Associations Between Drinking Water Source Watershed and Adverse Birth Outcomes in Central Appalachia

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dc.contributor.authorCornwell, Cameron Scotten
dc.contributor.committeechairKrometis, Leigh-Anne H.en
dc.contributor.committeememberGohlke, Julia M.en
dc.contributor.committeememberCzuba, Jonathan A.en
dc.contributor.committeememberKolivras, Korine N.en
dc.contributor.departmentBiological Systems Engineeringen
dc.coverage.countryUnited Statesen
dc.date.accessioned2022-07-01T08:00:16Zen
dc.date.available2022-07-01T08:00:16Zen
dc.date.issued2022-06-30en
dc.description.abstractIn order to ensure clean drinking water for all, it is crucial to understand potential upland stressors that compromise the quality of source waters treated by local community water systems (CWSs). Contamination associated with specific types of land cover can result in downstream water quality degradation, which may reduce the effectiveness of treatment by CWSs. Surface mining has been hypothesized as a source of drinking water degradation within the Central Appalachian region, which may result in adverse exposures and health disparities. The purpose of this study was to identify potential correlations between land cover and adverse birth outcomes (ABOs) through the application of watershed epidemiology, an emerging environmental health paradigm. Birth records for the Central Appalachian region were acquired from their respective state health departments from 2001 to 2015: each record contained the mother's street address, outcome variables, and covariates. Records were included in later analyses if they fell within an approximated CWS service area. Contributing land cover to each CWS was determined via previously delineated watersheds that relied on CWS intake points. A binomial generalized linear model was used to compare low birth weight (LBW), term low birth rate (tLBW), and preterm birth (PTB) incidence to CWS source watershed land cover, Safe Drinking Water Act (SDWA) violations, CWS size, and covariates related to the birth records. Source watershed mining and SDWA health based (HB) violations were significantly associated with greater risks for preterm birth (PTB) and low birth weight (LBW). Future work should be conducted to explore upstream flow impacts, address missing data in the birth records, and to more accurately represent CWS service areas to better characterize exposure.en
dc.description.abstractgeneralMillions of individuals throughout the world are sickened by waterborne exposures every year. To ensure clean drinking water long-term, it is crucial to understand how human land cover might change the water quality of source watersheds, as this may impact the effectiveness of water treatment and increase adverse human health exposures. The goal of this effort is to understand whether land cover is linked to downstream adverse birth outcomes (ABOs) in Central Appalachia, a region of the United States previously associated with high disease incidence suspected to be partially linked to environmental exposure. Birth records were acquired for the years of 2001 to 2015 from four (VA, WV, TN, KY) respective state health departments. Each record contained the mother's address, outcome variables, and covariates (e.g., race, ethnicity). Births were located within approximate service areas for 140 surface water dependent community water systems (CWS) within the region. Data from each CWS, including weighted land cover proportions for their source watershed, were merged with the birth records according to approximate service areas. Statistical analysis suggested that higher source watershed levels of mining and urban development were associated with higher risks of preterm birth (PTB) and low birth weight (LBW). The number of health based (HB) violations associated with each CWS was also associated with both of these outcomes. Major limitations of this work include birth record data gaps and the lack of publicly available CWS service areas and/or water consumption rates, which does increase the risk of exposure misclassification.en
dc.description.degreeMaster of Scienceen
dc.format.mediumETDen
dc.identifier.othervt_gsexam:34703en
dc.identifier.urihttp://hdl.handle.net/10919/111076en
dc.language.isoenen
dc.publisherVirginia Techen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectadverse birth outcomesen
dc.subjectAppalachiaen
dc.subjectland coveren
dc.subjectwatershedsen
dc.titleAssociations Between Drinking Water Source Watershed and Adverse Birth Outcomes in Central Appalachiaen
dc.typeThesisen
thesis.degree.disciplineBiological Systems Engineeringen
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen
thesis.degree.levelmastersen
thesis.degree.nameMaster of Scienceen

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