The U.S. Environmental Protection Agency (EPA) recently released its Ground Water Rule Source Water Monitoring Guidance Manual which summarizes EPA's Final Ground Water Rule and details the regular inspections that some drinking water facilities must undertake to help ensure water is free from pathogenic viruses and bacteria. Issued in October 2006, the rule impacts an estimated 147,000 drinking water utilities - serving about 100 million people - that use groundwater and are at high risk for contamination by fecal matter.

Ingestion of untreated pathogenic viruses and bacteria can cause gastroenteritis or serious illnesses such as hemolytic uremic syndrome, meningitis, hepatitis or myocarditis, which in children, the elderly or those with compromised immune systems, can lead to death. The manual describes the eight components of a water system that must be comprehensively and regularly monitored to protect against pathogenic viruses and bacteria:

• Source
• Treatment
• Distribution system
• Finished water storage
• Pumps, pump facilities and controls
• Monitoring, reporting and data verification
• System management and operation
• Operator compliance with state requirements

EPA also issued two related guidance documents: Consecutive System Guide for the Ground Water Rule, covering wholesale systems that supply ground water and the water systems that receive and distribute wholesale water, and Complying with the Ground Water Rule: Small Entity Compliance Guide, covering water systems serving fewer than 10,000 people.

The EPA finalized a plan last week for examining human health risks and developing new water quality criteria for bacteria and pathogens in recreational waters, which provides a five-year timeframe to conduct research and develop new criteria. The plan is in response to a federal court ruling earlier this year that found the agency had missed statutory deadlines for the research and standards.

At the annual meeting of the Association of State & Interstate Water Pollution Control Administrators in Sturgeon Bay, WI, the Director of the Office of Science & Technology within EPA's Office of Water, stated the plan will cover four basic areas:

• Risk assessment - identifying current data gaps, such as trying to distinguish between human and non-human sources of contamination and whether different sources have different levels of risk to humans;
• Contamination indicators - conducting six or seven epidemiological studies using a variety of indicators to determine which are the easiest to use and best characterize the potential health risks from recreational exposures to fecal contamination;
• Methods for detecting bacteria and pathogens - testing new methods to detect fecal contamination, including culture-based and molecular methods, with a goal of finding a technique that can more rapidly detect contamination so that beaches may be closed on the same day the contamination appears; and
• State guidance and implementation issues - developing guidance for state and other implementation issues, such as how criteria will be used to develop cleanup plans for impaired waters.

The EPA anticipates conducting research for the next three years, until 2010, and then spending two years developing new criteria to be issued in 2012.

During late 2006 and early 2007, increases in acute gastroenteritis (AGE) outbreaks, particularly involving long-term care facilities, consistent with noroviruses, were reported by many state public health departments. The U.S. Centers for Disease Control and Prevention recently issued a report highlighting the increased outbreaks during that time period were associated with the emergence of two new co-circulating strains of norovirus.

Noroviruses are the most common cause of sporadic cases and outbreaks of AGE. Transmissions occur via foodborne and person-to-person contact routes, as well as through contact with contaminated environmental surfaces. Control of norovirus outbreaks depends on consistent enforcement of measures such as:

• Practicing good hand hygiene by washing hands frequently
• Disinfecting contaminated surfaces with either chlorine bleach or registered EPA disinfectants
• Staying away from work or school for 24-72 hours after symptoms resolve

Currently, there is no national surveillance system in place for AGE outbreaks, including those caused by norovirus, unless foodborne transmission is suspected. The Council for State and Territorial Epidemiologists passed a resolution in 2006 stating that all AGE outbreaks should be reportable nationally, regardless of mode of transmission (i.e., foodborne or person to person). This will be implemented in 2008 through the National Outbreak Reporting System.

For more information on the report, please visit:
Norovirus Activity Report

A recent study suggests that higher water intake many decrease bladder cancer risks, regardless of levels of disinfection byproducts in drinking water. Many studies on water and total fluid intake and bladder cancer are inconsistent. While a previous analysis observed a positive association between tap water and bladder cancer, there was no such association for nontap fluid intake, suggesting that contaminants in tap water may be responsible for the excess risk. High-levels of arsenic and disinfection byproducts in drinking water have been associated with elevated bladder cancer risk.

A recent large case-control study conducted in Spain examined the association between total fluid and water consumption and bladder cancer risk, as well as the interaction between water intake and trihalomethane exposure. The results of the study suggest bladder cancer declines with water intake, regardless of the level of exposure to trihalomethane disinfection by-products.

According to the study, "A significant inverse association was observed for water intake…but not for other individual beverages. The inverse relationship persisted within each level of THM exposure; there was no statistical interaction."

For more information on the study, please visit:
Study on Bladder Cancer and Water Intake

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