Correspondence among

Hi all, Bob Scott updated me on the upload of child lead data into the warehouse “As of next Monday, we'll be two weeks behind on Lead records in the Warehouse. Jessica’s computer (and everyone’s around here) was upgraded to Office 2013 last Friday. ....but Access 2013 will not handle DBF files. We have used Access for a few years as a pass-through to get the DBF format (dates, | think) exactly right for loading to the Warehouse. When | get back, I’ll work with the folks from Optum to see what we can do about getting files in Warehouse-ready format.” Bob will be back next Monday. ican pull data from the warehouse next Monday, but be aware that it may not be complete. Patricia McKane, DVM MPH - Manager, Maternal & Child Health Epiderniology Section | Michigan Department of Health and Human Services | Lifecourse Epidemiology and Genomics Division | PO Box 30195 / 201 Townsend St 4" Floor - Lansing, MI 48909 | Cell Work Hours: M_F 7:30am — 4:00 pm Michigan has.a public records law. Most written communications to or from state officials regarding state business are public records available to the public and media upon request. Your e-mail communications and any attachments to them may be subject to public disclosure. xxxEND_PAGE:dhhs03_b0401_1522_1524_2 001524 This message, inclsttiag any attainments is intedred solely for the use af the RAHA reciprent(s) anh may eerttitin confistentia! and/or priviteged informtrtion. Any uirrtrehorzed review, use, dactesure, or distribation of any confitential endfor prviteged informenion eomtofded in this emi! is exprasty protibited. if you are net the irtterrfed recipient, please ewrtdct the sender by reply exraill art! destroy any td all copies of fe original messoge. xxxEND_PAGE:dhhs03_b0401_1522_1524_3

ATTOOOO1. htm, They didn’t take the gascline out per your suggestion Linda but altered the sentence on lead paint exposure from earlier versions at least.

Jim Sygo, DEQ, called to ask what the heck Genesee County actually issued and under what authority. i told him we didn’t know either per Brenda Lawson’s view at 5 pm last night.

GENESEE COUNTY, MI — Don't drink the water. That's one message Genesee County officials are pushing to residents who get their water supply from the city of Flint. Genesee County Commissioners Brenda Clack, Jamie Curtis and Bryant Nolden, along with Genesee County Health Officer Mark Valacak, held a news conference Thursday, Oct. 1, urging residents to not drink the city's water until it is checked for lead or they have installed an approved water filter. Don't Drink Flint's Water, County Leaders Warn Genesee County commissioners urge residents to not drink Flint's water until it is checked for lead or until they have installed an approved water filter. The commissioners declared a public health emergency and said they are hoping their declaration will move Gov. Rick Snyder to declare a state of emergency to handle Flint's water crisis. "This falls directly on the doorstep of the governor," said Nolden. "If we look at what happened with going to the Flint River, this falls smack-dab on the emergency manager and the governor. Now, | think it's imperative that the state step up and help us fix this problem. We're just imploring that the state actively engage and look at ways we can connect to the Detroit River. ... This is a major health situation for this entire community." xxxEND_PAGE:dhhs02_b0329_1263_1263_1

Eden, More analysis and review has been done by Sarah’ staff. Here are the talking points: The high risk Zip codes (48503 and 48504} Blood lead level rates among children under six years of age in the high risk Zip codes (48503, 48504} were 2.7 times higher than the rest of Genesee County before the switch to Flint River Water (o<0.0001}, After the switch to Flint River Water, rates in the high risk Zip codes were 3.2 times that of the rest of Genesee County {p<f.0001). Thus, compared to rates during 2040-2013, the rates after the switch to Flint River water in the high risk Zip codes increased 18 percent, although this difference did not reach statistical significance. xxxEND_PAGE:dhhs02_b0025_0147_0149_1 000148 Other Zip codes in Hint Rates of elevated blood lead levels among children under six years of age In other narts of the city of Hint were 2 times that of the rest of Genesee County before the switch to Flint River Water (p<0.0001). The magnitude of the elevated rate remained roughly the same during the period after the water source switch.

Date: Thursday, October 01, 2015 2:18:30 PM More analysis and review has been done by Sarah’s staff. Here are the talking points: The high risk Zip codes (48503 and 48504) Blood lead level rates among children under six years of age in the high risk Zip codes (48503, 48504} were 2.7 times higher than the rest of Genesee County before the switch to Flint River Water (p<0.0001}. After the switch to Flint River Water, rates in the high risk Zip codes were 3.2 times that of the rest of Genesee County (p<0.0004}. Thus, compared to rates during 2010-2013, the r: risk Zip codes increased 18 percent, although this difference did not reach statistical sig Other Zip codes in Flint Rates of elevated blood lead levels among children under six years of age in other parts of the city of Flint were 2 times that of the rest of Genesee County before the switch to Flint River Water (p<0.0001}. The magnitude of the elevated rate remained roughly the same during the period after switch. s after the switch to Flint River water in the high icance, the water source

Importance: High 2 things: 8 Leaded gasoline has been banned for use in road vehicies since 1996, so it’s not likely that Flint kids would be exposed that way 8 The sentence “Mast of the iead In household water usually comes from the slumbing in your house, not frarn the local water supply” is not completely accurate and could be challenged. On the call v EPA today | heard that maybe 50% of the city’s lead supaly lines are lead..these are outside the house and would include i portion of the run ow d by the resident and the portion owned by the city water s

Sent from my iPhone Begin forwarded message:

Hi all-- E talked to Sob to confirm the information | had shared about the Hurley lab results. itis a little more nuanced than | had explained, forwarding Bol‘s explanation, FY.

Date: Wednesday, September 30, 2015 8:45:36 AM

and EBLLs (4).pdf; ATT00002.htm; STATELEADDATA with original and updated numbers.xlsx; ATT00003.htm FYI only. Keeping you in the loop regarding MDHHS CLPPP data. Sent from my iPhone Begin forwarded message:

“Current water sampling protocols were designed to assess the adequacy of water treatment, not the level of human exposure to lead. Important fluctuations in water lead levels might be missed because of limitations inherent in sampling protocols developed for regulatory purposes.” Linda ®. Dyhena, PAD. Environmental Public Health Director Division of Environmental Health Michigari Department of Health & Human Services 517,335,8566 dykernal@ michigan gov xxxEND_PAGE:dhhs02_b0501_1930_1930_1

Date: Tuesday, September 29, 2015 12:07:52 PM

Date: Wednesday, July 29, 2015 8:54:24 AM

in’s work wit!

Linda and J talked and I am going to ce you both when the request goes back to Nancy. In the interim, Nancy wanted to add some more years of data to the comparison (so there are 4 total years of data). Cristin is adding these years to the control chart for the proportion of first time elevated BLL of those tested using method by Shewart for proportions. (Linda - the data are deduped to "kid". ) ao=-+ Original Message-----