1
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Rasheduzzaman M, O'Connell B, Krometis LA, Brown T, Cohen A. Point-of-use chlorine residuals and disinfection byproduct occurrences in rural households served by public water utilities in Appalachian Virginia. JOURNAL OF WATER AND HEALTH 2024; 22:1064-1074. [PMID: 38935457 DOI: 10.2166/wh.2024.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/10/2024] [Indexed: 06/29/2024]
Abstract
We characterized concentrations of trihalomethanes (THMs), a measure of disinfection byproducts (DBPs), in tap water samples collected from households with utility-supplied water in two rural counties in Appalachian Virginia, and assessed associations with pH, free chlorine, and metal ions which can impact THM formation. Free chlorine concentrations in all samples (n = 27 homes) complied with EPA drinking water guidelines, though 7% (n = 2) of first draw samples and 11% (n = 3) of 5-min flushed-tap water samples exceeded the US Safe Drinking Water Act (SDWA) maximum contaminant level (MCL) for THM (80 ppb). Regression analyses showed that free chlorine and pH were positively associated with the formation of THM levels above SDWA MCLs (OR = 1.04, p = 0.97 and OR = 1.74, p = 0.79, respectively), while temperature was negatively associated (OR = 0.78, p = 0.38). Of the eight utilities serving study households, samples from water served by three different utilities exceeded the EPA MCL for THM. Overall, these findings do not indicate substantial exposures to DBPs for rural households with utility-supplied water in this region of southwest Virginia. However, given the observed variability in THM concentrations between and across utilities, and established adverse health impacts associated with chronic and acute DBP exposure, more research on DBPs in rural Central Appalachia is warranted.
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Affiliation(s)
- Md Rasheduzzaman
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA 24061, USA
| | - Bethesda O'Connell
- Department of Community and Behavioral Health, East Tennessee State University (ETSU), Johnson City, TN 37614, USA
| | - Leigh-Anne Krometis
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, VA 24060, USA
| | - Teresa Brown
- Department of Natural Sciences, University of Virginia's College at Wise, Wise, VA 24293, USA
| | - Alasdair Cohen
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA 24061, USA; Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA E-mail:
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2
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Schubert A, Harrison J, Kent-Buchanan L, Bonds V, McElmurry SP, Love NG. A point-of-use drinking water quality dataset from fieldwork in Detroit, Michigan. Sci Data 2024; 11:443. [PMID: 38702401 PMCID: PMC11068869 DOI: 10.1038/s41597-024-03298-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
Drinking water quality sensor technology has rapidly advanced, facilitating the collection of rich datasets and real-time analytics. However, sensors have not yet been widely applied to monitor drinking water quality in premise plumbing. Richer quality of data in premise plumbing offers an improved understanding of the quality of drinking water present at the point-of-use. In this paper, online drinking water quality sensor nodes were temporarily installed in twenty-four homes in Detroit, Michigan. The water quality sensor nodes took measurements of five drinking water quality parameters every five minutes for four weeks. Additionally, free chlorine and lead were sampled periodically within each home. Together, these data make up a dataset that captures drinking water quality over time in a legacy city with an oversized drinking water system. This dataset offers more frequent measurements amongst more sample homes than are typically available in premise plumbing or at the tap. The data can be used to investigate temporal trends in drinking water quality, including diurnal patterns and anomaly detection. Additionally, this dataset could be utilized to evaluate water quality in comparison with other cities.
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Affiliation(s)
- Alyssa Schubert
- University of Michigan, Department of Civil and Environmental Engineering, Ann Arbor, USA
| | - Jacob Harrison
- University of Michigan, Department of Civil and Environmental Engineering, Ann Arbor, USA
| | | | | | - Shawn P McElmurry
- Wayne State University, Department of Civil and Environmental Engineering, Detroit, USA
| | - Nancy G Love
- University of Michigan, Department of Civil and Environmental Engineering, Ann Arbor, USA.
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3
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Clements E, Crank K, Nerenberg R, Atkinson A, Gerrity D, Hannoun D. Quantitative Microbial Risk Assessment Framework Incorporating Water Ages with Legionella pneumophila Growth Rates. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:6540-6551. [PMID: 38574283 PMCID: PMC11025131 DOI: 10.1021/acs.est.4c01208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024]
Abstract
Water age in drinking water systems is often used as a proxy for water quality but is rarely used as a direct input in assessing microbial risk. This study directly linked water ages in a premise plumbing system to concentrations of Legionella pneumophila via a growth model. In turn, the L. pneumophila concentrations were used for a quantitative microbial risk assessment to calculate the associated probabilities of infection (Pinf) and clinically severe illness (Pcsi) due to showering. Risk reductions achieved by purging devices, which reduce water age, were also quantified. The median annual Pinf exceeded the commonly used 1 in 10,000 (10-4) risk benchmark in all scenarios, but the median annual Pcsi was always 1-3 orders of magnitude below 10-4. The median annual Pcsi was lower in homes with two occupants (4.7 × 10-7) than with one occupant (7.5 × 10-7) due to more frequent use of water fixtures, which reduced water ages. The median annual Pcsi for homes with one occupant was reduced by 39-43% with scheduled purging 1-2 times per day. Smart purging devices, which purge only after a certain period of nonuse, maintained these lower annual Pcsi values while reducing additional water consumption by 45-62%.
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Affiliation(s)
- Emily Clements
- Southern
Nevada Water Authority, P.O. Box 99954, Las Vegas, Nevada 89193, United States
| | - Katherine Crank
- Southern
Nevada Water Authority, P.O. Box 99954, Las Vegas, Nevada 89193, United States
| | - Robert Nerenberg
- Department
of Civil & Environmental Engineering & Earth Science, University of Notre Dame, 156 Fitzpatrick Hall, Notre
Dame, Indiana 46556, United States
| | - Ariel Atkinson
- Southern
Nevada Water Authority, P.O. Box 99954, Las Vegas, Nevada 89193, United States
| | - Daniel Gerrity
- Southern
Nevada Water Authority, P.O. Box 99954, Las Vegas, Nevada 89193, United States
| | - Deena Hannoun
- Southern
Nevada Water Authority, P.O. Box 99954, Las Vegas, Nevada 89193, United States
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4
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Martinez Paz EF, Raskin L, Wigginton KR, Kerkez B. Toward the autonomous flushing of building plumbing: Characterizing oxidation-reduction potential and temperature sensor dynamics. WATER RESEARCH 2024; 251:121098. [PMID: 38219686 DOI: 10.1016/j.watres.2023.121098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/05/2023] [Accepted: 12/30/2023] [Indexed: 01/16/2024]
Abstract
Manual flushing of building plumbing is commonly used to address water quality issues that arise from water stagnation. Autonomous flushing informed by sensors has the potential to aid in the management of building plumbing, but a number of knowledge gaps hinder its application. This study evaluates autonomous flushing of building plumbing with online sensor and actuator nodes deployed under kitchen sinks in five residential houses. Online oxidation-reduction potential (ORP) and temperature data were collected for nine weeks during the winter and summer in houses with both free chlorine and chloramine. ORP levels in houses with free chlorine residuals decreased after overnight stagnation. The overnight decrease in ORP was not observed when tap water was automatically flushed for five minutes at 6:00 h every morning. ORP levels in houses with chloramine residuals did not decrease consistently after overnight stagnation, and daily automated flushes did not have an observable effect on the ORP signals. Additional laboratory experiments were carried out to evaluate ORP signals during chlorine decay and after incremental changes in chlorine, as would be expected in building plumbing conditions. Results from the lab and field deployments suggest on-line ORP sensors may be used to detect free chlorine decay due to stagnating water, but are not as effective in detecting chloramine decay. However, field results also suggest ORP may not respond as expected on a timely manner after free chlorine or chloramine have been restored, hindering their applicability in developing control algorithms. In this paper we tested twice-daily five-minute automatic flushing and found that it counteracts water quality degradation associated with overnight stagnation in free chlorine systems. An automatic sensor-based flushing is proposed using online temperature sensor data to determine when flushing has reached water from the main. The results suggest that flushing informed by temperature sensors can reduce the flushing time by 46 % compared to the preset five-minute static flush.
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Affiliation(s)
- Ernesto F Martinez Paz
- Department of Civil and Environmental Engineering, University of Michigan, 2350 Hayward Ave., 2044 GG Brown, Ann Arbor, MI 48109, USA
| | - Lutgarde Raskin
- Department of Civil and Environmental Engineering, University of Michigan, 2350 Hayward Ave., 2044 GG Brown, Ann Arbor, MI 48109, USA
| | - Krista R Wigginton
- Department of Civil and Environmental Engineering, University of Michigan, 2350 Hayward Ave., 2044 GG Brown, Ann Arbor, MI 48109, USA.
| | - Branko Kerkez
- Department of Civil and Environmental Engineering, University of Michigan, 2350 Hayward Ave., 2044 GG Brown, Ann Arbor, MI 48109, USA.
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5
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Clements E, Irwin C, Taflanidis A, Bibby K, Nerenberg R. Impact of fixture purging on water age and excess water usage, considering stochastic water demands. WATER RESEARCH 2023; 245:120643. [PMID: 37748346 DOI: 10.1016/j.watres.2023.120643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 09/27/2023]
Abstract
Higher water ages are linked with water quality decline as chlorine dissipates, temperatures become more favorable for microbial growth, and metals and organic matter leach from the pipes. Water fixtures with automated purging devices can limit water age in premise plumbing systems, but also increase water use. To develop purging strategies that lower age while also minimizing water use, the stochastic nature of water demands must be considered. In this research, a hydraulic plumbing network model, with stochastic demands at fixtures, was used to compare water age and water use for five purging conditions: purging at regular intervals, "smart" purging (considering the time of last use), purging with different volumes of water, purging at different fixtures, and the purging with different levels of home occupancy. Higher purging frequency and volume resulted in lower water ages, but higher water use. Purging greatly reduced the variability in water ages, avoiding extreme ages entirely. Water age was minimized by scheduling the purging around occupancy behavior, such as before the occupants wake up or return from work. Scheduled purging used more water than smart purging. Purging after 12 h of nonuse used only 55% of the additional water required for purging every 12 h. Purging after 24 h of nonuse at the kitchen tap and shower used only 38% of the additional water required for purging every 24 h, while maintaining lower water ages and removing the variability in water ages. While larger purging volumes had a greater impact on water age, there were diminishing returns. Purging has a larger impact on low-occupancy homes because fixtures have less frequent use. Overall, this research provides a methodology to compare purging strategies that minimize both water age and water use. While the numerical results presented here are only valid for the specific layout and usage habits, they provide insights and trends applicable to other cases.
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Affiliation(s)
- Emily Clements
- Department of Civil and Environmental Engineering and Earth Sciences 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Christopher Irwin
- Department of Civil and Environmental Engineering and Earth Sciences 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Alexandros Taflanidis
- Department of Civil and Environmental Engineering and Earth Sciences 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Robert Nerenberg
- Department of Civil and Environmental Engineering and Earth Sciences 156 Fitzpatrick Hall, University of Notre Dame, Notre Dame, IN 46556, USA.
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6
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Logan-Jackson AR, Batista MD, Healy W, Ullah T, Whelton AJ, Bartrand TA, Proctor C. A Critical Review on the Factors that Influence Opportunistic Premise Plumbing Pathogens: From Building Entry to Fixtures in Residences. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:6360-6372. [PMID: 37036108 DOI: 10.1021/acs.est.2c04277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Residential buildings provide unique conditions for opportunistic premise plumbing pathogen (OPPP) exposure via aerosolized water droplets produced by showerheads, faucets, and tubs. The objective of this review was to critically evaluate the existing literature that assessed the impact of potentially enhancing conditions to OPPP occurrence associated with residential plumbing and to point out knowledge gaps. Comprehensive studies on the topic were found to be lacking. Major knowledge gaps identified include the assessment of OPPP growth in the residential plumbing, from building entry to fixtures, and evaluation of the extent of the impact of typical residential plumbing design (e.g., trunk and branch and manifold), components (e.g., valves and fixtures), water heater types and temperature setting of operation, and common pipe materials (copper, PEX, and PVC/CPVC). In addition, impacts of the current plumbing code requirements on OPPP responses have not been assessed by any study and a lack of guidelines for OPPP risk management in residences was identified. Finally, the research required to expand knowledge on OPPP amplification in residences was discussed.
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Affiliation(s)
- Alshae' R Logan-Jackson
- Building Energy and Environment Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, United States
| | - Marylia Duarte Batista
- Building Energy and Environment Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, United States
| | - William Healy
- Building Energy and Environment Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, United States
| | - Tania Ullah
- Building Energy and Environment Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, United States
| | - Andrew J Whelton
- Lyles School of Civil Engineering, Division of Environmental and Ecological Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Timothy A Bartrand
- Environmental Science, Policy, and Research Institute, Bala Cynwyd, Pennsylvania 19004, United States
| | - Caitlin Proctor
- Agricultural and Biological Engineering, Division of Environmental and Ecological Engineering, Purdue University, West Lafayette, Indiana 47907, United States
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7
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Vosloo S, Huo L, Chauhan U, Cotto I, Gincley B, Vilardi KJ, Yoon B, Bian K, Gabrielli M, Pieper KJ, Stubbins A, Pinto AJ. Gradual Recovery of Building Plumbing-Associated Microbial Communities after Extended Periods of Altered Water Demand during the COVID-19 Pandemic. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:3248-3259. [PMID: 36795589 PMCID: PMC9969676 DOI: 10.1021/acs.est.2c07333] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 pandemic-related building restrictions heightened drinking water microbiological safety concerns post-reopening due to the unprecedented nature of commercial building closures. Starting with phased reopening (i.e., June 2020), we sampled drinking water for 6 months from three commercial buildings with reduced water usage and four occupied residential households. Samples were analyzed using flow cytometry and full-length 16S rRNA gene sequencing along with comprehensive water chemistry characterization. Prolonged building closures resulted in 10-fold higher microbial cell counts in the commercial buildings [(2.95 ± 3.67) × 105 cells mL-1] than in residential households [(1.11 ± 0.58) × 104 cells mL-1] with majority intact cells. While flushing reduced cell counts and increased disinfection residuals, microbial communities in commercial buildings remained distinct from those in residential households on the basis of flow cytometric fingerprinting [Bray-Curtis dissimilarity (dBC) = 0.33 ± 0.07] and 16S rRNA gene sequencing (dBC = 0.72 ± 0.20). An increase in water demand post-reopening resulted in gradual convergence in microbial communities in water samples collected from commercial buildings and residential households. Overall, we find that the gradual recovery of water demand played a key role in the recovery of building plumbing-associated microbial communities as compared to short-term flushing after extended periods of reduced water demand.
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Affiliation(s)
- Solize Vosloo
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Linxuan Huo
- School
of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, Georgia 30318, United States
| | - Umang Chauhan
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Irmarie Cotto
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Benjamin Gincley
- School
of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, Georgia 30318, United States
| | - Katherine J. Vilardi
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Bryan Yoon
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Kaiqin Bian
- School
of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, Georgia 30318, United States
| | - Marco Gabrielli
- Dipartimento
di Ingegneria Civile e Ambientale - Sezione Ambientale, Politecnico di Milano, 20133 Milan, Italy
| | - Kelsey J. Pieper
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Aron Stubbins
- Department
of Civil and Environmental Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 021115, United States
| | - Ameet J. Pinto
- School
of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, Georgia 30318, United States
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8
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Scanlon MM, Gordon JL, Tonozzi AA, Griffin SC. Reducing the Risk of Healthcare Associated Infections from Legionella and Other Waterborne Pathogens Using a Water Management for Construction (WMC) Infection Control Risk Assessment (ICRA) Tool. Infect Dis Rep 2022; 14:341-359. [PMID: 35645218 PMCID: PMC9149880 DOI: 10.3390/idr14030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
Construction activities in healthcare settings potentially expose building occupants to waterborne pathogens including Legionella and have been associated with morbidity and mortality. A Water Management for Construction—Infection Control Risk Assessment (WMC-ICRA) tool was developed addressing gaps in building water management programs. This enables healthcare organizations to meet the requirements of ANSI/ASHRAE Standard 188 referenced in numerous guidelines and regulations. A WMC-ICRA was modeled after the ICRA required for prevention and control of airborne pathogens to reduce the risk of healthcare associated infections. The tool allows users to evaluate risk from waterborne pathogen exposure by analyzing construction activities by project category and building occupant risk group. The users then select an appropriate level of risk mitigation measures. Technical aspects (e.g., water age/stagnation, flushing, filtration, disinfection, validation testing), are presented to assist with implementation. An exemplar WMC-ICRA tool is presented as ready for implementation by infection prevention and allied professionals, addressing current gaps in water management, morbidity/mortality risk, and regulatory compliance. To reduce exposure to waterborne pathogens in healthcare settings and improve regulatory compliance, organizations should examine the WMC-ICRA tool, customize it for organization-specific needs, while formulating an organizational policy to implement during all construction activities.
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Affiliation(s)
- Molly M. Scanlon
- Standards and Research, Phigenics, LLC, 3S701 West Avenue, Suite 100, Warrenville, IL 60555, USA
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- Correspondence: ; Tel.: +1-844-850-4087
| | | | | | - Stephanie C. Griffin
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
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9
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Proctor C, Garner E, Hamilton KA, Ashbolt NJ, Caverly LJ, Falkinham JO, Haas CN, Prevost M, Prevots DR, Pruden A, Raskin L, Stout J, Haig SJ. Tenets of a holistic approach to drinking water-associated pathogen research, management, and communication. WATER RESEARCH 2022; 211:117997. [PMID: 34999316 PMCID: PMC8821414 DOI: 10.1016/j.watres.2021.117997] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 05/10/2023]
Abstract
In recent years, drinking water-associated pathogens that can cause infections in immunocompromised or otherwise susceptible individuals (henceforth referred to as DWPI), sometimes referred to as opportunistic pathogens or opportunistic premise plumbing pathogens, have received considerable attention. DWPI research has largely been conducted by experts focusing on specific microorganisms or within silos of expertise. The resulting mitigation approaches optimized for a single microorganism may have unintended consequences and trade-offs for other DWPI or other interests (e.g., energy costs and conservation). For example, the ecological and epidemiological issues characteristic of Legionella pneumophila diverge from those relevant for Mycobacterium avium and other nontuberculous mycobacteria. Recent advances in understanding DWPI as part of a complex microbial ecosystem inhabiting drinking water systems continues to reveal additional challenges: namely, how can all microorganisms of concern be managed simultaneously? In order to protect public health, we must take a more holistic approach in all aspects of the field, including basic research, monitoring methods, risk-based mitigation techniques, and policy. A holistic approach will (i) target multiple microorganisms simultaneously, (ii) involve experts across several disciplines, and (iii) communicate results across disciplines and more broadly, proactively addressing source water-to-customer system management.
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Affiliation(s)
- Caitlin Proctor
- Department of Agricultural and Biological Engineering, Division of Environmental and Ecological Engineering, Purdue University, West Lafayette, IN, USA
| | - Emily Garner
- Wadsworth Department of Civil & Environmental Engineering, West Virginia University, Morgantown, WV, USA
| | - Kerry A Hamilton
- School of Sustainable Engineering and the Built Environment and The Biodesign Centre for Environmental Health Engineering, Arizona State University, Tempe, AZ, USA
| | - Nicholas J Ashbolt
- Faculty of Science and Engineering, Southern Cross University, Gold Coast. Queensland, Australia
| | - Lindsay J Caverly
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Charles N Haas
- Department of Civil, Architectural & Environmental Engineering, Drexel University, Philadelphia, PA, USA
| | - Michele Prevost
- Department of Civil, Geological and Mining Engineering, Polytechnique Montreal, Montreal, Quebec, Canada
| | - D Rebecca Prevots
- Epidemiology Unit, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Amy Pruden
- Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA USA
| | - Lutgarde Raskin
- Department of Civil & Environmental Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Janet Stout
- Department of Civil & Environmental Engineering, University of Pittsburgh, and Special Pathogens Laboratory, Pittsburgh, PA, USA
| | - Sarah-Jane Haig
- Department of Civil & Environmental Engineering, and Department of Environmental & Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA.
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10
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Practitioners’ Perspective on the Prevalent Water Quality Management Practices for Legionella Control in Large Buildings in the United States. WATER 2022. [DOI: 10.3390/w14040663] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Managing building water systems is complicated by the need to maintain hot water temperatures high enough to control the growth of Legionella spp. while minimizing the risk of scalding. This study assessed water quality management practices in large buildings in the United States. Surveys conducted with building water quality managers found that more than 85% of buildings have hot water temperatures that are consistent with scald risk mitigation guidelines (i.e., <122 °F/50 °C). However, nearly two thirds and three quarters of buildings do not comply with the common temperature guidance for opportunistic pathogen control, i.e., water heater setpoint > 140 °F (60 °C) and recirculation loop > 122 °F (50 °C), respectively; median values for both setpoint and recirculation loop temperatures are 10 °F (6 °C) or more below temperatures recommended for opportunistic pathogen control. These observations suggest that many buildings are prone to Legionella spp. risk. The study also found that 27% of buildings do not comply with guidelines for time to equilibrium hot water temperature, over 33% fail to monitor temperature in the recirculation loop, more than 70% fail to replace or disinfect showerheads, more than 40% lack a written management plan, and only a minority conduct any monitoring of residual disinfectant levels or microbiological quality. Given the rise in Legionellosis infections in recent years, coupled with highlighted water quality concerns because of prolonged water stagnation in plumbing, such as in buildings closed due to COVID-19, current management practices, which appear to be focused on scald risk, may need to be broadened to include greater attention to control of opportunistic pathogens. To accomplish this, there is a need for formal training and resources for facility managers.
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11
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Roy S, Mosteller K, Mosteller M, Webber K, Webber V, Webber S, Reid L, Walters L, Edwards MA. Citizen science chlorine surveillance during the Flint, Michigan federal water emergency. WATER RESEARCH 2021; 201:117304. [PMID: 34107367 DOI: 10.1016/j.watres.2021.117304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/30/2021] [Accepted: 05/24/2021] [Indexed: 05/12/2023]
Abstract
Rising incidence of waterborne diseases including Legionellosis linked to low chlorine residuals in buildings and the availability of inexpensive testing options, create an opportunity for citizen science chorine monitoring to complement sampling done by water utilities. University researchers and Flint residents coordinated a citizen science chlorine surveillance campaign in Flint, Michigan in 2015-19, that helped expose the nature of two deadly Legionnaires Disease outbreaks in 2014-2015 during the Flint Water Crisis and progress of system recovery during the Federal emergency. Results obtained with an inexpensive color wheel were in agreement with a digital colorimeter (R2 =0.99; p = 2.81 × 10-21) at 15 sites geographically distributed across Flint. Blinded tests revealed good agreement between official (n = 2051) and citizen (n = 654) data in terms of determining whether regulatory guidelines for chlorine were met, but a discovery that the citizen data were statistically lower than the city's (p<0.00001) especially in warm summer months led to recommendations for increased flushing of service lines before measurements. This work suggests that expanded citizen surveillance of chlorine, site specific flushing advice, and guidance on decisions about water heater set point could help consumers reduce Legionella risks in their homes. Citizen science initiatives for chlorine monitoring offer a unique opportunity for mutually beneficial collaborations between consumers and utilities to reduce the main source of waterborne disease in developed countries.
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Affiliation(s)
- Siddhartha Roy
- Civil and Environmental Engineering, Virginia Tech, USA.
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12
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Hamilton KA, Kuppravalli A, Heida A, Joshi S, Haas CN, Verhougstraete M, Gerrity D. Legionnaires' disease in dental offices: Quantifying aerosol risks to dental workers and patients. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:378-393. [PMID: 34161202 DOI: 10.1080/15459624.2021.1939878] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Legionella pneumophila is an opportunistic bacterial respiratory pathogen that is one of the leading causes of drinking water outbreaks in the United States. Dental offices pose a potential risk for inhalation or aspiration of L. pneumophila due to the high surface area to volume ratio of dental unit water lines-a feature that is conducive to biofilm growth. This is coupled with the use of high-pressure water devices (e.g., ultrasonic scalers) that produce fine aerosols within the breathing zone. Prior research confirms that L. pneumophila occurs in dental unit water lines, but the associated human health risks have not been assessed. We aimed to: (1) synthesize the evidence for transmission and management of Legionnaires' disease in dental offices; (2) create a quantitative modeling framework for predicting associated L. pneumophila infection risk; and (3) highlight influential parameters and research gaps requiring further study. We reviewed outbreaks, management guidance, and exposure studies and used these data to parameterize a quantitative microbial risk assessment (QMRA) model for L. pneumophila in dental applications. Probabilities of infection for dental hygienists and patients were assessed on a per-exposure and annual basis. We also assessed the impact of varying ventilation rates and the use of personal protective equipment (PPE). Following an instrument purge (i.e., flush) and with a ventilation rate of 1.2 air changes per hour, the median per-exposure probability of infection for dental hygienists and patients exceeded a 1-in-10,000 infection risk benchmark. Per-exposure risks for workers during a purge and annual risks for workers wearing N95 masks did not exceed the benchmark. Increasing air change rates in the treatment room from 1.2 to 10 would achieve an ∼85% risk reduction, while utilization of N95 respirators would reduce risks by ∼95%. The concentration of L. pneumophila in dental unit water lines was a dominant parameter in the model and driver of risk. Future risk assessment efforts and refinement of microbiological control protocols would benefit from expanded occurrence datasets for L. pneumophila in dental applications.
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Affiliation(s)
- Kerry A Hamilton
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona
| | - Aditya Kuppravalli
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona
- BASIS Scottsdale High School, Scottsdale, Arizona
| | - Ashley Heida
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona
| | - Sayalee Joshi
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona
| | - Charles N Haas
- Department of Civil, Architectural, and Environmental Engineering, Drexel University, Philadelphia, Pennsylvania
| | - Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona
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13
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Abstract
Security of supply of water, which meets the quality parameters specified in applicable standards, is now the basis for the functioning of most societies. In addition to climatic, biological, chemical, and physical hazards, it is worth paying attention to consumers’ subjective perception of the quality of tap water supplied in the area of Poland. The article discusses various activities related to water resources management and analyses the results of an evaluation of selected quality parameters of tap water in Poland. A novelty on a European scale here is an examination of the evaluation of these parameters based on potential seasonal differences (spring, summer, autumn, winter). For the first time in the world literature, PROFIT analysis was used to evaluate selected parameters of tap water quality. The aim of the article was to present a model for the evaluation of the parameters of tap water supplied in different seasons of the year in Poland. Due to the complexity of the research aspects, a mixed-methods research procedure was used in which a literature review was combined with a survey and statistical analysis. For the purpose of the survey, an original survey questionnaire called “Survey of customer opinions on selected parameters of tap water supplied in Poland” was developed especially for this study. The conducted research confirmed the adopted hypothesis that the results of evaluation of selected tap water parameters vary depending on the period (spring, summer, autumn, winter) in Poland. The model developed by means of PROFIT analysis makes it possible to highlight to water suppliers the specific quality parameters in particular seasons of the year (spring, summer, autumn, winter), which may improve the quality of water supplied in Poland and thus, in the long-term perspective, increase the level of satisfaction of water recipients and confidence in drinking tap water in Poland.
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14
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Causes, Factors, and Control Measures of Opportunistic Premise Plumbing Pathogens—A Critical Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11104474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This review critically analyses the chemical and physical parameters that influence the occurrence of opportunistic pathogens in the drinking water distribution system, specifically in premise plumbing. A comprehensive literature review reveals significant impacts of water age, disinfectant residual (type and concentration), temperature, pH, and pipe materials. Evidence suggests that there is substantial interplay between these parameters; however, the dynamics of such relationships is yet to be elucidated. There is a correlation between premise plumbing system characteristics, including those featuring water and energy conservation measures, and increased water quality issues and public health concerns. Other interconnected issues exacerbated by high water age, such as disinfectant decay and reduced corrosion control efficiency, deserve closer attention. Some common features and trends in the occurrence of opportunistic pathogens have been identified through a thorough analysis of the available literature. It is proposed that the efforts to reduce or eliminate their incidence might best focus on these common features.
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15
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Cullom AC, Martin RL, Song Y, Williams K, Williams A, Pruden A, Edwards MA. Critical Review: Propensity of Premise Plumbing Pipe Materials to Enhance or Diminish Growth of Legionella and Other Opportunistic Pathogens. Pathogens 2020; 9:E957. [PMID: 33212943 PMCID: PMC7698398 DOI: 10.3390/pathogens9110957] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022] Open
Abstract
Growth of Legionella pneumophila and other opportunistic pathogens (OPs) in drinking water premise plumbing poses an increasing public health concern. Premise plumbing is constructed of a variety of materials, creating complex environments that vary chemically, microbiologically, spatially, and temporally in a manner likely to influence survival and growth of OPs. Here we systematically review the literature to critically examine the varied effects of common metallic (copper, iron) and plastic (PVC, cross-linked polyethylene (PEX)) pipe materials on factors influencing OP growth in drinking water, including nutrient availability, disinfectant levels, and the composition of the broader microbiome. Plastic pipes can leach organic carbon, but demonstrate a lower disinfectant demand and fewer water chemistry interactions. Iron pipes may provide OPs with nutrients directly or indirectly, exhibiting a high disinfectant demand and potential to form scales with high surface areas suitable for biofilm colonization. While copper pipes are known for their antimicrobial properties, evidence of their efficacy for OP control is inconsistent. Under some circumstances, copper's interactions with premise plumbing water chemistry and resident microbes can encourage growth of OPs. Plumbing design, configuration, and operation can be manipulated to control such interactions and health outcomes. Influences of pipe materials on OP physiology should also be considered, including the possibility of influencing virulence and antibiotic resistance. In conclusion, all known pipe materials have a potential to either stimulate or inhibit OP growth, depending on the circumstances. This review delineates some of these circumstances and informs future research and guidance towards effective deployment of pipe materials for control of OPs.
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Affiliation(s)
- Abraham C. Cullom
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
| | - Rebekah L. Martin
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
- Civil and Environmental Engineering, Virginia Military Institute, Lexington, VA 24450, USA
| | - Yang Song
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
| | | | - Amanda Williams
- c/o Marc Edwards, Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA;
| | - Amy Pruden
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
| | - Marc A. Edwards
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
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16
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Rasheduzzaman M, Singh R, Haas CN, Gurian PL. Required water temperature in hotel plumbing to control Legionella growth. WATER RESEARCH 2020; 182:115943. [PMID: 32590203 DOI: 10.1016/j.watres.2020.115943] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 05/07/2023]
Abstract
Legionella spp. occurring in hotel hot water systems, in particular Legionella pneumophila, are causing serious pneumonic infections, and water temperature is a key factor to control their occurrence in plumbing systems. We performed a systematic review and meta-analyses of the available evidence on the association between water temperature and Legionella colonization to identify the water temperature in hotel hot water systems required for control of Legionella. Qualitative synthesis and quantitative analysis were performed on 13 studies that met our inclusion criteria to identify the effect of temperature. The Receiver Operating Characteristic (ROC) curve identified 55 °C as a cutoff point for hotel hot water temperature with an Area Under the Curve (AUC) value of 0.914. The odds ratios (OR) for detecting Legionella at temperatures >55 °C compared to lower temperatures from a meta-analysis of three studies was 0.17 [95% CI: 0.11, 0.25], which indicates a strong negative association between temperature and Legionella colonization. A logistic regression on results from multiple studies using both molecular and culture methods found a temperature of 59 °C associated with an 8% probability of detectable Legionella. Only two studies reported sufficiently detailed data to allow a model of concentration vs. temperature to be fit, and this model was not statistically significant. Additional research or more detailed reporting of existing datasets is required to assess if Legionella growth can be limited below particular concentration targets at different temperatures.
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Affiliation(s)
- Md Rasheduzzaman
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Rajveer Singh
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Charles N Haas
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Patrick L Gurian
- Department of Civil, Architectural and Environmental Engineering, Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
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17
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Proctor CR, Rhoads WJ, Keane T, Salehi M, Hamilton K, Pieper KJ, Cwiertny DM, Prévost M, Whelton AJ. Considerations for large building water quality after extended stagnation. AWWA WATER SCIENCE 2020; 2:e1186. [PMID: 32838226 DOI: 10.31219/osf.io/qvj3b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 05/25/2023]
Abstract
The unprecedented number of building closures related to the coronavirus disease (COVID-19) pandemic is concerning because water stagnation will occur in many buildings that do not have water management plans in place. Stagnant water can have chemical and microbiological contaminants that pose potential health risks to occupants. Health officials, building owners, utilities, and other entities are rapidly developing guidance to address this issue, but the scope, applicability, and details included in the guidance vary widely. To provide a primer of large building water system preventative and remedial strategies, peer-reviewed, government, industry, and nonprofit literature relevant to water stagnation and decontamination practices for plumbing was synthesized. Preventative practices to help avoid the need for recommissioning (e.g., routine flushing) and specific actions, challenges, and limitations associated with recommissioning were identified and characterized. Considerations for worker and occupant safety were also indicated. The intended audience of this work includes organizations developing guidance.
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Affiliation(s)
- Caitlin R Proctor
- Division of Environmental and Ecological Engineering, Lyles School of Civil Engineering, Weldon School of Biomedical Engineering, School of Materials Engineering Purdue University West Lafayette Indiana
| | - William J Rhoads
- Department of Civil and Environmental Engineering Virginia Tech Blacksburg Virginia
| | - Tim Keane
- Legionella Risk Management, Inc. Chalfont Pennsylvania
| | - Maryam Salehi
- Department of Civil Engineering University of Memphis Memphis Tennessee
| | - Kerry Hamilton
- School of Sustainable Engineering and the Built Environment Arizona State University Tempe Arizona
| | - Kelsey J Pieper
- Department of Civil and Environmental Engineering Northeastern University Boston Massachusetts
| | - David M Cwiertny
- Department of Civil and Environmental Engineering, Seamans Center for the Engineering Arts and Sciences University of Iowa Iowa City Iowa
- Center for Health Effects of Environmental Contamination University of Iowa Iowa City Iowa
- Public Policy Center University of Iowa Iowa City Iowa
| | - Michele Prévost
- Civil, Geological and Mining Engineering Polytechnique Montreal Montréal Québec Canada
| | - Andrew J Whelton
- Lyles School of Civil Engineering, Division of Environmental and Ecological Engineering Purdue University West Lafayette Indiana
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18
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Julien R, Dreelin E, Whelton AJ, Lee J, Aw TG, Dean K, Mitchell J. Knowledge gaps and risks associated with premise plumbing drinking water quality. ACTA ACUST UNITED AC 2020. [DOI: 10.1002/aws2.1177] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Ryan Julien
- Department of Biosystems and Agricultural EngineeringMichigan State University East Lansing Michigan
| | - Erin Dreelin
- Department of Fisheries and WildlifeMichigan State University East Lansing Michigan
| | - Andrew J. Whelton
- Lyles School of Civil Engineering and Environmental and Ecological EngineeringPurdue University West Lafayette Indiana
| | - Juneseok Lee
- Department of Civil and Environmental EngineeringManhattan College Riverdale New York
| | - Tiong Gim Aw
- Department of Environmental Health Sciences, School of Public Health and Tropical MedicineTulane University New Orleans Louisiana
| | - Kara Dean
- Department of Biosystems and Agricultural EngineeringMichigan State University East Lansing Michigan
| | - Jade Mitchell
- Department of Biosystems and Agricultural EngineeringMichigan State University East Lansing Michigan
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