In a new study from Beth Israel Deaconess Medical Center, researchers found that lead levels in drinking water that are permissible by the Environmental Protection Agency have detrimental health effects in individuals with kidney disease.
Despite advances in reducing the amount of lead in drinking water, low levels of contamination remain widespread throughout the United States.
This may be especially dangerous for the 30-40 million Americans living with chronic kidney disease, who have heightened susceptibility to the toxic effects of lead.
In the study, the team analyzed health information for 597,968 patients initiating dialysis in the United States between 2005 and 2017.
They aimed to find the effects of low levels of lead contamination on individuals with advanced kidney disease.
The team also assessed lead concentrations in community water systems in the 5-year period, relying on city-level data from the Environmental Protection Agency’s Safe Drinking Water Information System.
They focused on the potential effects of lead on levels of hemoglobin, the oxygen-carrying protein in red blood cells known to be affected by lead poisoning.
The researchers found people living in cities with detectable levels of lead in their community’s water had much lower hemoglobin concentrations before starting dialysis and during the first month of dialysis therapy.
They also were prescribed higher doses of medications to treat anemia, which occurs when red blood cell counts or hemoglobin levels are lower than normal.
These associations were observed at lead levels below the Environmental Protection Agency’s threshold (0.015 mg/L) that mandates regulatory action.
The findings suggest that for patients with poor kidney function, there is no safe amount of lead in drinking water.
While drinking water may seem uniformly healthy, low levels of lead contamination found in the majority of drinking water systems in the United States may have toxic effects for those with chronic kidney disease.
The team says more rigorous efforts to improve the water system infrastructure may be needed to protect individuals from unrecognized hazards.
The study is published in the Journal of the American Society of Nephrology. One author of the study is John Danziger, MD, MPhil.
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