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The presence of lead particles in tap water is an under-appreciated cause of lead poisoning in the United States. Routine water sampling procedures can "miss" lead particles present in drinking water. Consequently, the true extent of human exposure through this type of lead contamination can be underestimated. The authors describe recent cases of lead poisoning in Washington, D.C., Greenville, North Carolina, and Durham, North Carolina, when approved water sampling procedures did not show cause for alarm. Also, the authors compare the bioavailability of lead particles when ingested to their detection in drinking water samples and, in turn, compare human exposure to what utilities detect in water samples. Their findings reveal the potential limitations in current lead detection methods. This information can be used to improve current water sampling and preservation procedures. Includes 39 references, tables, figures.