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Abstract
This ecologic study notes that fetal death rates (FDR) during the Washington DC drinking
water "lead crisis" (2000-2004) peaked in 2001 when water lead levels (WLLs) were
highest, and were minimized in 2004 after public health interventions were implemented
to protect pregnant women. Changes in the DC FDR vs neighboring Baltimore City were
correlated to DC WLL (R(2) = 0.72). Birth rates in DC also increased versus Baltimore
City and versus the United States in 2004-2006, when consumers were protected from
high WLLs. The increased births in DC neighborhoods comparing 2004 versus 2001 was
correlated to the incidence of lead pipes (R(2) = 0.60). DC birth rates from 1999
to 2007 correlated with proxies for maternal blood lead including the geometric mean
blood lead in DC children (R(2) = 0.68) and the incidence of lead poisoning in children
under age 1.3 years (R(2) = 0.64). After public health protections were removed in
2006, DC FDR spiked in 2007-2009 versus 2004-2006 (p < 0.05), in a manner consistent
with high WLL health risks to consumers arising from partial lead service line replacements,
and DC FDR dropped to historically low levels in 2010-2011 after consumers were protected
and the PSLR program was terminated. Re-evaluation of a historic construction-related
miscarriage cluster in the USA Today Building (1987-1988), demonstrates that high
WLLs from disturbed plumbing were a possible cause. Overall results are consistent
with prior research linking increased lead exposure to higher incidence of miscarriages
and fetal death, even at blood lead elevations (≈5 μg/dL) once considered relatively
low.
[1
]Civil and Environmental Engineering Department, Virginia Polytechnic Institute and
State University, 418 Durham Hall, Blacksburg, Virginia 24061, United States