Changes to the Lead and Copper Rule: What Should Public Health Expect?
by Sarah Goodwin
One of the challenges that comes with tackling the important issue of lead in drinking water is the joint responsibility between water utilities and public health departments. Control of any given community’s drinking water system—and the responsibility for identifying lead levels in the drinking water—usually lies with the local water utility. However, local expertise on the health effects of lead exposure, as well as information on other potential non-water sources of lead, usually lives within the local or state public health department. Both institutions play necessary roles in a community response to lead in drinking water or a community plan to replace lead service lines.
Water systems have statutory and regulatory requirements to keep their community’s drinking water safe. Monitoring of lead in drinking water is governed by the Lead and Copper Rule (LCR), which is administered by the U.S. Environmental Protection Agency (EPA). EPA has issued significant changes to the original 1991 LCR twice over the past four years:
- In January 2021, EPA issued the final version of the Lead and Copper Rule Revisions (LCRR). Water systems must comply with these requirements by October 16, 2024.
- In December 2023, EPA published the proposed Lead and Copper Rule Improvements (LCRI). The LCRI builds upon the LCRR and adds several more protective requirements (the most notable being a requirement for the vast majority of water systems to replace all lead service lines in 10 years). As of this writing, EPA has not yet published a final version of this rule but plans to do so before the LCRR deadline in October. The proposed rule goes into effect three years after it is finalized.
Heading into this fall, where do local public health departments play a role in the upcoming requirements? Well, one of the elements of EPA’s regulations involves messages that water utilities are required to provide to customers in certain circumstances. There are several different events and timelines that trigger a public notification or messaging requirement, including when a water system exceeds the lead action level, when a lead service line is identified or suspected, and when a lead service line is being replaced. In some of these situations, water utilities may be recommended or required to provide information to public health departments or direct customers to seek healthcare support. So, public health departments should be aware that some of these requirements will be changing starting on October 16. And, if the LCRI is finalized as proposed, water systems may also be working over the next couple years to update messaging again.
Here are some key messages we’ve pulled out that are particularly relevant to public health. For this table, we focused on the steps that water utilities must follow when the lead action level has been exceeded.
| Requirements Beginning October 16, 2024 (or that are already in place) |
Anticipated Requirements Beginning 2027 |
| When the action level is exceeded (i.e., when the 90th percentile concentration of lead samples collected in the system is greater than 15 parts per billion), the water systems must alert the public within 24 hours under both the LCRR and LCRI. They must tell customers: | No change from the 2024 requirements. |
| 1. What happened and when. 2. Whether they should use alternate water sources. 3. What actions they should take. 4. What the water system is doing to fix the issue and when it will be resolved. 5. Contact information. |
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| Water systems can provide this notice by broadcast media, hand delivery, public signs/postings, or another state-approved method. | |
| After the required initial notice within 24 hours, water systems must then provide additional public information within 60 days after the water sampling period that had the exceedance. | No significant change from the 2024 requirements. |
| Required delivery methods are sending printed materials to bill-paying customers and including information in water bills, press releases, and online posts (applicable to large water systems only). | |
| Water systems must also perform three additional outreach activities that can include PSAs, ads, public displays and meetings, emails, and direct delivery to households. | |
| When conducting the public education within 60 days of the action level exceedance, water systems are required to provide materials about lead exposure and actions people can take to public health agencies, schools, WIC, Head Start, hospitals, clinics, pediatricians, and welfare agencies for distribution to customers. | Water systems must deliver the materials and also directly contact public health agencies in order to provide materials for distribution. In addition, if the public health agency provides a list of community-based organizations that serve populations at risk from lead exposure, the water system must deliver materials to those organizations as well. Water systems are required to deliver materials to schools, WIC, Head Start, hospitals, clinics, pediatricians, welfare agencies, and OB-GYNs for distribution to customers. |
| Water systems must also make a good-faith effort to deliver materials to childcare centers, pre-schools, and OB-GYNs and midwives. | |
| When conducting the public education within 60 days of the action level exceedance, water systems may advise customers to contact their local public health or healthcare provider if they are concerned about lead exposure to ask about a blood lead test for their children. | Water systems must suggest that parents have their child’s blood tested for lead and provide contact information for the state or local public health department. |
There are additional notification requirements when a water system identifies a known or potential lead service line and when the water system is replacing a lead service line. For full details on those circumstances, as well as more information on the requirements listed above, we suggest you read:
- This page from EPA on Lead and Copper Rule Implementation Tools.
- This section of the proposed LCRI, which describes the public education requirements.
- EPA’s Notification Templates for Known or Potential LSLs (docx).
Health Effects Language
One of the required elements in all of the above notices that water utilities cannot deviate from is including a specific paragraph of language on the health effects of lead exposure. This language is written directly into the regulations.
Starting October 16, 2024, this language will be:
Exposure to lead in drinking water can cause serious health effects in all age groups. Infants and children can have decreases in IQ and attention span. Lead exposure can lead to new learning and behavior problems or exacerbate existing learning and behavior problems. The children of women who are exposed to lead before or during pregnancy can have increased risk of these adverse health effects. Adults can have increased risks of heart disease, high blood pressure, kidney, or nervous system problems.
Starting in 2027, the language is proposed to be:
There is no safe level of lead in drinking water. Exposure to lead in drinking water can cause serious health effects in all age groups, especially pregnant people, infants (both formula-fed and breastfed) and young children. Some of the health effects to infants and children include decreases in IQ and attention span. Lead exposure can also result in new or worsened learning and behavior problems. The children of persons who are exposed to lead before or during pregnancy may be at increased risk of these harmful health effects. Adults can have increased risks of heart disease, high blood pressure, kidney, or nervous system problems. Contact your health care provider for more information about your risks.
Note that proposed new language encourages customers to contact their healthcare provider; public health departments may want to be prepared to answer questions from both residents and physicians.
As the changes to the Lead and Copper Rule are rolled out, all water systems will face new requirements regarding lead service line inventory and replacement as well as public notification and education. As these water systems become more active and work to fulfill their new regulatory obligations, it is important for local public health agencies to be prepared to partner with water utilities and respond to increased questions from the public, healthcare providers, and other relevant parties.
Additional Resources
The Lead Service Line Replacement Collaborative.
EDF’s Map of Public LSL Replacement Programs.
NCHH’s Safe Drinking Water page.
Sarah Goodwin joined NCHH as a policy analyst in June 2017. She previously served NCHH as a policy intern, helping to establish and run the Find It, Fix It, Fund It lead action drive and its work groups. She holds a Bachelor of Arts degree in Interdisciplinary Studies: Communications, Legal Institutions, Economics, and Government from American University.