Community Water Systems Research Articles

County-level associations between drinking water PFAS contamination and COVID-19 mortality in the United States.

Epidemiologic and animal studies both support relationships between exposures to per- and polyfluoroalkyl substances (PFAS) and harmful effects on the immune system. Accordingly, PFAS have been identified as potential environmental risk factors for adverse COVID-19 outcomes. Here, we examine associations between PFAS contamination of U.S. community water systems (CWS) and county-level COVID-19 mortality records. Our analyses leverage two datasets: one at the subnational scale (5371 CWS serving 621 counties) and one at the national scale (4798 CWS serving 1677 counties). The subnational monitoring dataset was obtained from statewide drinking monitoring of PFAS (2016-2020) and the national monitoring dataset was obtained from a survey of unregulated contaminants (2013-2015). We conducted parallel analyses using multilevel quasi-Poisson regressions to estimate cumulative incidence ratios for the association between county-level measures of PFAS drinking water contamination and COVID-19 mortality prior to vaccination onset (Jan-Dec 2020). In the primary analyses, these regressions were adjusted for several county-level sociodemographic factors, days after the first reported case in the county, and total hospital beds. In the subnational analysis, detection of at least one PFAS over 5 ng/L was associated with 12% higher [95% CI: 4%, 19%] COVID-19 mortality. In the national analysis, detection of at least one PFAS above the reporting limits (20-90 ng/L) was associated with 13% higher [95% CI: 8%, 19%] COVID-19 mortality. Our findings provide evidence for an association between area-level drinking water PFAS contamination and higher COVID-19 mortality in the United States. These findings reinforce the importance of ongoing state and federal monitoring efforts supporting the U.S. Environmental Protection Agency's 2024 drinking water regulations for PFAS. More broadly, this example suggests that drinking water quality could play a role in infectious disease severity. Future research would benefit from study designs that combine area-level exposure measures with individual-level outcome data.

Developing Service Line Inventories: Guidance for Utilities With Limited Lead Lines

Key TakeawaysIn the United States, all community and nontransient noncommunity water systems are required to submit an inventory describing the location and makeup of all service lines in their service areas.While the material can be designated as lead, galvanized requiring replacement, nonlead, or unknown, the last two designations require additional steps to be taken in the proposed Lead and Copper Rule Improvements (LCRI).Some utilities have few or no lead service lines, and this inventory requirement, issued by the US Environmental Protection Agency (EPA), may be burdensome to those utilities.This article demonstrates the methodology in EPA's proposed LCRI for verification of construction material, and an alternate validation procedure is proposed.

Impact of Droughts on Served Drinking Water Disparities in California, 2007-2020.

Objectives. To quantify the impact of droughts on drinking water arsenic and nitrate levels provided by community water systems (CWSs) in California and to assess whether this effect varies across sociodemographic subgroups. Methods. I integrated CWS characteristics, drought records, sociodemographic data, and regulatory drinking water samples (n = 83 317) from 2378 water systems serving 34.8 million residents from 2007 to 2020. I analyzed differential drought effects using fixed-effect regression analyses that cumulatively accounted for CWS-level trends, income, and agricultural measures. Results. CWSs serving majority Latino/a communities show persistently higher and more variable drinking water nitrate levels. Drought increased nitrate concentrations in majority Latino/a communities, with the effect doubling for CWSs with more than 75% Latino/a populations served. Arsenic concentrations in surface sources also increased during drought for all groups. Differential effects are driven by very small (< 500) and privately owned systems. Conclusions. Impending droughts driven by climate change may further increase drinking water disparities and arsenic threats. This underscores the critical need to address existing inequities in climate resilience planning and grant making. (Am J Public Health. 2024;114(9):935-945. https://doi.org/10.2105/AJPH.2024.307758).

Public drinking water contaminant estimates for birth cohorts in the Environmental Influences on Child Health Outcomes (ECHO) Cohort.

The United States Environmental Protection Agency (USEPA) regulates over 80 contaminants in community water systems (CWS), including those relevant to infant health outcomes. Multi-cohort analyses of the association between measured prenatal public water contaminant concentrations and infant health outcomes are sparse in the US. Our objectives were to (1) develop Zip Code Tabulation Area (ZCTA)-level CWS contaminant concentrations for participants in the Environmental Influences on Child Health Outcomes (ECHO) Cohort and (2) evaluate regional, seasonal, and sociodemographic inequities in contaminant concentrations at the ZCTA-level. The ECHO Cohort harmonizes data from over 69 extant pregnancy and pediatric cohorts across the US. We used CWS estimates derived from the USEPA's Six-Year Review 3 (2006-2011) to develop population-weighted, average concentrations for 10 contaminants across 7640 ZCTAs relevant to the ECHO Cohort. We evaluated contaminant distributions, exceedances of regulatory thresholds, and geometric mean ratios (with corresponding percent changes) associated with ZCTA sociodemographic characteristics via spatial lag linear regression models. We observed significant regional variability in contaminant concentrations across the US. ZCTAs were most likely to exceed the maximum contaminant level for arsenic (n = 100, 1.4%) and the health-protective threshold for total trihalomethanes (n = 3584, 64.0%). A 10% higher proportion of residents who were American Indian/Alaskan Native and Hispanic/Latino was associated with higher arsenic (11%, 95% CI: 7%, 15%; and 2%, 95% CI: 0%, 3%, respectively) and uranium (15%, 95% CI: 10%, 21%; and 9%, 95% CI: 6%, 12%, respectively) concentrations. Nationwide epidemiologic analyses evaluating the association between US community water system contaminant concentration estimates and associated adverse birth outcomes in cohort studies are sparse because public water contaminant concentration estimates that can be readily linked to participant addresses are not available. We developed Zip Code Tabulation Area (ZCTA)-level CWS contaminant concentrations that can be linked to participants in the Environmental Influences on Child Health Outcomes (ECHO) Cohort and evaluated regional, seasonal, and sociodemographic inequities in contaminant concentrations for these ZCTAs. Future epidemiologic studies can leverage these CWS exposure estimates in the ECHO Cohort to evaluate associations with relevant infant outcomes.

Public Community Water System Expenditures Across the Downstate Region of Illinois

Public Community Water System Expenditures Across the Downstate Region of Illinois

Drinking water source and exposure to regulated water contaminants in the California Teachers Study cohort.

Pollutants including metals/metalloids, nitrate, disinfection byproducts, and volatile organic compounds contaminate federally regulated community water systems (CWS) and unregulated domestic wells across the United States. Exposures and associated health effects, particularly at levels below regulatory limits, are understudied. We described drinking water sources and exposures for the California Teachers Study (CTS), a prospective cohort of female California teachers and administrators. Participants' geocoded addresses at enrollment (1995-1996) were linked to CWS service area boundaries and monitoring data (N = 115,206, 92%); we computed average (1990-2015) concentrations of arsenic, uranium, nitrate, gross alpha (GA), five haloacetic acids (HAA5), total trihalomethanes (TTHM), trichloroethylene (TCE), and tetrachloroethylene (PCE). We used generalized linear regression to estimate geometric mean ratios of CWS exposures across demographic subgroups and neighborhood characteristics. Self-reported drinking water source and consumption at follow-up (2017-2019) were also described. Medians (interquartile ranges) of average concentrations of all contaminants were below regulatory limits: arsenic: 1.03 (0.54,1.71) µg/L, uranium: 3.48 (1.01,6.18) µg/L, GA: 2.21 (1.32,3.67) pCi/L, nitrate: 0.54 (0.20,1.97) mg/L, HAA5: 8.67 (2.98,14.70) µg/L, and TTHM: 12.86 (4.58,21.95) µg/L. Among those who lived within a CWS boundary and self-reported drinking water information (2017-2019), approximately 74% self-reported their water source as municipal, 15% bottled, 2% private well, 4% other, and 5% did not know/missing. Spatially linked water source was largely consistent with self-reported source at follow-up (2017-2019). Relative to non-Hispanic white participants, average arsenic, uranium, GA, and nitrate concentrations were higher for Black, Hispanic and Native American participants. Relative to participants living in census block groups in the lowest socioeconomic status (SES) quartile, participants in higher SES quartiles had lower arsenic/uranium/GA/nitrate, and higher HAA5/TTHM. Non-metropolitan participants had higher arsenic/uranium/nitrate, and metropolitan participants had higher HAA5/TTHM. Though average water contaminant levels were mostly below regulatory limits in this large cohort of California women, we observed heterogeneity in exposures across sociodemographic subgroups and neighborhood characteristics. These data will be used to support future assessments of drinking water exposures and disease risk.

Submersible voltammetric sensing probe for rapid and extended remote monitoring of opioids in community water systems

The intensifying global opioid crisis, majorly attributed to fentanyl (FT) and its analogs, has necessitated the development of rapid and ultrasensitive remote/on-site FT sensing modalities. However, current approaches for tracking FT exposure through wastewater-based epidemiology (WBE) are unadaptable, time-consuming, and require trained professionals. Toward developing an extended in situ wastewater opioid monitoring system, we have developed a screen-printed electrochemical FT sensor and integrated it with a customized submersible remote sensing probe. The sensor composition and design have been optimized to address the challenges for extended in situ FT monitoring. Specifically, ZIF-8 metal–organic framework (MOF)-derived mesoporous carbon (MPC) nanoparticles (NPs) are incorporated in the screen-printed carbon electrode (SPCE) transducer to improve FT accumulation and its electrocatalytic oxidation. A rapid (10 s) and sensitive square wave voltammetric (SWV) FT detection down to 9.9 µgL−1 is thus achieved in aqueous buffer solution. A protective mixed-matrix membrane (MMM) has been optimized as the anti-fouling sensor coating to mitigate electrode passivation by FT oxidation products and enable long-term, intermittent FT monitoring. The unique MMM, comprising an insulating polyvinyl chloride (PVC) matrix and carboxyl-functionalized multi-walled carbon nanotubes (CNT-COOH) as semiconductive fillers, yielded highly stable FT sensor operation (> 95% normalized response) up to 10 h in domestic wastewater, and up to 4 h in untreated river water. This sensing platform enables wireless data acquisition on a smartphone via Bluetooth. Such effective remote operation of submersible opioid sensing probes could enable stricter surveillance of community water systems toward timely alerts, countermeasures, and legal enforcement.Graphical abstract

Effectiveness of countermeasure options for chemical facilities against the discharge of chemical substances into rivers caused by a large earthquake: case study of the Yodo river system in Osaka prefecture, Japan

Technological accidents triggered by natural hazards, which are commonly referred to as Natech events, are rare occurrences yet carry the potential for significant damage. Specifically, the release of hazardous chemicals into the aquatic environment and community water systems poses a grave threat to human health and society. Accordingly, we must conduct assessments that consider the potential consequences of these accidents. In this study, we examined the criteria for implementing spill protection measures to mitigate river spills of chemical substances using information on the amount of chemical substances and their toxicity. The countermeasure options readily available to employees at industrial plants and chemical storage sites where a chemical spill might originate included emergency shut-off valves, bunds and related spill containment structures, and other spill prevention measures. In this case study, a combination of countermeasure options was evaluated to examine the effectiveness of spill mitigation in the Yodo River located in the Kyoto Prefecture of Japan. Results of the case study showed that bunds were emerged as the most useful countermeasure option, reducing the probability of accidents occurring and impact of accidents. We also defined a methodology for calculating the chemical storage volumes appropriate for different countermeasures to ensure that the concentration of chemicals that could reach the water intake does not exceed the standard values. We believe that these methodologies can help chemical-handling companies make decisions when countermeasure options for responding to a chemical spill into a river. Chemical-handling companies can estimate the risk to downstream water treatment plants in the chemical spill, which can also help them consider mitigation measures.

Factors Associated with Public Water Supply Unreliability

Public water supply unreliability is a problem that causes human hardships and remains common in the United States. In this paper, we attempt to examine the factors associated with public water supply unreliability. We measure public water service unreliability by the issuance of boil water notices (BWNs). By using a Negative Binomial regression model and data from West Virginia community water systems in 2020, we find that water systems that purchase their water from other water systems, have more educated and experienced operators, and serve high-income areas and a higher percentage of Native residents are expected to issue more BWNs. On the other hand, water systems that are small and serve a higher percentage of rural, educated, employed residents are expected to issue fewer BWNs. The findings emphasize the need to move beyond simplistic assumptions about water system reliability and consider the combined influence of technical, socio-economic, and demographic factors.

Assessing Drinking Water Systems to Improve Performance and Capacity

Key TakeawaysFragmented data across state agencies and subagencies reduce the ability to assess a community water system's overall condition.Identifying relationships among different dimensions of performance can help assess how well systems respond to challenges.Balancing affordability with capacity for reliable drinking water delivery over time is an ongoing challenge for many utilities.Focusing only on safe drinking water compliance in research and oversight may overlook systems with other critical vulnerabilities.

PFAS-Contaminated Pesticides Applied near Public Supply Wells Disproportionately Impact Communities of Color in California.

Contaminated drinking water from widespread environmental pollutants such as perfluoroalkyl and polyfluoroalkyl substances (PFAS) poses a rising threat to public health. PFAS monitoring in groundwater is limited and fails to consider pesticides found to contain PFAS as a potential contamination source. Given previous findings on the disproportionate exposure of communities of Color to both pesticides and PFAS, we investigated disparities in PFAS-contaminated pesticide applications in California based on community-level sociodemographic characteristics. We utilized statewide pesticide application data from the California Department of Pesticide Regulation and recently reported concentrations of PFAS chemicals detected in eight pesticide products to calculate the areal density of PFAS applied within 1 km of individual community water systems' (CWSs) supply wells. Spatial regression analyses suggest that statewide, CWSs that serve a greater proportion of Latinx and non-Latinx People of Color residents experience a greater areal density of PFAS applied and greater likelihood of PFAS application near their public supply wells. These results highlight agroecosystems as potentially important sources of PFAS in drinking water and identify areas that may be at risk of PFAS contamination and warrant additional PFAS monitoring and remediation.

Water Fluoridation and Birth Outcomes in California.

There is a lack of research on the relationship between water fluoridation and pregnancy outcomes. We assessed whether hypothetical interventions to reduce fluoride levels would improve birth outcomes in California. We linked California birth records from 2000 to 2018 to annual average fluoride levels by community water system. Fluoride levels were collected from consumer confidence reports using publicly available data and public record requests. We estimated the effects of a hypothetical intervention reducing water fluoride levels to (the current level recommended by the US Department of Health and Human Services) and (below the current recommendation) on birth weight, birth-weight-for-gestational age z-scores, gestational age, preterm birth, small-for-gestational age, large-for-gestational age, and macrosomia using linear regression with natural cubic splines and G-computation. Inference was calculated using a clustered bootstrap with Wald-type confidence intervals. We evaluated race/ethnicity, health insurance type, fetal sex, and arsenic levels as potential effect modifiers. Fluoride levels ranged from 0 to , with a median of . There was a small negative association on birth weight with the hypothetical intervention to reduce fluoride levels to [; 95% confidence interval (CI): , 0.0] and to (; 95% CI: , ). There were small negative associations with birth-weight-for-gestational-age z-scores for both hypothetical interventions (: ; 95% CI: , 0.000 and : ; 95% CI: , 0.000). We also observed small negative associations for risk of large-for-gestational age for both the hypothetical interventions to [; 95% CI: , 0.000 and (; 95% CI: , 0.000)]. We did not observe any associations with preterm birth or with being small for gestational age for either hypothetical intervention. We did not observe any associations with risk of preterm birth or small-for-gestational age for either hypothetical intervention. We estimated that a reduction in water fluoride levels would modestly decrease birth weight and birth-weight-for-gestational-age z-scores in California. https://doi.org/10.1289/EHP13732.

Association of Water Arsenic With Incident Diabetes in U.S. Adults: The Multi-Ethnic Study of Atherosclerosis and the Strong Heart Study.

We examined the association of arsenic in federally regulated community water systems (CWS) and unregulated private wells with type 2 diabetes (T2D) incidence in the Strong Heart Family Study (SHFS), a prospective study of American Indian communities, and the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective study of racially and ethnically diverse urban U.S. communities. We evaluated 1,791 participants from SHFS and 5,777 participants from MESA who had water arsenic estimates available and were free of T2D at baseline (2001-2003 and 2000-2002, respectively). Participants were followed for incident T2D until 2010 (SHFS cohort) or 2019 (MESA cohort). We used Cox proportional hazards mixed-effects models to account for clustering by family and residential zip code, with adjustment for sex, baseline age, BMI, smoking status, and education. T2D incidence was 24.4 cases per 1,000 person-years (mean follow-up, 5.6 years) in SHFS and 11.2 per 1,000 person-years (mean follow-up, 14.0 years) in MESA. In a meta-analysis across the SHFS and MESA cohorts, the hazard ratio (95% CI) per doubling in CWS arsenic was 1.10 (1.02, 1.18). The corresponding hazard ratio was 1.09 (0.95, 1.26) in the SHFS group and 1.10 (1.01, 1.20) in the MESA group. The corresponding hazard ratio (95% CI) for arsenic in private wells and incident T2D in SHFS was 1.05 (0.95, 1.16). We observed statistical interaction and larger magnitude hazard ratios for participants with BMI <25 kg/m2 and female participants. Low to moderate water arsenic levels (<10 µg/L) were associated with T2D incidence in the SHFS and MESA cohorts.

Quantifying Disparities in Per- and Polyfluoroalkyl Substances (PFAS) Levels in Drinking Water from Overburdened Communities in New Jersey, 2019-2021.

Policymakers have become increasingly concerned regarding the widespread exposure and toxicity of per- and polyfluoroalkyl substances (PFAS). While concerns exist about unequal distribution of PFAS contamination in drinking water, research is lacking. We assess the scope of PFAS contamination in drinking water in New Jersey (NJ), the first US state to develop regulatory levels for PFAS in drinking water. We test for inequities in PFAS concentrations by community sociodemographic characteristics. We use PFAS testing data for community water systems (CWS) () from the NJ Department of Environmental Protection (NJDEP) from 2019 to 2021 and demographic data at the block group level from the US Census to estimate the demographics of the NJ population served by CWS. We use difference in means tests to determine whether CWSs serving "overburdened communities" (OBCs) have a statistically significant difference in likelihood of PFAS detections. OBCs are defined by the NJDEP to be census block groups in which: a) at least 35% of the households qualify as low-income, b) at least 40% of the residents identify as people of color, or c) at least 40% of the households have limited English proficiency. We calculate statewide summary statistics to approximate the relative proportions of sociodemographic groups that are served by CWSs with PFAS detections. We find that 63% of all CWSs tested by NJDEP from 2019 to 2021 had PFAS detections in public drinking water, collectively serving 84% of NJ's population receiving water from CWSs. Additionally, CWSs serving OBCs had a statistically significant higher likelihood of PFAS detection and a higher likelihood of exposure above state MCLs. We also find that a larger proportion of people of color lived in CWS service areas with PFAS detections compared to the non-Hispanic white population. These findings quantitatively identify disparities in PFAS contamination of drinking water by CWS service area and highlight the extent of PFAS drinking water contamination and the importance of PFAS remediation efforts for protecting environmental health and justice. https://doi.org/10.1289/EHP12787.

The Transaction Costs of the Administrative Presidency: Evidence From a Trump-Era Clean Water Act Enforcement Reduction

Over the last two decades, political polarization has gridlocked federal congressional capacity to meet environmental regulatory demands. As a result, presidential authority has expanded to overcome this legislative impediment leading to a new era of “administrative presidency.” In this new era, presidents have increasingly used their administrative authority to meet politically driven environmental goals. Yet, we still know little about how federal-level executive political actions impact the outcomes and operations of local regulatory environmental systems. This study fills this scholarly void by empirically testing the effect of a federal COVID-19 Clean Water Act (CWA) enforcement reduction on Safe Drinking Water Act (SDWA) implementation outcomes for local community water systems (CWSs) sourcing from surface waters (SWs). Using a framework grounded in transaction cost federalism, we argue that a politically motivated executive reduction in federal CWA enforcement is associated with poor local SDWA implementation outcomes. We test this assumption with a differences-in-differences econometric approach using data drawn from the federal Safe Drinking Water Information System database. Our findings suggest that the CWA enforcement reduction resulted in an over 50% increase in SDWA health violations by CWSs sourcing from SWs. The implications of this study extend to U.S. water policy and environmental federalism, highlighting the need for better coordination between the CWA and SDWA and the potential risks associated with relying on broadened executive actions to drive U.S. environmental policy. Further research is warranted to understand the consequences of administrative policy changes on U.S. environmental governance.

Detection of endotoxins from selected drinking water microbiota using an LAL-based assay and its implications for human health.

Endotoxins are pyrogenic lipopolysaccharides from Gram-negative bacteria that are known to induce fever, septic shock, and multiple organ failure, posing a substantial risk to human health. Drinking water systems are especially prone to home microbiomes containing a large variety of Gram-negative bacteria. Consumption of water from these systems in developed countries is generally regarded as non-hazardous to humans due to the low number of non-pathogenic bacterial cells per milliliter and oral admission. To assess potential risks posed by endotoxins in drinking water systems, we conducted a conventional microbiological investigation on a local community water system in the north of Germany and mined the resulting data to investigate the endotoxin contents of some of the most abundant microbiota found during these analyses. Using a Limulus amoebocyte lysate (LAL) -based endotoxin detection method, average normalized endotoxin content was determined. Although the average culturable amounts of microbiota in the drinking water system were insufficient to exert endotoxin levels critical to human health, peaks and acute contaminations may pose substantial health risks.

Effect of Community Water Service on Lead in Drinking Water in an Environmental Justice Community.

Multiple recent studies have found elevated lead (Pb) concentrations in tap water in U.S. homes relying on unregulated private wells. The main Pb source is dissolution from household plumbing, fixtures, and well components. Here, we leverage a natural experiment and citizen science approach to evaluate how extending community water service to an environmental justice community relying on private wells affects Pb in household water. We analyzed Pb in 260 first-draw kitchen tap water samples collected by individual homeowners over a 5-month period in residences that did and did not connect to the community system. Before the community water system was extended, 25% of homes had Pb > 15 μg/L (the U.S. regulatory action level for community water systems) in first-draw water samples. Pb was significantly correlated with nickel (ρ = 0.61), zinc (ρ = 0.50), and copper (ρ = 0.40), suggesting that corrosion of brass fittings and fixtures is the main Pb source. Among homes that connected to the community system, Pb decreased rapidly and was sustained at levels well below 15 μg/L over the study period. Overall, connecting to the municipal water supply was associated with a 92.5% decrease in first-draw tap water Pb.

An economic evaluation of strategies to ensure safer drinking water in the homes of families with young children in select United States locations

IntroductionIn the United States, safe, accessible drinking water is not equitable due to source water contamination, unreliable water treatment, or hazardous plumbing infrastructure. Drinking water free of lead, nitrates, and arsenic is vital for infant and young children’s health. MethodsResearchers conducted a study combining single-case study review methods and economic evaluation for 6 US policies or programs. Researchers used case-study findings, activity-based costing, publicly available US population data, and existing literature to create 5-year cost projections (2020–2024) for strategies to address lead, nitrates, or arsenic in drinking water from private wells or community water systems for families with low incomes and young children aged 0–5y. Researchers estimated the number of households reached and the costs by activity and payer of implementing each policy or program using case-specific geographic location and eligibility criteria. ResultsThe total number of households reached varied from 295 to 135,000 depending on water source, population of focus, and geographic location. Focused strategies reached higher proportions of families with low incomes and young children. Community water system and state-wide strategies had the broadest reach. The total annual program cost per household that received information about their water quality ranged from $75 to $2,780. Of this cost, the portion paid by the household varied from $0.12 to $1,590, not including mitigation. ConclusionsThese findings can inform local decisions about policies and programs in communities seeking to increase awareness and access to safer drinking water, particularly in homes of families with low incomes and young children.

Finding and Assessing US Galvanized Service Lines

Given impending regulations, a study of community water systems found challenges in defining, identifying, and funding remediation of the galvanized pipe associated with lead service lines.

Quantitative health risk assessment of microbial hazards from water sources for community and self-supply drinking water systems

In low and medium income countries (LMIC) drinking water sources (wells and boreholes) often contain a high number of pathogenic microorganisms, that can pose significant human and environmental health risks. In this study, a quantitative microbial risk assessment approach based on existing literature was conducted to evaluate and compare the quantitative health risks associated with different age groups using various drinking water supply systems. Results showed that both community-supply and self-supply modes exhibit similar levels of risk. However, the self-supply water source consistently showed higher risks compared to the community-supply one. Borehole water was found to be a more suitable option than well water, consistently showing between 5 and 8 lower health risks for E. coli and fecal coliform levels, respectively. The sensitivity analysis further showed the importance of prioritizing the reduction of E. coli concentration in well water and fecal coliform concentration in borehole water. This study offers a fresh perception on quantifying the impact of exposure concentration and age groups, shedding light on how they affect environmental health risks. These findings provide valuable insights for stakeholders involved in the management and protection of water sources.