Boiling over: A Descriptive Analysis of Drinking Water Advisories in First Nations Communities in Ontario, Canada

A systematic scoping review of antibiotic-resistance in drinking tap water

Environmental matrices have been considered of paramount importance in the spread of antibiotic-resistance; however, the role of drinking waters is still underexplored. Therefore, a scoping review was performed using a systematic approach based on PRISMA guidelines, with the aim of identifying and characterizing antibiotic-resistance in tap water, specifically, water treated at a potabilization plant and provided for drinking use through a water distribution system. The review included 45 studies, the majority of which were conducted in upper-middle-income economies (42.2%), mainly from the Western Pacific region (26.7%), followed by Europe (24.4%). Most of the papers focused on detecting antibiotic-resistant bacteria (ARB), either alone (37.8%) or in combination with antibiotic-resistant genes (ARGs) (26.7%). Multidrug-resistance profile was often identified in heterotrophic bacteria, including various species of nontuberculous mycobacteria, Pseudomonas spp., and Aeromonas spp., which were especially resistant to penicillins, cephalosporins (including 3rd-generation), and also to macrolides (erythromycin) and tetracyclines. Resistance to a wide range of antibiotics was also prevalent in fecal bacteria, e.g., the Enterobacteriaceae family, with common resistance to (fluoro)quinolones and sulfonamide groups. ARGs were investigated either in bacterial strains isolated from tap waters or directly in water samples, and the most frequently detected ARGs belonged to β-lactam, sulfonamide, and tetracycline types. Additionally, mobile genetic elements were found (i.e., int1 and tnpA). Sulfonamides and macrolides were the most frequently detected antibiotics across countries, although their concentrations were generally low (<10 ng/L) in Europe and the United States. From a health perspective, tap water hosted ARB of health concern based on the 2024 WHO bacterial priority pathogens list, mainly Enterobacteriaceae resistant to 3rd-generation cephalosporin and/or carbapenem. Despite the fact that tap water is treated to meet chemical and microbiological quality standards, current evidence suggests that it can harbor antibiotic-resistance determinants, thus supporting its potential role in environmental pathways contributing to antibiotic resistance.

"Coke's not a food": A critical discourse analysis of sugar-sweetened beverage tax acceptability by white residents from an upper-middle class neighborhood in Winnipeg Manitoba

Increasing concerns about the health impacts of sugar consumption has led to the proposition of a sugar-sweetened beverage (SSB) tax in Canada. However, competing concerns related to stigma and equity remain and have not been explored in a Canadian context. As part of a broader study examining the perspectives of various populations on SSB tax acceptability, we examined how residents of an upper-middle class neighborhood conceptualize SSB tax acceptability, and we explored the discourses that inform their discussion. We conducted and analyzed qualitative, semi-structured interviews with residents of an upper-middle class neighborhood in Winnipeg, Manitoba, Canada. Recruitment criteria were residence, adults, and English speaking. Critical discourse analysis methodology was used, and healthism (health moralism) and tax psychology informed the analysis. Eighteen participants volunteered: 15 females and 3 males; all self-identified as white, and all spoke about (grand)parenting. Healthist discourse was utilized in supportive discussion of SSB taxation. With the mobilization of healthism, ideal citizens and parents were described as "health conscious" and those who might be likely to reduce SSB intake because of taxation. Healthism also contributed to their identification of beverages targeted by a tax, versus those they deemed as having redeeming nutritional qualities. Limits to SSB tax support were expressed as fairness concerns, with a focus on the procedural justice of the tax. Participants supported SSB taxation and the discourses they employed suggested support for the tax was perceived as contributing to their construction of the kind of ideal, health-valuing citizens they hoped to embody. However, participants were also concerned about the fairness of implementation, although this did not outweigh the prioritization of good health.

Graphene-based nanomaterials for the removal of emerging contaminants of concern from water and their potential adaptation for point-of-use applications

Considering the plethora of work on the exceptional environmental performance of 2D nanomaterials, there is still a missing link in addressing their practical application in point-of-use (POU) water treatment. By reviewing the exceptional environmental performance of 2D nanomaterials with specific emphasis on graphene and its derivatives, this review aims at inspiring further discussions and research in graphene-based POU water treatment with particular focus on the removal of emerging contaminants of concern (ECCs), which is largely missing in the literature. We outlined the prevalence of ECCs in the environment, their health effects both on humans and marine life, and the potential of efficiently removing them from water using three-dimensional graphene-based macrostructures to ensure ease of adsorbent recovery and reuse compared to nanostructures. Given various successful studies showing superior adsorption capacity of graphene nanosheets, we give an account of the recent developments in graphene-based adsorbents. Moreover, several cost-effective materials which can be easily self-assembled with nanosheets to improve their environmental performance and safety for POU water treatment purposes were highlighted. We highlighted the strategy to overcome challenges of adsorbent regeneration and contaminant degradation; and concluded by noting the need for policy makers to act decisively considering the conservative nature of the water treatment industry, and the potential health risks from ingesting ECCs through drinking water. We further justified the need for the development of advanced POU water treatment devices in the face of the growing challenges regarding ECCs in surface water, and the rising cases of drinking water advisories across the world.

Operation Remote Immunity: exploring the impact of a service-learning elective in remote Indigenous communities

BACKGROUND

The novel coronavirus, COVID-19, emerged in December 2019. Shortly after, vaccines against the virus were distributed in Canada for public use, but the remoteness of many northern Indigenous communities in Ontario posed a challenge for vaccine distribution and dissemination. The Ministry of Health partnered with the Northern Ontario School of Medicine University (NOSMU) and the air ambulance service, Ornge, to assist in delivering the vaccination doses to 31 fly-in communities in the Nishnawbe Aski Nation and Moosonee, all within Ontario. These deployments were considered "service-learning electives" for Undergraduate and Postgraduate medical learners from NOSMU who joined the operation in two-week deployments. NOSMU is renowned for its social accountability mandate and gives its medical learners opportunities to participate in service-learning to enhance their medical skills and cultural sensitivity. The purpose of this study is to examine the relationship between social accountability and medical learners' experiences during a service-learning elective in northern Indigenous communities in Ontario during the COVID-19 pandemic.

METHODS

Data were collected through a planned post-placement activity completed by eighteen Undergraduate and Postgraduate medical learners, who participated in the vaccine deployment. The activity consisted of a 500-word reflective response passage. Thematic analysis was used to identify, analyze, and report the themes within the collected data.

RESULTS

Two themes were identified by the authors, which formed a concise overview of the collected data: (1) confronting the realities of working in Indigenous communities; and (2) service-learning as a path to social accountability.

CONCLUSIONS

These vaccine deployments were an opportunity for medical learners to engage in service-learning and engage with Indigenous communities in Northern Ontario. Service-learning is an exceptional method which provides an opportunity to expand knowledge on the social determinants of health, social justice, and social accountability. The medical learners in this study reiterated the idea that learning medicine through a service-learning model leads to a greater depth of knowledge on Indigenous health and culture, and enhances medical knowledge compared to classroom learning.

When Water Quality Crises Drive Change: A Comparative Analysis of the Policy Processes Behind Major Water Contamination Events

The occurrence of major water contamination events across the world have been met with varying levels of policy responses. Arsenic-a priority water contaminant globally, occurring naturally in groundwater, causing adverse health effects-is widespread in Bangladesh. However, the policy response has been slow, and marked by ineffectiveness and a lack of accountability. We explore the delayed policy response to the arsenic crisis in Bangladesh through comparison with water contamination crises in other contexts, using the Multiple Streams Framework to compare policy processes. These included Escherichia coli O157:H7 and Campylobacter in Walkerton, Canada; lead and Legionella in Flint, Michigan, USA; and chromium-6 contamination in Hinkley, California, USA. We find that, while water contamination issues are solvable, a range of complex conditions have to be met in order to reach a successful solution. These include aspects of the temporal nature of the event and the outcomes, the social and political context, the extent of the public or media attention regarding the crisis, the politics of visibility, and accountability and blame. In particular, contaminants with chronic health outcomes, and longer periods of subclinical disease, lead to smaller policy windows with less effective policy changes. Emerging evidence on health threats from drinking water contamination raise the risk of new crises and the need for new approaches to deliver policy change.

Integrated probabilistic-fuzzy synthetic evaluation of drinking water quality in rural and remote communities

An integrated probabilistic-fuzzy synthetic evaluation (PFSE) approach was developed for assessing drinking water quality in rural and remote communities (RRCs) through the lens of health risks and aesthetic impacts. The probabilistic health risk assessment can handle aleatory uncertainty raised by the variation of contaminant concentrations, and fuzzy synthetic evaluation (FSE) can address vagueness and ambiguity in human perception of risks and aesthetic impacts. The PFSE approach was applied to five RRCs in British Columbia, Canada where different drinking water quality issues, including high metal(loids) concentrations, the presence of coliforms, and poor aesthetics were reported. Cancer, non-cancer, and microbial risks assessed, as well as both quantitative and qualitative aesthetic impact assessment outcomes, were aggregated into synthetic water quality indices for water quality ranking. The probabilistic health risk assessment results revealed significant health risks for a community with relatively high arsenic concentrations (mean value = 7.0 μg/L) in the water supply. The microbial risks were also found significant (disability-adjusted life years >1 × 10^-6) for all communities because of the presence of coliforms in the water. The FSE results indicated that the drinking water quality of five RRCs was associated with high aggregated impacts, which concurred with the "poor" water quality ratings according to the Canadian Water Quality Index. The water quality of the five RRCs was ranked based on the synthetic water quality evaluation indices. The PFSE approach can help decision-makers prioritize RRCs in effective resource allocation for addressing drinking water quality issues.

Gel-like carbon dots: A high-performance future photocatalyst

To protect water resources, halt waterborne diseases, and prevent future water crises, photocatalytic degradation of water pollutants arouse worldwide interest. However, considering the low degradation efficiency and risk of secondary pollution displayed by most metal-based photocatalysts, highly efficient and environmentally friendly photocatalysts with appropriate band gap, such as carbon dots (CDs), are in urgent demand. In this study, the photocatalytic activity of gel-like CDs (G-CDs) was studied using diverse water pollution models for photocatalytic degradation. The degradation rate constants demonstrated a remarkably enhanced photocatalytic activity of G-CDs compared with most known CD species and comparability to graphitic carbon nitride (g-C₃N₄). In addition, the rate constant was further improved by 1.4 times through the embedment of g-C₃N₄ in G-CDs to obtain CD-C₃N₄. Significantly, the rate constant was also higher than that of g-C₃N₄ alone, revealing a synergistic effect. Moreover, the use of diverse radical scavengers suggested that the main contributors to the photocatalytic degradation with G-CDs alone were superoxide radicals (O₂^-) and holes that were, however, substituted by O₂^- and hydroxyl radicals (OH) due to the addition of g-C₃N₄. Furthermore, the photocatalytic stabilities of G-CDs and CD-C₃N₄ turned out to be excellent after four cycles of dye degradation were performed continuously. Eventually, the nontoxicity and environmental friendliness of G-CDs and CD-C₃N₄ were displayed with sea urchin cytotoxicity tests. Hence, through various characterizations, photocatalytic degradation and cytotoxicity tests, G-CDs proved to be an environmentally friendly and highly efficient future photocatalyst.

Canadian Continental-Scale Hydrology under a Changing Climate: A Review

Canada, like other high latitude cold regions on Earth, is experiencing some of the most accelerated and intense warming resulting from global climate change. In the northern regions, Arctic amplification has resulted in warming two to three times greater than global mean temperature trends. Unprecedented warming is matched by intensification of wet and dry regions and hydroclimatic cycles, which is altering the spatial and seasonal distribution of surface waters in Canada. Diagnosing and tracking hydrologic change across Canada requires the implementation of continental-scale prediction models owing the size of Canada’s drainage basins, their distribution across multiple eco- and climatic zones, and the scarcity and paucity of observational networks. This review examines the current state of continental-scale climate change across Canada and the anticipated impacts to freshwater availability, including the role of anthropogenic regulation. The review focuses on continental and regional-scale prediction that underpins operational design and long-term resource planning and management in Canada. While there are significant process-based changes being experienced within Canadian catchments that are equally—if not more so—critical for community water availability, the focus of this review is on the cumulative effects of climate change and anthropogenic regulation for the Canadian freshwater supply.

Health and social concerns about living in three communities affected by per- and polyfluoroalkyl substances (PFAS): A qualitative study in Australia

BACKGROUND

Exposure to per- and polyfluoroalkyl substances (PFAS) is a public health issue globally. In Australia high concentrations of PFAS have been found in environments close to sites where Aqueous Film Forming Foams (AFFF) were historically used for firefighting activities. This has resulted in significant community concern about the potential long-term health effects of these chemicals.

OBJECTIVE

We describe residents' perceptions and experiences of PFAS in three regional Australian towns where exposure has occurred.

METHODS

We conducted focus groups to generate free-flowing open discussion on PFAS in three affected communities, including some with significant numbers of First Nations Peoples. We recruited participants using a range of media outlets and postal services. Focus group transcripts were analysed thematically to identify major shared concerns using Atlas Ti.

RESULTS

One hundred and eighty residents attended fifteen focus groups that were conducted in the three communities. They included 69 First Nations People living in three communities near the town of Katherine in the Northern Territory. Study participants were concerned about potential physical health effects of exposure to PFAS, such as cancer clusters, unexplained deaths, potential exacerbation of existing health conditions, and the future health of their children. They expressed feelings of stress and anxiety about living with uncertainty related to the possible health and the socio-economic impacts of PFAS contamination in their communities.

CONCLUSION

While research has concentrated on the physical health effects of PFAS, more attention needs to be given to the immediate psychosocial impacts of living in an affected community.

"Is there anything good about a water advisory?": an exploration of the consequences of drinking water advisories in an indigenous community

Background

In Ontario, Canada, Indigenous communities experience some of the province’s worst drinking water, with issues ranging from deteriorating water quality to regulatory problems and lack of support. When water is known, or suspected, to be unsafe for human consumption, communities are placed under a Drinking Water Advisory. Between 2004 and 2013, approximately 70% of all on-reserve communities in Ontario were under at least one Drinking Water Advisory. Despite the widespread impact of Drinking Water Advisories on health and wellbeing, little is known about First Nation individuals’ perceptions and experiences living with a Drinking Water Advisory. This study presents information shared by members of a community who have lived with Boil Water Advisories on and off for many years, and a long-term Boil Water Advisory since 2017. The goal of this paper is to unpack and explore the Boil Water Advisories from the perspective of community members and provide considerations for current and future Boil Water Advisory management.

Methods

Methodological choices were driven by the principles of community-based participatory research. Two data collection methodologies were employed: hard copy surveys and interviews.

Results

Forty-four individuals (19.5%) completed a survey. Eight Elders and 16 key informants participated in 20 interviews. Respondents expressed varying degrees of uncertainty regarding protective actions to take while under a Boil Water Advisory. Further, 79% of men but only 46% of women indicated they always adhere to the Boil Water Advisory. Knowledge gaps that could lead to risky behaviours were also identified. Finally, Boil Water Advisories were demonstrated to have physical, financial, and time impacts on the majority of respondents.

Conclusions

A direct outcome was the identification of a critical need to reinforce best practices for health protection through community education and outreach. More broadly, Chief and Council were able to use the findings to successfully advocate for improved drinking water for the community. Additionally, benefits of participatory research and community ownership include enhanced local research capacity, and increased awareness of, and desire for, research to inform decisions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09825-9.

Drinking Water Consumption Patterns: An Exploration of Risk Perception and Governance in Two First Nations Communities

Many Indigenous communities across Canada suffer from the lack of access to clean drinking water; ensuring individuals and communities have safe water to drink either from their home or from their local environment requires the consideration of multiple factors including individual risk perception. In collaboration with local leaders, semi-structured interviews (n = 99) were conducted over a two-year period in the Dene Tha’ First Nation and Kátł’odeeche First Nation to unpack the issue of risk perception and its meaning to local community members. These local metrics of risk perception including smell, taste, safety, health fears and level of concern were then used to explore patterns in other data on drinking water consumption patterns and bottled water use. The results are consistent with previous research related to water insecurity and indicate that both communities consume more bottled water than the average Canadian. Results also varied by jurisdiction; those in Alberta indicated much higher levels of concern and a greater degree of bottled water consumption.

The Search for Environmental Justice: The Story of North Birmingham

Environmental justice is a rising social movement throughout the world. Research is beginning to define the movement and address the disparities that exist among communities exposed to pollution. North Birmingham, a community made up of six neighborhoods in Jefferson County, Alabama, in the United States, is a story of environmental injustice. Heavy industry, including the 35th Avenue Superfund Site, has caused significant environmental pollution over time, leaving residents concerned that their health and well-being are at risk from continued exposure. For years, pollution has impacted the community, and residents have fought and challenged industry and government. The United States (U.S.) Environmental Protection Agency (EPA), the U.S. Agency for Toxic Substances and Disease Registry (ATSDR), and the Jefferson County Department of Health (JCDH) in Alabama have historically played a role in working with the community regarding their health concerns. In this manuscript, we describe a city entrenched in environmental injustice. We provide the history of the community, the responsible parties named for the contamination, the government’s involvement, and the community’s response to this injustice. Through this manuscript, we offer insight into a global concern that challenges local communities on a daily basis.

Water infrastructure and well-being among First Nations, Métis and Inuit individuals in Canada: what does the data tell us?

This paper documents the association between water and sanitation infrastructure and health indicators in Canada for First Nations, Métis and Inuit individuals living on and off-reserve in Canada. We use two data sources: the Aboriginal Peoples Survey and a survey conducted in a First Nations community in northern Manitoba-St. Theresa Point First Nation. We find statistically significant relationships between water infrastructure and health status in both sources of data. In particular, among individuals living off-reserve, contaminated water is associated with a 5-7% lower likelihood of reporting good self-rated health and a 4% higher probability of reporting a health condition or stomach problem. Those in St. Theresa Point First Nation without running water are four times more likely to report an illness relative to those with running water. Off-reserve, this likely suggests a need for improved public education on the management of private water supplies and more frequent water testing. Our case study suggests that further investment in water/sanitation infrastructure and housing is needed in the community.

Water quality and health in northern Canada: stored drinking water and acute gastrointestinal illness in Labrador Inuit

One of the highest self-reported incidence rates of acute gastrointestinal illness (AGI) in the global peer-reviewed literature occurs in Inuit communities in the Canadian Arctic. This high incidence of illness could be due, in part, to the consumption of contaminated water, as many northern communities face challenges related to the quality of municipal drinking water. Furthermore, many Inuit store drinking water in containers in the home, which could increase the risk of contamination between source and point-of-use (i.e., water recontamination during storage). To examine this risk, this research characterized drinking water collection and storage practices, identified potential risk factors for water contamination between source and point-of-use, and examined possible associations between drinking water contamination and self-reported AGI in the Inuit community of Rigolet, Canada. The study included a cross-sectional census survey that captured data on types of drinking water used, household practices related to drinking water (e.g., how it was collected and stored), physical characteristics of water storage containers, and self-reported AGI. Additionally, water samples were collected from all identified drinking water containers in homes and analyzed for presence of Escherichia coli and total coliforms. Despite municipally treated tap water being available in all homes, 77.6% of households had alternative sources of drinking water stored in containers, and of these containers, 25.2% tested positive for total coliforms. The use of transfer devices and water dippers (i.e., smaller bowls or measuring cups) for the collection and retrieval of water from containers were both significantly associated with increased odds of total coliform presence in stored water (OR_{transfer device} = 3.4, 95% CI 1.2-11.7; OR_dipper = 13.4, 95% CI 3.8-47.1). Twenty-eight-day period prevalence of self-reported AGI during the month before the survey was 17.2% (95% CI 13.0-22.5), which yielded an annual incidence rate of 2.4 cases per person per year (95% CI 1.8-3.1); no water-related risk factors were significantly associated with AGI. Considering the high prevalence of, and risk factors associated with, indicator bacteria in drinking water stored in containers, potential exposure to waterborne pathogens may be minimized through interventions at the household level.

Shifting the Framework of Canadian Water Governance through Indigenous Research Methods: Acknowledging the Past with an Eye on the Future

First Nations communities in Canada are disproportionately affected by poor water quality. As one example, many communities have been living under boil water advisories for decades, but government interventions to date have had limited impact. This paper examines the importance of using Indigenous research methodologies to address current water issues affecting First Nations. The work is part of larger project applying decolonizing methodologies to Indigenous water governance. Because Indigenous epistemologies are a central component of Indigenous research methods, our analysis begins with presenting a theoretical framework for understanding Indigenous water relations. We then consider three cases of innovative Indigenous research initiatives that demonstrate how water research and policy initiatives can adopt a more Indigenous-centered approach in practice. Cases include (1) an Indigenous Community-Based Health Research Lab that follows a two-eyed seeing philosophy (Saskatchewan); (2) water policy research that uses collective knowledge sharing frameworks to facilitate respectful, non-extractive conversations among Elders and traditional knowledge holders (Ontario); and (3) a long-term community-based research initiative on decolonizing water that is practicing reciprocal learning methodologies (British Columbia, Alberta). By establishing new water governance frameworks informed by Indigenous research methods, the authors hope to promote innovative, adaptable solutions, rooted in Indigenous epistemologies.

Self-reported Effects of Water on Health in First Nations Communities in Saskatchewan, Canada: Results From Community-Based Participatory Research

Water-related health challenges on First Nations reserves in Canada have been previously documented. Our objective was to describe factors associated with self-reported health effects from tap water in 8 First Nations reserve communities in Saskatchewan, Canada. Community-based participatory approaches were used in designing and implementing cross-sectional household surveys. Individual, household, community, and contextual effects were considered in multilevel analysis. Negative health effects from tap water were reported by 28% of households (n = 579). Concerns about environmental factors affecting water quality (odds ratio [OR] = 3.4, 95% confidence interval [CI] = 1.8-6.7), rarely or never drinking tap water (OR = 2.9, 95% CI = 1.3-6.6), insufficient tap water (OR = 3.0, 95% CI = 1.4-6.3), paying for bottled water (OR = 3.2, 95% CI = 1.2-8.7), and dissatisfaction with tap water were associated with self-reported health effects (n = 393); however, the effect of dissatisfaction was modified by respondent age (P = .03). Quality and availability were associated with perceptions of health effects from drinking water, providing additional information on how ongoing concerns about drinking water influence self-reported health in some First Nations.

Environmental Justice Research: Contemporary Issues and Emerging Topics

Environmental justice (EJ) research seeks to document and redress the disproportionate environmental burdens and benefits associated with social inequalities. Although its initial focus was on disparities in exposure to anthropogenic pollution, the scope of EJ research has expanded. In the context of intensifying social inequalities and environmental problems, there is a need to further strengthen the EJ research framework and diversify its application. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) incorporates 19 articles that broaden EJ research by considering emerging topics such as energy, food, drinking water, flooding, sustainability, and gender dynamics, including issues in Canada, the UK, and Eastern Europe. Additionally, the articles contribute to three research themes: (1) documenting connections between unjust environmental exposures and health impacts by examining unsafe infrastructure, substance use, and children’s obesity and academic performance; (2) promoting and achieving EJ by implementing interventions to improve environmental knowledge and health, identifying avenues for sustainable community change, and incorporating EJ metrics in government programs; and (3) clarifying stakeholder perceptions of EJ issues to extend research beyond the documentation of unjust conditions and processes. Collectively, the articles highlight potentially compounding injustices and an array of approaches being employed to achieve EJ.

Detection of Antibiotic Resistance Genes in Source and Drinking Water Samples from a First Nations Community in Canada

Access to safe drinking water is now recognized as a human right by the United Nations. In developed countries like Canada, access to clean water is generally not a matter of concern. However, one in every five First Nations reserves is under a drinking water advisory, often due to unacceptable microbiological quality. In this study, we analyzed source and potable water from a First Nations community for the presence of coliform bacteria as well as various antibiotic resistance genes. Samples, including those from drinking water sources, were found to be positive for various antibiotic resistance genes, namely, ampC, tet(A), mecA, β-lactamase genes (SHV-type, TEM-type, CTX-M-type, OXA-1, and CMY-2-type), and carbapenemase genes (KPC, IMP, VIM, NDM, GES, and OXA-48 genes). Not surprisingly, substantial numbers of total coliforms, including Escherichia coli, were recovered from these samples, and this result was also confirmed using Illumina sequencing of the 16S rRNA gene. These findings deserve further attention, as the presence of coliforms and antibiotic resistance genes potentially puts the health of the community members at risk.

IMPORTANCE

In this study, we highlight the poor microbiological quality of drinking water in a First Nations community in Canada. We examined the coliform load as well as the presence of antibiotic resistance genes in these samples. This study examined the presence of antibiotic-resistant genes in drinking water samples from a First Nations Community in Canada. We believe that our findings are of considerable significance, since the issue of poor water quality in First Nations communities in Canada is often ignored, and our findings will help shed some light on this important issue.