Project Regions North America
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Drinking Water & Health in Rural Appalachia

We are working on a number of projects to better understand issues related to drinking water (access, quality, use), sanitation, and health in the Appalachia region. In 2020, we started a comprehensive systematic review and meta-analysis study to identify and synthesize published research on drinking water contamination and associated health outcomes in the Appalachian region over a 20-year time period. We pre-registered our study protocols and completed data extraction and analysis in 2022; we anticipate publishing this work in 2023 (as of the end of 2022 our manuscript was under review). In collaboration with UVA, ETSU, and others, we are also conducting two, small-scale, water-and-health focused prospective cohort studies in southwest VA. In 2022, we published initial findings from one of these studies (focused on a small community in one county), and we anticipate publishing preliminary findings from the other, larger-scale, study (households across two counties) in 2023. Given the relatively high rates of household bottled water use/reliance we observed, we are also conducting an additional study to analyze water quality parameters in bottled water sold in big-box and grocery stores in the region; we also anticipate publishing those findings in 2023.

Arsenic in Rural & Carceral Drinking Water Systems

Source: Adapted from

In the United States, millions of people lack reliable access to safe drinking water, a problem that is particularly acute in low-income rural areas. California legally recognized the human right to water in 2012, but this right remains unevenly realized. To better understand the status of the human right to water in rural communities, we analyzed 20 years of publicly available drinking water quality monitoring and violation data from 2001-2021, with a focus on arsenic contamination (a carcinogenic heavy metal) from a state prison as well as public water systems in three neighboring rural communities in southern California. We found that all four of these drinking water systems repeatedly exceeded the legal limit for arsenic during the study period, with mean served arsenic levels ranging from 3.4 (SD=6.7) to 9.3 (SD:=2.9) μg/L across the systems (based on 2,426 samples from four systems). In addition to arsenic-specific findings and comparisons across these four sites, our analyses demonstrate how publicly reported annually averaged water quality data (used to monitor system violations and to track progress toward the human right to water) provide only a partial guide to whether the right to safe water is being realized. We published our findings in 2022.

Wastewater Surveillance & Epidemiology at Multiple Scales

Our group is working on a number of wastewater focused research projects. Over the 2020/21 academic year, Dr.s Pruden & Vikesland (pictured) in Environmental Engineering led an initiative with collaborators across Virginia Tech (and at HRSD) to collect and analyze wastewater samples from different buildings and sites across the university campus with the goal of developing a coronavirus disease-2019 (COVID-19) surveillance program. Wastewater surveillance has been used by many other research groups, as well as wastewater utilities, to monitor SARS-CoV-2 (i.e., the virus that causes COVID-19) trends. Our primary research objective for that study was to evaluate the use of wastewater-based surveillance and epidemiologic methods to monitor and predict SARS-CoV-2 virus trends at sub-sewershed scales. Using pre-specified methods, our analyses showed that the detection of SARS-CoV-2 genes in wastewater samples was associated with statistically significant increases in COVID-19 cases 8 days after sample collection. We published our methods and findings from this research in 2022 and continue to collaborate and expand on this work in other settings. Starting in 2020, our group also supported wastewater surveillance efforts led by colleagues at the Virginia Department of Health (Dr. Degen) the Roanoke Health District, UVA (Dr. Taniuchi), and Radford University (Dr. Tolliver). In the summer of 2022, our research group (in collaboration with other VT faculty, students, and Dr. Taniuchi’s group at UVA) initiated a new wastewater surveillance and epidemiology study in collaboration with a wastewater utility in southwest VA; we started a monthly sub-sewershed sampling campaign in September 2022, and anticipate publishing initial findings from this project by/before 2024.