grant 1743587. I give many thanks to my committee (Drs. Steve Nelson, Barry Bickmore, Zach Aanderud, and Norm Jones), who made large contributions to the statistical methods, sampling strategies, groundwater model design, and critiques. Dr. Randy Larsen deserves credit for helping to create scientifically sound, logistic models. Josephine Hoh and Richard Pezzulo were a great help in granting access and providing escorted sampling trips in Waimea Valley. Kevin Rey and Kaleb Markert assisted through field and lab support. Dave Tingey must be acknowledged for his intellectual support in preparing samples for analysis and instruction. My best friend and wife, Kaylee, has been a great support and encouragement through both the hard and comfortable aspects of this thesis, for which, I am very grateful.

Although uncommon, nontuberculous mycobacterial (NTM) pulmonary infection in the Hawaiian Islands has a relatively high incidence and mortality compared to the mainland U.S. As a result, this study examines the possible geological and hydrological pathways by which NTM patients may become infected, including the environmental conditions that may favor growth and transport. Previously suggested infection routes include the inhalation of NTM attached to micro-droplets from infected home plumbing systems and aerosolized dust from garden soil. In this study we evaluate the possible routes NTM may take from riparian environments, into groundwater, into public water supplies and then into homes. Because NTM are notoriously hydrophobic and prone to attach to surfaces, mineralogy and surface chemistry of suspended sediment in streams, soils, and rock scrapings suggest that NTM may especially attach to Fe-oxides/hydroxides, and be transported as particles from losing streams to the aquifer on timescales of minutes to days. Within the aquifer, flow models indicate that water may be drawn into production wells on time scales (months) that permit NTM to survive and enter domestic water supplies. These processes depend on the presence of interconnected fracture networks with sufficient aperture to preclude complete autofiltration. The common occurrence of NTM in and around streams, in addition to wells, implies that the natural and built environments are capable of introducing a source of NTM into domestic water supplies via groundwater withdrawals. This may produce a persistent source of NTM infection to individuals through the presence of NTM-laden biofilms in home plumbing.

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