Under pressure: community water systems in the United States—a production model with water quality and organization type effects

2014 ◽  
Vol 42 (3) ◽  
pp. 277-292
Author(s):  
Roberto Mosheim
2021 ◽  
pp. ASN.2020091281
Author(s):  
John Danziger ◽  
Kenneth J. Mukamal ◽  
Eric Weinhandl

BackgroundAlthough patients with kidney disease may be particularly susceptible to the adverse health effects associated with lead exposure, whether levels of lead found commonly in drinking water are associated with adverse outcomes in patients with ESKD is not known.MethodsTo investigate associations of lead in community water systems with hemoglobin concentrations and erythropoietin stimulating agent (ESA) use among incident patients with ESKD, we merged data from the Environmental Protection Agency (EPA) Safe Drinking Water Information System (documenting average 90th percentile lead concentrations in community water systems during 5 years before dialysis initiation, according to city of residence) with patient-level data from the United States Renal Data System.ResultsAmong 597,968 patients initiating dialysis in the United States in 2005 through 2017, those in cities with detectable lead levels in community water had significantly lower pre-ESKD hemoglobin concentrations and more ESA use per 0.01 mg/L increase in 90th percentile water lead. Findings were similar for the 208,912 patients with data from the first month of ESKD therapy, with lower hemoglobin and higher ESA use per 0.01 mg/L higher lead concentration. These associations were observed at lead levels below the EPA threshold (0.015 mg/L) that mandates regulatory action. We also observed environmental inequities, finding significantly higher water lead levels and slower declines over time among Black versus White patients.ConclusionsThis first nationwide analysis linking EPA water supply records to patient data shows that even low levels of lead that are commonly encountered in community water systems throughout the United States are associated with lower hemoglobin levels and higher ESA use among patients with advanced kidney disease.


Author(s):  
Joshua F. Valder ◽  
Gregory C. Delzer ◽  
James A. Kingsbury ◽  
Jessica A. Hopple ◽  
Curtis V. Price ◽  
...  

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Filippo Ravalli ◽  
Yuanzhi Yu ◽  
Benjamin C. Bostick ◽  
Steven N. Chillrud ◽  
Kathrin Schilling ◽  
...  

2018 ◽  
Vol 115 (9) ◽  
pp. 2078-2083 ◽  
Author(s):  
Maura Allaire ◽  
Haowei Wu ◽  
Upmanu Lall

Ensuring safe water supply for communities across the United States is a growing challenge in the face of aging infrastructure, impaired source water, and strained community finances. In the aftermath of the Flint lead crisis, there is an urgent need to assess the current state of US drinking water. However, no nationwide assessment has yet been conducted on trends in drinking water quality violations across several decades. Efforts to reduce violations are of national concern given that, in 2015, nearly 21 million people relied on community water systems that violated health-based quality standards. In this paper, we evaluate spatial and temporal patterns in health-related violations of the Safe Drinking Water Act using a panel dataset of 17,900 community water systems over the period 1982–2015. We also identify vulnerability factors of communities and water systems through probit regression. Increasing time trends and violation hot spots are detected in several states, particularly in the Southwest region. Repeat violations are prevalent in locations of violation hot spots, indicating that water systems in these regions struggle with recurring issues. In terms of vulnerability factors, we find that violation incidence in rural areas is substantially higher than in urbanized areas. Meanwhile, private ownership and purchased water source are associated with compliance. These findings indicate the types of underperforming systems that might benefit from assistance in achieving consistent compliance. We discuss why certain violations might be clustered in some regions and strategies for improving national drinking water quality.


2020 ◽  
Vol 6 (11) ◽  
pp. 3091-3105
Author(s):  
Senne Michielssen ◽  
Matthew C. Vedrin ◽  
Seth D. Guikema

Trends in microbiological drinking water quality violations in the U.S. indicate that very small and transient non-community water systems bear a disproportionate burden exacerbated by recent regulatory changes.


2020 ◽  
Vol 128 (12) ◽  
pp. 127001
Author(s):  
Anne E. Nigra ◽  
Qixuan Chen ◽  
Steven N. Chillrud ◽  
Lili Wang ◽  
David Harvey ◽  
...  

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