Alasdair Cohen , Md Rasheduzzaman , Bethesda O'Connell , Teresa Brown , Mami Taniuchi , Leigh-Anne Krometis , Alan Hubbard , Phillip Scheuerman , Marc Edwards , Amanda Darling , Blaine Pennala , Sarah Price , Breanna Lytton , Erin Wettstone , Suporn Pholwat , Honorine Ward , Daniel R. Hallinger , Steven O. Simmons , Shannon M. Griffin , Jason Kobylanski , Timothy J. Wade
{"title":"阿巴拉契亚弗吉尼亚州的饮用水源、水质和相关健康结果:两个县的风险特征研究。","authors":"Alasdair Cohen , Md Rasheduzzaman , Bethesda O'Connell , Teresa Brown , Mami Taniuchi , Leigh-Anne Krometis , Alan Hubbard , Phillip Scheuerman , Marc Edwards , Amanda Darling , Blaine Pennala , Sarah Price , Breanna Lytton , Erin Wettstone , Suporn Pholwat , Honorine Ward , Daniel R. Hallinger , Steven O. Simmons , Shannon M. Griffin , Jason Kobylanski , Timothy J. Wade","doi":"10.1016/j.ijheh.2024.114390","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>In the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia.</p></div><div><h3>Methods</h3><p>We administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, <em>E. coli</em>, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households.</p></div><div><h3>Results</h3><p>We enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, <em>E. coli</em> in 12%, all with wells or springs (n = 4), and <em>Aeromonas</em>, <em>Campylobacter</em>, and <em>Enterobacter</em> in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with <em>E. coli</em> detection. 34% (n = 15) of saliva samples had detectable antibody responses for <em>Cryptosporidium</em> spp.<em>, C. jejuni</em>, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01–10.65).</p></div><div><h3>Conclusions</h3><p>To our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Drinking water sources, quality, and associated health outcomes in Appalachian Virginia: A risk characterization study in two counties\",\"authors\":\"Alasdair Cohen , Md Rasheduzzaman , Bethesda O'Connell , Teresa Brown , Mami Taniuchi , Leigh-Anne Krometis , Alan Hubbard , Phillip Scheuerman , Marc Edwards , Amanda Darling , Blaine Pennala , Sarah Price , Breanna Lytton , Erin Wettstone , Suporn Pholwat , Honorine Ward , Daniel R. Hallinger , Steven O. Simmons , Shannon M. Griffin , Jason Kobylanski , Timothy J. Wade\",\"doi\":\"10.1016/j.ijheh.2024.114390\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>In the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia.</p></div><div><h3>Methods</h3><p>We administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, <em>E. coli</em>, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households.</p></div><div><h3>Results</h3><p>We enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, <em>E. coli</em> in 12%, all with wells or springs (n = 4), and <em>Aeromonas</em>, <em>Campylobacter</em>, and <em>Enterobacter</em> in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with <em>E. coli</em> detection. 34% (n = 15) of saliva samples had detectable antibody responses for <em>Cryptosporidium</em> spp.<em>, C. jejuni</em>, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01–10.65).</p></div><div><h3>Conclusions</h3><p>To our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.</p></div>\",\"PeriodicalId\":13994,\"journal\":{\"name\":\"International journal of hygiene and environmental health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of hygiene and environmental health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1438463924000713\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of hygiene and environmental health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1438463924000713","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Drinking water sources, quality, and associated health outcomes in Appalachian Virginia: A risk characterization study in two counties
Objectives
In the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia.
Methods
We administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, E. coli, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households.
Results
We enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, E. coli in 12%, all with wells or springs (n = 4), and Aeromonas, Campylobacter, and Enterobacter in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with E. coli detection. 34% (n = 15) of saliva samples had detectable antibody responses for Cryptosporidium spp., C. jejuni, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01–10.65).
Conclusions
To our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.
期刊介绍:
The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.