In 2016 the Pennsylvania Department of Health released ZIP code figures on childhood blood lead testing in response to a public request. For 2015, the data showed that more than 7 percent of children under age 6 who were tested in the Lititz 17543 ZIP code had confirmed blood lead levels at or above 5 micrograms per deciliter, the threshold the Centers for Disease Control and Prevention used at the time to flag elevated exposure.
The number landed hard because of what it was compared with. Researchers at Hurley Medical Center in Flint, led by pediatrician Mona Hanna-Attisha, had published an analysis showing the share of Flint children with elevated levels in high-risk ZIP codes rose from about 2.5 percent before the city’s 2014 water switch to about 6.3 percent afterward. On those figures, the Lititz-area rate was higher.
What the comparison does and does not show
The comparison was accurate as arithmetic, and it was a fair reason to ask questions. It also needs context that was not always given at the time.
- The Lititz figure is a share of children tested, not of all children. Testing in Pennsylvania has not been universal. If doctors test mainly children they consider at risk, the share with elevated results can be higher than it would be in a full population.
- The two data sets were collected differently. The Flint study used hospital records over defined periods; the Pennsylvania figures came from state surveillance reports. Small differences in method can move percentages.
- Water is not the only source. In Lititz, a large share of homes predate 1978, when lead paint was banned for residential use. Paint dust and soil are the most common sources of childhood exposure nationally, and the state data did not separate sources.
- Small numbers swing. In a single ZIP code, a handful of children can shift the percentage noticeably from year to year.
None of this makes the 2015 figure unimportant. It means the right reading was “too many children here have elevated lead, and the causes need to be found,” rather than a direct verdict on the water supply alone.
The same year’s water questions
The data arrived alongside state notices that Lititz Borough and Warwick Township had not followed federal lead sampling rules between 2010 and 2013. Our restored coverage of those notices: the borough, the township, and the list of lead gooseneck addresses the borough later released.
What has changed since
Two big things changed after 2016.
First, the CDC lowered its blood lead reference value in 2021 from 5 to 3.5 micrograms per deciliter. A child at 4 micrograms would not have been counted in the 2015 Lititz figure but would be flagged today. Comparisons between old and new reports need to account for that.
Second, Pennsylvania moved toward broader testing. Universal blood lead testing for young children was a long-running goal of public health advocates, and state law and Department of Health guidance now call for testing children at ages 1 and 2 in many circumstances. More testing produces a more representative picture, which makes ZIP code figures more meaningful.
The Department of Health publishes annual childhood lead surveillance reports with county and ZIP code data. Readers can compare Lancaster County and 17543 figures with the statewide rate there.
What parents can do
- Ask your pediatrician whether your child has had a blood lead test, especially at ages 1 and 2.
- If your home was built before 1978, watch for chipping or peeling paint and keep windowsills and floors clean with damp wiping.
- Use cold water for drinking and formula, and ask your water provider how your service line is classified.
Our guide for families, what pregnant women and parents in Lititz should know about lead, covers each step in more detail.