United States       Science Advisory      EPA-SAB-DWC-97-003 '•
        Environmental       Board (1400)       February 1997
        Protection Agency      Washington, DC
oEPA AN SAB REPORT: REVIEW OF
       THE RESEARCH PLAN FOR
       MICROBIAL PATHOGENS AND
       DISINFECTION BYPRODUCTS
       IN DRINKING WATER
       REVIEW BY THE DRINKING
       WATER COMMITTEE (DWC) OF
       THE SCIENCE ADVISORY BOARD
               U.S. Environmental Protection Agency
               Region 5, Library (PL- 12J)
               //West Jackson Boulevard, 12th Fkx»
               Chicago, IL 60604-3590

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                 UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
                               WASHINGTON, D.C.  20460
                                  February 28, 1997

                                                                    OFFICE OF THE ADMINISTRATOR
EPA-SAB-DWC-97-003                                                SCIENCE ADVISORY BOARD

Honorable Carol M. Browner
Administrator
U.S. Environmental Protection Agency
401 M Street, SW
Washington, DC 20460

       Subject:      Review of the Research Plan for Microbial Pathogens and Disinfection
                    Byproducts in Drinking Water

Dear Ms. Browner.

   At the request of the Office of Research and Development (ORD), the Drinking Water
Committee (DWC) of the Science Advisory Board reviewed the Agency's Research Plan for
Microbial Pathogens and Disinfection Byproducts in Drinking Water.  The Committee met to
consider the plan during November 1995, March 1996, and July 1996.  The DWC approved
this report on December 30, 1996 and the Executive Committee approved  this report on
January 15,  1997.

   The Agency charge to the Committee was to review the research plan and to  provide
advice on whether:

       a)     EPA had identified the correct research issues to support the development of
             the Interim and long term  Enhanced Surface Water Treatment Rules, Ground
             Water Disinfection Rule, and Stage 2 Disinfectant/Disinfection Byproducts
             Rules;

       b)     The research topic areas or projects underway, or envisioned under the five-
             year plan, appear to adequately address the issues, and if not, should any
             other research topic area be funded in lieu of or in addition to those presented;
             and

       c)     EPA assigned appropriate priorities to the research?

   The Plan was developed cooperatively between representatives of the Office of Research
and Development and the Office of Water pursuant to the vision and general procedures
contained in  the Strategic Plan of the EPA Office of Research and Development.  The
Drinking Water Committee appreciates the opportunity to comment on this  research plan.
The Committee recognizes the magnitude of the effort and congratulates those within the
Office of Research and  Development and the Office of Water who have labored to create and
coordinate this complex project. Their efforts have resulted in a plan that is much improved

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over previous drafts which have been reviewed by the Drinking Water Committee.

   Even though it notes the Agency's considerable progress with this research plan, the
Committee is concerned that the short and long-term  resources devoted to this plan will not
be adequate to address all of the urgent needs for the development and promulgation of
effective and efficient rules for drinking water protection  and for the development of cost-
effective technologies for the control of drinking water purity.

   Two of the Committee's comments address overarching issues with the plan. First, the
plan does not provide sufficient information on many of the proposed research projects to
permit the Committee to fully understand what is intended, the need for the project, and why
some projects indicated as being of lower priority are  underway while others of higher priority
are yet to be initiated.   Second, the Plan does not provide information that reflects the critical
path and flow of research components, information which is necessary to show project
progression and help to ensure that projects of greatest uncertainty and importance  are
accorded appropriate attention and placed in realistic time frames.

   A number of specific comments that the Committee wishes to bring to the Agency's
attention are contained in the following paragraphs. An issue, that is of extreme  importance
to risk-based  rulemaking, is the identification and quantification of the occurrence and
distribution of pathogens, and the risks they present, in drinking water.  This research
deserves special emphasis.  Without this effort, the Agency's ability to target the  most
important health risks associated with drinking water pathogens will be diminished.

   The Committee also believes that it is important to develop a mechanism to identify
emerging waterborne pathogens and to conduct intensive research on them as necessary.
The Agency should be  proactive  in  this area and should establish a program that anticipates
these types of emerging pathogenic microorganisms.  There is also a need for a microbial
epidemiological study in ground water systems that should include efforts to identify the
pathogens responsible  for the measured health effects.

   Research needs in  the area of microbial risk management include: effectiveness of
treatment processes for Cryptosporidium, treatment technologies appropriate for small
systems, and identification and characterization of factors influencing microbial growth in
distribution systems along with strategies for its control.  In fact, research on microbial
contamination in distribution systems must be regarded  as a high priority component of this
plan.

   The Committee believes that  a critical area that has  been overlooked is the need for
methods to assess the  reliability of treatment plants and individual treatment processes.  The
Committee also  believes that additional research is needed on the reliability of multiple
barriers of treatment including: watershed protection  and pathogen monitoring, multiple
chemical inactivation steps, and filtration and/or sedimentation in addition to chemical
inactivation.

   In the area of disinfection byproducts, the proposed  reevaluation  of existing epidemiologic
research, should be assigned the highest priority from among the group of health effects
research projects, if it can be completed in a time frame relevant to the rule making process.
In addition, in order to perform risk  assessments for disinfection byproducts, there is an

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absolute requirement for exposure data and knowledge of human health effects.  Currently,
exposure data are inadequate, primarily due to the lack of methods for proper measurement.
This suggests that the highest priority should be placed on the acquisition of such methods
for both Stage I and Stage II Disinfectant Byproduct Rules.

   A critical component of the research plan is a discussion of which of the three risk
management options the Agency and the industry will endorse for control of disinfection
byproducts.  The options discussed in the plan are:  removal before disinfection, removal
after disinfection, and changing the disinfection process to minimize the formation of related
byproducts.   Removal before, and changing the disinfection process, appear to be the most
promising  options.

   A number of risk management projects of high priority include: analytical methods for
viruses, protozoa, natural organic matter, and  chemical contaminants; methods for control of
byproducts formed during treatment with ozone, chloramines, and chlorine dioxide; and
projects on disinfection byproduct control (e.g., such as granular activated carbon,
coagulation, oxidation and biological filtration, membrane technology and ultraviolet
methodology). The Committee has provided comments on other projects contained in the
research plan which are not highlighted in this letter; however, they are available for your
review  in the enclosed report.

   In summary, the Committee felt that the research issues identified to  support the five
rules, and the research questions to respond to the issues, were appropriate and that the
current plan reflects considerable progress over past versions of the plan.  Attention to the
comments highlighted in this letter and detailed in the  report should result in research results
which will enhance the scientific support for your rule making in this  important area.  The
Committee looks forward to the response from the Office of Research and Development and
the Office  of Water to its comments on this research plan.
                             Sincerely,
Dr. Genevieve M. Matanoski, Chair           Dr. Verne Ray, Chair
Executive Committee                        Drinking Water Committee

ENCLOSURE

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                                      NOTICE
           This report has been written as a part of the activities of the Science Advisory
Board, a public advisory group providing extramural scientific information and advice to the
Administrator and other officials of the Environmental Protection Agency.  The Board is
structured to provide balanced, expert assessment of scientific matters related to problems
facing the Agency. This report has not been reviewed for approval by the Agency and,
hence, the contents of this report do not necessarily represent the views and policies of the
Environmental Protection Agency, nor of other agencies in the Executive Branch of the
Federal government, nor does mention of trade  names or commercial products constitute a
recommendation for use.

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                                  ABSTRACT

   The Science Advisory Board's (SAB) Drinking Water Committee (DWC) reviewed the draft
Research Plan for Microbial Pathogens and Disinfection By-Products in Drinking Water
which was prepared by the EPA Office of Research and Development (ORD) and the Office
of Water (OW).  The Plan presented information on knowledge gaps relative to pending
policy determinations and discussed specific research projects for microbial pathogens and
for disinfection byproducts that would provide information to fill these gaps.  Research was
also discussed in relation to the five major drinking water regulations it is intended to support.
The  charge to the DWC asked if EPA had identified the correct research issues to support
rule making, whether research topic areas and projects adequately addressed the issues,
and whether EPA had assigned appropriate priorities to the research?

   The DWC  .recognized the complexity of the plan and complimented the Agency on its
efforts which resulted in a substantially improved research plan. The  DWC also agreed that,
in general, the research issues identified to support the five rules and the questions proposed
in the research plan were appropriate.
                                                         »
   The Committee asked a number of questions about the plan. Among other
things, they noted the large number of high priority projects and  apparent insufficient
resources to  fund them all,  and questioned how the Agency decided which ones to
fund and why some medium priority projects were funded (i.e., already underway)
while many high priority projects  were not funded.

   The Committee offered a number of comments and recommendations intended to help
focus, augment, and supplement  the Agency effort to plan the development of knowledge
essential for informed and scientifically accurate rule making.  The DWC suggested that
the plan would be clearer if the discussion on the purpose of the research plan,
presented in  Section  IV, was moved to the beginning of the plan. The Committee
stated that many of the project discussions were unclear and did not provide
complete information  on the planned efforts. Further, the Committee stated that the
Plan lacked information  on a critical path of project progression that would ensure that
research projects of greatest uncertainty and resource requirements were accorded
appropriate and primary attention and placed in a realistic time frame  for overall research
progress.

   The Committee noted a disconnect between the priority pathogens for health effects
research (i.e., Norwalk  virus and Cryptosporidium) and the priorities of the occurrence
research and  that not enough emphasis was being given to microbial  identification and
occurrence  research.  In addition, they suggested that a critical area had been overlooked on
methods to assess the  reliability of treatment plants and individual treatment processes and
that additional research  was needed on the reliability of multiple barriers of treatment. The
Committee also  noted the importance of the  reevaluation of existing epidemiology studies to
ensuring that  appropriate additional DBP  health effects research was  relevant to planned rule
making.

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    The Committee recommended that greater emphasis be given to identifying and
quantifying the occurrence of the key pathogens and the health risks they pose in
drinking water in order to support risk based management of the highest risks.  They
also stated that it was important for EPA to develop a mechanism to identify "new"
waterborne pathogens as they emerge. The Committee recommended that data be
developed on the concentration of viruses in groundwater sources and that the
development of rapid, reliable monitoring  methods for waterborne pathogens should
receive a high priority.

    The Committee also noted the importance of proper design and operation of
water treatment facilities to reducing waterborne illness.  In that regard, the
Committee stated that it was important to know the percentage of epidemic
waterborne illness attributed to treatment  process upsets in comparison to the
percentage of endemic waterborne disease caused by pathogens passing through
well-operated treatment plants.  The Committee suggested that it might be more cost
effective to improve operational reliability  of water treatment than  to require
increasingly higher logs of pathogen removal/inactivation.

    The Committee noted that EPA chose to place a medium priority on research
projects related to the growth of bacteria in distribution systems.  They agreed that
projects related to heterotrophic bacteria in distribution systems, should not be the
highest priority.  However, in light of the information being obtained in studies on the
role of the distribution system in endemic  microbial disease, the Committee believed
that it would be appropriate to place a higher priority on research of microbial
contamination in distribution systems.  Besides characterizing the biofilms in the
systems, research is needed on the integrity of distribution systems and their
vulnerability to pathogen introduction from cross-connections, line breaks, pressure
drops, etc.

    The Committee also noted the absolute requirement for exposure data, and knowledge
of human health effects, in order to perform risk assessments for disinfection byproducts
(DBFs).  Further, the Committee noted that the overall challenge was not merely in
writing a  regulation to balance the costs of more disinfection with the benefits of
fewer microbes.  They suggested that the bigger challenge is to write a regulation
that sets  tough microbial standards and allows goals to be met at the lowest cost
without allowing new, significant risks from chemical byproducts, particularly if those
risks are  of greater importance than the microbial risk avoided.

Key Words: Drinking water, disinfection, disinfection byproducts, microbial risk,
pathogens

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               ENVIRONMENTAL PROTECTION AGENCY
                      SCIENCE ADVISORY BOARD
                     DRINKING WATER COMMITTEE

CHAIR

Dr. Verne A. Ray, Medical Research Laboratory, Pfizer Inc., Groton, CT

MEMBERS and CONSULTANTS

Dr. Judy A. Bean, University of Miami  School of Medicine, Miami, FL

Dr. Keith  E. Cams, Electric  Power Research Institute, St. Louis, MO

Dr. Lenore S. Clesceri, Rensselaer Polytechnic Institute, Materials Research Center,
      Troy, NY

Dr. Anna  Fan-Cheuk, State of California, California Environmental Protection Agency,
       Berkeley, CA

Dr. Charles Gerba, University of Arizona, Tucson, AZ

Dr. Curtis Klaassen, University of Kansas Medical Center, Kansas City, KS

Dr.  Ellen O'Flaherty, University of Cincinnati, College of Medicine, Cincinnati, OH

Dr. Edo D. Pellizzari, Research Triangle Institute, Research Triangle Park, NC

Dr. Vernon L. Snoeyink, Department of Civil Engineering, University of Illinois,
      Urbana, IL

Dr. Mark Sobsey*, University of North  Carolina, Chapel Hill, NC

Dr. Rhodes Trussell, Montgomery Watson Consulting Engineers, Pasadena, CA

Dr, Marylynn Yates, University of California, Riverside, CA

SCIENCE ADVISORY BOARD STAFF

Mr. Thomas O. Miller,  Designated Federal Official, Science Advisory Board (1400),
      U.S. EPA, 401 M Street, SW, Washington, DC 20460

Mrs. Mary Winston, Staff Secretary, Drinking Water Committee, Science Advisory
      Board (1400), U.S. EPA, 401  M Street, SW, Washington, DC  20460
indicates consultant to the Drinking Water Committee.
                                      IV

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                                  GLOSSARY
AWWARF
BBDR
BM1
EPA
DAA
D/DBP
DWC
ESWTR
EXD
EXM
GAC
GWDR
HAV
HED
HEM
ICR
IESWTR
NOM
NWRI
NOEL
ORD
OW
PBPK
PCR
POE
POU
QSAR
RAD
RAM
RMD

RMM
SAB
SWTR
TOC
American Water Works Association Research Foundation
Biologically-based Dose Response
Benchmark Dose
US Environmental Protection Agency
Dichloracetic Acid
Disinfection/Disinfectant Byproducts
US EPA SAB Drinking Water Committee
Enhanced Surface Water Treatment Rule
Exposure Research, Disinfection/Disinfectant Byproducts Project
Exposure Research, Microbes Project
Granular Activated Carbon
Ground Water Disinfection Rule
Hepatitis A Virus
Health Effects Research, Disinfection/Disinfectant Byproducts Project
Health Effects Research, Microbes Project
Information Collection Rule
Interim Enhanced Surface Water Treatment Rule
Natural Organic Material
National Water Research Institute
No Observed Effect Level
US EPA/Office of Research and Development
US EPA/Office of Water
Physiologically-based Pharmacokinetic
Polymerase Chain Reaction
Point of Entry
Point of Use
Quantitative Structure Activity Relationship
Risk Assessment Research, Disinfection/Disinfectant Byproducts Project
Risk Assessment Research, Microbes Project
Risk Management Research, Disinfection/Disinfectant Byproducts
      Project
Risk Management Research, Microbes Project
US EPA/Science  Advisory Board
Surface Water Treatment Rule
Total Organic Carbon

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                           TABLE OF CONTENTS
1.  Executive Summary	  1

2.  Introduction	  6
      2.1 Background	  6
      2.2 The Charge	  7
      2.3 Overview of the Research Plan	  7

3.  Overarching Comments	  10
      3.1 General Comments on the Charge	  10
             3.1.1 Charge question 1  	  10
             3.1.2 Charge question 2  	  10
             3.1.3 Charge question 3  	  12

4.  Microbial Research  	  13
      4.1 Overview	  13
             4.1.1 Health Effects Research Needs for Microbial Pathogens  	  13
             4.1.2 Exposure Research Needs for Microbial Pathogens	  14
             4.1.3 Risk Assessment Research Needs for Microbial Pathogens  	  15
      4.2 Specific Comments on Microbial Research  	  15
             4.2.1 Health Effects Research	  15
             4.2.2  Exposure Research  	  17
             4.2.3  Risk Assessment Research	  20
             4.2.4. Risk Management Research-Microbial  Pathogens 	  21

5.  Disinfectant/Byproducts Research	  27
      5.1 Overview	  27
      5.2 Specific Comments on DBP Research   	  29
             5.2.1 Health Effects Research	  29
             5.2.2 Exposure Research  	  31
             5.2.3 Risk Assessment Research	  32
             5.2.4 Risk Management Research	  35

6.  Conclusions and Recommendations	  37

REFERENCES	  40

DISTRIBUTION  	  41

APPENDIX
                                       VI

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                          1.  EXECUTIVE SUMMARY

   The EPA Office of Research and Development (ORD) and the Office of Water (OW)
requested the Science Advisory Board's (SAB) Drinking Water Committee (DWC) to review a
draft research plan for microbial pathogens and disinfection byproducts in drinking water.
Following a series of preliminary presentations of the plan, a complete plan was presented in
March, 1996. The DWC held a working session at a meeting in July, 1996.

   The Drinking Water Committee appreciates the opportunity to comment on the Office of
Research and Development's Research Plan for Microbial Pathogens and Disinfection By-
Products in Drinking Water. Further, the Committee recognizes the magnitude of the effort
and congratulates those within the Office of Research and Development and the Office of
Water who have labored to create and  coordinate a project of this complexity.  The
comments of the Drinking Water Committee are intended to help focus, augment, and
supplement this effort that will have an  important impact on the quality of U.S.  drinking water
by acquiring knowledge essential  for a  more  informed and scientifically accurate
implementation  of the rule making process.

   The Agency plan consists of four chapters, three appendices, and approximately 175
individual research projects that were intended to define the research needed to support
EPA's development of drinking water regulations  covering disinfectants, disinfection
byproducts, and microbial pathogens.  The regulations affected are the Stage I D/DBP rule,
the Interim Enhanced Surface Water Treatment Rule (IESWTR), the Stage II DBF Rule, the
Enhanced Surface Water Treatment Rule (ESWTR) and the Ground Water Disinfection Rule
(GWDR). Another rule, the Information Collection Rule (ICR), that was promulgated during
1996, is intended to provide essential data on the occurrence and treatment for pathogens
and DBFs in larger public drinking water systems. This Plan also includes projects that are
sponsored by the American Water Works Association  Research  Foundation (AWWARF) and
the National Water Research Institute (NWRI).

   Chapter I of the Plan  states the Agency's research needs that are linked to major policy
questions that must be answered  by research results.  Chapter II focuses on research for
microbial pathogens and  Chapter III discusses research for disinfection byproducts.  These
projects are clustered under headings of Health Effects Research, Exposure Research, Risk
Assessment  Research, and Risk Management Research. The information provided includes
the state of the science, specific research needs, and a short (in many cases too brief)
explanatory statement on  each of the selected research projects that address the research
needs. This structure was intended to relate policy questions and major  research questions
to research needs and goals. In Chapter IV research  projects are grouped into five major
categories that show how the research  is integrated within each  of the specific drinking water
regulations.

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   The Agency's charge to the DWC was composed of three major questions and a series of
other questions specific to the separate components of the plan:

       Charge Question I: Has EPA identified the correct research issues to be addressed
       to support the development of the interim and long-term Enhanced Surface Water
       Treatment Rules, Ground Water Disinfection Rule and D/DBP Rules?

       Charge Question II Do the research topic areas or projects underway or envisioned
       in the research plan appear to adequately address these issues?

       Charge Question III: Has EPA assigned appropriate priorities to the research?

   The Committee recognizes the substantial efforts of the Agency to describe the research
program for disinfectants, microbial agents and disinfection byproducts in a manner that
reflects its relationship to research supported by the regulated community, and the
cooperative approach to planning between the EPA office of Research and Development and
the Office of Water.  The Committee also recognizes the substantial effort made to  relate
specific research projects to research goals that must be met for human and environmental
health  purposes.

   Response to Question I:  In general, the research  issues identified to support the five
rules are appropriate. The Committee recognizes the complexity of the research plan with its
multifactorial approach to both microbial and DBP research and  acknowledges the
considerable progress made by  ORD and OW in comparison to previous versions of the plan.
Also, in general, the questions proposed in the research plan are appropriate.  However, the
Plan lacks the identification of a critical path of project  progression  that would identify the rate
limiting components.  Such a critical path helps prioritize and plan the research projects so
that those of greatest uncertainty and resource requirements are accorded appropriate and
primary attention and placed in a realistic time frame for overall research  progress.  This
would allow sequencing of data  acquisition that satisfies requirements for interdependency of
project data.

   The purpose of the research plan is to provide EPA and others with information required
to answer questions on the development of potentially  significant research results to support
drinking water regulations.  The  most meaningful discussion on the purpose of the research
plan is presented in the last section (Section IV). Within this final section of the Plan, EPA
presents the basis and foundations for the type of research needed to develop key
regulations over the next five to  ten years.  EPA discusses the studies and why the
information is needed. The driving force behind the development of the Plan would be
clarified if Chapter IV was placed at the beginning of the Plan.  Each portion of this section
would then identify the types of studies needed to provide the necessary information.

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    Response to Question II: Because of the approach that is taken, the Committee
questions whether some studies are included in the Plan because they are already underway,
or if they are included because they provide critical information for the development of
regulations.  There is less than a clear statement of the information needs and the studies
planned. The Committee suggests a process that EPA might have followed to identify the
needed projects in section 3.1.2 of this report.

    The Committee recommends that the microbial research goals statement put an even
greater emphasis on identifying and quantifying the occurrence of the key pathogens and the
health risks they pose in drinking water. This is necessary since the whole process of
developing regulations for minimizing the human health risks of contaminants in drinking
water requires identifying and specifying the contaminants posing the highest risks.  If
prioritization of contaminants for regulation is to be risk based, this approach must carry
through to the identification and quantitation of the key pathogens and their health risks.

    The Committee believes that it is important for EPA to develop a mechanism to identify
"new" waterborne pathogens as they emerge. The current research program has placed the
effort almost exclusively on one organism  (Cryptosporidium) because it is currently believed
to be the most resistant, worst-case organism. The Committee would be interested in
knowing how a different organism, that might emerge next year, would be accommodated in
the research plan?

    The organisms of greatest health concern, as stated in the health effects portion of the
microbial research plan are Norwalk type viruses and Cryptosporidium.  Yet, the Information
Collection Rule (ICR) will provide no information on Norwalk virus occurrence and the
information on Cryptosporidium will be limited for risk assessment because the ICR method
does not differentiate between infectious and non-infectious oocysts.  The Committee
believes that there is a potentially serious disconnect between the priority pathogens of the
health effects research (i.e., Norwalk virus and Cryptosporidium) and the priorities of the
occurrence research.  These different priorities do not facilitate a coordinated pathogen risk
assessment program.

    The Committee is concerned  about the absence of research projects examining the
potential for surrogates to serve as indicators of virus or fecal contamination of groundwater.
The Committee and other scientific panels have identified such indicators as critical research
needs for the GWDR.  EPA sponsored a national workshop  to discuss the GWDR on July 10-
11, 1996.  Several research needs were identified at the workshop and the Committee
recommends that these research needs be included and prioritized in a  revised plan. Also,
information about the concentration of viruses in  a groundwater source must be known.
Current surveys of viruses  in groundwater are determining occurrence of viruses, but their
densities are not being determined and the detection methods are inadequate. In addition,
the EPA has stated that the focus must be on those viruses that occur most frequently, in the
highest numbers and have the greatest health impacts.  The Committee contends that the

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research effort is not doing this. In order to achieve their stated goal, EPA should establish a
mechanism whereby those viruses that are detected in groundwater are identified.

   The Committee believes that a critical area that has been overlooked is the need for
methods to assess the reliability of a treatment plant and individual treatment processes.
The Committee also  believes that  additional research is needed on the reliability of multiple
barriers of treatment to include: watershed  protection  and pathogen monitoring, multiple
chemical inactivation steps, and filtration and/or sedimentation in addition to chemical
inactivation.

   In order to perform risk assessments for disinfection byproducts (DBFs) there is an
absolute requirement for exposure data and knowledge of human health effects.  Currently
exposure data are inadequate  primarily due to the lack of methods for proper measurement.
This  places the highest priority on  the acquisition of such methods for both Stage I  and Stage
II Disinfectant Byproduct Rules. Until this component of the research plan is in place,
adequate data for risk assessment will not be available.

   The issues of epidemiological research, DBP mixtures research, and research on the
toxicity of individual DBPs are appropriate,  but the emphasis placed on each of them may not
be. Much of the proposed DBP health effects research does not have direct impact either on
the balance  between controlling risks from pathogens and from DBPs in drinking water, or on
the rule making process itself.  This is partly because of the probable timing of the
epidemiologic reevaluation, and studies that could have a major impact, and partly  because
the other studies are directed at providing the experimental foundation from which rational
projections can be made in the future.  This does not imply that the basic experimental
toxicity studies are not important, but rather their accomplishment is less urgent.  If the
reevaluation of existing epidemiologic research can be completed in a time frame relevant to
the rule making process, it should  be assigned the highest priority from among this group of
proposed projects. The evaluations and reanalysis of the epidemiologic studies should  be
paramount.

   Response to Question ill. EPA characterizes the research task as one of balancing the
risk associated with disinfectants with the risks associated with microbial diseases, the idea
being that, as disinfection is increased to reduce microbial risks, the risk of DBPs is
inherently increased.  This way of  presenting the problem is not wholly accurate and it could
easily lead to an erroneous identification of the research tasks that must be undertaken to
produce the most effective regulation.  In the view of the Committee, the challenge  is not
merely writing a regulation that balances the costs of  more  disinfection with the benefits of
fewer microbes.  In fact, the bigger part of the challenge is to write a regulation that sets
tough microbial standards and allows this goal to be met at the lowest cost without  allowing
new, significant risks from chemical byproducts, particularly if those risks are of greater
importance than the  microbial risk avoided.

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   The Committee notes that there are many high priority projects and it is concerned with
how they are ranked among themselves.  There are obviously insufficient resources to fund
all the high priority projects.  How does the Agency decide which ones to fund? Also, why
are some medium priority projects funded (i.e., already underway) when many high priority
projects are not funded?

   The development of rapid reliable monitoring methods for waterborne pathogens  should
receive  a high priority.  Also, proper design and operation of water treatment facilities is
crucial to reducing waterborne illness.  It would be extremely helpful to know what
percentage of waterborne illness is caused by treatment  process upsets resulting in
epidemics versus the percentage  of endemic waterborne disease caused by pathogens
passing through well-operated treatment plants. It may be much more cost effective  to
improve operational reliability of water treatment than to require  increasingly higher logs of
pathogen removal/inactivation.

   The EPA has  chosen to place a medium priority on those research projects related to the
growth of bacteria in distribution systems. The Committee agrees that projects related to
heterotrophic bacteria in distribution systems should not be the highest priority.  However, in
light of the information that is being obtained in Payment's studies on  the role of the
distribution  system in endemic microbial disease, the Committee believes that it would be
appropriate to place a higher priority on microbial contamination  in distribution systems.
Besides characterizing the biofilms in the systems, research is needed on the integrity of
distribution  systems and their vulnerability to pathogen introduction from cross-connections,
line breaks, pressure drops, etc.

   Responses to specific issues in the Plan are contained in the appropriate sections of this
report.

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                              2.  INTRODUCTION

2.1  Background

   The U.S. Environmental Protection Agency (EPA or the Agency) is developing a series of
drinking water regulations on disinfectants, disinfection by-products (DBPs) and microbial
pathogens. The EPA Office of Research and Development (ORD) and the Office of Water
(OW) prepared  a draft Research Plan for Microbial Pathogens and Disinfection By-products
in Drinking Water (the Plan)(EPA,  1995). The Plan is intended to define the research
needed to support EPA's development of drinking water regulations  covering disinfectants,
disinfection byproducts, and microbial pathogens, to  serve as a vehicle for facilitating and
coordinating research with cooperators, and for communicating with those outside the agency
who are interested in these regulations.

    Disinfection  and disinfection byproducts have been a recurring issue with the Science
Advisory Board's (SAB) Drinking Water Committee (the Committee).  Since  1990, the
Committee has  provided advice to  the agency on at least seven occasions,  including:

       a)     a report on  recommendations for research on disinfectants and disinfection
             byproducts  (SAB,  1990);
       b)     a review of  the Office of Research and Development's drinking water
             microbiology research plan (SAB, 1991);
       c)     a commentary  to the Administrator asking for adequate resource investments
             in disinfection byproduct research (SAB, 1992);
       d)     a commentary  on the negotiated regulation for disinfectants and byproducts
             which highlighted the need for research in this area (SAB, 1993);
       e)     a report on  the research program on disinfectants and disinfection byproducts
             in the Risk Reduction Research Laboratory (SAB, 1993a)
       f)      a report on  the information collection rule (ICR) asserting the  need for  an
             overall plan to guide collection and analysis of data resulting from the ICR
             (SAB, 1994); and
       g)     an advisory on some near-term research proposals on DBPs  along with a
             strong recommendation for a structured effort to coordinate EPA's DBP
             research program, including the use of formal scheduling and resource
             management (SAB,  1995).

   The current  review was fnitiated by a request from the  Deputy Assistant Administrator for
Science of the EPA Office of Research and Development (ORD).  Portions of the draft
Research Plan for Microbial Pathogens and Disinfection By-products in Drinking Water were
forwarded  to the Committee during October, 1995. Agency officials introduced the Plan to
the Committee at a teleconference  meeting  on November 9, 1995.  A follow up meeting was
held in March, 1996 to discuss the  Plan in detail. Additional information, in the form of
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appendices to the plan, was delivered to the Committee just prior to its March, 1996 review
meeting.  The Committee held a working session on the Plan at a meeting during July, 1996.

2.2 The Charge

   The Agency charge to the Committee was to review the research plan and to provide
advice on whether:

       a)     EPA had identified the correct research issues to support the development of
             the Interim and long term Enhanced Surface Water Treatment Rules, Ground
             Water Disinfection Rule, and Stage  2 Disinfectant/Disinfection Byproducts
             Rules;
       b)     The research topic areas or projects underway, or envisioned under  the five-
             year plan, appear to adequately address the issues, and if not, should any
             other research topic area be funded in lieu of or in  addition to those  presented;
             and
       c)     EPA assigned appropriate priorities to the research?

2.3 Overview of the Research Plan

   The Agency's research plan consists of four chapters and three appendices.  Chapter I
introduces the Plan's purpose and  the drinking water quality issues that the Plan and the
regulations address; reviews EPA regulatory efforts;  provides an overview of drinking water
treatment; and describes the relationship  among regulatory policy questions, research goals,
research questions, and research needs.

   Chapter I states that the Agency's research needs (pages I-6  through 1-21) are  linked to
major policy questions that must  be answered by research results (e.g., should drinking
water disinfection by ozonation be  encouraged in place of chlorination?). The Plan presents
major research questions that are important to resolving the policy questions (e.g., What
are the health risks caused by exposure to microbial pathogens?) and identifies research
goals that, if attained, would provide useful data to address each question (e.g.,  To identify
the health effects caused by microbial pathogens in drinking water.).  Next, the Plan outlines
more  focused research questions (e.g., What are the health effects associated with
exposure to waterborne pathogens?) and research needs which  further identify the type of
information that is needed (e.g.,  information on the pathobiology of infection and  disease for
waterborne pathogens.). The research goals have a one-for-one relationship to the four
major elements in the environmental health risk assessment-risk management paradigm
(health effects, exposure, risk assessment, and risk management).

   Chapter I also presents an overview of the elements within this structure for the research
plan and the criteria that the Agency applied in selecting research projects for each need.

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Although all projects are high priorities, the Agency has assigned relative priorities (see
Appendix A) within the population of projects using the following criteria:

       a)    High risk (research is likely to elucidate factors where preliminary information
             suggests significant public health impacts);
       b)    High uncertainty (results are likely to reduce significant uncertainties);
       c)    Regulatory relevance (high likelihood that results will lead to criteria which
             reduce  risk in a cost-effective manner).

Other factors which the Agency considered in setting priorities included:

       a)    Short-term and long-term research needs balancing,
       b)    Linkage to other efforts  (complements other research),
       c)    Anticipatory research (results will help anticipate future problems), and
       d)    Wider applicability (results may extend to other environmental issues)

   Chapters II and III present information on the specific research projects.  Chapter II
focuses on research for microbial pathogens and Chapter III discusses research for
disinfection byproducts. Both follow the same structure.  For example, the microbial
pathogen chapter (Chapter II) first discusses background information on waterborne
infectious disease links to microbes and then repeats, in table form, the research questions
that address each research goal (paradigm component). Then, information on specific
projects clustered under the categories of Health Effects Research, Exposure Research,
Risk Assessment Research, and Risk Management Research is given. This information
includes the state of the science, specific research needs, and a short explanatory statement
on each of the selected research projects that address the research needs.  This structure
was intended to relate  policy questions and major research questions to research goals,
questions, needs, and projects.

   In Chapter IV. research projects are clustered into five major groups, which show how the
research is integrated with each of the specific drinking water regulations. Within each
cluster,  the projects are further subdivided into either health effects, exposure, risk
assessment, or risk management research.  The  regulatory clusters used to  categorize
research projects in the plan include:

       a)    Stage 1  Disinfectant/Disinfection Byproduct (D/DBP) Rule  which addresses
             limits for a number of DBFs (THMs, haloacetic acids,  bromate, chlorite,
             chlorine, chlorine dioxide, and chloramines) (proposed July 1994);
       b)     Interim Enhanced Surface Water Treatment Rule (IESWTR) which will
             enhance protection from  pathogens while the Stage I  DBF rule is being
             implemented (proposed  July 1994);
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      c)     Long-term Enhanced Surface Water Treatment Rule (ESWTR) which
             extends protection from pathogens for systems serving fewer persons than
             those addressed by the IEWSTR (not yet proposed);
      d)     Stage 2 DBP Rule which further reduces DBP levels addressed by the Stage
             1 rule (proposed in part in July 1994); and the
      e)     Ground Water Disinfection Rule (GWDR) which enhances protection against
             pathogens in systems using ground water not under the influence of surface
             water (not yet proposed).

   One additional rule that is relevant to these regulations is the Information Collection
Rule (ICR) which will  provide data on occurrence and treatment for pathogens and DBFs in
larger public drinking  water systems. This rule was proposed in February of 1994 and
promulgated during 1996.

   The  Plan, and the DWC's review, also included  projects that are sponsored by the
American Water Works Association Research Foundation (AWWARF) and the National Water
Research  Institute (NWRI). These projects can also be grouped into  these same categories.
It is not  clear to the Committee whether the Plan  has been coordinated with research
organizations other than  the AWWARF.  The Committee encourages the Agency to interact
with the broadest possible group of organizations doing research in this area.

   Chapter IV also presents information on how the research will be  used to support
estimation of national and local costs and benefits associated with each of the rules, and an
approach to  balancing the risk associated with regulatory decisions for microbial pathogens
and DBPs.

   A number of general  characteristics are evident about the projects listed within the
various categories. The  interim ESWTR projects in health effects, exposure, and risk
assessment  are all focused on  microbial studies as are the research projects in support of
the long-term ESWTR and the ground water disinfection rule. Risk management research in
support  of both the interim and long-term ESWTR concentrates on either physical and
biological removal of  microbes or disinfection by single or multiple agents and also includes
distribution system research.   The Stage 1 and Stage 2 DBP rule associated research
focuses on disease conditions that might result from chemical exposures and includes health
effects related to cancer, tumor formation,  reproductive effects, neurotoxicity, immunotoxicity,
mutagenicity, and other toxic effects. Epidemiological feasibility studies on these disease
states are part of the  health effects research being  conducted. All of the health effects
projects in the Stage  1 DBP rule and all of the AWWARF exposure research projects are
expected to be finished by the end of Calendar Year 1996.  The projects on D/DBP methods,
EXD 1 through EXD 6, will not be completed until 1998 and 1999. Risk assessment research
activities are not identified in the research plan to support the Stage  1 DBP rule. Both risk
assessment  and risk  management projects are concentrated on the Stage 2  DBP rule.

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                       3.  OVERARCHING  COMMENTS

3.1  General Comments on the Charge

    The Committee recognizes the substantial efforts of the Agency to describe the research
program for disinfectants, microbial agents, and disinfection byproducts in a manner which
reflects its relationship to the research supported by the regulated community, and the
cooperative approach to planning the research between the EPA Office of Research and
Development (ORD) and the Office of Water (OW).  The Committee also recognizes the
substantial effort made in relating specific research projects to research goals that must be
met for human and environmental health purposes.

    The general comments of the Committee are provided in this section in response to the
three major elements of the charge from the Agency.  Later sections of the report provide
more detailed comments on components of the Plan.

       3.1.1  Charge Question 1: Has EPA identified the correct research issues to
             support rulemaking?

    In general, the research issues identified to support the five rules are appropriate.
However, the committee is concerned that this plan, which is organized topically, does not
provide research paths and schedules, and with few notable exceptions,  does not convey  a
sense of research  flow.

    The purpose of the research plan is for EPA and others to coordinate development of
research projects designed to answer questions about information needed to  support drinking
water regulations,  as well as development of research projects designed  to generate the
significant  research results needed.  The most meaningful discussion on  the purpose of the
research plan is presented in the last section (Section IV-Balancing microbial and DBP risks:
Integrating Research to Support Rule Development) in which the Agency attempts to tie all
the  pieces together.   Within this final section of the Plan EPA presents the basis and
foundation for the type of research needed to develop key regulations over the next five to
ten  years.  EPA discusses the studies  and why the information is needed.  The driving force
behind  the development of the Plan would be clarified if Chapter IV was placed at the
beginning of the Plan. Each portion  of this section should identify the types of studies
needed to  provide  the necessary information.

       3.1.2  Charge Question 2: Do the research topic areas or projects underway  or
             envisioned under the plan adequately address the issues?

    Because of the approach that is taken, the Committee questions whether some studies
are  included in the Plan because they are already underway, or if they are included because
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they provide critical information for the development of the regulations.  There is less than a
clear statement of the information needs and the studies planned.

    The Committee believes that it would be helpful to look at the process that EPA might
have gone through to identify the needed projects.  The process could have included the
following elements:

       a)    Definition of the regulatory objective: to coordinate the efforts to regulate
             microbial disease with the efforts to  regulate disinfection byproducts so that
             neither regulation is done in the absence of satisfactory understanding of the
             impact it will have on the other.
       b)    Articulation of an  understanding of the regulatory alternatives.
       c)    Articulation of an  understanding of the impact of each alternative on both
             microbial and DBP issues.  Note, the following relevant points: 1) models
             might be required; and 2) a strawman could be constructed to identify gaps in
             our understanding.  Some can be filled by gathering data (e.g., how much
             dichloroacetic acid, DAA, is occurring);  others can be filled by conducting some
             basic research  (e.g., is there a threshold for the effects of bromate?);  others
             gaps are unlikely to be filled in the coming decade; and filling  still others may
             fall under questions of policy (comparing mortality and costs, identifying all the
             byproducts of each oxidant,  etc.).
       d)    Development of a research plan to  address the near term data gaps, a
             research plan to address the longer-term data gaps and white papers on the
             appropriate policy issues.
       e)    Review the research already being conducted by other parties to determine
             which data gaps remain.
       f)     Development of a schedule showing the relationships among all projects (EPA,
             others,  near term data, long term data and policy  issues). The schedule
             should show the resources required of EPA (manpower and funding).

    It would also be helpful to provide a mechanism to review EPA's current list of projects.
The following screening questions might be appropriate for this purpose:

       a)    Is this research essential to the current regulatory agenda? That is, what
             information need does it fill and what would be done differently if the research
             were not carried out now and in the future?
       b)    Does a good strawman exist that shows how this  information could  impact the
             regulatory outcome?
       c)    Ignoring funding, can this research be conducted  before it is  required for
             regulatory use?
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       3.1.3  Charge Question 3:  Has EPA assigned appropriate priorities to the
             research?

    EPA characterizes the task as one of balancing the risk associated with disinfectants with
the risks associated with microbial disease, the idea  being that, as disinfection is increased
to reduce  microbial risks, the risk of DBPs is inherently increased. This way of presenting the
problem is not wholly accurate and it could easily lead to an erroneous identification of the
research tasks that must be undertaken to produce the most effective regulation.

    The Committee believes the question is one of reducing the risks associated with all
drinking water practices as well  as reducing the risk  associated with microbial disease. All
drinking water practices that reduce microbial risks do not necessarily result in increased
health risks from chemical pollutants.  One treatment practice, disinfection, which is
particularly effective in controlling bacterial and viral agents, does produce a variety of
chemical byproducts that are thought to present a health risk. This is particularly true of
chlorine, the most  common disinfectant. To date, water treatment practice, worldwide, has
depended  heavily on the effectiveness of  chlorine, perhaps too much so.  In the view of the
Committee, the challenge is not merely writing a regulation that balances the costs of more
disinfection with the benefits of fewer microbes.   In fact, the bigger part of the challenge is to
write a regulation that sets tough microbial standards and allows this goal to be met at the
lowest cost without allowing new, significant risks from chemical byproducts, particularly if
those risks are of greater importance than the microbial risk avoided.

    The Committee notes that there are  many "high"  priority projects and it is concerned with
how they are ranked among themselves since the resources are obviously insufficient to fund
all of the "high" priority  projects.  How does the Agency decide which ones to fund?  Also,
why are some "medium" priority projects funded  (i.e.. they are already underway) when
many "high" priority projects are  not funded?

    The Committee also notes that the evaluation and reanalysis of the epidemiologic studies
are core components of this plan. The outcome  of this broad component of disinfection
byproduct research should help direct research activities in the other two areas (health
effects and risk assessment related research).  However, some  highly focused and relatively
isolated individual research projects are  already in progress that have no apparent
connection to human epidemiologic studies.  Of the three main issues identified, the
Committee thinks that the priority order should be: a)  evaluation and reassessment of the
epidemiologic studies, with feasibility studies if called  for; b) research on  DBP mixtures; and
c) toxicologic research on individual DBPs.  This order applies to the proposed risk
assessment projects  as well as to the health effects studies.  It is also not clear that core
microbiological issues are addressed adequately by epidemiologic studies.  Priorities for
individual research projects in these areas  are discussed later in this report.
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                          4.  MICROBIAL RESEARCH

4.1 Overview

    Microbial waterborne pathogens of concern include various bacteria, viruses, and
protozoans that are the etiologic agents of human disease.  Devastating, bacterial pathogens
are largely under control with widely used disinfection measures. Therefore, the focus of
concern for microbial pathogens in drinking water has been mostly directed to those
pathogenic protozoans and viruses found as drinking water contaminants.

    The research plan for microbial pathogens identifies key research issues for microbial
pathogens and their health effects by stating major questions and research goals, and then
presents research needs for more-specific research questions that respond to the research
goals.  In  its presentation of microbial pathogen research, the Agency has made considerable
progress in identifying key research issues as compared to  the previous versions of the
research plan. However, the Committee is concerned that the  microbiological research
questions and needs statements are perhaps not the key ones, or are not adequately
articulated.

    Research goals:  Goals 1 and 3 are to identify the health effects  and assess the risks
caused by microbial pathogens (and DBFs) in  drinking water.  These statements are useful,
but they do not specifically express the need to identify the  important microbial pathogens
and quantify their health effects in drinking water. Goal 2 is to  determine the population
distribution of exposure to microbial pathogens (and DBFs)  in drinking water.  This research
statement is useful because it alludes to the need to quantitatively measure microbial
pathogen  exposure  in drinking water.   However, also equally important is the determination of
the health effects of pathogen exposure on various segments of the  population for a
complete evaluation of the public health risk.  Goal 4 is to evaluate the effectiveness of
options for reducing risks from microbial pathogens (and DBFs).  This goal also alludes to
the quantitative aspects of pathogen exposures and their health effects by the need to reduce
the risks through various options. The Committee recommends that the research goals
statement put an even greater emphasis on identifying and  quantifying the occurrence of key
pathogens and the health risks they pose in drinking water. This is  necessary since the
whole process of developing regulations for minimizing the human health risks of
contaminants in drinking water requires identifying and specifying the contaminants  posing
the highest risks. If prioritization of contaminants for regulation is to  be risk based, this
approach  must carry through to the identification  and quantitation of  the key  pathogens and
their health risks.

       4.1.1 Health Effects Research Needs for Microbial Pathogens.

    The research question posed is: What are the health effects associated with exposure to
waterborne pathogens?  Based on the regulation of specific microbial pathogens or groups of

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pathogens as contaminants, the Committee believes that this research question should be
reframed as:  What are the microbial agents that are causing health effects in drinking
water? The reason for restating the question is to focus on hazard (microbial pathogen)
identification, which is appropriate for a risk based approach to the regulations.  The second
research need in this section is epidemiology studies to characterize endemic and epidemic
illness rates, to assess magnitude of risk, and to provide data for use in verifying risk models.
The Committee believes that this research need should also include the phrase: "to
determine etiologies of illness." The identification of the causative (etiologic) agents of
waterborne illness is an essential part of the risk assessment process leading to contaminant
regulation.  Therefore, epidemiological studies lacking the identification of specific microbial
pathogens (or immunological evidence of infections or illnesses attributable to them) will not
provide the essential information for risk based regulation.

      4.1.2 Exposure Research Needs for Microbial Pathogens

    The  Plan states that "little information is available on the levels of pathogens that occur in
drinking water." Actually, little  information is available on the types and levels of pathogens.
Again, the Committee believes that pathogen (hazard) identification, that is, specifying
particular pathogens, must  be an essential part of the microbial research plan and deserves
great emphasis. Research questions on page 1-11 are:

      a)    What methods are needed to adequately measure or estimate occurrence of
             pathogens?,
      b)    What are frequencies of occurrence and densities of pathogens in source
             water, finished water, and distribution  system water and what is the population
             distribution of exposure to the pathogens?, and
      c)    What are the factors affecting microbial contamination of ground water?

    The  Committee believes that the stated questions must put greater emphasis on the
identification or specification of the microbial pathogens and the indicators or surrogates for
them. The reasons for this have been stated previously: the criticality of the  need for hazard
(pathogen) identification in a risk based approach to the science in support of these drinking
water regulations.

    The  first two research needs to address this question are:  Analytical methods to detect
and enumerate protozoa and viruses in water.  The committee believes that these research
needs should be expanded to include the identification of the pathogens.  The research
needs statements should be:  analytical methods to detect, enumerate, and identify  bacteria,
protozoa, and viruses in water.

    As will be elaborated later in this report, the Committee believes that the research  Plan
does not adequately address some of the important  waterborne pathogens posing a high risk.
In some  of the proposed epidemiological studies, pathogen identification is lacking because
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there is no effort to look for them or because the methods used to look for them (or evidence
of infection with them) are inadequate.

       4.1.3  Risk Assessment Research Needs  for Microbial Pathogens

   The research question posed in this section is: "How can the risks posed by pathogens in
drinking water be characterized?"  The identified research needs are:  Modification of the risk
assessment paradigm for microbial disease, development and application of dose-response
models for microbiological disease, and methods to characterize risks from mixtures of
pathogens, and mixtures of DBFs and pathogens.

   The Committee agrees that these are the appropriate research questions and needs in
the area of microbial  risk assessment.  However, the Committee is concerned about the need
for balance in the levels of effort between microbial and DBF risk assessment research.
Because both classes of contaminants  are important and their risks must be balanced, there
must also be a balanced level of effort  in  assessing their risks.  In past communications, the
Committee has noted that in the important area of hazard identification (contaminant
selection), the approach for chemicals has been to conduct a separate analysis for each one,
while the approach for microbes has been to focus on a single worst case pathogen
(Cryptosporidium or a worst case virus) or to combine many of them into a into a single
group (enteric viruses or culturable enteric viruses).  Therefore the Committee recommends
that greater emphasis be placed on a risk based approach to the identification and analysis
of all human microbial pathogens,  including bacteria, in drinking water. The proposed
research plan has not taken this approach.  Instead, it has focused on a few individual
pathogens or large, heterogeneous groups of pathogens (e.g., enteric viruses)  assumed
(perhaps inappropriately) to represent the worst case.  Further, the Committee  believes that
investments  should be made  according to risk,  and that the risk associated with microbial
agents merit greater investments.

4.2 Specific Comments on Microbial Research

       4.2.1  Health Effects Research

   In the following subsections, the Drinking Water Committee comments on the microbial
research  parts of the  EPA Research  Plan with emphasis on  responding to the specific
questions of its charge (Section 3.1).

       a)     Emphasis on characterizing the dose-response for Cryptosporidium and
             Norwalk virus.

   The proposed research projects can be categorized into two groups: those related to
quantifying the dose-response curve for pathogens, and those related to surveillance and
investigation of waterborne disease outbreaks.  Quantifying the dose-response  relationships
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for pathogenic microorganisms of concern is critical to the development of a risk based rule.
All three of the microbiology-related rules (Interim Enhanced Surface Water Treatment Rule,
Enhanced Surface Water Treatment Rule, and the Ground Water Disinfection Rule) are
intended to be risk based; therefore, these projects should be given a high priority for
funding. The two proposed dose-response projects are for Cryptosporidium and Norwalk
virus. To our knowledge, the second phase of the Norwalk virus study, that will examine the
low dose range, has not been funded.  This project is crucial for the development of the three
rules. In addition, there are other significant  microorganisms for which dose-response data
are needed. For example, Norwalk virus is one of a large group of human caliciviruses.  It is
unknown whether the dose-response relationship for Norwalk virus will be representative of
the other members of the group.  Therefore, investigating the dose-response  of other viruses
is necessary, in the Committee's opinion.

   The Committee believes that it is important for EPA to develop a mechanism to identify
emerging waterborne pathogens and undertake fast-track research on them as necessary.
The current structure appears too rigid to identify and accommodate new waterborne
pathogens as they emerge. The current research program has put the effort almost
exclusively on one organism (Cryptosporidium) because it is currently believed to be the
most resistant, worst-case  organism.  If a different organism is discovered to be the worst-
case organism next year, how will this be accommodated in the research plan?  The Agency
needs to be proactive in this area and should establish a program that anticipates these
types of emerging pathogenic microorganisms.

   b) Specific pathogens  and endemic/epidemic waterborne disease

   Several projects (HEM  7-10) in the area of epidemiology are described.  The  Committee
believes that, while this information is important to quantify the effects of drinking water
contamination on public health,  it is not essential for rule development unless it includes
pathogen identification and quantitation.

   The project to characterize endemic disease (HEM 7) plans to compare  endemic illness in
communities with different water treatment systems. While it is listed as a high priority
project, the Committee questions whether this project will be completed in time to have an
impact on the ESWTR.  Furthermore,  because the project has a very  limited scope - only 4
communities will be involved - the Committee is concerned that this will not be sufficient to
allow an extrapolation to the rest of the country. Having  additional details about the
proposed study, including the types of treatment processes being used in the communities,
would help the Committee  in its efforts to determine how representative these communities
may be.

   Although two epidemiological studies for surface water have been  conducted, and others
are proposed, no mention is made of an epidemiological study in ground water systems. The
Committee believes that such a study would be as helpful in the development of the GWDR


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as are the proposed epidemiological studies to the development of the IESWTR and the
ESWTR. The Committee believes that such epidemiological studies should include efforts to
identify the pathogens responsible for the measured health effects.

      4.2.2 Exposure Research

      a)     Pathogens selected for study, analytical methods development

   The  EPA research plan proposes several research projects to develop methods to detect
and quantify infectious pathogens. The Committee agrees that the ability to detect infectious
pathogens is critical to the development of meaningful regulations that protect public health
but do not pose an undue economic burden on the industry. A large number of these
projects are focused on Cryptosporidium, and a few on Norwalk virus. Because a large
number of projects to develop methods for Cryptosporidium are being funded by AVWVARF,
the Committee recommends that the EPA's efforts in this area be fully coordinated with those
of AWWARF and other agencies.  The  Committee also recommends that research on
methods for Norwalk virus detection be inclusive of the other Norwalk-like viruses (i.e.,
human caliciviruses) to the extent possible.

   Research is needed to determine if Norwalk virus  is the appropriate representative,  or
whether another human calicivirus would be a better representative of the group.  Project
EXM 9 is to develop culture methods for the detection of Norwalk virus.  The Committee
considers this an extremely high priority project,  as Norwalk and related viruses may cause
25% of the waterborne disease in the U.S. The Committee asks whether this project is being
conducted. We consider it to be particularly relevant to the GWDR, where viruses are the
primary  pathogens of concern.  The Committee believes that the number of waterborne
pathogens for which methods are developed needs to be increased.

   The  Committee recognizes that methods using viability assays to detect important
waterborne pathogens are not yet available. Some of the proposed  research projects (EMM
2, EXM  3, EXM 9) are attempting  to develop such methods, which the Committee supports.
However, the Committee believes that intensive efforts on such projects are needed in a time
frame consistent with the time line of the proposed rules.  This is needed in order to be able
to do the risk assessment for these high priority pathogens.  In addition, the Committee
believes that greater emphasis should be placed on obtaining the best possible occurrence
data for these important pathogens in drinking water systems using state of the science
methods that attempt to measure viability or infectivity. The Committee also recommends
that the  Agency consider intensified efforts to obtain such occurrence data on these
pathogens during future waterborne  outbreaks. This would require better (more
comprehensive and better coordinated) preparedness for timely investigative response to
waterborne outbreaks.   The Committee believes this to be achievable through the
development of a coordinated, rapid response surveillance effort by the EPA, the Centers for
Disease Control and Prevention, and the states and territories.
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       b)     Approaches to estimate occurrence and exposure

   The Committee believes that the current research plan has some important limitations
and gaps in the area of microbial exposure assessment. These deficiencies are most critical
for the long term ESWTR and the Ground Water Disinfection Rule.  Too little emphasis is
given to determining the occurrence of important waterborne pathogens in drinking water
supplies to support the conduct of meaningful microbial risk assessments. If viable
Cryptosporidium, Norwalk and other Norwalk-type viruses are truly the most important
drinking water pathogens, because  of their health effects, then greater emphasis is needed
on obtaining exposure (occurrence) data.  In addition, the Committee believes that current
and proposed research on the occurrence of Mycobacteria (EXM 14), heterotrophic bacteria
(EXM 17,  19, 20), and opportunistic pathogens (EXM 18) would be of limited or uncertain
health significance  in drinking water.  Unless and until appropriate health effects research
provides better and more direct evidence that they truly present significant health risks in
drinking water, research on their occurrence should  be given lower priority. Higher priority
should be given to  obtaining  better  occurrence and exposure data for those pathogens whose
health effects in drinking water are clearly documented (e.g., Norwalk and other Norwalk-like
viruses, rotaviruses and  Cryptosporidium parvum).

   The Committee is concerned that currently planned efforts to obtain data on occurrence
of Cryptosporidium (ICR) and enteric viruses (ICR and ground water virus surveys) will not
adequately address the research needs for exposure assessment.  This is because the
Cryptosporidium method does not determine viability and the enteric virus method detects
only readily culturable (cytopathogenic) enteric viruses.  The ICR virus detection  method does
not include hepatitis A virus (HAV),  Norwalk, and the other Norwalk-type viruses judged most
significant for health effects.  The ground water virus survey attempts to detect Norwalk virus
and HAV by polymerase chaing reaction (PCR), but the methods being used are inadequate.
There are limitations of the PCR primers for Norwalk-type viruses and the method may detect
the nucleic acid of  inactivated viruses.

   Project EXM  22 is described as  a project to examine exposure to pathogens  as a function
of population distribution.  It would be important to examine the health effects of the
pathogens as a function of population distribution prior to examining the exposure.  The
Committee recommends that the Agency consider refocusing this project to examine how
health effects may  differ as a function of the population distribution. This information will
assist in the  risk  assessment for vulnerable populations.

   The EPA lists a number of projects (EXM 14  to 22) to examine the occurrence of several
microorganisms in  source water and distribution systems.  The majority of these  projects
involve pathogenic and opportunistic bacteria in distribution systems.  The Committee agrees
that information on the occurrence of potential pathogens in distribution systems will be
useful, but is concerned  about the lack of  projects on the occurrence of viral and parasitic
pathogens.  The Committee  understands that the ICR is a massive effort to collect data on


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the occurrence of Cryptosporidium and cultivable cytopathogenic enteroviruses in source
water, but considers this occurrence information inadequate for the development of risk-
based regulations. The organisms of greatest health concern, as stated in the health effects
portion of this research plan, are Norwalk type viruses and Cryptosporidium.  The Committee
agrees that these enteric virus and protozoan pathogens and others documented as causing
waterborne disease, such as rotaviruses and  Giardia lamblia, are the most important.
Therefore, these pathogens of documented waterborne disease should be the highest priority
for research on their occurrence in source water and distribution systems.  The Committee
believes that there is a serious disconnect or difference between the priority pathogens of the
health effects research (such as Norwalk virus and Cryptosporidium),  and the priority
organisms of the occurrence research (Mycobacteria, heterotrophic bacteria,  opportunistic
pathogens, and certain newly emerging pathogens, such as Aeromonas and Pseudomonas).
The Committee believes that these differences in the targeted organisms for research
priorities  in health effects and exposure (occurrence) should be resolved. Such differences  in
priority organisms do not provide the basis for a coordinated and  integrated research
program facilitating a risk-based  approach to the microbial aspects of these regulations.

    The Committee is concerned about the research projects on POU/POE devices (EXM 19-
20). We  believe that these projects should be low priority until there is documented evidence
of health  effects by the microbes associated with them from an articulated research program.
 Previous EPA studies have shown no such health effects. At the current time, these projects
are not well designed,  well focused, or justified as a part of an overall  research plan.  They
could be  redesigned and focused as treatment alternatives for small community and non-
community systems.

       c)     Groundwater  Research

       The Committee perceives a disconnect between the research plan and the direction of
development of the GWDR.  The focus of the projects to support the development of a
Ground Water Disinfection Rule is on the use of models to predict virus fate and transport.
There is little or no credible evidence to support this modeling approach.   It is unclear from
the available information which of these projects (other than EXM 24b) is funded.  Consistent
with the data from waterborne disease outbreaks, it is clear that the emphasis for microbial
research  on ground water systems is correctly placed on viruses.   However, the Committee
believes that bacteria,  and perhaps protozoans,  should be included as potential concerns in
these systems.  Furthermore, the Committee is concerned about the absence of research
projects examining the potential for surrogates to serve as indicators of virus or fecal
contamination of ground water.  The Committee and other scientific panels have identified
such indicators as critical research needs for the GWDR.  EPA sponsored a national
workshop to discuss the GWDR on July 10-11, 1996. Several research needs were identified
at the workshop and the Committee recommends  that these research  needs should be
included and prioritized in a  revised plan.
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   Monitoring for indicators or even pathogens may be an important aspect of the GWDR,
yet there is little research to support this approach.  There are no projects designed to
determine which indicators to use and the manner in which they would be used (e.g., when to
monitor, what sample volume to collect, etc.).

   Project EXM 23 (virus survival in the subsurface) is clearly important because information
on virus survival in the subsurface is vital to determining a system's vulnerability to
contamination.  Therefore, the Committee encourages such research. A project in this area
is being funded by AVWVARF, but more information will be necessary to obtain an adequate
picture of the important factors controlling virus survival.  The Committee is concerned about
the proposed project's reliance on bacteriophages.  This  is because bacteriophages are
indicator viruses, and  ultimately, it will be necessary to provide findings  from similar research
on human enteric viruses.

   Projects  EXM 25-27 focus on the use of mathematical models to predict virus fate and
transport, and this may be a long-term goal of the Agency. However, the Committee believes
that this goal will not be achieved in the time frame of the GWDR.  Therefore, the Committee
questions the priority of these projects relative to other potential projects.  In particular, the
Committee believes that high priority research projects are needed to characterize and
quantify  the factors affecting virus survival and transport in groundwater, and to develop
methods for assessing fecal  contamination of ground  water using reliable indicators.

       4.2.3  Risk Assessment Research

       a)    Development of quantitative microbiological extrapolation  model accounting for
             thresholds, severity, and duration of exposure

   The Committee is concerned that the level of effort in the  critical area of microbial risk
assessment is inadequate.  The resource investment  proposed for this research is appears to
be inadequate for the research needed to develop risk-based regulations. Microbial risk
assessment is a relatively new area compared to chemical risk assessment and additional
effort is needed before adequate comparative  risk assessment is possible.  The Committee
believes that additional areas that need to be addressed  include: 1) the  effects of mixtures of
microorganisms (there is  evidence that co-infection with enteric viruses and bacteria may
result in infections with more severe health effects); 2) the effects of multiple exposures over
time;  3) multiple routes of exposure (i.e., ingestion and inhalation); 4) model validation by the
use of epidemiological data or other approaches; 5) the effects of immunity of the exposed
individual and population  on  susceptibility to infection; and 6)  evaluation  of secondary spread
of infectious agents. The Committee also believes that end points of infection in addition to
diarrhea  (e.g., meningitis, myocarditis, respiratory disease, diabetes) need to be assessed
and quantified.
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   The Committee is pleased to see that the Agency has developed a risk assessment
paradigm for use in these regulations.  However,  the Committee is concerned that the data
needed for the risk assessment model are not available nor are there projects proposed to
obtain the needed information.

   Projects RAM 2 and 3 propose to conduct research on important topics such as severity
of the exposure endpoint and mixtures of pathogens.  It is unclear from the research plan
who will conduct these  projects and whether they will be funded.  Lack of details on these
projects makes it difficult for the Committee to evaluate them. The Committee has some
concerns about the efforts to develop a threshold model.  Existing data on dose-response in
human feeding studies  do not preclude threshold or non-threshold models. A non-threshold
response seems likely for microorganisms for which multiplication within the host results in
infection.   For this reason, the Committee believes that a threshold for microorganisms
would have to  be demonstrated experimentally.
       4.2.4  Risk Management Research-Microbial Pathogens

       a)     Overview

             1)     Risk management research for Microbial Pathogens

   The key research questions in this section of the Plan are: "How effective are various
treatment processes in removing pathogens?", and "How can the quality of treated water be
maintained in the distribution system?" The Committee agrees that these are appropriate
and important research questions. However, the Committee also believes that another
critical research question is:  "How can the microbial quality of source water be protected
and evaluated to insure that it is consistent with finished water quality of acceptable microbial
risk after appropriate treatment?" The research needs in the area of risk management
include: Effectiveness of treatment processes for Cryptosporidiurrr, treatment technologies
appropriate for small systems; and identification and characterization of factors influencing
microbial growth in distribution systems and strategies for its control.

   Furthermore, the Committee also believes that there are additional research needs in the
area of risk management for microbial pathogens. A focus on treatment for Cryptosporidium
is reasonable, based on  current  information of its health risks and resistance to disinfection.
However, other  waterborne microbial pathogens may emerge that are highly resistant to
treatment and of significant health risk. However, Cryptosporidium only recently  supplanted
Giardia as the worst case waterborne protozoan pathogen to date.  With the continued
discovery of new, potentially waterborne protozoan parasites, such as Cyclospora
cayetanensis and the Microsporidia, the research needs for treatment processes should
extend to additional waterborne pathogens as their existence and significance is recognized.
The Committee  also believes that the research needs on factors influencing  microbial growth


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in distribution systems and strategies for control should be expanded to include microbial
intrusion as well. This is because the extent of cross connections, water line breaks and
repair practices, and other conditions causing microbially contaminated water to enter
distribution systems is not adequately known at present.

       b)     Specific Comments

   The October 1995 SAB Review Draft of the EPA's Research Plan for Microbial Pathogens
and Disinfection Byproducts in Drinking Water contains the following statement (page II-30):
"For example, in the United States the waterborne disease outbreak rate for communities
using  surface sources without filtration is eight fold greater than communities with filtered
water systems.  Properly designed and operated water treatment systems that include
filtration and disinfection can greatly reduce the risk of waterborne disease."  This statement
raises several important points regarding reducing waterborne illnesses in the U.S.  They are:
1) Improved watershed protection and better pathogen monitoring systems that provide early
warning of increased pathogen loading to treatment plants is needed.  Storm events and
other activities on watersheds often lead to highly increased concentrations of pathogens in
raw waters entering water treatment facilities.  Watershed control programs and rapid,
reliable pathogen monitoring systems for both raw and treated waters would be extremely
effective in reducing waterborne epidemics. The development of rapid, reliable monitoring
methods for waterborne pathogens should  receive a high priority;  2) Proper design and
reliable operation of water  treatment facilities is critical to reducing waterborne illness.  It
would be extremely helpful to know what percentage of waterborne illness is caused by
treatment  process upsets resulting in epidemics versus the percentage of endemic
waterborne disease caused by pathogens passing through well operated treatment  plants.  It
may be much more cost effective to improve the operational reliability of water treatment
plants than to require increasingly higher logs of pathogen removal/inactivation.  The
Committee believes that another critical area that has been overlooked is the need for
methods to assess the reliability of a treatment plant and individual treatment processes.
The questions that need to be answered include a) how reliable are these processes in
continually achieving the required level of pathogen reduction?; b) how often do these
processes fail and how often do they achieve less than the required level of reduction?; c)
What  are acceptable levels of failure and sub-optimal  treatment?; and d) Should item 'c' be
based on  the quality of the  source water?  The Committee believes that field studies are
needed on individual treatment processes and plants to answer these questions, as this
information is needed for the ESWTR and future regulations; and 3) the Committee believes
that additional research is needed on the reliability of multiple barriers of treatment, to
include: watershed protection and pathogen monitoring, multiple chemical inactivation steps,
and filtration and /or sedimentation  in addition to chemical inactivation. The issue of multiple
independent  treatment barriers relates closely to improved reliability of operations described
above.  For example, physical-chemical treatment steps for surface water supplies can
efficiently  remove most pathogens,  so  an upset in one of the  barrier(s) is less likely to
generate a waterborne disease outbreak.
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    Microbiological population densities in the watershed vary over several orders of
magnitude over a period of time and the events that result in their transport to the water plant
intake are also highly variable. Moreover, where microbiological pathogens are concerned
substantial health impacts can occur from high concentrations in drinking water for only a
short time. Hence, in this area, treatment systems must be  fail-safe. Adequate public health
protection is not achieved just by providing a  certain number of logs of removal.  It is
important that significant portions of the removal are performed by independent treatment
barriers,  where the performance of one barrier is not entirely dependent on the success of
the other.  A treatment plant with filtration and chlorination does have independent barriers
for bacteria and virus removal, but not for the control of Cryptosporidium.

    There are two ways microbiological risks can be  viewed. First in terms of catastrophic
events, outbreaks, epidemics,  etc.  Second  as a more  or less continuous, low level endemic
event occurring at low density throughout the population.  The first sort of risk is  a well-known
fact and  many examples can  be cited.  The second is the result of a reasonable  hypothesis
which epidemiological studies are presently struggling to confirm. The  Committee feels that
EPA's efforts should  be designed to effectively address both of these types of risks.

    The risk of endemic disease can be addressed by requiring treatment process trains that
can be expected,  over the long haul, to achieve more effective  pathogen removal.  This
appears  to be the course EPA has presently set.  The  risk of catastrophic events requires
that watershed protection be addressed and that treatment trains include greater reliability.
One way to achieve that reliability is to  provide the sort of independent treatment barriers
mentioned earlier,  so that, if one treatment barrier fails, chances are another is still in place.

              1)     Alternative treatment processes development and emphasis on
                    Cryp tosporidium.

    The focus on treatment alternatives for Cryptosporidium inactivation in surface water
systems  seems appropriate, although the Committee is concerned about this  approach of
choosing a single "worst-case" pathogen. However,  the Committee believes that there is a
lack of research on those pathogens of greatest health concern in ground water, especially
the enteric viruses. Systems using ground waters will need  information on treatment
alternatives that are effective against viruses. More  information is needed on poorly-
characterized viral  pathogens,  such as Norwalk virus and the other human enteric viruses.
While the need for projects of this type  is described in the Plan, the Committee is concerned
that no specific projects on this topic are listed in the FY 95-96 Plan.

             2)     Assignment of medium priority to projects related to microbial quality

    The EPA has chosen to place a medium  priority on those research  projects related to the
growth of bacteria in  distribution systems. The Committee agrees that projects related to
heterotrophic bacteria in distribution systems should  not be the  highest  priority.  However, in
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light of the information that is being obtained in Payment's studies on the role of the
distribution system in endemic microbial disease, the Committee believes that it would be
appropriate to place a higher priority on microbial contamination in distribution systems.
Besides characterizing the biofilms in these systems, research is needed on the integrity of
distribution systems and their vulnerability to pathogen introduction from cross-connections,
line breaks, pressure drops, etc.

       c)     Comments on Chapter IV, Balancing Microbial and DBP Risks

             1)     Interim and Long-Term ESWTR

    EPA states that because the long-term ESWTR will apply to small systems, very simple
and inexpensive methods must become available for measuring or estimating (through
surrogates) Cryptosporidium in water. Several research projects are underway, by both EPA
and AWWARF,  to develop more efficient and reliable methods for the detection of
Cryptosporidium in water.  The Committee does not feel additional efforts to find biological
indicators for Cryptosporidium will be fruitful. Instead, EPA should consider other suitable
approaches to assessing the exposure of small systems to this and other pathogens. (IV-6,
line 15)

    EPA will  likely require that some level of disinfection, in addition to physical removal, be
required to ensure that virus levels are adequately reduced.  There is a need to assess how
much virus removal is actually achieved through physical removal processes. This  will
enable EPA  to determine exactly what level  of removal through disinfection will be required,
so that the total virus removal is adequate. The Committee believes that the contributions of
physical and chemical removal and inactivation by disinfection  must  be quantified for viruses.
It is not possible to quantify chemical risks of disinfectants and their  byproducts without
specifying treatment trains for effective reductions of viruses and other pathogens.  (IV-6, line
20)

    It is stated that the ICR data will be used to validate gross assumptions on treatment
effectiveness.  It is not clear how the data obtained from the ICR will be  used to accomplish
this. Finished water monitoring will occur, presumably, at a limited number of sites.  Whether
these data will be reflective of treatment systems nationwide is unknown. (IV-7, line 26)

    EPA proposes  to test the validity of risk estimates  based on dose-response curves using
epidemiolgical data. It is not clear how the projects listed to accomplish  this will provide the
necessary information.  For example, waterborne disease  outbreak surveillance is unlikely to
provide epidemiological evidence in a form that will allow an evaluation of dose-response.
This is because current surveillance is too slow to respond to outbreaks  to get good samples
for pathogen analysis.  Furthermore, such pathogen analysis is rarely done or is done using
inadequate recovery and detection methods. (IV-12, line 8)
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   Several projects are listed to examine the health significance of bacteria growing in
biofilms in the distribution system. This is certainly an important area of research.  However,
a more comprehensive need is the issue of distribution system integrity. There is growing
evidence that endemic and epidemic waterborne disease is associated with breaks in the
distribution lines, cross-connections and other breaches of distribution system integrity.
Greater research effort should be expended in the area of design, construction, operation,
and maintenance of distribution system integrity.  (IV-12, line 14)

       2)     Ground-Water Disinfection Rule

   One of the key issues identified by EPA is to determine the  level of disinfection to require
for systems that are vulnerable to fecal contamination. In order to determine the level of
disinfection required, target disinfection requirements must be determined  based on an
acceptable level of risk of infections per year.  Additionally, information about the
concentration of viruses in the source water must also be known.  Current surveys of viruses
in ground  water are determining occurrence of viruses, but their densities are not being
determined and the detection methods  are inadequate.  In addition (line 25), EPA states that
the focus  must  be on those viruses that occur most frequently, in the highest numbers,  and
have the greatest health impacts.  The Committee contends that the research effort is not
doing this.  In order to achieve their stated goal, EPA must establish a mechanism whereby
those viruses that are detected in ground water are identified. (IV-21, line 7)

   The GWDR will have a major impact on non-community systems, thus the approach used
in this Rule will  of necessity be much different than that used in the SWTR and ESWTR.
From the  current research plan, it is not clear to the Committee that the needs of non-
community systems are going to  be addressed.  (IV-22, line 22)

   EPA has listed  projects to define the public health significance of microorganisms in
ground water systems. However, no epidemiological study for ground-water systems is
proposed, so it  is difficult to see how risks of endemic disease will be determined. It is also
stated that indicator occurrence in source waters and distribution  systems will be determined.
Yet, no projects are listed to study indicator occurrence in any ground water system.  In a
previous section of this report, the Committee noted that this  information will be critical to the
development of the rule, which is likely to require monitoring for indicators.  (IV-23, line  5)

   The Committee notes that a survey on disinfection practices currently in use by ground-
water systems by industry is mentioned but details of the study  are not provided.  Therefore,
it is not possible for the Committee to judge or comment on the merits of this study in terms
of its objectives and design.  The Committee believes surveys of this nature can only be
helpful in measuring process effectiveness.  (IV-23,  line 12)

   Approaches for monitoring for coliphages are stated as being investigated.   But no
projects on this topic are listed in the research plan. The Committee has already expressed
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its concern about the lack of research to identify and utilize coliphages or other appropriate
indicators of virus pathogens and fecal contamination in general. (IV-23,  line 30)
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              5.  DISINFECTANT/BYPRODUCTS RESEARCH

5.1 Overview

    In order to perform risk assessments for disinfection byproducts (DBFs) there is an
absolute requirement for exposure data and knowledge of human health effects.  Currently,
exposure data are inadequate primarily due to the lack of methods for proper measurement.
This places the highest priority on the acquisition of such methods for both Stage 1 and
Stage 2 Disinfectant Byproduct Rules (e.g., projects EXD 1, EXD 2, and EXD 3).  Until this
component of the research plan is in place, adequate data  for risk assessment will not be
available. As such, risk assessments conducted on current data will have high degrees of
uncertainty (health effects research is dealt with in section 5.2).

    Another critical component of the research plan is a discussion on control of disinfection
byproducts by one of three options:

       a)    Removal of natural organic materials before disinfection;
       b)    Changes in the disinfection process that will minimize the formation of related
             byproducts; and
       c)    Removal of disinfection byproducts after they are formed.

    The Committee believes that a combination of options 'a' and 'b' listed above will be the
most effective way to concurrently  meet the need to control  microbiological contaminants
while also avoiding undesirable chemical byproducts.

    The issue is not one of byproducts of disinfection, but of byproducts of oxidation. At the
present time,  the use of strong chemical oxidants, particularly chlorine,  is probably the most
important single tool for controlling microorganisms in drinking water.  In that role oxidants
are called disinfectants. But these same oxidants are also used for certain other treatment
objectives, such as oxidation of sulfide, oxidation of iron and manganese, odor control, etc.
Whenever they are used, strong oxidants are  likely to react with natural organic matter
(NOM) in the  water to produce chemical byproducts.  Chlorine is noteworthy because it
reacts not only by oxidation, .but by other mechanisms such  as addition and substitution.  As
a result, evidence suggests that chlorine produces a greater number of chemical byproducts.

    Disinfection with chemical oxidants is attractive because  evidence suggests it is more
effective in removal or inactivation of many microorganisms than are traditional
physiochemical treatment processes alone.  It is doubtful if some drinking water supplies
currently in use could be made safe from bacterial disease  using traditional treatment
technologies,  were it not for the use of chemical oxidants as disinfectants.
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   Nevertheless, alternatives are appearing on the horizon that offer the promise of
removing or inactivating microorganisms without the formation of such extensive chemical
byproducts.  Examples are ultraviolet light, microfiltration, ultrafiltration, and reverse osmosis.
Research in the use of these technologies is of critical importance, especially for small
systems.

   Moreover, there are also some strong chemical oxidants that are seeing wide use outside
the U.S., such as chlorine dioxide and ozone, which produce a more limited number of
chemical byproducts, and where control of byproduct formation may be feasible under certain
conditions.  Chlorine dioxide and ozone are also found to be effective in inactivating a wider
variety of microorganisms than chlorine. It does not make sense to abandon the search for
alternatives to disinfection when chlorine itself is not effective with Cryptosporidium and
some of the alternatives are.

   Nevertheless, conditions in the distribution system must be controlled.  Today it is U.S.
practice to do this by maintaining the presence of a chemical oxidant in the system (that is
also  known as a disinfectant) usually free or combined chlorine.  So long as utilities elect to
use a free chlorine residual as a means for maintaining acceptable conditions in the
distribution  system, they must also seriously consider controlling the level of natural organic
material (precursor material) in the water entering the distribution  system as well.

   Evidence suggests that chloramines, properly administered,  result in far fewer chemical
byproducts, allowing their use to maintain distribution systems with much higher levels of
NOM present. On the other hand there is also some indication that,  under certain conditions,
particularly  warm temperatures, chloramine residuals may become unstable, resulting in
nitrite formation.  Finally in Europe today, particularly in Holland and Switzerland, some
success is being achieved in maintaining distribution systems with no residual at all.

   The Committee urges the EPA to probe deeper into the need for distribution system
residuals and into the alternatives for achieving them. What role does the disinfectant
residual play in protecting the distribution system?   How important is  the disinfection residual
in the overall context of actions effective in protecting the distribution system?  If methods for
removing pathogens from the water  supply are found that do not require that the bulk of the
NOM be removed as well, the problem  of the distribution system will  remain to confound
success unless these  issues are more seriously addressed.

   Still another decision that must be made in prioritizing or orienting treatment processes is
whether to use an enhanced softening process in removing total organic carbon (TOC). This
process is tied to the removal of precursor materials.  Research in the use of membrane
technology for small systems is another critical area. Operator education and capability are
important components of membrane technology use.
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   Alternate disinfectant research, e.g., EXD 10, EXD 11, and EXD 12 are of the highest
priority along with treatment research projects such as RMD 1, RMD 2, RMD 3, RMD 4, RMD
6 and RMD 7.   Appendix A contains the table of EPA research projects that support rules for
Enhanced Surface Water Treatment, Disinfection Byproducts, and Ground Water Disinfection.
The projects have been arranged in the risk assessment/risk management paradigm to
facilitate the review on scope, their applicability, and comprehensiveness in satisfying the risk
characterization process.  Also, the Committee's priority recommendations for these  projects
are indicated.

5.2 Specific Comments on DBP Research

       5.2.1  Health Effects Research

   The issues (epidemiologic research, DBP mixtures research, and research on the toxicity
of individual DBPs) are appropriate,  but the emphasis placed on each of them may not be.
Much of the proposed health effects research does not have direct impact either on the
balance between  controlling risks from pathogens and from DBPs in drinking water, or  on the
rulemaking process itself.  This is partly because of the probable timing of the epidemiologic
reevaluation, and studies that could  have a major impact, and partly because the other
studies are directed at providing the experimental foundation from which rational projections
can be made in the future. This does not imply that the basic experimental toxicity studies
are not important, but rather that their accomplishment is less urgent.

   If the reevaluation of existing epidemiologic data and completion of any feasibility or
larger epidemiologic research can be completed within a time frame relevant to the
rulemaking process, it should  be assigned the highest priority from among this group of
proposed projects. The evaluation and reanalysis of the epidemiologic studies should be
paramount; the outcome of this broad project should inform research activities in other  health
effects-related  areas, and in risk assessment-related research.  However, individual research
projects in the  areas of health effects and risk assessment, some of them highly focused and
relatively isolated, are already in progress without the benefit of any insight to be gained from
the human  epidemiologic studies.  Of the three main issues identified,  the priority  order
should be (a) evaluation and reassessment of the epidemiologic studies, with feasibility
studies if called for; (b)  research on DBP mixtures; and (c) toxicologic research  on individual
DBPs.  This order applies to the proposed risk assessment projects as well as to the health
effects studies.  Committee advice on the priorities for individual projects are  listed in
Appendix B. Comments on specific studies are given in the following paragraphs.

   Epidemiology studies on the residual DBP are limited because of unknown exposure.
Therefore, improving  estimates of residual DBP exposure are needed. This aim has a  high
priority, and has already been funded.  However, these data will not be useful for  immediate
regulatory purposes (HED  1).  A search for biomarkers  in the field is very  unlikely to be
productive,  given the  multiplicity of exposures that might be associated with any identified
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health effect and the near impossibility of teasing out any single exposure from among the
many (HED 2).  Little information is available on the reproductive effects of DBF.  The use of
geographic information systems (DBF in relation to distance from water plant) and birth
weight has the possibility of providing epidemiological data on reproductive effects of DBP in
humans (HED 3).

   Implementation of either or both of the feasibility studies HED 4 and HED 5 is dependent
on completion of reassessments of existing epidemiologic data, and on completion of
epidemiologic studies underway.  We are hampered in this evaluation by lack of information
concerning which of the data reanalyses, which we understood might have been undertaken
shortly after our initial briefing in the spring of 1995, may in fact have been undertaken, nor
have we been given the results of any of the current epidemiological studies. However,
particularly in view of the new carcinogen risk assessment guidelines proposed and shortly to
be promulgated by the EPA, it is clear that reassessment of existing epidemiologic data is a
prerequisite to the determination whether either these feasibility studies or the related full
epidemiologic study, HED 6, should be carried out.  It is probable that a thoughtful data
reanalysis will reduce the range of estimates of excess cancer risk for the U.S. population as
a result  of consumption of chlorinated water.  The results of the data reanalysis likely will also
direct the design of feasibility studies.  While we endorse the high priority  assigned to these
three proposals,  it is not clear whether even the feasibility studies, if they are deemed to be
warranted, can be completed within a time frame that would allow their outcomes to influence
the rule  making process significantly.  It is certainly unlikely (although not  impossible) that
HED 6 could  be completed within that time frame.  With respect to policy questions and
research goals, these three proposals are correctly assigned the highest priority.  The results
of the proposed studies would  help greatly to reduce the uncertainty associated with
assessments of current health  risks (HED 4, 5, and 6).

   We strongly discourage the conduct of standard two-year bioassays.   Of considerably
greater utility would be chronic studies at lower dose rates (lower, that is,  than the maximum
tolerated dose), incorporating other toxicity endpoints in addition to  carcinogenicity and
having pharmacokinetic and  mechanistic components.  In other words, the best use of
resources would be a well-planned study designed to generate as much relevant  information
as possible at dose rates somewhat in excess of intake rates in drinking water, but not
ludicrously so. Parts of other proposed projects would  be subsumed  in a  general chronic
study of this kind  (HED 7).

   Screening of reproductive and developmental effects is needed for DBPs. The EPA and
NTP have superb capabilities for performing these studies (HED 8). There is little indication
that either neurotoxicity or immunotoxicity is a likely endpoint of toxicity for DBPs. Other,
more immediate  issues should be addressed  first (HED 9).

   Successful development and validation of physiologically-based pharmacokinetic  (PBPK)
and biologically-based dose-response (BBDR) models for DBPs are laudable proposals and
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would greatly facilitate extrapolation of animal dose-response data to humans. The likelihood
is high that they would significantly improve utilization of animal dose-response data in
human health risk assessment for specific DBFs, reducing the risk to public health in a cost-
effective manner.  The two proposals are not independent, since, as noted, every BBDR
model has a PBPK model at its core. They should be combined and addressed as a unit.
Further, developing a BBDR or PBPK model, adequately validated for extrapolation
applications, is not a light undertaking.  The list of potential DBPs to be modeled  (bromate,
trihalomethanes, and haloacids) is too large. Some economy could be achieved  by utilizing
generic physiologic models that would accommodate the kinetic characteristics of specific
chemicals, but nonetheless some selections must be made.  Achievement of a BBDR model,
utilizable in practice, will require 18 months to two years for each chemical modeled.  It is
unlikely that this work would have broad impact on the rulemaking process itself (HED 11,
12).

   EPA scientists have shown that haloacetic acids have toxic effects on the male
reproductive system in rodents. To determine if this effect occurs in humans as well as if
other DBPs are likely to produce this effect, one needs to understand the mechanism.  By
understanding the mechanism, biomarkers can also be developed (HED 13). However, while
we encourage mechanistic research on DBPs, rationales should be provided for undertaking
specific research projects with individual chemicals. Why were the haloacetic acids chosen
for mechanistic research, while other DBPs were not?

   The mixtures workshop has been conducted. A report of the workshop should be
provided to the SAB (HED 14A). The toxicity of mixtures of DBPs is of extreme importance.
However, the scientific community is not convinced how  to best perform these studies.
Information from the workshop and details of the studies to be performed are necessary to
adequately evaluate this proposal (HED 14B). Interaction studies that are likely to be of most
value are of known mixtures.  The EPA has been performing good studies in this area and
they should be continued (HED 17).

   Many chemical carcinogens are mutagens however,  many are not.  Most of the "weak"
carcinogens in drinking water are not thought to produce tumors by mutagenic mechanisms.
Other mutagenic mixture studies have not been overly revealing (HED 16).

       5.2.2  Exposure Research

   The Committee agrees with methods development for bromate, haloacetic acids, and
expanding quality control for TOC as high priority projects (EXD 1, 2, 3).  Also methods for
peroxides and aldehydes (EXD 7 and 9) are high priority. The identification of new
disinfection byproducts from alternate disinfectants, methods for non-volatile  DBPs (EXD 10
and 11) also rank high.  The Committee considers DBP  changes in distribution systems to be
a high priority project (EXD 12). Without these methods for exposure and the concomitant
health effects research, risk assessments are not possible.  Further, these methods are
                                        31

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needed to obtain information on occurrence and population exposure to these byproducts.
On the other hand, there are no significant projects that address capturing exposure
information to contaminants or byproducts.  The exposure modeling attempt is inadequate in
the absence of good exposure monitoring to validate models that are employed.  Without
quality exposure information, the risk assessment  would have significant uncertainties, and
would not be useful or reliable in risk management decisions.  Quality risk assessments on
contaminants byproducts are needed for making balanced risk management decisions
between  byproducts and microbes.

       5.2.3  Risk Assessment Research

       a)    General Comments

   In general, the research projects, when successfully completed, can be expected to
generate very useful information.  However, there  seem to be some inconsistencies in the
expected completion dates for some of the projects based on two US  EPA documents.  The
dates are expected completion  dates based on the Revised  EPA Research Plan Chapter 4
Tables, dated April 8, 1996.  Accordingly, most of  the projects  are expected to have started
as of today. It is not clear whether the completion dates would include the completion of the
final  reports (after peer reviews) or just the active  research.  The funding appropriations do
not show resource  allocations (e.g., number of person years, equipment, etc.). Such
information would be useful.  There is no information provided on the qualifications of the
investigators or  detailed description of the research projects, thus precluding an adequate
evaluation.

   In summary, the research projects aim at providing more accurate risk estimates,
reducing  uncertainties  and  developing methodologies to evaluate more complicated issues.
All of these would be very useful in determining how to use experimental information most
appropriately and most effectively for regulatory purposes.  It is important that these are
coordinated with the health effects research projects which generate data and information for
risk assessment.  In turn, the health research components need to be planned to generate
data that will be useful for risk assessment. However, the schedules for the risk assessment
projects and health effects  studies do not seem to be coordinated.  For example, the peer-
reviewed papers describing the results of cancer dose-response studies will be prepared in
FY'96-99, and the ones for trihalomethanes and bromate will be prepared in FY'96-99,
whereas  the final reports for the risk assessment are expected in FY'97.  It would be useful
for a timeline to be constructed to show how the different projects relate to each other in
content and time sequence.  The  US EPA can also form partnerships with state water
programs that have the expertise  and capabilities to conduct work related to the research
activities, especially in  coordination with state level drinking water programs which share  the
same interest in regulating  the same chemicals. This will contribute to more efficient use of
resources.
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    Quantitative risk assessment models are to be applied to human and animal data to
characterize the risks associated with exposure to disinfectants and DBFs.  It is important to
start using the recently revised Agency cancer risk assessment guidelines with available new
studies, new data analysis and improved dose response models.  Therefore RAD 1 is very
appropriate. As an initiation, two to four chemicals can be assessed using the guidelines,
and then the assessment can be completed with the other chemicals as appropriate.  These
risk assessments  must continue  and they should use new available data or analyses which
provide new risk parameters (e.g., cancer potencies).  This project is essential for generating
new assessments so that no resources will be wasted on using the old risk  assessment
guidelines.  USEPA is soliciting public comments on  selecting priority chemicals for risk
characterization also  using new guidelines.  DBFs are high priority chemicals in this regard
and RAD 1 should be integrated with RAD 4. (RAD 1: Cancer risk assessments, completion
date 1997)  The comment on RAD 1 also applies to  other research projects, especially RAD
2,3, and 4.

   One project examines the validity of combining data sets prior to modeling and calculating
a pooled slope factor. From this project, RAD 2, two studies and a final report and a case
study have been published.  It would be necessary for the Committee to see the results of
this work in order  to evaluate its  potential applicability to the rule making process.  On the
other hand, while  bromate is a DBF of potentially great concern, no broad rationale is
provided for combining bromate  data sets to estimate a pooled slope factor. Meta-analysis
can be justified in  some cases, and its statistical advantages can be real; but no justification
for combining data sets is given  here. This project is well underway, but it is not relevant to
immediate rulemaking needs (RAD 2; Cancer combination study for bromates,  completion
date 1997).

   Another project uses a benchmark dose (BM1) and/or categorical regression approach for
estimating references doses. Development of these potentially useful new approaches,
versus the traditional  NOEL and  margin  of safety approaches, should be strongly supported.
It would be necessary to compare  results with the traditional approach. Benchmark doses
were indicated to have been completed for methyl mercury and boron.  The Committee
members should be provided with these reports. In addition, non-cancer risk assessments
need to continue and be combined with cancer risk assessments for a complete assessment
(RAD 3:  Non-cancer  risk assessments,  completion date 1998).

   The project to  develop case studies,  with development of models for estimating  variances
in uncertainty factors for  both cancer and non-cancer endpoints, will be useful for comparing
cancer estimates.  It involves the implementation of the agency's recently released risk
characterization policy that addresses the need for informative  and consistent approaches for
communicating risk assessments to the public and decision makers. This is essential in
order that risk assessment be appropriately  understood and will contribute toward the trust
and credibility given to the Agency performing  the risk assessments.  As noted  above, RAD 4
should be integrated with RAD 1. However, application of the new EPA guidelines to DBF


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risk characterization is less immediate in the context of standard setting and rule making than
reanalysis of the epidemiologic studies,  RAD 5 to 7. (RAD 4:  Risk characterization,
completion date 1998).

   Three studies (RAD 5 to 7) set the stage for all other health effects research on DBFs by
defining clearly what is known and what is not.  RAD 5 will evaluate the newer epidemiologic
studies (completion  date 1997). This project applies a meta-analysis approach to earlier
studies and evaluates new studies on adverse health outcomes associated with drinking
water conducted in Canada and Colorado. This will  provide a better understanding of actual
risks and it is essential that the newer epidemiology data be reviewed.  RAD 6 will assess
previously conducted studies (completion date1997).  This project will develop consistent
statistical tools and improved methods for analyzing epidemiologic data to address
confounding factors. Meta-analysis will  be conducted on bladder and rectal cancers.  RAD 7
will identify ongoing  cancer studies (completion date 1996).  The  project identifies dietary
cohort studies and case control cancer-risk studies. This information, compiled into a data
base, will assist in determining the need for future studies and identifying areas for future
studies. The data will be used to evaluate pregnancy outcomes.  Although these seem to be
important  studies, the description of this project is not clear.  Especially unclear is the
anticipated products. The reference to evaluation of pregnancy outcome in relation to
identifying cancer studies is confusing as there is no description of collecting specific data
relating to pregnancy outcomes after identifying the studies.  The Agency must follow all on-
going cancer studies.

   RAD 8, 9, and 10 seem to be related.  The agency should show how these projects
complement each other.  RAD 8 will characterize interactions for mixtures of DBFs
(completion date  1997).  This project will develop procedures and conduct studies to evaluate
interaction data from a number of studies and define the types of interaction.  Like RAD 5 to
7, this project sets the stage for proposals listed in the HED  section.  However,
implementation of RAD 5 to 7 does not  require that this project be carried out.  Some
components of this project appear to be add-ons; their utility and even practicability are
questionable.  How, for example, will PBPK models be used to predict response to mixtures?
How will sensitivity analysis be used to identify those parameters that have the greatest
influence on response, unless the model includes the interactions in question?  If this is the
case, are the models to  be developed for specific mixtures, prototypical mixtures, or generic
mixtures?  Nonetheless, the basic intent, to examine interaction data  for DBFs closely, is
sound.  One project (RAD 9,  Threshold studies for D/DBPs, completion date 1997) builds a
dose-response plane for data from a mixture  of D/DBPs under the assumption of additivity.
The  use of dose-response planes to evaluate interactions is an interesting proposal.   RAD
10 (Use of QSAR model to estimate risk for single compounds/classes of compounds with a
mixture, completion  date, 1996) is developing a model that combines the chemical and
physical properties of compounds to define their reactivity and toxicity.  QSAR models have
good potential for future use in estimating the risk of single and multiple  exposures.
However, that potential is not  likely to be realized within the time frame of this research plan.
                                          34

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In addition, this is more a basic, longer-range research plan than one with direct relevance to
immediate needs and goals.

   A comparative risk analysis (RAD 11, completion date, 1998) proposes to develop a
model to measure and compare the known and potential health risks that might result from
exposure to multiple stressors from the same drinking water source. It is to address  multiple
outcomes, their impacts and costs.  This would be useful, when validated, for regulatory
decision making.  Whether it will yield useful results in time for any of the projected rule
making actions is uncertain.

      5.2.4  Risk Management Research

   Appendix A of the Research Plan briefly describes three categories of risk management
research projects being conducted by EPA to address disinfection byproducts.  The first
category focuses on the effectiveness of different treatment processes in reducing DBP
precursors  (e.g.,  enhanced softening for precursor and pathogen removal-RMD 1; control of
precursor, pathogen and pesticide removal-RMD 2a; effect of pH on ozonation and enhanced
coagulation-RMD 2b; removal of DBP precursors  by granular activated carbon [GAG] and
membranes-RMD 4a & b; membrane scale-up and fouling-RMD 5). Only one project is
included in agency research on the effectiveness  of using different disinfectants in limiting
DBP formation (ozonation byproduct formation and control-RMD 6).  The final category
focuses on small system technologies for precursor and DBP control and it contains only one
project (membranes/ advanced oxidation and other technology combinations-RMD 7).

   Many of the issues discussed  in the overview  (see Section  5.1) are directed to risk
management research. A critical  component of the research plan is a decision on which of
the three risk management options the Agency and the industry will endorse for control of
disinfection byproducts. These are removal before disinfection, removal after disinfection, or
changing the disinfection process  to  minimize formation of related byproducts. Removal
before and changing the disinfection process appear to be the  most promising.  As part of
this procedure, RMD 1, enhanced softening for precursor (TOC) and pathogen removal is a
project that deserves high priority. If this process is as successful as indicated, both
microbial and DBPs  may be lowered sufficiently to overcome many of the problems that now
occupy a significant  number of research projects.  High pH will also have a significant impact
on virus populations. However, many of the other projects in the Risk Management section
including RMD 2, RMD 3, RMD 4, RMD 6 and RMD 7 are also considered of high priority.
Further,  the Committee suggests that it would be desirable for  EPA to develop a white paper
on the need for residuals in the distribution system.  Appendix A of this report reflects both
EPA and Committee priorities for these projects.

   Many of the American Water Works Association Research  Foundation (AWWARF)
projects listed in Appendix C of the Plan are focused primarily  on risk management research.
Most of these projects  have very brief descriptions that make it difficult for the committee to


                                        35

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ascertain the objectives, approach, and methodology of the research.  Therefore, a
commentary on each of them would  be quite superficial.  There are, in fact, over eighty-five
such research  projects listed for AWWARF and five for the National Water Research Institute
(NWRI) listed in Appendix C.  However, a number of these projects dealing with analytical
methods  for viruses and protozoa, natural organic matter, chemical contaminants,  disinfection
byproducts,  and methods for control of byproducts made by treatment with ozone,
chloramines, and chlorine dioxide that are very high priority projects.  A series of projects on
DBP control such as granular activated carbon, coagulation, oxidation and biological filtration,
membrane technology, and ultraviolet methods also deserve high priority.  It is hoped that as
these research projects are completed and reported, that the DWC will have the opportunity
to be appraised of the results and conclusions achieved.
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              6.  CONCLUSIONS AND RECOMMENDATIONS

   The Committee recognizes the complexity of this research plan with its multifactorial
approach to both microbial and DBP research and acknowledges the considerable progress
made by ORD and the Office of Water in comparison to previous versions of the plan.  In
general, the questions proposed in the research plan are appropriate.  However, the plan
lacks the identification of a critical path of project progression that would identify the rate
limiting components.  Such a critical path  helps prioritize or plan the research projects so that
those of greatest research uncertainty and resource requirements are accorded appropriate
and primary attention and placed in a realistic time frame for overall research progress.  This
would allow sequencing of data acquisition that satisfies requirements for interdependency of
project data.

   The Committee notes that two of the rules, the long-term ESWTR and the GWDR have
not yet been proposed and a third rule, the Stage 2 DBP rule has only been  proposed in part.
This  raises a degree of uncertainty in defining the precise research needs to support the final
development of these rules.

   The Committee recommends  that in iterations of this plan, or in other ORD research
plans, that projects be more fully described.  This will enable the reviewers to determine what
actually is projected in the research and to better appreciate the budgeted costs.  This is also
applicable to research projects performed by other ogranizations (e.g., AWWARF and NWRI).

   A significant number of research projects identified in the plan (e.g., those of the
American Water Works Association Research Foundation-AWWARF) have been completed
or projected to be completed in the years from 1994 to 1996. It is difficult to  ascertain what
effect the results of these projects have had, or will have, on the research plan. Full
coordination of the drinking water research program  by the  agency Drinking Water Research
Coordination Team was a stated goal of the Agency. The final plan should identify and
incorporate the results of this research;  which have presumably provided direction to the
program.    Further, the Committee encourages the Agency to interact with the broadest
possible group of organizations doing research in this area.

   The research plan has many specific questions on microbial research projects. These
are addressed in the microbial section.  The following are a few of the more general or
overarching recommendations.

       a)     The Committee recommends that the research goals statement put a greater
             emphasis on identifying and quantifying the key pathogens and the health risks
             they pose in drinking water if prioritization of contaminants for regulation is to
             be risk based.  This approach must carry through to the identification and
             quantitation of the key pathogens and their health risks.
                                        37

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      b)     The Committee believes that focusing on a single worst case pathogen or
             arbitrarily creating a large group is a scientifically inappropriate and
             unacceptable approach. Therefore, the committee recommends that greater
             emphasis be placed on a risk based approach to the identification and risk
            . based analysis of all microbial pathogens in drinking water.
      c)     The Committee believes that it is important for EPA to develop a mechanism to
             identify emerging waterborne pathogens and carry out fast-track research on
             them as necessary. Further, the Agency needs to be proactive in this area
             and should establish a program that anticipates these types of emerging
             pathogenic microorganisms.
      d)     There is a need for a microbial epidemiological study in ground water systems
             that should include efforts to identify the pathogens responsible for the
             measured health effects.
      e)     The Committee is concerned that the ICR will provide no occurrence
             information on Norwalk virus.  Also, the information on  Cryptosporidium will not
             be sufficient for a detailed risk assessment because the methods used in the
             ICR do not differentiate between infectious and non-infectious oocysts. Thus
             the Committee believes that there is a serious disconnect between the priority
             pathogens of the health effects research (i.e., Norwalk virus and
             Cryptosporidium) and the priorities of the occurrence research.
      f)     There is concern that the level of funding and effort in the area of microbial
             risk assessment is inadequate for the task.
      g)     The research needs in the area of risk management include:  Effectiveness of
             treatment processes for Cryptosporidium', treatment technologies appropriate
             for small systems; and identification and characterization of factors influencing
             microbial growth in distribution  systems and strategies for its control.
             Research needs on factors  influencing microbial growth in distribution systems
             and strategies for control should be expanded to include microbial intrusion as
             well.

   Specific comments in the DBP portion  of the research plan are also addressed in a
separate section.  The following are a few of the more general or overarching
recommendations on that section.

      a)     The evaluation and reanalysis of the epidemiologic studies should inform
             research  activities in the areas of health effects and risk assessment.  If the
             reevaluation of existing epidemiologic data and completion  of any feasibility or
             larger epidemiologic research can be completed within  a time frame relevant to
             the rule making process,  it should be assigned the highest priority from among
             this group of proposed  projects.
      b)     The committee endorses a  high priority rating for  those methodological projects
             that subsequently are applied to obtain quality exposure data and knowledge
             of human health effects.  Projects that address obtaining population-based


                                          38

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       exposure data should be developed and added to the research plan to provide
       one of the necessary cornerstones for performing  risk assessments.
c)     The Committee believes that additional research is needed on the reliability of
       multiple barriers (multiple barriers of treatment can include: watershed
       protection and pathogen monitoring, multiple chemical inactivation steps, and
       filtration and/or sedimentation in addition to chemical inactivation).
d)     The Committee considers it necessary to decide at the earliest time whether to
       remove precursor material  before disinfection, change the disinfection process
       or remove DBFs  after they are  formed. The enhanced softening process run
       at high pH may provide the means to significantly  lower TOC and kill microbes
       including viruses  at the same time.  Several projects either underway or
       completed (AWWARF) should guide this decision (e.g., 608, 814)
e)     Membrane research projects and  those using ultraviolet or high intensity broad
       band radiation disinfection should also have high priority.  These are a
       necessary component of deciding on ground water disinfection methods.
f)      The Committee urges EPA to develop a definitive  paper on protecting the
       distribution system (why, how, etc.).
                                   39

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                                REFERENCES
EPA. 1995.  Office of Research and Development and the Office of Water.  Research Plan for
      Microbial Pathogens and Disinfection By-products in Drinking Water (Review Draft)
      US EPA, Office of Research and Development and Office of Water  (Plus
      Appendices).  October 1995.

SAB.  1990.  Recommendations for Research in the Area of Disinfectants and Disinfection
      Byproducts.  U.S. EPA/SAB, Washington, D.C.  EPA-SAB-DWC-90-007.

SAB. 1991.  Report of the Science Advisory Board's Drinking Water Committee on the
      Drinking Water Mircobiology Research Program.  U.S.  EPA/SAB. Washington, D.C.
      EPA-SAB-DWC-91-004.

SAB.  1992.  Science Advisory Board Commentary on Alternative Disinfectant and
      Disinfectant By-Products. U.S. EPA/SAB. Washington, D.C. EPA-SAB-DWC-COM-
      92-008.

SAB.  1993.  Drinking Water Committee Commentary on Negotiated Regulation for
      Disinfectants and By-products. U.S. EPA/SAB.  Washington, D.C.  EPA-SAB-DWC-
      COM-94-002.

SAB. 1993a. Review of the Research Program on Disinfectants and Disinfection By-
      Products in the Risk Reduction Research Laboratory.  U.S. EPA/SAB.  Washington,
      D.C.   EPA-SAB-DWC-94-006.

SAB.  1994.  Review of Information Collection Rule.  U.S. EPA/SAB.  Washington, D.C.
      EPA-SAB-DWC-LTR-94-010.

SAB.  1995.  Advisory by the science Advisory Board's Drinking Water Committee
      Concerning EPA's Five-Year Research Plan on Disinfection/Disinfectant Byproducts
      (D/DBP).  U.S. EPA/SAB.  Washington,  D.C. EPA-SAB-DWC-ADV-95-002.
                                       40

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                          APPENDIX A

  EPA RESEARCH PLAN SHOWING RESEARCH PROJECTS AND
PRIORITIES ARRANGED BY RULE, AND RISK ASSESSMENT-RISK
           MANAGEMENT PARADIGM COMPONENTS
  The following is the key to spreadsheet column headings in Appendix A.

    1) Date: Expected completion date

    2) EPA Priority: H=High, M=Medium, L=Low
         Italicized project name and asterisk in priority column indicates that the project
         is either underway or planned for start in FY'96.

    3) SAB Priority: 1 to 10; 1=Highest and 10=Lowest

    4) Funds (Resource Estimate):
         1=<$0.5m
         2=$0.5- 1.0m
         3=$1.0-1.5m
         4=$1.5 -2.0m
         5=$>2.0m

    5) Page #: Page number in Appendix A of the Research
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