United States
Environmental Protection
Agency
EPA 570/9^89-008
August 1989
Office of Water (WH-550)
c/EPA
Protecting Our
Drinking Water
From Microbes
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Contents
Safe Drinking Water Act 1
EPA Drinking Water Regulations 2
Waterborne Diseases In The United States... 4
What Are The Most Common
Waterborne Diseases? 5
How Are The Causes Of
Diseases Detected? 7
How Can Waterborne Diseases
Be Controlled? 9
Safe Drinking Water Act Requirements 14
Summing Up ... What All This
Means To You 19
Glossary 20
EPA Regional Offices 21
State Water Supply Agencies 22
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Protecting Our Drinking Water
From Microbes
Most of us take safe, clean drinking water
for granted. Conventional wisdom says only
travelers to foreign countries or campers
roughing it on vacation get sick from the
water they drink. But conventional wisdom
is often wrong. Waterborne diseases are still
a problem in the United States, especially
in areas where the water supplies are not
subject to adequate treatment.
Although filtration, chlorination, and
other preventive actions have helped
control cholera, typhoid fever, and other
waterborne bacterial diseases once common
in this country, other microbes such as
viruses and protozoa—usually more
resistant to chlorination than bacteria—are
still not being adequately controlled in
some water supplies.
Safe Drinking To deal with this serious problem, Congress
Water Act enacted the Safe Drinking Water Act
(SDWA) in 1974. The law was amended in
1986 to expand EPA's role in protecting the
public health from contaminated drinking
water. The amendments require the Agency
to:
• Control specific disease-causing
organisms and indicators of their presence
in drinking water.
• Require public water-supply systems that
use surface water sources such as lakes to
filter their water unless it is established
that their sources are very clean and
well-protected.
• Require public systems to disinfect their
water, with allowance for variances if the
water comes from sources that are
determined not to be at risk from
microbiological contamination.
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Sources
Public Water Systems
Sources and Users
Systems*
Population
Served
Surface Water
Ground Water
14,500
174,000
150 Million
90 Million
Includes systems that purchase their water
EPA
Drinking-Water
Regulations
EPA has published new regulations to
implement these amendments. All public
water systems and virtually every American
will be affected by the new rule regulating
total coliform bacteria levels in drinking
water. The filtration and disinfection
requirements of the Surface Water
Treatment Rule (SWTR) will affect surface
water systems. Filtration removes many
contaminants, including microbes, and
improves the overall quality of the drinking
water. EPA is also developing disinfection
regulations for ground-water systems.
The public health protection provided by
these new rules will not be inexpensive,
however. EPA estimates compliance with
the revised total coliforms rule alone will
cost water supply systems collectively
about $70 million more than they now pay
to comply with the current requirements. In
addition, surface water systems that do not
already filter their water will have to spend
$2.3 billion in capital costs to meet the
SWTR requirement to provide filtration or
to meet the criteria for avoiding filtration.
Public water systems that already filter, bul
must upgrade their operations to meet
federal standards collectively will face $660
million in additional capital costs.
Ultimately, consumers will be charged for
these improvements in higher water bills.
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This pamphlet explains what they will be
getting for their money. It also explains
what causes various waterborne diseases
and how public water suppliers can control
such diseases, and tells what EPA is doing
under the 1986 Safe Drinking Water Act
amendments to see that the quality of
drinking water is improved.
Because we all have a stake in safe
drinking water, readers served by public
water systems (those with at least 15
service connections or at least 25
customers) will find this information useful
in keeping tabs on what their water system
is, or should be, doing to make sure their
drinking water is as safe as possible. Private
well owners will find some ideas for
improving the quality of their own water.
Waterborne Disease: Reported Cases
(1971-1985)
Thousands of Cases
VI -72 '73 74 '75 '76 '77 '78 78 'BO '81 '62 'S3 '84 '85
Year
Data: AWWA Journal, February 1988
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Waterborne Disease In The
United States
Safe... But Not
Perfectly
Drinking water in the United States is
among the safest in the world. Between
1971 and 1985, however, there were more
than 500 "outbreaks" of waterborne disease
involving 110,000 illnesses related to
contaminated surface- and ground-water
systems, household wells, and cisterns
reported in this country. An "outbreak" is
when two or more people contract similar
illnesses after using drinking water from
the same source that contains
disease-causing organisms responsible for
their maladies. Public health experts
believe the actual number of illnesses may
be much higher.
The number of reported outbreaks and
cases varies year by year, but this is
probably due to variability in the reliability
of detection and reporting. Actually, the
risk of contracting a waterborne disease is
probably declining, thanks to better
treatment and management of the water supply.
Smaller Water
Systems,
Bigger Problems
Generally, waterborne diseases tend to
break out among customers of small public
water systems serving fewer than 3,300
persons. Although such systems account for
more than 85 percent of all U.S. public
water suppliers, they serve only about 25
million people. Such systems often lack the
financial and technical resources to ensure
that the water they provide is safe to drink.
Unfortunately, many serve campgrounds,
recreational areas, etc., so large numbers of
people—in addition to those living in the
vicinity—may be exposed to waterborne
bacteria and other infectious contaminants
every year. Hikers and backpackers who
drink from untreated and unfiltered rivers,
lakes, and springs are also vulnerable
because these "pristine" sources may
contain disease-carrying microorganisms.
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What are the most common waterborne diseases?
AGI The most frequently reported waterborne
disease in the United States is acute
gastrointestinal illness (AGI), also called
gastroenteritis. AGI is actually a group of
diseases caused by various viruses, bacteria,
or protozoa. When health professionals
cannot identify the exact cause of a
waterborne illness or outbreak, they call it
AGI. Possible symptoms include nausea
and vomiting, diarrhea, and abdominal
discomfort. (These fairly common
symptoms are also usually associated with
colds, flu, and many other problems,
unrelated to drinking water, which might
account for some of the underreporting
referred to earlier.)
Giardiasis From 1971 to 1985, a severe intestinal
ailment known as giardiasis was the most
frequently diagnosed waterborne disease.
More than 23,000 cases have been reported
in the last 20 years. Its symptoms are the
same as AGI, but more severe, and may
include severe dehydration, weight loss,
and fatigue. Giardiasis can persist for
several months or longer.
A single-cell protozoan, Giardia lamblia
causes this disease. Sometimes called
"backpacker's disease," giardiasis is usually
associated with unfiltered surface-water
supply systems whose disinfection was
either interrupted or inadequate to kill the
Giardia protozoan. It may also result from
inadequately designed or operated filtration
systems. (Because the Giardia protozoan is
large enough to be naturally filtered out of
ground water as it passes through sand and
gravel, outbreaks of giardiasis are rarely
associated with ground-water systems.)
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Microbes Responsible For
Waterborne Disease Outbreaks
Number of Outbreaks
Disease Agents
tm Bacteria ^3 Parasites
Data: Centers for Disease Control, 1988
AGI - Acute Gastrointestinal Illness
(Agent Unidentified)
1981-1982
I Viruses
Other Diseases
Other prevalent diseases transmitted in
drinking water are shigellosis,
campylobacteriosis, and salmonellosis.
Caused by bacteria, their symptoms also
include diarrhea, vomiting, and nausea.
These diseases are considered specific
types of AGI. Hepatitis A, which is caused
by a virus, can also be spread in drinking
water. Symptoms vary from minor flu-like
complaints to fatal liver failure.
Even Without
Drinking
You can also get sick by inhaling the
disease-causing organisms (also known as
pathogens) that live in water, or from
exposure to contaminants at beaches and
pools, in standing water, or in moisture
collecting in ventilation and
air-conditioning systems. One example is a
common soil bacterium called Legionella
pneumophila which causes legionellosis,
which is most familiar in its pneumonia
form, "Legionnaire's Disease" or in a
milder, non-pneumonia form, "Potomac
Fever." There have been reports that some
patients might have contracted
Legionnaire's Disease by inhalation
exposure to bacteria in water.
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How are the causes of diseases detected?
Current federal and state drinking-water
regulations require operators of public
water systems to test their drinking water
for bacteria and other contaminants.
(Coliform bacteria have been regulated in
some water supplies since 1914 and
universally since 1976.) These same
regulations set enforceable limits, called
maximum contaminant levels (MCLs),
which specify how much of a contaminant
can be present before the water is
considered unsafe.
But identifying every type of
disease-causing organism in water samples
is impossible and unnecessary. So many
varieties of bacteria, viruses, and protozoa
can make people sick that EPA cannot
develop MCLs for each one. Also, analyzing
water samples for many of these harmful
bacteria is expensive and, in some cases,
not yet possible. Regulators and water
suppliers, therefore, must look for
"indicators" to determine if drinking water
meets safety standards.
Indicators An indicator is an easily identified single
microbe or group of related microorganisms
whose presence can mean drinking water
has been contaminated by animal or human
feces—the source of most waterborne
diseases.
Indicators also serve as a check on the
efficiency of water treatment and the
integrity of the water distribution system.
Treatment that provides indicator-free
water greatly reduces the likelihood that
disease-causing organisms are present. The
absence of an indicator, however, doesn't
necessarily mean that no disease-causing
organisms are present in a given sample.
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Coliforms Total coliforms, a group of closely related,
generally harmless bacteria, are regarded as
the best indicator and are most often used
because they are common in the
environment and easy to measure.
Occasionally fecal coliforms, a sub-group of
total coliforms that usually live in human
or animal intestinal tracts, are also used.
Coliforms are good indicators of possible
drinking water contamination because their
presence in a sample can signal (1) possible
fecal contamination, (2) the effectiveness of
water treatment to combat contamination,
and (3) deterioration of the drinking water
system. Total coliforms are a sensitive
screening system since they normally
outnumber pathogens in drinking water by
a wide margin and are easily detected in
the small water samples used for laboratory
analysis. Fecal coliforms, when present, are
even more accurate indicators of fecal
pollution, but are harder to detect because
of their smaller numbers.
Coliforms are very reliable as indicators,
but not infallible. Because coliforms are
generally more sensitive to disinfection
than other pathogens (e.g. chlorine-resistant
bacteria, some viruses, and protozoa such
as Giardia), their absence from drinking
water does not necessarily mean that such
pathogens are not present. Also, some
coliforms occur naturally so their presence
in a sample may not indicate the water has
fecal contamination.
Other Indicators Other indicators used in laboratory analysis
include:
Heterotrophic bacteria, which are bacteria
that use organic nutrients for growth and
activity. This large group includes almost
all bacterial pathogens and most harmless
microbes. Their presence in high numbers
might signal deficiencies in water treatment
or problems with the pipes through which
water is distributed, but it does not
necessarily indicate a risk of waterbourne
disease.
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Turbidity, which measures solid particles
that often make water cloudy. These
particles can show if filtration techniques
are working. This is important because
particles may interfere with coliform
analysis and reduce the effectiveness of
disinfecting agents such as chlorine. There
is no direct link between turbidity and
waterborne illness, but in general "less is
better."
Outbreaks And Cases
(1971 -1085)
Reported Occurrence*
Disease Outbreaks ^ Cases Per Outbreak
Data: AWWAJoum*!, February 1988
How can waterborne diseases be controlled?
Almost half of the waterborne disease
outbreaks and illnesses from 1971 to 1985
affected people who drank untreated or
inadequately disinfected ground water.
Twenty-four percent of the outbreaks and
32 percent of the illnesses were traced to
untreated or inadequately treated surface
water, and another 16 percent of the
outbreaks and illnesses were specifically
linked to distribution and storage
deficiencies. The remainder were attributed
to miscellaneous causes. Virtually all of the
illnesses associated with inadequate water
treatment or system operation could have
been avoided.
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Multiple Barriers
Water Supply Problems Linked To
Disease Outbreaks and Cases
(1971 -1985)
Poor or No
Surface-Water Ti
24%
Distribution or Storage
Deficiencies
18%
Miscellaneous,
11%
Poor or No
Ground-Water Treatment
49%
Causes of Outbreaks
(Outbreaks = 502)
Poor or No
Surface-Water Treatment
32%
Distribution or Storage
Deficiencies
16%
Miscellaneous
9%
Poor or No
Ground-Water Treatment
47%
Causes of Illness
(Cases = 111,228)
Data: AWWA Journal, February 1988
10
Experience shows that the best defense
against waterborne diseases is a multiple
barrier concept. This begins with watershed
management to protect high quality surface-
and ground-water sources from
contamination by human and animal waste.
It extends to drinking water systems where
contaminants are filtered out or treated
before the water is sent on to consumers.
Each of these steps—watershed
management, filtration, and disinfection—is
a barrier to waterborne pathogens.
Most public water systems that use a
multiple-barrier approach rely on some
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combination of disinfection, chemical
pre-treatment, filtration, and sedimentation
in addition to watershed management.
Disinfection kills or disables, usually
with chemicals, any pathogens remaining
in the water. Sometimes ultraviolet light is
used instead of chemicals, particularly to
treat well water. Disinfection is not
intended to sterilize the water.
Filtration passes water through beds of
granular material—such as sand—that
remove a substantial amount of solids,
including many microbes. Filters remove
solids that can interfere with disinfection
and large organisms that might resist
disinfectants.
Chemical Pretreatment relies on alum or
other chemicals to form clumps of
impurities, known as floe. Most of the floe
settles out of the raw drinking water; the
floe that remains—with the attached
impurities—can easily be filtered out of the
water.
Sedimentation involves the settling out of
heavy particles from raw water in holding
ponds or basins before filtration.
Common
• Techniques
Disinfection is the most common treatment
technique. It is used by about 97 percent of
the U.S. surface-water supply systems;
two-thirds of them also filter their water.
Less than half of the public water systems
drawing on ground-water sources disinfect
their water because the water is filtered
naturally as it moves through the soil.
However, ground-water systems should
disinfect their raw water if it is vulnerable
to fecal contamination from sewage.
Chlorine
Used since the turn of the century, chlorine
is the most frequently applied disinfectant.
When applied before filtration, it controls
the growth of algae and other microbes that
reduce filter efficiency, and it kills many
microbes, including most pathogens. When
applied after filtration, chlorine kills
additional pathogens and controls the
11
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growth of microbes in the drinking water
distribution system.
Mixed with water, chlorine forms
hypochlorous acid, which is the actual
disinfectant. Household bleach contains a
form of hypochlorous acid, which is why
campers can disinfect their drinking water
with a few drops of bleach.
Unfortunately, chlorine can also combine
with natural organic chemicals in raw
water to create some undesirable
by-products such as trihalomethane. Some
researchers suggest that long-term use of
chlorinated drinking water might slightly
increase the risk of bladder and colon
cancer. Additional studies are underway
that should yield new information about
how chlorine affects human health.
Nonetheless, the benefits of chlorine as a
treatment for waterborne, disease-causing
organisms far outweigh the presently
known risks from chlorine or its
by-products. EPA regulations already
control certain by-products and other rules
are being developed to provide additional
protection from other disinfectants and
their by-products.
Other Chloramine (NH2C1) is a pungent colorless
Disinfectants liquid made by adding ammonia to
chlorine. It is weaker than hypochlorous
acid so more must be used. Unlike
chlorine, it breaks down slowly in the
water supply distribution system so its
disinfection properties last longer.
Chlorine dioxide (C1O2) is used to control
tastes and odors in drinking water. Because
of concern about health risks related to its
by-products, EPA recommends that
chlorine dioxide be used only at
concentrations of less than one part per
million.
Ozone (Oa) is an unstable form of oxygen
sometimes used to disinfect drinking water.
It works more quickly than chlorine or
chloramine but is more expensive and does
12
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not produce a residual for controlling
bacterial growth in the distribution system.
Ozone also eliminates some bad tastes and
odors in water.
Ultraviolet (UV) light is used by some
small systems to disinfect water. For
effective UV disinfection, the water should
contain few particles, which is usually the
case for ground water. UV light does not
leave a disinfectant residue in the water to
kill remaining organisms and it is not
effective against Giardia.
Iodine is occasionally used by campers to
treat small amounts of water.
Filtration There are three types of filtration: rapid
sand or "mixed media" used by 90 percent
of the U.S. filtration systems, slow sand,
and diatomaceous earth (DE). DE is the
fossilized remains of single-cell algae
known as diatoms and is used by some
rural systems whose water is relatively
clear. It is commonly used in swimming
pool filters.
The major differences are the size of the
sand and the speed at which raw water
passes through the filters. Water passes
relatively quickly through rapid sand
filters, and much more slowly through slow
sand filters. The rapid sand technique also
requires that the water be chemically
pretreated to make the solid particles in it
easier to filter. Such filters are suited to
urban areas because they require relatively
little space.
Slow sand filters are simple, do not
require chemical pretreatment of the water,
are easy to operate, and are biologically
active. Bacteria growing naturally on the
filter surface make it more effective for
removing disease-causing organisms and
some other contaminants. Slow sand filters
are especially appropriate for systems with
little solid material in their raw water, but
because the filters require large surface
areas they are usually found in rural areas.
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Safe Drinking Water Act
Requirements
The Safe Drinking Water Act of 1974
(SDWA) established a far-reaching federal
program to ensure clean drinking water for
everyone and to protect the public health.
Under this program, EPA sets national
standards and monitoring requirements
which are to be adopted and implemented
by the states and met by the public
water-supply operators. The 1986 SDWA
Amendments updated this program and set
deadlines for EPA to regulate key
contaminants, required EPA to set criteria
for deciding when public water systems
using surface sources must filter their
water, and mandated that EPA write a
regulation requiring disinfection of all
public water systems, as appropriate.
SWTR To comply with the 1986 amendments,
EPA published the Surface Water
Treatment Rule (SWTR), under which all
public water systems that use surface
water—or water (including ground water)
that is under the direct influence of surface
water—must disinfect their source water.
These systems may also be required to filter
their water if their sources do not meet
certain quality requirements and
site-specific conditions.
The SWTR also establishes treatment
technique requirements in lieu of
Maximum Contaminant Limits (MCLs) for
Giardia, viruses, heterotrophic plate count
bacteria, Legionella, and turbidity. The rule
also requires that all public systems be
managed by qualified operators, as
determined by the state.
The SWTR requires disinfection because
all surface-water sources may be subject to
fecal contamination, and because water
14
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quality indicators, such as total coliforms,
are not adequate to signal whether a
surface-water system is vulnerable to
Giardia and other organisms more resistant
to disinfection than are the indicators. Also,
pretreatment and filtration without
disinfection do not provide adequate
protection from pathogens.
Ground-Water
Disinfection Rule
The Ground-Water Disinfection Rule is
several years away. EPA anticipates that the
rule will regulate viruses, heterotrophic
bacteria, and Legionella by requiring
drinking-water systems to disinfect any
ground water they use, with allowances for
variances as appropriate. The Agency may
also regulate for Cryptosporidium, a
protozoan similar to Giardia, which has
caused recent outbreaks of waterborne
disease.
EPA is confident that the total coliform
rule, the SWTR, and the ground-water
treatment rule will, together, protect the
public from most pathogens in drinking
water.
NPDWRs
The National Primary Drinking-Water
Regulations (NPDWRs) are another key
element in EPA's effort to keep drinking
water clean and protect the public from
waterborne disease. They define either a
Maximum Contaminant Level (MCL) or a
treatment technique requirement to control
the presence of a contaminant in drinking
water. These are enforceable standards that
protect the public health by limiting how
much of a contaminant is permitted in
drinking water. A treatment technique is
established instead of an MCL if EPA
decides that measuring a contaminant level
is not technically or economically feasible.
Public water systems are required by law to
monitor their water to ensure it does not
endanger the public health by exceeding
MCLs or treatment technique requirements.
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MCLGs
The 1986 amendments also provide for
Maximum Contaminant Level Goals
(MCLGs). These are the highest
concentration of a drinking-water
contaminant at which no known or
anticipated health effects occur, plus an
adequate margin of safety. These are
non-enforceable, ideal health goals issued
as part of the National Primary Drinking
Water Regulations. EPA must set MCLs as
close as possible to MCLGs, taking into
account the cost and limits of technology
for large public water supplies.
The amendments required EPA to
regulate six microbiological contaminants
by mid-1989. Five are regulated under the
Surface Water Treatment Rule. EPA also
regulated total coliforms in ground- and
surface-water supplies, and will establish
ground-water disinfection or treatment
requirements to control for bacteria,
viruses, heterotrophic bacteria, and
Legionella in the near future.
Regulation of Microbiological Contaminants &
Turbidity By Surface Water Treatment Rule
Contaminant
Giardfa lamblia
Viruses
Legionella
Heterotrophic Bacteria
Turbidity
MCLG
Zero
Zero
Zero
None
None
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MCLGs setting zero levels for Giardia,
viruses, and Legionella have been
published. The zero levels were established
because the minimum numbers needed to
cause illness are not known. No MCLs were
published because EPA finds the analytical
methods to measure Giardia, viruses, and
Legionella are neither technically nor
economically feasible, so these
contaminants are better controlled in
surface water by treatment techniques such
as filtration or disinfection. The SWTR
requires that at least 99.9 percent of Giardia
and 99.99 percent of viruses in the source
water be killed or removed from drinking
water. Any water system that meets those
regulations should also control Legionella
and heterotrophic bacteria.
No MCLG or MCL has been established
for heterotrophic bacteria because EPA
believes the test for heterotrophic bacteria
counts innocuous bacteria and pathogens
alike, so no sensible test is possible.
Nevertheless, since high counts of
heterotrophic bacteria can indicate poor
water quality, they are regulated in the
SWTR. And, although they are easy to
monitor, EPA recognizes that the extra cost
of monitoring for these microorganisms,
compared to total coliforms, is not worth
the small gain in benefit that would result.
Therefore, EPA believes that the treatment
techniques required by the SWTR and the
forthcoming Ground-Water Disinfection
Rule are better ways of controlling these
bacteria.
No MCLG has been published for
turbidity because there is no direct health
risk associated with it. It is, however,
useful as an indicator of treatment
effectiveness and turbidity limits have been
set in the SWTR.
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Total coliforms are an indicator of
possible fecal contamination, but their
actual number does not correspond to the
number of disease-causing organisms
present in a water sample. Nevertheless,
coliforms are so closely related to potential
microbiological contamination that EPA
published a zero MCLG for them since it is
technologically possible to achieve virtually
zero levels of total coliforms. They are the
only contaminant on the list for which EPA
has also set an MCL (1 per 100 milliliters)
instead of a treatment technique
requirement. Drinking water suppliers can
tell if their system complies with this MCL
because they must monitor the quality of
their water. The larger the system, the more
samples it must collect. Systems that
collect fewer than five samples each month
must perform periodic on-site sanitary
surveys to evaluate the capability of the
system to produce and distribute safe
drinking water.
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Summing Up ... What All This
Means To You
Current federal and state drinking water
regulations help protect the public health,
but, in general, they do not go far enough.
Every year, thousands of Americans still get
sick because their drinking water is not
safe. That is one reason why Congress
strengthened the nation's environmental
laws by passing the 1986 amendments to
the Safe Drinking Water Act, and why EPA
has set more drinking-water standards.
Improving and maintaining
drinking-water quality is not just the
responsibility of the states, the water
suppliers, and EPA. It is also the
responsibility of all concerned citizens.
With the public health—and so much time
and money—at stake, everyone should be
paying more attention to drinking water
and how safe it is.
This pamphlet has described the threat to
public health posed by waterborne
pathogens and what EPA proposes to do
about them as it implements the 1986
SDWA amendments. Your cooperation and
support are vital to this program's success.
Now that you have the facts, you can
monitor what your drinking water supplier
is doing to maintain and/or improve the
quality of the water you drink. You also
know why your water rates may increase to
help suppliers meet these new standards. If
you get your water from a private well, you
can read EPA's Manual of Individual Water
Supply Systems (EPA 570/9-82-004) to find
out how to correct household well
problems. And there is one other fact to
keep in mind—the added cost of safer
drinking water is a small price to pay for
ensuring that your water, the community's
water, and that of all Americans, is truly
safe to drink.
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Public Water System
Community Water System
Non-Community Water
System
Surface Water
Glossary
A system that pipes water for human consumption to
least 25 people or has 15 or more service connections
A Public Water System serving at least 25 year-round
residents or that has 15 or more connections used by
year-round residents.
A Public Water System that does not meet the defini-
tion of a Community Water System. Some schools,
factories, campgrounds, motels and restaurants are
examples of Non-Community Water Systems.
Sources of water such as lakes, reservoirs, rivers, and
streams found on the earth's surface.
Ground Water Water sources found below the surface of the earth.
Raw Water Untreated surface or ground water.
Bacteria Minute one-celled organisms such as total conforms,
the vast majority of which do not require a host organ-
ism for survival or do not cause disease.
Pathogens Microbes such as salmonella and shigella that cause
disease.
Protozoa One-celled animals which are larger and have a more
complex structure than bacteria. A few types, such as
Giardia and Cryptosporidium, cause disease.
Microbe An organism too small to be seen without a micro-
scope. Microbes include bacteria, protozoa, and
viruses.
Viruses The smallest and simplest form of microbial life.
Viruses can only reproduce inside a host cell. Ex-
amples of viruses include Hepatitis A agent and Nor-
walk Agent.
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Need More
Information?
Additional information about safe drinking water, the 1986 amendments to the Safe
Drinking Water Act, and other related issues is available from EPA's Drinking Water
Hotline: 1-800-426-4791 (in Alaska and the Washington, DC, area, 202-382-5533).
The following EPA regional offices and State agencies can also provide you with
information.
EPA Regional Offices
Region 1
Room 2203
John F. Kennedy Federal Building
Boston, MA 02203
(617) 565-3610
Connecticut, Maine, Massachusetts, New
Hampshire, Rhode Island, Vermont
Region 2
26 Federal Plaza
New York, NY 10278
(212) 264-1800
Region 6
12th Floor, Suite 1200
1445 Ross Ave.
Dallas, TX 75270
(214) 655-7155
Arkansas, Louisiana, New Mexico, Oklahoma,
Texas
Region 7
726 Minnesota Ave.
Kansas City, KS 66101
(913)236-2815
New Jersey, New York, Puerto Rico, Virgin Islands towa, Kansas, Missouri, Nebraska
Region 3
841 Chestnut St.
Philadelphia, PA 19107
(215) 597-9873
Delaware, District of Columbia, Maryland,
Pennsylvania, Virginia, West Virginia
Region 4
345 Courtland St., N.E.
Atlanta, GA 30365
(404) 347-2913
Alabama, Florida, Georgia, Kentucky, Mississippi,
North Carolina, South Carolina, Tennessee
Region 5
230 South Dearborn St.
Chicago, IL 60604
(312) 353-2650
Illinois, Indiana, Michigan, Minnesota, Ohio,
Wisconsin
Region 8
Suite 500
999 18th St.
Denver, CO 80202-2405
(303)293-1424
Colorado, Montana, North Dakota, South Dakota,
Utah, Wyoming
Region 9
215FreemontSt.
San Francisco, CA 94105
(415)974-0763
Arizona, California, Hawaii, Nevada, American
Samoa, Trust Territories of the Pacific, Guam,
Northern Marianas
Region 10
1200 Sixth Ave.
Seattle, WA 98101
(206) 442-1225
Alaska, Idaho, Oregon, Washington
21
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Region 1
Water Supplies Section
Connecticut [Department of
Health
150 Washington Street
Hartford, CT 06106
(203) 566-1251
Division of Water Supply
Department of Environmental
Quality Engineering
One Winter Street
Boston, MA 02108
(617) 292-5770
Division of Health Engineering
Maine Department of Human
Services
State House (STA 10)
Augusta, ME 04333
(207) 289-5685
Water Supply Division
New Hampshire Water Supply
and Pollution Control
Commission
Post Office Box 95
Hazen Drive
Concord, NH 03301
(603) 271-3503
Division of Water Supply
Rhode Island Department of
Health
75 Davis Street, Health Building
Providence, Rl 02908
(401) 277-6867
Environmental Health Division
Vermont Department of Health
60 Main Street
Post Office Box 70
Burlington, VT 05401
(802) 863-7220
Region 2
Bureau of Safe Drinking Water
Division of Water Resources
New Jersey Department of
Environmental Protection
Post Office Box CN-029
Trenton, NJ 06825
(609) 984-7945
State Water Supply
Agencies
Bureau of Public Water Supply
Protection
New York Department of Health
2 University Place, Room 406
Western Avenue
Albany, NY 12203-3399
(518)458-6731
Water Supply Supervision
Program
Puerto Rico Department of
Health
Post Office Box 70184
San Juan, Puerto Rico 00936
(809) 766-1616
Public Water Supply System
Government of Virgin Islands
Post Office Box 4340
Charlotte Amalie
St. Thomas, Virgin Is. 00801
(809) 774-3320
Region 3
Office of Sanitary Engineering
Division of Public Health
Jesse Cooper Memorial
Building
Capital Square
Dover, DE 19901
(302) 736-4731
Water Hygiene Branch
Department of Consumer and
Regulatory Affairs
5010 Overlook Ave., S.W.
Washington, DC 20032
(202) 767-7370
Division of Water Supply
Office of Environmental
Programs
201 West Preston Street
Baltimore, MD 21201
(301) 225-6361
Division of Water Supplies
Department of Environmental
Resources
Post Office Box 2357
Harrisburg, PA 17120
(717) 787-9035
Bureau of Water Supply
Engineering
Virginia Department of Health
James Madison Building
109 Governor Street
Richmond, VA 23219
(804) 786-1766
Drinking Water Division
Office of Environmental Health
Services
State Department of Health
1800 Washington St., East
Charleston, West Virginia 2530
(304) 348-2981
Region 4
Water Supply Branch
Department of Environmental
Management
1751 Federal Drive
Montgomery, AL 36130
(205) 271-7773
Drinking Water Program
Department of Environmental
Regulation
Twin Towers Office Building
2600 Blair Stone Road
Tallahassee, FL 32301-8241
(904) 487-1779
Water Protection Branch
Environmental Protection
Division
Department of Natural
Resources
270 Washington Street, S.W.
Atlanta, GA 30334
(404)656-5600
Division of Water
Department of Environmental
Protection
18 Reilly Road, Fort Boone
Plaza
Frankfort, KY 40601
(502) 564-3410
22
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Division of Water Supply
State Board of Health
Post Office Box 1700
Jackson, MS 39205
(601)960-7518
Water Supply Branch
Division of Health Services
Department of Human
Resources
Bath Building
Post Office Box 2091
Raleigh, NC 27602-2091
(919) 733-2321
Bureau of Water & Special
Environmental Programs
Department of Health and
Environmental Control
2600 Bull Street
Columbia, SC 29201
(803) 734-5310
Division of Water Supply
Tennessee Department of
Health and Environment
150 9th. Ave., North
Nashville, TN 37219-5404
(615) 741-6636
legion 5
Division of Public Water
Supplies
Ilinois Environmental
protection Agency
>200 Churchill Rd.
Springfield, IL 62706
;217) 785-8653
Division of Public Water Supply
ndiana State Board of Health
5500 West Bradbury Ave.
ndianapolis, IN 46241
(317) 243-9100
Division of Water Supply
Michigan Department of Public
Health
3.O. Box 30035
Lansing, Ml 48909
(517) 335-8318
Section of Public Water
Supplies
Minnesota Department of
Health
717 Delaware St.
Minneapolis, MN 55440
(612) 623-5330
Office of Public Water Supply
Ohio Environmental Protection
Agency
1800 Watermark Drive
P.O. Box 1049
Columbus, OH 43266-0149
Bureau of Water Supply
Department of National
Resources
P.O. Box 7921
Madison, Wl 53707
(608) 267-7651
Region 6
Division of Engineering
Arkansas Department of Health
4815 West Markham St.
Little Rock, AR 72205-3867
(501) 661-2623
Office of Preventive and Public
Health Services
Louisiana Department of Health
and Human Resources
P.O. Box 60630
New Orleans, LA 70160
(504) 568-5105
Drinking Water Section
New Mexico Health &
Environment Department
P.O. Box 968
Santa Fe, NM 87504-0968
(505) 827-2778
Water Facility Engineering
Service
Oklahoma State Department of
Health
P.O. Box 53551
Oklahoma City, OK 73152
(405) 271-5204
Division of Water Hygiene
Texas Department of Health
1100 West 49th St.
Austin, TX 78756-3199
(512) 458-7497
Region 7
Environmental Protection
Division
Iowa Department of Natural
Resources
Wallace State Office Building
900 East Grant St.
DesMoines, IA53109
(515) 281-6284
Support Services Section
Kansas Department of Health
and the Environment
Forbes Reid
Topeka, KS 66605
(913) 296-5503
Public Drinking Water Program
Division of Environmental
Quality
P.O. Box 176
Jefferson City, MO 65102
(314) 751-0535
Division of Environmental
Health and Housing
Surveillance
Nebraska Department of Health
301 Centennial Mall South
P.O. Box 95007, 3rd Floor
Lincoln, NE 68509
(402) 471-2674
(402) 471-0510
Region 8
Drinking Water Unit
Colorado Department of Health
4210 East 11th Ave.
Denver, CO 80220
(303) 331-4546
Bureau of Water Quality
Health and Environmental
Services
Cogswell Building, Room A206
Helena, MT 59620
(406) 444-2406
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Division of Water Supply and
Pollution Control
State Department of Health
1200 Missouri Ave.
Bismarck, ND 58501
(701) 224-2354
Office of Drinking Water
Department of Water and
Natural Resources
Joe Foss Building
523 Capital Ave., East
Pierre, SD 57501
(605) 773-3754
Bureau of Drinking Water/
Sanitation
Utah Department of Health
P.O. Box 16690
Salt Lake City, UT 84116-0690
(801) 538-6163
Water Quality Division
Department of Environmental
Quality
401 West 19th St.
Cheyenne, WY 82002
(307) 777-7781
Region 9
Reid Services Section
Office of Water Quality
2655 East Magnolia St.
Phoenix, AZ 85034
(602) 392-4002
Sanitary Engineering Branch
California Department of Health
714 P St.
Sacramento, CA 95814
(916)323-6111
Drinking Water Program
Sanitation Branch
Environmental Protection and
Health Services Division
P.O. Box 3378
Honolulu, HI 96801
(808)548-4682
Public Health Engineering
Nevada Department of Human
Resources
Consumer Health Protection
Services
505 East King St., Room 103
Carson City, NV 89710
(702) 885-4750
Guam Environmental Protection
Agency
Government of Guam
P.O. Box 2999
Agana, Guam 96910
Division of Environmental
Quality
Commonwealth of the Northern
Mariana Islands
P.O. Box 1304
Saipan, Mariana Islands 96950
Marshall Islands Environmental
Protection Authority
Hospital
Majuro, Marshall Islands 96960
FSM Environmental Protection
Board
FSM Health Services
Kolonia, Pohnpei 96941
Palau Environmental Quality
Protection Board
Hospital
Koror, Palau 96940
Region 10
Alaska Drinking Water Program
Water Quality Management
Department of Environmental
Conservation
P.O. Box O
Juneau, AK 99811
(907) 465-2653
Bureau of Water Quality
Division of Environment
Idaho Department of Health
and Welfare
Statehouse
Boise, ID 83720
(208) 334-5867
Drinking Water Program
Health Division
Department of Human
Resources
1400S.W. 5th Ave.
Portland, OR 97201
(503) 229-6310
Drinking Water Program
Section
Department of Social and
Health Services
Mail Stop LD-11
Olympia, WA 98504
(206) 753-5954
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EPA Regional Map
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