Grantee Research Project Results
2013 Progress Report: Water Infrastructure Sustainability and Health in Alabama’s Black Belt
EPA Grant Number: R834866Title: 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 Period Covered by this Report: August 1, 2012 through July 31,2013
Project Amount: $598,739
RFA: Advancing Public Health Protection through Water Infrastructure Sustainability (2009) RFA Text | Recipients Lists
Research Category: Drinking Water , Water
Objective:
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.
Progress Summary:
Experimental Approach. We are conducting a prospective cohort study that follows 900 households for eighteen (18) months and includes 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 are being 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.
Progress to Date. We have obtained approval for our QAPP; obtained IRB approval from the University of Alabama; created a field laboratory for the processing of samples and as the operational base for field data collection; trained data collection assistants; refined methods for pathogen sampling, storage, and processing; refined methods and established a library for the proposed microbial source tracking of E. coli isolates; established communication and coordination with partners including operators, water boards, the Alabama Department of Public Health, the US Centers for Disease Control, and local non-profit organizations; obtained maps and system information from operators; concluded household-level water quality and survey data collection; refined methods for pathogen sampling, storage, and processing; liaised with and formally met with each water supply system in our study (14 in all); and have begun system-level sampling using dead-end ultrafiltration for molecular work.
At the conclusion of year 2, we have interviewed 897 households and collected detailed water quality and service delivery data on this cohort. After an in-depth review of the data, and after seeking guidance from EPA, we have decided to suspend household-based sampling in favor of increasing the scale and scope of system-level, dead-end ultrafiltration sampling for more detailed microbial molecular identification of indicators (and pathogens) that may be present in lower quantities than our pilot data suggested may have been present.
Initial Results. In the preliminary analysis, household reported water service conditions such as intermittent service, low water pressure, poor taste, odor and odd color were examined to determine if there were associations with reported health symptoms via chi-square analysis. Households that reported poor service conditions such as experiencing intermittent service were more likely to report any gastrointestinal symptoms as well as individual symptoms such as diarrhea or vomiting. Similar associations were found for households that reported low water pressure, poor taste and odor as well as water with an odd color. In addition to reported water service conditions, we examined associations between bacterial contamination and health symptoms and sanitation conditions and health symptoms but found no significant associations. Additional analysis is on-going to better understand the associations between water service conditions, household health and water quality and sanitation conditions.
Future Activities:
Future activities include pathogen sampling across systems, additional rounds of surveillance among enrolled households, and analysis of health data. Quantitative microbial risk assessment models will be constructed to make use of microbial data, and, together with partners, we are working with systems to pilot Water Safety Plans with systems.
Journal Articles:
No journal articles submitted with this report: View all 12 publications for this projectSupplemental Keywords:
drinking water, health effects, sensitive populations, risk assessmentProgress 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.
Project Research Results
- Final Report
- 2016 Progress Report
- 2015 Progress Report
- 2014 Progress Report
- 2012 Progress Report
- Original Abstract
3 journal articles for this project