1
|
Cohen A, Rasheduzzaman M, O'Connell B, Brown T, Taniuchi M, Krometis LA, Hubbard A, Scheuerman P, Edwards M, Darling A, Pennala B, Price S, Lytton B, Wettstone E, Pholwat S, Ward H, Hallinger DR, Simmons SO, Griffin SM, Kobylanski J, Egorov AI, Wade TJ. Drinking water sources, quality, and associated health outcomes in Appalachian Virginia: A risk characterization study in two counties. Int J Hyg Environ Health 2024; 260:114390. [PMID: 38772087 DOI: 10.1016/j.ijheh.2024.114390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES In the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia. METHODS We administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, E. coli, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households. RESULTS We enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, E. coli in 12%, all with wells or springs (n = 4), and Aeromonas, Campylobacter, and Enterobacter in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with E. coli detection. 34% (n = 15) of saliva samples had detectable antibody responses for Cryptosporidium spp., C. jejuni, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01-10.65). CONCLUSIONS To our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.
Collapse
Affiliation(s)
- Alasdair Cohen
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA, USA; Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA, USA.
| | - Md Rasheduzzaman
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Bethesda O'Connell
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, USA
| | - Teresa Brown
- Department of Natural Sciences, University of Virginia's College at Wise, Wise, VA, USA
| | - Mami Taniuchi
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, VA, USA; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA; Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Leigh-Anne Krometis
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Alan Hubbard
- Department of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Phillip Scheuerman
- Department of Environmental and Occupational Health and Safety Sciences, East Tennessee State University, Johnson City, TN, USA
| | - Marc Edwards
- Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Amanda Darling
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA, USA; Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Blaine Pennala
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, USA
| | - Sarah Price
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Breanna Lytton
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Erin Wettstone
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Suporn Pholwat
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | - Daniel R Hallinger
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Steven O Simmons
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Shannon M Griffin
- Office of Research and Development, US Environmental Protection Agency, Cincinnati, OH, USA
| | - Jason Kobylanski
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Andrey I Egorov
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Timothy J Wade
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC, USA
| |
Collapse
|
2
|
Nascimento Santos NG, Silva LC, Guidone GHM, Montini VH, Dias Oliva BH, Nascimento AB, de Sousa DNR, Kuroda EK, Rocha SPD. Water quality monitoring in southern Brazil and the assessment of risk factors related to contamination by coliforms and Escherichia coli. JOURNAL OF WATER AND HEALTH 2023; 21:1550-1561. [PMID: 37902208 PMCID: wh_2023_182 DOI: 10.2166/wh.2023.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The potability of water, including underground sources, is constantly affected by human activities. To assess water quality and water security in rural and urban areas of southern Brazil, a quantitative, retrospective analysis of water samples collected monthly by the Brazilian health authorities (19,687 samples from 2013 to 2021) was performed. In rural areas, 5,979 water samples (77.54%) were found to be contaminated by coliform bacteria and 3,431 (44.50%) by Escherichia coli. In addition, 1,616 (20.95%) of the contaminated samples were significantly correlated with rainfall amount. In urban areas, 1,268 (10.95%) of the samples contained coliform bacteria and 293 (2.53%) of these samples contained E. coli, with the factor of rainfall associated with 1,081 samples (9.33%) with bacterial contamination. In terms of physicochemical parameters, turbidity exceeded the national standard (5 uT) in 448 (2.32%) samples and fluoride fell below the required level (0.8 mg/L) in 106 samples (0.54%). The presence of free residual chlorine (0.2-2.0 mg/L) was verified in 846 samples (14.38%) in rural areas and in 10,825 samples (56.13%) in urban areas. These results suggest a strong association between rainfall factors and physicochemical alterations, as well as the risk of greater microbial contamination of water for human consumption.
Collapse
Affiliation(s)
- Nathalia Geovana Nascimento Santos
- Laboratory of Bacteriology, Department of Microbiology, Center of Biological Sciences, Universidade Estadual de Londrina, Londrina, Brazil E-mail:
| | - Luana Carvalho Silva
- Laboratory of Bacteriology, Department of Microbiology, Center of Biological Sciences, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - Victor Hugo Montini
- Laboratory of Bacteriology, Department of Microbiology, Center of Biological Sciences, Universidade Estadual de Londrina, Londrina, Brazil
| | - Bruno Henrique Dias Oliva
- Laboratory of Bacteriology, Department of Microbiology, Center of Biological Sciences, Universidade Estadual de Londrina, Londrina, Brazil
| | - Arthur Bossi Nascimento
- Laboratory of Bacteriology, Department of Microbiology, Center of Biological Sciences, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - Emília Kiyomi Kuroda
- Department of Civil Construction, Center of Technology and Urbanization, Universidade Estadual de Londrina, Londrina, Brazil
| | - Sergio Paulo Dejato Rocha
- Laboratory of Bacteriology, Department of Microbiology, Center of Biological Sciences, Universidade Estadual de Londrina, Londrina, Brazil
| |
Collapse
|