Examining the Relationship Between Safe Drinking Water Violations and Adverse Birth Outcomes in Virginia

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dc.contributor.authorYoung, Holly Annen
dc.contributor.committeechairKolivras, Korine N.en
dc.contributor.committeememberKrometis, Leigh-Anne H.en
dc.contributor.committeememberGohlke, Julia M.en
dc.contributor.departmentGeographyen
dc.date.accessioned2023-02-03T07:00:07Zen
dc.date.available2023-02-03T07:00:07Zen
dc.date.issued2021-08-11en
dc.description.abstractThe Safe Drinking Water Act (SDWA) was established to protect consumers from potential exposure to over 90 water contaminants. Each contaminant is assigned a health-based standard meant to reflect the maximum level at which an adverse human health outcome is unlikely; measurements beyond that level have greater potential to result in an adverse health outcome. While extensive research has been done on the human health implications of water contaminants, few studies have specifically examined the risk to fetal health under real world monitoring conditions. Therefore, the objective of this study is to assess whether drinking water violations are related to fetal health in the Commonwealth of Virginia, by examining the association between SDWA violations and preterm birth (PTB), low birth weight (LBW), and term-low birth weight (tLBW). Singleton births (n=665,984) occurring between 2007 and 2015 in Virginia were geocoded and assigned to their corresponding water service area. Health-based (HB) and monitoring and reporting (MR) violations for 12 contaminants were acquired from the USEPA Safe Drinking Water System, and exposure to contaminants was defined at the service area level to limit exposure misclassification. A logistic regression model for each birth outcome was performed to evaluate potential relationships with water contaminants. When examining the relationship between individual monitoring and reporting violations and PTB, Nitrate-Nitrite and Disinfectant Byproducts Stage 2 violations were both positively associated with the birth outcome. When examining the relationship between health-based violations and birth outcomes, the total coliform rule was negatively associated with tLBW. These findings indicate that monitoring and reporting requirements may need to be more stringent to reduce MR violation occurrence.en
dc.description.abstractgeneralThe Safe Drinking Water Act (SDWA) was established to protect consumers from potential exposure to over 90 water contaminants. Each contaminant is assigned a health-based standard, called the maximum contaminant level (MCL), meant to reflect the maximum level at which an adverse human health outcome is unlikely; measurements beyond that level have greater potential to result in an adverse health outcome. If a contaminant exceeds the MCL or if the water system fails to treat contaminants, then a health-based violation is issued. These health-based violations are a good indication of the water quality within a public water system. In addition to meeting these health-based requirements, public water systems are required to perform regular monitoring and reporting. When a system fails to evaluate water samples or report results, a monitoring and reporting violation is issued. While extensive research has been done on the human health implications of water contaminants, few studies have specifically examined the risk to fetal health under real world monitoring conditions. Therefore, the objective of this study is to assess whether drinking water violations (health-based and monitoring and reporting) are related to fetal health in the Commonwealth of Virginia, by examining the association between SDWA violations and preterm birth (PTB), low birth weight (LBW), and term-low birth weight (tLBW). Singleton births (n=665,984) occurring between 2007 and 2015 in Virginia were geocoded and assigned to their corresponding water service area. Health-based and monitoring and reporting (MR) violations for 12 contaminants were acquired from the USEPA Safe Drinking Water Information System, and exposure to contaminants was defined at the service area level to limit exposure misclassification. A logistic regression model for each birth outcome was performed to evaluate potential relationships with water contaminants. When examining the relationship between individual monitoring and reporting violations and PTB, Nitrate-Nitrite and Disinfectant Byproducts Stage 2 violations were both positively associated with PTB. When examining the relationship between health-based violations and birth outcomes, the total coliform rule was negatively associated with tLBW. These findings indicate that monitoring and reporting requirements may need to be more stringent to reduce MR violation occurrence.en
dc.description.degreeMaster of Scienceen
dc.format.mediumETDen
dc.identifier.othervt_gsexam:31887en
dc.identifier.urihttp://hdl.handle.net/10919/113642en
dc.publisherVirginia Techen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectmedical geographyen
dc.subjectgeographyen
dc.subjectenvironmental healthen
dc.subjectspatial epidemiologyen
dc.subjectwater qualityen
dc.subjectbirth outcomesen
dc.titleExamining the Relationship Between Safe Drinking Water Violations and Adverse Birth Outcomes in Virginiaen
dc.typeThesisen
thesis.degree.disciplineGeographyen
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen
thesis.degree.levelmastersen
thesis.degree.nameMaster of Scienceen

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