The goals of this project are: 1) to provide a descriptive assessment of the current methodologies used in state-based school water quality testing programs compared to recommended standard surveillance elements; and 2) to summarize water lead content data derived from state testing programs and present and evaluate data by school social and demographic characteristics. First a standardized policy and document content review protocol will be used to document key features of state water quality testing programs and relevant elements of the public surveillance system. These will include lead agency, policy mechanism, sample size target specifics, water sample collection protocols, case identification by lead content action level, response procedure requirements, and reporting and communication requirements. These will be compared to Environmental Protection Agency recommendations and guidelines for public health surveillance elements. Next the researchers will access online or request data on all testing samples of measured lead in tap water from states conducting voluntary or mandatory school tap water testing for lead (and copper, when available). This school-level water quality testing data will then be linked with school-level characteristics using publicly available data on all public schools and other state-agency provided data.