title: Does the public receive and adhere to boil water advisory recommendations? A cross-sectional study in Newfoundland and Labrador, Canada.
abstract: BACKGROUND
  Highly publicized water supply problems highlight the importance of safe drinking water to the public. Boil water advisories (BWAs) are an important precautionary measure meant to protect public health by ensuring drinking water safety. Newfoundland and Labrador, Canada is a prime location for exploring public notification practices and adherence to recommendations as there were a total of 215 BWAs, affecting 6 % of the provincial population, in 145 communities between April 2006 and March 2007 when data for the present study were collected.
  
  
  METHODS
  Residents who received household water from a public water supply were randomly selected for a telephone interview. Collected data included participants' notification of boil water advisory, satisfaction with information provided, and their adherence to recommendations.
  
  
  RESULTS
  Most participants learned that a BWA had been issued or lifted in their community through radio, television, or word of mouth. BWAs were issued for a range of operational reasons. Almost all participants who had experienced a BWA reported wanting more information about the reasons a BWA had been issued. Low adherence to water use recommendations during a BWA was common.
  
  
  CONCLUSIONS
  This study is first to report on public adherence to boil water advisory recommendations in Canada. The findings raise public health concerns, particularly given the high number of BWAs issued each year. Further studies in partnership with community stakeholders and government decision-makers responsible for overseeing public water systems are needed to assess the perceptions of BWAs, the reasons for non-adherence, and to identify information dissemination methods to increase information uptake and public adherence with acceptable uses of public drinking water during a BWA.
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, ON, N1G 2W1, Canada. aqjones@uoguelph.ca.
authors.forename: Andria
authors.initials: A
authors.lastname: Jones-Bitton
authors.affiliation: Division of Community Health and Humanities, HSC 2834 Faculty of Medicine, Memorial University, St. John's, NL, A1B 3V6, Canada. diana.gustafson@med.mun.ca.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Gustafson
authors.affiliation: Division of Community Health and Humanities, HSC 2834 Faculty of Medicine, Memorial University, St. John's, NL, A1B 3V6, Canada. kelly.butt@mun.ca.
authors.forename: Kelly
authors.initials: K
authors.lastname: Butt
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, BMH 2316, Waterloo, ON, N2L 3G1, Canada. smajowicz@uwaterloo.ca.
authors.forename: Shannon E
authors.initials: SE
authors.lastname: Majowicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001290:Attitude; D002170:Canada; D003430:Cross-Sectional Studies; D003625:Data Collection; D060766:Drinking Water / Q000592:standards*; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D006358:Hot Temperature; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D009523:Newfoundland and Labrador; D011634:Public Health; D014867:Water; D018508:Water Purification / Q000379:methods*; D014881:Water Supply; D055815:Young Adult
chemical_list: D060766:Drinking Water; D014867:Water