Three-quarters of Hawaii’s public elementary schools have tested positive for high lead levels in at least one sink or drinking water fountain, according to extensive testing recently completed by state health officials as part of a nationwide push to reduce childhood exposure to the heavy metal that can cause permanent developmental disabilities.

Thousands of samples were taken from 178 elementary schools throughout the state over the past two years. A sample taken from a kitchen sink at the Hawaii School for Deaf and Blind had the highest detection, 2,054 parts per billion, which is 137 times the 15 ppb action level set by the U.S. Environmental Protection Agency.

Overall, 9% of the samples collected from the school had lead levels above the threshold, with the second highest registering 76 ppb.

At most schools, a very small percentage of the samples tested above the EPA level. But at Barbers Point Elementary on Oahu, 22% of the 83 samples collected tested at or above 15 ppb, including a sink that registered lead levels that were 141 ppb.

About 15% of the samples collected at Kailua Elementary and Keolu Elementary, which is also in Kailua, were at or above 15 ppb.

Overall, less that 5% of the samples tested above the EPA action level. But that still translates to several hundred drinking water sources, including a kitchen sink at Hanalei Elementary School that registered lead at 379 ppb; a water fountain at Iroquois Point Elementary on Oahu that had a lead level of 128 ppb; a water fountain at Waimea Elementary on Hawaii island that had 103 ppb of lead; and a water fountain at Haiku Elementary on Maui where lead was detected at 340 ppb.

The schools were tested in two stages. Facilities at highest risk of having lead in their pipes were tested between February and October 2021, with the rest tested this year. Charter schools were not included in the testing.

The state Department of Health also tested 117 child care facilities throughout the state. Only four facilities had at least one exceedance: Malamalama Waldorf School Kinderhale and Pact Keauhou Head Start on Hawaii island; Kama‘aina Kids Calvary on Oahu; and Kamehameha Preschool Paukukalo on Maui.

“We found very few problems with the child care facilities, which is great,” said Diana Felton, the state toxicologist for DOH.

The testing was overseen by DOH and the state Department of Education as part of a nationwide program created by the Water Infrastructure Improvements for the Nation Act, signed by former President Barack Obama in 2016 in the midst of the Flint, Mich., drinking water emergency. Lead had seeped into the city’s drinking water after Flint switched its source in 2014, creating a massive public health crisis.

High blood lead levels are particularly dangerous for the developing brains of young children and can cause learning disabilities, lower IQs and behavioral problems, as well as slowed growth, hearing problems and headaches, according to the EPA.

Felton said it’s difficult to use the data to gauge the risk of health effects in children.

“It’s very hard to use this information to predict the individual risk for an individual child because we don’t know how much the kid was drinking, but also because the amount of lead can really fluctuate even from the same tap. Even in the same day, it can really go up and down,” she said. “So it’s really hard to predict how much an individual child may have been exposed to lead from their school water.”

Felton said the larger goal of the testing is to minimize the population’s overall exposure to lead. “We don’t want kids getting any more lead; we don’t want kids getting any lead at all,” she said.

The biggest source of lead exposure is in homes with deteriorating lead-based paint that was commonly used in buildings constructed prior to 1978, when it was banned for residential use. Water is the second main source of lead levels in children, according to a 2016 American Academy of Pediatrics report, which found that lead typically contributes to about 20% of a child’s blood level concentrations if the level of lead in the water exceeds 5 ppb.

Lead in water is particularly dangerous for infants who are formula fed using tap water.

Roya Alkafaji, a manager for the Environmental Defense Fund’s Healthy Communities program who specializes in lead contamination in water, said that while it can be scary to see the lead results in Hawaii’s schools, it’s an important step to addressing the problem.

“You want to know if there is lead and where it is coming from,” she said. “There is no safe level of lead exposure, whether it is 5 ppb, 50 or 2,000.”

Fixing the problem

Every tap within schools and child care facilities that are used by children was tested. DOH then retested the locations that registered lead at or above 15 ppb. The follow-up testing, which included a first draw and a flushed sample, helps determine if the lead is coming from a faucet fixture or from plumbing deeper in the wall. Felton said that in most cases the lead can be attributed to faucets, which is easier to fix.

Facilities where lead was detected were quickly notified and those sinks and faucets were disconnected or blocked off or restricted to hand-washing stations only, as there is no risk of lead being absorbed through the skin.

Schools posted the notification of test results in their administrative offices and parents received a notification letter with links to the online results prior to the testing, said DOE spokesperson Derek Inoshita. He said there is no requirement that parents be notified if water samples in their children’s schools come back with elevated lead levels.

All of the test results, which are searchable by school or child care facility, are posted on DOH’s website at 808ne.ws/DOElead.

State officials are planning to replace plumbing fixtures in all of the locations where lead registered above 5 ppb, a lower threshold that is more protective of health. They then plan to do follow-­­up testing to make sure the source of contamination has been eliminated.

DOH and DOE had hoped to start those repairs months ago after securing $1.85 million from the Legislature in May. But the bill appropriating the funding specified it was for the 2022 fiscal year, which ended June 30.

State officials say they only had about one month to encumber the funding, which wasn’t possible under the constraints of the state’s procurement code.

“That money is no longer available, which is crushing,” said Felton.

Gov. David Ige requested emergency funding for lead abatement in a bill submitted to the Legislature in January as part of his legislative package. He asked lawmakers to release the funding quickly, rather than waiting until May when the legislative session ended.

“The administration had hoped its request for an emergency appropriation would be fast-tracked, but it was not,” said a spokesperson for Ige.

DOH was able to secure a $2 million competitive grant from EPA earlier this month to do the work.

Young kids not tested

While DOH is focused on preventing childhood exposure to lead, it also screens blood lead tests that are sent to an electronic state surveillance system, which flags results that are above a certain threshold. In the past, the U.S. Centers for Disease Control and Prevention set that level at 5 micrograms per decilitre, but reduced it to 3.5 mcg/dL last year.

In 2021, 15,159 Hawaii children under the age of 6 were tested for lead and 1.78%, or 270, had levels in their blood that were above the 3.5 mcg/dL threshold. Between 2015 and 2020, the number of kids who annually tested above this level ranged from 244 to 1,126.

But health care providers have been testing only about 15% of children under the age of 6, so the actual prevalence of lead exposure in Hawaii isn’t known. Even for recipients of Medicaid insurance, only 38.8% of children between the ages of 1 and 2 were tested, even though federal rules require it, according to a 2020 report by the Hawaii Children’s Action Network, which emphasises the benefits of universal testing.

Seven states and the District of Columbia require testing of all children, according to a 2018 state survey.

Felton agreed that Hawaii should be testing more kids.

State testing is targeted toward children in the lower socioeconomic brackets because they tend to face a higher risk of exposure. But Felton noted that in Hawaii, there are upscale neighborhoods, such as Manoa, that also have old housing and infrastructure.

“There are certainly kids out there that aren’t getting tested that have lead exposure that we are missing,” she said. “And then they’re not getting the follow-up services. They are not getting the help eliminating the source and follow-up services to help mitigate the long-term effects.”

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LEAD IN SCHOOLS

While most elementary schools had a sink or water fountain test positive for elevated lead levels, the vast majority of samples tested had lead below the Environmental Protection Agency threshold of 15 parts per billion.

178 elementary schools tested

74% of schools had elevated lead levels

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117 child care facilities tested

3% of child care facilities had elevated lead levels

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Total samples collected: 10,669

Less than 5% of the samples had lead levels above the level requiring remediation.

Source: State Department of Health