COMMUNITY-RANDOMIZED INTERVENTION TRIAL WITH UV DISINFECTION FOR ESTIMATING THE RISK OF PEDIATRIC ILLNESS FROM MUNICIPAL GROUNDWATER CONSUMPTION
Impact/Purpose:
Approximately 50% of all waterborne disease outbreaks in the US are related to contaminated groundwater, and national surveys have shown that approximately 30% of drinking water wells are contaminated with human pathogenic viruses. However, it is unknown whether these microbial contaminants are responsible for a significant fraction of endemic (i.e., non-outbreak) illness or if they are effectively inactivated by standard disinfection practices. The primary objective of this study is to estimate the attributable risk for acute gastrointestinal illness (AGI) and febrile illness (FI) for children who drink municipal water in communities that use chlorinated or unchlorinated groundwater. A secondary objective is to determine if there is an association between the drinking water concentration of viruses on the EPA Contaminate Candidate List (CCL) and community rates of AGI and FI.
Description:
The goal of this study is to estimate the risk of childhood febrile and gastrointestinal illnesses associated with drinking municipal water from a groundwater source. The risk estimate will be partitioned into two separate components— illness attributable to contaminated groundwater and illness attributable to vulnerabilities in the water distribution system.
Record Details:
Record Type:PROJECT(
ABSTRACT
)
Start Date:01/01/2005
Completion Date:12/31/2007
Record ID:
114401
Keywords:
DRINKING WATER, GROUNDWATER, EPIDEMIOLOGY, HUMAN HEALTH, PATHOGENS, MICROBIAL WATER QUALITY,
Related Organizations:
Role
:OWNER
Organization Name
:MARSHFIELD CLINIC RESEARCH FOUNDATION
Mailing Address
:1000 North Oak Avenue
Citation
:Marshfield
State
:WI
Zip Code
:54449
Role
:OWNER
Organization Name
:WASHINGTON STATE UNIVERSITY
Mailing Address
:Institutional Research
Citation
:Pullman
State
:WA
Zip Code
:99164
Project Information:
Approach
:The study design is a community-randomized intervention trial with a cross-over component. Seven intervention communities will have UV disinfection reactors installed at all their wellheads and seven control communities will continue their current disinfection practices. Active surveillance for AGI and FI will be conducted among children in participating households for six months. The intervention and control communities will then cross-over, with removal of UV reactors from the original intervention communities and installation of reactors in the original control communities. All communities will be tracked for another six-month period. Each community will serve as its own control in a matched analysis of illness rates. Households with children 12 months to 12 years old will be eligible to participate with a target sample size of 62 households per community. An adult in each household will complete a weekly health status survey for each eligible child. Stool specimens from children with AGI will be analyzed for bacterial, protozoan, and viral pathogens. Water samples obtained monthly from all wellheads and 10 households in every community will be analyzed quantitatively for pathogenic viruses using fluorescence-based real-time PCR. Attributable risk due to source water will be calculated as the difference in illness incidence between control and intervention periods. Risk due to the distribution system will be estimated using a risk-assessment approach based on measured virus concentrations.
Cost
:$2,289,169.00
Research Component
:Drinking Water
Risk Paradigm
:RISK ASSESSMENT
Approach
:The study design is a community-randomized intervention trial with a cross-over component. Seven intervention communities will have UV disinfection reactors installed at all their wellheads and seven control communities will continue their current disinfection practices. Active surveillance for AGI and FI will be conducted among children in participating households for six months. The intervention and control communities will then cross-over, with removal of UV reactors from the original intervention communities and installation of reactors in the original control communities. All communities will be tracked for another six-month period. Each community will serve as its own control in a matched analysis of illness rates. Households with children 12 months to 12 years old will be eligible to participate with a target sample size of 62 households per community. An adult in each household will complete a weekly health status survey for each eligible child. Stool specimens from children with AGI will be analyzed for bacterial, protozoan, and viral pathogens. Water samples obtained monthly from all wellheads and 10 households in every community will be analyzed quantitatively for pathogenic viruses using fluorescence-based real-time PCR. Attributable risk due to source water will be calculated as the difference in illness incidence between control and intervention periods. Risk due to the distribution system will be estimated using a risk-assessment approach based on measured virus concentrations.
Cost
:$2,289,169.00
Research Component
:OTHER
Risk Paradigm
:RISK ASSESSMENT
Approach
:The study design is a community-randomized intervention trial with a cross-over component. Seven intervention communities will have UV disinfection reactors installed at all their wellheads and seven control communities will continue their current disinfection practices. Active surveillance for AGI and FI will be conducted among children in participating households for six months. The intervention and control communities will then cross-over, with removal of UV reactors from the original intervention communities and installation of reactors in the original control communities. All communities will be tracked for another six-month period. Each community will serve as its own control in a matched analysis of illness rates. Households with children 12 months to 12 years old will be eligible to participate with a target sample size of 62 households per community. An adult in each household will complete a weekly health status survey for each eligible child. Stool specimens from children with AGI will be analyzed for bacterial, protozoan, and viral pathogens. Water samples obtained monthly from all wellheads and 10 households in every community will be analyzed quantitatively for pathogenic viruses using fluorescence-based real-time PCR. Attributable risk due to source water will be calculated as the difference in illness incidence between control and intervention periods. Risk due to the distribution system will be estimated using a risk-assessment approach based on measured virus concentrations.
Cost
:$2,289,169.00
Research Component
:M/DBP (MICROBIAL)
Risk Paradigm
:RISK ASSESSMENT
Approach
:The study design is a community-randomized intervention trial with a cross-over component. Seven intervention communities will have UV disinfection reactors installed at all their wellheads and seven control communities will continue their current disinfection practices. Active surveillance for AGI and FI will be conducted among children in participating households for six months. The intervention and control communities will then cross-over, with removal of UV reactors from the original intervention communities and installation of reactors in the original control communities. All communities will be tracked for another six-month period. Each community will serve as its own control in a matched analysis of illness rates. Households with children 12 months to 12 years old will be eligible to participate with a target sample size of 62 households per community. An adult in each household will complete a weekly health status survey for each eligible child. Stool specimens from children with AGI will be analyzed for bacterial, protozoan, and viral pathogens. Water samples obtained monthly from all wellheads and 10 households in every community will be analyzed quantitatively for pathogenic viruses using fluorescence-based real-time PCR. Attributable risk due to source water will be calculated as the difference in illness incidence between control and intervention periods. Risk due to the distribution system will be estimated using a risk-assessment approach based on measured virus concentrations.
Cost
:$2,289,169.00
Research Component
:Health Effects
Risk Paradigm
:RISK ASSESSMENT
Project IDs:
ID Code
:R831630
Project type
:EPA Grant