking water. Lead typically enters tap water as a result of the corrosion of lead in the water lines or household plumbing. EPA's lead rule establishes testing and treatment requirements. This report discusses (1) EPA's data on the rule's implementation; (2) what implementation of the rule suggests about the need for changes to the regulatory framework; and (3) the extent to which drinking water at schools and child care facilities is tested for lead. EPA's data suggest that the number of drinking water systems with elevated lead levels has dropped significantly since testing began in the early 1990s. However, EPA's database does not contain recent test results for over 30 percent of large and medium-sized community water systems and lacks data on the status of water systems' efforts to implement the lead rule for over 70 percent of all community systems, apparently because states have not met reporting requirements. In addition, EPA's data on water systems' violations of testing and treatment requirements are questionable because some states have reported few or no violations. As a result, EPA does not have sufficient data to gauge the rule's effectiveness. Implementation experiences to date have revealed weaknesses in the regulatory framework for the lead rule. For example, most states do not require their water systems to notify homeowners that volunteer for periodic lead monitoring of the test results. In addition, corrosion control can be impaired by changes to other treatment processes, and controls that would help avoid such impacts may not be adequate. Finally, because testing indicates that some "lead-free" products leach high levels of lead into drinking water, existing standards for plumbing materials may not be sufficiently protective. According to EPA officials, the agency is considering some changes to the lead rule. On the basis of the limited data available, it appears that few schools and child care facilities have tested their water for lead, either in response to the Lead Contamination Control Act of 1988 or as part of their current operating practices. In addition, no focal point exists at either the national or state level to collect and analyze test results. Thus, the pervasiveness of lead contamination in the drinking water at schools and child care facilities--and the need for more concerted action--is unclear.