title: Rural children's exposure to well water contaminants: implications in light of the American Academy of Pediatrics' recent policy statement.
abstract: OBJECTIVE
  Implementing the recent American Academy of Pediatrics' (AAP) policy for annual well water testing will impact pediatric healthcare providers, who will be called upon for advice regarding testing, interpretation, and mitigation. We report findings from a study of low-income rural families' participation in household well water testing.
  
  
  METHODS
  We collected data from 188 rural low-income households inclusive of 320 children under the age of seven. Participating families lived in one of two western U.S. counties and received water from a well with <15 connections. Household water samples and questionnaire data were collected for analysis.
  
  
  CONCLUSIONS
  Twenty-seven percent of households tested positive for at least one contaminant, including total coliforms (18%), arsenic (6%), synthetic organic chemicals (6%), nitrates (2%), fluoride (2%), and E. coli (<1%). Eighty-nine percent of households testing positive for total coliforms were positive at re-test. Respondents expressed greatest concern for biological contamination and took multiple precautionary actions, although only 31% had ever tested their water for contaminants. Higher levels of education, income, and age, as well as homeowner status, were significantly associated with previous testing.
  
  
  CONCLUSIONS
  Recommendations for communicating abnormal results, mitigating risks, and overcoming logistical challenges are presented.
authors.affiliation: Washington State University College of Nursing, Department of Civil and Environmental Engineering, Spokane, Washington 99210-1495, USA. jpostma@wsu.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Postma
authors.forename: Philip W
authors.initials: PW
authors.lastname: Butterfield
authors.forename: Tamara
authors.initials: T
authors.lastname: Odom-Maryon
authors.forename: Wade
authors.initials: W
authors.lastname: Hill
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Butterfield
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D004782:Environmental Health; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D010372:Pediatrics / Q000706:statistics & numerical data*; D011203:Poverty; D015980:Public Health Practice; D040242:Risk Reduction Behavior; D012424:Rural Population / Q000706:statistics & numerical data*; D012955:Societies, Medical; D012956:Societies, Nursing; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D014861:Washington; D014871:Water Microbiology; D014876:Water Pollution / Q000009:adverse effects*; D014881:Water Supply / Q000706:statistics & numerical data*; D055815:Young Adult