Private groundwater contamination and risk management: A comparative scoping review of similarities, drivers and challenges across two socio-economically developed regions

Consolidation of multi-domain risk management research is essential for strategies facilitating the concerted government (educational) and population-level (behavioural) actions required to reduce microbial private groundwater contamination. However, few studies to date have synthesised this literature or sought to ascertain the causal generality and extent of supply contamination and preventive responses. In light of the Republic of Ireland (ROI) and Ontario's high reliance and research focus on private wells and consequent utility for empirical comparison, a scoping review of pertinent literature (1990-2022) from both regions was undertaken. The SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) method was employed to inform literature searches, with Scopus and Web of Science selected as primary databases for article identification. The review identified 65 relevant articles (Ontario = 34, ROI = 31), with those investigating well user actions (n = 22) and groundwater quality (n = 28) the most frequent. A markedly higher pooled proportion of private supplies in the ROI exhibited microbial contamination (38.3 % vs. 4.1 %), despite interregional similarities in contamination drivers (e.g., weather, physical supply characteristics). While Ontarian well users demonstrated higher rates of historical (≥ 1) and annual well testing (90.6 % vs. 71.1 %; 39.1 % vs. 8.6 %) and higher rates of historical well treatment (42.3 % vs. 24.3 %), interregional levels of general supply knowledge were analogous (70.7 % vs. 71.0 %). Financial cost, organoleptic properties and residence on property during supply construction emerged as predictors of cognition and behaviour in both regions. Review findings suggest broad interregional similarities in drivers of supply contamination and individual-level risk mitigation, indicating that divergence in contamination rates may be attributable to policy discrepancies - particularly well testing incentivisation. The paucity of identified intervention-oriented studies further highlights the importance of renewed research and policy agendas for improved, targeted well user outreach and incentivised, convenience-based services promoting routine supply maintenance.

Nitrate exposure from drinking water and dietary sources among Iowa farmers using private wells

Nitrate levels are increasing in water resources across the United States and nitrate ingestion from drinking water has been associated with adverse health risks in epidemiologic studies at levels below the maximum contaminant level (MCL). In contrast, dietary nitrate ingestion has generally been associated with beneficial health effects. Few studies have characterized the contribution of both drinking water and dietary sources to nitrate exposure. The Agricultural Health Study is a prospective cohort of farmers and their spouses in Iowa and North Carolina. In 2018-2019, we assessed nitrate exposure for 47 farmers who used private wells for their drinking water and lived in 8 eastern Iowa counties where groundwater is vulnerable to nitrate contamination. Drinking water and dietary intakes were estimated using the National Cancer Institute Automated Self-Administered 24-Hour Dietary Assessment tool. We measured nitrate in tap water and estimated dietary nitrate from a database of food concentrations. Urinary nitrate was measured in first morning void samples in 2018-19 and in archived samples from 2010 to 2017 (minimum time between samples: 2 years; median: 7 years). We used linear regression to evaluate urinary nitrate concentrations in relation to total nitrate, and drinking water and dietary intakes separately. Overall, dietary nitrate contributed the most to total intake (median: 97 %; interquartile range [IQR]: 57-99 %). Among 15 participants (32 %) whose drinking water nitrate concentrations were at/above the U.S. Environmental Protection Agency MCL (10 mg/L NO3-N), median intake from water was 44 % (IQR: 26-72 %). Total nitrate intake was the strongest predictor of urinary nitrate concentrations (R2 = 0.53). Drinking water explained a similar proportion of the variation in nitrate excretion (R2 = 0.52) as diet (R2 = 0.47). Our findings demonstrate the importance of both dietary and drinking water intakes as determinants of nitrate excretion.

Do animal husbandry operations contaminate groundwater sources with antimicrobial resistance: systematic review

Antimicrobial resistance (AMR) is a critical global health concern. Animal husbandry operations are AMR hotspots due to heavy antibiotic use and dissemination of animal waste into the environment. In this systematic review, we examined the impact of swine, poultry, and cattle operations on AMR in groundwater. We searched PubMed, Web of Science, CAB Direct, and the North Carolina State University Agricultural and Environmental Science databases in June 2022. The search returned 2487 studies. Of the 23 eligible studies, 17 were conducted in high-income countries (primarily the USA, also Canada, Saudi Arabia, Cyprus), and 6 were conducted in a single upper-middle-income country (China). Studies investigated facilities for swine (13), poultry (4), cattle (3), and multiple types of animals (3). The sampling distance ranged from onsite to > 20 km from facilities; the majority of studies (19) sampled onsite. Most studies collected samples from monitoring wells; only 5 studies investigated private drinking water wells. AMR in groundwater was associated with animal husbandry operations in 74% (17/23) of all studies, 65% (11/17) of studies in high-income countries, and 100% (6/6) of studies in China. Contamination was mostly found in onsite wells, especially downgradient of waste lagoons, but also in offsite private wells up to 2-3 km away. Few studies reported weather data, but AMR contamination appeared to increase with rainy conditions. Future studies should sample private wells at varying distances from animal husbandry operations under different weather conditions and include low- and middle-income countries where food animal production is intensifying.

Sampling methods may drive short-term groundwater nitrate variability in an irrigated watershed connected to a coastal lagoon (Campo de Cartagena-Mar Menor, SE Spain)

This study highlights concerns regarding the reliability of groundwater nitrate data used in official surveys, such as within the EU-mandated Water Framework Directive (WFD). The focus is on the Campo de Cartagena - Mar Menor hydrosystem in Spain, a region known for its intensively irrigated watershed and eutrophicated lagoon, where monitoring the evolution of nitrate contamination in surface and groundwater is crucial but challenging due to the risk of inconsistent characterization leading to erratic remediation measures. The study employed an experimental approach in private wells that belong to a longstanding official nitrate survey network marked by irregular sampling practices. Importantly, these wells lacked comprehensive design documentation and were frequently used by farmers. The study aimed to evaluate the representativity of dissolved nitrate measurements in such an emblematic case, while investigating the source of the water using geochemical and isotope tracers. This assessment considered the effects of different sampling techniques (bailer or pumping) and sampling parameters (depth and time), acknowledging actual practices. The research highlights several key findings. Firstly, the bailer sampling method proved to account for a substantial portion of the observed variation in nitrate content. Secondly, in some cases, pumping introduced contributions from different water horizons, complicating the interpretation of nitrate data. Thirdly, alterations in the sampling protocol had a notable impact on the resulting nitrate measurements. Furthermore, the study emphasized a critical issue: the lack of analytical uncertainty estimation in official surveys introduces significant bias in result interpretation, with discrepancies exceeding 100 mg/L in four of the six wells analyzed. This underscores the pressing need for improved sampling protocols, dedicated borehole infrastructure and precise data interpretation. Given the potential unreliability of some official groundwater nitrate data shared under EU or other regulations, with corresponding economic and environmental impacts, the study recommends meticulous verification before transmitting data.

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

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

Assessing antimicrobial and metal resistance genes in Escherichia coli from domestic groundwater supplies in rural Ireland

Natural ecosystems can become significant reservoirs and/or pathways for antimicrobial resistance (AMR) dissemination, with the potential to affect nearby microbiological, animal, and ultimately human communities. This is further accentuated in environments that provide direct human exposure, such as drinking water. To date, however, few studies have investigated AMR dissemination potential and the presence of co-selective stressors (e.g., metals/metalloids) in groundwater environments of human health significance. Accordingly, the present study analysed samples from rural (drinking) groundwater supplies (i.e., private wells) in the Republic of Ireland, where land use is dominated by livestock grazing activities. In total, 48 Escherichia coli isolates tested phenotypically for antimicrobial susceptibility in an earlier study were further subject to whole genome sequencing (WGS) and corresponding water samples were further analysed for trace metal/metalloid concentrations. Eight isolates (i.e., 16.7%) were genotypically resistant to antimicrobials, confirming prior phenotypic results through the identification of ten antimicrobial resistance genes (ARGs); namely: aph(3″)-lb (strA; n=7), aph(6)-Id (strA; n = 6), blaTEM (n = 6), sul2 (n = 6), tetA (n = 4), floR (n = 2), dfrA5 (n = 1), tetB (n = 1), and tetY (n = 1). Additional bioinformatic analysis revealed that all ARGs were plasmid-borne, except for two of the six sul2 genes, and that 31.2% of all tested isolates (n = 15) and 37.5% of resistant ones (n = 3) carried virulence genes. Study results also found no significant relationships between metal concentrations and ARG abundance. Additionally, just one genetic linkage was identified between ARGs and a metal resistance gene (MRG), namely merA, a mercury-resistant gene found on the same plasmid as blaTEM, dfrA5, strA, strB, and sul2 in the only isolate of inferred porcine (as opposed to bovine) origin. Overall, findings suggest that ARG (and MRG) acquisition may be occurring prior to groundwater ingress, and are likely a legacy issue arising from agricultural practices.

Juxtaposition of intensive agriculture, vulnerable aquifers, and mixed chemical/microbial exposures in private-well tapwater in northeast Iowa

In the United States and globally, contaminant exposure in unregulated private-well point-of-use tapwater (TW) is a recognized public-health data gap and an obstacle to both risk-management and homeowner decision making. To help address the lack of data on broad contaminant exposures in private-well TW from hydrologically-vulnerable (alluvial, karst) aquifers in agriculturally-intensive landscapes, samples were collected in 2018-2019 from 47 northeast Iowa farms and analyzed for 35 inorganics, 437 unique organics, 5 in vitro bioassays, and 11 microbial assays. Twenty-six inorganics and 51 organics, dominated by pesticides and related transformation products (35 herbicide-, 5 insecticide-, and 2 fungicide-related), were observed in TW. Heterotrophic bacteria detections were near ubiquitous (94 % of the samples), with detection of total coliform bacteria in 28 % of the samples and growth on at least one putative-pathogen selective media across all TW samples. Health-based hazard index screening levels were exceeded frequently in private-well TW and attributed primarily to inorganics (nitrate, uranium). Results support incorporation of residential treatment systems to protect against contaminant exposure and the need for increased monitoring of rural private-well homes. Continued assessment of unmonitored and unregulated private-supply TW is needed to model contaminant exposures and human-health risks.

Air temperature spikes increase bacteria presence in drinking water wells downstream of hog lagoons

>44 million United States residents depend on private drinking water wells that are federally unregulated. Maintaining a clean groundwater supply for populations without access to public water systems is essential to supporting public health and falls to state regulators and private well owners. Yet, monitoring practices do not reflect the fact that groundwater pollution risk varies seasonally and with proximity to nearby surface-contaminated sites. Examination of nearly 50,000 well water samples across North Carolina, ranked second nationally in domestic well dependence and swine production, from 2013 to 2018 reveals a uniform sampling schedule but a variable risk of bacterial contamination within each calendar year. We document a threshold of 32.2 °C (90 °F) where total coliform bacteria and Escherichia coli (E. coli) detection in private well water spikes near swine lagoons but is absent from "upstream" wells and otherwise unexplained by a variety of other known contamination sites. Closing the gap between perceived and actual risks of drinking water contamination has potential to improve public health. State regulations and federal guidelines should consider coordinating domestic well sampling with seasonally and spatially fluctuating risks of groundwater contamination. Findings from this study are generalizable, having implications for other parts of the world with water sources that have the potential to get contaminated by nearby surface sources of human and animal waste, such as manure applications and leaching septic systems.

Targeted education and outreach to neighbors of homes with high gross alpha radioactivity in domestic well water

Gross alpha, a measurement of radioactivity in drinking water, is the most frequent laboratory test to exceed primary drinking water standards among wells tested under the New Jersey Private Well Testing Act (NJ PWTA). Certain geological factors prevalent in New Jersey (NJ) are primarily responsible for the presence of radioactivity in private well drinking water and thus, many of the estimated one million private well users in NJ may be at-risk of water contamination from naturally occurring radionuclides. Neighbor-based private well outreach methodology was utilized to identify high risk wells in both northern and southern NJ regions and offer free private well testing for radionuclides. Previously tested wells with gross alpha exceeding or equal to 3.7 becquerels per liter (Bq L^-1; 100 pCi/L) were selected (n = 49) to identify neighbors (n = 406) within 152.4 m (500 feet). Invitation letters were mailed to selected neighbors and some of the previously tested high wells (n = 12) offering free water sampling for the following parameters: gross alpha (48-hour rapid test), combined radium-226 and radium-228 (Ra-226 + Ra-228), uranium-238 (U-238), radon-222 (Rn-222) and iron. Overall, 70 neighbors and 5 high PWTA wells participated in this free water testing opportunity. For neighboring wells, gross alpha results revealed 47 (67.1%) wells exceeding the gross alpha MCL of 0.555 Bq L^-1 (15 pCi/L) mainly due to radium activity in the raw/untreated water. Of those with water treatment (n = 62), 12 (19.4%) treated water samples exceeded the gross alpha MCL. Targeting neighbors of known highly radioactive wells for private well testing is an effective public health outreach method and can also provide useful insight of regional contaminant variations.

Characterization of Shiga toxin-producing Escherichia coli presence, serogroups and risk factors from private groundwater sources in western Ireland

Over recent years, Ireland has reported the highest crude incidence rates of Shiga toxin-producing Escherichia coli (STEC) enteritis in Europe. Unregulated private groundwater sources have emerged as an important potential transmission route for STEC, with up to 750,000 Irish residents reliant on these sources for domestic waters. This study aimed to investigate the prevalence and serogroup profile of STEC contamination from domestic private wells in western Ireland. Fifty-two groundwater sources were analysed during two sampling campaigns in the autumn (September/October) of 2019 (n = 21) and 2021 (n = 31). Untreated groundwater samples (30 L) were collected and analysed using the "CapE" (capture, amplify, extract) method. Extracted DNA was tested using multiplex real-time PCR for Shiga toxin stx1 and/or stx2 and eae genes. STEC positive DNA samples were tested for clinically relevant serogroups by real-time PCR. Data relating to 27 potential groundwater contamination risk factors were geospatially linked to each well and assessed for association with E. coli, stx1 and/or stx2 and eae presence/absence. Overall, 20/52 wells (38.4 %) were positive for E. coli (median concentration 8.5 MPN/100 mL as assessed by Colilert-18 method). Stx1 and/or stx2 was detected in 10/52 (19.2 %) wells overall and 8/20 E. coli positive wells, equating to a STEC to "generic" E. coli detection ratio of 40 %. Six of these wells (30 %) were also positive for eae. One or more serogroup-specific gene targets were identified in all but one stx1 and/or stx2 positive sample, with O145 (n = 6), O157 (n = 5) and O103 (n = 4) most prevalent. STEC presence was significantly associated with decreasing well depth (U = -2.243; p = 0.024) and increasing 30-day mean antecedent rainfall (U = 2.126; p = 0.034). Serogroup O104 was associated with increased sheep density (U = 2.089; p = 0.044) and detection of stx1 and/or stx2 + eae with increased septic tank density (U = 2.246 p = 0.023). Findings indicate high detection rates of clinically relevant STEC in E. coli contaminated groundwater sources in Ireland.

Generation of the Chemical and Social Stressors Integration Technique (CASS-IT) to identify areas of holistic public health concern: An application to North Carolina

Due to structural racism and income inequality, exposure to environmental chemicals is tightly linked to socioeconomic factors. In addition, exposure to psychosocial stressors, such as racial discrimination, as well as having limited resources, can increase susceptibility to environmentally induced disease. Yet, studies are often conducted separately in fields of social science and environmental science, reducing the potential for holistic risk estimates. To tackle this gap, we developed the Chemical and Social Stressors Integration Technique (CASS-IT) to integrate environmental chemical and social stressor datasets. The CASS-IT provides a framework to identify distinct geographic areas based on combinations of environmental chemical exposure, social vulnerability, and access to resources. It incorporates two data dimension reduction tools: k-means clustering and latent profile analysis. Here, the CASS-IT was applied to North Carolina (NC) as a case study. Environmental chemical data included toxic metals - arsenic, manganese, and lead - in private drinking well water. Social stressor data were captured by the CDC's social vulnerability index's four domains: socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. Data on resources were derived from Federal Emergency Management Agency (FEMA's) Resilience and Analysis Planning Tool, which generated measures of health resources, social resources, and information resources. The results highlighted 31 NC counties where exposure to both toxic metals and social stressors are elevated, and health resources are minimal; these are counties in which environmental justice is of utmost concern. A census-tract level analysis was also conducted to demonstrate the utility of CASS-IT at different geographical scales. The tract-level analysis highlighted specific tracts within counties of concern that are particularly high priority. In future research, the CASS-IT can be used to analyze United States-wide environmental datasets providing guidance for targeted public health interventions and reducing environmental disparities.

Evaluation of a water arsenic filter in a participatory intervention to reduce arsenic exposure in American Indian communities: The Strong Heart Water Study

Many rural populations, including American Indian communities, that use private wells from groundwater for their source of drinking and cooking water are disproportionately exposed to elevated levels of arsenic. However, programs aimed at reducing arsenic in American Indian communities are limited. The Strong Heart Water Study (SHWS) is a randomized controlled trial aimed at reducing arsenic exposure among private well users in American Indian Northern Great Plains communities. The community-led SHWS program installed point-of-use (POU) arsenic filters in the kitchen sink of households, and health promoters delivered arsenic health communication programs. In this study we evaluated the efficacy of these POU arsenic filters in removing arsenic during the two-year installation period. Participants were randomized into two arms. In the first arm households received a POU arsenic filter, and 3 calls promoting filter use (SHWS mobile health (mHealth) & filter arm). The second arm received the same filter and phone calls, and 3 in-person home visits and 3 Facebook messages (SHWS intensive arm) for program delivery. Temporal variability in water arsenic concentrations from the main kitchen faucet was also evaluated. A total of 283 water samples were collected from 50 households with private wells from groundwater (139 filter and 144 kitchen faucet samples). Ninety-three percent of households followed after baseline had filter faucet water arsenic concentrations below the arsenic maximum contaminant level of 10 μg/L at the final visit during our 2 year study period with no difference between study arms (98 % in the intensive arm vs. 94 % in the mHealth & filter arm). No significant temporal variation in kitchen arsenic concentration was observed over the study period (intraclass correlation coefficient = 0.99). This study demonstrates that POU arsenic filters installed for the community participatory SHWS program were effective in reducing water arsenic concentration in study households in both arms, even with delivery of the POU arsenic filter and mHealth program only. Furthermore, we observed limited temporal variability of water arsenic concentrations from kitchen faucet samples collected over time from private wells in our study setting.

The antimicrobial resistance profiles of Escherichia coli and Pseudomonas aeruginosa isolated from private groundwater wells in the Republic of Ireland

The role of the natural environment in the dissemination of antimicrobial resistant bacteria has been increasingly recognised in the literature. However, knowledge surrounding the critical factors and mechanisms mediating their occurrence is still limited, particularly in relatively 'pristine' groundwater environments. In the Republic of Ireland (RoI), a country characterised by high groundwater reliance, household-based (unregulated) wells provide drinking water to 11% of the population. These private wells are generally located in rural areas, where the risk of microbiological contamination is high due to intensive agricultural practices and high reliance on domestic wastewater treatment systems; both of which are also potential sources of antimicrobials and antimicrobial resistant bacteria. Accordingly, the current research sought to elucidate current rates of antimicrobial resistant bacteria and the principal factors associated with their presence in private wells in the RoI. A total of 250 samples (from 132 wells nationwide) were assessed for the presence of faecal (Escherichia coli) and environmental (Pseudomonas aeruginosa) bacteria, with single isolates from each contaminated sample tested phenotypically against 18 and 9 antimicrobials, respectively. Findings show that while 16.7% of E. coli (n = 8/48) were categorically resistant to ≥1 antimicrobial, with a further 79.2% classified as intermediately resistant, no categorical resistance was found among P. aeruginosa isolates (n = 0/6), with just one intermediately resistant isolate detected. Multivariate regression modelling indicates significantly higher odds of resistant E. coli detection in concurrence with elevated cattle density (OR = 1.028, p = 0.032), aligning with findings of highest resistance rates to veterinary antimicrobials (e.g., streptomycin = 14.6%, tetracycline = 12.5%, and ampicillin = 12.5%). Multivariate model results also suggest overland flow culminating in direct wellhead ingress as a primary ingress mechanism for resistant E. coli. Study findings may inform groundwater source protection initiatives and antimicrobial resistance surveillance moving forward.

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

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

Arsenic in private well water and birth outcomes in the United States

BACKGROUND

Prenatal exposure to drinking water with arsenic concentrations >50 μg/L is associated with adverse birth outcomes, with inconclusive evidence for concentrations ≤50 μg/L. In a collaborative effort by public health experts, hydrologists, and geologists, we used published machine learning model estimates to characterize arsenic concentrations in private wells-federally unregulated for drinking water contaminants-and evaluated associations with birth outcomes throughout the conterminous U.S.

METHODS

Using several machine learning models, including boosted regression trees (BRT) and random forest classification (RFC), developed from measured groundwater arsenic concentrations of ∼20,000 private wells, we characterized the probability that arsenic concentrations occurred within specific ranges in groundwater. Probabilistic model estimates and private well usage data were linked by county to all live birth certificates from 2016 (n = 3.6 million). We evaluated associations with gestational age and term birth weight using mixed-effects models, adjusted for potential confounders and incorporated random intercepts for spatial clustering.

RESULTS

We generally observed inverse associations with term birth weight. For instance, when using BRT estimates, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 5 μg/L was associated with a -1.83 g (95% CI: -3.30, -0.38) lower term birth weight after adjusting for covariates. Similarly, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 10 μg/L was associated with a -2.79 g (95% CI: -4.99, -0.58) lower term birth weight. Associations with gestational age were null.

CONCLUSION

In this largest epidemiologic study of arsenic and birth outcomes to date, we did not observe associations of modeled arsenic estimates in private wells with gestational age and found modest inverse associations with term birth weight. Study limitations may have obscured true associations, including measurement error stemming from a lack of individual-level information on primary water sources, water arsenic concentrations, and water consumption patterns.

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

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

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

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

Are carbon water filters safe for private wells? Evaluating the occurrence of microbial indicator organisms in private well water treated by point-of-use activated carbon block filters

Point-of-use (POU) water treatment is highly relevant to private well users vulnerable to chemical contamination, but uncertainty remains around the effects of activated carbon based POU devices on the microbial quality of the treated water. In this study, under-sink activated carbon block water filters were installed in 17 homes relying on private well water in North Carolina. The influent and effluent water in each home was evaluated for bacterial and viral microbial indicator organisms monthly for five months. Multiple logistic regression was used to identify water quality and water usage variables that were significant predictors of each indicator organism occurring in the filter effluent. The odds of total coliforms occurring in the effluent decreased by 84% with each 1-log₁₀ increase in the influent HPC (p < 0.05), suggesting a protective effect by native heterotrophic bacteria, but increased by over 50 times with low cumulative water use (p < 0.05). The filters were not protective against coliphages in the influent and viral shedding may occur after periods of increased virus concentrations in the raw well water. Specific bacteria were also found to increase in the effluent, causing a shift in the bacterial community composition, although potential opportunistic pathogens were detected in both the influent and the effluent. Overall, under normal conditions of use, the filters tested in this study did not represent a significant additional risk for well users beyond the existing exposures from undisinfected well water alone.

The prevalence and levels of enteric viruses in groundwater of private wells in rural Alberta, Canada

The prevalence and levels of enteric viruses in untreated groundwater of private wells used for drinking and/or agricultural practices in rural Alberta were studied using the qPCR panel assay, integrated cell culture with qPCR and cell culture in the volume of 500 liters per sample through serial sampling. Seven viruses were assessed including adenovirus, rotavirus, norovirus, astrovirus, sapovirus, reovirus and JC virus. Five viruses were detected with an overall positive detection rate of 6.33 % (45 of 711 samples). The most frequently detected virus was adenovirus (48.9%, 22/45) followed by rotavirus (44.4%, 20/45), reovirus (20%, 9/45), JC virus (6.7%, 3/45) and norovirus (6.7%, 3/45). There was no significant difference in the positive detection rates, ranging from 1.1% to 3.4% by various well settings used for broiler farms, cow/calf farms, feedlots and rural acreages. Effects of well characteristics (aquifer type, well depth, static level of water, well seal) and well completion lithology on potential viral contamination of groundwater of private wells were also analyzed upon available data. The findings demonstrate that occurrence of enteric viruses is low and viral contamination is sporadic in groundwater of private wells in rural Alberta. Conventional fecal bacterial indicators (coliform and/or E. coli) were not a representative marker for viral contamination in groundwater wells in rural Alberta.

Occurrence of male-specific and somatic coliphages and relationship with rainfall in privately-owned wells from peri‑urban and rural households

Privately-owned drinking water wells serving fewer than 25 people (private wells) are prevalent and understudied across most of the US. Private wells primarily serve rural households located outside of municipal drinking water and sewerage service coverage areas. These wells are not regulated by United States Environmental Protection Agency (EPA) under the Safe Drinking Water Act, are not regularly monitored by any public agency or utility, and generally do not undergo disinfection treatment. Coliphages are a group of viruses that infect coliform bacteria and are useful viral surrogates for fecal contamination in water systems in much the same way that fecal indicator bacteria (FIB), such as E. coli and to a lesser extent total coliforms, are used to quantify fecal contamination. Coliphages are approved by the EPA for regulatory monitoring in groundwater wells in the USA, but are not routinely used for this purpose. The present study characterizes the occurrence of male-specific and somatic coliphages, along with FIB, in private wells (n = 122) across two different counties in North Carolina. While occurrences of E. coli were rare and frequency of total coliform was generally low (~20%), male-specific and somatic coliphages were detectable in 66% and 54% of samples, respectively. Concentrations of male-specific coliphages were higher than somatics at each county and on a monthly basis. Rainfall appears to be partly influencing higher coliphage concentrations in December, January and February. This research underscores the need for increased surveillance in private wells and consideration of using coliphages in order to better characterize occurrence of fecal contamination at the time of sampling, especially during rainier months.

Examining influential drivers of private well users' perceptions in Ontario: A cross-sectional population study

Private well users are responsible for managing and maintaining the quality of their drinking water source. Previous studies in Canada have reported low testing rates among well users, a cornerstone of well stewardship behaviours that can prevent the consumption of contaminated groundwater. To improve well stewardship, it is important to understand the interactions between, and the impacts of, various factors that may influence behaviours. Accordingly, the objective of the current study was to investigate the impact of socio-demographics, property characteristics, and experiences with well construction and acute gastrointestinal illness (AGI) (i.e., previous experiences) on levels of awareness, attitudes, risk perceptions, and beliefs (i.e., risk domains) among private well users in Ontario. A link to a province-wide online survey was circulated between May and August 2018 and novel "risk domain" scoring protocols were developed to classify and summarize response data. The survey was undertaken by 1228 respondents, of which 1030 completed the survey in full. Results indicate a low level of waterborne pathogen awareness, with 50.8% of respondents unaware of any groundwater associated pathogens. Respondents' geographic location, gender, and well type were significantly associated with well users' attitudes and perceptions of risk regarding their personal well water supply and the quality and quantity of local groundwater sources. Higher levels of awareness and lower risk perception scores (i.e., lower perceptions of risk) were associated with residential presence during well construction (p < 0.001 and p = 0.017, respectively). Previous case(s) of AGI within the respondent's household were significantly associated with negative attitudes towards their well water (p < 0.001) and higher risk perception scores (p = 0.025) with respect to the quantity of local groundwater sources. Results may be used to identify critical experiential control points (e.g., during well construction or after a physician confirmed AGI diagnosis) and develop improved risk management and communication strategies aimed at private well users.

Predicting coliform presence in private wells as a function of well characteristics, parcel size and leachfield soil rating

Public water systems must be tested frequently for coliform bacteria to determine whether other pathogens may be present, yet no testing or disinfection is required for private wells. In this paper, we identify whether well age, type of well, well depth, parcel size, and soil ratings for a leachfield can predict the probability of detecting coliform bacteria in private wells using a multivariate logistic regression model. Samples from 1163 wells were analyzed for the presence of coliform bacteria between October 2017 and October 2019 across Gaston County, North Carolina, USA. The maximum well age was 30 years, and bored wells (median age = 24 years) were older than drilled wells (median age = 19 years). Bored wells were shallower (mean depth = 18 m) compared to drilled wells (mean depth = 79 m). We found coliform bacteria in 329 samples, including 290 of 1091 drilled wells and 39 of 72 bored wells. The model results showed bored wells were 4.76 times more likely to contain bacteria compared to drilled wells. We found that the likelihood of coliform bacteria significantly increased with well age, suggesting that those constructed before well standards were enforced in 1989 may be at a higher risk. We found no significant association between poorly rated soils for a leachfield, well depth, parcel size and the likelihood of having coliform in wells. These findings can be leveraged to determine areas of concern to encourage well users to take action to reduce their risk of drinking possible pathogens in well water.

Private Wells and Rural Health: Groundwater Contaminants of Emerging Concern

PURPOSE OF REVIEW

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

RECENT FINDINGS

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

An assessment of contamination fingerprinting techniques for determining the impact of domestic wastewater treatment systems on private well supplies

Private wells in Ireland and elsewhere have been shown to be prone to microbial contamination with the main suspected sources being practices associated with agriculture and domestic wastewater treatment systems (DWWTS). While the microbial quality of private well water is commonly assessed using faecal indicator bacteria, such as Escherichia coli, such organisms are not usually source-specific, and hence cannot definitively conclude the exact origin of the contamination. This research assessed a range of different chemical contamination fingerprinting techniques (ionic ratios, artificial sweeteners, caffeine, fluorescent whitening compounds, faecal sterol profiles and pharmaceuticals) as to their use to apportion contamination of private wells between human wastewater and animal husbandry wastes in rural areas of Ireland. A one-off sampling and analysis campaign of 212 private wells found that 15% were contaminated with E. coli. More extensive monitoring of 24 selected wells found 58% to be contaminated with E. coli on at least one occasion over a 14-month period. The application of fingerprinting techniques to these monitored wells found that the use of chloride/bromide and potassium/sodium ratios is a useful low-cost fingerprinting technique capable of identifying impacts from human wastewater and organic agricultural contamination, respectively. The artificial sweetener acesulfame was detected on several occasions in a number of monitored wells, indicating its conservative nature and potential use as a fingerprinting technique for human wastewater. However, neither fluorescent whitening compounds nor caffeine were detected in any wells, and faecal sterol profiles proved inconclusive, suggesting limited suitability for the conditions investigated.

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

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

Private well water testing promotion in pediatric preventive care: A randomized intervention study

Over 43 million U.S. residents rely on private unregulated wells for their drinking water, raising public health concerns, particularly in regions like northern New England where widespread groundwater arsenic contamination is now recognized. Children are particularly vulnerable to adverse health effects from arsenic exposure. Despite AAP Guidelines, approaches to engage pediatric clinicians in promoting private well testing have not been previously described. We sought to determine the most effective practice approaches to achieve successful well water testing in routine pediatric care. 12 primary care clinics were block randomized to one of four study arms. Two intervention variables were assessed: (1) test results access (parent only vs. parent and clinic) and (2) follow up approaches (yes/no). Parents of children under 12 months using a private well were eligible. Prepaid water tests were provided. Primary outcome was parental water test completion. Eleven clinics successfully implemented processes identifying well users. 240 testing kits were dispensed. Completion rates averaged 29% (range 10 to 61%). The study arm with both clinic results access and staff follow up system was 2.3 times more likely to achieve test completion than other arms (95% CI 1.12-4.86, p = .03). Kit distribution by clinicians versus nursing staff, irrespective of study arm, had 2.4 times greater completion (95% CI 1.13-5.11, p = .02). Systematic drinking water source screening can be improved in pediatric care. Higher testing completion was found in practices randomized to reminders and structured follow up versus single visit discussion, but clinician involvement was the most predictive factor.

Health and economic impact of nitrate pollution in drinking water: a Wisconsin case study

Nitrate contamination of drinking water, common in agricultural areas, increases the risk of certain cancers and impacts fetal development during pregnancy. Building on previously published methodology, this study evaluates nitrate-attributable disease cases and adverse birth outcomes as well as their economic costs for Wisconsin, USA. Nitrate is the most common contaminant in groundwater in Wisconsin. Two-thirds of the state's residents use groundwater as the primary source of drinking water. Here, we analyze nitrate exposure from drinking water in Wisconsin based on nitrate test results for community water systems for the period of 2010-2017 and a novel methodology for estimating nitrate exposure for the 28% of state's residents who use private wells. We estimate that annually, 111-298 combined cases of colorectal, ovarian, thyroid, bladder, and kidney cancer in Wisconsin may be due to nitrate contamination of drinking water. Each year, up to 137-149 cases of very low birth weight, 72-79 cases of very preterm birth, and two cases of neural tube defects could be due to nitrate exposure from drinking water. The direct medical cost estimates for all nitrate-attributable adverse health outcomes range between $23 and $80 million annually. Simulating targeted reductions in the counties with the highest current drinking water nitrate concentrations resulted in similar reductions in adverse health outcomes as statewide reduction efforts, up to nitrate reductions of 20%. Time trend analysis suggests that groundwater nitrate concentrations are overall increasing. Thus, nitrate contamination of water supplies in Wisconsin is a public health problem that needs to be addressed.

Association between private drinking water wells and the incidence of Campylobacteriosis in Maryland: An ecological analysis using Foodborne Diseases Active Surveillance Network (FoodNet) data (2007-2016)

Campylobacter is a leading cause of bacterial foodborne illness in the United States. Campylobacter infections have most often been associated with food-related risk factors, such as the consumption of poultry and raw milk. Socioeconomic, agricultural and environmental factors, including drinking water source, can also influence the risk of campylobacteriosis. Approximately 19% of Maryland residents rely on private wells as their sole source of water. Given that the federal Safe Drinking Water Act does not regulate the water quality of private wells, these could be important non-foodborne transmission pathways for Campylobacter. To address this issue, data on the number of culture-confirmed cases of Campylobacter infection in Maryland between 2007 and 2016 were obtained from the Foodborne Diseases Active Surveillance Network. Cases were linked by zip code with data from the Maryland well permits registry, the 2010 U.S. Census, the 2016 American Community Survey, and the USDA Agricultural Census. Campylobacteriosis incidence rates and well prevalence were calculated by zip code. Negative binomial regression models were then constructed to evaluate the association between the prevalence of private wells, presence/absence of animal feeding operations and the incidence of campylobacteriosis across the physiographic provinces in Maryland. From 2007 to 2016, a total of 5746 cases of campylobacteriosis were reported in Maryland, and annual incidence rates ranged from 6.65 to 11.59 per 100,000 people. In our statewide analysis, a significant positive association was observed between well prevalence and increased campylobacteriosis incidence at the zip code level (Incidence Rate Ratio (IRR) = 1.35, 95% Confidence Interval (CI) = 1.11, 1.63). A significant positive association was also observed between well prevalence and increased campylobacteriosis incidence in the Appalachian and Coastal provinces of Maryland (IRR = 2.94, 95% CI = 1.11, 7.76 and IRR = 1.70, 95% CI = 1.25, 2.31, respectively). The presence of broiler chicken operations, increasing median age and percentage of residents living in poverty were also significantly associated with campylobacteriosis incidence at the zip code level in some physiographic provinces in Maryland. To our knowledge, these are the first US data to demonstrate an association between prevalence of private wells and campylobacteriosis incidence at the zip code level.

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

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

Private well stewardship within a rural, agricultural Latino community: a qualitative study

BACKGROUND

Nitrate contamination in groundwater disproportionately impacts agricultural Latino communities, creating a significant hazard for Latinos that rely on private wells. Private well users must conduct water testing and other well stewardship behaviors to ensure that their well water is safe to drink. This study sought to identify the key factors impacting private well water testing behavior in rural, agricultural Latino communities.

METHODS

We conducted 4 focus groups with private well users, 2 in Spanish and 2 in English. We recruited 37 participants from the Lower Yakima Valley, Washington State, a rural, agricultural community with a large Latino population and elevated nitrate concentrations in groundwater. A semi-structured interview guide was developed to capture factors impacting testing as guided by the Risk, Attitudes, Norms, Ability, and Self-Regulation (RANAS) model. Inductive thematic analysis was conducted by two coders to identify common themes.

RESULTS

Themes emerged around the factors impacting well stewardship, including well water testing, treatment, and maintenance, and were not specific to nitrate contamination. Private well users reported many of the same factors reported in other communities, with the exception of home repair experience and challenges around landlords and neighbors on shared wells, which have not been reported previously. In addition to landlords and neighbors, lack of actionable information, economic limitations, and lack of technical support emerged as factors that made well stewardship burdensome for individuals. The majority of participants reported using bottled water, including many who used point-of-use or point-of-entry water treatment systems.

CONCLUSIONS

The burden of well stewardship in rural, agricultural Latino communities may suggest the need for interventions at the community, county, or state levels and not at the individual level alone. Additionally, the role of landlords, neighbors on shared wells, and home repair experience in well stewardship represent important areas of exploration for researchers and public health practitioners.

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

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

The Strong Heart Water Study: Informing and designing a multi-level intervention to reduce arsenic exposure among private well users in Great Plains Indian Nations

Elevated arsenic exposure from drinking water is associated with an increased risk of cardiovascular disease, diabetes, kidney disease, and skin, lung, and bladder cancer. Arsenic contamination in groundwater supplies disproportionately affects rural populations using private wells. Arsenic mitigation programs for American Indian communities are limited. There is an urgent need for targeted approaches to reduce arsenic exposure for at-risk communities using private wells. Formative research was conducted to inform and design a community-based arsenic mitigation intervention for Lakota and Dakota Nations in the Great Plains Area of the United States, where, in some communities, one-quarter of private wells are estimated to have elevated arsenic. Formative research included semi-structured interviews, a community workshop, intervention-planning workshops, and a pilot study of the developed intervention. Community members prioritize aesthetic qualities of water (e.g. taste, color), safety, and other situational factors (e.g. cost) when considering their drinking and cooking water. Although water safety is a concern, awareness and concern for arsenic vary substantially within communities. To reduce arsenic exposure, community members recommended communication of water test results, home visits for intervention delivery, and reminders to use arsenic-safe water. Findings informed the development of an intervention to prevent arsenic exposure through drinking water and cooking, including health promotion messages and household items to facilitate use of an arsenic removal device (e.g. tankards to store filtered water). The pilot study indicated promising acceptability and operability of the developed intervention. This research provides a model for the development of environmental health interventions in partnership with American Indian and other private well-using communities.

Mobility and speciation of geogenic arsenic in bedrock groundwater from the Canadian Shield in western Quebec, Canada

High arsenic concentrations occur in groundwater collected from a fractured crystalline bedrock aquifer in western Quebec (Canada). Sampling and analysis of water from 59 private wells reveal that more than half of the bedrock wells exceed the Canadian guideline value of 10μg/l for arsenic, whereas shallow wells in unconsolidated surficial deposits are not affected by the contamination. The weathering of arsenic-bearing sulfides present along the mineralized fault zone is considered to be the primary source of arsenic in groundwater. High-arsenic wells are generally characterized by mildly reducing conditions (Eh<250mV), weak alkaline conditions (pH>7.4), low Ca/Na ratios, elevated dissolved Fe and Mn concentrations and high proportions of As(III). Private bedrock wells are open boreholes that likely receive groundwater from multiple contributing fractures. Hence, it is proposed that dissolved arsenic is mainly derived from the contribution to the well discharge of reducing and alkaline geochemically evolved groundwater that contains arsenic as As(III). Geochemically evolved groundwater provides favorable conditions to release arsenic by reductive dissolution of iron and manganese oxyhydroxides and alkaline desorption from mineral surfaces. Thus, high-arsenic wells would contain a high proportion of geochemically evolved groundwater, while oxidizing low-pH recharge water causes dilution and sequestration of arsenic. In relation with the chemical evolution of groundwater along the flow path, most contaminated wells are located in confined areas whereas most of the wells located in unconfined recharge areas are not contaminated. The occurrence of boreholes with high dissolved arsenic as As(V) and oxidizing conditions is attributed to extensive sulfide oxidation and alkaline desorption. This work shows that the determination of arsenic speciation provides a valuable tool to investigate the behavior of arsenic in bedrock groundwater.

Assessing the relationship between groundwater nitrate and animal feeding operations in Iowa (USA)

Nitrate-nitrogen is a common contaminant of drinking water in many agricultural areas of the United States of America (USA). Ingested nitrate from contaminated drinking water has been linked to an increased risk of several cancers, specific birth defects, and other diseases. In this research, we assessed the relationship between animal feeding operations (AFOs) and groundwater nitrate in private wells in Iowa. We characterized AFOs by swine and total animal units and type (open, confined, or mixed), and we evaluated the number and spatial intensities of AFOs in proximity to private wells. The types of AFO indicate the extent to which a facility is enclosed by a roof. Using linear regression models, we found significant positive associations between the total number of AFOs within 2km of a well (p trend <0.001), number of open AFOs within 5km of a well (p trend <0.001), and number of mixed AFOs within 30km of a well (p trend <0.001) and the log nitrate concentration. Additionally, we found significant increases in log nitrate in the top quartiles for AFO spatial intensity, open AFO spatial intensity, and mixed AFO spatial intensity compared to the bottom quartile (0.171log(mg/L), 0.319log(mg/L), and 0.541log(mg/L), respectively; all p<0.001). We also explored the spatial distribution of nitrate-nitrogen in drinking wells and found significant spatial clustering of high-nitrate wells (>5mg/L) compared with low-nitrate (≤5mg/L) wells (p=0.001). A generalized additive model for high-nitrate status identified statistically significant areas of risk for high levels of nitrate. Adjustment for some AFO predictor variables explained a portion of the elevated nitrate risk. These results support a relationship between animal feeding operations and groundwater nitrate concentrations and differences in nitrate loss from confined AFOs vs. open or mixed types.

Meeting the public health challenge of protecting private wells: Proceedings and recommendations from an expert panel workshop

Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on "Future and Emerging Issues for Private Wells" was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs.

Septic systems as sources of organic wastewater compounds in domestic drinking water wells in a shallow sand and gravel aquifer

Domestic drinking water wells serve 44 million people in the US and are common globally. They are often located in areas served by onsite wastewater treatment systems, including septic systems, which can be sources of biological and chemical pollutants to groundwater. In this study we tested 20 domestic drinking water wells in a sand and gravel aquifer on Cape Cod, Massachusetts, USA, for 117 organic wastewater compounds (OWCs) and for inorganic markers of septic system impact. We detected 27 OWCs, including 12 pharmaceuticals, five per- and polyfluoroalkyl substances (PFASs), four organophosphate flame retardants, and an artificial sweetener (acesulfame). Maximum concentrations of several PFASs and pharmaceuticals were relatively high compared to public drinking water supplies in the US. The number of detected OWCs and total concentrations of pharmaceuticals and of PFASs were positively correlated with nitrate, boron, and acesulfame and negatively correlated with well depth. These wells were all located in areas served exclusively by onsite wastewater treatment systems, which are likely the main source of the OWCs in these wells, although landfill leachate may also be a source. Our results suggest that current regulations to protect domestic wells from pathogens in septic system discharges do not prevent OWCs from reaching domestic wells, and that nitrate, a commonly measured drinking water contaminant, is a useful screening tool for OWCs in domestic wells. Nitrate concentrations of 1mg/L NO3-N, which are tenfold higher than local background and tenfold lower than the US federal drinking water standard, were associated with wastewater impacts from OWCs in this study.

Understanding the translation of scientific knowledge about arsenic risk exposure among private well water users in Nova Scotia

Arsenic is a class I human carcinogen that has been identified as the second most important global health concern in groundwater supplies after contamination by pathogenic organisms. Hydrogeological assessments have shown naturally occurring arsenic to be widespread in groundwater across the northeastern United States and eastern Canada. Knowledge of arsenic risk exposure among private well users in these arsenic endemic areas has not yet been fully explored but research on water quality perceptions indicates a consistent misalignment between public and scientific assessments of environmental risk. This paper evaluates knowledge of arsenic risk exposure among a demographic cross-section of well users residing in 5 areas of Nova Scotia assessed to be at variable risk (high-low) of arsenic occurrence in groundwater based on water sample analysis. An integrated knowledge-to-action (KTA) methodological approach is utilized to comprehensively assess the personal, social and local factors shaping perception of well water contaminant risks and the translation of knowledge into routine water testing behaviors. Analysis of well user survey data (n=420) reveals a high level of confidence in well water quality that is unrelated to the relative risk of arsenic exposure or homeowner adherence to government testing recommendations. Further analysis from the survey and in-depth well user interviews (n=32) finds that well users' assessments of risk are influenced by personal experience, local knowledge, social networks and convenience of infrastructure rather than by formal information channels, which are largely failing to reach their target audiences. Insights from interviews with stakeholders representing government health and environment agencies (n=15) are used to reflect on the institutional barriers that mediate the translation of scientific knowledge into public awareness and stewardship behaviors. The utilization of local knowledge brokers, community-based networks and regulatory incentives to improve risk knowledge and support routine testing among private well users is discussed.