2012 Progress Report: Community Based Risk Assessment of Exposure to Contaminants via Water Sources on the Crow Reservation in MontanaEPA Grant Number: R833706
Title: Community Based Risk Assessment of Exposure to Contaminants via Water Sources on the Crow Reservation in Montana
Investigators: Ford, Timothy E.
Current Investigators: Ford, Timothy E. , Camper, Anne
Institution: University of New England - University Campus
Current Institution: University of New England - University Campus , Montana State University - Bozeman
EPA Project Officer: McOliver, Cynthia
Project Period: June 1, 2009 through May 31, 2012 (Extended to May 31, 2014)
Project Period Covered by this Report: June 1, 2012 through May 31,2013
Project Amount: $329,532
RFA: Issues in Tribal Environmental Research and Health Promotion: Novel Approaches for Assessing and Managing Cumulative Risks and Impacts of Global Climate Change (2007) RFA Text | Recipients Lists
Research Category: Environmental Justice , Global Climate Change , Tribal Environmental Health Research , Health , Climate Change
The objectives of this community-based participatory research (CBPR) project are to collaborate to:
- Establish a sampling and analysis program to assess contaminant loadings to water and to aquatic subsistence foods;
- Evaluate lifestyle and cultural practices that contribute to exposure risk from water sources;
- Draw on existing conceptual models for cumulative risk assessment to integrate our research data and other available local data into a community-based cumulative risk assessment that is useful to and appropriate for the Crow Reservation community and potentially a model for other Tribal communities; and
- Design and support culturally appropriate risk communication and risk mitigation measures that minimize impact on subsistence and other traditional practices, and which may be transferable to other Tribes.
This is a CBPR project and therefore the research is jointly guided and conducted by the Crow Environmental Health Steering Committee (CEHSC) and academic partners. The CEHSC includes representatives of the Apsaalooke [Crow] Water and Wastewater Authority, the Crow Tribal Administration and Tribal Environmental Protection Program, Little Big Horn College (LBHC - the tribal college for the reservation), the local Indian Health Service Hospital and the local non-profit Messengers for Health, along with other community stakeholders. Academic partners include LBHC, Montana State University-Bozeman (MSU) and the University of New England (UNE). The Steering Committee continues to meet monthly to discuss a range of environmental health issues on the Reservation, and to provide guidance and input into this risk assessment project. Staff includes Project Leader Margaret (Mari) Eggers, Project Coordinator John Doyle and student interns Dayle Felicia and Eric Dietrich.
Funding for methods development and data analysis under this contract is complemented by NIH funding for a community-based risk assessment of exposure to contaminants through water sources and select subsistence foods. The EPA funding covers expenses at UNE, project leader Eggers’ time at MSU (half-time), a small portion of the Project Coordinator’s time, and some of the student interns at MSU. Eggers’ effort now is primarily focused on methods development, data analysis, project coordination and literature review, especially the cumulative risk assessment literature.
In this report, we describe the overall project accomplishments to provide the context for the methods development and data analysis work. Our hypotheses are that (a) reliance on shallow wells, inclusion of subsistence foods in the diet, use of river water in traditional ways, leasing of lands and other local practices place residents at an increased risk of exposure to environmental contaminants and pathogens via water sources, including through ingestion of local fish; and (b) following CBPR principles in conducting risk assessment is an effective way to reduce health disparities in underrepresented communities. Tribal College science majors serve as our research interns, as one of our goals is to increase community capacity in environmental health. Methods include: (1) bacterial and comprehensive chemical analyses of domestic, cultural and recreational water sources; (2) mercury analyses of local fish; (3) family surveys to assess routes of exposure and to identify risk factors for well contamination; and (4) interviews with key informants to elucidate and document the social, cultural, spiritual and economic impacts of water contamination. The resulting data will be combined with historical data from LBHC, the Crow Tribe, the Indian Health Service Hospital, the USGS and the EPA to provide the basis for the risk assessment.
Sampling and Analysis (Objective 1)
The bacterial and comprehensive chemical analyses of domestic well water were completed in the spring of 2012, with 164 wells tested to date (with NIH funding). The water in every well has exceeded one or more EPA secondary standards (related to aesthetics). Mineral and/or microbial contamination of home well water exceed EPA primary standards or health advisories in 55% of wells tested, presenting health risks to Reservation residents who own and use wells. Data for 550+ additional local wells, tested by the Indian Health Service at time of installation, have been scanned and manually entered into our database (with NIH funding). GIS maps showing the spatial distribution of each contaminant have been prepared (with NIH funding) and are being presented to the community (with EPA funding). For further information on the well water data, see the 2012 annual report. With other funding sources and a variety of collaborators we: (1) have sampled the Little Big Horn River water and sediments for minerals, especially metals, to establish baseline levels prior to pending energy development in the watershed; (2) have sampled the Big Horn and Little Big Horn Rivers for mineral and microbial contamination (including Cryptosporidium in the water treatment plant’s intake); and (3) are sampling Pryor Creek for microbial contamination. All three rivers periodically exhibit severe fecal contamination, at levels far exceeding safe recreational uses.
Evaluate Routes of Exposure (Objective 2)
Surveys accompanying the well water testing were completed by 237 adult family members (with NIH funding). Both well water and survey data are being entered into MS Access for analysis (with EPA funding). The survey data will be analyzed against the well water data. For instance, potential risk factors for fecal contamination of wells are being compared against the data for coliform contamination of wells. A preliminary analysis of the first 80 wells entered into the database showed that sanitary well caps are significantly protective of well water quality (p < 0.05). Inadequate maintenance of septic systems and an out-of-service well on the property are more often associated with coliform contamination, but the analysis will need to be re-run when all the data are entered. Somewhat surprisingly, livestock grazing (and hence manure) in the vicinity of the wellheads was not a risk factor in this preliminary analysis. Survey data analysis will document routes of exposure, including via cultural practices. With the local non-profit Messengers for Health, interviews were conducted with 30 key Tribal informants on the broader impacts of water contamination and measures being taken by families to reduce waterborne contaminant exposures (with NIH funding). These interviews were analyzed utilizing collaborative ethnography. With EPA, NIH and other funding, we investigated and published an article on the current and projected impacts of climate change on Tribal health, primarily via changes to local water quantity and quality (Doyle, et. al., 2013). (EPA funded the hydrologic data analysis and write up.)
Cumulative Risk Assessment Models (Objective 3)
The literature on CRA models (e.g., Linder 2011, EPA 2007, NRC 2009, Gee and Payne-Sturges 2004, Payne-Sturges and Gee 2006) and on risk assessment work in other Native American communities is being reviewed (e.g., Arquette, et al., 2002; Harper, et al., 2007; Donatuto, et al., 2011; Burger and Gochfeld 2011). The EPA’s ongoing CRA webinar series is a very useful source of current information. The recent Environmental Health Disparities and Environmental Justice Meeting held in Raleigh, NC (co-sponsored by the EPA) also was helpful. EPA’s new Microbial Risk Assessment guidelines (https://www.epa.gov/osa/basic-information-about-risk-assessment-guidelines-development) will be another source of guidance. The information we have gained from the literature, the EPA website and these meetings will help inform our work over this coming year. We will work on integrating all the diverse sources of data into a cumulative or comprehensive risk assessment framework that can be most effectively used by the Crow Tribe, and potentially other Tribal and rural communities. Incorporating qualitative cultural data also is a challenge. Therefore, we are continuing to evaluate these, and potentially other models, both for adaptability to microbial and cultural data and ease of use by the Crow Community.
Risk Communication and Mitigation (Objective 4)
All well owners have received their well test results in writing, with an explanation of the risks, the acceptable uses of their well water, and their options for treatment. A DVD on home well and septic system maintenance and a homeowner’s booklet explaining treatment options were included. For many families, especially those whose first language is Crow, we learned that these materials were not sufficient. Hence our Program Coordinator now is conducting home visits to discuss well test results and evaluate the intervention. Community engagement and state and national outreach to share our research results are ongoing. Mitigation of microbially contaminated wells is a widespread need, especially in the Little Big Horn River valley as a result of increasingly frequent and severe spring flooding. An analysis of available data for this river valley revealed that there are long-term changes (50 years +) in both climate and hydrology that are consistent with regional climate change predictions. An EPA proposal addressing water-related health impacts of climate change on the Reservation was developed and submitted and is under review. Also, an EPA Environmental Justice Small Grants proposal addressing microbial contamination of a sacred spring and home wells in the Pryor Creek Valley of the Reservation was submitted and is in the process of being awarded. Additionally, we have pilot tested a low-cost, high-tech home water filtration system on the Reservation as a potential mitigation measure. Since the beginning of this project in 2004, our research data have been used by the Water and Wastewater Authority to obtain more than $20 million in funding to upgrade the water and wastewater treatment systems, and to provide centralized access to municipal water for residents currently on well water.
The primary challenges we have faced are in risk communication and mitigation. We learned that for the majority of families, risk communication is far more effective when conducted orally, in person, as explained above. The mitigation required to ensure families have access to safe drinking water far exceeds the scope and resources of our current funding (not surprisingly), hence we are working to leverage other funding. Data analysis from the current project will be extremely useful in designing targeted risk communication and mitigation in the future. An additional challenge has been the need for expertise in qualitative research. New collaborators were recruited to join our partnership (with other funding): Dr. Timothy McCleary, an anthropologist of Crow descent who is on faculty at Little Big Horn College, and Dr. Martha Ann Carey, a retired NIH Project Officer and qualitative research expert. Dr. McCleary has provided guidance in collaborative ethnography, and Dr. Carey has provided two workshops in qualitative research and project development to our entire Steering Committee and staff (2 days in May 2012, and 3 days in May 2013). Both continue to consult with us as needed.
As a community-based participatory research project, continue to collaborate to:
- Complete follow-up home visits and project evaluation with project participants;
- Continue risk communication and risk mitigation work with the community;
- Present results at the Geological Society of America’s Medical Geology Conference in August 2013, and at the regional NIH-INBRE meeting in October 2013;
- Analyze, write up and publish well testing and survey data;
- Complete and publish qualitative research on broader impacts of well water contamination;
- Write up and publish work on home water filter system testing;
- Integrate diverse sources of data into a cumulative or comprehensive risk assessment framework useful to and appropriate for the Crow Tribe, and potentially other Tribal and rural communities, and publish the results.