An Overview of Drinking Water Fluoridation

With cost efficiency community fluoridation overcomes disparities in oral health regardless of community size, age, education, or income level. A dental health study found that the savings from fluoridation in communities of 1,000 people or more exceeded program costs by $20 per every dollar invested. When Juneau, Alaska voted to end fluoridation in 2007, a study found that children six years and under had an increase of one dental cavity per year, roughly equivalent to $300 in dental costs per child annually. Juneau’s increase in cavities was also reflected in adults.

All water contains some levels of naturally-occurring fluoride though these levels are often too low for health benefits. In untreated water, fluoride levels vary considerably with geology and land practices. Fluoride is introduced to water when dissolved from the Earth’s crust into groundwater or discharged from fertilizer and aluminum factories. Systems with fluoridation should set final levels near 0.7 mg/L as suggested by the Department of Public Health. This concentration factors for other sources of consumer fluoride exposure such as toothpaste. Fluorosilicic acid (FSA) is most commonly used in water treatment. Though fluoridation decisions are left to a state or local municipality, the EPA has established federal standards for the upper limits allowed in drinking water.

At high levels fluoride can cause the development of bone disease and tooth mottling. As a result, the EPA has set both the Maximum Contaminant Level Goal (MCLG) and the MCL for fluoride at 4 mg/L. Levels higher than 4 mg/L can lead to increased rates of bone fracture, Enamel Fluorosis, and Skeletal Fluorosis. If systems find fluoride concentrations higher than the MCL, they are required to notify customers within 30 days and potentially install treatment methods such as distillation or reverse osmosis to remove the excess fluoride. 

The EPA has also set a secondary standard for fluoride at 2.0 mg/L. The secondary standard is intended to be used as a guideline for an upper bound level in areas with high levels of naturally occurring fluoride. Below this level, the chance for tooth mottling and more severe health impacts are close to zero. Even if the secondary standard is reached, systems must notify customers. In the U.S. very few systems have exceeded the fluoride MCL at all. Where violations have occurred, the concentrations are generally a result of natural, geological conditions. 

Even with this track record, some concerned customers are still weary of fluoridation. When customers broach fluoridation concerns, operators can offer educational materials and refer customers to consumer confidence reports. The CDC and the EPA offers a variety of consumer-friendly educational material that operators can reference in addition to the resources linked in this blog post. Remember that good customer service starts by establishing a trusted relationship with your community.

What's on the Drinking Water Radar for the Year Ahead: 2019

Being a small-town water operator is not easy; it is up to you to ensure the quality of your community's water day-in and day-out, often with very limited resources. Let WaterOperator.org help you meet the challenge head-on with this list of tools and resources to put on your radar for the year ahead:

• Have you gotten in the groove yet with the new RTCR requirements? Here are two new documents from the USEPA designed to help small public water systems: Revised Total Coliform Rule Placards and a Revised Total Coliform Rule Sample Siting Plan with Template Manual. Additional compliance help, including public notification templates, a RTCR rule guide, a corrective actions guidance and more can be found here.
• While we know your hands are full just getting the job done, there are new and emerging issues you may have to deal with in the year ahead. For example, this past year many communities have been dealing with PFAS contamination issues. This ITRC website provides PFAS fact sheets that are regularly being updated on PFAS regulations, guidance, advisories and remediation methods. Especially of interest is this excel file that has begun to list the different state standards and guidance values for PFAS in drinking water as they are developed. Be sure to check back often for updates.
• Your utility may also have to adjust to new compliance rules in the coming year. In Michigan, for example, a new Lead and Copper Rule arising from the water crisis in Flint has gone into effect, making it the strictest in the nation. Other states, such as Ohio, have also adopted tougher standards, or are now requiring schools to test for lead. Oregon has established temporary rules that will require drinking water systems in the state using certain surface water sources to routinely test for cyanotoxins and notify the public about the test results.
• With a warming climate, these incidences of harmful algal blooms in surface water are on the increase, causing all sorts of challenges for water systems that now have to treat this contaminant. This cyanotoxin management template from the EPA can help assist you with a plan specific to your location.
• Worker turnover and retirements will still be an issue in 2019. According to this article, the median age for water workers in general (42.8 years) and water treatment operators specifically (46.4 years) are both above the national average across all occupations (42.2 years). You can keep transitions as smooth as possible by using EPA's Knowledge Retention Tool Spreadsheet and/or this Electronic Preventive Maintenance Log.
• New Tech Solutions: A UMass lab focusing on affordable water treatment technologies for small systems will be rolling out its Mobile Water Innovation Laboratory in 2019 for on-site testing. In addition, the facility is testing approaches to help communities address water-quality issues in affordable ways. "Early next year, in the maiden voyage of the mobile water treatment lab, UMass engineer David Reckhow plans to test ferrate, an ion of iron, as a replacement for several water treatments steps in the small town of Gloucester, MA.

But even without all these challenges and new ideas for the future, simply achieving compliance on a day-to-day basis can be tricky - if this sounds familiar, you may want to check out our recent video on how operators can approach the most common drinking water compliance issues.

Featured Video: The Future of Water

Water is a scarce resource for many communities around the globe, and this scarcity is becoming more and more widespread. Our featured video this week from Quartz Media looks out how one locality half a world away has addressed this challenge, and how the rest of us can learn from systems like these where the "future of water" has already arrived.

While this video focuses on a larger metropolitan area, there are some interesting takeaways for smaller systems as well such as:

•  Solutions to water challenges are best solved at the individual and/or community level. 
•  Water reuse is most likely already happening in your community and efforts can be made to change public perceptions. For example, a wastewater pipe enters the Mississippi River every 8 miles - meaning almost every community using the river as a water source is already drinking someone else's wastewater!     

Focus on Chemical Feed Control

Chemical dosing at the water treatment plant is a critical, but often underrated step in producing safe drinking water. Historically, process control points have focused on the hazards present in incoming source water - with emphasis on the filtration and disinfection steps to minimize microbial risks. But while many hazards do indeed enter the plant with the raw water, it is just as important to identify the multiple risks associated with treating this raw water.   

Spooky Sewers and Things That Go Bump at the Treatment Plant: 2018 Edition

Featured Video: Using Powdered Activated Carbon to Remove Cyanotoxins

In May of this year, the city of Salem, Oregon discovered the state's first-ever algae breach in finished drinking water. Since then, there has been quite a bit of soul-searching, as well as a third-party assessment of exactly what happened and the effectiveness of the water utility's response after the event. In the end, the assessment concluded that the city was not prepared to deal with the public relations fallout, or the more practical matter of helping citizens access emergency water supplies. 

In the meantime, the Oregon Health Authority responded by creating almost unprecedented new cyanotoxin monitoring regulations for systems across the state, and the city of Salem was left to figure out how to cope with what may turn out to be a long-standing threat.

As an emergency measure, the utility started using powdered activated carbon (see video below from Statesman Journal reporter Dick Hughes) but it can cause clogging of the filtration plant.  The city is now also looking into ozone filtration, as well as other improvements including hazard response and crisis communication planning in order to be better prepared to handle future events.  

Featured Videos: Small Communities Benefit From Shared Resources

The Small Communities Environmental Infrastructure Group assists small Ohio communities in finding resources to help solve their infrastructure and funding problems. These two videos feature water and sewer district officials and staff discussing the benefits of participating in SCEIG regional partnerships in order to better serve their communities. 

The Disinfection By-Product Challenge

Staying in compliance with Stage II DBP testing can be a challenge for many small systems. Moreover, when preventing DBP formation becomes a pressing need, it is easy to get overwhelmed by the range and cost of options out there, especially if you are trying to keep up with new technologies. Then there is the fact that solutions to DBP problems often involve several different actions or multiple steps, giving the situation an extra level of challenge.

However, before planning a remediation strategy it might be valuable to initiate a DBP profile study - testing from the source water through the treatment process, and continuing into the distribution system. Why? Because, as Justin Spears in a recent H2Outlook (Kentucky Water & Wastewater Operator's Association) article found out, sometimes the problem isn't where you think it is!

According to his article, he was all set to add a mixer to his storage tank when results from his DBP profile study showed that most of his DBPs were forming in the plant's clearwell. His problem was at the treatment plant, not in the tank! In the end, Justin solved his DBP problem quickly by using chlorine dioxide, made on site by mixing chlorine gas, which he had already in place, with sodium chlorite. However, every treatment plant and source water is different, and what worked for him might not be the best for you.

Interested in finding out more about options for DBP control? Check out this video or this website or this manual. In addition, you can choose Disinfection and Disinfection By-Products as a category in WaterOperator's document or event database to find all sorts of resources.

Need a Roadtrip Idea? Check Out These Waterworks Museums

 Are you fascinated by old steam-powered pumps and engines, or the stories that inspired ingenuity and invention in the water industry? Do you like cool old buildings? If the answer is "yes," then pack up your family and/or friends and take a road trip to one (or more) of the following waterworks museums! 

• The Waterworks Museum, Boston, MA: This museum interprets unique stories of one of the country's first metropolitan water systems through exhibitions and educational programs on engineering, architecture, social history and public health. The centerpiece of the museum is its collection of original 3-story high coal-powered, steam-driven water pumps. Admission is free (donations accepted). 
• The WaterWorks Museum, Louisville, KY: Located inside the west wing of Louisville Water Company's original Pumping Station No. 1, the WaterWorks Museum highlights Louisville Water’ Company's archive of historic photographs, films and memorabilia, some of which date back to 1860. Discover the company’s contributions to safe drinking water through its innovations in science and engineering. 
• The Shreveport Water Works Museum, Shreveport, LA: This museum, a national historic landmark, is the last known steam-powered municipal water treatment plant in the US. It was also among the earliest facilities to use chlorine in the treatment process. Today, the entire physical plant (pumps, filters and other machinery) remains in place after more than 100 years of service and is a rare example of an intact steam water works. Best of all, admission is free!
• Fairmount Water Works, Philadelphia, PA: The Fairmount Water Works is a National Historic Landmark, a Civil Engineering Landmark, and a National Mechanical Engineering Landmark, and was designed and constructed to provide safe, clean drinking water to a city on the cusp of remarkable growth. This museum educates citizens regarding the interconnections between their community and environment, particularly the public’s essential role in protecting and stewarding our water and natural land resources. Cost: Free.
• In the mood for overseas exploration? You might want to check out the Museum of Sewerage Science in Osaka, Japan (the third floor is dedicated entirely to advanced wastewater treatment technology), or this active steam-powered waterworks museum in Hereford, UK or these sewer museums in London, Paris, and Brussels!  

Featured Videos: Invisible Heroes, Minnesota's Drinking Water Providers

This week's featured videos are part of a new series produced by the Minnesota Department of Health showcasing the "invisible heroes" of Minnesota's drinking water supply. In these 3-minute videos, small town water system heroes face and overcome a variety of challenges including contamination, source water shortages and aging infrastructure in order to provide safe, reliable water for their communities. Three of the videos feature small or very small water systems and the innovative strategies and partnerships they have developed to overcome their challenges. 

The first video looks at how the tiny community of St. Martin (pop. 350) has become the first town in the state with a biologically active treatment plant in order to effectively respond to high levels of iron and ammonia in their water. 

The next video explains the unique wellhead protection program developed by the City of Worthington, MN (pop. 13,000). In order to protect the City's drinking water wells from contamination, the city, along with partner Pheasants Forever, created the Worthington Wells Wildlife Management Area. 

And finally, here is a video about how the small city of Fairmont, MN (pop. 10,000) sprang into action when faced with increasing nitrate levels.