338 - Infant Exposure to Lead in Water in Flint, Michigan

The Flint Water Crisis (FWC) exposed >100,000 individuals to lead in drinking water without public knowledge. Water consumption is a medical and public health necessity, especially for formula fed infants who are exposed to lead in water at a period of greatest neurodevelopmental vulnerability. Low breastfeeding rates and dependence on reconstituted formula, coupled with neurotoxicant-contaminated drinking water, has population-level implications for children’s health and development in Flint and nationally. Blood lead surveillance programs are unreliable for detecting lead-in-water exposure, especially with the short half-life of lead and younger exposure age. There are no current recommendations for lead-free infant feeding practices or policies.
 

Objective:

To better delineate the burden of exposure for this at-risk population, we analyzed Flint Registry data to determine infants’ consumption of unfiltered tap water during the water crisis. This is the first large-scale, population-level, analysis quantifying the extent of exposure of infants’ tap water consumption.

Design/Methods:

Caregivers reported infant water use during the FWC (April 2014-Oct 2015) for those born April 2013-October 2015 who were enrolled in the Flint Registry between 2017-2021. Caregivers indicated the amount of unfiltered tap water consumed by the infant (daily, less than daily, not at all) through direct drinking or powdered infant formula reconstitution.

Results:

The majority of caregivers (68.9%, 735/1066) reported that their infant used unfiltered tap water for either drinking and/or mixing formula every day. An additional 13.5% (n=144) reported using the water less than daily. Only 16.5% (n=187) said they did not give unfiltered tap water to their infant. Over half (53.2%, 603/1058) reported that they used unfiltered tap water to mix with powered infant formula and 73.9% (838/1054) reported their infant drinking unfiltered tap water.

Conclusion(s):

With almost 70% of infants consuming unfiltered tap water during the FWC, this analysis has grave implications for the long-term health and development of Flint kids. Given the large burden of exposure, there is a continued need for long-term surveillance and support of Flint children. Additionally, with the greater recognition of widespread lead-in-water contamination (even in non-crisis communities), the ubiquitous nature of lead in drinking water infrastructure, and the laxity of drinking water regulations with no guarantee of lead-free water, there is a growing imperative for more protective formula reconstitution guidelines and stronger drinking water regulations.