Boil, Boil, Toil and Trouble: The Trouble With Boil Water Advisories in British Columbia

Abstract

Boil water advisories (BWAs) are public notifications of drinking water quality and are used as temporary, precautionary measures to protect the public from possible waterborne illnesses. British Columbia (BC) has among the highest numbers of BWAs and many have been in place for months to years, leading to the concern over their use as a "band-aid" to water treatment and a substitute to action needed for its removal. With lengthier or on-again-off-again BWAs, there is concern that the public will become complacent and not comply with the BWA.Research on BWA is scarce and not much evidence is available to support practical decision making by the two groups of key players responsible for the management of BWAshealth authority officials and water suppliers.Short-term and long-term BWAs from four of BC"s five health authorities were randomly selected for investigation. Interviews of health authority officials and water suppliers were conducted to determine the decision-making process by which BWAs are issued; how BWAs are communicated to the public; and what consequential corrective action is taken after issuing, to progress towards the notification"s removal. A total of 31 BWAs were investigated.The decision-making processes varied considerably from case to case; different factors were considered depending on who was involved and the water system in question. The history of the water system, lack of water treatment, positive bacteriological water sample results and the type of water source were common criteria considered in the decision process. The majority of BWAs were communicated via personal interactions with the members of the public and public postings. Challenges with risk communication, message fatigue and public compliance were identified. Obstacles to the removal of longstanding BWAs included the lack of funding for infrastructure improvements or construction and technical challenges with the geographical remoteness of some small water systems.Solutions that look to improving the overall management of small water systems in BC and that provide necessary guidance to decision-makers, before, during and after the issuing of BWAs, are needed for alleviating some of the challenges faced with BWAs.iii Preface

Does the public receive and adhere to boil water advisory recommendations? A cross-sectional study in Newfoundland and Labrador, Canada

“…As of March 31, 2013, there were 140 long-term BWAs in effect in the province, many of which served as substitutes for adequate drinking water treatment [ 9 ]. Concerns with heavy reliance on BWAs have been raised and include message fatigue, creation of unnecessary public panic, loss of public confidence in the water system, and risk of the public not taking seriously future BWAs [ 6 , 11 ]. Dawe outlines policy recommendations for an improved drinking water advisory framework to help increase drinking water safety and reduce the number of BWAs in NL [ 9 ].…”

“…Less often published in the national press are smaller scale water contamination events and boil water advisories (BWAs), such as the years-long BWAs in many Aboriginal communities of Canada [ 4 ]. BWAs are an important precautionary measure meant to protect the public health by ensuring drinking water safety; however, they can also increase consumer anxiety and alter perceptions about public drinking water [ 5 , 6 ].…”

Co-design of water services and infrastructure for Indigenous Canada: A scoping review

“…The climate, especially in northern reaches, provides challenges for the development of infrastructure; some communities experience short construction seasons with limited accessibility by road. Others have requirements for more expensive water systems to supply water through the cold winters without freezing and damaging infrastructure, or to improve very low quality source water (Smith et al 2006;Maal-Bared et al 2008;Grover 2011). Most of the drinking water systems in these reserves are classified as small drinking water systems (serving fewer than 5000 people) (National Collaborating Centres for Public Health 2009).…”

Fabrication of Polymer–Protein Hybrids

“…Polymer–protein conjugates combine the advantages of synthetic polymers, such as good stability and mechanical properties, diversity, and processability, with biological functionalities of proteins. Generally, synthetic approaches toward polymer–protein conjugates can be divided into “grafting‐to” and “grafting‐from” methods . In the “grafting‐to” approach, polymers are grafted onto the protein molecules by chemical reactions or specific interactions between the polymer chains and the protein molecules.…”

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toward polymer-protein conjugates can be divided into "grafting-to" and "graftingfrom" methods. [16][17][18][19][20] In the "grafting-to" approach, polymers are grafted onto the protein molecules by chemical reactions or specific interactions between the polymer chains and the protein molecules. In the "grafting-from" approach, the protein molecules are modified with initiators and polymer chains grow from the modified protein molecules.

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