Table of Contents

ABSTRACT

Exposures to lead can have profound impacts on human development through irreversible neurocognitive damage. While the United States has managed to eliminate many significant sources of lead in recent decades, millions of children may still be at risk for elevated blood lead levels. This study shows how private well water in the home is a strong predictor of childhood lead exposure via water and its associations with poorer academic performance later in life. Data was obtained from 13,372 children in Wake County, North Carolina, linking their early childhood blood lead levels to home drinking water sources, individual and household characteristics, and end-of-grade test scores in 4th and 8th grade. Children in homes with private wells had blood lead levels approximately 6.7% higher than those on community water (P < 0.001). Higher blood lead levels detected before the age of 6 were associated with lower academic performance later in life. Children on private wells scored 11 points lower on reading (P < 0.001) and 10 points lower on math (P < 0.001); while among 8th graders, there was smaller variance with children on private wells scoring 1 point lower on reading (P < 0.001) and 4 points lower in math (P < 0.001). Social determinants of health including ethnicity, gender, and household income were also contributors to this relationship. These findings suggest that private well water can be a significant yet overlooked source of childhood lead exposures and interventions to further mitigate such exposures can be greatly beneficial to academic outcomes. Keywords: Lead exposure, children, academic performance, disparities, United States