Measures of Distribution System Water Quality and Their Relation to Health Outcomes in Atlanta

EPA Grant Number: R834250
Title: Measures of Distribution System Water Quality and Their Relation to Health Outcomes in Atlanta
Investigators: Moe, Christine L. , Uber, Jim , Klein, Mitchel , Tolbert, Paige , Tinker, Sarah , Hooper, Stuart
Current Investigators: Moe, Christine L. , Sarnat, Stefanie Ebelt , Kirby, Amy , Levy, Karen , Klein, Mitchel , Tolbert, Paige
Institution: Rollins School of Public Health, Emory University , University of Cincinnati
Current Institution: Rollins School of Public Health, Emory University
EPA Project Officer: Page, Angela
Project Period: July 1, 2009 through June 30, 2012 (Extended to June 30, 2014)
Project Amount: $599,756
RFA: Innovative and Integrative Approaches for Advancing Public Health Protection Through Water Infrastructure Sustainability (2008) RFA Text |  Recipients Lists
Research Category: Pollution Prevention/Sustainable Development , Health Effects , Sustainability , Water


The investigators propose research that will link health outcomes, quantified through emergency department (ED) visits for gastrointestinal (GI) illness, to distribution system water quality and infrastructure characteristics. In addition, the investigators propose an integrative approach for characterizing health risks associated with microbial contamination of drinking water distribution systems through the development of vulnerability assessments and the implementation of an innovative continuous water quality monitor for use in distribution systems. The proposed study builds upon previous studies by the same investigators that examined the importance of distribution systems in providing safe drinking water. From these previous studies the investigators have access to extensive information regarding the drinking water distribution systems serving the Atlanta metropolitan area, which can be linked to ED data on GI illness in the community, allowing the assessment of potential health risks associated with drinking water distribution systems.


The overall study design has three main parts. A pathogen contamination vulnerability assessment will be conducted for a selected drinking water utility. The investigators will extend, expand, and refine the epidemiological analyses involving distribution system exposure from their previous EPA-funded drinking water epidemiological study. The results from the vulnerability assessment will be leveraged by considering them as an exposure metric in epidemiological analyses. Concurrent with these aspects of the proposed study, the investigators will also directly assess distribution system water quality through an innovative continuous monitoring device.

Expected Results:

The intended outcome of the proposed research is improved public health protection through improved distribution system water quality, resulting from the knowledge gained from implementing vulnerability assessments and/or continuous monitoring and an understanding of the public health risks conveyed through contamination occurring in drinking water distribution systems. Further, the results of these analyses will inform the public health and drinking water communities regarding the usefulness of various measures of distribution system water quality. This information should be particularly useful as drinking water regulations are revised (e.g. Total Coliform Rule).

Publications and Presentations:

Publications have been submitted on this project: View all 14 publications for this project

Journal Articles:

Journal Articles have been submitted on this project: View all 1 journal articles for this project

Supplemental Keywords:

water, drinking water, exposure, risk, health effects, human health, vulnerability, population, indicators, public policy, epidemiology, engineering, modeling, monitoring, Georgia, GA

Progress and Final Reports:

  • 2009 Progress Report
  • 2010 Progress Report
  • 2011 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • Final Report