The articles below provide additional background information about relevant studies, presentations and cases that contribute to the conversations that will take place during the summit.


“Flint’s Water Crisis Started 5 Years Ago. It’s Not Over.”

The New York Times – April 25, 2019

In April of 2014, City officials of Flint, Michigan cheered in front of television screens to welcome in a new water supply directly from the Flint River. The Flint water crisis was born that day. Almost immediately, Flint residents began telling their elected officials that there was something wrong with the water, which smelled terrible, tasted like metal and seemed to give them skin rashes. The outcry that followed the Flint Water Crisis forced a change in the city’s leadership, criminal charges against state and local officials and a year’s long effort to replace Flint’s dangerous lead pipes.

But in Flint, the water crisis is by no means in the past.

Monitoring Legionella Pneumophila In Drinking Water Distribution Systems In Southern Croatia

Fresenius Environmental Bulletin – June 2013

This study collected water samples from 2009-2011 in hotels and nursing homes in Croatia. The monitoring results showed that free chlorine had little impact on combatting pathogens. The samples drawn with a hotter water temperature above 54 degrees Celsius were protective.

Research Presents New Information About Flint Water Crisis

Wayne State University – February 5, 2018

The Flint Area Community Health and Environment Partnership (FACHEP) research team found that most Legionnaires’ disease cases that occurred during the 2014-15 outbreak in Genesee County, Michigan, can be attributed to the change in the city of Flint’s drinking water supply to the Flint River. “During the period when their water was supplied from the Flint River, Flint residents were seven times more likely to develop Legionnaires’ disease,” said lead author Sammy Zahran, professor of economics at Colorado State University.


Public Health Impacts from Pressure Loss Events – CDC/WaterRF Epidemiological Study Update

Confluence Engineering Group LLC.  – May 7, 2014

This presentation aligns with the CDC/WRF’s pilot study surveying low pressure events. It displays the survey and other materials used within the pilot study and reiterated the need for the full-scale, national study. 

Academic Studies

Water Main Break Rates in the USA and Canada: A Comprehensive Study

Steven Folkman, Utah State University – March 1, 2018

This study examined the aging state of the United States’ water infrastructure system. Folkman surveyed over 200,000 miles of pipe condition and found that polyvinyl chloride  has the lowest break rate of all pipe materials. Lower break rates mean lower costs and improved longevity. However, water main break rates have increased by 27% since 2012, but the total of cast iron and asbestos cement pipe breaks have increased by 40%.

Threats on Tap: Widespread Violations Highlight Need for Investment in Water Infrastructure and Protections

The Natural Resources Defense Council  – May 2017

For more than 25 years, NRDC has been documenting serious problems with our outdated and deteriorating water infrastructure and the inadequate implementation of the Safe Drinking Water Act. These problems include poor EPA and state enforcement, serious underreporting of violations, and weaknesses in the EPA’s drinking water standards for contaminants like arsenic and lead.

Summary Document State of Research On High-Priority Distribution Systems Issues

U.S. Environmental Protection Agency and the Water Research Foundation – June 2016

This report was authored of a working group formed by the Total Coliform Rule Distribution System Advisory Committee aimed at stimulating water distribution system research and information collection. The working group found more surveys are needed to collect information as well as an increased ability to train utility staff on distribution systems and storage facilities.

CDC Water and Health Study: Pilot for an Epidemiologic Study of Low Pressure Events in Drinking Water Distribution Systems (WRF #4390) 

CDC and Water Research Foundation – August 2014

The CDC’s waterborne disease prevention branch completed a pilot study aimed at determining acute gastrointestinal or respiratory illness caused through a water distribution system. The study saw little issue with low pressure or service loss and it planned to launch a national multi-site study.

Benefits of Genomic Insights and CRISPR-Cas Signatures to Monitor Potential Pathogens Across Drinking Water Production and Distribution Systems

Frontiers in Microbiology – October 19, 2017

Using metagenomic analysis to study a drinking water distribution system, the researchers found their method can determine pathogens within the production/distribution system. Further development of genomic analysis can help surveillance of waterborne pathogens.

Detection of Legionella, L. Pneumophila and Mycobacterium Avium Complex (MAC) Along Potable Water Distribution Pipelines

International Journal of Environmental Research and Public Health – July 18, 2014

Conducted in Australia, the study detected Legionella and MAC in portable water systems within the distribution system pipelines. This study demonstrates the ability of these microorganisms to survive the potable water disinfection process and emphasizes the need to have better measures to control these organisms from source to tap.

Drinking Water Microbiome Assembly Induced by Water Stagnation

The ISME Journal- March 2018

Examining current water quality monitoring and plumbing systems, the study found that the smaller-diameter pipes held the highest cell counts and are therefore sites for biological regrowth.

Molecular Survey of the Occurrence of Legionella spp., Mycobacterium spp., Pseudomonas Aeruginosa, and Amoeba Hosts in Two Chloraminated Drinking Water Distribution Systems.

Applied and Environmental Microbiology – September 2012

This study identifies occurring patterns of Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa in water distribution systems. It confirmed premise plumbing serves as a reservoir for pathogens even when in the presence of high chloramine.