ENVIRONMENTAL HEALTH
Indiana Strategizes with Partners to Protect
Vulnerable from Private Well Water Risks
by Mary Hagerman, MS, chemistry division director, Indiana State Department of Health (ISDH) Laboratories and Sarah Wright, MS, manager,
Environmental Laboratories
Featured on the agenda were two
nationally-known experts on the
relationship between well water and
health. Steve Wilson, an expert on private
wells, explained the importance of health
professionals in promoting water testing.
Dr. Susan Buchanan, director of the Great
Lakes Center for Children’s Environmental
Health in Chicago, discussed children
as “the canaries in the coal mine” of
environmental health and addressed
the effects of contaminant exposures in
pregnancy and early childhood.
In 2014, APHL partnered with the US Centers
for Disease Control and Prevention (CDC)
National Center for Environmental Health
Environmental Hazards and Health Effects
Division to provide funding for laboratories
to develop and host a meeting of their
environmental health system partners. In
fall 2017, APHL issued a request for proposal
for laboratories to apply for up to $15,000
for meeting support. Indiana was a funding
recipient and hosted its meeting in October
2018.
Indiana has over 600,000 private,
unregulated wells used for drinking water,
and most are not tested to determine if
the water is safe. Arsenic is estimated
to be found in more than 10 percent
of private drinking water wells in the
state with levels in excess of the US
Environmental Protection Agency (US
EPA) Safe Drinking Water Act limit of
10 µg/L. Maternal arsenic exposure has
been linked to gestational diabetes, lower
infant birth weights and infant mortality.
In light of the high prevalence of
naturally-occurring arsenic in Indiana’s
well water, the Indiana State Department
of Health (ISDH) laboratory was concerned
about exposure of expectant mothers
and small children to untested and
untreated drinking water. Were healthcare
providers asking expectant or new
mothers about their drinking water
source? Were clinicians recommending
well water testing?
From Meeting to Action
The Indiana Public Health Laboratory
For organizations planning similar
events, the ISDH laboratory
recommends early budgeting
and partnership with a medical
organization to secure continuing
medical education (CME) units, which
are expensive and time-consuming
to obtain. In contrast, nursing
continuing education units proved to
be relatively easy to obtain and an
incentive to participation.
ISDH staff decided they needed
answers. With APHL meeting support,
the laboratory planned a meeting that
brought together environmental health
laboratory scientists, environmental
health specialists and clinicians—public
health nurses, OB/GYNs, pediatricians
and others—to discuss actions to protect
mothers and young children from the
effects of contaminated well water.
12
LAB MATTERS Winter 2019
The meeting demonstrated the value of
laboratory outreach to the environmental
health community, and notably to
clinicians. Participants contributed
creative ways to reach mothers with
information on well water testing. For
example, they suggested that information
be included on immunization schedules
for young children and obstetricians’
checklist for safe pregnancy. The ISDH
laboratory will pursue these leads with
support from the Special Supplemental
Nutrition Program for Women, Infants,
and Children (WIC) and the Indiana
section of the American Congress of
Obstetricians and Gynecologists (ACOG).
The ISDH laboratory is now working
with the Indiana Health Commissioner
to explore how the state can enlist
pediatricians to promote well water
testing for mothers and young children,
thereby becoming a model for other
states. Other plans include 1) an update
to Indiana’s pregnancy mobile phone
app to allow users to find recommended
well water tests and testing schedules,
certified laboratories and information on
treatment of unsafe well water, and 2) a
regular meeting of state environmental
health representatives with private well
water issues on the agenda. n
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