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Onsite wastewater treatment systems (OWTSs) and private wells are commonly used in Eastern North Carolina, USA. Water from private wells is not required to be tested after the initial startup, and thus persons using these wells may experience negative health outcomes if their water is contaminated with waste-related pollutants including bacteria, nitrate or synthetic chemicals such as hexafluoropropylne oxide dimer acid and its ammonium salt (GenX). Water samples from 18 sites with OWTSs and groundwater wells were collected for nitrate, Escherichia coli (E. coli), total coliform, and GenX concentration analyses. Results showed that none of the 18 water supplies were positive for E. coli, nitrate concentrations were all below the maximum contaminant level of 10 mg L-1, and one well had 1 MPN 100 mL-1 of total coliform. However, GenX was detected in wastewater collected from all 18 septic tanks and 22% of the water supplies tested had concentrations that exceeded the health advisory levels for GenX. Water supplies with low concentrations of traditionally tested for pollutants (nitrate, E. coli) may still pose health risks due to elevated concentrations of emerging contaminants like GenX and thus more comprehensive and routine water testing is suggested for this and similar persistent compounds.

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Disaster recovery poses unique challenges for residents reliant on private wells. Flooding events are drivers of microbial contamination in well water, but the relationship observed between flooding and contamination varies substantially. Here, we investigate the performance of different flood boundaries─the FEMA 100 year flood hazard boundary, height above nearest drainage-derived inundation extents, and satellite-derived extents from the Dartmouth Flood Observatory─in their ability to identify well water contamination following Hurricane Florence. Using these flood boundaries, we estimated about 2600 wells to 108,400 private wells may have been inundated─over 2 orders of magnitude difference based on boundary used. Using state-generated routine and post-Florence testing data, we observed that microbial contamination rates were 7.1-10.5 times higher within the three flood boundaries compared to routine conditions. However, the ability of the flood boundaries to identify contaminated samples varied spatially depending on the type of flooding (e.g., riverine, overbank, coastal). While participation in testing increased after Florence, rates were overall still low. With <1% of wells tested, there is a critical need for enhanced well water testing efforts. This work provides an understanding of the strengths and limitations of inundation mapping techniques, which are critical for guiding postdisaster well water response and recovery.

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Consolidation of multi-domain risk management research is essential for strategies facilitating the concerted government (educational) and population-level (behavioural) actions required to reduce microbial private groundwater contamination. However, few studies to date have synthesised this literature or sought to ascertain the causal generality and extent of supply contamination and preventive responses. In light of the Republic of Ireland (ROI) and Ontario's high reliance and research focus on private wells and consequent utility for empirical comparison, a scoping review of pertinent literature (1990-2022) from both regions was undertaken. The SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) method was employed to inform literature searches, with Scopus and Web of Science selected as primary databases for article identification. The review identified 65 relevant articles (Ontario = 34, ROI = 31), with those investigating well user actions (n = 22) and groundwater quality (n = 28) the most frequent. A markedly higher pooled proportion of private supplies in the ROI exhibited microbial contamination (38.3 % vs. 4.1 %), despite interregional similarities in contamination drivers (e.g., weather, physical supply characteristics). While Ontarian well users demonstrated higher rates of historical (≥ 1) and annual well testing (90.6 % vs. 71.1 %; 39.1 % vs. 8.6 %) and higher rates of historical well treatment (42.3 % vs. 24.3 %), interregional levels of general supply knowledge were analogous (70.7 % vs. 71.0 %). Financial cost, organoleptic properties and residence on property during supply construction emerged as predictors of cognition and behaviour in both regions. Review findings suggest broad interregional similarities in drivers of supply contamination and individual-level risk mitigation, indicating that divergence in contamination rates may be attributable to policy discrepancies - particularly well testing incentivisation. The paucity of identified intervention-oriented studies further highlights the importance of renewed research and policy agendas for improved, targeted well user outreach and incentivised, convenience-based services promoting routine supply maintenance.

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We used quantitative microbial risk assessment to estimate ingestion risk for intI1, erm(B), sul1, tet(A), tet(W), and tet(X) in private wells contaminated by human and/or livestock feces. Genes were quantified with five human-specific and six bovine-specific microbial source-tracking (MST) markers in 138 well-water samples from a rural Wisconsin county. Daily ingestion risk (probability of swallowing ≥1 gene) was based on daily water consumption and a Poisson exposure model. Calculations were stratified by MST source and soil depth over the aquifer where wells were drilled. Relative ingestion risk was estimated using wells with no MST detections and >6.1 m soil depth as a referent category. Daily ingestion risk varied from 0 to 8.8 × 10-1 by gene and fecal source (i.e., human or bovine). The estimated number of residents ingesting target genes from private wells varied from 910 (tet(A)) to 1,500 (intI1 and tet(X)) per day out of 12,000 total. Relative risk of tet(A) ingestion was significantly higher in wells with MST markers detected, including wells with ≤6.1 m soil depth contaminated by bovine markers (2.2 [90% CI: 1.1-4.7]), wells with >6.1 m soil depth contaminated by bovine markers (1.8 [1.002-3.9]), and wells with ≤6.1 m soil depth contaminated by bovine and human markers simultaneously (3.1 [1.7-6.5]). Antibiotic resistance genes (ARGs) were not necessarily present in viable microorganisms, and ingestion is not directly associated with infection. However, results illustrate relative contributions of human and livestock fecal sources to ARG exposure and highlight rural groundwater as a significant point of exposure.IMPORTANCEAntibiotic resistance is a global public health challenge with well-known environmental dimensions, but quantitative analyses of the roles played by various natural environments in transmission of antibiotic resistance are lacking, particularly for drinking water. This study assesses risk of ingestion for several antibiotic resistance genes (ARGs) and the class 1 integron gene (intI1) in drinking water from private wells in a rural area of northeast Wisconsin, United States. Results allow comparison of drinking water as an exposure route for antibiotic resistance relative to other routes like food and recreational water. They also enable a comparison of the importance of human versus livestock fecal sources in the study area. Our study demonstrates the previously unrecognized importance of untreated rural drinking water as an exposure route for antibiotic resistance and identifies bovine fecal material as an important exposure factor in the study setting.

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Antimicrobial resistance (AMR) is a critical global health concern. Animal husbandry operations are AMR hotspots due to heavy antibiotic use and dissemination of animal waste into the environment. In this systematic review, we examined the impact of swine, poultry, and cattle operations on AMR in groundwater. We searched PubMed, Web of Science, CAB Direct, and the North Carolina State University Agricultural and Environmental Science databases in June 2022. The search returned 2487 studies. Of the 23 eligible studies, 17 were conducted in high-income countries (primarily the USA, also Canada, Saudi Arabia, Cyprus), and 6 were conducted in a single upper-middle-income country (China). Studies investigated facilities for swine (13), poultry (4), cattle (3), and multiple types of animals (3). The sampling distance ranged from onsite to > 20 km from facilities; the majority of studies (19) sampled onsite. Most studies collected samples from monitoring wells; only 5 studies investigated private drinking water wells. AMR in groundwater was associated with animal husbandry operations in 74% (17/23) of all studies, 65% (11/17) of studies in high-income countries, and 100% (6/6) of studies in China. Contamination was mostly found in onsite wells, especially downgradient of waste lagoons, but also in offsite private wells up to 2-3 km away. Few studies reported weather data, but AMR contamination appeared to increase with rainy conditions. Future studies should sample private wells at varying distances from animal husbandry operations under different weather conditions and include low- and middle-income countries where food animal production is intensifying.

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Nitrate levels are increasing in water resources across the United States and nitrate ingestion from drinking water has been associated with adverse health risks in epidemiologic studies at levels below the maximum contaminant level (MCL). In contrast, dietary nitrate ingestion has generally been associated with beneficial health effects. Few studies have characterized the contribution of both drinking water and dietary sources to nitrate exposure. The Agricultural Health Study is a prospective cohort of farmers and their spouses in Iowa and North Carolina. In 2018-2019, we assessed nitrate exposure for 47 farmers who used private wells for their drinking water and lived in 8 eastern Iowa counties where groundwater is vulnerable to nitrate contamination. Drinking water and dietary intakes were estimated using the National Cancer Institute Automated Self-Administered 24-Hour Dietary Assessment tool. We measured nitrate in tap water and estimated dietary nitrate from a database of food concentrations. Urinary nitrate was measured in first morning void samples in 2018-19 and in archived samples from 2010 to 2017 (minimum time between samples: 2 years; median: 7 years). We used linear regression to evaluate urinary nitrate concentrations in relation to total nitrate, and drinking water and dietary intakes separately. Overall, dietary nitrate contributed the most to total intake (median: 97 %; interquartile range [IQR]: 57-99 %). Among 15 participants (32 %) whose drinking water nitrate concentrations were at/above the U.S. Environmental Protection Agency MCL (10 mg/L NO3-N), median intake from water was 44 % (IQR: 26-72 %). Total nitrate intake was the strongest predictor of urinary nitrate concentrations (R2 = 0.53). Drinking water explained a similar proportion of the variation in nitrate excretion (R2 = 0.52) as diet (R2 = 0.47). Our findings demonstrate the importance of both dietary and drinking water intakes as determinants of nitrate excretion.

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This study highlights concerns regarding the reliability of groundwater nitrate data used in official surveys, such as within the EU-mandated Water Framework Directive (WFD). The focus is on the Campo de Cartagena - Mar Menor hydrosystem in Spain, a region known for its intensively irrigated watershed and eutrophicated lagoon, where monitoring the evolution of nitrate contamination in surface and groundwater is crucial but challenging due to the risk of inconsistent characterization leading to erratic remediation measures. The study employed an experimental approach in private wells that belong to a longstanding official nitrate survey network marked by irregular sampling practices. Importantly, these wells lacked comprehensive design documentation and were frequently used by farmers. The study aimed to evaluate the representativity of dissolved nitrate measurements in such an emblematic case, while investigating the source of the water using geochemical and isotope tracers. This assessment considered the effects of different sampling techniques (bailer or pumping) and sampling parameters (depth and time), acknowledging actual practices. The research highlights several key findings. Firstly, the bailer sampling method proved to account for a substantial portion of the observed variation in nitrate content. Secondly, in some cases, pumping introduced contributions from different water horizons, complicating the interpretation of nitrate data. Thirdly, alterations in the sampling protocol had a notable impact on the resulting nitrate measurements. Furthermore, the study emphasized a critical issue: the lack of analytical uncertainty estimation in official surveys introduces significant bias in result interpretation, with discrepancies exceeding 100 mg/L in four of the six wells analyzed. This underscores the pressing need for improved sampling protocols, dedicated borehole infrastructure and precise data interpretation. Given the potential unreliability of some official groundwater nitrate data shared under EU or other regulations, with corresponding economic and environmental impacts, the study recommends meticulous verification before transmitting data.

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Natural ecosystems can become significant reservoirs and/or pathways for antimicrobial resistance (AMR) dissemination, with the potential to affect nearby microbiological, animal, and ultimately human communities. This is further accentuated in environments that provide direct human exposure, such as drinking water. To date, however, few studies have investigated AMR dissemination potential and the presence of co-selective stressors (e.g., metals/metalloids) in groundwater environments of human health significance. Accordingly, the present study analysed samples from rural (drinking) groundwater supplies (i.e., private wells) in the Republic of Ireland, where land use is dominated by livestock grazing activities. In total, 48 Escherichia coli isolates tested phenotypically for antimicrobial susceptibility in an earlier study were further subject to whole genome sequencing (WGS) and corresponding water samples were further analysed for trace metal/metalloid concentrations. Eight isolates (i.e., 16.7%) were genotypically resistant to antimicrobials, confirming prior phenotypic results through the identification of ten antimicrobial resistance genes (ARGs); namely: aph(3″)-lb (strA; n=7), aph(6)-Id (strA; n = 6), blaTEM (n = 6), sul2 (n = 6), tetA (n = 4), floR (n = 2), dfrA5 (n = 1), tetB (n = 1), and tetY (n = 1). Additional bioinformatic analysis revealed that all ARGs were plasmid-borne, except for two of the six sul2 genes, and that 31.2% of all tested isolates (n = 15) and 37.5% of resistant ones (n = 3) carried virulence genes. Study results also found no significant relationships between metal concentrations and ARG abundance. Additionally, just one genetic linkage was identified between ARGs and a metal resistance gene (MRG), namely merA, a mercury-resistant gene found on the same plasmid as blaTEM, dfrA5, strA, strB, and sul2 in the only isolate of inferred porcine (as opposed to bovine) origin. Overall, findings suggest that ARG (and MRG) acquisition may be occurring prior to groundwater ingress, and are likely a legacy issue arising from agricultural practices.

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Drinking-water quality is a rising concern in the United States (US), emphasizing the need to broadly assess exposures and potential health effects at the point-of-use. Drinking-water exposures to per- and poly-fluoroalkyl substances (PFAS) are a national concern, however, there is limited information on PFAS in residential tapwater at the point-of-use, especially from private-wells. We conducted a national reconnaissance to compare human PFAS exposures in unregulated private-well and regulated public-supply tapwater. Tapwater from 716 locations (269 private-wells; 447 public supply) across the US was collected during 2016-2021 including three locations where temporal sampling was conducted. Concentrations of PFAS were assessed by three laboratories and compared with land-use and potential-source metrics to explore drivers of contamination. The number of individual PFAS observed ranged from 1 to 9 (median: 2) with corresponding cumulative concentrations (sum of detected PFAS) ranging from 0.348 to 346 ng/L. Seventeen PFAS were observed at least once with PFBS, PFHxS and PFOA observed most frequently in approximately 15% of the samples. Across the US, PFAS profiles and estimated median cumulative concentrations were similar among private wells and public-supply tapwater. We estimate that at least one PFAS could be detected in about 45% of US drinking-water samples. These detection probabilities varied spatially with limited temporal variation in concentrations/numbers of PFAS detected. Benchmark screening approaches indicated potential human exposure risk was dominated by PFOA and PFOS, when detected. Potential source and land-use information was related to cumulative PFAS concentrations, and the number of PFAS detected; however, corresponding relations with specific PFAS were limited likely due to low detection frequencies and higher detection limits. Information generated supports the need for further assessments of cumulative health risks of PFAS as a class and in combination with other co-occurring contaminants, particularly in unmonitored private-wells where information is limited or not available.

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Gross alpha, a measurement of radioactivity in drinking water, is the most frequent laboratory test to exceed primary drinking water standards among wells tested under the New Jersey Private Well Testing Act (NJ PWTA). Certain geological factors prevalent in New Jersey (NJ) are primarily responsible for the presence of radioactivity in private well drinking water and thus, many of the estimated one million private well users in NJ may be at-risk of water contamination from naturally occurring radionuclides. Neighbor-based private well outreach methodology was utilized to identify high risk wells in both northern and southern NJ regions and offer free private well testing for radionuclides. Previously tested wells with gross alpha exceeding or equal to 3.7 becquerels per liter (Bq L-1; 100 pCi/L) were selected (n = 49) to identify neighbors (n = 406) within 152.4 m (500 feet). Invitation letters were mailed to selected neighbors and some of the previously tested high wells (n = 12) offering free water sampling for the following parameters: gross alpha (48-hour rapid test), combined radium-226 and radium-228 (Ra-226 + Ra-228), uranium-238 (U-238), radon-222 (Rn-222) and iron. Overall, 70 neighbors and 5 high PWTA wells participated in this free water testing opportunity. For neighboring wells, gross alpha results revealed 47 (67.1%) wells exceeding the gross alpha MCL of 0.555 Bq L-1 (15 pCi/L) mainly due to radium activity in the raw/untreated water. Of those with water treatment (n = 62), 12 (19.4%) treated water samples exceeded the gross alpha MCL. Targeting neighbors of known highly radioactive wells for private well testing is an effective public health outreach method and can also provide useful insight of regional contaminant variations.

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>44 million United States residents depend on private drinking water wells that are federally unregulated. Maintaining a clean groundwater supply for populations without access to public water systems is essential to supporting public health and falls to state regulators and private well owners. Yet, monitoring practices do not reflect the fact that groundwater pollution risk varies seasonally and with proximity to nearby surface-contaminated sites. Examination of nearly 50,000 well water samples across North Carolina, ranked second nationally in domestic well dependence and swine production, from 2013 to 2018 reveals a uniform sampling schedule but a variable risk of bacterial contamination within each calendar year. We document a threshold of 32.2 °C (90 °F) where total coliform bacteria and Escherichia coli (E. coli) detection in private well water spikes near swine lagoons but is absent from "upstream" wells and otherwise unexplained by a variety of other known contamination sites. Closing the gap between perceived and actual risks of drinking water contamination has potential to improve public health. State regulations and federal guidelines should consider coordinating domestic well sampling with seasonally and spatially fluctuating risks of groundwater contamination. Findings from this study are generalizable, having implications for other parts of the world with water sources that have the potential to get contaminated by nearby surface sources of human and animal waste, such as manure applications and leaching septic systems.

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Over recent years, Ireland has reported the highest crude incidence rates of Shiga toxin-producing Escherichia coli (STEC) enteritis in Europe. Unregulated private groundwater sources have emerged as an important potential transmission route for STEC, with up to 750,000 Irish residents reliant on these sources for domestic waters. This study aimed to investigate the prevalence and serogroup profile of STEC contamination from domestic private wells in western Ireland. Fifty-two groundwater sources were analysed during two sampling campaigns in the autumn (September/October) of 2019 (n = 21) and 2021 (n = 31). Untreated groundwater samples (30 L) were collected and analysed using the "CapE" (capture, amplify, extract) method. Extracted DNA was tested using multiplex real-time PCR for Shiga toxin stx1 and/or stx2 and eae genes. STEC positive DNA samples were tested for clinically relevant serogroups by real-time PCR. Data relating to 27 potential groundwater contamination risk factors were geospatially linked to each well and assessed for association with E. coli, stx1 and/or stx2 and eae presence/absence. Overall, 20/52 wells (38.4 %) were positive for E. coli (median concentration 8.5 MPN/100 mL as assessed by Colilert-18 method). Stx1 and/or stx2 was detected in 10/52 (19.2 %) wells overall and 8/20 E. coli positive wells, equating to a STEC to "generic" E. coli detection ratio of 40 %. Six of these wells (30 %) were also positive for eae. One or more serogroup-specific gene targets were identified in all but one stx1 and/or stx2 positive sample, with O145 (n = 6), O157 (n = 5) and O103 (n = 4) most prevalent. STEC presence was significantly associated with decreasing well depth (U = -2.243; p = 0.024) and increasing 30-day mean antecedent rainfall (U = 2.126; p = 0.034). Serogroup O104 was associated with increased sheep density (U = 2.089; p = 0.044) and detection of stx1 and/or stx2 + eae with increased septic tank density (U = 2.246 p = 0.023). Findings indicate high detection rates of clinically relevant STEC in E. coli contaminated groundwater sources in Ireland.

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In the United States and globally, contaminant exposure in unregulated private-well point-of-use tapwater (TW) is a recognized public-health data gap and an obstacle to both risk-management and homeowner decision making. To help address the lack of data on broad contaminant exposures in private-well TW from hydrologically-vulnerable (alluvial, karst) aquifers in agriculturally-intensive landscapes, samples were collected in 2018-2019 from 47 northeast Iowa farms and analyzed for 35 inorganics, 437 unique organics, 5 in vitro bioassays, and 11 microbial assays. Twenty-six inorganics and 51 organics, dominated by pesticides and related transformation products (35 herbicide-, 5 insecticide-, and 2 fungicide-related), were observed in TW. Heterotrophic bacteria detections were near ubiquitous (94 % of the samples), with detection of total coliform bacteria in 28 % of the samples and growth on at least one putative-pathogen selective media across all TW samples. Health-based hazard index screening levels were exceeded frequently in private-well TW and attributed primarily to inorganics (nitrate, uranium). Results support incorporation of residential treatment systems to protect against contaminant exposure and the need for increased monitoring of rural private-well homes. Continued assessment of unmonitored and unregulated private-supply TW is needed to model contaminant exposures and human-health risks.

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Complex, multihazard risks such as private groundwater contamination necessitate multiannual risk reduction actions including seasonal, weather-based hazard evaluations. In the Republic of Ireland (ROI), high rural reliance on unregulated private wells renders behavior promotion a vital instrument toward safeguarding household health from waterborne infection. However, to date, pathways between behavioral predictors remain unknown while latent constructs such as extreme weather event (EWE) risk perception and self-efficacy (perceived behavioral competency) have yet to be sufficiently explored. Accordingly, a nationwide survey of 560 Irish private well owners was conducted, with structural equation modeling (SEM) employed to identify underlying relationships determining key supply management behaviors. The pathway analysis (SEM) approach was used to model three binary outcomes: information seeking, post-EWE action, and well testing behavior. Upon development of optimal models, perceived self-efficacy emerged as a significant direct and/or indirect driver of all three behavior types-demonstrating the greatest indirect effect (ß = -0.057) on adoption of post-EWE actions and greatest direct (ß = 0.222) and total effect (ß = 0.245) on supply testing. Perceived self-efficacy inversely influenced EWE risk perception in all three models but positively influenced supply awareness (where present). Notably, the presence of a vulnerable (infant and/or elderly) household member negatively influenced adoption of post-EWE actions (ß = -0.131, p = 0.016). Results suggest that residential and age-related factors constitute key demographic variables influencing risk mitigation and are strongly mediated by cognitive variables-particularly self-efficacy. Study findings may help contextualize predictors of private water supply management, providing a basis for future risk-based water interventions.

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Many rural populations, including American Indian communities, that use private wells from groundwater for their source of drinking and cooking water are disproportionately exposed to elevated levels of arsenic. However, programs aimed at reducing arsenic in American Indian communities are limited. The Strong Heart Water Study (SHWS) is a randomized controlled trial aimed at reducing arsenic exposure among private well users in American Indian Northern Great Plains communities. The community-led SHWS program installed point-of-use (POU) arsenic filters in the kitchen sink of households, and health promoters delivered arsenic health communication programs. In this study we evaluated the efficacy of these POU arsenic filters in removing arsenic during the two-year installation period. Participants were randomized into two arms. In the first arm households received a POU arsenic filter, and 3 calls promoting filter use (SHWS mobile health (mHealth) & filter arm). The second arm received the same filter and phone calls, and 3 in-person home visits and 3 Facebook messages (SHWS intensive arm) for program delivery. Temporal variability in water arsenic concentrations from the main kitchen faucet was also evaluated. A total of 283 water samples were collected from 50 households with private wells from groundwater (139 filter and 144 kitchen faucet samples). Ninety-three percent of households followed after baseline had filter faucet water arsenic concentrations below the arsenic maximum contaminant level of 10 µg/L at the final visit during our 2 year study period with no difference between study arms (98 % in the intensive arm vs. 94 % in the mHealth & filter arm). No significant temporal variation in kitchen arsenic concentration was observed over the study period (intraclass correlation coefficient = 0.99). This study demonstrates that POU arsenic filters installed for the community participatory SHWS program were effective in reducing water arsenic concentration in study households in both arms, even with delivery of the POU arsenic filter and mHealth program only. Furthermore, we observed limited temporal variability of water arsenic concentrations from kitchen faucet samples collected over time from private wells in our study setting.

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Due to structural racism and income inequality, exposure to environmental chemicals is tightly linked to socioeconomic factors. In addition, exposure to psychosocial stressors, such as racial discrimination, as well as having limited resources, can increase susceptibility to environmentally induced disease. Yet, studies are often conducted separately in fields of social science and environmental science, reducing the potential for holistic risk estimates. To tackle this gap, we developed the Chemical and Social Stressors Integration Technique (CASS-IT) to integrate environmental chemical and social stressor datasets. The CASS-IT provides a framework to identify distinct geographic areas based on combinations of environmental chemical exposure, social vulnerability, and access to resources. It incorporates two data dimension reduction tools: k-means clustering and latent profile analysis. Here, the CASS-IT was applied to North Carolina (NC) as a case study. Environmental chemical data included toxic metals - arsenic, manganese, and lead - in private drinking well water. Social stressor data were captured by the CDC's social vulnerability index's four domains: socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. Data on resources were derived from Federal Emergency Management Agency (FEMA's) Resilience and Analysis Planning Tool, which generated measures of health resources, social resources, and information resources. The results highlighted 31 NC counties where exposure to both toxic metals and social stressors are elevated, and health resources are minimal; these are counties in which environmental justice is of utmost concern. A census-tract level analysis was also conducted to demonstrate the utility of CASS-IT at different geographical scales. The tract-level analysis highlighted specific tracts within counties of concern that are particularly high priority. In future research, the CASS-IT can be used to analyze United States-wide environmental datasets providing guidance for targeted public health interventions and reducing environmental disparities.

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The role of the natural environment in the dissemination of antimicrobial resistant bacteria has been increasingly recognised in the literature. However, knowledge surrounding the critical factors and mechanisms mediating their occurrence is still limited, particularly in relatively 'pristine' groundwater environments. In the Republic of Ireland (RoI), a country characterised by high groundwater reliance, household-based (unregulated) wells provide drinking water to 11% of the population. These private wells are generally located in rural areas, where the risk of microbiological contamination is high due to intensive agricultural practices and high reliance on domestic wastewater treatment systems; both of which are also potential sources of antimicrobials and antimicrobial resistant bacteria. Accordingly, the current research sought to elucidate current rates of antimicrobial resistant bacteria and the principal factors associated with their presence in private wells in the RoI. A total of 250 samples (from 132 wells nationwide) were assessed for the presence of faecal (Escherichia coli) and environmental (Pseudomonas aeruginosa) bacteria, with single isolates from each contaminated sample tested phenotypically against 18 and 9 antimicrobials, respectively. Findings show that while 16.7% of E. coli (n = 8/48) were categorically resistant to ≥1 antimicrobial, with a further 79.2% classified as intermediately resistant, no categorical resistance was found among P. aeruginosa isolates (n = 0/6), with just one intermediately resistant isolate detected. Multivariate regression modelling indicates significantly higher odds of resistant E. coli detection in concurrence with elevated cattle density (OR = 1.028, p = 0.032), aligning with findings of highest resistance rates to veterinary antimicrobials (e.g., streptomycin = 14.6%, tetracycline = 12.5%, and ampicillin = 12.5%). Multivariate model results also suggest overland flow culminating in direct wellhead ingress as a primary ingress mechanism for resistant E. coli. Study findings may inform groundwater source protection initiatives and antimicrobial resistance surveillance moving forward.

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Toxic metal exposure via private drinking wells is an environmental health challenge in North Carolina (NC). Policies tainted by environmental racism shape who has access to public water supplies, with Black People, Indigenous People, and People of Color (BIPOC) often excluded from municipal services. Thus, toxic metal exposure via private wells is an environmental justice (EJ) issue, and it is under-studied in NC. In this study, we developed four Toxic Metal Environmental Justice Indices (TM-EJIs) for inorganic arsenic (iAs), cadmium (Cd), lead (Pb), and manganese (Mn) to quantitatively identify areas of environmental injustice in NC. TM-EJIs were calculated at the census tract level (n = 2038) as the product of the following: (1) number of well water tests with concentrations exceeding national standards, (2) percentage of the low-income and minority population, and (3) population density. Mn had the greatest proportion (25.17%) of positive TM-EJIs, which are indicative of socioeconomically disadvantaged groups exposed to toxic metals. Positive TM-EJIs, particularly for Pb and Mn, were primarily located in eastern NC. These results highlight several new counties of concern and can be used by public health professionals and state environmental agencies to prioritize remediation efforts and efforts to reduce environmental injustices.

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Uranium (U) is one of the typical naturally occurring radioactive elements enriched in groundwater through geological mechanisms, thereby bringing about adverse effects on human health. For this reason, some countries and the World Health Organization (WHO) regulate U with drinking water standards and monitor its status in groundwater. In Korea, there have been continuous investigations to monitor and manage U in groundwater, but they have targeted only public groundwater wells. However, the features of private wells differ from public ones, particularly in regard to the well's depth and diameter, affecting the U distribution in private wells. This study was initiated to investigate U concentrations in private groundwater wells for potable use, and the significant factors controlling them were also elucidated through statistical methods. The results obtained from the analyses of 7036 groundwater samples from private wells showed that the highest, average, and median values of U concentrations were 1450, 0.4, and 4.0 µg/L, respectively, and 2.1% of the wells had U concentrations exceeding the Korean and WHO standard (30 µg/L). In addition, the U concentrations were highest in areas of the Jurassic granite, followed by Quaternary alluvium and Precambrian metamorphic rocks. A more detailed investigation of the relationship between U concentration and geology revealed that the Jurassic porphyritic granite, mainly composed of Daebo granite, showed the highest U contents, which indicated that U might originate from uraninite (UO2) and coffinite (USiO4). Consequently, significant caution should be exercised when using the groundwater in these geological areas for potable use. The results of this study might be applied to establish relevant management plans to protect human health from the detrimental effect of U in groundwater.

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BACKGROUND: Prenatal exposure to drinking water with arsenic concentrations >50 µg/L is associated with adverse birth outcomes, with inconclusive evidence for concentrations ≤50 µg/L. In a collaborative effort by public health experts, hydrologists, and geologists, we used published machine learning model estimates to characterize arsenic concentrations in private wells-federally unregulated for drinking water contaminants-and evaluated associations with birth outcomes throughout the conterminous U.S. METHODS: Using several machine learning models, including boosted regression trees (BRT) and random forest classification (RFC), developed from measured groundwater arsenic concentrations of ∼20,000 private wells, we characterized the probability that arsenic concentrations occurred within specific ranges in groundwater. Probabilistic model estimates and private well usage data were linked by county to all live birth certificates from 2016 (n = 3.6 million). We evaluated associations with gestational age and term birth weight using mixed-effects models, adjusted for potential confounders and incorporated random intercepts for spatial clustering. RESULTS: We generally observed inverse associations with term birth weight. For instance, when using BRT estimates, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 5 µg/L was associated with a -1.83 g (95% CI: -3.30, -0.38) lower term birth weight after adjusting for covariates. Similarly, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 10 µg/L was associated with a -2.79 g (95% CI: -4.99, -0.58) lower term birth weight. Associations with gestational age were null. CONCLUSION: In this largest epidemiologic study of arsenic and birth outcomes to date, we did not observe associations of modeled arsenic estimates in private wells with gestational age and found modest inverse associations with term birth weight. Study limitations may have obscured true associations, including measurement error stemming from a lack of individual-level information on primary water sources, water arsenic concentrations, and water consumption patterns.

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