Protecting children from lead in tap water
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* Heide B. Schneider, MD PhD

*   © 2008 Canadian Medical Association or its licensors

Lead in drinking water is still an important health issue in Germany. There is concern about the association of lead exposure with neurologic and intellectual deficits as described by Mark Payne1 and with hearing impairment in infants; higher levels of lead exposure have been associated with increased morbidity in adults and with cognitive decline in older people.2,3 Although the maximum allowable lead concentration in tap water will be reduced from 0.025 mg/L to 0.01 mg/L by December 2013 in Germany, a 2005 test of 237 000 random samples of tap water showed that the lead concentration in more than 5% of the samples exceeded 0.025 mg/L in several regions.4 In Germany it is recommended that pipes be flushed to reduce lead levels by running water for at least 5 minutes every morning, as also suggested by Payne.

Data from the German Federal Environment Agency suggest that even at a lead concentration of 0.01 mg/L in tap water, infants should not consume more than 0.4 L of tap water per day if the water comes from plumbing systems containing lead. As an interim solution until all lead is removed from plumbing, it has been proposed that infants should be given bottled water to avoid exposure to tap water during childhood because the threshold exposure level for lead toxicity has not yet been established.5

Most German municipalities are taking responsibility for removing lead from plumbing systems to protect infants and toddlers in particular from the health hazards associated with exposure to lead in drinking water. In Hamburg alone, all plumbing systems containing lead will be replaced for 28 000 households.

## Footnotes

*   **Competing interests:** None declared.

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5.  5. Wilhelm M, Dieter HH. Lead exposure via drinking water — unnecessary and preventable. Umweltmed Forsch Prax 2003;8:239-41.