Water Quality Project Frequently Asked Questions and Resources

General FAQ

Below are some frequently asked questions related to UCSF's water testing plan and general information related to lead in water. Questions are organized by these categories:


Information About the Plan

Q1: Why is UCSF conducting water quality testing?

UCSF is taking voluntary, proactive steps to test the quality of drinking water at its campus locations to determine if lead levels are above what is considered actionable by the U.S. Environmental Protection Agency (EPA). UCSF is not required to test water quality. UCSF Medical Center does regularly test for legionnaire’s disease. However, recent national cases indicate that implementation of a proactive regular water-testing program to test for lead is a best practice.

Q2: Why is UCSF limiting its water testing for lead?

This is UCSF’s first comprehensive water quality testing effort, and given recent national cases concerning lead in drinking water, UCSF is focusing its current program on testing for lead in drinking water.

Based on advice from the Scientific Advisory Group, UCSF is only testing for lead since the San Francisco Public Utility Commission (SFPUC) routinely monitors for inorganic contaminants, such as metals, that can be naturally occurring or result from corrosion of metals (e.g., rust). The presence of these metals is not typically detectable or detected at very low levels in the city’s water supply, according to the SFPUC. These very low levels are within the public health limits set by the EPA and the State Water Resources Control Board and do not pose any negative health risks, according to the SFPUC.

Although UCSF is not testing for other analytes at this time, such as copper, as results from the SFPUC from our lead tests are reviewed, if higher or lower than normal pH levels are detected — which are an indicator for other analytes and/or changes in the SFPUC’s water intake — we will investigate further. So far, none of UCSF’s pH levels have been out of normal range (6.5 – 8.5), suggesting our water is likely not contaminated with other analytes.

Q3: What protocol is UCSF following to test for lead in its drinking water?

UCSF is following EPA guidelines for testing water quality in K-12 schools, outlined in the agency’s document “3Ts for Reducing Lead in Drinking Water in Schools.” The EPA guidelines were developed to address the potential for elevated lead levels in drinking water in schools, as children are most susceptible to health effects of lead. There are no specific guidelines for universities or medical centers.

UCSF elected to follow these guidelines given their applicability to UCSF and based on the advice of a UCSF-convened Scientific Advisory Group made up of public health and water quality experts.

In accordance with these guidelines, UCSF is sampling and testing cold drinking water at hundreds of locations on UCSF-owned property for lead content. Other locations, such as leased properties, may be sampled at a later time, based on recommendations from the Scientific Advisory Group.

When lead levels from the sampled drinking water fixtures exceed the “action level” of 20 parts per billion (ppb), corrective actions are taken, as directed by the EPA. These actions are listed below.

Q4: Why is UCSF using the EPA “action level” of 20 ppb?

UCSF’s Scientific Advisory Group selected the “3T’s” protocol because it is considered the more rigorous and applicable to UCSF than other protocols. In the “3T’s” protocol, the EPA has set a guidance level of 20 ppb (0.020 mg/L) in schools or child care settings for the testing of two 250 ml samples from water fountains and drinking water outlets – a 250 mL first-draw sample, and a second 250 mL "flush" sample. First draw refers to the first water to come out of a tap after an 8- to 18-hour period of inactivity. The second "flush" sample is taken after the tap has flushed for 30 seconds. This protocol is designed to pinpoint specific areas either within the actual fountain, outlet or fixture or in the plumbing system that may require remediation. It also maximizes the likelihood that the highest concentrations of lead are found because the first 250 ml are analyzed after overnight stagnation.

You may have read in news reports that some communities are testing to a 15 ppb standard. This lead-testing standard is for public water systems and is intended to identify system-wide issues rather than test water quality at drinking water outlets in buildings. Testing at 15 ppb is also different from the “3 T’s” in that it is established for one-liter samples and only triggers action if more than 10 percent of the samples taken from residences that use a specific public drinking water system exceed 15 ppb.

Q5: Who are the members of the Scientific Advisory Group?

Members are:

  • Robert Kosnik, MD, Director of Occupational Health Services, UCSF Medical Center; Clinical Professor of Medicine, Occupational and Environmental Medicine, UCSF School of Medicine
  • Anisha Patel, MD, MSPH, MSHS, Assistant Professor of Pediatrics, UCSF School of Medicine
  • Timur Durrani, MD, MPH, MBA, Assistant Professor, UCSF School of Medicine
  • Andrew DeGraca, PE, Director, Water Quality Division, San Francisco Public Utilities Commission
  • June Weintraub, ScD, Manager, Water, Noise, and Medical Cannabis, San Francisco Department of Public Health

Q6: What is the projected timeline for the testing program?

UCSF launched a pilot program aimed at sampling a few locations on the Parnassus campus in June 2016. The water-testing program will continue through calendar year 2017.

Q7: How many UCSF-owned buildings will be tested?

More than 100 buildings across campus and medical center locations will be tested. The testing plan is being conducted in phases at locations throughout UCSF-owned properties. See the testing schedule.

Q8: Why is UCSF phasing the testing program?

Due to the quantity and diversity of uses in UCSF’s buildings, which are located throughout San Francisco and beyond, the voluntary testing program is being conducted in phases.

Q9: Will water be tested at other UC campuses?

There is no plan to test water quality across the UC system. UCSF has kept the UC Office of the President informed about its water testing program and results to date.

Q10: Has UCSF tested for lead in its drinking water outlets before?

No. UCSF is not required to evaluate lead in drinking water. However, UCSF Medical Center and UCSF Benioff Children’s Hospitals routinely test for Legionnaire’s disease.oeHoHo

Q11: How frequently will UCSF test its water quality?

The Scientific Advisory Group that UCSF convened to guide the development and implementation of UCSF’s water testing program recommends that drinking water be tested for lead every 3 to 5 years.

Q12: Who is managing this program and making decisions on sampling strategy and mitigation protocols?

Following approval from the UCSF Chancellor, UCSF’s water-testing program is being managed by the UCSF Leadership Groups, which included experts across multiple campus and medical center departments. They are drawing upon the expertise of the UCSF-convened Scientific Advisory Group.

The UCSF Leadership Group provides final approval for all project implementation strategies, internal and external communications, and proposed mitigations. The Leadership Group includes senior leaders from Research Infrastructure and Operations, Campus Life Services and University Relations. The team approves each testing phase, reviews project milestones and approves lead reduction strategies/mitigations.

The Strategic Communications Group, consisting mostly of representatives from UCSF’s Office of Strategic Communications and University Relations, in consultation with others, develops and approves all communications for sampling notification, data results, and future mitigation, if necessary. UCSF University Relations coordinates with SFDPH and SFPUC communications staff to ensure messaging is consistent with the City and County and EPA and CDC information.

The Scientific Advisory Group provides suggestions and advises UCSF Leadership on strategy and best practices for implementation of this water-testing plan and technical aspects of this project. The Scientific Advisory Group is comprised of subject matter experts from various disciplines and, includes members from UCSF’s Environmental Health & Safety (EH&S), the San Francisco Department of Public Health (SFDPH) and the SFPUC, as well as members of the research community with recognized expertise in testing drinking water, and stakeholder groups.

Others involved in the project include:

  • Project Manager – Working within EH&S, the project manager facilitates communication and coordination between project functional groups, ensures efficient flow of information, and provides status updates and/or summary reports to project functional groups and UCSF Leadership Group as requested or necessary.
  • SFPUC – Provides expertise in water quality, water distribution systems and public communication. SFPUC members serve on the Scientific Advisory Group and the Strategic Communications Group. SFPUC also operates the analytical lab that will be used for this project.
  • SFDPH – Provides expertise in water quality and messaging to the community as it relates to this project. SFDPH also has a member of the Scientific Advisory Group.
  • UCSF EH&S – EH&S has one or more members participating on the Scientific Advisory Group, provides staff to collect samples and coordinate water analysis with SFPUC.
  • UCSF Facilities Services – Identifies sampling locations and isolates fixtures prior to sampling. Facilities Services staff also meets with affected users as needed, proposes mitigations where appropriate and executes mitigations upon approval.
  • UCSF Capital Programs – Capital Programs will direct and implement large-scale mitigations, if necessary, such as underground pipes.
  • UCSF Housing Services – Housing Services has been notifying and meeting with occupants when residential units become available for sampling and coordinate with the sampling team to provide access.
  • UCSF Family Services – Family Services has been communicating with parents with children enrolled in the four UCSF-located childcare centers and has been working closely with Bright Horizons, the operator of the centers.

Notifications and Communications

Q13: How will UCSF inform the public about the testing program?

UCSF is informing the university community, and the broader public, about the water-testing plan and the results of the testing through various communications channels including:

  • The UCSF Environmental Health & Safety (EH&S) website
  • Emails and/or letters to the UCSF community
  • Campuswide announcements and e-newsletters
  • Meetings on campus

Q14: Will all users be notified if lead is discovered in water samples?

Yes. UCSF is posting results of drinking water outlets that are below, meet or exceed the EPA action level of 20 ppb for lead on the EH&S website. If the samples exceed the action level, affected users are notified as to what corrective actions UCSF is taking to meet EPA guidelines. Users are also informed of the testing results after the corrective actions are taken.

Q15: Where can I find updates on UCSF’s water testing?

UCSF’s Environmental Health & Safety website is posting updated information throughout the water-testing program.

Q16: Is drinking water the primary way someone can be exposed to lead?

Exposure to lead can come from many sources other than drinking water. The San Francisco Department of Public Health (SFDPH) Childhood Lead Prevention Program investigates sources of lead exposures in places where children spend time. The program’s investigations have found that the most common sources of lead poisoning in children include paint, soil and dust. In the 22 years the program has been following these cases, it has never found water as a source of lead poisoning. UCSF’s testing program is an opportunity to raise awareness about the potential health risks posed by lead.

Campus Housing

Q17: What is the plan for testing water quality in UCSF’s residential units?

UCSF is prioritizing its testing on older campus housing units; newer housing complexes, such as 145 Irving Street (built in 2008) and Mission Bay (built in 2004), may be tested at a later time.

Older campus housing units are located on the Parnassus campus (Aldea Housing and Avenue Housing). To date, these units have been widely tested and only three units tested slighted above the EPA 20 ppb action level. These have since been remediated in coordination with the tenant involved. All housing results are posted on the EH&S website.

If a housing resident in a unit that has not yet been tested requests that their unit be tested, UCSF will test their drinking water fixtures.

Q18: Can I bathe, shower, or wash clothes with water that tests above the EPA action level for lead?

Both the EPA and the U.S. Centers for Disease Control and Prevention advise that bathing, showering, and washing clothes is safe, even if the water tests above the EPA action level for lead, as human skin does not absorb lead in water. Ingestion is the primary route of lead exposure.

Q19: Can I wash dishes or fruits and vegetables in water that has tested above the EPA action level for lead?

Water flushed from the tap can be used to wash dishes or fruits and vegetables. Flush the tap by running the water for 30 seconds to 2 minutes. Use only cold water to wash fruits or vegetables. If you need warm or hot water, it is recommended that you draw cold water after flushing the tap and then heat the water. It is important to note that should water samples taken from any campus housing kitchen faucet test above the EPA action level for lead, corrective actions will be taken to ensure drinking water meets EPA guidelines. Once corrective actions are taken and the water meets EPA guidelines, it would not be necessary to flush the tap.

Childcare Centers

Q20: What is the plan for testing water quality at UCSF’s childcare centers?

All fixtures providing drinking water in UCSF childcare facilities were tested during the summer recess in 2016. All fixtures providing drinking water to children in the Mission Bay, Kirkham Street, Parnassus and Laurel Heights facilities tested below the EPA action level.

Water testing for lead conducted at the Lucia childcare facility on the Parnassus campus did find one water fountain and one break room sink serving adults only that tested above the EPA action level. The childcare operator, Bright Horizons, has confirmed to UCSF that neither the drinking fountain nor the break room sink provided drinking water to children.

Facilities Services, working in consultation with a water consultant, is taking corrective actions to reduce lead levels below 20 ppb. In the interim, the drinking fountain and the break room sink have been removed from service.

Corrective Actions

Q21: If any of the water samples show lead levels above EPA standards, what action will UCSF take to remedy the problem?

When lead levels above the EPA action level of 20 ppb are detected at a sampling point – e.g., a public drinking fountain, kitchen sink, etc. – UCSF, working under advisement of the Scientific Advisory Group, UCSF Risk Management and UCSF Occupational Health, informs affected users about the results and the corrective actions being taken to reduce lead levels below 20 ppb.

Mitigation efforts depend on the test results and may include one or more of the following:

  • Removing the water fixture from service
  • Distributing bottled water to affected users
  • Cleaning aerators
  • Installing an appropriate filter
  • Replacing the physical components in the plumbing system. [Note that the replacement of the physical components of the plumbing system will likely span several months and even years.]

Health Impacts

Q22: What should UCSF employees or students do if they are concerned about exposure to lead while on campus?

Those who have additional questions or health concerns may consult with:

  • UCSF Occupational Health Program (for employees) at 415/885-7580;
  • Student Health and Counseling Service (for students) at 415/476-1281; or
  • Their personal medical care providers.

Q23: What should I do if I think I’ve been exposed to lead in my drinking water at home?

If you are concerned or if you have specific questions about your health, you should contact your personal medical care provider for advice and to answer any questions.

Q24: Does lead in my tap water cause health effects?

High levels of lead in tap water can cause health effects if the lead in the water enters the blood stream and causes an elevated blood lead level. According to the CDC, most studies show that exposure to lead-contaminated water alone would not be likely to elevate blood levels in most adults. The CDC also notes that exposure can vary, depending on the individual, the circumstances, and the amount of water consumed.

Q25: What should I do if I am concerned about my child’s exposure to lead?

Generally, children are most often exposed to lead when they touch damaged paint, soil, or surfaces with lead dust and when they place those objects in their mouth.

The San Francisco Department of Public Health’s Childhood Lead Prevention Program works to eliminate children’s exposure to lead hazards. For a free inspection in San Francisco, call 415/252-3956. The program offers useful resources for childproofing homes on its website.

General Information About Lead in Water

Q26: How do I know if my drinking water at home contains lead?

The only way to know whether your drinking water contains lead is to have it tested. You cannot see, taste or smell lead in the drinking water. If you are concerned about lead levels in your older plumbing fixtures at home, you should replace them with lead-free fixtures.

You can ask your water provider whether the water has lead in it. For homes served by public water systems, data on lead in tap water is usually available on the Internet from your local water authority. If you live in San Francisco, you can also request a low-cost water quality test by filling out the Lead Analysis Application.

Q27: What can I do to reduce or eliminate lead in my tap water?

Individuals can take actions to reduce or eliminate lead in their tap water at home. For example, the Centers for Disease Control (CDC) advises that before using any tap water for drinking or cooking, individuals should flush their water system by running the kitchen tap (or any other tap you use for drinking or cooking water) on COLD for 30 seconds to 2 minutes. Further, the CDC recommends that in all situations, individuals should drink or cook only with water that comes out of the tap cold since hot or warm tap water can contain higher levels of lead. Here is the CDC’s handout on actions to reduce lead.

Q28: What is the condition of the water pipes that are maintained by the City and County of San Francisco and that provide drinking water to UCSF facilities?

According to the San Francisco Public Utilities Commission (SFPUC), all known lead pipes and service lines were removed from the San Francisco retail service area more than two decades ago. The San Francisco Water Department replaced more than 7,000 lead service lines in the 1980s and discontinued the use of lead joints in its distribution system. Additionally, the City began lead monitoring in 1992 (in adherence with the Lead & Copper Rule, one of the EPA’s National Primary Drinking Water Regulations).

Q29: What are other sources of information?

 

Clinical FAQ

Developed by UCSF Occupational Health

Q1: Why is UCSF testing water for lead?

UCSF is taking voluntary, proactive measures to characterize the drinking water it provides to the UCSF community, in light of recent national cases that have brought the issue into public discussion. UCSF has elected to conduct this testing as it aligns with our mission as a leading health care institution. UCSF is not required to take this action, either as a university or medical center, but believes it’s the right thing to do to ensure that drinking water meets U.S. Environmental Protection Agency (EPA) guidelines.

Q2: Who will be affected by the water testing?

This testing program is being conducted campuswide, with a rollout that prioritizes sensitive and primary user groups, specifically children in UCSF-operated childcare centers, UCSF housing residents, long-term patients and members of the UCSF community. It began on the Parnassus campus, which has the oldest buildings, and is being phased in over the course of a year to other UCSF locations. See estimated testing schedule.

Q3: How will UCSF conduct the water testing?

UCSF developed its water testing plan using the EPA guidelines for schools and childcare centers, in collaboration with experts at San Francisco Department of Public Health (SFDPH), Zuckerberg San Francisco General (ZSFG), San Francisco Public Utilities Commission (SFPUC) and others with experience in water-quality testing.

The tests began as a pilot on campus at the end of June 2016, as a means of training staff in conducting the tests and setting up systems to work effectively with the SFPUC to analyze and report results. A second pilot program began in the clinical areas in September, at Parnassus, Mount Zion and Mission Bay. The full program will roll out across all campus and clinical sites over the course of a year. Throughout the testing, UCSF will identify any locations where lead levels are elevated above the EPA’s point-of-use standard of 20 parts per billion (ppb), take corrective actions as appropriate and necessary, and communicate findings and actions to the community. Updated results can be found on the Water Testing Results page. These are posted as soon as possible after they are received from the SFPUC.

UCSF is testing the following water fixtures on university-owned properties: drinking fountains, water-bottle filling stations, break room/kitchen sinks and food preparation sinks, including UCSF Health cafeterias and vendor-operated eateries on UCSF property and residential housing kitchens. It will not test bathroom, laboratory and custodial sinks that are not primarily used for consumption.

Q4: What have the results shown so far?

Of the more than 560 samples tested to date (Jan. 6, 2017), 31 tested above the EPA standard of 20 ppb for end-user drinking water. Testing to date includes all campus housing units and day care centers, as well as multiple research and clinical buildings at Parnassus, Mount Zion and Mission Bay.

All fixtures providing drinking water to children tested below the EPA standard, as did the sinks in all but two housing units. Those faucets have been replaced, along with housing faucets with moderately elevated levels, but below the EPA action level.

On the Parnassus campus, testing results from Health Sciences West and Health Sciences East indicated a systemic issue, for which remediation is underway. Testing at Mount Zion also indicated a broader issue in some of the older buildings. These sites have been provided with an alternate source of drinking water until the issues can be resolved.

In the clinical areas, the main sources of drinking water for patients and staff – filtered-water dispensers and ice machines – all tested below the EPA’s action level, with most between 1 to 3.25 ppb. While there is limited cause for concern in clinical areas, we recommend using ice machines or filtered-water dispensers for drinking water at Parnassus and Mount Zion, as these filters screen for lead, phosphates and water-borne pathogens. All samples in the Mission Bay hospitals tested below 1 ppb.

See a full analysis of the results.

Q5: What does this mean for my patient?

While lead in drinking water can contribute to elevations in blood lead levels (BLL), it is rarely the primary source. The SFDPH Childhood Lead Prevention Program, which investigates sources of lead exposures in places where children spend time, reports that in the 22 years it has been following these cases, the program has never found water as a source of lead poisoning.

The contribution from water varies based on the amount of lead-contaminated water ingested. For example, an infant who is fed formula constituted with lead-contaminated water is likely to have a higher contribution to his or her BLL than an adult or child who occasionally drinks from that source. There is no indication that any children have been exposed to elevated lead levels in water at UCSF.

For inpatients, we are not aware of any concerns at this time. For outpatients who are employees or occupants of areas in which water sources have tested above the EPA standard, a questionnaire is available through UCSF Occupational Health Service to help identify whether individuals might be at risk. Clinical guidance also can be obtained through eConsult.

Q6: Should I order a blood lead level for my patients based on the results of the water lead test?

No. The American Board of Internal Medicine, in collaboration with the American College of Medical Toxicology, has addressed heavy metal screening tests, to include lead, in their Choosing Wisely Campaign.

In general, children ages 1-2 should be screened for lead exposure, based on recommendations from the Centers for Disease Control and Prevention (CDC) and California Department of Public Health (CA DPH). Further details are below. However, testing results to date show no indication that children have had any exposure to elevated lead levels through campus drinking water.

Q7: What are the major causes of an elevated BLL?

Exposure to lead can come from many sources. Lead paint and contaminated dust/soil are responsible for the majority of elevated blood lead levels (BLL) above the reference level in U.S. children (5 mcg/dL). Lead in drinking water also can contribute to BLL, but usually makes up about 10-20% of the total BLL.

Adults can be exposed to lead from their occupation or environment. The California DPH Occupational Lead Poisoning Prevention Program notes that in 2011, roughly 55% of elevated adult lead levels were due to unknown exposure. Of the adults who were identified to have an occupational cause, 75% worked in manufacturing (58%) or construction (17%); the remainder worked in other various industries.

Q8: Who is most at risk of health problems from lead poisoning?

While this is not a current concern on campus, in general, children less than six years old are especially vulnerable to health problems from lead exposure. The following groups are also at risk of greater exposure:

  • As defined by the CDC, children who are members of racial-ethnic minority groups, live in poverty or in substandard housing, are recent immigrants, or have parents exposed to occupational sources of lead are disproportionately at higher risk of lead exposure.
  • Infants who drink formula prepared with lead-contaminated water are at higher risk because their brains are rapidly developing and because they consume large volumes of formula relative to their body size.
  • Lead levels in breast milk tend to be low; breast milk is highly nutritious and the best choice for most babies.

Adults, particularly females of childbearing age (including a developing fetus) are also vulnerable to the effects of lead. Elevated lead levels in adults have been reported to increase the risk of a variety of health problems, including spontaneous abortion, hypertension and kidney dysfunction.

Q9: What health conditions among patients would make them more vulnerable to lead if exposed either on campus or in the medical center?

Patients’ conditions do not make them vulnerable; the exposure does. As identified above, the leading vulnerable populations are children and the growing fetus. There are no additional categories of medical conditions that make patients more vulnerable.

Q10: Who should I screen for lead poisoning/exposure?

There are no published recommendations on whether or when to screen based specifically on lead in drinking water. Clinicians will need to determine a patient’s overall exposure to lead to determine if blood level testing is appropriate. This would take into account the patient’s exposure to a campus faucet or fountain with elevated levels, a patient’s specific health situation (such as pregnancy), as well as lead levels at that outlet, and the amount, duration and frequency of exposure. A questionnaire is available through UCSF Occupational Health Service to help identify whether individuals might be at risk.

CHILDREN: In general, California state regulations impose specific responsibilities on doctors, nurse practitioners and physician's assistants doing periodic health care assessments on children between the ages of 6 months and 6 years, with an emphasis on children in publicly supported programs (such as Medi-Cal, CHDP, Healthy Families and WIC). Because the majority of San Francisco homes were built prior to 1978, nearly all children in San Francisco should be screened at ages 12 and 24 months for elevated blood lead levels.

ADULTS: Occupationally exposed adults should be screened based on their risk of exposure. The California Department of Public Health (CADPH) Occupational Lead Poisoning Prevention Program has developed Medical Guidelines for Lead-Exposed Workers. Lead-exposed means handling or disturbing materials with a significant lead content in a manner that could reasonably be expected to cause potentially harmful exposure through inhalation or ingestion. UCSF does not expect its employees to meet the threshold for lead exposure based on drinking water.

Q11: What do I do if my patient’s blood lead levels (BLL) are elevated?

The most effective treatment for lead poisoning is removal of the source.

The California DPH has specific guidelines on managing children with elevated blood lead levels, which can be found on the CA DPH website: CA Management Guidelines on Childhood Lead Poisoning. For children with BLL >15 mcg/dL, the SF DPH provides home assessments to determine the source of the lead. See Childhood Lead Prevention Program.

For adults, the CA DPH Occupational Lead Poisoning Prevention Program has published medical management guidelines.

In addition to removal of the source, additional recommended actions include the following:

  • Ensure iron sufficiency and consider a multivitamin: Lead shares common absorptive mechanisms with iron, calcium, and zinc. Nutritional deficiencies in these minerals promote lead absorption. Ensure iron sufficiency with adequate laboratory testing and treatment per American Academy of Pediatrics statement on Lead Exposure and Lead Poisoning. Consider starting a multivitamin with iron, or iron supplementation, as indicated. Manufacturers of dietary supplements are not required to demonstrate that a product is lead-free prior to marketing so caution should be exercised with “dietary” supplements.
  • Perform structured developmental screening evaluations at child health maintenance visits per the recommendations in Bright Futures. Refer to therapeutic programs such as Early Intervention Programs and Individualized Education Programs, as appropriate, since lead’s effect on development may manifest over years.

Public health, environmental and housing policies are needed to ensure protection from lead exposure. Doctors and other healthcare providers are in a unique position to promote safe and healthy housing for children.

Q12: If BLL are elevated, should I consider chelation?

Oral chelation in children who continue to be exposed can be dangerous. Chelation therapy is not recommended and has not been shown to be effective in mitigating adverse health effects in the setting of small or transient elevations of blood lead levels. If you are considering chelating a patient based on elevated lead levels, call the California DPH, California Poison Control Center or PEHSU for guidance prior to initiating treatment.

Q13: What can a family do to decrease lead in their drinking water?

In general, San Francisco has some of the cleanest water in the nation, with undetectable lead levels in most city sources, including those serving UCSF.

Individuals residing in houses that are not campus owned and that were built before 1986, when lead soldering was banned, could have lead in their local water pipes. These individuals are encouraged to flush their tap water for 30 seconds to 2 minutes before drinking or drawing water – especially before preparing baby formula or cooking – and to run the water until it reaches the coldest temperature possible. The amount of time to run the water depends on whether the home has a lead service line and whether the water in the home has been sitting in the pipes for more than six hours. A study conducted by Maas, et. al., found that among water samples with a first-draw lead level >15 ppb, 83% of cases could be reduced to < 15 ppb simply by running the tap for a full minute.

Use only the cold water tap for drinking, cooking, and especially for making infant formula. Families can fill a pitcher with water after flushing the tap and keep it in the refrigerator for drinking, cooking, and making baby formula. The captured flushed water can be used for other purposes, such as watering plants.

Clean and remove any debris from faucet aerators on a regular basis to clear out any particles of lead that may become trapped in the aerator.

Additional Resources:

If you have further questions, please contact UCSF Occupational Health Services, at OccupationalHealthServices@ucsf.edu.

 

Resource Links

 

Definitions / Glossary of Terms

  1. UCSF Drinking Water Sampling Protocol – General water sampling protocol for lead in drinking water. Based on the US Environmental Protection Agency’s “3T” guidance document. The full sampling protocol can be found here.
  2. Supplemental Water Sampling Protocol – A supplemental water sampling protocol that may be used by mitigation teams to characterize additional water quality parameters. This protocol is used for troubleshooting purposes and is primarily employed to determine a water supply’s ability to accumulate scale within a piping system. The full protocol can be found here.
  3. Action Level – the actionable level for lead concentration in drinking water established in the US Environmental Protection Agency’s “3T” guidance document. The Action Level is not a regulatory or legal limit for lead content in drinking water, but is identified as the “limit” employed the voluntary UCSF water program.