{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T18:37:41Z","timestamp":1772822261650,"version":"3.50.1"},"reference-count":83,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2018,7,20]],"date-time":"2018-07-20T00:00:00Z","timestamp":1532044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Louisiana Board of Regents (LBOR)","award":["LEQSF-EPS(2015)-PFUND-406"],"award-info":[{"award-number":["LEQSF-EPS(2015)-PFUND-406"]}]},{"name":"Louisiana Board of Regents (LBOR)","award":["LEQSF(2015-18)-RD-A-13"],"award-info":[{"award-number":["LEQSF(2015-18)-RD-A-13"]}]},{"name":"Louisiana Clinical and Translational Science Center","award":["1 U54 GM104940"],"award-info":[{"award-number":["1 U54 GM104940"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Flushing tap water is promoted as a low cost approach to reducing water lead exposures. This study evaluated lead reduction when prevailing flush guidelines (30 s\u20132 min) are implemented in a city compliant with lead-associated water regulations (New Orleans, LA, USA). Water samples (n = 1497) collected from a convenience sample of 376 residential sites (2015\u20132017) were analyzed for lead. Samples were collected at (1) first draw (n = 375) and after incremental flushes of (2) 30\u201345 s (n = 375); (3) 2.5\u20133 min (n = 373), and (4) 5.5\u20136 min (n = 218). There was a small but significant increase in water lead after the 30 s flush (vs. first draw lead). There was no significant lead reduction until the 6 min flush (p &lt; 0.05); but of these samples, 52% still had detectable lead (\u22651 ppb). Older homes (pre-1950) and low occupancy sites had significantly higher water lead (p &lt; 0.05). Each sample type had health-based standard exceedances in over 50% of sites sampled (max: 58 ppb). While flushing may be an effective short-term approach to remediate high lead, prevailing flush recommendations are an inconsistently effective exposure prevention measure that may inadvertently increase exposures. Public health messages should be modified to ensure appropriate application of flushing, while acknowledging its short-comings and practical limitations.<\/jats:p>","DOI":"10.3390\/ijerph15071537","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T03:24:27Z","timestamp":1532316267000},"page":"1537","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Effectiveness of Prevailing Flush Guidelines to Prevent Exposure to Lead in Tap Water"],"prefix":"10.3390","volume":"15","author":[{"given":"Adrienne","family":"Katner","sequence":"first","affiliation":[{"name":"School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey","family":"Pieper","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Komal","family":"Brown","sequence":"additional","affiliation":[{"name":"School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-Yi","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Parks","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinnan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Yang","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheldon","family":"Masters","sequence":"additional","affiliation":[{"name":"Corona Environmental Consulting, Philadelphia, PA 19146, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-3807","authenticated-orcid":false,"given":"Howard","family":"Mielke","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,7,20]]},"reference":[{"key":"ref_1","unstructured":"National Toxicology Program (NTP) (2012). Health Effects of Low-Level Lead, NTP Monograph."},{"key":"ref_2","unstructured":"Sandvig, A., Kwan, P., Kirmeyer, G., Maynard, B., Mast, R., and Rhodes, R.T. (2008). Contribution of Service Line and Plumbing Fixtures to Lead and Copper Rule Compliance Issues, International Water Association. AWAARF Report 91229."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1080\/10643389.2011.556556","article-title":"Lead (Pb) in Tap water and in blood: Implications for lead exposure in the United States","volume":"42","author":"Triantafyllidou","year":"2012","journal-title":"Crit. Rev. Environ. Sci. Technol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1289\/ehp.11241","article-title":"Lead Exposures in US Children, 2008: Implications for Prevention","volume":"116","author":"Levin","year":"2008","journal-title":"Environ. Health Perspect."},{"key":"ref_5","unstructured":"U.S. Environmental Protection Agency (US EPA) (1991). Safe Drinking Water Act Lead and Copper Rule (LCR). Fed. Reg., 56, 26460\u201326564."},{"key":"ref_6","unstructured":"U.S. Environmental Protection Agency (US EPA) (2010). Lead and Copper Rule: Monitoring and Reporting Guidance for Public Water Systems."},{"key":"ref_7","unstructured":"National Drinking Water Advisory Council (NDWAC) (2015). LCR Long-Term Revisions White Paper."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1016\/j.watres.2013.02.010","article-title":"Application of lead monitoring results to predict 0\u20137 year old children\u2019s exposure at the tap","volume":"47","author":"Deshommes","year":"2013","journal-title":"Water Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2166\/wh.2013.067","article-title":"Assessing risk with increasingly stringent public health goals: The case of water lead and blood lead in children","volume":"12","author":"Triantafyllidou","year":"2014","journal-title":"J. Water Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1289\/ehp.1409144","article-title":"Use of a cumulative exposure index to estimate the impact of tap water lead concentration on blood lead levels in 1- to 5-year-old children (Montreal, Canada)","volume":"124","author":"Ngueta","year":"2016","journal-title":"Environ. Health Perspect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6836","DOI":"10.1021\/es501342j","article-title":"Profile sampling to characterize particulate lead risks in potable water","volume":"48","author":"Clark","year":"2014","journal-title":"Environ. Sci. Technol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E140","DOI":"10.5942\/jawwa.2015.107.0012","article-title":"High-velocity household and service line flushing following LSL replacement","volume":"107","author":"Brown","year":"2015","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_13","first-page":"128","article-title":"Effect of partial lead service line replacement on total lead at the tap in Cranston, Rhode Island","volume":"126","author":"Commons","year":"2012","journal-title":"J. New Eng. Water Works Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"12697","DOI":"10.1021\/acs.est.5b03174","article-title":"Profiling private water systems to identify patterns of waterborne lead exposure","volume":"49","author":"Pieper","year":"2015","journal-title":"Environ. Sci. Technol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/j.1551-8833.2007.tb07959.x","article-title":"Lead particles in potable water","volume":"99","author":"Triantafyllidou","year":"2007","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Vasile, G.G., Catrangiu, A., and Cruceru, L.V. (2014, January 17\u201326). A field study on overnight stagnation of drinking water in domestic distribution system. Proceedings of the 14th International Multidisciplinary Scientific Geoconference and EXPO, Albena, Bulgaria.","DOI":"10.5593\/SGEM2014\/B31\/S12.002"},{"key":"ref_17","unstructured":"U.S. Environmental Protection Agency (US EPA) (2007). 40 CFR Parts 141 and 142 National Primary Drinking Water Regulations for Lead and Copper: Short-term regulatory revisions and clarifications; Final Rule. Fed. Regist., 62, Available online: https:\/\/www.gpo.gov\/fdsys\/pkg\/FR-2007-10-10\/pdf\/E7-19432.pdf."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1002\/j.1551-8833.2004.tb10724.x","article-title":"Role of chlorine and chloramine in corrosion of lead-bearing plumbing materials","volume":"96","author":"Edwards","year":"2004","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1061\/(ASCE)0733-9372(2004)130:10(1188)","article-title":"Pb in tap water following simulated partial lead pipe replacements","volume":"130","author":"Boyd","year":"2004","journal-title":"J. Environ. Eng."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/BF00454749","article-title":"Causes of temporal variability of lead in domestic plumbing systems","volume":"15","author":"Schock","year":"1990","journal-title":"Environ. Monit. Assess."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1061\/(ASCE)0733-9372(2005)131:11(1514)","article-title":"Modified Larsons ratio incorporating temperature, water age, and electroneutrality effects on red water release","volume":"131","author":"Imran","year":"2005","journal-title":"J. Environ. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1089\/ees.2014.0400","article-title":"Increased lead in water associated with iron corrosion","volume":"32","author":"Masters","year":"2015","journal-title":"Environ. Eng. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/j.1551-8833.2007.tb08060.x","article-title":"Combined chlorine dissipation: Pipe material, water quality, and hydraulic effects","volume":"99","author":"Mutoti","year":"2007","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10661-016-5182-x","article-title":"Inherent variability in lead and copper collected during standardized sampling","volume":"188","author":"Masters","year":"2016","journal-title":"Environ. Monit. Assess."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2166\/ws.2001.0050","article-title":"The role of pipe aging in copper corrosion by-product release","volume":"1","author":"Edwards","year":"2001","journal-title":"Water Sci. Technol. Water Supply"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"39","DOI":"10.5942\/jawwa.2012.104.0002","article-title":"Control of new copper corrosion in high-alkalinity drinking water","volume":"104","author":"Grace","year":"2012","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/j.1551-8833.2001.tb09338.x","article-title":"Aging of copper pipes by drinking water","volume":"93","author":"Lagos","year":"2001","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1006\/enrs.2002.4356","article-title":"Metals in drinking water from new housing estates in the Sydney area","volume":"89","author":"Rajaratnam","year":"2001","journal-title":"Environ. Res."},{"key":"ref_29","unstructured":"Schock, M.R., Wagner, I., and Oliphant, R. (1996). Corrosion and solubility of lead in drinking water. Internal Corrosion of Water Distribution Systems, AWWA Research Foundation. [2nd ed.]. Chapter 4."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1089\/ees.2015.0337","article-title":"Long-term behavior of simulated partial lead service line replacements","volume":"33","author":"Cartier","year":"2016","journal-title":"Environ. Eng. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"9300","DOI":"10.1021\/es4003636","article-title":"Detection and evaluation of elevated lead release from service lines: A field study","volume":"47","author":"Porter","year":"2013","journal-title":"Environ. Sci. Technol."},{"key":"ref_32","first-page":"2387","article-title":"Chlorine decay in drinking-water transmission and distribution systems: Pipe service age effect","volume":"4","year":"2007","journal-title":"Water Res."},{"key":"ref_33","unstructured":"Crozes, G.F., and Cushing, R.S. (2000). Evaluating Biological Regrowth in Distribution Systems, AWWA Research Foundation."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2166\/aqua.2005.0001","article-title":"Calculation of the mean residence time in distribution systems from tracer studies and models","volume":"54","author":"DiGiano","year":"2005","journal-title":"J. Water Supply Res. Technol. Aqua"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/0043-1354(94)00323-Y","article-title":"The effects of water resident time on biological quality in a distribution network","volume":"29","author":"Kerneis","year":"1995","journal-title":"Water Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/0043-1354(94)00202-I","article-title":"Simultaneous transport of substrates, disinfectants and microorganisms","volume":"29","author":"Lu","year":"1995","journal-title":"Water Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s10661-015-4747-4","article-title":"Distribution system water age can create premise plumbing corrosion hotspots","volume":"187","author":"Masters","year":"2015","journal-title":"Environ. Monit. Assess."},{"key":"ref_38","unstructured":"U.S. Environmental Protection Agency Science Advisory Board (US EPA SAB) (2011). Evaluation of the Effectiveness of Partial Service Line Replacements."},{"key":"ref_39","unstructured":"U.S. Environmental Protection Agency (US EPA) (2008, May 01). Implementing the Lead Public Education Provision of the Lead and Copper Rule: A Guide for Community Water Systems, Available online: https:\/\/nepis.epa.gov\/Exe\/ZyPDF.cgi\/60001I4N.PDF?Dockey=60001I4N.PDF."},{"key":"ref_40","unstructured":"U.S. Environmental Protection Agency (US EPA) (2008). Lead and Copper Rule: Public Education and Other Public Information Requirements for Community Water Systems."},{"key":"ref_41","unstructured":"Sewerage and Water Board of New Orleans (S & WB) (2017, August 28). Water Quality 2014 Report. Available online: https:\/\/www.swbno.org\/docs.asp."},{"key":"ref_42","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2017, May 23). ATSDR Toxzine: Lead, Available online: https:\/\/www.atsdr.cdc.gov\/sites\/toxzine\/docs\/lead_toxzine.pdf."},{"key":"ref_43","unstructured":"U.S. Centers for Disease Control and Prevention (US CDC) (2017, August 28). Learn How to Prevent Children\u2019s Exposure to Lead, Available online: http:\/\/www.cdc.gov\/features\/leadpoisoning\/."},{"key":"ref_44","unstructured":"U.S. Environmental Protection Agency (US EPA) (1993). Lead in Your Drinking Water-Actions You Can Take to Reduce Lead in Drinking Water."},{"key":"ref_45","unstructured":"American Water Works Association (AWWA) (1996). Water:\/\/Stats 1996 Distribution Survey, AWWA."},{"key":"ref_46","unstructured":"Sewerage and Water Board of New Orleans (S & WB) (2017, August 28). Water Quality 2008 Report. Available online: https:\/\/www.swbno.org\/docs.asp."},{"key":"ref_47","unstructured":"Black and Veatch (1970, January 01). Report on Current and Future Capital Needs: 2006. Prepared for the Sewerage and Water Board of New Orleans. Available online: https:\/\/www.swbno.org\/getfile.asp?documents\/Reports\/Needs%20Report%202006.pdf."},{"key":"ref_48","unstructured":"Black and Veatch (2017, June 08). Report on Operations for 2015: Black and Veatch Project No.192043. Prepared for the Sewerage and Water Board of New Orleans. Available online: https:\/\/www.swbno.org\/docs.asp."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"E555","DOI":"10.5942\/jawwa.2016.108.0167","article-title":"Prevost, M. Monitoring-based framework to detect and manage lead service lines","volume":"108","author":"Deshommes","year":"2016","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"E374","DOI":"10.5942\/jawwa.2016.108.0085","article-title":"Typical Kitchen faucet-use flow rates: Implications for lead concentration sampling","volume":"108","author":"Welter","year":"2016","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_51","unstructured":"American Public Health Association (APHA), American Water Works Association (AWWA), and Water Environment Federation (WEF) (1998). Standard Methods for Examination of Water and Wastewater, APHA. [20th ed.]."},{"key":"ref_52","unstructured":"American Academy of Pediatrics (AAP) Council on Environmental Health (2016). Prevention of childhood lead toxicity. Pediatrics, 138, e20161493. Available online: http:\/\/pediatrics.aappublications.org\/content\/pediatrics\/138\/1\/e20161493.full.pdf."},{"key":"ref_53","unstructured":"Department of Health and Human Services (US) (DHHS), and Food and Drug Administration (FDA) (2017, August 25). Bottled Water, Available online: https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfcfr\/CFRSearch.cfm?fr=165.110."},{"key":"ref_54","unstructured":"World Health Organization (WHO) (1995). Lead in Drinking Water: Background Document for Development of WHO Guidelines for Drinking-water Quality, WHO. Available online: http:\/\/www.who.int\/water_sanitation_health\/dwq\/chemicals\/lead.pdf."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"10941","DOI":"10.1021\/es3017396","article-title":"Potential reversal and the effects of flow pattern on galvanic corrosion of lead","volume":"46","author":"Arnold","year":"2012","journal-title":"Environ. Sci. Technol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1002\/j.1551-8833.2010.tb11340.x","article-title":"Lead-contaminated water from brass plumbing devices in new buildings","volume":"102","author":"Elfland","year":"2010","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"E596","DOI":"10.5942\/jawwa.2012.104.0143","article-title":"A rapid method for lead service line detection","volume":"104","author":"Cartier","year":"2012","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_58","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (1988). The Nature and Extent of Lead Poisoning in Children in the UNITED States: A Report to Congress."},{"key":"ref_59","unstructured":"Mauss, E.A., Kass, A.R., and Warren, J.M. (1991). The Lead Contamination Control Act a Study in Non-Compliance, Natural Resources Defense Council."},{"key":"ref_60","unstructured":"World Health Organization (WHO) (2017). Guidelines for Drinking-Water Quality: Incorporating the First Addendum, WHO. [4th ed.]. Available online: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/254637\/9789241549950-eng.pdf;jsessionid=07E0E7A995A08EFAFC3CDAE257E1A6C3?sequence=1."},{"key":"ref_61","unstructured":"California Environmental Protection Agency (Cal-EPA) Office of Environmental Health Hazard Assessment (OEHHA) (2017, August 28). Public Health Goals for Chemicals in Drinking Water: Lead, Available online: https:\/\/oehha.ca.gov\/media\/downloads\/water\/chemicals\/phg\/leadfinalphg042409_0.pdf."},{"key":"ref_62","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (1970, January 01). Meeting of the Lead Poisoning Prevention Subcommittee of the NCEH\/ATSDR Board of Scientific Counselors, Available online: https:\/\/www.atsdr.cdc.gov\/science\/lpp\/docs\/lead_subcommittee_minutes_9_19_2016_508.pdf."},{"key":"ref_63","unstructured":"U.S. Environmental Protection Agency (US EPA) (2018, May 21). Proposed Modeling Approaches for a Health-Based Benchmark for Lead in Drinking Water, Available online: https:\/\/www.epa.gov\/sites\/production\/files\/2017-01\/documents\/report_proposed_modeling_approaches_for_a_health_based_benchmark_for_lead_in_drinking_water_final_0.pdf."},{"key":"ref_64","first-page":"18","article-title":"Lead leaching from faucet fixtures under residential conditions","volume":"61","author":"Patch","year":"1998","journal-title":"J. Environ. Health"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1089\/ees.2015.0073","article-title":"Lead released to drinking water from galvanized steel pipe coatings","volume":"32","author":"Clark","year":"2015","journal-title":"Env. Eng. Sci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.watres.2018.04.045","article-title":"Sampling in schools and large institutional buildings: Implications for regulations, exposure and management of lead and copper","volume":"140","author":"Dore","year":"2018","journal-title":"Water Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1289\/ehp.93101240","article-title":"Effectiveness of flushing on reducing lead and copper levels in school drinking water","volume":"101","author":"Murphy","year":"1993","journal-title":"Environ. Health Perspect."},{"key":"ref_68","unstructured":"U.S. Government Accountability Office (US GAO) (2017, May 23). Water Infrastructure: Information on Selected Midsize and Large Cities with Declining Populations, Available online: http:\/\/www.gao.gov\/assets\/680\/679783.pdf."},{"key":"ref_69","unstructured":"State of Michigan, Department of Treasury (2017, September 10). Flint Water Rate Analysis: Final Report, Available online: http:\/\/www.michigan.gov\/documents\/snyder\/Flint_Rate_Analysis_Final_Raftelis_Report_May_13_2016_524463_7.pdf."},{"key":"ref_70","unstructured":"Edwards, M., Lambrinidou, Y., Schott, R., and Schwartz, P. (2017, August 28). Gaps in the EPA Lead and Copper Rule that Can Allow for Gaming of Compliance: DC WASA 2003\u20132009, Available online: https:\/\/democrats-oversight.house.gov\/sites\/democrats.oversight.house.gov\/files\/documents\/Edwards-VA%20Tech%20Statement%203-15%20Flint%20Water%20II.pdf."},{"key":"ref_71","unstructured":"Lead and Copper Rule Working Group (LCRWG) (2017, August 28). Report of the Lead and Copper Rule Working Group to the National Drinking Water Advisory Council: Final. Available online: https:\/\/www.epa.gov\/sites\/production\/files\/2016-01\/documents\/ndwaclcrwgfinalreportaug2015.pdf."},{"key":"ref_72","unstructured":"New Orleans Office of Inspector General (NO OIG) (2017, September 01). Lead Exposure and Infrastructure Reconstruction. Available online: http:\/\/www.nolaoig.gov\/index.php?option=com_mtree&task=att_download&link_id=171&cf_id=37."},{"key":"ref_73","first-page":"9507","article-title":"Short- and long-term release after partial lead service line replacements in a metropolitan water distribution system","volume":"51","author":"Desmarais","year":"2015","journal-title":"Environ. Sci. Technol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1021\/acs.est.6b04034","article-title":"Flint water crisis caused by interrupted corrosion control: Investigating \u201cGround Zero\u201d home","volume":"51","author":"Pieper","year":"2017","journal-title":"Environ. Sci. Technol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1089\/env.2016.0012","article-title":"Weaknesses in drinking water regulations and public health policies that may impede lead poisoning prevention and environmental justice","volume":"9","author":"Katner","year":"2016","journal-title":"J. Environ. Justice"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5991\/OPF.2017.43.0079","article-title":"Lead in drinking water: Past, present, and future","volume":"43","author":"Russell","year":"2017","journal-title":"Opflow"},{"key":"ref_77","unstructured":"Taking Action on Flint (2019, May 26). State of Michigan, Available online: https:\/\/www.michigan.gov\/flintwater\/."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1021\/es4034952","article-title":"Fetal death and reduced birth rates associated with exposure to lead-contaminated drinking water","volume":"48","author":"Edwards","year":"2014","journal-title":"Environ. Sci. Technol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"283","DOI":"10.2105\/AJPH.2015.303003","article-title":"Elevated blood lead levels in children associated with the Flint drinking water crisis: A spatial analysis of risk and public health response","volume":"106","author":"LaChance","year":"2016","journal-title":"Am. J. Public Health"},{"key":"ref_80","unstructured":"U.S. Centers for Disease Control and Prevention (US CDC) (2017, June 04). Managing Elevated Blood Lead Levels among Young Children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention of the US CDC, Available online: http:\/\/www.cdc.gov\/nceh\/lead\/CaseManagement\/caseManage_main.htm."},{"key":"ref_81","unstructured":"U.S. Centers for Disease Control and Prevention (US CDC) (2017, September 10). Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention, from the Advisory Committee on Childhood Lead Poisoning Prevention of the US CDC, Available online: https:\/\/www.cdc.gov\/nceh\/lead\/acclpp\/final_document_030712.pdf."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/j.1551-8833.2010.tb10210.x","article-title":"Lead removal from tap water using POU devices","volume":"102","author":"Deshommes","year":"2010","journal-title":"J. Am. Water Works Assoc."},{"key":"ref_83","unstructured":"United States Census Bureau (US Census) (2017, August 28). American Community Survey Data (5-Year Estimates, 2010 through 2014) and Decennial Census Data, Available online: https:\/\/www.census.gov\/programs-surveys\/acs\/."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/7\/1537\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:13:15Z","timestamp":1760195595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/7\/1537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,20]]},"references-count":83,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2018,7]]}},"alternative-id":["ijerph15071537"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15071537","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints201805.0405.v2","asserted-by":"object"},{"id-type":"doi","id":"10.20944\/preprints201805.0405.v1","asserted-by":"object"}]},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,20]]}}}