Online Program

Improving public policy through qualitative research: Lessons from homeowners about lead service line replacement under the federal Lead and Copper Rule

Monday, November 4, 2013 : 4:50 p.m. - 5:10 p.m.

Yanna Lambrinidou, PhD, Science and Technology in Society, Virginia Tech, Falls Church, VA
Marc Edwards, PhD, Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA
The Environmental Protection Agency's (EPA's) Lead and Copper Rule (LCR) of 1991 was issued to protect consumers from lead in drinking water. Key among the Rule's provisions is that when a jurisdiction's drinking water tests high for lead, the responsible utility must implement a program to replace lead service lines (LSLs). This provision mandates only "partial" replacement – that is, replacing the publically owned portion of a LSL. Replacement of the privately owned portion, which results in "full" replacement, requires homeowner willingness to cover the cost of the work. To date, the vast majority of LSL replacements in the US under the LCR have been partial. Concerns about health risks associated with such replacements surfaced in the early days of the LCR's inception, but relying on unexamined assumptions about homeowner decision-making, EPA deemed that the benefits of the provision would outweigh the risks. Twenty years after the Rule's adoption, however, the Centers for Disease Control and Prevention (CDC) found a link between homes with a partial LSL replacement and elevated blood lead levels among children. Our study, sponsored by the Robert Wood Johnson Foundation, set out to identify potential gaps in the LCR's LSL replacement provision that might contribute to unintended public health harm. We will present data from ethnographic interviews with homeowners in Washington, DC and Providence, RI – two cities with extensive LSL replacements – to shed light on consumers' first-hand experiences with, decisions about, and assessments of the LCR's LSL replacement requirement. We will conclude with the recommendation that EPA reexamine the safety of the LCR's LSL replacement provision, not only by reassessing its original assumptions, but also by examining the possibility that the requirement it created to eliminate an important source of lead in water may be contributing to environmental injustices in communities across the country.

Learning Areas:

Diversity and culture
Ethics, professional and legal requirements
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
List two assumptions that informed the federal Lead and Copper Rule's lead service line replacement requirement List research findings contradicting these assumptions Discuss ways in which the federal Lead and Copper Rule's lead service line replacement requirement could be strengthened to better protect public health Describe how qualitative research can help improve public policy

Keyword(s): Environmental Health, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have researched public health and policy aspects of lead in drinking water since 2007. My current work on the federal Lead and Copper Rule (LCR) is funded by the Public Health Law Research (PHLR) program of the Robert Wood Johnson Foundation (RWJF) and the Washington, DC Water and Sewer Authority (DC Water). I teach graduate engineering ethics at Virginia Tech.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.