A Community Study of Drinking Water Supply and Storage in Rural Puerto Rico: Toward Understanding the Impacts of Climate Change on Vulnerable Systems
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Waterborne disease in the form of acute gastrointestinal illness (AGI) can be caused by over 70 pathogens of potential concern for drinking water. Data from the US Waterborne Disease and Outbreak Surveillance System suggest that waterborne illnesses continue to pose economic challenges and health risks to community water systems across the US, including Puerto Rico. There are 235 registered small water systems that are not served by the Puerto Rico Aqueduct and Sewer Authority (PRASA). Some non-PRASA systems have a history of non-compliance with water quality standards and lack managerial, technical, and financial capacity to operate and maintain their functionality. Furthermore, households in these communities may store water in cisterns and collect rainwater as an additional water supply; these supplemental water sources become increasingly important when natural disasters, like hurricanes, destroy resources and infrastructure. Since 2014, an ongoing intervention study in three non-PRASA communities has aimed to evaluate health benefits of water treatment by comparing rates of infections before and after introduction of filtration and reliable disinfection. This work investigates the link between community health and drinking water in rural Puerto Rico using a combination of methods for evaluating water quality (physicochemical parameters) and assessing AGI (stool analysis, immunoassays) and provides information regarding the scale of cistern use. This presentation provides results of efforts used to educate, build capacity, and support communities in identifying options for improving water quality, quantity, and community health, especially considering changes to water quality risks given projected increases in extreme weather event frequency and severity.