Co-Occurrence of Metal Contaminants in United States Public Water Systems in 2013–2015

The United States Environmental Protection Agency monitors contaminants in drinking water and consolidates these results in the National Contaminant Occurrence Database. Our objective was to assess the co-occurrence of metal contaminants (total chromium, hexavalent chromium, molybdenum, vanadium, cobalt, and strontium) over the years 2013–2015. We used multilevel Tobit regression models with state and water system-level random intercepts to predict the geometric mean of each contaminant occurring in each public water system, and estimated the pairwise correlations of predicted water system-specific geometric means across contaminants. We found that the geometric means of vanadium and total chromium were positively correlated both in large public water systems (r = 0.45, p < 0.01) and in small public water systems (r = 0.47, p < 0.01). Further research may address the cumulative human health impacts of ingesting more than one contaminant in drinking water.

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An approach for developing a national estimate of waterborne disease due to drinking water and a national estimate model application

Journal of Water and Health ◽

10.2166/wh.2006.024 ◽

2006 ◽

Vol 4 (S2) ◽

pp. 201-240 ◽

Cited By ~ 78

Author(s):

Michael Messner ◽

Susan Shaw ◽

Stig Regli ◽

Ken Rotert ◽

Valerie Blank ◽

...

Keyword(s):

Drinking Water ◽

Environmental Protection Agency ◽

Water System ◽

Credible Interval ◽

The United States ◽

Water Systems ◽

Epidemiologic Studies ◽

Incidence Rates ◽

Waterborne Disease ◽

Public Water Systems

In this paper, the US Environmental Protection Agency (EPA) presents an approach and a national estimate of drinking water related endemic acute gastrointestinal illness (AGI) that uses information from epidemiologic studies. There have been a limited number of epidemiologic studies that have measured waterborne disease occurrence in the United States. For this analysis, we assume that certain unknown incidence of AGI in each public drinking water system is due to drinking water and that a statistical distribution of the different incidence rates for the population served by each system can be estimated to inform a mean national estimate of AGI illness due to drinking water. Data from public water systems suggest that the incidence rate of AGI due to drinking water may vary by several orders of magnitude. In addition, data from epidemiologic studies show AGI incidence due to drinking water ranging from essentially none (or less than the study detection level) to a rate of 0.26 cases per person-year. Considering these two perspectives collectively, and associated uncertainties, EPA has developed an analytical approach and model for generating a national estimate of annual AGI illness due to drinking water. EPA developed a national estimate of waterborne disease to address, in part, the 1996 Safe Drinking Water Act Amendments. The national estimate uses best available science, but also recognizes gaps in the data to support some of the model assumptions and uncertainties in the estimate. Based on the model presented, EPA estimates a mean incidence of AGI attributable to drinking water of 0.06 cases per year (with a 95% credible interval of 0.02–0.12). The mean estimate represents approximately 8.5% of cases of AGI illness due to all causes among the population served by community water systems. The estimated incidence translates to 16.4 million cases/year among the same population. The estimate illustrates the potential usefulness and challenges of the approach, and provides a focus for discussions of data needs and future study designs. Areas of major uncertainty that currently limit the usefulness of the approach are discussed in the context of the estimate analysis.

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Causes of Outbreaks Associated with Drinking Water in the United States from 1971 to 2006

Clinical Microbiology Reviews ◽

10.1128/cmr.00077-09 ◽

2010 ◽

Vol 23 (3) ◽

pp. 507-528 ◽

Cited By ~ 248

Author(s):

Gunther F. Craun ◽

Joan M. Brunkard ◽

Jonathan S. Yoder ◽

Virginia A. Roberts ◽

Joe Carpenter ◽

...

Keyword(s):

Public Health ◽

United States ◽

Distribution System ◽

Water System ◽

The United States ◽

Water Systems ◽

Outbreak Detection ◽

Waterborne Disease ◽

Public Water Systems ◽

Annual Proportion

SUMMARY Since 1971, the CDC, EPA, and Council of State and Territorial Epidemiologists (CSTE) have maintained the collaborative national Waterborne Disease and Outbreak Surveillance System (WBDOSS) to document waterborne disease outbreaks (WBDOs) reported by local, state, and territorial health departments. WBDOs were recently reclassified to better characterize water system deficiencies and risk factors; data were analyzed for trends in outbreak occurrence, etiologies, and deficiencies during 1971 to 2006. A total of 833 WBDOs, 577,991 cases of illness, and 106 deaths were reported during 1971 to 2006. Trends of public health significance include (i) a decrease in the number of reported outbreaks over time and in the annual proportion of outbreaks reported in public water systems, (ii) an increase in the annual proportion of outbreaks reported in individual water systems and in the proportion of outbreaks associated with premise plumbing deficiencies in public water systems, (iii) no change in the annual proportion of outbreaks associated with distribution system deficiencies or the use of untreated and improperly treated groundwater in public water systems, and (iv) the increasing importance of Legionella since its inclusion in WBDOSS in 2001. Data from WBDOSS have helped inform public health and regulatory responses. Additional resources for waterborne disease surveillance and outbreak detection are essential to improve our ability to monitor, detect, and prevent waterborne disease in the United States.

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Associations of Community Water Lead Concentrations with Hemoglobin Concentrations and Erythropoietin-Stimulating Agent Use among Patients with Advanced CKD

Journal of the American Society of Nephrology ◽

10.1681/asn.2020091281 ◽

2021 ◽

pp. ASN.2020091281

Author(s):

John Danziger ◽

Kenneth J. Mukamal ◽

Eric Weinhandl

Keyword(s):

United States ◽

Drinking Water ◽

Kidney Disease ◽

The United States ◽

Water Systems ◽

Adverse Outcomes ◽

Content Type ◽

Community Water Systems ◽

Community Water ◽

Lead Levels

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.

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Total coliform and E. coli in public water systems using undisinfected ground water in the United States

International Journal of Hygiene and Environmental Health ◽

10.1016/j.ijheh.2017.03.003 ◽

2017 ◽

Vol 220 (4) ◽

pp. 736-743 ◽

Cited By ~ 5

Author(s):

Michael J. Messner ◽

Philip Berger ◽

Julie Javier

Keyword(s):

United States ◽

Ground Water ◽

The United States ◽

Total Coliform ◽

Water Systems ◽

E Coli ◽

Public Water Systems

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Approximating Community Water System Service Areas to Explore the Demographics of SDWA Compliance in Virginia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413254 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13254

Author(s):

Cristina Marcillo ◽

Leigh-Anne Krometis ◽

Justin Krometis

Keyword(s):

United States ◽

Water Quality ◽

Drinking Water ◽

Negative Binomial ◽

Water System ◽

The United States ◽

Drinking Water Quality ◽

Safe Drinking Water ◽

Community Water ◽

Service Areas

Although the United States Safe Drinking Water Act (SDWA) theoretically ensures drinking water quality, recent studies have questioned the reliability and equity associated with community water system (CWS) service. This study aimed to identify SDWA violation differences (i.e., monitoring and reporting (MR) and health-based (HB)) between Virginia CWSs given associated service demographics, rurality, and system characteristics. A novel geospatial methodology delineated CWS service areas at the zip code scale to connect 2000 US Census demographics with 2006–2016 SDWA violations, with significant associations determined via negative binomial regression. The proportion of Black Americans within a service area was positively associated with the likelihood of HB violations. This effort supports the need for further investigation of racial and socioeconomic disparities in access to safe drinking water within the United States in particular and offers a geospatial strategy to explore demographics in other settings where data on infrastructure extents are limited. Further interdisciplinary efforts at multiple scales are necessary to identify the entwined causes for differential risks in adverse drinking water quality exposures and would be substantially strengthened by the mapping of official CWS service boundaries.

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Community-Level Analysis of Drinking Water Data Highlights the Importance of Drinking Water Metrics for the State, Federal Environmental Health Justice Priorities in the United States

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910401 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10401

Author(s):

Uloma Igara Uche ◽

Sydney Evans ◽

Soren Rundquist ◽

Chris Campbell ◽

Olga V. Naidenko

Keyword(s):

United States ◽

Drinking Water ◽

Cancer Risk ◽

Environmental Health ◽

The United States ◽

Water Systems ◽

Community Level ◽

Community Water ◽

Health Justice ◽

The U.S

Research studies analyzing the geospatial distribution of air pollution and other types of environmental contamination documented the persistence of environmental health disparities between communities. Due to the shortage of publicly available data, only limited research has been published on the geospatial distribution of drinking water pollution. Here we present a framework for the joint consideration of community-level drinking water data and demographic data. Our analysis builds on a comprehensive data set of drinking water contaminant occurrence for the United States for 2014–2019 and the American Community Survey 5-year estimates (2015–2019) from the U.S. Census Bureau. Focusing on the U.S. states of California and Texas for which geospatial data on community water system service boundaries are publicly available, we examine cumulative cancer risk for water served by community water systems of different sizes relative to demographic characteristics for the populations served by these water systems. In both California and Texas, greater cumulative cancer risk was observed for water systems serving communities with a higher percentage of Hispanic/Latino and Black/African American community members. This investigation demonstrates that it is both practical and essential to incorporate and expand the drinking water data metrics in the analysis of environmental pollution and environmental health. The framework presented here can support the development of public policies to advance environmental health justice priorities on state and federal levels in the U.S.

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Review of perchlorate occurrence in large public drinking water systems in the United States of America

Water Science & Technology Water Supply ◽

10.2166/ws.2018.135 ◽

2018 ◽

Vol 19 (3) ◽

pp. 681-694

Author(s):

Steven J. Luis ◽

Elizabeth A. Miesner ◽

Clarissa L. Enslin ◽

Keith Heidecorn

Keyword(s):

United States ◽

Decision Making ◽

Drinking Water ◽

Environmental Protection Agency ◽

The United States ◽

Water Systems ◽

Contaminant Monitoring ◽

Public Drinking Water ◽

Regulatory Bodies ◽

Public Drinking

Abstract When deciding whether or not to regulate a chemical, regulatory bodies often evaluate the degree to which the public may be exposed by evaluating the chemical's occurrence in food and drinking water. As part of its decision-making process, the United States Environmental Protection Agency (USEPA) evaluated the occurrence of perchlorate in public drinking water by sampling public water systems (PWSs) as part of the first implementation of the Unregulated Contaminant Monitoring Rule (UCMR 1) between 2001 and 2005. The objective of this paper is to evaluate the current representativeness of the UCMR 1 dataset. To achieve this objective, publicly available sources were searched to obtain updated perchlorate data for the majority of large PWSs with perchlorate detections under UCMR 1. Comparison of the updated and UCMR 1 perchlorate datasets shows that the UCMR 1 dataset is no longer representative because the extent and degree of occurrence has decreased since implementation of UCMR 1. Given this finding, it seems appropriate for regulatory bodies engaged in decision-making processes over several years to periodically re-evaluate the conditions that prompted the regulatory effort, thereby ensuring that rules and regulations address actual conditions of concern.

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