Areas for Expanded
Service
Although the general quality of water
and the oversight of the water industry is of a
relatively high level in most States, no system of
Federal environmental oversight is perfect or complete;
certain areas of Government oversight or support are
weaker than others. Listed below are service gaps as
perceived by members of the subcommittee:
- Certain subpopulations (e.g.,
migrants, people in substandard housing, and
people living in certain geographical areas, such
as the U.S.-Mexico border) lack access to
adequate quantities of safe water. HRSA is
mandated to defend their interests; however, its
budget is not sufficient to monitor these
problems or to promote enforcement of existing
laws.
- Outbreak investigations are the
main source of public health information about
waterborne pathogens and their transmission.
These investigations are also an important
vehicle for developing insight into the
limitations of the sanitary barriers erected to
protect the public water supply. CDC and State
health departments often have had to respond to
waterborne outbreaks through epidemiologic
investigations that include limited environmental
and engineering analyses. For some outbreaks, EPA
has been able to provide scientists and
engineers, who have significantly broadened the
scope and capacity of the Federal
Government’s investigations and the
thoroughness of the responses. The knowledge
gained by an interdisciplinary investigation of
outbreaks that combines the expertise of CDC,
EPA, and other agencies will enable the Federal
Government to formulate integrated and
coordinated strategies for source water
protection, educational campaigns, and disease
surveillance. Multidisciplinary teams should be
developed for rapid response during acute
exposure or outbreak-type events. Resources and
operating procedures need to be established for
this purpose.
- The CDC-EPA waterborne disease
outbreak surveillance system depends on States to
report outbreaks and may be incomplete. Its
purpose is to characterize waterborne outbreaks
epidemiologically (e.g., to investigate the
agents, the reasons for the outbreak, and the
adequacy of various treatment methods) and to
strengthen the public health community’s
ability to respond to these outbreaks. Outbreak
summaries are produced biannually after
information is obtained and verified, and enough
reports have been collected to justify
summarizing. New methods for identifying
outbreaks should be explored in order to increase
the sensitivity and timeliness of the
surveillance system.
- The HHS, EPA, and other Federal
agencies can do a better job of informing the
public of the potential health risks from
specific drinking water problems and the health
benefits of various programs and measures taken
by public health agencies. This educational
effort should address specific ongoing issues of
public concern (as is now occurring with Cryptosporidium)
and should include the preparing of educational
messages (such as "boil water" notices)
for various types of public health crises.
- Training and education programs
and professional guidelines should be examined
and strengthened as needed to emphasize human
health protection. Enhanced programs might
address, for example, issues, such as
distribution system flushing and inspection or
watershed protection campaigns. Educational
messages (e.g., communicating the value of
bottled water for specific subpopulations in
specific instances) should be developed and
tested before they are needed.
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