Good afternoon. My name is Daniel R. Lucey, MD, and I am the Interim Chief Medical Officer for the DC Department of Health. In the next five minutes, prior to responding to your questions, I would like to summarize my background and list several key points about the lead issues in Washington, DC.
I am a physician trained in adult medicine and infectious diseases with a Masters degree in Public Health. After serving in the military as a physician I joined the US Public Health Service while working at the National Institutes of Health and the Food and Drug Administration. During 9/11 and the subsequent anthrax attacks I was the Chairman of the Infectious Disease Service at the Washington Hospital Center in DC. In 2002 I was involved with the smallpox vaccination program, in 2003 with SARS (traveling to Hong Kong and mainland China, and working in a hospital in Toronto), and in 2004 with avian influenza.
On February 10, 2004 I began work at the DC Department of Health (DOH) with a focus on biodefense. On February 13th I attended a Lead Task Force meeting. Every day since then I have worked on lead issues. Although not a lead expert, I have approached learning about the lead issues through an intensive process, much like learning about other previously unfamiliar diseases such as anthrax, SARS, and avian influenza.
On February 16th, I contacted the Director of the Centers for Disease Control and Prevention (CDC), Dr. Julie Gerberding, to request advice from lead experts at the CDC. Her response was immediate and outstanding CDC assistance has been ongoing since that time.
On February 26th, the City Administrator, Mr. Robert Bobb, instructed me to direct the Department of Health response to lead issues. Later that day I completed and signed a Health Advisory letter from the Department of Health to the approximately 23,000 residences in DC with lead service lines. (Attachment #1) The advisory contained recommendations about drinking water and measuring blood lead levels in persons most at risk for lead poisoning in order to assess the health impact of increased lead in the water. To our knowledge, no such widespread health advisory on lead in drinking water has ever been issued in the United States. Our findings may be useful to other cities that find increased lead concentrations in their drinking water.
In order to provide blood lead level testing by the Department of Health, starting on February 28th at DC General Hospital, we mobilized many persons in the Department of Health. In addition, on March 1st, I contacted the US Surgeon General, Dr. Carmona, to request personnel assistance. He responded immediately, and via Admiral Babb and the Commissioned Corps Readiness Force (CCRF), provided a team of Public Health Service officers over the next four weeks who worked long hours with us in clinics across DC. They also went to several hundred homes of persons at high risk of lead poisoning. On March 30th the DC DOH, CCRF and CDC published our preliminary results on blood lead levels in the CDC’s Morbidity and Mortality Weekly Report (MMWR).
To summarize key points:
1. None of the 201 persons we tested who live in homes with the highest measured levels of lead in the drinking water (i.e. > 300 parts per billion (ppb)) had elevated blood lead levels. (Attachment #2 MMWR March 30, 2004).
2. From 2000 – 2003 the percentage of children less than 6 years of age with elevated blood lead levels (> 10 mcg/dl) continued to decline in DC both in homes with and without lead service lines. The percent of children with blood lead levels > 5 mcg/dl did not decline in homes with lead service lines, although this percent did decline in homes without lead service lines. (Attachment #2 MMWR March 30, 2004)
3. Only 2 of the initial 280 children in home childcare facilities with lead service lines had elevated blood lead levels (Attachment #3).
4. Of the initial 4,106 persons who came to our clinics across DC for free blood lead level testing in our laboratory, 1,277 were young children <6 years old, of whom 16 had elevated blood levels. The initial 14 children have been found to live in homes with dust and/or soil lead levels exceeding EPA/HUD guidelines. The homes of the other 2 children are currently being evaluated. (Attachment #4).
5. According to the CDC, from 1976 – 1980, nearly 9 of 10 (88.2%) children 1-5 years old (adults now 24 – 28 years old) in the USA had blood lead levels that today are considered elevated, namely at least 10 micrograms/ deciliter (“>10 ug/dl”). (Attachment #5).
6. The EPA “action level” for lead in drinking water of 15 parts per billion (or 0.015 mg/Liter) is not a health-based recommendation. According to the EPA: “This action level was not designed to measure health risks from water represented by individual samples. Rather, it is a statistical trigger that, if exceeded, requires more treatment, public education and possibly lead service line replacement” (Attachment # 6).
Thank you for your time and I will be pleased to respond to your questions.
Daniel R. Lucey, MD, MPH
Interim Chief Medical Officer
DC Department of Health