SURVEY OF DRINKING WATER QUALITY AND HEALTH IN ALABAMA'S BLACK BELT

182 Pages·2014·1.09 MB·English

by  John Chambers

SURVEY OF DRINKING WATER QUALITY
AND HEALTH IN ALABAMA’S BLACK BELT

by
JESSICA COOK WEDGWORTH
JULIE B. OLSON, COMMITTEE CHAIR
JOE BROWN
CAROL DUFFY
HANK HEATH
JOHN HIGGINBOTHAM
PAULINE JOHNSON

A DISSERTATION

Submitted in partial fulfillment of the requirements
for the degree of Doctor of Philosophy
in the Department of Biological Sciences
in the Graduate School of
The University of Alabama

TUSCALOOSA, ALABAMA

2014
Copyright Jessica C. Wedgworth 2014
ALL RIGHTS RESERVED
ABSTRACT
Worldwide, approximately 768 million people drink unsafe water, which is potentially
contaminated by the 2.5 billion people without sanitation facilities. The need for basic services
such as safe drinking water and effective waste treatment in underserved and un-served human
populations is usually associated with developing countries, but poor, rural areas of the US with
small populations are also at risk.
The majority of US public water systems serve small populations, creating unique
financial, operational, and infrastructure sustainability challenges that limit the ability of the
system to provide drinking water that meets current Environmental Protection Agency standards.
Small water systems in Alabama’s rural Black Belt face these challenges, with potential impacts
on the health of the consumers. To investigate drinking water quality in this region, a cross
sectional pilot study of 305 households using both private wells and county public supply in a
rural Alabama county was initiated. Results found a substantial number of water samples were
positive for fecal coliforms and members of households with positive samples were more likely
to experience illness. These data suggested that access to safe water may be limited in this area,
putting residents at risk for illness.
To test hypotheses generated in the pilot study, the research area was expanded to include
910 households in 3 counties representing 14 water systems. At each household, water samples
and measurements were taken, and a survey was completed. Consumer-reported data were found
to be of limited utility in predicting potential microbiological risks, although consumer feedback
on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful
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in future monitoring efforts. Also, poor water service delivery and aesthetic characteristics were
shown to be good indicators for reported gastrointestinal illness.
To examine the water quality at the system level, large volume water samples were taken
from 12 water systems across the same 3 counties. Within each system, 10 sample locations
were chosen and sampled at 3 different time points. Overall, sample collection location within
the distribution system proved to have minimal effects on water quality suggesting that time and
possibly seasonality were potential indicators of water quality and contamination events.
It was concluded that for the study area wastewater containment at the household level,
and water quality at the household and system level were both found to be substandard.
However, regulation of household wastewater is a required prerequisite to improving water
quality in the Black belt of rural Alabama.

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DEDICATION
To my husband and best friend, Evan, and my always smiling 2 year old, Louis.

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LIST OF ABBREVIATIONS AND SYMBOLS

°C Degree Celsius
μg Microgram
μL Microliter
ADEM Alabama Department of Environmental Management
ADPH Alabama Department of Public Health
ASCE American Society of Civil Engineers
ARHA Alabama Rural Health Association
CDC Center for Disease Control
CFU Colony forming unit
CI Confidence interval
Cl Chlorine
DEUF Dead end ultrafiltration
DPD1 Diethyl-p-phenylene diamine 1
DPD3 Diethyl-p-phenylene diamine 3
EPA Environmental Protection Agency
E. coli Escherichia coli
FC Fecal Coliform
GI Gastrointestinal
GII Gastrointestinal Illness
GPS Global positioning system
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HCGI Highly credible gastrointestinal illness
HPC Heterotrophic Plate Count
IESWTR Interim Enhanced Surface Water Treatment Rule
IRB Institutional Review Board
kPa Kilopascal
L Liter
MCL Maximum contaminate level
MCLG Maximum contaminate level goal
MPN Most probably number
mg Milligrams
mL Milliliter
mm Millimeter
MSLB Membrane lauryl sulfate broth
MST Microbial source tracking
N Sample size
NESIS National Educational Statistical Information System
NEWWA New England Water Works Association
NTU Nephelometric turbidity unit
Obs Observation
OR Odd’s Ratio
PCR Polymerase chain reaction
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PFU Plaque forming unit
POU Point of use
psi Pounds per square inch
PWS Public water system
RNA Ribonucleic acid
RTCT Revised Total Coliform Rule
SDWA Safe Drinking Water Act
SDWIS Safe drinking water information system
SWTR Surface Water Treatment Rule
TC Total coliform
TCR Total Coliform Rule
UF Ultrafiltration
UN United Nations
UNICEF United Nations International Children’s Emergency Fund
US United States
WBDOSS Waterborne Disease and Outbreak Surveillance System
WHO World Health Organization

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ACKNOWLEDGMENTS
I feel that I must begin by saying thank you to where I came from. I would like say thank
you to my parents, Bruce and Cindy Cook, for always believing in me and encouraging me to
chase my dreams. You fostered in me a spirit of love and compassion, but also a desire to be
independent and adventurous and dream big, and for that I am forever grateful. Thank you to my
Nanny and Paw-Paw, for demonstrating to me what it means to love unconditionally. Thank you
to my Aunt Jane, for always loving me like your own. And last, but certainly not least, thanks to
my little sister, Bliss, for loving me unconditionally and for always cheering me on. I am
absolutely certain that without the influence of each and every one of you, I would not be
standing where I am today.
I must say a very special thanks to my husband and better half, Evan, and my biggest fan,
Louis. Evan, thank you for supporting my dream. Thank you for encouraging me to keep going
when I thought the end would never come, and thank you for all the sacrifices you have made to
see me reach my goals. Thank you for your patience, and your unconditional love. To my little
Louis, thanks for blessing our lives with so much joy and laughter. I am so proud to be your
mom and I cherish every single hug, even the ones that are needed in the middle of the night.
This journey would not have been possible without the unconditional love and support that I
received from both of you.
My most sincere thanks goes to my advisors and mentors, Drs. Julie Olson and Joe
Brown. Joe, thank you for welcoming me as a graduate student in 2008 and teaching me the
ropes of writing proposals, organizing field research, and publishing manuscripts. Thank you for
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providing a foundation of knowledge and support for me to build upon in the coming years. Dr.
Olson, thank you for “taking me in” and inviting me to work in your lab 4 years ago. Your
guidance, constant encouragement and enthusiasm, and sharp insight have always given me the
motivation that I need to “keep on keeping on.” Thank you for your patience when things didn’t
go as planned, or when “life” happened in a very untimely fashion. You have set such an
example of what it means to be a professional in science, and I can only hope that I walk away
from this opportunity as the creative, independent scientist that you aspire for all of your students
to be. I would also like to thank my committee members, Drs. Carol Duffy, Hank Heath, John
Higginbotham, and Pauline Johnson, and Drs. Mark Elliott and Christine Stauber who have
continually supported and encouraged me throughout this process.
The research presented here has been supported by the Center for Community Based
Partnerships Seed Funding Program and the Environmental Protection Agencies (EPA) STAR
program entitled Advancing Public Health Protection through Water Infrastructure
Sustainability (EPA-G2009-STAR-F1).
This research would not have been possible without the help of our local non-profit
partner, HERO, and its director, Pam Dorr. Thank you for providing us with a field office and
lab space, and many other essential resources necessary for the day to day demands of field work
over the past 6 years. I would also like to say a personal thanks to each water utility and their
respective operators for your cooperation and participation in our study.
Lastly, there are many people that have worked on this project over the course of the last
6 years, many of which held very key roles in the completion of this research. Thank you to my
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