Fix the lead pipes

Kids' brains are infrastructure

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I’ve written about the not-really-infrastructure part of Biden’s Jobs Plan and also about the transportation element. But I’m inclined to think that the best and most important parts of the Biden program are the ones that fall into neither of those buckets — infrastructure construction projects that aren’t about transportation.

High on this list is a proposed $111 billion injection of funds into projects designed to address the needs of municipal water systems. The most concrete chunk of that is an ambitious $45 billion investment in eliminating lead pipes. But there’s also a mix of grants and loans to address other water systems and clean water needs, including a $10 billion program to address something called PFAS.

The case for an infusion of funds into this area strikes me as very compelling. These are goods the public cannot buy on its own and that local officials struggle to get the necessary financing for. And on lead in particular, the evidence of large benefits not just to the people directly impacted but to the public at large seems really strong.

America is full of lead pipes

Back in chemistry class, I used to wonder why the chemical symbol for lead is Pb. It turns out the reason is the Latin word for it is “plumbum” which is also the etymological root of “plumbing” because even way back in the day, lead had properties that made it a good material for water pipes.

The key advantage is that unlike iron, it’s relatively easy to bend a lead pipe while maintaining its integrity as a water-tight vessel. Since water systems generally need to bend a lot, that’s very useful. Unfortunately, lead is also a powerful neurotoxin.

And it seems that people have been broadly aware of the health risks associated with lead for a long time. Here’s an article that ran in the British Medical Journal by Alfred Swann back in 1889:

It has fallen to my lot to observe many cases of plumbism, and its relation to sterility and abortion only touches the very fringe of a vast subject. The influence of lead on the nervous, vascular, muscular, lymphatic, and digestive systems merits greater consideration than has hitherto been devoted to it.

To suppose that plumbism means only wrist-drop and paralysis of the extensors of the forearms seems to me to be illogical. I believe that in plumbism, neuritis is not confined to any particular set of nerves. Is not lead colic due to paralysis of the nerves regulating the muscular coats of the intestines? What is the meaning in cases of lead-poisoning of the tense pulse, the liability to epileptiform seizure, to cerebral and other haemorrhages, to gout and uric acid, and to albuminuria and rheumatic pains? Surely these point to both nervous, vascular, and metabolic derangements which open up a wide field of inquiry for those who are interested in our food and water supply, and in public health generally.

Well, we probably should have listened to Alfred Swann! Instead, in the United States, we kept putting lead pipes everywhere for a generation. Starting in the 1920s you had pushback, and its use in water pipes was reduced.

But at the same time, as Beth Gardiner recounts in her excellent book “Choked,” the pressure was on to expand the use of lead. One idea was that since it’s poisonous, you could use it as a chemical weapon to kill Germans. That didn’t work out, so instead they put it in gasoline:

A Yale physiologist named Yandell Henderson had tested tetraethyl lead as a potential nerve agent during World War I, and when GM asked his thoughts on putting it into gasoline [in 1921], he replied with alarm. “Widespread lead poisoning was almost certain to result,” he warned. Later he deemed it the “single greatest question in the field of public health that has ever faced the American public.”

The science was clear: Lead is a powerful neurotoxin. The threat was vividly demonstrated at a New Jersey refinery whose tetraethyl lead operation was known as “the loony gas building” because of its workers’ bizarre behavior — stumbling, memory loss, explosions of rage. After an accident, dozens collapsed, suffering seizures and hallucinations; more than 30 were hospitalized and 5 died.

The Lead Industries Association was formed in 1928 to push back against state and local bans on lead pipes, advocate for leaded gasoline, and promote the use of lead paint. Eventually this lobbying effort failed, with lead paint banned in the 1970s, leaded gasoline phased out in the 1980s, other kinds of leaded fuel phased out later, and lead water pipes not definitively banned until 1986.

Conceptually, the issue we keep having with lead is this — it’s like smoking cigarettes, in which light users don’t suffer as much as heavy users, but nobody’s lungs go unharmed when you inhale a bunch of burning tobacco. Instead of acknowledging this, the policy quest for over 100 years has been to try to determine some threshold at which lead poisoning (Swann’s “plumbism”) sets in and then say that it’s fine to have less lead than that. So maybe we don’t build any new lead pipes, but it would be really annoying to dig up all the old ones, and maybe it’s not so bad to just leave them there.

There’s lots of old lead

My understanding is that the most generally dangerous lead problem in America is not in the pipes but in the soil. All the old lead that was sent into the atmosphere in leaded gasoline didn’t vanish. Instead, it returned to earth as lead dust and it sits there mixed in with dirt. Across the majority of the country, it’s not such a big issue. But any place where lots of people were driving cars in the 1940s, 1950s, 1960s, and 1970s is full of lead. And unfortunately, though residential patterns have changed since those days, they haven’t changed all that much. Most of the land in America is pretty empty and doesn’t have much lead. But tons of people live in central cities, small towns, or inner-ring suburbs that were densely populated in the post-WWII generation, and there’s just all kinds of lead lying around.

The problem is particularly bad in former industrial areas, but it’s really very widespread. So much so that policymakers seem to be somewhat paralyzed in the face of the scope and somewhat ill-defined nature of the problem. It’s challenging to even get a credible cost estimate for what cleanup would look like. And actually, I find that when you try to describe it to people, the mind sort of rebels at the idea that there’s toxic dust lurking all around.

Pipes, by contrast, are a big issue but also a well-defined one. Lots of places have lead service pipes but most do not. We know more or less where they are and what it costs to replace them. Big replacement projects have been done before. And there are even existing federal funding streams for them.

But in the past, instead of ponying up what it costs, America has repeatedly tried band-aids. A lot of people know the story of Flint, but we had a huge lead crisis when I was new to D.C. back in 2004. D.C. is full of lead pipes, but instead of replacing them all, a number of remediation efforts were made to stop corrosion and allow unsafe pipes to carry safe drinking water. Then suddenly this happened:

Tap water in thousands of District houses has recently tested above the federal limit for lead contamination, a new phenomenon that has baffled the D.C. Water and Sewer Authority and forced the agency to begin replacing service pipes.

Two-thirds of the 6,118 residences that WASA tested last summer, or 4,075 homes, had water that exceeded the lead limit of 15 parts per billion set by the Environmental Protection Agency in 1991. This is the first time the city's water has shown significant lead contamination since the late 1980s, officials said.

The culprit appears to have been a decision to switch from the use of chlorine to chloramine as a treatment chemical. Apparently, chloramine generates fewer harmful byproducts than chlorine but also corrodes lead pipes more. The immediate crisis was addressed by adding some anti-corrosion chemicals into the chloramine mix. But the fact that this kind of snafu happens is an illustration of the danger of just letting the pipes sit around and hoping for the best.

I also note that the EPA sets this action trigger threshold, but it’s arbitrary — there is no safe amount of lead. We see this in the monitoring of blood lead concentrations for children. The CDC recommends intervention when kids have more than 10 micrograms of lead per deciliter of blood. That’s lead poisoning, and mercifully, it is rare these days. Some public health agencies have pushed the threshold down to the five μg/dL mark, where about 2% of kids count as lead poisoned. And the really bad news is that to the extent that scientists are able to measure lower concentrations, they just continue to find evidence of harm. Indeed, when Nigg et al. studied a population with blood levels “slightly below United States and Western Europe population exposure averages” (emphasis added), they still found that higher levels of lead are associated with more ADHD diagnoses. Just to repeat that, kids with below-average levels of lead exposure seem to be suffering quantifiable cognitive harms.

Now obviously when we’re talking about small levels of lead, we are talking about small effect sizes. But the fact that even tiny amounts of lead are harmful combined with the fact that anti-lead systems suffer from occasional catastrophic failures (as we saw in DC 15 years ago or Flint more recently) makes me think that total elimination of the lead water pipes is the right goal.

Biden’s plan — get the lead out

The Jobs Act policy proposal on this is pretty simple to the point where the full paragraph from the fact sheet is worth quoting:

Replace 100 percent of the nation’s lead pipes and service lines.  According to the CDC, there is no safe level of lead exposure for children. Lead can slow development and cause learning, behavior, and hearing problems in children, as well as lasting kidney and brain damage. President Biden believes that no American family should still be receiving drinking water through lead pipes and service lines. To eliminate all lead pipes and service lines in the country, he is calling on Congress to invest $45 billion in the Environmental Protection Agency’s Drinking Water State Revolving Fund and in Water Infrastructure Improvements for the Nation Act (WIIN) grants. In addition to reducing lead exposure in homes, this investment also will reduce lead exposure in 400,000 schools and childcare facilities.

It’s not totally clear that $45 billion is the right figure here, but it’s in the right universe. When I looked into this in 2019, the best estimate I could find was from Fitch, which rates municipal bonds and therefore knows a lot about water systems. They say it would cost “from a few billion to $50 billion.”

If anything, I think the biggest question about this policy is how quickly you could do it. As things stand today, the Drinking Water State Revolving Fund spends about $1 billion a year, and WIIN is much smaller than that. To do $45 billion in the normal 10-year horizon, you’d be talking about expanding these programs five-fold. I’m all for it if that’s genuinely doable, but I suspect we may run into some resource constraints on the real (rather than financial) side of the equation since this is the kind of thing where you need some specialized skills and licenses to do the work (I tried to ask the White House for more detail on this but so far, no response).

Flint, which is 54% Black, put this on the map as a racial justice issue. And it’s certainly true that a lot of older and poorer cities with large African American populations like Detroit and Jackson have big lead problems. On the other hand, the water is much freer of lead in heavily Black Birmingham than it is in Omaha, which is whiter than America and Los Angeles, which is plurality Latin.¹ These problems just pop up in different places. And as we saw in the D.C. case, the corrosion situation can be fine until suddenly it’s not fine. At the time that my household water supply was heavily contaminated with lead, I was a young single person and I reassured myself that it’s really only a problem for kids and pregnant women. But that’s not really true (see the loony gas building episode); it’s just that it’s a more serious problem for young developing brains. The truth, as we have apparently known since the late 19th century but just chosen not to act on, is that getting your drinking water from lead pipes is never genuinely okay.

Of course water is infrastructure

Tacking a $400 billion elder care initiative onto what’s primarily an infrastructure plan was weird, and it’s easy to see why Republicans are complaining about it.

But the idea promoted by many GOP politicians that water pipes aren’t infrastructure is bizarre, and indeed some of the people leveling this critique have referred to water systems as infrastructure in the past.

Aaron Rupar @atrupar

Pete Buttigieg: "I heard the governor of South Dakota recently saying, 'this isn't infrastructure -- it's got money for pipes.' Well, we believe that pipes are infrastructure, because you need water to live. And too many families now live with the threat of lead poisoning."

I did a Twitter Spaces with Karl Smith last week and he suggested that the real question of what is and isn’t infrastructure is what kind of economic return you can expect from it. The interstate highway system, he said, raised productivity and GDP a lot. That’s what infrastructure is all about.

I’d say that lead removal easily meets that test. You’ve probably heard of the link between lead and crime. But what’s interesting is that the mechanism is the link between lead and general cognitive ability, both in terms of IQ and self-control. That’s what makes lead removal especially valuable. You’re moving millions of people into at least slightly better cognitive functioning, and that actually helps everyone in society. Garrett Jones has a whole book — “Hive Mind” — about this, showing that while being a little bit smarter than someone else is only a little bit valuable, living in a whole society of smarter people is extremely valuable. And as much as digging up tons of old pipes and replacing them is a pain in the ass, it’s also completely doable. Really good preschools seem to have cognitive benefits, but it’s not clear that anyone actually knows how to create really good preschools for millions of children all across the country. But we really do know how to replace lead pipes.

It’s just a question of time and money. And we should do it. Frankly, my only concern with this initiative is that I’d like to see at least as many resources dedicated to starting to figure out what we can do about the lead soil problem, too.

1. Municipalities are required to publish “Consumer Confidence Reports” also known as “Water Quality Reports,” which contain data on concentrations of all sorts of chemicals including lead. For most chemicals, there is a threshold “below which there is no known or expected risk to health,” but for lead, that’s 0, so they also have an “action level,” above which swift action must be taken to fix the situation. That “action level” is 15 parts per billion (ppb), and the number that is reported is the 90th percentile measurement (where 90 percent of the measuring sites had less lead). Birmingham water has approximately no lead; Los Angeles, Omaha, and Jackson have their 90th percentile measurement at around 8 ppb, half the action level. Detroit’s is 10 ppb. In theory, you can find every city’s Consumer Confidence Report using the EPA’s tool, but most of those links are broken and you’re more likely to find it by just googling “[City] Water CCR” or “[City] Water Quality Report].”