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

Mapili, Kris; Rhoads, William J.; Coughter, Mary; Pieper, Kelsey J.; Edwards, Marc; Pruden, Amy

doi:10.1016/j.scitotenv.2022.153901

Cited by 17 publications

(13 citation statements)

References 37 publications

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“…Some research suggests that when pathogens are present in well water, the home plumbing environment may encourage additional microbial growth, resulting in increased pathogen concentration in the water. 53 This could well be a possible explanation for gastric discomfort in well water users. Other possible cause may be presence of latrine in the house.…”

Section: Discussionmentioning

confidence: 99%

Human Health Risk Assessment due to Heavy Metals in Ground and Surface Water and Association of Diseases With Drinking Water Sources: A Study From Maharashtra, India

Mawari

Kumar

Sarkar

et al. 2022

Environ�Health�Insights

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Background: Contamination of freshwater sources can be caused by both anthropogenic and natural processes. According to Central Pollution Control Board, Maharashtra along with 2 other states, contribute 80% of hazardous waste generated in India, including heavy metal pollution. Hence, it is important to quantify heavy metal concentrations in drinking water sources in such areas. Materials and methods: Water samples were analyzed for toxic elements (F, As, Cd, Hg, Pb, Ni, Cu, Zn, Mn, and Cr) using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) Agilent 7500. Health risks due to ingestion and dermal contact was assessed. A total of 557 people were randomly selected, with consumers from all 4 types of water sources that is surface water, hand pump, wells, and municipal water. Spot urine samples were collected from 47 people after considering inclusion and exclusion criteria. Urine was collected for estimating mercury and arsenic levels in the study participants. Results: Arsenic contributes the most health risk from ingestion from water. Among surface water users, 14 people (32%) reported frequent loose stool ( P-value < .05) (OR 2.5), and 11 people (23%) reported frequent abdominal pain (OR 1.9). Hand pump and well water users reported frequent abdominal pain (27%) (OR 1.4) and gastric discomfort (31%) ( P-value < .05) (OR 3) respectively. The mean value of urinary Hg and As were 4.91 ± 0.280 and 42.04 ± 2.635 µg/L respectively. Conclusion: Frequent loose stool, gastric discomfort, and frequent abdominal pain were associated with the various sources of drinking water. Urine Hg levels were found higher than the NHANES (USA) Survey. It is recommended that frequent monitoring of drinking water should be enforced around the industrial hub, so that appropriate actions can be taken if present in excess.

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Section: Discussionmentioning

confidence: 99%

Human Health Risk Assessment due to Heavy Metals in Ground and Surface Water and Association of Diseases With Drinking Water Sources: A Study From Maharashtra, India

Mawari

Kumar

Sarkar

et al. 2022

Environ�Health�Insights

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“…In rural areas similar to the one reported on here, well water can be susceptible to fecal contamination from humans and animals via failing septic systems, runoff, and flooding. There is also some evidence that when pathogens are present in well water the home plumbing environment may contribute to further microbial growth, and, in turn, to higher pathogen concentrations in tap water samples [ 46 , 47 ]. Our finding that one third (33.3%, n = 3) of study households had enteric pathogens detected in their well water is concerning with regard to drinking-water-associated enteric disease exposure risk in this community.…”

Section: Discussionmentioning

confidence: 99%

Bottled and Well Water Quality in a Small Central Appalachian Community: Household-Level Analysis of Enteric Pathogens, Inorganic Chemicals, and Health Outcomes in Rural Southwest Virginia

Cohen

Rasheduzzaman

Darling

et al. 2022

IJERPH

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Consumption of unsafe drinking water is associated with a substantial burden of disease globally. In the US, ~1.8 million people in rural areas lack reliable access to safe drinking water. Our objective was to characterize and assess household-level water sources, water quality, and associated health outcomes in Central Appalachia. We collected survey data and water samples (tap, source, and bottled water) from consenting households in a small rural community without utility-supplied water in southwest Virginia. Water samples were analyzed for physicochemical parameters, total coliforms, E. coli, nitrate, sulfate, metals (e.g., arsenic, cadmium, lead), and 30+ enteric pathogens. Among the 69% (n = 9) of households that participated, all had piped well water, though 67% (n = 6) used bottled water as their primary drinking water source. Total coliforms were detected in water samples from 44.4% (n = 4) of homes, E. coli in one home, and enteric pathogens (Aeromonas, Campylobacter, Enterobacter) in 33% (n = 3) of homes. Tap water samples from 11% (n = 1) of homes exceeded the EPA MCL for nitrate, and 33% (n = 3) exceeded the EPA SMCL for iron. Among the 19 individuals residing in study households, reported diarrhea was 25% more likely in homes with measured E. coli and/or specific pathogens (risk ratio = 1.25, cluster-robust standard error = 1.64, p = 0.865). Although our sample size was small, our findings suggest that a considerable number of lower-income residents without utility-supplied water in rural areas of southwest Virginia may be exposed to microbiological and/or chemical contaminants in their water, and many, if not most, rely on bottled water as their primary source of drinking water.

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“…Flooding events driven by increased rainfall have also been found to be associated with elevated legionellosis cases, which may be due to exposures to OP contaminated mud or aerosolized dust during clean up and remediation (European Center for Disease Prevention and Control (ECDC), 2021; Mitsui et al, 2021;Oda et al, 2019). Flooding can increase turbidity and nutrient content and decrease oxygen in receiving waters, which could increase NTM in surface waters and shallow groundwater, and generally enhance growing conditions for OPs while making water more difficult to treat (Blanc et al, 2021;Mapili et al, 2022;Zhang & Lu, 2021).…”

Section: Precipitation and Storm Eventsmentioning

confidence: 99%

Climate change and opportunistic pathogens (OPs) in the built environment

O’Keeffe¹

2022

Environ. Health Rev.

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Table 1: Characteristics of selected opportunistic pathogens (OPs) of concern in Canada.Legionella spp. Description: Gram-negative bacteria, found in natural water systems and soils, have been detected in most large building water systems and some 10%-30% of home water systems in the United States. Legionella bacteria can be present in water storage containers, pipes, or outlets. Optimal growing conditions: Preference for warm water (e.g., 25-45 °C), high water age, low disinfectant residual, and often associated with biofilms or free-living amoeba (FLA). Routes of transmission: Inhalation or accidental aspiration of aerosolized contaminated water droplets into the lungs from faucets, showerhead, water misters, decorative fountains, hot tubs, cooling towers, etc. Outcome of infection: Legionellosis, includes Legionnaires' disease (LD), a severe pneumonia with a fatality rate of about 10%, and Pontiac fever, a milder flu-like illness. L. pneumophila is the cause of most cases of LD. Groups most at risk: Smokers, over-50s, men, immune-compromised persons, and those with conditions like chronic obstructive pulmonary disease, coronary artery disease, dementia, diabetes, kidney disease, and neurological diseases. Pseudomonas spp. Description: Gram-negative bacteria that can form or join biofilms and colonize plumbing. Found in building water system at point of use areas (e.g., faucets, drains, and showerheads) more often than distribution systems, and can colonize humidifiers, respiratory equipment, swimming pools, hot tubs, and water baths. Optimal growing conditions: Tolerate a range of temperatures (4-42 °C), with an optimum around 37 °C, and reduced virulence below 30 °C; optimal pH around 7.2 and tolerate low dissolved oxygen, low nutrient, and stagnant waters. Grow well in poorly disinfected systems, but also resist disinfectants and can survive in FLA. Routes of transmission: Direct ear and skin contact in swimming pools, hot tubs, and whirlpools; inhalation of aerosols dispersed from faucets, showerhead, etc.; indirect transfer from contaminated devices or fomites. More commonly found in plumbing fixtures than in distribution systems. Outcome of infection: Most infections (80%) associated with P. aeruginosa and P. maltophila range from minor eye, skin, and ear conditions (e.g., swimmer's ear), to bacteremia in immune-compromised individuals or other susceptible patients. A major cause of healthcare-acquired pneumonia, wound infections, and urinary tract infections, and a cause of morbidity and mortality for cystic fibrosis patients. Groups most at risk: Children with cystic fibrosis, hospitalized patients at risk of hospital-acquired pneumonia, newborns, burn patients, patients with invasive devices, and those with underlying pulmonary disease. Nontuberculous mycobacterium (NTM) Description: NTM are a group of more than 190 known species of OP found in natural waters and soil, and building water systems. Includes Mycobacterium avium complex, a group of related bacteria that includes both M. avium and M. intrac...

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

Cited by 17 publications

References 37 publications

Human Health Risk Assessment due to Heavy Metals in Ground and Surface Water and Association of Diseases With Drinking Water Sources: A Study From Maharashtra, India

Human Health Risk Assessment due to Heavy Metals in Ground and Surface Water and Association of Diseases With Drinking Water Sources: A Study From Maharashtra, India

Bottled and Well Water Quality in a Small Central Appalachian Community: Household-Level Analysis of Enteric Pathogens, Inorganic Chemicals, and Health Outcomes in Rural Southwest Virginia

Climate change and opportunistic pathogens (OPs) in the built environment

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