Toronto ’ s Management of Lead Service Lines Lead Colloborative Consortium Workshop, June 8, 2012

1. Toronto’s Management of Lead Service Lines Lead Colloborative Consortium Workshop, June 8, 2012 Howard Shapiro, Toronto Public Health 1

2. What is a Service Line / Water Service?

3. Health effects seen at levels of lead in current population • Lead exposure should be minimized where possible • However, issue portrayed as individual crisis • Question for TPH was is significance of water lead levels that are slightly above drinking water guidelines • Communication to public • Management strategies Overall Approach and Issues

4. Toronto • City 2.7 million • Very active media presence • History of lead contamination in certain communities now largely resolved • Lead not much of an issue in recent past • Spring 2007 lead found in London, Ontario drinking water above drinking water standard in older homes due to lead services • Toronto media asks about situation in Toronto Situation

5. Samples from 5 Minute Flush How Big a Problem?

6. How Big a Problem

7. Desire to not counter extensive promotion of Toronto’s water • Water leaving treatment plant very low in lead • Water from Toronto homes within Ontario Drinking Water Standard for lead • Homes built before 1955 usually have lead service and may have high lead in water • Can find out by requesting free water test from Toronto Water • While waiting use water filter Early Messaging

8. Tried to provide health context • Effects of lead at this level in water would be subtle on intelligence of children but not detectable but parent or physician • Water one source of lead but not only one • Important in older homes with lead pipes since likely to have lead paint, lead in soil • Takes place within trends of decreasing lead levels over time • Developed TPH web pages for lead • Very hard to distinguish between population and individual importance of lead Early Messaging

9. Of City side only • Homeowner can pay to have their side done at same time • When: • At time of scheduled water main replacement • During emergency repairs • In response to high lead water test • On request (long waiting period) • Toronto Water reluctant to undertake corrosion control Early Program Focused on Replacement

10. Estimated 65,000 lead services • 28,000 already replaced • Original plan 13 year time frame • Accelerate replacement to 9 years • Additional $19 million per year • Mainly through increasing main replacement in area likely to have lead services Toronto Water Accelerates Program

11. Requires twice yearly testing • 2 X 1 litre samples • 30 minutes stagnation after flushing • 100 homes in large city such as Toronto • Benchmark – 10 ppb 90 %ile • Corrosion Control plan if fail 2 out of 3 consecutive rounds of testing Province Introduces New Rules

12. City Fails 2nd Round of Testing

13. Trained nurses doing neonatal visits in lead water issue • Initiated development of filter faucet rebate program • Sent postcard to approx. 50,000 homes in areas likely to have LSL Changes to Approach

14. Changes to Approach

15. Testing of water for lead not a good way to risk stratify individual homes • Intermittent particulate release • Impact of water on lead levels may be more significant than some studies suggested • Replacing part of lead service with copper may be worse than leaving entire lead line Existing and Developing Information

16. Sources of Lead In Drinking Water

17. Seasonal Variation in Water Lead

18. Edwards et al. Environ. Sci. Technol. 2009 • Showed impacts of spike in DC water levels on BLL’s • Incidence of BLL > 10 μg/dL increased 4 times for children ≤1.3 years during time of high lead water levels • CDC Issues notice in 2010 about past MMWR • Cross-sectional study of people with high water lead levels (> 300 ppb) in DC flawed • Sampling time of blood and water not known • Issue was a temporary spike in water lead levels in DC • Also warned against partial replacement Further Developments Water Impact

19. In-house modelling (IEUBK)

20. Lead Levels Similar After Partial Replacement

21. Galvanic Corrosion can Increase Lead Levels • Process used in batteries • Occurs with metals of different electrical potential • Results in corrosion of one metal • With lead and copper results in corrosion of lead • Lead levels can be higher than lead pipe alone

24. Accelerated LSL replacement discontinued • Now only done as part of state of good repair (e.g. when replacing main) • Water filter and information sheet left at each home after all LSL replacements • Corrosion control is being implemented Additional Changes

26. Water testing de-emphasized for individual homes • Not promoted for individuals to risk stratify • People can request LSL replacement without water testing so long as commit to replacing their side • Vulnerable groups are encouraged to use filter until lead service removed (no longer based on testing result) • Re-evaluating communication strategy based on survey of homes with partial and full LSL replacements Additional Changes

27. Howard Shapiro • Toronto Public Health • hshapir@toronto.ca • 416-338-8562 Questions