The Genesee County Medical Society has reviewed the announcement in which the CDC stated that Flint municipal water which has been correctly filtered is no longer a health hazard for lead, as well as the EPA report on which it is based.
Data supports decreasing lead levels in Flint municipal water during the period of January-April 2016. When levels were high in the tested samples, filters which were properly maintained did not allow lead levels above 15 ppb, the EPA “action level.” This is the lead level for which a formal response is triggered if more than 10% of homes are measured at or above this number, although all acknowledge that no level of lead is considered “safe”.
However, despite these encouraging results, the Genesee County Medical Society wishes to caution that this data was collected before the system flushing program in May 2016, so it is important to have the residential water tested again to make sure that no lead sediment was dislodged in the pipes leading to a residence. Bare metal in the pipes or stray metal flakes (lead and other metals), could unexpectedly cause higher levels in water than previously measured in an individual home.
Further, in order for filtered Flint municipal water to be safe, the filter system must be used correctly at all times, with the filter changed as instructed and never left beyond its recommended date of use. The aerators must be flushed according to instructions on a regular basis, as the recent pipe flushing has raised the risk of lead particles dislodging from inside the pipes and being caught in the aerators.
Lastly, it is also very important that consumers of Flint municipal water understand that the filters for lead do not filter out legionella or other microorganisms. Those who are at high risk for legionella infections due to the following risk factors are recommended to continue using only bottled water for drinking, cooking and brushing teeth:
Legionella Risk Factors for Individual Adults and Children (as applicable):
- Recent travel with an overnight stay away from home (up to 14 days prior to symptom onset), recent hospital or outpatient (office) healthcare exposure (up to 14 days before symptom onset)
- Exposure to hot tubs (such as whirlpool spas) including either direct use, walking or sitting near a spa.
- Recent repairs or maintenance work on household plumbing
- Chronic kidney or liver disease including end-stage organ disease (such as kidney dialysis)
- Diabetes mellitus
- Chronic lung disease (such as chronic obstructive lung disease – COPD, emphysema, chronic bronchitis, severe asthma and other severe lung conditions)
- Solid organ or hematologic malignancy (such as cancer, leukemia, lymphoma, sarcoma)
- Immune system disorders (such as HIV/AIDS, transplant patients on immunosuppressant drugs, long-term steroid use)
- Current or former smokers
- Age ≥ 50 years
In summary, the Genesee County Medical Society is making the following recommendations:
For those people who are most at risk for the negative effects of lead on the brain – Children less than 6 years old and pregnant women (for the fetus) – we recommend remaining on bottled water until the water is tested if it has not been tested since the beginning of this June (2016)
Filters should be maintained and changed as per the individual instructions. Filters should not be used more than 3 months under any circumstances.
Aerators on any taps used for drinking, cooking or brushing teeth should be checked regularly to remove any metal bits that may have been caught.
People who are in the high-risk groups for legionella (see above) should continue using only bottled water for drinking, cooking and brushing teeth, and should continue to follow the other guidelines to reduce legionella risk, because of the risk of aspiration.
People who are using filters correctly, have had their water tested and shown to be negative for lead, and who are not members of one of the high-risk groups (see list), may use correctly filtered Flint Municipal Water.
While it is our understanding that bottled water will be available indefinitely for those who need it, the GCMS also reminds our patients to be prepared for unforeseen circumstances. State and federal agencies advise that to prepare for any emergency anywhere everyone should keep enough water to provide three gallons of water to last three days for each person and pet in the household (i.e. 9 gallons for each person or pet).
For questions or comments, please contact Peter Levine at plevine@gcms.org
For more information or questions, please contact Peter Levine, MPH, at 810-733-9925.
