“Staggering” Health Benefits From Replacing Lead Water Pipes Could Save Nearly $1 Trillion from Avoided Health Impacts

WASHINGTON – Replacing every lead pipe that delivers drinking water to homes nationwide would yield hundreds of billions of dollars in avoided health costs, according to a new state-by-state analysis released today from NRDC (Natural Resources Defense Council). “Getting the Lead Out” finds that every state would reap enormous savings in avoided health costs – with nearly 90% of the savings coming from reduced cardiovascular disease, the leading cause of death in the U.S. 

“Decades ago, health risks led to a ban on lead from gasoline and paint, but lead remains widespread in drinking water across the nation. This is an urgent public health crisis, as tens of millions of people essentially drink water from a lead straw, unaware of the big risk to their health,” said Erik D. Olson, NRDC’s senior strategic director for health, who authored the report. “We found staggering health and dollar benefits for removing lead water pipes. And water utilities that do nothing are essentially opting in favor of avoidable and costly health risks and even deaths.”

Federal rules for tap water adopted by the Trump Administration in 2021 failed to consider these enormous public health benefits. However, with the Environmental Protection Agency (EPA) poised to release a new rule regulating lead in drinking water in a few weeks, the agency is expected to require that all lead drinking water pipes be fully replaced.

Health experts agree there is no safe level of exposure to lead. In addition to long-known risks, such as damage to children’s brains and certain cancers, the American Heart Association recently issued a formal Scientific Statement emphasizing there is significant evidence that exposure to lead is linked to numerous cardiovascular diseases, including stroke and heart attack. The risk of heart disease is especially high in populations of color and low socioeconomic means, due in part to greater lead exposure.

“No amount of lead is safe. Most people know children’s brains are vulnerable to this toxic metal, but lead is also a striking risk factor for fatal heart disease in adults. Lead pipes are a major source of lead in drinking water, so states and cities must urgently replace them,” said Bruce P. Lanphear, MD, MPH, Professor of Children’s Environmental Health, Simon Fraser University. Dr. Lanphear has conducted research on the sources of lead exposure and the health impacts of lead poisoning for over 25 years. 

The benefits of removing lead service lines, the lead pipes that connect homes to the water mains in the street, dwarf the costs by an enormous margin. NRDC’s analysis determined the benefits of removing lead pipes outweigh the costs by 14- to 17-fold. EPA and the water utility trade association in the past have estimated the total cost of removing all 9.2 million lead service lines nationwide would be in the range of $46 to $56 billion. The total health savings of reducing lead levels in tap water would be orders of magnitude higher, according to a recent Harvard T.H. Chan School of Public Health study, which formed much of the basis for the NRDC study. Ronnie Levin, the lead co-author of the Harvard study, extracted data on the benefits of removing lead pipes from that study, and based upon that analysis forecast at least $9 billion in annual health benefits from removing all lead pipes in the country, with total health savings of $786 billion over the next 35 years.

“Lead can seriously harm our health and kids are especially vulnerable. But the study released today highlights that adults are at risk too, and that the health and economic benefits of removing lead pipes would be significant, many times what it would cost to pull them out. It may surprise many people that about 90 percent of the quantifiable health costs from lead released by lead service lines is due to its link to cardiovascular disease and death. We can fix this problem, we just need the will to do it,” said Ronnie Levin, lead co-author of the Harvard study and instructor at the T.H. Chan School of Public Health.

The financial benefits in avoided health costs in each state are enormous. Benefits for individual states based on NRDC estimates of lead service lines range from $325 million for Alaska on the low end to $58 billion in Illinois on the high end.

Top States: Total Benefits and Costs of Full Lead Service Line Replacement*

1. Illinois $58B to $89B
2. Ohio $56B to $64B
3. Michigan $39B to $26B
4. New York $31B to $42B
5. New Jersey $30B to $29B
6. Missouri $28B to $17B
7. Wisconsin $28B to $29B
8. Indiana $25B to $23B
9. Texas $23B to $55B
10. Minnesota $22B to $23B
11. Florida $17B to $99B
12. Pennsylvania $14B to $59B

* Total Estimated Benefits over 35-year Analysis Period to closest billion dollars (USD); based on NRDC and EPA estimates of the number of lead service lines (LSLs). Ranking based on NRDC estimates; EPA’s estimates for certain states, particularly FL, have been questioned–see report for full details. 

NRDC recommendations include:

• The Biden-Harris administration, the EPA, states, and water utilities must make complete removal of every lead service line a top priority.
• The EPA’s improvements to the Lead and Copper Rule should require that all lead service lines be fully replaced by the water utilities within 10 years. “Partial” replacements of the lead service line should be banned, as that practice can actually increase lead exposure.
• The EPA rule should require water utilities to cover all the costs of full lead service line replacement to ensure low-income homeowners and renters get safe drinking water.
• State and local governments should access federal funding to help water systems get the lead out:
  • The Bipartisan Infrastructure Law makes a $15 billion down payment to start getting lead service lines out of the ground.
  • Further funding is available through the Drinking Water State Revolving Funds, Water Infrastructure Finance and Innovation Act, and the American Rescue Plan Act to help communities, especially disadvantaged communities, pay to replace their lead service lines.
  • To avoid exacerbating water affordability issues, utilities should seek all available government funding and adopt water affordability programs (see the Water Affordability Advocacy Toolkit by NRDC and the National Consumer Law Center).

METHODOLOGY:

NRDC’s report, “Getting the Lead Out,” builds on a Harvard School of Public Health study that sought to quantify and monetize the full range of health benefits of reducing lead levels in drinking water. Other data points used to develop the state-by-state health benefits analysis were taken from EPA’s recent state survey and NRDC’s 50-state survey identifying the number of lead pipes in each state.

The Harvard study was published in July 2023 in the peer-reviewed scientific journal Environmental Research by Harvard researchers Ronnie Levin and Joel Schwartz. The authors are recognized lead experts who were formerly involved in developing EPA’s estimates of the health benefits of reducing lead exposure. 

The Harvard analysis shows that the EPA’s January 2021 proposed plan to regulate lead in drinking water during the Trump Administration failed to consider the vast majority of the $9.2 billion in annual health benefits that EPA’s published scientific assessments found are caused by lead exposure. The study found the EPA had “developed a highly detailed and comprehensive cost analysis while ignoring 95 percent of the health effects it has determined are causally related to lead exposure.” The study noted the EPA’s 2021 analysis of the economic costs of addressing lead in water is 359 pages long while the discussion of health benefits totals 56 pages.    

NRDC (Natural Resources Defense Council) is an international nonprofit environmental organization with more than 3 million members and online activists. Established in 1970, NRDC uses science, policy, law and people power to confront the climate crisis, protect public health and safeguard nature. NRDC has offices in New York City, Washington, D.C., Los Angeles, San Francisco, Chicago, Bozeman, MT, Beijing and Dehli (an office of NRDC India Pvt. Ltd). Visit us at www.nrdc.org and follow us on Twitter @NRDC.