Predictors of Water Lead Levels in Drinking Water of Homes With Domestic Wells in 3 Illinois Counties

Sarah D Geiger, Jonathan Bressler, Walton Kelly, David E Jacobs, Saria S Awadalla, Bart Hagston, Uche Onwuta, Carey Panier, Samuel Dorevitch

Research output: Contribution to journalArticlepeer-review


CONTEXT: Millions of US homes receive water from private wells, which are not required to be tested for lead (Pb). An approach to prioritizing high-risk homes for water lead level (WLL) testing may help focus outreach and screening efforts, while reducing the testing of homes at low risk.

OBJECTIVE: To (1) characterize distribution of WLLs and corrosivity in tap water of homes with private residential wells, and (2) develop and evaluate a screening strategy for predicting Pb detection within a home.

DESIGN: Cross-sectional.

SETTING: Three Illinois counties: Kane (northern), Peoria (central), and Jackson (southern).

PARTICIPANTS: 151 private well users from 3 Illinois counties.

INTERVENTION: Water samples were analyzed for WLL and corrosivity.

MAIN OUTCOME MEASURES: (1) WLL and corrosivity, and (2) the sensitivity, specificity, and predictive value of a strategy for prioritizing homes for WLL testing.

RESULTS: Pb was detected (>0.76 ppb) in tap water of 48.3% homes, and 3.3% exceeded 15 ppb, the US Environmental Protection Agency action level for community water systems. Compared with homes built in/after 1987 with relatively low corrosivity, older homes with more corrosive water were far more likely to contain measurable Pb (odds ratio = 11.07; 95% confidence interval, 3.47-35.31). The strategy for screening homes with private wells for WLL had a sensitivity of 88%, specificity of 42%, positive predictive value of 58%, and negative predictive value of 80%.

CONCLUSIONS: Pb in residential well water is widespread. The screening strategy for prioritizing homes with private wells for WLL testing is greater than 85% sensitive.

Original languageEnglish (US)
Pages (from-to)567-576
Number of pages10
JournalJournal of public health management and practice : JPHMP
Issue number6
StatePublished - Nov 1 2021


  • ISWS
  • Water
  • Pb
  • Corrosivity
  • Well
  • Lead
  • Rural health
  • Screening programs
  • Housing

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy


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