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Pittsburgh, Pennsylvania is currently struggling to manage and improve its aging water system, with a focus on elevated lead levels for many customers. The issue is well covered in the local media, and several steps are being taken or proposed for remediating lead in Pittsburgh's tap water. Under federal and state regulatory action and pressure from residents, the city is at a critical decision point for addressing the issue of lead in its water. This Perspective reviews the history and recent developments related to the use of lead in Pittsburgh's water system and the policy options for lead remediation currently being weighed by local decisionmakers.

We review the costs, regulatory barriers, and feasibility of the various options under consideration, including the City of Pittsburgh's new Safe Water Program and multiple pipe replacement options. We conclude with recommendations, including ensuring optimal pipe corrosion control and filtering in the immediate term and pursuing innovations from other cities to reduce the public and private costs of the permanent solution of full lead service line replacement.