| Sumario: | Introduction: Childhood lead exposure is associated with impaired cognitive development, decreased IQ levels, and increased rates of juvenile delinquency. Lack of access to municipal water services, which in some communities disproportionately affects Black neighborhoods, is associated with higher levels of lead in drinking water. Objectives: This study aims to characterize the effects of exclusion from municipal water infrastructure on childhood blood lead levels. Methods: We created a novel 20-year database of 34,314 children, with which we examined the effects of municipal water access on childhood blood lead levels in Wake County, NC. Using childhood blood lead data from 2002 to 2017, we used ordinary-least squares and logistic regression models with childhood blood lead levels as the primary outcome of interest and municipal water access at time of birth as the primary exposure of interest. Results: Our results suggest that a lack of access to municipal water is significantly associated with elevated blood lead levels. Children without municipal water service at birth had blood lead concentrations that were 0.12 µg/dL higher than children with municipal water. Children with access to municipal water service had significantly lower odds of having elevated blood lead above the 'level of concern' as defined by the Centers for Disease Control than children with municipal water service (OR = 0.82). Conclusion: These findings support the need for more regulatory oversight and water quality tests of private water systems or facilitating access to municipal supplies in order to mitigate the impacts associated with childhood lead exposure
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