title: Associations between perceptions of drinking water service delivery and measured drinking water quality in rural Alabama.
abstract: Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure-a risk factor for contamination-may be relatively reliable and therefore useful in future monitoring efforts.
authors.affiliation: Department of Biological Sciences, University of Alabama, 300 Hackberry Lane, Tuscaloosa, AL 35487, USA. jjcook@crimson.ua.edu.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Wedgworth
authors.affiliation: School of Civil and Environmental Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA 30332, USA. joe.brown@ce.gatech.edu.
authors.forename: Joe
authors.initials: J
authors.lastname: Brown
authors.affiliation: Department of Civil and Environmental Engineering, University of Alabama, 245 7th Avenue, Tuscaloosa, AL 35487, USA. pdjohnson@ua.edu.
authors.forename: Pauline
authors.initials: P
authors.lastname: Johnson
authors.affiliation: Department of Biological Sciences, University of Alabama, 300 Hackberry Lane, Tuscaloosa, AL 35487, USA. jolson@as.ua.edu.
authors.forename: Julie B
authors.initials: JB
authors.lastname: Olson
authors.affiliation: Department of Civil and Environmental Engineering, University of Alabama, 245 7th Avenue, Tuscaloosa, AL 35487, USA. melliott@eng.ua.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Elliott
authors.affiliation: Barge Waggoner Sumner and Cannon Inc., 2047 West Main Street, Suite 1, Dothan, AL 36301, USA. rick.forehand@bwsc.net.
authors.forename: Rick
authors.initials: R
authors.lastname: Forehand
authors.affiliation: Division of Environmental Health, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, USA. cstauber@gsu.edu.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Stauber
mesh_terms: D000328:Adult; D000407:Alabama; D058491:Bacterial Load; D002713:Chlorine / Q000032:analysis; D003116:Color; D003625:Data Collection; D004202:Disinfectants / Q000032:analysis; D060766:Drinking Water / Q000032:analysis / Q000382:microbiology; D004755:Enterobacteriaceae / Q000302:isolation & purification; D004784:Environmental Monitoring; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D009812:Odorants; D010465:Perception; D011312:Pressure; D012424:Rural Population; D013649:Taste; D060753:Water Quality; D014881:Water Supply
chemical_list: D004202:Disinfectants; D060766:Drinking Water; D002713:Chlorine