Appendix B
Review of Previous Reports
Like Appendix A, this appendix addresses a requirement of the committee’s statement of task; specifically the requirement to “review and provide perspective on the importance and public health impacts of waterborne pathogens as discussed in previous National Academies’ reports and other seminal reports.”
NRC REPORTS
Although this is the first National Research Council (NRC) study to focus specifically on indicators for waterborne pathogens, issues surrounding their use in a variety of applications have been discussed in several recent NRC reports, as summarized in Table B-1 beginning with the most recent. In addition, several of these reports include a discussion of the importance of waterborne pathogens to public health, which is reviewed in Chapters 1 and 2 of this report.
OTHER SEMINAL REPORTS
The U.S. Environmental Protection Agency (EPA) and other groups, including the water industry and academia, have addressed the issue of the microbial quality of drinking water and recreational water and its association with various human health effects such as gastroenteritis, ear and eye infections, dermatitis, and respiratory disease. Thus, Table B-1 also summarizes some of the major reports that have been published addressing these concerns.
Many of the reports included in Table B-1 stress the need for better indicator approaches, including those designed to address the greatest public health threats.
For example, in light of the public health importance of viral pathogens in ground and coastal waters (as described in this report), several of the reports suggest that viral indicators, such as coliphage, be implemented. Other reports recommend development and use of molecular strategies so that new or (re)emerging pathogens can be detected in water. However, all reports included in Table B-1 agree that, given the documented public health impacts of waterborne disease, new and improved indicators of the presence of waterborne pathogens are needed.
REFERENCES
ASM (American Society for Microbiology). 1999. Microbial Pollutants in Our Nation’s Water—Environmental and Public Health Issues. Washington, D.C.: ASM Press.
AWWARF (American Water Works Association Research Foundation). 2000a. An Epidemiological Study of Gastrointestinal Health Effects of Drinking Water. Denver, Colorado: American Water Works Association Research Foundation.
AWWARF. 2000b. Development of a Decision Process for Prioritization of Emerging Pathogens Research. Denver, Colorado: American Water Works Association Research Foundation.
AWWARF. 2001. Design of Early Warning and Predictive Source-Water Monitoring Systems. Denver, Colorado: American Water Works Association Research Foundation.
EPA (U.S. Environmental Protection Agency). 1998. Improved Indicator Methods of Pathogen Occurrence in Water. Workshop Summary: August 10-11, 1998. Arlington, Virginia: Office of Water.
EPA. 1999a. EPA Action Plan for Beaches and Recreational Waters. Washington, D.C.: Office of Research and Development and Office of Water. EPA-600-R-98-079.
EPA. 1999b. Review of Potential Modeling Tools and Approaches to Support the BEACH Program. Washington, D.C.: Office of Science and Technology. EPA-823-R-99-002.
EPA. 2001a. Developing Strategy for Waterborne Microbial Disease. Presentation at Waterborne Microbial Disease Stakeholder Meeting. November 6, 2001. Washington, D.C.
EPA. 2001b. Protocol for Developing Pathogen TMDLs: First Edition. Washington, D.C.: Office of Water. EPA-841-R-00-002.
EPA Workshop Group. 2001. Proceedings of Workshop on Development of Microbiological Criteria for Drinking Water Sources, Recreational Waters, and Shellfish Growing Waters, August 27-29. Washington, D.C.: Office of Water.
ILSI (International Life Sciences Institute) Risk Science Institute. 1999. Early Warning Monitoring to Detect Hazardous Events in Water Supplies. T.K. Brosnan, ed. Washington, D.C.: International Life Sciences Institute.
NRC (National Research Council). 1996. Use of Reclaimed Water and Sludge in Food Crop Production. Washington, D.C.: National Academy Press.
NRC. 1998. Issues in Potable Reuse. Washington, D.C.: National Academy Press.
NRC. 1999a. Setting Priorities for Drinking Water Contaminants. Washington, D.C.: National Academy Press.
NRC. 1999b. Identifying Future Drinking Water Contaminants. Washington, D.C.: National Academy Press.
NRC. 2000a. From Monsoons to Microbes. Washington, D.C.: National Academy Press.
NRC. 2000b Watershed Management for Potable Water Supply: Assessing the New York City Strategy. Washington, D.C.: National Academy Press.
NRC. 2001. Classifying Drinking Water Contaminants for Regulatory Consideration. Washington, D.C.: National Academy Press.
TABLE B-1 Selected Studies and Reports that Address Waterborne Pathogens and Their Indicators
Title |
Focus of Study |
Points of Emphasis Related to Indicators for Waterborne Pathogens and Committee’s Charge |
Biosolids Applied to Land (NRC, 2002a) |
To evaluate the technical approaches used (by EPA) to establish the chemical and pathogen standards for biosolids |
Recommendations:
|
Opportunities to Improve the U.S. Geological Survey National Water Quality Assessment Program (NRC, 2002b) |
To provide guidance to the U.S. Geological Survey on opportunities to improve the National Water Quality Assessment (NAWQA) Program as it enters its second decade of nationwide monitoring |
Chapter 3 “NAWQA Cycle II Goals—Status”: Includes a brief review of the importance of waterborne pathogens in public health risk Conclusions:
Recommendations:
|
Classifying Drinking Water Contaminants for Regulatory Consideration (NRC, 2001) |
To evaluate and revise conceptual approach to generate future Drinking Water Contaminant Candidate Lists (CCLs) first recommended in Identifying Future Drinking Water Contaminants (NRC, 1999b) |
Chapter 6 “Virulence-Factor Activity Relationships” (VFAR): Describes what VFARs are and concludes that the development and use of VFARs by EPA to help identify future waterborne pathogens appears to be feasible Recommendations:
|
Development of Microbiological Criteria for Drinking Water Sources, Recreational Waters, and Shellfish Growing Waters (EPA Workshop, 2001) |
To identify approaches for the development of microbiological criteria for drinking water sources and other ambient water uses |
Conclusions and recommendations:
|
Developing Strategy for Waterborne Microbial Disease (draft) (EPA, 2001a) |
To develop a strategy that unites the influence of the Safe Drinking Water Act and the Clean Water Act |
Conclusions:
|
Title |
Focus of Study |
Points of Emphasis Related to Indicators for Waterborne Pathogens and Committee’s Charge |
|
|
Recommendation:
|
Design of Early Warning and Predictive Source-Water Monitoring Systems (AWWARF, 2001) |
To provide water utilities with information to help them better assess the needs, options, design, and operation of early-warning and source water monitoring programs |
Conclusions:
|
Protocol for Developing Pathogen TMDLs (First Edition) (EPA, 2001b) |
To assist the development of rational, science-based assessments and decisions that will lead to understandable and justifiable pathogen total maximum daily loads (TMDLs) |
Provides a step-by-step description of the TMDL process for pathogens and includes case studies and hypothetical examples to illustrate the major points in the process Recommendations:
|
|
|
|
An Epidemiological Study of Gastrointestinal Health Effects of Drinking Water (AWWARF, 2000a) |
To evaluate drinking water-related gastrointestinal illnesses in a population consuming tap water of a quality that meets current water regulations; determine the source of these illnesses should health effects be observed; provide regulatory agencies and public health authorities with information on health risks associated with drinking water; and find suitable risk indicators |
Findings:
Conclusion:
|
Development of a Decision Process for Prioritization of Emerging Pathogens Research (AWWARF, 2000b) |
To develop a decision support tool to assist expert panels in the allocation of limited resources for research related to emerging waterborne pathogens |
Findings:
|
Title |
Focus of Study |
Points of Emphasis Related to Indicators for Waterborne Pathogens and Committee’s Charge |
|
|
|
From Monsoons to Microbes (NRC, 2000a) |
Overview document based in part on a workshop to elucidate the ocean’s role in human health and suggest directions for future efforts to respond to health needs and threats |
Chapter 2 “Infectious Diseases” Lists:
Discussions:
|
|
|
|
Watershed Management for Potable Water Supply: Assessing the New York City Strategy (NRC, 2000b) |
Evaluates the New York City Watershed Memorandum of Agreement (MoA), a comprehensive watershed management plan |
Chapter 5 “Sources of Pollution in the New York City Watershed” emphasizes the public health importance of protozoan parasites Cryptosporidium and Giardia and their that allows the City to avoid filtration of its current and future regulatory importance under the federal large upstate surface water supply Safe Drinking Water Act Chapter 6 “Tools for Monitoring and Evaluation” Recommends:
Appendix C “Microbial Risk Assessment Methods” emphasizes the potential usefulness of linking microbial risk assessment with an epidemiologic surveillance program. |
Setting Priorities for Drinking Water Contaminants (NRC, 1999a) |
First report to establish a process for setting priorities for an existing CCL; to establish framework for deciding what to regulate, monitor, or study further |
Chapter 3 “Review of Methods for Assessing Microbial Pathogens” Conclusions:
|
Title |
Focus of Study |
Points of Emphasis Related to Indicators for Waterborne Pathogens and Committee’s Charge |
|
|
|
Identifying Future Drinking Water Contaminants (NRC, 1999b) |
Short committee report to identify emerging drinking water contaminants and develop a database to support future decision making on these, as well as help develop an approach to determine future CCLs Report includes three individually authored chapters on (1) historical overview of drinking water contaminants and public water utilities, (2) emerging pathogens, and (3) methods to identify and detect microbial contaminants in drinking water |
Emphasizes the inclusion of microbes and all other types of potential contaminants on preliminary and final CCLs Recommendations:
|
Early Warning Monitoring to Detect Hazardous Events in Water−Supplies (ILSI Workshop, 1999) |
To define the state of the science for early-warning monitoring systems for drinking water; to identify strengths and weaknesses of existing technologies and strategies; to raise consciousness regarding the potential for the occurrence of transient hazardous events; and to promote research into prevention, detection, and mitigation or treatment of these events |
Conclusions and recommendations:
|
|
|
|
Microbial Pollutants in our Nation’s Water—Environmental and Public Health Issues (ASM, 1999) |
To focus attention on the risk of microbial pollutants in water |
Conclusions and recommendations:
|
Action Plan for Beaches and Recreational Waters (BEACH Program) (EPA, 1999a) |
To reduce the risk of infection to users of recreational waters through improvements in recreational water programs, communication, and scientific advances; to describe EPA actions to improve and assist state, tribal, and |
Recommendations:
|
Title |
Focus of Study |
Points of Emphasis Related to Indicators for Waterborne Pathogens and Committee’s Charge |
|
local implementation of recreational water monitoring and public notification programs |
|
Review of Potential Modeling Tools and Approaches to Support the BEACH Program (EPA, 1999b) |
To provide an inventory of predictive models or tools currently in use by agencies responsible for evaluating the need for closing beaches or issuing advisories and warnings |
Conclusions:
|
|
|
|
Improved Indicator Methods of Pathogen Occurrence in Water (EPA Workshop, 1998) |
To provide scientific and technical guidance on current and alternative indicators and methods; to suggest ways for indicator technology to improve health protection; and to discuss approaches for future dialogues to further the process |
Conclusions and recommendations:
|
Issues in Potable Reuse (NRC, 1998) |
To assess public health implications of using reclaimed water as a component of the potable water supply |
Chapter 3 “Microbial Contaminants in Reuse Systems” Recommendations:
|
Title |
Focus of Study |
Points of Emphasis Related to Indicators for Waterborne Pathogens and Committee’s Charge |
|
|
|
Use of Reclaimed Water and Sludge in Food Crop Production (NRC, 1996) |
To examine the use of treated municipal wastewater and sludge in the production of crops for human consumption |
Chapter 5 “Public Health Concerns about Infectious Disease Agents” outlines leading pathogens associated with raw sewage and emphasizes the need to be able to effectively monitor for treatment efficacy and, therefore, the need for effective indicator organisms or direct pathogen detection Conclusions:
|