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Four phases of the Flint Water Crisis: Evidence from blood lead levels in children.

Abstract The Flint Water Crisis (FWC) is divisible into four phases of child water-lead exposure risk: Phase A) before the switch in water source to the Flint River (our baseline); Phase B) after the switch in water source, but before boil water advisories; Phase C) after boil water advisories, but before the switch back to the baseline water source of the Detroit Water and Sewerage Department (DWSD); and Phase D) after the switch back to DWSD. The objective of this work is to estimate water-lead attributable movements in child blood lead levels (BLLs) that correspond with the four phases in the FWC. With over 21,000 geo-referenced and time-stamped blood lead samples from children in Genesee County drawn from January 01, 2013 to July 19, 2016, we develop a series of quasi-experimental models to identify the causal effect of water-lead exposure on child BLLs in Flint. We find that the switch in water source (transitioning from phase A to B) caused mean BLLs to increase by about 0.5μg/dL, and increased the likelihood of a child presenting with a BLL ≥ 5μg/dL by a factor of 1.91-3.50, implying an additional 561 children exceeding 5μg/dL. We conservatively estimate cohort social costs (through lost earnings alone) of this increase in water-lead exposed children at $65 million, contrasted with expected annual savings of $2 million from switching water source. On the switch from Phase B to C, we find BLLs decreased about 50% from their initial rise following boil water advisories and subsequent water avoidance behaviors by households. Finally, the return to the baseline source water (Phase D) returned child BLLs to pre-FWC levels further implicating water-lead exposure as a causal source of child BLLs throughout the FWC.
PMID
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Authors

Mayor MeshTerms

Environmental Exposure

Keywords

Blood lead levels

Child BLLs

Child health

Flint Water Crisis

Lead exposure

Journal Title environmental research
Publication Year Start




PMID- 28570960
OWN - NLM
STAT- MEDLINE
DA  - 20170601
DCOM- 20170619
LR  - 20170619
IS  - 1096-0953 (Electronic)
IS  - 0013-9351 (Linking)
VI  - 157
DP  - 2017 Aug
TI  - Four phases of the Flint Water Crisis: Evidence from blood lead levels in
      children.
PG  - 160-172
LID - S0013-9351(17)30371-7 [pii]
LID - 10.1016/j.envres.2017.05.028 [doi]
AB  - The Flint Water Crisis (FWC) is divisible into four phases of child water-lead
      exposure risk: Phase A) before the switch in water source to the Flint River (our
      baseline); Phase B) after the switch in water source, but before boil water
      advisories; Phase C) after boil water advisories, but before the switch back to
      the baseline water source of the Detroit Water and Sewerage Department (DWSD);
      and Phase D) after the switch back to DWSD. The objective of this work is to
      estimate water-lead attributable movements in child blood lead levels (BLLs) that
      correspond with the four phases in the FWC. With over 21,000 geo-referenced and
      time-stamped blood lead samples from children in Genesee County drawn from
      January 01, 2013 to July 19, 2016, we develop a series of quasi-experimental
      models to identify the causal effect of water-lead exposure on child BLLs in
      Flint. We find that the switch in water source (transitioning from phase A to B) 
      caused mean BLLs to increase by about 0.5mug/dL, and increased the likelihood of 
      a child presenting with a BLL &gt;/= 5mug/dL by a factor of 1.91-3.50, implying an
      additional 561 children exceeding 5mug/dL. We conservatively estimate cohort
      social costs (through lost earnings alone) of this increase in water-lead exposed
      children at $65 million, contrasted with expected annual savings of $2 million
      from switching water source. On the switch from Phase B to C, we find BLLs
      decreased about 50% from their initial rise following boil water advisories and
      subsequent water avoidance behaviors by households. Finally, the return to the
      baseline source water (Phase D) returned child BLLs to pre-FWC levels further
      implicating water-lead exposure as a causal source of child BLLs throughout the
      FWC.
CI  - Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Zahran, Sammy
AU  - Zahran S
AD  - Department of Economics, Colorado State University, Fort Collins, CO, United
      States. Electronic address: [email protected]
FAU - McElmurry, Shawn P
AU  - McElmurry SP
AD  - Department of Civil &amp; Environmental Engineering, Wayne State University, Detroit,
      MI, United States. Electronic address: [email protected]
FAU - Sadler, Richard C
AU  - Sadler RC
AD  - Department of Family Medicine, Michigan State University, Flint, MI, United
      States. Electronic address: [email protected]
LA  - eng
GR  - R21 ES027199/ES/NIEHS NIH HHS/United States
PT  - Journal Article
PL  - Netherlands
TA  - Environ Res
JT  - Environmental research
JID - 0147621
RN  - 0 (Drinking Water)
RN  - 0 (Water Pollutants, Chemical)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Drinking Water/*analysis
MH  - *Environmental Exposure
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Lead Poisoning/*blood/etiology
MH  - Male
MH  - Michigan
MH  - Risk Factors
MH  - Water Pollutants, Chemical/blood/*poisoning
OTO - NOTNLM
OT  - Blood lead levels
OT  - Child BLLs
OT  - Child health
OT  - Flint Water Crisis
OT  - Lead exposure
EDAT- 2017/06/02 06:00
MHDA- 2017/06/20 06:00
CRDT- 2017/06/02 06:00
PHST- 2017/02/20 [received]
PHST- 2017/05/19 [revised]
PHST- 2017/05/24 [accepted]
AID - S0013-9351(17)30371-7 [pii]
AID - 10.1016/j.envres.2017.05.028 [doi]
PST - ppublish
SO  - Environ Res. 2017 Aug;157:160-172. doi: 10.1016/j.envres.2017.05.028.