Analysis of building plumbing system flushing practices and communications.

Drinking water distribution system contamination incidents can prompt public agencies and drinking water utilities to issue do-not-drink and do-not-use advisories. After the contaminant is cleared from distribution mains, consumers are often directed to flush their plumbing. However, little validated guidance and few evaluated communications strategies are available on using flushing to decontaminate building water systems.

Communicating with healthcare providers.

Studies of risk communication have identified healthcare providers, especially physicians, as the source of information most trusted by the public on issues of environmental health. Nothing in medical, nursing or most healthcare provider training actually prepares practitioners to play this role and healthcare providers are generally more oriented toward treatment and medical care than prevention and public health. Healthcare providers require education in order to play this role but rarely seek it.

DC Water and Sewer Authority and lead in drinking water: a case study in environmental health risk management.

In 2001, following a change in disinfection agent in anticipation of the Environment Protection Agency Disinfection Byproduct Rule, lead levels began rising in drinking water in Washington, District of Columbia, and in 2002, the DC Water and Sewer Authority was found to have exceeded the Environment Protection Agency lead action level, requiring compliance with a series of measures under the Lead and Copper Rule. In 2004, the issue became a public concern, drawing considerable media attention. The problem was eventually resolved through the application of orthophosphate but while it played out, the utility was forced to respond to a novel public health issue with few risk management options.

Elevated lead in drinking water in Washington, DC, 2003-2004: the public health response.

Background: In 2003, residents of the District of Columbia (DC) experienced an abrupt rise in lead levels in drinking water, which followed a change in water-disinfection treatment in 2001 and which was attributed to consequent changes in water chemistry and corrosivity.

Objectives: To evaluate the public health implications of the exceedance, the DC Department of Health expanded the scope of its monitoring programs for blood lead levels in children.

Methods: From 3 February 2004 to 31 July 2004, 6,834 DC residents were screened to determine their blood lead levels.

Protecting children from toxic exposure: three strategies.

To a toxicologist, "poisonings" are cases in which the child has a defined pattern of symptoms, corresponding to toxic effects at a mid to high level of exposure. "Toxicity" refers to a broader spectrum of effects. At lower levels of toxicity a child may have no specific, individual symptoms but may be affected subclinically.

Defining susceptibility for microbial risk assessment: results of a workshop.

An interdisciplinary workshop was convened by the George Washington University in June 2001 to discuss how to incorporate new knowledge about susceptibility to microbial pathogens into risk assessment and management strategies. Experts from government, academic, and private sector organizations discussed definitions, methods, data needs, and issues related to susceptibility in microbial risk assessment. The participants agreed that modeling approaches need to account for the highly specific nature of host-pathogen relationships, and the wide variability of infectivity, immunity, disease transmission, and outcome rates within microbial species and strains.