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Community Health Impact of Extended Loss of Water Service --- Alabama, January 2010




Community Health Impact of Extended Loss of Water Service --- Alabama, January 2010
Weekly
February 18, 2011 / 60(06);161-166


Access to clean water is fundamental to good health (1). During January 2010, approximately 18,000 residents of two predominantly rural counties in Alabama lost access to municipal water for up to 12 days after below-freezing temperatures led to breaks in water mains and residential water pipes and caused widespread systemic mechanical failures. To assess potential health impacts, use of alternative water sources, and effectiveness of the emergency response, the Alabama Department of Public Health (ADPH) invited CDC to assist in an investigation that included a survey of 470 households representing 1,283 residents and a qualitative investigation (i.e., focus group discussions and interviews with key informants). This report summarizes the results of that investigation, which found a significantly higher prevalence of acute gastrointestinal illness (AGI) among residents of households that lost both water service and water pressure (adjusted odds ratio [AOR] = 2.6), that lost water service for ≥7 days (AOR = 2.4), and that lost water pressure for ≥7 days (AOR = 3.5). Significant dose-response relationships were observed between increased duration of lost water service or pressure and AGI. The survey and qualitative investigation revealed that households, communities, water utilities, and institutions were not adequately prepared for water emergencies in areas of communication and notification, planning for alternative water sources, and interagency coordination. Health effects from loss of water supply or water pressure might be mitigated by public health involvement in fostering household, community, and interagency preparedness, and developing communication strategies that will reach the majority of citizens in a timely manner.

Community A and community B are located in two contiguous, predominantly rural counties in southwestern Alabama, served primarily by three interconnected public water utilities. Because freezing conditions are rare in this area, few building code regulations require burial or insulation of residential water pipes. During January 4--11, 2010, overnight low temperatures ranged from 12°F to 22°F (-11°C to -6°C), causing many utility water mains and residential water pipes to break. The resulting systemic water loss and related mechanical failures forced water utilities to cut off service to most households in the two communities (Figure). Local ADPH offices did not learn about the water shortages until January 10 in community A, when a resident complained about restaurants operating without water, and January 11 in community B, when an ADPH nurse found a school operating without water. Subsequently, ADPH issued boil water advisories for both communities. Three agencies were involved in supplying emergency water to the affected communities: the Alabama Emergency Management Agency provided five truckloads of bottled water to community A and one truckload to community B; the National Guard delivered nonpotable water to community A; and ADPH deployed water filtration/UV disinfection units to both communities.

full-text:
Community Health Impact of Extended Loss of Water Service --- Alabama, January 2010

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