Trends in Methyl tert-Butyl Ether Concentrations in Private Wells in Southeast New Hampshire: 2005 to 2015

In southeast New Hampshire, where reformulated gasoline was used from the 1990s to 2007, methyl tert-butyl ether (MtBE) concentrations ≥0.2 μg/L were found in water from 26.7% of 195 domestic wells sampled in 2005. Ten years later in 2015, and eight years after MtBE was banned, 10.3% continue to have MtBE. Most wells (140 of 195) had no MtBE detections (concentrations <0.2 μg/L) in 2005 and 2015. Of the remaining wells, MtBE concentrations increased in 4 wells, decreased in 47 wells, and did not change in 4 wells. On average, MtBE concentrations decreased 65% among 47 wells whereas MtBE concentrations increased 17% among 4 wells between 2005 and 2015. The percent change in detection frequency from 2005 to 2015 (the decontamination rate) was lowest (45.5%) in high-population-density areas and in wells completed in the Berwick Formation geologic units. The decontamination rate was the highest (78.6%) where population densities were low and wells were completed in bedrock composed of granite, metamorphic, and mafic rocks. Wells in the Berwick Formation are characteristically deeper and have lower yields than wells in other rock types and have shallower overburden cover, which may allow for more rapid transport of MtBE from land-surface releases. Low-yielding, deep bedrock wells may require large contributing areas to achieve adequate well yield, and thus have a greater chance of intercepting MtBE, in addition to diluting contaminants at a slower rate and thus requiring more time to decontaminate.

Factors affecting temporal variability of arsenic in groundwater used for drinking water supply in the United States

The occurrence of arsenic in groundwater is a recognized environmental hazard with worldwide importance and much effort has been focused on surveying and predicting where arsenic occurs. Temporal variability is one aspect of this environmental hazard that has until recently received less attention than other aspects. For this study, we analyzed 1245 wells with two samples per well. We suggest that temporal variability, often reported as affecting very few wells, is perhaps a larger issue than it appears and has been overshadowed by datasets with large numbers of non-detect data. Although there was only a slight difference in arsenic concentration variability among samples from public and private wells (p=0.0452), the range of variability was larger for public than for private wells. Further, we relate the variability we see to geochemical factors-primarily variability in redox-but also variability in major-ion chemistry. We also show that in New England there is a weak but statistically significant indication that seasonality may have an effect on concentrations, whereby concentrations in the first two quarters of the year (January-June) are significantly lower than in the second two quarters (July-December) (p<0.0001). In the Central Valley of California, the relation of arsenic concentration to season was not statistically significant (p=0.4169). In New England, these changes appear to follow groundwater levels. It is possible that this difference in arsenic concentrations is related to groundwater level changes, pumping stresses, evapotranspiration effects, or perhaps mixing of more oxidizing, lower pH recharge water in wetter months. Focusing on the understanding the geochemical conditions in aquifers where arsenic concentrations are concerns and causes of geochemical changes in the groundwater environment may lead to a better understanding of where and by how much arsenic will vary over time.

Adverse outcomes after colposcopy

BACKGROUND

Colposcopy is an essential part of the National Health Service Cervical Screening Programme (NHSCSP). It is used for both diagnosis and treatment of pre-cancerous cells of the cervix. Despite colposcopy being a commonly performed and relatively invasive procedure, very little research has explored the potential long-term impacts of colposcopic examination upon patient quality of life.The aim of this study is to investigate and quantify any potential reduction in women's quality of life following a colposcopy procedure. More specifically, the degree of female sexual dysfunction and the excess risk of adverse events in those undergoing colposcopy will be explored. If such risks are identified, these can be communicated to women before undergoing colposcopy. It will also assist in identifying whether there are particular sub-groups at greater risk and if so, this may lead to a re-evaluation of current recommendations concerning colposcopically directed treatments.

METHODS/DESIGN

Cohort study using postal surveys to assess sexual function and quality of life in women who have attended for colposcopy (cases), compared with those who have not attended colposcopy (controls). The prevalence and excess risk of female sexual dysfunction will be determined. Logistic regression will identify the predictors of adverse outcomes.

DISCUSSION

There are more than 400,000 colposcopy appointments each year in England, of which 134,000 are new referrals. There is some evidence that there may be long-term implications for women treated under colposcopy with respect to adverse obstetric outcomes, persisting anxiety, increased rates of sexual dysfunction and reduced quality of life. Reliably establishing whether such adverse outcomes exist and the excess risk of adverse events will facilitate informed decision-making and patient choice.

'Reaching the hard to reach'--lessons learned from the VCS (voluntary and community Sector). A qualitative study

Background

The notion 'hard to reach' is a contested and ambiguous term that is commonly used within the spheres of social care and health, especially in discourse around health and social inequalities. There is a need to address health inequalities and to engage in services the marginalized and socially excluded sectors of society.

Methods

This paper describes a pilot study involving interviews with representatives from eight Voluntary and Community Sector (VCS) organisations. The purpose of the study was to explore the notion of 'hard to reach' and perceptions of the barriers and facilitators to accessing services for 'hard to reach' groups from a voluntary and community sector perspective.

Results

The 'hard to reach' may include drug users, people living with HIV, people from sexual minority communities, asylum seekers, refugees, people from black and ethnic minority communities, and homeless people although defining the notion of the 'hard to reach' is not straight forward. It may be that certain groups resist engaging in treatment services and are deemed hard to reach by a particular service or from a societal stance. There are a number of potential barriers for people who may try and access services, including people having bad experiences in the past; location and opening times of services and how services are funded and managed. A number of areas of commonality are found in terms of how access to services for 'hard to reach' individuals and groups could be improved including: respectful treatment of service users, establishing trust with service users, offering service flexibility, partnership working with other organisations and harnessing service user involvement.

Conclusions

If health services are to engage with groups that are deemed 'hard to reach' and marginalised from mainstream health services, the experiences and practices for engagement from within the VCS may serve as useful lessons for service improvement for statutory health services.

Methyl tert-butyl ether (MTBE) in public and private wells in New Hampshire: occurrence, factors, and possible implications

Methyl tert-butyl ether (MTBE) concentrations > or = 0.2 /microg/L were found in samples of untreated water in 18% of public-supply wells (n = 284) and 9.1% of private domestic wells (n = 264) sampled in 2005 and 2006 in New Hampshire. In counties that used reformulated gasoline (RFG), MTBE occurred at or above 0.2 microg/L in 30% of public- and 17% of private-supply wells. Additionally, 52% of public-supply wells collocated with fuel storage and 71% of mobile home park wells had MTBE. MTBE occurrence in public-supply wells was predicted by factors such as proximity to sources of fuel, land use, and population density, as well as low pH and distance from mapped lineaments. RFG use, land-use variables, and pH were important predictors of private-well MTBE occurrence. Variables representing sources of MTBE, such as the distance to known fuel sources, were not significant predictors of MTBE occurrence in private-supply wells. It is hypothesized that private wells may become contaminated from the collective effects of sources in high population areas and from undocumented incidental releases from onsite or proximal gasoline use. From 2003 to 2005, MTBE occurrence decreased in 63 public-supply wells and increased in 60 private-supply wells, but neither trend was statistically significant.

Arsenic in groundwater in eastern New England: occurrence, controls, and human health implications

In eastern New England, high concentrations (greater than 10 microg/L) of arsenic occur in groundwater. Privately supplied drinking water from bedrock aquifers often has arsenic concentrations at levels of concern to human health, whereas drinking water from unconsolidated aquifers is least affected by arsenic contamination. Water from wells in metasedimentary bedrock units, primarily in Maine and New Hampshire, has the highest arsenic concentrations-nearly 30% of wells in these aquifers produce water with arsenic concentrations greater than 10 microg/L. Arsenic was also found at concentrations of 3-40 mg/kg in whole rock samples in these formations, suggesting a possible geologic source. Arsenic is most common in groundwater with high pH. High pH is related to groundwater age and possibly the presence of calcite in bedrock. Ion exchange in areas formerly inundated by seawater also may increase pH. Wells sampled twice during periods of 1-10 months have similar arsenic concentrations (slope = 0.89; r-squared = 0.97). On the basis of water-use information for the aquifers studied, about 103,000 people with private wells could have water supplies with arsenic at levels of concern (greater than 10 microg/L) for human health.