Water Quality Trade-offs for Risk Management Interventions in a Green Building.

Premise plumbing water quality degradation has led to negative health impacts from pathogen outbreaks (e.g., Legionella pneumophila and non-tuberculous mycobacteria), as well as chronic effects from exposure to heavy metals or disinfection by-products (DBP). Common water quality management interventions include flushing, heat shock (thermal disinfection), supplemental disinfection (shock or super chlorination), and water heater temperature setpoint change. In this study, a Legionella pneumophila- colonized Leadership in Energy and Environmental Design (LEED) certified building was monitored to study health-relevant water quality changes before and after three controlled management interventions: (1) flushing at several points throughout the building; (2) changing the water heater set point; and (3) a combination of interventions (1) and (2) by flushing during a period of elevated water heater set point (incompletely performed due to operational issues). Microbial (culturable L. pneumophila, the L. pneumophila mip gene, and cATP) and physico-chemical (pH, temperature, conductivity, disinfectant residual, disinfection by-products (DBPs; total trihalomethanes, TTHM), and heavy metals) water quality were monitored alongside building occupancy as approximated using Wi-Fi logins. Flushing alone resulted in a significant decrease in cATP and L. pneumophila concentrations (p = 0.018 and 0.019, respectively) and a significant increase in chlorine concentrations (p = 0.002) as well as iron and DBP levels (p = 0.002). Copper concentrations increased during the water heater temperature setpoint increase alone to 140°F during December 2022 (p = 0.01). During the flushing and elevated temperature in parts of the building in February 2023, there was a significant increase in chlorine concentrations (p = 0.002) and iron (p = 0.002) but no significant decrease in L. pneumophila concentrations in the drinking water samples (p = 0.27). This study demonstrated the potential impacts of short term or incompletely implemented interventions which in this case were not sufficient to holistically improve water quality. As implementing interventions is logistically- and time-intensive, more effective and holistic approaches are needed for informing preventative and corrective actions that are beneficial for multiple water quality and sustainability goals.

Research gaps and priorities for quantitative microbial risk assessment (QMRA).

The coronavirus disease 2019 pandemic highlighted the need for more rapid and routine application of modeling approaches such as quantitative microbial risk assessment (QMRA) for protecting public health. QMRA is a transdisciplinary science dedicated to understanding, predicting, and mitigating infectious disease risks. To better equip QMRA researchers to inform policy and public health management, an Advances in Research for QMRA workshop was held to synthesize a path forward for QMRA research. We summarize insights from 41 QMRA researchers and experts to clarify the role of QMRA in risk analysis by (1) identifying key research needs, (2) highlighting emerging applications of QMRA; and (3) describing data needs and key scientific efforts to improve the science of QMRA. Key identified research priorities included using molecular tools in QMRA, advancing dose-response methodology, addressing needed exposure assessments, harmonizing environmental monitoring for QMRA, unifying a divide between disease transmission and QMRA models, calibrating and/or validating QMRA models, modeling co-exposures and mixtures, and standardizing practices for incorporating variability and uncertainty throughout the source-to-outcome continuum. Cross-cutting needs identified were to: develop a community of research and practice, integrate QMRA with other scientific approaches, increase QMRA translation and impacts, build communication strategies, and encourage sustainable funding mechanisms. Ultimately, a vision for advancing the science of QMRA is outlined for informing national to global health assessments, controls, and policies.

Characterization of roof runoff microbial quality in four U.S. cities with varying climate and land use characteristics.

Roof runoff has the potential to serve as an important local water source in regions with growing populations and limited water supply. Given the scarcity of guidance regulating the use of roof runoff, a need exists to characterize the microbial quality of roof runoff. The objective of this 2-year research effort was to examine roof runoff microbial quality in four U.S. cities: Fort Collins, CO; Tucson, AZ; Baltimore, MD; and Miami, FL. Seven participants, i.e., homeowners and schools, were recruited in each city to collect roof runoff samples across 13 precipitation events. Sample collection was done as part of a citizen science approach. The presence and concentrations of indicator organisms and potentially human-infectious pathogens in roof runoff were determined using culture methods and digital droplet polymerase chain reaction (ddPCR), respectively. The analyzed pathogens included Salmonella spp., Campylobacter spp., Giardia duodenalis, and Cryptosporidium parvum. Several factors were evaluated to study their influence on the presence of potentially human-infectious pathogens including the physicochemical characteristics (total suspended solids, volatile suspended solids, total dissolved solids, chemical oxygen demand, and turbidity) of roof runoff, concentrations of indicator organisms, presence/absence of trees, storm properties (rainfall depth and antecedent dry period), percent of impervious cover surrounding each sampling location, seasonality, and geographical location. E. coli and enterococci were detected in 73.4% and 96.2% of the analyzed samples, respectively. Concentrations of both E. coli and enterococci ranged from <0 log10 to >3.38 log10 MPN/100 mL. Salmonella spp. invA, Campylobacter spp. ceuE, and G. duodenalis ß - giardin gene targets were detected in 8.9%, 2.5%, and 5.1% of the analyzed samples, respectively. Campylobacter spp. mapA and C. parvum 18S rRNA gene targets were not detected in any of the analyzed samples. The detection of Salmonella spp. invA was influenced by the geographical location of the sampling site (Chi-square p-value < 0.001) as well as the number of antecedent dry days prior to a rain event (p-value = 0.002, negative correlation). The antecedent dry period was negatively correlated with the occurrence of Campylobacter spp. ceuE as well (p-value = 0.07). On the other hand, the presence of G. duodenalis ß-giardin in roof runoff was positively correlated with rainfall depth (p-value = 0.05). While physicochemical parameters and impervious area were not found to be correlated with the presence/absence of potentially human-infectious pathogens, significant correlations were found between meteorological parameters and the presence/absence of potentially human-infectious pathogens. Additionally, a weak, yet significant positive correlation, was found only between the concentrations of E. coli and those of Giardia duodenalis ß-giardin. This dataset represents the largest-scale study to date of enteric pathogens in U.S. roof runoff collections and will inform treatment targets for different non-potable end uses for roof runoff. However, the dataset is limited by the low percent detection of bacterial and protozoan pathogens, an issue that is likely to persist challenging the characterization of roof runoff microbial quality given sampling limitations related to the volume and number of samples.