Review of the New York City Watershed Protection Program (2020) / Chapter Skim
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11 Public Health Systems
11 Public Health Systems
Pages 293-314
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From page 293... ...
Finally, the drinking water cannot be a source of waterborne disease outbreaks. This chapter considers the three watershed protection programs that aim to accomplish these goals: the Waterborne Disease Risk Assessment Program, microbial monitoring in the Catskill/Delaware system, and the Waterfowl Management Program.
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. NYC Waterborne Disease Risk Assessment Program Description The Waterborne Disease Risk Assessment Program (WDRAP)
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Data collected from disease surveillance are assessed for trends over time and seasonal distribution and to analyze risk factors for the disease. Outbreak Detection Syndromic and sentinel surveillance can be useful in measuring disease trends in the general population by identifying signals that might indicate a waterborne disease outbreak more rapidly than disease surveillance alone.
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Data analysis via the cumulative sums methods is performed to determine if an increase is statistically significant. TABLE 11-1 Summary of Waterborne Disease Risk Assessment Program Outbreak Detection Approaches System Data Frequency Geographic Unit Data Analysis Emergency departments (EDs)
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Current Rates of Waterborne Disease Disease Surveillance As reported in the 2017 WDRAP Annual Report (NYC DOHMH and NYC DEP, 2018) , cases of giardiasis have declined overall during the 23-year surveillance period.
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Outbreak Detection The syndromic surveillance system includes the four systems described above, which are used to identify trends or signals that might indicate possible disease outbreaks linked to the drinking water supply. As the signals in these systems can often be the result of a statistical aberration or a non-public health related event, the systems are used in concert to detect an outbreak.
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. FIGURE 11-5 Summary of outbreak detection data for each two-week period between January 1 and December 31, 2018.
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that currently have a FAD, no annual reports regarding a comprehensive waterborne disease risk assessment program were readily identified via their websites for watershed protection. One annual report for cryptosporidiosis disease surveillance was found on San Francisco's website, indicating that the San Francisco Department of Public Health in cooperation with the San Francisco Public Utilities Commission and local health departments has an active surveillance program for cryptosporidiosis and provides an annual summary along with quarterly updates.
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Recommendations from the 2000 Report In the National Academies' first review of the NYC strategy for watershed protection (NRC, 2000) , the waterborne disease surveillance program was reviewed and six recommendations were made, some of which have been addressed since 2000.
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This increased detection may result in increased sensitivity and timeliness to detect an outbreak, and hence deserves further consideration as a method for early outbreak detection for giardiasis and cryptosporidiosis. The ability to detect oocysts of Cryptosporidium in wastewater was documented during a large waterborne disease outbreak in Sweden where researchers found increased oocysts in wastewater during the outbreak time period (Widerström et al., 2014)
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. Total coliforms include fecal coliforms and other coliforms derived from human and animal waste that can be found in water influenced by surface water, soil, and sediments.
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4/week Operational decisions TC non-sheen 1/month Operational decisions Pepacton Reservoir Cryptosporidium 1/month IESWTR Giardia 1/month IESWTR TC 5/month WR&R TC/FC 4/week Operational decisions TC non-sheen 1/month Operational decisions Neversink Reservoir Cryptosporidium 1/month IESWTR Giardia 1/month IESWTR TC 5/month WR&R TC/FC 4/week Operational decisions TC non-sheen 1/month Operational decisions Rondout Reservoir Cryptosporidium 1/month IESWTR Giardia 1/month IESWTR FC 5/week WR&R TC/FC 4/week IESWTR and Operations decisions TC non-sheen 1/month IESWTR and Operations decisions West Branch Reservoir Cryptosporidium 1/month IESWTR Giardia 1/month IESWTR FC 5/week IESWTR; WR&R TC/FC 5/week IESWTR and operations decisions Schoharie Reservoir Cryptosporidium 1/month IESWTR Giardia 1/month IESWTR TC 5/month IESWTR; WR&R TC/FC 4/week Operational decisions TC non-sheen 1/month Operational decisions Ashokan Reservoir Cryptosporidium 1/month IESWTR Giardia 1/month IESWTR FC 5/week IESWTR; WR&R TC 1/month TCR TC/FC 4/week IESWTR and operations decisions E coli 1/month TCR West-of-Hudson tributaries Cryptosporidium 1/month Operational decisions Giardia 1/month Operational decisions FC 1/month Operational decisions
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Colilert SM9223B04 reported as MPN/100 mL Sample volumes: Cryptosporidium and Giardia 50 L, HEV up to 240 L, potable TC/FC 100 mL, source water TC/FC/non-sheen various CFU = colony-forming units MPN = most probable number IESWTR = Interim Enhanced Surface Water Treatment Rule WR&R = Watershed Rules and Regulations TCR = Total Coliform Rule
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, land use characterization, and coliform bacteria concentrations to understand the impact of septic systems in a watershed. Similar studies would be useful in the NYC watershed to better understand the roles of various animal sources of fecal coliforms, from humans to waterfowl to livestock, if the reservoirs or tributaries exceed regulatory limits for fecal or total coliforms or are designated as coliform-restricted.
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From page 307... ...
Kensico Reservoir Because Kensico Reservoir is the terminal reservoir for the unfiltered Cat/Del water supply before chemical and UV disinfection, its protection is particularly important to preventing water quality degradation and maintaining compliance with the revised FAD. Hence, NYC DEP has an extensive routine pathogen monitoring strategy for streams such Bear Gutter Creek, Malcolm Brook, and Whippoorwill Creek that feed into Kensico Reservoir; indeed this monitoring comprises approximately 40 percent of the entire watershed sampling effort for pathogens (NYC DEP, 2016)
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The management of water-bird populations, therefore, is important to meeting water quality regulations for fecal coliform bacteria limits in the SWTR. Untreated water samples have shown fecal coliform increases concurrent with avian populations at several NYC reservoirs in the past (NYC DEP, 2016)
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CONCLUSIONS AND RECOMMENDATIONS The Waterborne Disease Risk Assessment Program should determine whether the recent increase in protozoan parasitic infections observed via the disease surveillance system is from increased use of culture-independent diagnostic tests. A survey of the laboratories included in the surveillance system and an analysis of the proportion of tests that are culture-independent diagnostic tests are essential to understanding this apparent increase.
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percent of samples greater than 20 fecal coliforms per 100 mL. The increase in 2011-2012 corresponds to Tropical Storms Irene and Lee.
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Although the microbial monitoring program is well-structured and meets all regulatory requirements, the data it collects could be better analyzed and used to inform the Watershed Protection Program. For example, if reservoirs or tributaries exceed regulatory limits for fecal or total coliforms, or are designated as coliform-restricted, NYC DEP should use Microbial Source Tracking studies to identify sources, determine the relative importance of anthropogenic versus animal sources, and inform control strategies within the Watershed Agricultural Program, the Septic System Program, and the Stormwater Program.
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2012. The importance of waterborne disease outbreak surveillance in the United States.
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2018. Waterborne Disease Risk Assessment Program 2017 Annual Report.
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2018. NYC's Waterborne Disease Risk Assessment Program.
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