Incidence of waterborne lead in private drinking water systems in Virginia

Release of lead, copper, zinc from the initial corrosion of brass water meter in drinking water: Influences of solution composition and electrochemical characterization

Corrosion of brass plumbing materials may lead to metal release and deteriorate the drinking water quality. In this study, the initial corrosion of brass coupon cut from commercially available water meter was investigated. High rates of Pb, Cu and Zn release from the brass coupon were found during the early stage of corrosion (0-5 d) due to general corrosion and galvanic corrosion. The corrosion current density (Icorr) increased and resistance (RF) decreased during this period indicating that severe corrosion had occurred. In a later stage (5-30 d), a decreased Icorr and an increased RF were observed due to the development of a denser layer of Pb and Cu corrosion products which regulated the release of soluble Pb and Cu. The release of Zn continued and no significant Zn precipitation was found. Overall, particulate Pb, particulate Cu and soluble Zn dominated in the metal release during the initial corrosion of brass. The release of Pb, Cu and Zn was enhanced by a lower pH. Free chlorine was found to slightly reduce the release of Pb but promote the release of Cu and Zn. The presence of Pb on the brass surfaces was found to alleviate the dezincification process. A conceptual model based on metal release profile and electrochemical characterization was proposed to describe the initial corrosion of brass in typical drinking water.

Incidence of per- and polyfluoroalkyl substances (PFAS) in private drinking water supplies in Southwest Virginia, USA

Per- and polyfluoroalkyl substances (PFAS) are a class of man-made contaminants of human health concern due to their resistance to degradation, widespread environmental occurrence, bioaccumulation in living organisms, and potential negative health impacts. Private drinking water supplies may be uniquely vulnerable to PFAS contamination in impacted areas, as these systems are not protected under federal regulations and often include limited treatment or remediation, if contaminated, prior to use. The goal of this study was to determine the incidence of PFAS contamination in private drinking water supplies in two counties in Southwest Virginia, USA (Floyd and Roanoke) that share similar bedrock geologies, are representative of different state Department of Health risk categories, and to examine the potential for reliance on citizen-science based strategies for sample collection in subsequent efforts. Samples for inorganic ions, bacteria, and PFAS analysis were collected on separate occasions by participants and experts at the home drinking water point of use (POU) for comparison. Experts also collected outside tap samples for analysis of 30 PFAS compounds. At least one PFAS was detectable in 95 % of POU samples collected (n = 60), with a mean total PFAS concentration of 23.5 ± 30.8 ppt. PFOA and PFOS, two PFAS compounds which presently have EPA health advisories, were detectable in 13 % and 22 % of POU samples, respectively. On average, each POU sample contained >3 PFAS compounds, and one sample contained as many as 8 compounds, indicating that exposure to a mixture of PFAS in drinking water may be occurring. Although there were significant differences in total PFAS concentrations between expert and participant collected samples (Wilcoxon, alpha = 0.05), collector bias was inconsistent, and may be due to the time of day of sampling (i.e. morning, afternoon) or specific attributes of a given home. Further research is required to resolve sources of intra-sample variability.

An overview of the Be Well Home Health Navigator Program to reduce contaminants in well water: Design and methods

BACKGROUND

The Be Well Home Health Navigator Program is a prospective, randomized controlled trial (RCT) implemented to compare a community health navigator program to usual care program to reduce contaminants in drinking water.

DESIGN AND SETTING

This 4-year two-armed RCT will involve well owners in Oregon that have private drinking water wells that contain arsenic, nitrate, or lead above maximum contaminant levels.

INTERVENTION

The intervention leverages the trusted relationship between Cooperative Extension Service (CES) Community Educators and rural well owners to educate, assist and motivate to make decisions and set actionable steps to mitigate water contamination. In this study, CES will serve as home health navigators to deliver: 1) individualized feedback, 2) positive reinforcement, 3) teach-back moments, 4) decision-making skills, 5) navigation to resources, 6) self-management, and 7) repeated contact for shaping and maintenance of behaviors. Usual care includes information only with no access to individual meetings with CES.

MEASURABLE OUTCOMES

Pre-specified primary outcomes include 1) adoption of treatment to reduce exposure to arsenic, nitrate, or lead in water which may include switching to bottled water and 2) engagement with well stewardship behaviors assessed at baseline, and post-6 and 12 months follow-up. Water quality will be measured at baseline and 12-month through household water tests. Secondary outcomes include increased health literacy scores and risk perception assessed at baseline and 6-month surveys.

IMPLICATIONS

The results will demonstrate the efficacy of a domestic well water safety program to disseminate to other CES organizations.

TRIAL REGISTRATION NUMBER

NCT05395663.

Effect of Community Water Service on Lead in Drinking Water in an Environmental Justice Community

Multiple recent studies have found elevated lead (Pb) concentrations in tap water in U.S. homes relying on unregulated private wells. The main Pb source is dissolution from household plumbing, fixtures, and well components. Here, we leverage a natural experiment and citizen science approach to evaluate how extending community water service to an environmental justice community relying on private wells affects Pb in household water. We analyzed Pb in 260 first-draw kitchen tap water samples collected by individual homeowners over a 5-month period in residences that did and did not connect to the community system. Before the community water system was extended, 25% of homes had Pb > 15 μg/L (the U.S. regulatory action level for community water systems) in first-draw water samples. Pb was significantly correlated with nickel (ρ = 0.61), zinc (ρ = 0.50), and copper (ρ = 0.40), suggesting that corrosion of brass fittings and fixtures is the main Pb source. Among homes that connected to the community system, Pb decreased rapidly and was sustained at levels well below 15 μg/L over the study period. Overall, connecting to the municipal water supply was associated with a 92.5% decrease in first-draw tap water Pb.

Repeated home drinking water sampling to improve detection of particulate lead spikes: a simulation study

BACKGROUND

Lead can be present in drinking water in soluble and particulate forms. The intermittent release of lead particulates in drinking water can produce highly variable water lead levels (WLLs) in individual homes, a health concern because both particulate and soluble lead are bioavailable. More frequent water sampling would increase the likelihood of identifying sporadic lead "spikes," though little information is available to aid in estimating how many samples are needed to achieve a given degree of sensitivity to spike detection.

OBJECTIVE

To estimate the number of rounds of tap water sampling needed to determine with a given level of confidence that an individual household is at low risk for the intermittent release of lead particulates.

METHODS

We simulated WLLs for 100,000 homes on 15 rounds of sampling under a variety of assumptions about lead spike release. A Markovian structure was used to describe WLLs for individual homes on subsequent rounds of sampling given a set of transitional probabilities, in which homes with higher WLLs at baseline were more likely to exhibit a spike on repeated sampling.

RESULTS

Assuming 2% of homes had a spike on the first round of sampling and a mid-range estimate of transitional probabilities, the initial round of sampling had a 6.4% sensitivity to detect a spike. Seven rounds of sampling would be needed to increase the sensitivity to 50%, which would leave unrecognized the more than 15,000 homes that intermittently exhibit spikes.

SIGNIFICANCE

For assessing household risk for lead exposure through drinking water, multiple rounds of water sampling are needed to detect the infrequent but high spikes in WLLs due to particulate release. Water sampling procedures for assessment of lead exposure in individual homes should be modified to account for the infrequent but high spikes in WLL.

IMPACT

It has been known for decades that intermittent "spikes" in water lead occur due to the sporadic release of lead particulates. However, conventional water sampling strategies do not account for these infrequent but hazardous events. This research suggests that current approaches to sampling tap water for lead testing identify only a small fraction of homes in which particulate spikes occur, and that sampling procedures should be changed substantially to increase the probability of identifying the hazard of particulate lead release into drinking water.

Faucet-mounted point-of-use drinking water filters to improve water quality in households served by private wells

Approximately 13 % of Americans rely on private wells for household potable water. As private wells are not regulated beyond initial construction and often employ limited or no treatment, source water from wells can be vulnerable to contamination. While several studies have assessed applications of point-of-use (POU) filters in improving municipal tap water quality, few have investigated their use with private well water. This effort aims to build on previous examinations of POU treatment as a strategy to reduce adverse household drinking water exposures by: 1) assessing the effectiveness of commercially available faucet-mounted POU filters for improving microbial and chemical water quality in homes with private wells; and 2) documenting household ease of use and satisfaction with the filters. Faucet-mounted POU filters were distributed to 21 homes reliant on private wells in southern West Virginia and southwestern Virginia. Study participants were asked to collect water samples from two taps in their homes pre-filter installation, and again two-weeks and four-weeks post-installation. Participants filled out surveys about perceptions of their drinking water and the filter. Concentrations of Total Coliform, Ba, Cd, Cr, U, Cu, Pb, Al, Fe, Mn, Zn, and Sr were significantly lower (p < 0.05, Wilcoxon Rank Sum) in filtered water samples compared to paired unfiltered samples (n = 42) for the study period. However, concentrations of certain contaminants in filtered samples from homes with high levels of source water contamination still exceeded drinking water standards. Less than half of study participants reported that they intended to keep using the filters, citing issues of flowrate. Our findings suggest that faucet-mounted POU filters, while effective in reducing contaminants, might not be an appropriate intervention to improve water quality for all homes on private well water. Future investigation is required to improve filter user satisfaction and better assess appropriate source water chemistries for implementation.

Characterization of bacterial diversity and capacity to remove lead of a consortium from mining soil

INTRODUCTION

At present, the presence of lead (Pb2+) continues to be a problem in water bodies due to its continuous use and high toxicity. The aim of this study was to investigate the bacterial diversity of a potential consortium used as a biosorbent for the removal of lead in an aqueous solution.

METHODS

The minimum inhibitory concentration and the mean lethal dose of the consortium were determined, and then the optimal variables of pH and temperature for the removal process were obtained. With the optimal conditions, the kinetic behavior was evaluated, and adjustments were made to different mathematical models. A Fourier transform infrared spectroscopy analysis was performed to determine the functional groups of the biomass participating in the removal process, and the diversity of the bacterial consortium was evaluated during Pb2+ removal by an Ion Torrent Personal Genome Machine System.

RESULTS

It was found that the intraparticle diffusion model was the one that described the adsorption kinetics showing a higher rate constant with a higher concentration of Pb2+, while the Langmuir model was that explained the isotherm at 35 °C, defining a maximum adsorption load for the consortium of 54 mg/g. In addition, it was found that Pb2+ modified the diversity and abundance of the bacterial consortium, detecting genera such as Pseudomonas, Enterobacter, Citrobacter, among others.

CONCLUSIONS

Thus, it can be concluded that the bacterial consortium from mining soil was a biosorbent with the ability to tolerate high concentrations of Pb2+ exposure. The population dynamics during adsorption showed enrichment of Proteobacteria phyla, with a wide range of bacterial families and genera capable of resisting and removing Pb2+ in solution.

Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina

BACKGROUND

Prenatal exposure to metals in private well water may increase the risk of preterm birth (PTB) (delivery < 37 weeks' gestation). In this study, we estimated associations between arsenic, manganese, lead, cadmium, chromium, copper, and zinc concentrations in private well water and PTB incidence in North Carolina (NC).

METHODS

Birth certificates from 2003-2015 (n = 1,329,071) were obtained and pregnancies were assigned exposure using the mean concentration and the percentage of tests above the maximum contaminant level (MCL) for the census tract of each individuals' residence at the time of delivery using the NCWELL database (117,960 well water tests from 1998-2019). We evaluated associations between single metals and PTB using adjusted logistic regression models. Metals mixtures were assessed using quantile-based g-computation.

RESULTS

Compared with those in other census tracts, individuals residing in tracts where > 25% of tests exceeded the MCL for lead (aOR 1.10, 95%CI 1.02,1.18) or cadmium (aOR 1.11, 95% CI 1.00,1.23) had an increased odds of PTB. Conversely, those residing in areas with > 25% MCL for zinc (aOR 0.77 (95% CI: 0.56,1.02) and copper (aOR 0.53 (95% CI: 0.13,1.34)) had a reduced odds of PTB. A quartile increase in the concentrations of a mixture of lead, cadmium, and chromium was associated with a small increased odds for PTB (aOR 1.02, 95% CI 1.01, 1.03). This metal mixture effect was most pronounced among American Indian individuals (aOR per quartile increase in all metals: 1.19 (95% CI 1.06,1.34)).

CONCLUSIONS

In a large study population of over one million births, lead and cadmium were found to increase the risk of PTB individually and in a mixture, with additional mixtures-related impacts estimated from co-exposure with chromium. This study highlights critical racial and ethnic health disparities in relation to private well water thereby emphasizing the urgent need for improved private well water quality to protect vulnerable populations.

A national survey of lead and other metal(loids) in residential drinking water in the United States

BACKGROUND

Exposure to lead (Pb), arsenic (As) and copper (Cu) may cause significant health issues including harmful neurological effects, cancer or organ damage. Determination of human exposure-relevant concentrations of these metal(loids) in drinking water, therefore, is critical.

OBJECTIVE

We sought to characterize exposure-relevant Pb, As, and Cu concentrations in drinking water collected from homes participating in the American Healthy Homes Survey II, a national survey that monitors the prevalence of Pb and related hazards in United States homes.

METHODS

Drinking water samples were collected from a national survey of 678 U.S. homes where children may live using an exposure-based composite sampling protocol. Relationships between metal(loid) concentration, water source and house age were evaluated.

RESULTS

18 of 678 (2.6%) of samples analyzed exceeded 5 µg Pb L-1 (Mean = 1.0 µg L-1). 1.5% of samples exceeded 10 µg As L-1 (Mean = 1.7 µg L-1) and 1,300 µg Cu L-1 (Mean = 125 µg L-1). Private well samples were more likely to exceed metal(loid) concentration thresholds than public water samples. Pb concentrations were correlated with Cu and Zn, indicative of brass as a common Pb source is samples analyzed.

SIGNIFICANCE

Results represent the largest national-scale effort to date to inform exposure risks to Pb, As, and Cu in drinking water in U.S. homes using an exposure-based composite sampling approach.

IMPACT STATEMENT

To date, there are no national-level estimates of Pb, As and Cu in US drinking water collected from household taps using an exposure-based sampling protocol. Therefore, assessing public health impacts from metal(loids) in drinking water remains challenging. Results presented in this study represent the largest effort to date to test for exposure-relevant concentrations of Pb, As and Cu in US household drinking water, providing a critical step toward improved understanding of metal(loid) exposure risk.

Elevated water lead levels in schools using water from on-site wells

Only 8% of US public schools operate their own community water systems, and thus are subject to the federal Lead and Copper Rule's regulation of water lead levels (WLLs). To date, the absence of parallel water testing data for all other schools has prevented the comparison of WLLs with schools that do not face federal regulation. This study compiled and analyzed newly available school-level WLL data that included water source (on-site well water or public utility) and pipe material data for public schools in New York State located outside of New York City. Despite direct federal regulation, schools that used water from on-site wells had a substantially higher percentage of water fixtures with elevated WLLs. Schools that used both on-site well water and iron pipes in their water distribution system had the highest percentage of elevated fixtures. Variation in water treatment practices was identified as a potential contributing mechanism, as schools that used on-site well water were less likely to implement corrosion control. The study concluded that information about water source and premise plumbing material may be useful to policymakers targeting schools for testing and remediation.

Lead Levels in Tap Water at Licensed North Carolina Child Care Facilities, 2020-2021

Objectives. To evaluate lead levels in tap water at licensed North Carolina child care facilities. Methods. Between July 2020 and October 2021, we enrolled 4005 facilities in a grant-funded, participatory science testing program. We identified risk factors associated with elevated first-draw lead levels using multiple logistic regression analysis. Results. By sample (n = 22 943), 3% of tap water sources exceeded the 10 parts per billion (ppb) North Carolina hazard level, whereas 25% of tap water sources exceeded 1 ppb, the American Academy of Pediatrics' reference level. By facility, at least 1 tap water source exceeded 1 ppb and 10 ppb at 56% and 12% of facilities, respectively. Well water reliance was the largest risk factor, followed by participation in Head Start programs and building age. We observed large variability between tap water sources within the same facility. Conclusions. Tap water in child care facilities is a potential lead exposure source for children. Given variability among tap water sources, it is imperative to test every source used for drinking and cooking so appropriate action can be taken to protect children's health. (Am J Public Health. 2022;112(S7):S695-S705. https://doi.org/10.2105/AJPH.2022.307003).

Developing early warning systems to predict water lead levels in tap water for private systems

Lead is a chemical contaminant that threatens public health, and high levels of lead have been identified in drinking water at locations across the globe. Under-served populations that use private systems for drinking water supplies may be at an elevated level of risk because utilities and governing agencies are not responsible for ensuring that lead levels meet the Lead and Copper Rule at these systems. Predictive models that can be used by residents to assess water quality threats in their households can create awareness of water lead levels (WLLs). This research explores and compares the use of statistical models (i.e., Bayesian Belief classifiers) and machine learning models (i.e., ensemble of decision trees) for predicting WLLs. Models are developed using a dataset collected by the Virginia Household Water Quality Program (VAHWQP) at approximately 8000 households in Virginia during 2012-2017. The dataset reports laboratory-tested water quality parameters at households, location information, and household and plumbing characteristics, including observations of water odor, taste, discoloration. Some water quality parameters, such as pH, iron, and copper, can be measured at low resolution by residents using at-home water test kits and can be used to predict risk of WLLs. The use of at-home water quality test kits was simulated through the discretization of water quality parameter measurements to match the resolution of at-home water quality test kits and the introduction of error in water quality readings. Using this approach, this research demonstrates that low-resolution data collected by residents can be used as input for models to estimate WLLs. Model predictability was explored for a set of at-home water quality test kits that observe a variety of water quality parameters and report parameters at a range of resolutions. The effects of the timing of water sampling (e.g., first-draw vs. flushed samples) and error in kits on model error were tested through simulations. The prediction models developed through this research provide a set of tools for private well users to assess the risk of lead contamination. Models can be implemented as early warning systems in citizen science and online platforms to improve awareness of drinking water threats.

Occurrence of opportunistic pathogens in private wells after major flooding events: A four state molecular survey

Private wells can become contaminated with waterborne pathogens during flooding events; however, testing efforts focus almost exclusively on fecal indicator bacteria. Opportunistic pathogens (OPs), which are the leading cause of identified waterborne disease in the United States, are understudied in private wells. We conducted a quantitative polymerase chain reaction survey of Legionella spp., L. pneumophila, Mycobacterium spp., M. avium, Naegleria fowleri, and shiga toxin-producing Escherichia coli gene markers and total coliform and E. coli in drinking water supplied by private wells following the Louisiana Floods (2016), Hurricane Harvey (2017), Hurricane Irma (2017), and Hurricane Florence (2018). Self-reported well characteristics and recovery status were collected via questionnaires. Of the 211 water samples collected, 40.3% and 5.2% were positive for total coliform and E. coli, which were slightly elevated positivity rates compared to prior work in coastal aquifers. DNA markers for Legionella and Mycobacterium were detected in 54.5% and 36.5% of samples, with L. pneumophila and M. avium detected in 15.6% and 17.1%, which was a similar positivity rate relative to municipal system surveys. Total bacterial 16S rRNA gene copies were positively associated with Legionella and Mycobacterium, indicating that conditions that favor occurrence of general bacteria can also favor OPs. N. fowleri DNA was detected in 6.6% of samples and was the only OP that was more prevalent in submerged wells compared to non-submerged wells. Self-reported well characteristics were not associated with OP occurrence. This study exposes the value of routine baseline monitoring and timely sampling after flooding events in order to effectively assess well water contamination risks.

A critical opportunity: Detecting and Reducing Lead in Drinking Water at child care facilities

There is no safe level of lead exposure. As exposure from point sources like lead paint have decreased, non-point sources such as drinking water have become a greater proportional source of total lead exposure. Even at low levels, lead exposure is shown to harm children, contributing to impaired development as well as learning and behavioral issues. This paper summarizes the key results of an Environmental Defense Fund (EDF) pilot study conducted at 11 child care facilities in 4 US states to evaluate approaches to testing and remediating lead in water at child care facilities. Over 75% of first draw samples contained lead levels under the 1 μg/L level recommended by the American Academy of Pediatrics (AAP). However, 10 of 11 child care facilities produced at least one sample above 1 μg/L. Fixture flushing, aerator cleaning, and fixture replacement were evaluated as remediation strategies. Fixture replacement was effective when initial lead was above 5 μg/L. Aerator cleaning did not have a measurable effect on lead levels for most fixtures but unexpectedly significantly increased lead levels in approximately 30% of fixtures. The 2021 Lead and Copper Rule (LCR) revision was applied to study data to determine whether updates would flag cases of low-level lead in child care settings and was found insufficient to prompt mitigation unless high lead was present at most taps.

Private Well Testing in Peri-Urban African-American Communities Lacking Access to Regulated Municipal Drinking Water: A Mental Models Approach to Risk Communication

Majority African-American neighborhoods on the edges of North Carolina municipalities are less likely than white peri-urban neighborhoods to be served by a community system regulated under the Safe Drinking Water Act. These households rely on unregulated private wells, which are at much higher risk of contamination than neighboring community water supplies. Yet, risk awareness of consuming well water is low, and no prior research has tested risk communication interventions for these communities. We present a randomized-controlled trial of an oversized postcard to promote water testing among this audience. The postcard design followed the mental models approach to risk communication. To our knowledge, this is the first U.S. randomized-controlled trial of a mailed communication to promote water testing in any audience and one of few trials of the mental models approach. We evaluated the postcard's effects on self-reported water testing with and without a free water test offer (vs. no-intervention control) via a survey mailed one month after the interventions. The combined communication and free test doubled the odds of self-reported water testing, compared to the control group (p = 0.046). It increased the odds of testing by 65%, compared to the free test alone. Recall of receiving a postcard about water testing increased the odds of self-reported testing twelve-fold (p < 0.001). Although these results suggest that targeted risk information delivered by mail can promote water testing when paired with a free test, the mechanism remains unclear. Additional research on beliefs influencing perceptions about well water may yield interventions that are even more effective.

Analysis of the novel NCWELL database highlights two decades of co-occurrence of toxic metals in North Carolina private well water: Public health and environmental justice implications

Private well users are particularly vulnerable to metal exposure as they are not protected by the Safe Drinking Water Act. In North Carolina (NC), approximately 2.4 million individuals rely on private well water. In the present study, we constructed the NCWELL database: a comprehensive database of 117,960 geocoded well water tests over twenty-years in NC inclusive of 28 metals/metalloids. The NCWELL database was analyzed to identify areas of concern for single and co-occurring toxic metal contamination of private wells in NC. County-level population-at-risk rankings were calculated by combining toxic metal levels and the proportion of residents relying on well water. Additionally, k-means analysis was used to identify counties with critical co-occurrence of toxic metals. In the NCWELL database, inorganic arsenic (iAs) and lead (Pb) were detected above the EPA standards of 10 and 15 ppb in over 2500 and over 3000 tests, respectively. Shockingly, iAs was observed at levels up to 806 ppb and Pb at levels up to 105,440 ppb. Manganese (Mn) was detected above the EPA lifetime Health Advisory Limit in 4.9% and above the secondary Maximum Contaminant Level in 24.3% of all well water tests in NC, with a maximum concentration of 46,300 ppb reported. Mixtures-based analysis identified four distinct clusters of counties, one demonstrating high iAs and Mn and another with high Pb. Over the twenty-year period, metal levels remained high, indicative of sustained contamination in areas of concern. This study provides a novel database for researchers and concerned citizens in NC, demonstrates a methodology for identifying priority geographic regions for single and multiple contaminants, and has environmental justice implications in NC where metal exposure via private well water remains a serious public health concern.

User experience of point-of-use water treatment for private wells in North Carolina: Implications for outreach and well stewardship

Private well users are potentially exposed to a range of chemical contaminants through their drinking water. Point-of-use (POU) water treatment represents one potential solution to reduce harmful exposures through well water, but well users frequently do not adopt household treatment even if they learn their water is contaminated. This study elucidates the experiences, perceptions, and beliefs of 17 households on private wells in North Carolina that participated in a pilot-scale POU water treatment intervention to better understand the drivers and barriers of POU treatment adoption among well users. The intervention consisted of an under-sink activated carbon block POU filter designed to remove lead and two long-chain perfluoroalkyl acids. Filter effluents and influents were tested monthly for eight months. Questionnaires administered before and after the intervention showed a significant decrease in participants' perceived vulnerability to well water contamination, with 77% feeling vulnerable to poor well water quality before, compared to 23% after the filter was installed. However, the POU filters did not fully eliminate feelings of water insecurity (for example, concerns about exposure to contaminants when bathing remained). Lack of knowledge and skills associated with installing and maintaining POU treatment were important barriers to adoption for some well users. Perceptions of POU treatment were also significantly correlated with the intent to implement other well stewardship behaviors such as well water testing. The results highlight the need for strengthened outreach and support programs that provide technical assistance, education, and financial support for households relying on private wells.

Early life lead exposure from private well water increases juvenile delinquency risk among US teens

Public health agencies worldwide have determined that there is no safe level for children’s exposure to lead, a neurotoxin. This study shows that lead in drinking water from private wells is significantly associated with juvenile delinquency. Compared to children in homes with public water supplies, those relying on private wells have a 21% higher risk of any delinquency and a 38% increased risk of serious delinquency. The steepest increases in risk occur at the lowest exposure levels. The results highlight the need to prevent lead-leaching from well components, plumbing, and fixtures in the 13% of US households relying on private wells. They also suggest the need to decrease blood and environmental lead thresholds currently used to identify at-risk children.

Early life exposure to environmental lead (Pb) has been linked to decreased IQ, behavior problems, lower lifetime earnings, and increased criminal activity. Beginning in the 1970s, limits on Pb in paint, gasoline, food cans, and regulated water utilities sharply curtailed US environmental Pb exposure. Nonetheless, hundreds of thousands of US children remain at risk. This study reports on how unregulated private well water is an underrecognized Pb exposure source that is associated with an increased risk of teenage juvenile delinquency. We build a longitudinal dataset linking blood Pb measurements for 13,580 children under age 6 to their drinking water source, individual- and neighborhood-level demographics, and reported juvenile delinquency records. We estimate how early life Pb exposure from private well water influences reported delinquency. On average, children in homes with unregulated private wells had 11% higher blood Pb than those with community water service. This higher blood Pb was significantly associated with reported delinquency. Compared to children with community water service, those relying on private wells had a 21% (95% CI: 5 to 40%) higher risk of being reported for any delinquency and a 38% (95% CI: 10 to 73%) increased risk of being reported for serious delinquency after age 14. These results suggest that there could be substantial but as-yet-unrecognized social benefits from intervention programs to prevent children’s exposure to Pb from private wells, on which 13% of the US population relies.

Evaluation of Preparedness and Recovery Needs of Private Well Users After the Great Louisiana Flood of 2016

CONTEXT

The August 2016 Louisiana flood marked the second 500-year flood in the state in 1 year.

OBJECTIVE

The aim of this study was to identify private well user needs in the aftermath of the flood and to develop disaster planning and recovery recommendations for flood-prone well-reliant communities.

DESIGN

A descriptive cross-sectional study was conducted to collect information from a convenience sample of flood-impacted well users via surveys and water sampling kits, which were distributed to well users 9 to 11 weeks after floodwaters receded (n = 106).

SETTING

Surveys and kits were distributed at roadside flood response and recovery stations set up by local churches in French Settlement, Livingston Parish, Louisiana, an area at the epicenter of the flood-impacted area.

PARTICIPANTS

Subjects were included if they self-reported having a flood-impacted well.

MAIN OUTCOME MEASURES

Surveys collected information to characterize knowledge gaps, risk perceptions, flood impacts, resource accessibility, and well maintenance barriers. Well water tests evaluated total coliform and Escherichia coli.

RESULTS

Among those in low-risk flood zones (n = 22), 27% were in areas designated as having flooded. Among flood-impacted wells that were shock chlorinated after the flood (n = 16), 31.3% tested positive for total coliform and 12.5% for E coli. Only 26% of respondents received well-related information after the disaster.

CONCLUSIONS

Results highlight critical needs for disaster planning and well user education in flood-prone areas, changes to flood risk maps, and concerns with the efficacy of disinfection strategies. Information and resources needs for flood-impacted well users are presented and recommendations on how to improve flood preparedness and recovery are made.

Predictors of Water Lead Levels in Drinking Water of Homes With Domestic Wells in 3 Illinois Counties

CONTEXT

Millions of US homes receive water from private wells, which are not required to be tested for lead (Pb). An approach to prioritizing high-risk homes for water lead level (WLL) testing may help focus outreach and screening efforts, while reducing the testing of homes at low risk.

OBJECTIVE

To (1) characterize distribution of WLLs and corrosivity in tap water of homes with private residential wells, and (2) develop and evaluate a screening strategy for predicting Pb detection within a home.

DESIGN

Cross-sectional.

SETTING

Three Illinois counties: Kane (northern), Peoria (central), and Jackson (southern).

PARTICIPANTS

151 private well users from 3 Illinois counties.

INTERVENTION

Water samples were analyzed for WLL and corrosivity.

MAIN OUTCOME MEASURES

(1) WLL and corrosivity, and (2) the sensitivity, specificity, and predictive value of a strategy for prioritizing homes for WLL testing.

RESULTS

Pb was detected (>0.76 ppb) in tap water of 48.3% homes, and 3.3% exceeded 15 ppb, the US Environmental Protection Agency action level for community water systems. Compared with homes built in/after 1987 with relatively low corrosivity, older homes with more corrosive water were far more likely to contain measurable Pb (odds ratio = 11.07; 95% confidence interval, 3.47-35.31). The strategy for screening homes with private wells for WLL had a sensitivity of 88%, specificity of 42%, positive predictive value of 58%, and negative predictive value of 80%.

CONCLUSIONS

Pb in residential well water is widespread. The screening strategy for prioritizing homes with private wells for WLL testing is greater than 85% sensitive.

Children and adults are exposed to dual risks from ingestion of water and inhalation of ultrasonic humidifier particles from Pb-containing water

Room-sized ultrasonic humidifiers are exposure pathways to aerosolized metals, with dose positively associated with increased concentrations of metals in fill water. This study innovatively quantifies water ingestion along with inhalation doses from humidifiers for 10-1000 μg/L dissolved lead (Pb) in tap water. The subsequent indoor air Pb concentrations, average daily doses, and inhalation deposited respiratory fractions were predicted under four room scenarios for 3-mo, 12-mo, 28-mo, and 6-yr children and adults. Elevated blood Pb levels (BLLs) in children were modeled using USEPA's Integrated Exposure Uptake Biokinetic (IEUBK) model. Indoor air Pb exceeds the USEPA ambient air standard of 0.15 μg/m³ when humidifier fill water contains 33 μg/L Pb in the small room of 33.5 m³ and 0.2 h^-1 air exchange rate (AER). For this room, ~40-46% inhaled Pb-containing humidifier particles deposit in children's respiratory tracts; inhaling humidifier particles from ≥500 μg/L Pb water results in >1 μg/dL BLL in 2-7 yr children. For adults, ~23% of particles deposit in the respiratory tract; 8-h inhalation exposure with ≥17 μg/L Pb water exceeds the California EPA reproductive toxicity guideline of 0.5 μg/day. Larger rooms and higher AER decrease Pb inhalation exposure under the same water Pb concentration.

Microbial Contamination of Drinking Water Supplied by Private Wells after Hurricane Harvey

Hurricane Hurricane Harvey made landfall on the Texas Gulf Coast on August 25, 2017, as a Category 4 hurricane and caused widespread flooding. We explored spatial and temporal distributions of well testing and contamination rates; relationships between contamination and system characteristics and recovery behaviors; and efficacy of mitigation strategies. We estimated that over 500 000 well users (∼130 000 to 260 000 wells) may have been affected, but only around 15 000 well users (∼3800 to 7500 wells) had inundated systems based on inundation maps. Local health departments and our team sampled 8822 wells in 44 counties in the 10 months that followed. Total coliform occurrence was 1.5 times and Escherichia coli was 2.8 times higher after Hurricane Harvey compared to baseline levels. Microbial contamination was more likely (1.7-2.5 times higher) when wells were inundated and/or residents felt their water was unsafe. Although more wells in urban counties were affected, E. coli rates were higher in wells in rural counties. Disinfection did not always eliminate contamination, highlighting concerns about the implementation and efficacy of chlorination procedures. Despite this extensive well testing conducted after Hurricane Harvey, we estimate that only 4.1% of potentially affected wells were tested, underscoring the magnitude of recovery assistance needed to assist well users after flooding events.

Occurrence of Lead and Other Toxic Metals Derived from Drinking-Water Systems in Three West African Countries

BACKGROUND

Exposure to toxic metals (TMs) such as lead can cause lifelong neurodevelopmental impairment and other adverse outcomes. TMs enter drinking water from human activity, geogenic contamination, and corrosion of water system components. Several studies report TM contamination in piped systems and private wells in high-income countries (HICs). However, few robust studies report on TM contamination in low- and middle-income countries (LMICs).

OBJECTIVES

We characterized the occurrence and investigated sources of TM contamination in 261 rural water systems in three West African LMICs to inform prevention and management.

METHODS

Water samples were collected from 261 community water systems (handpumps and public taps) across rural Ghana, Mali, and Niger. Scrapings were collected from accessible components of a subset of these systems using a drill with acid-washed diamond-tipped bits. Samples were analyzed by inductively coupled plasma (ICP) mass spectrometry or ICP optical emission spectroscopy.

RESULTS

Of the TMs studied, lead most frequently occurred at levels of concern in sampled water system components and water samples. Lead mass fractions exceeded International Plumbing Code (IPC) recommended limits (0.25% wt/wt) for components in 82% (107/130) of systems tested; brass components proved most problematic, with 72% (26/36) exceeding IPC limits. Presence of a brass component in a water system increased expected lead concentrations in drinking-water samples by 3.8 times. Overall, lead exceeded World Health Organization (WHO) guideline values in 9% (24/261) of drinking-water samples across countries; these results are broadly comparable to results observed in many HICs. Results did not vary significantly by geography or system type.

DISCUSSION

Ensuring use of lead-free (<0.25%) components in new water systems and progressively remediating existing systems could reduce drinking-water lead exposures and improve health outcomes for millions. However, reflexive decommissioning of existing systems may deprive users of sufficient water for health or drive them to riskier sources. Because supply chains for many water system components are global, TM monitoring, prevention, and management may be warranted in other LMICs beyond the study area as well. https://doi.org/10.1289/EHP7804.

Challenges of Detecting Lead in Drinking Water Using at-Home Test Kits

Lead in drinking water remains a significant human health risk. At-home lead in water test kits could provide consumers with a convenient and affordable option to evaluate this risk, but their accuracy and reliability is uncertain. This study examined the ability of at-home lead test kits to detect varying concentrations of dissolved and particulate lead in drinking water. Sixteen brands representing four test kit types (binary color, binary strip, colorimetric vial, and color strip) were identified. Most kits (12 of 16 brands) were not suitable for drinking water analysis, with lead detection limits of 5-20 mg/L. Binary strips detected dissolved lead at drinking water-relevant levels but failed to detect particulate lead. Household acids (lemon juice and vinegar) improved the strip's ability to detect lead by dissolving some of the lead particulates to the point soluble lead exceeded 15 μg/L. These results illustrate the applications of at-home testing kits for drinking water analysis, highlight limitations and areas for possible improvement, and put forth a testing protocol by which new at-home lead test kits can be judged.

Developing a framework for classifying water lead levels at private drinking water systems: A Bayesian Belief Network approach

The presence of lead in drinking water creates a public health crisis, as lead causes neurological damage at low levels of exposure. The objective of this research is to explore modeling approaches to predict the risk of lead at private drinking water systems. This research uses Bayesian Network approaches to explore interactions among household characteristics, geological parameters, observations of tap water, and laboratory tests of water quality parameters. A knowledge discovery framework is developed by integrating methods for data discretization, feature selection, and Bayes classifiers. Forward selection and backward selection are explored for feature selection. Discretization approaches, including domain-knowledge, statistical, and information-based approaches, are tested to discretize continuous features. Bayes classifiers that are tested include General Bayesian Network, Naive Bayes, and Tree-Augmented Naive Bayes, which are applied to identify Directed Acyclic Graphs (DAGs). Bayesian inference is used to fit conditional probability tables for each DAG. The Bayesian framework is applied to fit models for a dataset collected by the Virginia Household Water Quality Program (VAHWQP), which collected water samples and conducted household surveys at 2,146 households that use private water systems, including wells and springs, in Virginia during 2012 and 2013. Relationships among laboratory-tested water quality parameters, observations of tap water, and household characteristics, including plumbing type, source water, household location, and on-site water treatment are explored to develop features for predicting water lead levels. Results demonstrate that Naive Bayes classifiers perform best based on recall and precision, when compared with other classifiers. Copper is the most significant predictor of lead, and other important predictors include county, pH, and on-site water treatment. Feature selection methods have a marginal effect on performance, and discretization methods can greatly affect model performance when paired with classifiers. Owners of private wells remain disadvantaged and may be at an elevated level of risk, because utilities and governing agencies are not responsible for ensuring that lead levels meet the Lead and Copper Rule for private wells. Insight gained from models can be used to identify water quality parameters, plumbing characteristics, and household variables that increase the likelihood of high water lead levels to inform decisions about lead testing and treatment.

Private Wells and Rural Health: Groundwater Contaminants of Emerging Concern

PURPOSE OF REVIEW

Approximately 12% of the population in the US and Canada rely on federally unregulated private wells, which are common in rural areas and may be susceptible to microbiological and chemical contamination. This review identifies and summarizes recent findings on contaminants of emerging concern in well water across the US and Canada.

RECENT FINDINGS

Private well water quality modeling is complicated by the substantial variability in contamination sources, well construction, well depth, and the hydrogeology of the environment surrounding the well. Temporal variation in contaminant levels in wells suggests the need for monitoring efforts with greater spatial and temporal coverage. More extensive private well monitoring will help identify wells at greater risk of contamination, and in turn, public health efforts can focus on education and outreach to improve monitoring, maintaining, and treating private wells in these communities. Community interventions need to be coupled with stricter regulations and financing mechanisms that can support and protect private well owners.

A Retrospective Chart Review Evaluating the Relationship between Cancer Diagnosis and Residential Water Source on the Lower Eastern Shore of Maryland, USA

Well water contamination in heavily agricultural regions has previously been linked with increased cancer incidence and mortality. The lower Eastern shore of Maryland is a rural, agricultural region with some of the highest rates of cancer in Maryland and the United States. Our study sought to characterize residential private well water use among cancer patients on the lower Eastern shore of Maryland, and to compare private well water utilization between cancer patients and the general regional population. Retrospective chart review was conducted to identify patients diagnosed with colon, lung, melanoma or breast cancer at a regional hospital from 1 January 2017 through 31 December 2018. Residential water source was determined using residential address and municipal water records. Fisher’s exact test was used to compare residential private well water utilization between our study population and the baseline regional population. The majority of cancer patients (57%) lived in homes supplied by private well water (428/746). Cancer patients were more likely to live in homes supplied by private well water compared to individuals in the general regional population (57% vs. 32%, p < 0.001). In conclusion, cancer patients on the lower Eastern shore of Maryland were more likely to live in homes supplied by residential private well water than the regional population. Additional studies are needed to evaluate well water use and cancer risk in this vulnerable region.

Under-Sink Activated Carbon Water Filters Effectively Remove Lead from Private Well Water for over Six Months

Children who rely on private well water in the United States have been shown to be at greater risk of having elevated blood lead levels. Evidence-based solutions are needed to prevent drinking water lead exposure among private well users, but minimal data are available regarding the real-world effectiveness of available interventions like point-of-use water treatment for well water. In this study, under-sink activated carbon block water filters were tested for lead and other heavy metals removal in an eight-month longitudinal study in 17 homes relying on private wells. The device removed 98% of all influent lead for the entirety of the study, with all effluent lead levels less than 1 µg/L. Profile sampling in a subset of homes showed that the faucet fixture is a significant source of lead leaching where well water is corrosive. Flushing alone was not capable of reducing first-draw lead to levels below 1 µg/L, but the under-sink filter was found to increase the safety and effectiveness of faucet flushing. The results of this study can be used by individual well users and policymakers alike to improve decision-making around the use of under-sink point-of-use devices to prevent disproportionate lead exposures among private well users.

Disparities in well water outreach and assistance offered by local health departments: A North Carolina case study

Drinking water supplied by private wells is a national concern that would benefit from improved outreach and support to ensure safe drinking water quality. In North Carolina (NC), local health departments (LHDs) have private well programs that enforce statewide well construction standards, offer water testing services, and provide well water outreach and assistance. Programs were evaluated to determine their capacity and capability for well water outreach and assistance and identify differences among programs. All LHDs reported overseeing the construction of new wells as required by law. However, services provided to existing well users were offered infrequently and/or inconsistently offered. Lack of uniformity was observed in the number of LHD staff and their assigned responsibilities; the costs and availability of well water testing; and the comfort of LHD staff communicating with well owners. While the total number of staff was lower in LHDs in rural counties, the number of outreach activities and services offered was typically not related to the number of well users served. Variations in structure and capacity of well programs at LHDs have created unequal access to services and information for well users in NC. This research underscores the need to examine infrastructure that supports the well water community on a national scale.

Molecular detection of opportunistic pathogens and insights into microbial diversity in private well water and premise plumbing

Private well water systems in rural areas that are improperly maintained will result in poor drinking water quality, loss of water supply, and pose human health risk. The purpose of this study was to investigate the occurrence of fecal indicator bacteria (FIB) and opportunistic pathogens in private well water in rural areas surrounding New Orleans, Louisiana. Our results confirmed the ubiquitous nature of Legionella (86.7%) and mycobacteria (68.1%) in private well water in the study area, with gene concentration ranged from 0.60 to 5.53 and 0.67 to 5.95 Log₁₀ of GC/100 mL, respectively. Naegleria fowleri target sequence was detected in 16.8% and Escherichia coli was detected in 43.4% of the water samples. Total coliform, as well as Legionella and mycobacteria genetic markers' concentrations were significantly reduced by 3-minute flushing. Next-generation sequencing (NGS) data indicated that the abundance of bacterial species was significantly increased in water collected in kitchens compared with samples from wells directly. This study provided integrated knowledge on the persistence of pathogenic organisms in private well water. Further study is needed to explore the presence of clinical species of those opportunistic pathogens in private well water systems to elucidate the health risk.

Inorganic contaminants in Canadian First Nation community water systems

While previous Canadian studies have examined microbiological water quality in First Nations, there is little published information on inorganic contaminants. In Atlantic Canada, the lead, manganese, and arsenic content of First Nations' drinking water has been measured for more than a decade, but the data have not been analyzed comprehensively. These contaminants are linked with health problems, and high levels in drinking water are a cause for concern. We examined 12 years of data from 47 First Nation community water systems to identify systems experiencing difficulties meeting sampling frequency or regulatory guidelines. While most contaminant concentrations were below guideline values, we identified elevated concentrations and issues with sampling frequency. No system met both sampling frequency requirements - a minimum of one sample per year per analyte - and regulatory guidelines. Exceedance rates for lead, manganese, and arsenic were high in some systems. Moreover, current sampling procedures for lead specify that taps be flushed prior to sampling, which is known to underestimate lead exposure. We find that a switch to random daytime sampling would at least sometimes yield higher estimates of lead at the tap. Our analysis demonstrates the need for increased monitoring and updated sampling procedures to better characterize inorganic contaminant occurrence in First Nations.

Children drinking private well water have higher blood lead than those with city water

In the United States, 13% of households depend on an unregulated private well for their water. Compared with children in houses served by a regulated water utility, children in these homes have a 25% increased risk of elevated blood lead. Because lead is a neurotoxin, these children are at greater risk of experiencing irreversible cognitive damage, which can decrease their performance in school and increase their risks of behavioral problems. This study assesses associations between children’s blood lead and dependence on an unregulated private well for drinking water. It highlights the need for interventions to control lead corrosion from plumbing and well components (such as drop pipes, pump parts, and valves and fittings) in households depending on private wells.

Although the Flint, Michigan, water crisis renewed concerns about lead (Pb) in city drinking water, little attention has been paid to Pb in private wells, which provide drinking water for 13% of the US population. This study evaluates the risk of Pb exposure in children in households relying on private wells. It is based on a curated dataset of blood Pb records from 59,483 North Carolina children matched with household water source information. We analyze the dataset for statistical associations between children’s blood Pb and household drinking water source. The analysis shows that children in homes relying on private wells have 25% increased odds (95% CI 6.2 to 48%, P < 0.01) of elevated blood Pb, compared with children in houses served by a community water system that is regulated under the Safe Drinking Water Act. This increased Pb exposure is likely a result of corrosion of household plumbing and well components, because homes relying on private wells rarely treat their water to prevent corrosion. In contrast, corrosion control is required in regulated community water systems. These findings highlight the need for targeted outreach to prevent Pb exposure for the 42.5 million Americans depending on private wells for their drinking water.

Improving state-level emergency well disinfection strategies in the United States

After flooding events, well users are encouraged to disinfect their private wells. However, well disinfection strategies are not consistently applied or proven effective. This study examines the science-based evidence that disinfection procedures reduce microbial loading in well water; reviews inclusion of disinfection principles in state-level emergency protocols; and explores research gaps potentially hindering disinfection efficacy. Emergency well disinfection protocols from 34 states were reviewed based on instructions for creating chlorine solutions; circulating chlorine solutions throughout the distribution system; achieving effective CT disinfection (chlorine dose*contact time); and post-disinfection guidance. Many protocols were missing key information about fundamentals of disinfection. Only two protocols instructed well users to verify chlorine residuals and three protocols instructed users to measure water pH. Most protocols recommended that high chlorine doses be introduced into the well, circulated throughout the system, and stagnated for several hours. A CT value estimated to inactivate at least 99.9% (3-log removal) of Cryptosporidium (255 mg-hr/L) was predicted to be achieved by 72.7% of protocols, and estimated CT values ranged from 35 to 16,327 mg-hr/L. Two research gaps identified were determining whether chlorine doses should differ based on well water chemistries and evaluating the appropriate chlorine dose that should be recommended for inactivating pathogens. This effort underscores a need for consistent, evidence-based messaging in emergency well disinfection protocols.

A review: The challenge, consensus, and confusion of describing odors and tastes in drinking water

Documentation exists for many chemicals that cause tastes and odors in water, however, water suppliers do not routinely monitor for these chemicals. Effective management of a taste-and-odor (T&O) problem in drinking water often requires good verbal description of the offending sensory experience. Experience demonstrates that obtaining verbal descriptions is challenging. To improve our understanding of communications, sensory science literature was reviewed to obtain descriptors for twenty-one chemicals acknowledged to cause T&O issues in drinking water. The review focused on pure chemicals above their odor threshold concentrations. Results reveal that descriptors follow four general categories. For select chemicals, strong consensus exists around a single or very few appropriate descriptors. Examples are "salty" for sodium and "chlorinous" for free chlorine. The next category has moderate agreement for several descriptors, with at least one major descriptor. For example the microbiological metabolite 2-methylisoborneol is most commonly described as "earthy/musty/moldy" but also "camphor, grass, and sweet". Some chemicals have weak agreement on their descriptors, but overall associate words with similar meaning. An example is the chemical toluene with descriptors of "solvent-like" words including "solvent", "gasoline", "paint-like", "cleaning fluid", and "etherish", but also "vinegar" and "sweet". The last chemical category possesses diverse descriptors with no consensus. For example, the oxylipin n-heptanal is described as "oily, fatty, chemical, musty/earthy/moldy, rancid, sweaty, grass, sickening, and stale". While descriptor diversity for select chemicals may not identify the cause of T&O, understanding that certain chemicals are perceived very differently aids in effective communications and eliminates confusion from expecting consumers or utility personnel to respond with consensus.

Springing for Safe Water: Drinking Water Quality and Source Selection in Central Appalachian Communities

Issues surrounding water infrastructure, access, and quality are well documented in the Central Appalachian region of the United States. Even in cases where residents have in-home piped point-of-use (POU) water, some rely on alternative drinking water sources for daily needs—including water collection from roadside springs. This effort aims to better understand and document spring usage in this region by identifying the factors that influence drinking water source selection and comparing household and spring water quality to Safe Drinking Water Act (SDWA) health-based and aesthetic contaminant recommendations. Households were recruited from communities surrounding known springs in three states (Kentucky, Virginia, and West Virginia). First- and second-draw, in-home POU tap water samples were collected from participating households and compared to samples collected from local springs on the same day. Samples were analyzed for fecal indicator bacteria and inorganic ions. Study participants completed surveys to document perceptions of household drinking water and typical usage. The majority of survey participants (82.6%) did not trust their home tap water due to aesthetic issues. Water quality results suggested that fecal indicator bacteria were more common in spring water, while several metallic ions were recovered in higher concentrations from household samples. These observations highlight that health risks and perceptions may be different between sources.

Protection through participation: Crowdsourced tap water quality monitoring for enhanced public health

Lead contamination in municipal drinking water is a national public health issue and is generally the result of water contact with leaded distribution piping and on premise plumbing. As a result, the US Environmental Protection Agency's Lead and Copper Rule requires point of use sampling methods at a small fraction of consumer taps on the public water distribution system. While this approach is practical, it leaves large gaps of consumers without direct monitoring and protection. In response, a novel contest-based crowdsourcing study was conducted to engage the public in monitoring their own water quality at their home taps and study factors that shaped participation in drinking water monitoring. Participants were asked to collect samples of their household drinking water through social media postings, kiosks, and community events with the chance to win a cash prize. The project distributed approximately 800 sampling packets and received 147 packets from participants of which 93% had at least partially completed surveys. On average, private wells were found to have higher lead levels than the public water supply, and the higher lead levels were not attributed to older building age. There is also no statistical relevance between the participants' perceived and actual tap water quality. Survey responses indicated that citizens were motivated to participate in the project due to concerns about their own health and/or the health of their families. In contrast, participants reported that they were not motivated by the cash prize. This project helps inform future public engagement with water quality monitoring, create new knowledge about the influence of personal motivations for participation, and provide recommendations to help increase awareness of water quality issues.

Systematic review and meta-analyses of lead (Pb) concentrations in environmental media (soil, dust, water, food, and air) reported in the United States from 1996 to 2016

Environmental lead (Pb) contamination is a persistent public health issue that prominently impacts communities across the United States. Multimedia Pb exposure assessments are utilized to provide a holistic evaluation of Pb exposure and inform the development of programs and regulations that are protective of human health. To conduct multimedia exposure assessments, robust, media-specific environmental Pb concentration data are necessary. To support this effort, systematic review and meta-analysis methods were used to conduct a comprehensive synthesis of research measuring Pb in multiple environmental media (soil, dust, water, food, and air) over a 20-year period within the United States. The breadth of the resulting database allowed for the evaluation of sample characteristics that can serve as indicators of environmental Pb contamination. Random effects models run on literature and national survey datasets generated overall mean estimates of Pb concentrations that can be used for multimedia Pb exposure modeling for general and high-exposure-risk populations. Results from our study highlighted several important trends: 1) The mean estimate of Pb in residential soils is three times higher for urbanized areas than non-urbanized areas; 2) The mean estimate of Pb in produce reported in the literature is approximately three orders of magnitude greater than commercially-sourced raw produce monitored in national surveys; 3) The mean estimate of Pb in soils from shooting ranges is two times greater than non-residential Pb contaminated Superfund sites reported in the literature; 4) Research reporting environmental Pb concentrations for school and daycare sites is very limited; 5) Inconsistent sample collection and reporting of results limited synthesis efforts; and 6) The U.S. EPA's Air Quality System was the most robust, publicly available national survey resource. Results from these analyses will inform future multimedia Pb exposure assessments and be useful in prioritizing future research and program development.

Well water testing in African-American communities without municipal infrastructure: Beliefs driving decisions

Some peri-urban African-American communities in North Carolina remain excluded from nearby municipal water service, forcing them to rely on unregulated private wells. Despite evidence of elevated drinking water contamination risks in these communities, water monitoring is rare. To identify factors influencing decisions to test private wells, we developed and administered a survey to residents of affected areas. A factor analysis identified three constructs significantly associated with a decreased likelihood of water testing: (1) the misconception that contaminants can be detected by sensory perception, (2) concerns about costs of testing and/or water treatment, and (3) not knowing how to get a water test or having time to do so. Increased knowledge about how to test and the importance of testing was significantly associated with a decreased concern about costs which, in turn, was significantly associated with an increased odds of testing. These results suggest the need for targeted risk communications that correct the misperception that contaminants can be tasted, smelled, or seen. The results also suggest the need for clear information about how to get a water test and for low-cost testing programs. Increased monitoring could empower residents to take protective actions and potentially mobilize political support for water service extensions.

Understanding lead in water and avoidance strategies: a United States perspective for informed decision-making

The pervasiveness of lead in drinking water poses a significant public health threat, which can be reduced by implementing preventive measures. However, the causes of elevated lead in water and the benefits of lead in water avoidance strategies are often misunderstood. Based on experiences in the United States, this paper describes an oversimplified 'lead in water equation' to explain key variables controlling the presence of lead in drinking water to better inform public health practitioners, government officials, utility personnel, and concerned residents. We illustrate the application of the equation in Flint, Michigan and explore the primary household-level water lead avoidance strategies recommended during the crisis, including flushing, filtration, bottled water use, and lead pipe removal. In addition to lead reduction, strategies are evaluated based on costs and limitations. While these lead avoidance strategies will reduce water lead to some degree, the costs, limitations, and effectiveness of these strategies will be site- and event-specific. This paper presents a simplified approach to communicate key factors which must be considered to effectively reduce waterborne lead exposures for a wide range of decision makers.

Factors influencing perceptions of private water quality in North America: a systematic review

BACKGROUND

An estimated four million and 43 million people in Canada and the USA use private water supplies. Private water supplies are vulnerable to waterborne disease outbreaks. Private water supplies in Canada and the USA are often unregulated and private water management is often a choice left to the owner. Perceptions of water quality become important in influencing the adoption of private water stewardship practices, therefore safeguarding public health.

METHODS

We conducted a systematic literature review to understand factors that shape perceptions of water quality among private water users. We searched six computer databases (Web of science, Medline, Scopus, EBSCO, PubMed and Agricola). The search was limited to primary peer-reviewed publications, grey literature and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and to articles which published data on surveys of private water users within Canada and the USA. The search was also restricted to publications from 1986 to 2017. The literature search generated 36,478 records. Two hundred and four full text were reviewed.

RESULTS

Fifty-two articles were included in the final review. Several factors were found to influence perceptions of water quality including organoleptic preferences, chemical and microbiological contaminants, perceived risks, water well infrastructure, past experience with water quality, external information, demographics, in addition to the values, attitudes, and beliefs held by well owners.

CONCLUSIONS

Understanding the factors that shape perceptions of water quality among private water users is an important step in developing private water management policies to increase compliance towards water testing and treatment in Canada and the USA. As many jurisdictions in Canada and the USA do not have mandatory private water testing or treatment guidelines, delineating these factors is an important step in informing future research and guiding policy on the public health of private water systems.

Combinatorial Sensor Design in Caulobacter crescentus for Selective Environmental Uranium Detection

The ability to detect uranium (U) through environmental monitoring is of critical importance for informing water resource protection and nonproliferation efforts. While technologies exist for environmental U detection, wide-area environmental monitoring, i.e. sampling coverage over large areas not known to possess U contamination, remains a challenging prospect that necessitates the development of novel detection approaches. Herein, we describe the development of a whole-cell U sensor by integrating two functionally independent, native U-responsive two-component signaling systems (TCS), UzcRS and UrpRS, within an AND gate circuit in the bacterium Caulobacter crescentus. Through leverage of the distinct but imperfect selectivity profiles of both TCS, this combinatorial approach enabled greater selectivity relative to a prior biosensor developed with UzcRS alone; no cross-reactivity was observed with most common environmental metals (e.g, Fe, As, Cu, Ca, Mg, Cd, Cr, Al) or the U decay-chain product Th, and the selectivity against Zn and Pb was significantly improved. In addition, integration of the UzcRS signal amplifier protein UzcY within the AND gate circuit further enhanced overall sensitivity and selectivity for U. The functionality of the sensor in an environmental context was confirmed by detection of U concentrations as low as 1 μM in groundwater samples. The results highlight the value of a combinatorial approach for constructing whole-cell sensors for the selective detection of analytes for which there are no known evolved regulators.

Assessing the Lead Solubility Potential of Untreated Groundwater of the United States

In the U.S., about 44 million people rely on self-supplied groundwater for drinking water. Because most self-supplied homeowners do not treat their water to control corrosion, drinking water can be susceptible to lead (Pb) contamination from metal plumbing. To assess the types and locations of susceptible groundwater, a geochemical reaction model that included pure Pb minerals and solid solutions of calcite (Ca _xPb_{1- x}CO₃) and apatite [Ca _xPb_5-x(PO₄)₃(OH; Cl; F)] was developed to estimate the lead solubility potential (LSP) for over 8300 untreated groundwater samples collected from domestic and public-supply sites between 2000 and 2016 in the U.S. The LSP is the calculated amount of Pb metal that could dissolve at 25 °C before a Pb-bearing mineral precipitates. About 33% of untreated groundwater samples had LSP greater than 15 μg/L-the USEPA action level for dissolved plus particulate forms of Pb. Five percent of samples had high LSP (above 300 μg/L) and tended to occur in the eastern and southeastern U.S. Measured Pb concentrations above 15 μg/L were rarely detected (<1%) but always coincided with high LSP values. Future work will provide a better understanding of the relation between water chemistry, Pb-mineral formation, and dissolved Pb concentrations in tap water.

Impact of Road Salt on Drinking Water Quality and Infrastructure Corrosion in Private Wells

Increased road salt use and resulting source water contamination has widespread implications for corrosion of drinking water infrastructure, including chloride acceleration of galvanic corrosion and other premature plumbing failures. In this study, we utilized citizen science sampling, bench-scale corrosion studies, and state-level spatial modeling to examine the potential extent of chloride concentrations in groundwater and the resulting impact on private wells in New York. Across the sampled community, chloride levels varied spatially, with the highest levels in private wells downgradient of a road salt storage facility followed by wells within 30 m of a major roadway. Most well users surveyed (70%) had stopped drinking their well water for aesthetic and safety reasons. In the bench-scale experiment, increasing chloride concentration in water increased galvanic corrosion and dezincification of plumbing materials, resulting in increased metal leaching and pipe wall thinning. Our simple spatial analysis suggests that 2% of private well users in New York could potentially be impacted by road salt storage facilities and 24% could potentially be impacted by road salt application. Our research underscores the need to include the damage to public and privately owned drinking water infrastructure in future discussion of road salt management.

Health Risk Assessment of Household Drinking Water in a District in the UAE

The quality of household drinking water in a community of 30 houses in a district in Abu Dhabi, United Arab Emirates (UAE) was assessed over a period of one year (January to November 2015). Standard analytical techniques were used to screen for water quality parameters and contaminants of concern. Water quality was evaluated in the 30 households at four sampling points: kitchen faucet, bathroom faucet, household water tank, and main water pipe. The sampling points were chosen to help identify the source when an elevated level of a particular contaminant is observed. Water quality data was interpreted by utilizing two main techniques: spatial variation analysis and multivariate statistical techniques. Initial analysis showed that many households had As, Cd, and Pb concentrations that were higher than the maximum allowable level set by UAE drinking water standards. In addition, the water main samples had the highest concentration of the heavy metals compared to other sampling points. Health risk assessment results indicated that approximately 30%, 55%, and 15% of the houses studied had a high, moderate, and low risk from the prolonged exposure to heavy metals, respectively. The analysis can help with planning a spatially focused sampling plan to confirm the study findings and set an appropriate course of action.

Modeling lead concentration in drinking water of residential plumbing pipes and hot water tanks

Drinking water is a potential source of exposure to lead (Pb), which can pose risk to humans. The regulatory agencies often monitor Pb in water treatment plants (WTP) and/or water distribution systems (WDS). However, people are exposed to tap water inside the house while water may stay in the plumbing premise for several hours prior to reaching the tap. Depending on stagnation period and plumbing premise, concentrations of Pb in tap water can be significantly higher than the WDS leading to higher intake of Pb than the values from WDS or WTP. In this study, concentrations of Pb and water quality parameters were investigated in WDS, plumbing pipe (PP) and hot water tanks (HWT) for 7months. The samples were collected and analyzed on bi-weekly basis for 7 times a day. Several linear, non-linear and neural network models were developed for predicting Pb in PP and HWT. The models were validated using the additional data, which were not used for model development. The concentrations of Pb in PP and HWT were 1-1.17 and 1-1.21 times the Pb in WDS respectively. Concentrations of Pb were higher in summer than winter. The models showed moderate to excellent performance (R²=0.85-0.99) in predicting Pb in PP and HWT. The correlation coefficients (r) with the validation data were in the ranges of 0.76-0.90 and 0.97-0.99 for PP and HWT respectively. The models can be used for predicting Pb in tap water, which can assist to better protect the humans.

Prevalence of Microbiological and Chemical Contaminants in Private Drinking Water Wells in Maryland, USA

Although many U.S. homes rely on private wells, few studies have investigated the quality of these water sources. This cross-sectional study evaluated private well water quality in Maryland, and explored possible environmental sources that could impact water quality. Well water samples (n = 118) were collected in four Maryland counties and were analyzed for microbiological and chemical contaminants. Data from the U.S. Census of Agriculture were used to evaluate associations between the presence of animal feeding operations and well water quality at the zip code level using logistic regression. Overall, 43.2% of tested wells did not meet at least one federal health-based drinking water standard. Total coliforms, fecal coliforms, enterococci, and Escherichia coli were detected in 25.4%, 15.3%, 5.1%, and 3.4% of tested wells, respectively. Approximately 26%, 3.4%, and <1% of wells did not meet standards for pH, nitrate-N, and total dissolved solids, respectively. There were no statistically significant associations between the presence of cattle, dairy, broiler, turkey, or aquaculture operations and the detection of fecal indicator bacteria in tested wells. In conclusion, nearly half of tested wells did not meet federal health-based drinking water standards, and additional research is needed to evaluate factors that impact well water quality. However, homeowner education on well water testing and well maintenance could be important for public health.

Strategies to Improve Private-Well Water Quality: A North Carolina Perspective

BACKGROUND

Evidence suggests that the 44.5 million U.S. residents drawing their drinking water from private wells face higher risks of waterborne contaminant exposure than those served by regulated community water supplies. Among U.S. states, North Carolina (N.C.) has the second-largest population relying on private wells, making it a useful microcosm to study challenges to maintaining private-well water quality.

OBJECTIVES

This paper summarizes recommendations from a two-day summit to identify options to improve drinking-water quality for N.C. residents served by private wells.

METHODS

The Research Triangle Environmental Health Collaborative invited 111 participants with knowledge of private-well water challenges to attend the Summit. Participants worked in small groups that focused on specific aspects and reconvened in plenary sessions to formulate consensus recommendations.

DISCUSSION

Summit participants highlighted four main barriers to ensuring safe water for residents currently relying on private wells: (1) a database of private well locations is unavailable; (2) racial disparities have perpetuated reliance on private wells in some urbanized areas; (3) many private-well users lack information or resources to monitor and maintain their wells; and (4) private-well support programs are fragmented and lack sufficient resources. The Summit produced 10 consensus recommendations for ways to overcome these barriers.

CONCLUSIONS

The Summit recommendations, if undertaken, could improve the health of North Carolinians facing elevated risks of exposure to waterborne contaminants because of their reliance on inadequately monitored and maintained private wells. Because many of the challenges in N.C. are common nationwide, these recommendations could serve as models for other states. https://doi.org/10.1289/EHP890.

Exposure to Contaminated Drinking Water and Health Disparities in North Carolina

OBJECTIVES

To examine drinking water quality in majority Black periurban neighborhoods in Wake County, North Carolina, that are excluded from nearby municipal water service and to estimate the health benefits of extending water service.

METHODS

We tested 3 samples collected July through December 2014 in 57 private wells for microbial contaminants. We compared contaminant prevalences to those in adjacent community water systems (35 280 samples from routine monitoring). Using a population intervention model, we assessed the number of annual emergency department visits for acute gastrointestinal illness that is preventable by extending water services to the 3799 residents of these periurban communities.

RESULTS

Overall, 29.2% of 171 private well samples tested positive for total coliform bacteria and 6.43% for Escherichia coli, compared with 0.556% and 0.00850% of municipal system samples. An estimated 22% of 114 annual emergency department visits for acute gastrointestinal illness could be prevented by extending community water service.

CONCLUSIONS

Predominantly Black periurban neighborhoods excluded from municipal water service have poorer quality drinking water than do adjacent neighborhoods with municipal services. These disparities increase the risk of emergency department visits for acute gastrointestinal illness.

Widespread copper and lead contamination of household drinking water, New South Wales, Australia

This study examines arsenic, copper, lead and manganese drinking water contamination at the domestic consumer's kitchen tap in homes of New South Wales, Australia. Analysis of 212 first draw drinking water samples shows that almost 100% and 56% of samples contain detectable concentrations of copper and lead, respectively. Of these detectable concentrations, copper exceeds Australian Drinking Water Guidelines (ADWG) in 5% of samples and lead in 8%. By contrast, no samples contained arsenic and manganese water concentrations in excess of the ADWG. Analysis of household plumbing fittings (taps and connecting pipework) show that these are a significant source of drinking water lead contamination. Water lead concentrations derived for plumbing components range from 108µg/L to 1440µg/L (n=28, mean - 328µg/L, median - 225µg/L). Analysis of kitchen tap fittings demonstrates these are a primary source of drinking water lead contamination (n=9, mean - 63.4µg/L, median - 59.0µg/L). The results of this study demonstrate that along with other potential sources of contamination in households, plumbing products that contain detectable lead up to 2.84% are contributing to contamination of household drinking water. Given that both copper and lead are known to cause significant health detriments, products for use in contact with drinking water should be manufactured free from copper and lead.