A Prospective Epidemiological Study of Gastrointestinal Health Effects Associated with Consumption of Conventionally Treated GroundwaterEPA Grant Number: R830376
Title: A Prospective Epidemiological Study of Gastrointestinal Health Effects Associated with Consumption of Conventionally Treated Groundwater
Investigators: Moe, Christine L. , Payment, Pierre , Rose, Joan B.
Current Investigators: Moe, Christine L. , Hooper, Stuart , Moll, Deborah , Nilsson, Kenneth
Institution: Emory University , INRS - Institut Armand-Frappier , University of South Florida
Current Institution: Emory University , Centers for Disease Control and Prevention , University of South Florida
EPA Project Officer: Page, Angela
Project Period: October 1, 2002 through September 30, 2005 (Extended to September 30, 2008)
Project Amount: $1,820,900
RFA: Microbial Risk in Drinking Water (2001) RFA Text | Recipients Lists
Research Category: Water , Drinking Water , Health Effects
The overall goal of this study is to estimate the risks of endemic gastrointestinal illness (GI) associated with the consumption of conventionally treated groundwater (GW) in the US and determine the relative contributions of source water quality, treatment efficacy and distribution system vulnerability to endemic waterborne disease.
In the US, over 85 million people depend on community GW systems for drinking water. Epidemiology studies in communities using surface water sources have suggested that 10-40% of gastrointestinal illness may be associated with drinking water. Recent national GW surveys have found significant occurrence of microbial contamination in GW sources, and there is no information about the endemic illness that may be associated with consumption of treated GW. There is also uncertainty about the risks from problems with distribution systems vs. risks from treatment deficiencies. The specific aims are to: 1) compare GI rates in individuals drinking highly purified bottled water to GI rates in individuals drinking conventionally treated GW bottled at the treatment plant to determine the risk of GI illness associated with source water quality and treatment; 2) compare GI rates in individuals drinking bottled treatment plant water to GI rates in individuals drinking treated GW from selected areas of the distribution system to determine the risk of GI illness associated with distribution system vulnerability.
The proposed study is a 12-month, double-blinded, randomized intervention trial of 900 households in a large metropolitan area in the southeastern US with a community GW system that uses conventional treatment methods, meets current water quality standards and has a well-characterized distribution system with areas of vulnerability. Study households will be randomly divided into three groups of 300 households: Group 1 = Households that drink bottled water that has been treated with reverse osmosis and other advanced treatment methods, Group 2 = Households that drink bottled municipal water collected at the water treatment plant, and Group 3 = Households that drink municipal tap water. Groups 1 and 2 will be blinded to their group assignment. Half of the households within each group will be recruited from vulnerable areas in the distribution system in order to examine the health risks from distribution system contamination. Study participants will report GI symptoms and selected risk factors in a weekly health diary and biweekly telephone interview. Samples will be routinely collected from raw source water, treated water, distribution system water and bottled water and analyzed for microbial indicators. Data analyses will compare GI rates and water quality between the three study groups and between study households in different parts of the distribution system.
This is the first study to measure the risk of GI associated with the consumption of conventionally treated GW and to distinguish between the risk from source water and treatment vs. the risk from the distribution system. The results of this study will provide valuable information on the magnitude of endemic GI associated with drinking water in the US.