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Hamilton KA, Ciol Harrison J, Mitchell J, Weir M, Verhougstraete M, Haas CN, Nejadhashemi AP, Libarkin J, Gim Aw T, Bibby K, Bivins A, Brown J, Dean K, Dunbar G, Eisenberg JNS, Emelko M, Gerrity D, Gurian PL, Hartnett E, Jahne M, Jones RM, Julian TR, Li H, Li Y, Gibson JM, Medema G, Meschke JS, Mraz A, Murphy H, Oryang D, Owusu-Ansah EDGJ, Pasek E, Pradhan AK, Razzolini MTP, Ryan MO, Schoen M, Smeets PWMH, Soller J, Solo-Gabriele H, Williams C, Wilson AM, Zimmer-Faust A, Alja'fari J, Rose JB. Research gaps and priorities for quantitative microbial risk assessment (QMRA). RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024. [PMID: 38772724 DOI: 10.1111/risa.14318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 03/12/2024] [Accepted: 04/28/2024] [Indexed: 05/23/2024]
Abstract
The coronavirus disease 2019 pandemic highlighted the need for more rapid and routine application of modeling approaches such as quantitative microbial risk assessment (QMRA) for protecting public health. QMRA is a transdisciplinary science dedicated to understanding, predicting, and mitigating infectious disease risks. To better equip QMRA researchers to inform policy and public health management, an Advances in Research for QMRA workshop was held to synthesize a path forward for QMRA research. We summarize insights from 41 QMRA researchers and experts to clarify the role of QMRA in risk analysis by (1) identifying key research needs, (2) highlighting emerging applications of QMRA; and (3) describing data needs and key scientific efforts to improve the science of QMRA. Key identified research priorities included using molecular tools in QMRA, advancing dose-response methodology, addressing needed exposure assessments, harmonizing environmental monitoring for QMRA, unifying a divide between disease transmission and QMRA models, calibrating and/or validating QMRA models, modeling co-exposures and mixtures, and standardizing practices for incorporating variability and uncertainty throughout the source-to-outcome continuum. Cross-cutting needs identified were to: develop a community of research and practice, integrate QMRA with other scientific approaches, increase QMRA translation and impacts, build communication strategies, and encourage sustainable funding mechanisms. Ultimately, a vision for advancing the science of QMRA is outlined for informing national to global health assessments, controls, and policies.
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Affiliation(s)
- Kerry A Hamilton
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona, USA
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
| | - Joanna Ciol Harrison
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona, USA
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Mark Weir
- Division of Environmental Health Sciences and Sustainability Institute, The Ohio State University, Columbus, Ohio, USA
| | - Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | - Charles N Haas
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - A Pouyan Nejadhashemi
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Julie Libarkin
- Department of Earth and Environmental Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Tiong Gim Aw
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - Aaron Bivins
- Department of Civil & Environmental Engineering, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Joe Brown
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Gwyneth Dunbar
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Joseph N S Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Monica Emelko
- Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Daniel Gerrity
- Applied Research and Development Center, Southern Nevada Water Authority, Las Vegas, Nevada, USA
| | - Patrick L Gurian
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Michael Jahne
- Office of Research and Development, United States Environmental Protection Agency, Cincinnati, Ohio, USA
| | - Rachael M Jones
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Timothy R Julian
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Duebendorf, Switzerland
| | - Hongwan Li
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Yanbin Li
- Department of Biological and Agricultural Engineering, The University of Arkansas, Fayetteville, Arkansas, USA
| | - Jacqueline MacDonald Gibson
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Gertjan Medema
- KWR Water Research Institute, Nieuwegein, The Netherlands
- TU Delft, Delft, The Netherlands
| | - J Scott Meschke
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Alexis Mraz
- Department of Public Health, School of Nursing, Health and Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
| | - Heather Murphy
- Ontario Veterinary College Department of Pathobiology, University of Guelph, Ontario, Canada
| | - David Oryang
- Food and Drug Administration (FDA), US Department of Health and Human Services (DHHS), Center for Food Safety and Applied Nutrition (CFSAN), College Park, United States
| | | | - Emily Pasek
- Department of Earth and Environmental Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Abani K Pradhan
- Department of Nutrition and Food Science & Center for Food Safety and Security Systems, University of Maryland, College Park, Maryland, USA
| | | | - Michael O Ryan
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mary Schoen
- Soller Environmental, Berkeley, California, USA
| | - Patrick W M H Smeets
- KWR Water Research Institute, Nieuwegein, The Netherlands
- TU Delft, Delft, The Netherlands
| | | | - Helena Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, College of Engineering, University of Miami, Coral Gables, Florida, USA
| | - Clinton Williams
- US Arid Land Agricultural Research Center, Maricopa, Arizona, USA
| | - Amanda M Wilson
- Community, Environment & Policy Department, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | | | - Jumana Alja'fari
- National Institute of Standards and Technology (NIST), Gaithersburg, Maryland, USA
| | - Joan B Rose
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
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Burch TR, Stokdyk JP, Rice N, Anderson AC, Walsh JF, Spencer SK, Firnstahl AD, Borchardt MA. Statewide Quantitative Microbial Risk Assessment for Waterborne Viruses, Bacteria, and Protozoa in Public Water Supply Wells in Minnesota. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:6315-6324. [PMID: 35507527 PMCID: PMC9118547 DOI: 10.1021/acs.est.1c06472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 05/22/2023]
Abstract
Infection risk from waterborne pathogens can be estimated via quantitative microbial risk assessment (QMRA) and forms an important consideration in the management of public groundwater systems. However, few groundwater QMRAs use site-specific hazard identification and exposure assessment, so prevailing risks in these systems remain poorly defined. We estimated the infection risk for 9 waterborne pathogens based on a 2-year pathogen occurrence study in which 964 water samples were collected from 145 public wells throughout Minnesota, USA. Annual risk across all nine pathogens combined was 3.3 × 10-1 (95% CI: 2.3 × 10-1 to 4.2 × 10-1), 3.9 × 10-2 (2.3 × 10-2 to 5.4 × 10-2), and 1.2 × 10-1 (2.6 × 10-2 to 2.7 × 10-1) infections person-1 year-1 for noncommunity, nondisinfecting community, and disinfecting community wells, respectively. Risk estimates exceeded the U.S. benchmark of 10-4 infections person-1 year-1 in 59% of well-years, indicating that the risk was widespread. While the annual risk for all pathogens combined was relatively high, the average daily doses for individual pathogens were low, indicating that significant risk results from sporadic pathogen exposure. Cryptosporidium dominated annual risk, so improved identification of wells susceptible to Cryptosporidium contamination may be important for risk mitigation.
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Affiliation(s)
- Tucker R. Burch
- U.S.
Department of Agriculture−Agricultural Research Service (USDA−ARS),
Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- . Phone: 715-207-9244
| | - Joel P. Stokdyk
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- U.S.
Geological Survey, Upper Midwest Water Science Center, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
| | - Nancy Rice
- Minnesota
Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164, United States
| | - Anita C. Anderson
- Minnesota
Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164, United States
| | - James F. Walsh
- Minnesota
Department of Health, P.O. Box 64975, St. Paul, Minnesota 55164, United States
| | - Susan K. Spencer
- U.S.
Department of Agriculture−Agricultural Research Service (USDA−ARS),
Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
| | - Aaron D. Firnstahl
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- U.S.
Geological Survey, Upper Midwest Water Science Center, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
| | - Mark A. Borchardt
- U.S.
Department of Agriculture−Agricultural Research Service (USDA−ARS),
Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
- Laboratory
for Infectious Disease and the Environment (An Interagency Laboratory Supported By USDA-ARS and the U.S. Geological
Survey), 2615 Yellowstone Drive, Marshfield, Wisconsin 54449, United States
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Burch TR, Stokdyk JP, Spencer SK, Kieke BA, Firnstahl AD, Muldoon MA, Borchardt MA. Quantitative Microbial Risk Assessment for Contaminated Private Wells in the Fractured Dolomite Aquifer of Kewaunee County, Wisconsin. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:67003. [PMID: 34160247 PMCID: PMC8221031 DOI: 10.1289/ehp7815] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/23/2021] [Accepted: 05/07/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND Private wells are an important source of drinking water in Kewaunee County, Wisconsin. Due to the region's fractured dolomite aquifer, these wells are vulnerable to contamination by human and zoonotic gastrointestinal pathogens originating from land-applied cattle manure and private septic systems. OBJECTIVE We determined the magnitude of the health burden associated with contamination of private wells in Kewaunee County by feces-borne gastrointestinal pathogens. METHODS This study used data from a year-long countywide pathogen occurrence study as inputs into a quantitative microbial risk assessment (QMRA) to predict the total cases of acute gastrointestinal illness (AGI) caused by private well contamination in the county. Microbial source tracking was used to associate predicted cases of illness with bovine, human, or unknown fecal sources. RESULTS Results suggest that private well contamination could be responsible for as many as 301 AGI cases per year in Kewaunee County, and that 230 and 12 cases per year were associated with a bovine and human fecal source, respectively. Furthermore, Cryptosporidium parvum was predicted to cause 190 cases per year, the most out of all 8 pathogens included in the QMRA. DISCUSSION This study has important implications for land use and water resource management in Kewaunee County and informs the public health impacts of consuming drinking water produced in other similarly vulnerable hydrogeological settings. https://doi.org/10.1289/EHP7815.
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Affiliation(s)
- Tucker R. Burch
- Environmentally Integrated Dairy Management Research Unit, U.S. Dairy Forage Research Center, U.S. Department of Agriculture-Agricultural Research Service (USDA-ARS), Marshfield, Wisconsin, USA
| | - Joel P. Stokdyk
- Upper Midwest Water Science Center, U.S. Geological Survey, Marshfield, Wisconsin, USA
| | - Susan K. Spencer
- Environmentally Integrated Dairy Management Research Unit, U.S. Dairy Forage Research Center, U.S. Department of Agriculture-Agricultural Research Service (USDA-ARS), Marshfield, Wisconsin, USA
| | - Burney A. Kieke
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Aaron D. Firnstahl
- Upper Midwest Water Science Center, U.S. Geological Survey, Marshfield, Wisconsin, USA
| | - Maureen A. Muldoon
- Wisconsin Geological and Natural History Survey, University of Wisconsin-Madison Division of Extension, Madison, Wisconsin, USA
| | - Mark A. Borchardt
- Environmentally Integrated Dairy Management Research Unit, U.S. Dairy Forage Research Center, U.S. Department of Agriculture-Agricultural Research Service (USDA-ARS), Marshfield, Wisconsin, USA
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