Water Infrastructure Sustainability and Health in Alabama’s Black Belt

EPA Grant Number: R834866
Title: Water Infrastructure Sustainability and Health in Alabama’s Black Belt
Investigators: Johnson, Pauline , Stauber, Christine , Brown, Joe , Olson, Julie
Institution: The University of Alabama at Birmingham , Georgia State University
EPA Project Officer: Packard, Benjamin H
Project Period: August 1, 2011 through September 30, 2015 (Extended to September 30, 2016)
Project Amount: $598,739
RFA: Advancing Public Health Protection through Water Infrastructure Sustainability (2009) RFA Text |  Recipients Lists
Research Category: Drinking Water , Water


The objectives of this study are to: (i) assess public health impacts associated with rural water supply system performance and water quality across a range of small public and private utilities in rural Alabama, (ii) conduct a quantitative microbial risk assessment using measured water quality exposure data, (iii) identify possible transmission pathways for waterborne pathogens in rural water supply systems, and (iv) identify low-cost, practicable risk mitigation strategies to protect public health.


We will conduct a prospective cohort study that will follow 900 households for eighteen (18) months and will include active surveillance of household water quality and health outcomes (HCGI). Exposures used in the analysis of epidemiological data include piped system attributes (e.g., age, details of operation and maintenance, system-level water quality data, treatment details), key household variables (e.g., location in system, age of connection, volumetric use data, sanitation system data, household-level water quality data), and quantitative/qualitative data collected from the householders themselves (perception of water, details on service interruptions, socio-economic data). Water quality data will be used in quantitative microbial risk assessment (QMRA) models and compared with epidemiological data. Transmission pathways for waterborne pathogens will be assessed through QMRA modeling and microbial source tracking together with an assessment of system-level risks to water quality. Data will be used in a Hazard Analysis and Critical Control Point (HACCP) framework to identify cost-effective risk mitigation strategies.

Expected Results:

Key project outputs will be (i) a prospective cohort study of water quality and system performance impacts on public health, (ii) robust quantitative microbial risk assessment (QMRA) using local drinking water quality monitoring data, and (iii) identification of transmission pathways through QMRA and microbial source tracking. The primary outcome will be a collaborative HACCP analysis, to be conducted in partnership with local water utilities, with the purpose of identifying cost-effective, sustainable control measures to reduce system vulnerabilities and protect public health.

Publications and Presentations:

Publications have been submitted on this project: View all 12 publications for this project

Journal Articles:

Journal Articles have been submitted on this project: View all 3 journal articles for this project

Supplemental Keywords:

Drinking water, health effects, public health protection, sensitive populations, risk assessment,

Progress and Final Reports:

  • 2012 Progress Report
  • 2013 Progress Report
  • 2014 Progress Report
  • 2015 Progress Report
  • 2016 Progress Report
  • Final Report