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Poor documentation of elevated Pb levels in underserved regions prevents the development of environmental contamination policies and interventions. This study investigates Pb contamination and associated carcinogenic and non-carcinogenic health risks in Makululu, a large compound near the former Pb mine in Kabwe City, Zambia. We analyzed 34 drinking groundwater samples from hand pump boreholes (n = 21) and shallow wells (n = 13). Pb concentrations exceeded WHO and USEPA standards for safe drinking in 100% of boreholes (median = 0.15 mg\/L) and 77% of shallow wells (median = 0.06 mg\/L). Linear regression analysis identified temperature and depth as key predictors of Pb concentrations, with higher temperatures correlating with increased Pb levels (p = 0.008), and deeper boreholes (50\u2013100 m) exhibiting significantly higher Pb concentrations (p = 0.007) than shallow wells (10 m). Health risk assessments revealed that adults consuming borehole water had an average daily dose of 0.005 mg\/kg\/day of Pb exceeding WHO thresholds, with hazard quotients (HQ &amp;gt; 1) indicating non-carcinogenic risks. The findings highlight the urgent need for policies to mitigate environmental pollution, enforce water quality standards to reduce Pb levels and protect public health in Makululu.<\/jats:p>","DOI":"10.2166\/wh.2025.343","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T07:35:02Z","timestamp":1743492902000},"page":"615-629","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":10,"title":["Lead-contaminated groundwater exposes residents to health risks in Makululu, Zambia"],"prefix":"10.2166","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7890-7645","authenticated-orcid":false,"given":"Tasha","family":"Siame","sequence":"first","affiliation":[{"name":"a University of Zambia, Biomedical Sciences Department, School of Veterinary Medicine, P.O Box 32379, Lusaka, Zambia"},{"name":"b Michigan State University, Department of Forestry, Environmental Science & Policy Program, College of Agriculture & Natural Resources, East Lansing MI, 48824, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8517-7272","authenticated-orcid":false,"given":"Kaampwe","family":"Muzandu","sequence":"additional","affiliation":[{"name":"a University of Zambia, Biomedical Sciences Department, School of Veterinary Medicine, P.O Box 32379, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1881-7797","authenticated-orcid":false,"given":"Keagan K.","family":"Mulenga","sequence":"additional","affiliation":[{"name":"a University of Zambia, Biomedical Sciences Department, School of Veterinary Medicine, P.O Box 32379, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine B.","family":"Dzombe","sequence":"additional","affiliation":[{"name":"a University of Zambia, Biomedical Sciences Department, School of Veterinary Medicine, P.O Box 32379, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"945","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"key-10.2166\/wh.2025.343-1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2024.118320"},{"key":"key-10.2166\/wh.2025.343-2","doi-asserted-by":"publisher","DOI":"10.33271\/nvngu\/2024-1\/122"},{"key":"key-10.2166\/wh.2025.343-3","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2023.162274"},{"key":"key-10.2166\/wh.2025.343-4","unstructured":"CDC (2022) Calculating Hazard Quotients and Cancer Risk Estimates. 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