NewsBeat

February 2023 NewsBeat 23 tems serving under 1,000 people. As of 2016, the federal government no longer requires that water systems of any size notify residents of coli- form violations stemming from regular sampling — so long as any indications of fecal contaminants fall below pre- scribed levels and the water system identifies and fixes the problem. In its final rule, which was published in 2013 but did not go into effect until 2016, Environmental Protection Agency officials maintain that the mere pres- ence of coliforms "by themselves do not indicate a health threat." But the recent research shows that when the public is not notified of coli- form violations in a timely way, there can still be costly consequences related to purchases of over-the-counter rem- edies, hospital stays and lost time at work. Immediate notice, less sickness Waterborne pathogens that cause gastrointestinal illness account for $160 million in direct healthcare costs each year in the U.S., according to research published in January 2021 in the journal Emerging Infectious Diseas- es. The authors estimate an additional $2.39 billion in direct healthcare costs when people get sick from breathing contaminated water droplets — at a hot tub or spa, for example. The new paper in The Review of Eco- nomics and Statistics explores how the timing of public notifications related to water quality issues affects household behavior. Marcus focuses on coliform vio- lations from 2004 to 2015 in North Carolina, because of the quality and detail of data available for the state. This period covers roughly the decade before the federal rule went into effect that made it so community water sys- tems no longer had to tell the public about certain types of contamination identified during routine testing. Acute violations — those arising from testing indicating an immediate health risk and requiring 24-hour pub- lic notice — led households in affected areas to increase bottled water purchas- es by roughly 78%, on average, during the month the violation occurred, Mar- cus finds. Less severe violations related to rou- tine testing — those requiring public notice within 30 days rather than 24 hours — did not, on the whole, affect bottled water purchases. Marcus finds 60% of community water systems in North Carolina noti- fied households of those less severe violations within one week. Yet for water systems that notified households within one day of less severe violations, bottled water sales increased 40% on average. Notifications sent beyond the first day did not affect bottled water purchases. While the notification timing was available for North Carolina, the meth- od of communication was "not system- atically recorded," Marcus says. But the research shows early notification of wa- ter problems can meaningfully change household behavior. "The timing of information to the public really matters," Marcus says. "That's something that can broadly apply to many different violations for drinking water, and even violations for different types of pollution." Although most coliforms do not affect human health, Marcus notably links less severe violations — those that water systems typically took longer to communicate to the public — with more purchases of over-the-counter medicines for stomach distress. That relationship was not evident for acute violations, indicating the uptick in purchases of clean bottled water following quick notifications helped people avoid sickness. Hospital admissions were also linked to monthly violations, especially for school-aged children. Likewise, monthly violations were linked to school absenc- es, especially for elementary school students. Costs of delayed notification Marcus also estimates how much the violations that water systems were slower to communicate to the public cost residents in terms of medication purchases, hospital visits and time lost at work. Some $441,000 worth of over-the- counter gastrointestinal medicines were purchased due to coliform violations in North Carolina. Emergency department visits cost another $422,000. Assuming an average wage of $25 per hour and assuming one parent missed one work day for each day a student was absent from school, there were nearly $7 million in lost earnings over the decade. These are, to be sure, "back-of-the- envelope" calculations, as Marcus writes in the paper. Considering the wages-lost estimate, for example, some parents will have paid time off and won't have foregone earnings because their child missed school. Others might have nearby relatives to help. Still, the rough total estimate of costs related to monthly coliform violations that were not immediately communi- cated to the public comes out to $7.7 million — well above the several hun- dred thousand dollars' worth of bottled water that would have been purchased if the public had been immediately no- tified about every violation. "The jury's still out," Marcus says, referring to the long-term effects of the Environmental Protection Agency's decision to no longer require public notifications for less severe coliform violations. But, she adds, her research "does indicate that previous to that re- vision, we were observing health effects for even that monthly coliform viola- tion, which was thought not to matter very much in terms of health." This article was originally published byThe Journalist's Resource at the Shoreinstein Center.

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