Grantee Research Project Results
2005 Progress Report: Drinking Water Quality and Emergency Visits for Gastroenteritis in Atlanta
EPA Grant Number: R831629Title: Drinking Water Quality and Emergency Visits for Gastroenteritis in Atlanta
Investigators: Tolbert, Paige , Singer, Philip C. , Moe, Christine L. , Amirtharajah, A. , Flanders, Dana , Uber, Jim , Klein, Mitchel , Tinker, Sarah , Hooper, Stuart
Institution: Emory University , University of Cincinnati , Georgia Institute of Technology , University of North Carolina at Chapel Hill
Current Institution: Emory University , Georgia Institute of Technology , University of Cincinnati , University of North Carolina at Chapel Hill
EPA Project Officer: Page, Angela
Project Period: September 1, 2004 through August 31, 2007 (Extended to August 31, 2008)
Project Period Covered by this Report: September 1, 2004 through August 31, 2005
Project Amount: $1,223,366
RFA: Microbial Risk in Drinking Water (2003) RFA Text | Recipients Lists
Research Category: Drinking Water , Water , Human Health
Objective:
The objective of this research project is to assess the relationship between drinking water quality and the incidence of gastrointestinal (GI) illness and develop an estimate for the proportion of endemic GI illness that can be attributed to water quality degradation within the distribution system. The research takes advantage of an extensive database containing information on emergency department (ED) visits in the 20-county Atlanta metropolitan area from 1993 through 2004. Water quality data are being assembled from a variety of sources within the five-county Atlanta metropolitan area. The relationship between drinking water quality and GI illness will be examined by temporal and spatial analyses of counts of ED visits for GI complaints with levels of estimated water quality, both in the general population and in susceptible subpopulations. The modifying effect of the drinking water distribution system on the quality of water measured as it is leaving the treatment plant, both during normal operation and during failures in the water transport system, will be examined. The impact of treatment changes on water quality and levels of endemic GI illness in Atlanta will be considered. The proportion of risk for GI illness attributable to microbial contamination at the treatment plant and within the distribution system will be estimated. The impact of measurement error on these analyses also will be estimated.
Progress Summary:
In Year 1 of the project, we obtained the participation and cooperation of all 10 of the major drinking water utilities in the study area of the five-county Atlanta metropolitan area. We are nearing completion of the inventory of the water quality data available from each of these utilities. A detailed study protocol has been developed in consultation with the Georgia Department of Natural Resources (GA DNR) and the drinking water utilities. We have met on multiple occasions with representatives from the utilities to assure a clear understanding of the study design and purpose. We have collected and entered all available monthly reports containing information required to be reported to GA DNR. We have obtained detailed information regarding microbiological measurements taken from the distribution system from all of the utilities. We have obtained data regarding customer complaints, flushing programs, new line placement, contact time and disinfection, as well as algae data from some of the utilities. We will continue to collect such data until we have obtained all that are relevant and available from each of the participating utilities.
We completed collection of the ED data from the metropolitan area. The compiled data set contains data for 12 years, from 1993 through 2004. Thirty-seven of 42 hospitals serving the greater 20-county Atlanta metropolitan area have contributed data. We have updated the database to include case groups for GI illness. We are in the process of cleaning these data and preparing them for use in the analytical data set.
Distribution system modeling has been initiated. We held a meeting in February 2005 for those involved in distribution system modeling at each utility to inform them of our study goals regarding modeling and to receive their input on how best to proceed with this aspect of the study. Generalized distribution system models have been developed that will be applied to each utility based on the models they currently use. Individual meetings are being arranged with each utility to obtain information regarding their models. Models providing estimates of water age will be the first focus of the modeling efforts.
Future Activities:
In the next year (Year 2), we will perform the following activities: (1) complete the construction of the analytical data set, including both data collection and editing; (2) develop distribution system models for water age and other quantities indicative of delivered water quality; (3) conduct descriptive analyses; (4) carry out analysis assessing the association between estimated residence time and other measures of pathogen intrusion vulnerability and ED visits for GI illness; (5) carry out analysis assessing the association between drinking water treatment plant and ED visits for GI illness; (6) carry out analysis assessing the association between measured water quality parameters and ED visits for GI illness; and (7) prepare manuscripts for publication to report the findings of our analyses.
Journal Articles:
No journal articles submitted with this report: View all 13 publications for this projectSupplemental Keywords:
water, drinking water, exposure, risk, health effects, human health, population, sensitive populations, children, elderly, pathogens, dose-response, public policy, socioeconomic, epidemiology, modeling, Georgia, GA,, RFA, Health, Scientific Discipline, INTERNATIONAL COOPERATION, Water, POLLUTANTS/TOXICS, Environmental Chemistry, Health Risk Assessment, Epidemiology, Risk Assessments, Drinking Water, Microorganisms, groundwater disinfection, health effects, microbial contamination, bacteria, human health effects, waterborne disease, other - risk assessment, Atlanta, treatment, human exposure, microbial effects, water quality, microbial risk, water disinfection, groundwater contamination, dietary ingestion exposures, drinking water contaminants, drinking water treatment, human health, gastrointestinal health, groundwater, gastrointestinal health effectsProgress and Final Reports:
Original AbstractThe perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.