The Environmental Protection Agency finalized a rule Tuesday requiring water utilities to replace all lead pipes within a decade, a move aimed at eliminating a toxic threat that continues to affect tens of thousands of American children each year.

The move, which also tightens the amount of lead allowed in the nation’s drinking water, comes nearly 40 years after Congress determined that lead pipes posed a serious risk to public health and banned them in new construction.

Research has shown that lead, a toxic contaminant that seeps from pipes into the drinking water supply, can cause irreversible developmental delays, difficulty learning and behavioral problems among children. In adults, according to the Centers for Disease Control and Prevention, lead exposure can cause increased blood pressure, heart disease, decreased kidney function and cancer.

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But replacing the lead pipes that deliver water to millions of U.S. homes will cost tens of billions of dollars, and the push to eradicate them only gathered momentum after a water crisis in Flint, Mich., a decade ago exposed the extent to which children remain vulnerable to lead poisoning through tap water.

“All Americans, no matter where they come from, should have access to their most basic needs, including being able to turn on the tap and drink clean drinking water without fear,” Natalie Quillian, a White House deputy chief of staff, told reporters in a phone call.

The groundbreaking regulation, called the Lead and Copper Rule Improvements, will establish a national inventory of lead service lines and require that utilities take more aggressive action to remove lead pipes on homeowners’ private property. It also lowers the level of lead contamination that will trigger government enforcement from 15 parts per billion (ppb) to 10 ppb.

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The rule also establishes the first-ever national requirement to test for lead in schools that rely on water from public utilities. It mandates that water systems screen all elementary and child-care facilities, where those who are the most vulnerable to lead’s effects — young children — are enrolled, and that they offer testing to middle and high schools.

The White House estimates that more than 9 million homes across the country are still supplied by lead pipelines, which are the leading source of lead contamination through drinking water. The EPA has projected that replacing all of them could cost at least $45 billion.

Lead pipes were initially installed in cities decades ago because they were cheaper and more malleable, but the heavy metal can wear down and corrode over time. President Joe Biden has made replacing them one of his top environmental priorities, securing $15 billion to give states over five years through the bipartisan infrastructure law and vowing to rid the country of lead pipes by 2031. The administration has spent $9 billion so far — enough to replace up to 1.7 million lead pipes, the administration said.

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On Tuesday, the administration said it was providing an additional $2.6 billion in funding for pipe replacement. Over 367,000 lead pipes have been replaced nationwide since Biden took office, according to White House officials, affecting nearly 1 million people.

Water utilities, which have challenged past efforts to make them bear the financial cost of digging up existing lines, have said they support the move but the new requirements will be difficult to meet.

The rule does not specify what kind of pipes should be installed as replacements, though copper and plastic are often used. Utilities are required to provide an initial inventory of all lead pipes and identify service lines with unknown material by Oct. 16.

The American Water Works Association (AWWA) and the Association of Metropolitan Water Agencies (AMWA), both of which represent water utilities, commented in February that the effort will cost twice as much as the Biden administration has estimated.

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AMWA chief executive Tom Dobbins said that there are three major challenges: access to the private property, the cost to remove the pipes and the timeline.

“It’s a big project,” he said. “It took decades and decades and decades to put all of these lead service lines in, and we’re going to get them out in 10 years.”

Rate payers will ultimately bear the brunt for the cost, Dobbins added. “The whole system will have to pay to have to do this. And there’s going to be an impact on all of us when we pay our monthly or quarterly water bill,” he said.

It is unclear whether the groups, which have already challenged the administration’s new drinking water limits on per- and polyfluoroalkyl substances (PFAS), will seek to block the new regulation in court. These substances, also known as “forever chemicals,” are linked to an increased risk of certain types of cancer, low birth weights, high cholesterol and negative effects on the liver, thyroid and immune system.

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In 1991, the AWWA thwarted the EPA’s efforts to make utilities responsible for the entire lead line after they sued. Instead, the agency issued the original lead and copper rule, which critics described as ineffective in protecting residents across the country.

Environmental advocates said that former president Donald Trump, who issued much more modest revisions to the lead and copper rule just days before Biden took office, would have a hard time reversing the new standards.

Erik Olson, the senior strategic director for health at the Natural Resources Defense Council, said that the Safe Drinking Water Act has provisions prohibiting weakening the health protections of existing standards.

“A possible future administration could try to wiggle out of that, but they would face legal challenges if they tried,” Olson said.

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Olson added that the rule “represents a major victory for public health” and will protect millions of people “whose health is threatened every time they fill a glass from the kitchen sink contaminated by lead.”

“While the rule is imperfect and we still have more to do, this is by far the biggest step towards eliminating lead in tap water in over three decades,” he said.

The EPA estimates that when the new rule is fully implemented, it will protect up to 900,000 infants from having low birth weight; prevent attention-deficit/hyperactivity disorder in up to 2,600 children; reduce up to 1,500 cases of premature death from heart disease; and prevent up to 200,000 IQ points lost in children.

The new rule is a “significant win to our children, who no longer have to be exposed to lead and can use their full God-given potential to learn and to contribute to society and continue to make society great,” EPA Administrator Michael Regan said in a phone interview, adding that lead-contaminated water amounts to a “generational public health crisis.”

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Administration officials did not provide a figure for how many Americans are drinking tap water that poses a health risk, but they said that less than 3 percent of the public water systems covered by the lead and copper rule exceeded the previous threshold of 15 parts per billion in the past three-year monitoring period.

Still, many surveys have indicated that a number of Americans are exposed to lead through their tap water. One NRDC analysis found that, between 2018 and 2020, 56 percent of the U.S. population drank from water systems with detectable levels of lead. In Chicago, more than two-thirds of children under 6 years old are exposed to lead in their drinking water, according to a study published in March. In New Jersey, a health department report found that more than 2,800 children under 6 years old had blood lead levels above the state standard in 2022.

Without federal guidelines, some states already started replacing lead service lines — often only replacing those that were considered public property while leaving others in place that snake through the ground between the edge of the property and the home.

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The rule will eradicate the current patchwork system of lead pipe replacements — generally in the middle of the street — to the home. And it requires utilities to make four different attempts to reach the owners to offer to replace the lines.

Senior administration officials said 99 percent of cities across the country should be able to make the rule’s 2034 deadline. Some cities may take more time, including Chicago, where experts say it could take as long as 40 years to replace an estimated 400,000 lead service lines.

Ben Grumbles, executive director of the Environmental Council of the States, whose members include the 50 state environmental secretaries charged with implementing and enforcing the Safe Drinking Water Act, said in an interview that this is a “galvanizing moment,” but that states need enough money to pay for state regulators and additional enforcement.

Grumbles, who served as the EPA’s assistant administrator for water from 2004 to 2008, said current funding is “a drop in the bucket” compared with what is going to be needed.

Regan said the administration has provided some funding through the infrastructure law, adding that some cities had already started removing lead service pipes and the health benefits outweighed any cost.

Quillian expressed confidence that the new standards could overcome any potential political or legal challenges. “We believe and hope that ending the poisoning of our kids from lead in water could and should be a bipartisan priority,” she said.

Mona Hanna, a pediatrician and associate dean of public health at Michigan State University who helped expose the widespread contamination of Flint’s drinking water a decade ago, called the new rule “historic.”

“This is finally the strengthening of regulations to really follow the science and to really put kids at the center of what needs to be done,” Hanna said.