Year of Publication

2016

College

Public Health

Date Available

11-28-2016

Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Member

Glyn Caldwell, MD

Advisor

Steven Browning, PhD, MSPH

Co-Director of Graduate Studies

Gail Brion, PhD

Abstract

At least 400,000 people in Kentucky rely on private water wells or springs for drinking water. 551 households that rely on private water wells for drinking water were surveyed in 2009 about adverse health outcomes, including selected cancer incidence, adverse birth outcomes, and yearly incidence of diarrheal illness. Survey recipients were drawn from a population of well owners in the Jackson Purchase Region of Kentucky whose wells were tested for nitrate-nitrogen (NO3-N), triazine pesticides, and E. coli or total coliforms, by Kentucky Geologic Survey within the previous 15 years. 214 questionnaires were returned and matched to water quality data for analysis; the effective response rate was 39%. Of 211 wells in this study with NO3-N results available, 11 (5.91%) had NO3-N concentration above the MCL of 10 mg/L. Of 189 wells in this study with triazine pesticide results available, 1 (0.53%) had concentration above the MCL of 3 μg/L; 123 (65.08%) had undetectable concentrations of triazine pesticides. NO3-N and triazine levels were not independently distributed; shallower bored well construction was predictive of higher concentrations of both contaminants, consistent with other research. E. coli contamination was detected in 14.5% of wells tested in the study population, and total coliforms were present in 59.3%. Over one-fifth (21%) of wells in the study population were contaminated with all three, total coliforms, triazine pesticides and NO3-N, above background concentrations, indicating the wells’ vulnerability to surface-level contamination that can result from well construction and agricultural land use practices. Survey respondents were asked about household incidence of non-Hodgkin’s lymphoma and liver, stomach and breast cancers. SIRs were calculated to compare the study population with reference populations. Wilcoxon rank sum statistics comparing the distribution of nitrate in cancer-reporting household and non-cancer reporting households suggest an association between NO3-N exposure in drinking water and cancer incidence. Analysis of NO3-N concentration in the study population did not suggest an association between higher concentrations in drinking water and adverse birth outcomes including intrauterine death, miscarriage and premature birth; no statistically significant relationship was shown. Presence of E.coli or total coliform in the water from wells in the study population, whether modeled on a continuous or present/absent scale, was a poor predictor of yearly household incidence of gastrointestinal disease.

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