Abstract：
Private well users in Ontario are responsible for ensuring the potability of their own private drinking water source through protective actions (i.e., water treatment, well maintenance, and regular water quality testing). In the absence of regulation and limited surveillance, quantitative microbial risk assessment (QMRA) represents the most practical and robust approach to estimating the human health burden attributable to private wells. For an increasingly accurate estimation, QMRA of private well water should be represented by a coupled model, which includes both the socio-cognitive and physical aspects of private well water contamination and microbial exposure. The objective of the current study was to determine levels of waterborne exposure via well water consumption among three sub-groups (i.e., clusters) of private well users in Ontario and quantify the risk of waterborne acute gastrointestinal illness (AGI) attributed to Giardia, shiga-toxin producing E. coli (STEC) and norovirus from private drinking water sources in Ontario. Baseline simulations were utilized to explore the effect of varying socio-cognitive scenarios on model inputs (i.e., increased awareness, protective actions, aging population). The current study uses a large spatio-temporal groundwater quality dataset and cross-sectional province-wide survey to create socio-cognitive-specific QMRA simulations to estimate the risk of waterborne AGI attributed to three enteric pathogens in private drinking waters source in Ontario. Findings suggest significant differences in the level of exposure among sub-groups of private well users. Private well users within Cluster 3 are characterised by higher levels of exposure and annual illness attributable to STEC, Giardia and norovirus than Clusters 1 and 2. Provincial incidence rates of 520.9 (1522 illness per year), 532.1 (2211 illness per year) and 605.5 (5345 illness per year) cases/100,000 private well users per year were predicted for private well users associated with Clusters 1 through 3. Established models will enable development of necessary tools tailored to specific groups of at-risk well users, allowing for preventative public health management of private groundwater sources.
摘要：
安大略省的私人井用户有责任通过保护行动确保自己的私人饮用水源的可使用性（即，水处理,良好的维护,和定期水质测试)。在缺乏监管和有限监督的情况下，定量微生物风险评估（QMRA）代表了最实用和可靠的方法来估计可归因于私人水井的人类健康负担。为了越来越准确的估计，私人井水的QMRA应该用耦合模型来表示，其中包括私人井水污染和微生物暴露的社会认知和物理方面。本研究的目的是确定三个小组之间通过井水消耗的水暴露水平(即，集群）安大略省的私人井用户，并量化归因于贾第虫的水传播急性胃肠道疾病（AGI）的风险，来自安大略省私人饮用水源的产志贺毒素大肠杆菌（STEC）和诺如病毒。基线模拟被用来探索不同的社会认知情景对模型输入的影响(即，提高认识,保护行动,人口老龄化)。本研究使用大型时空地下水质量数据集和全省范围的横断面调查来创建特定于社会认知的QMRA模拟，以估计安大略省私人饮用水源中归因于三种肠道病原体的水传播AGI的风险。研究结果表明，私人油井用户亚组之间的暴露水平存在显着差异。集群3中的私人油井用户的特点是暴露水平较高，每年因STEC而患病。贾第虫和诺如病毒比簇1和2。省级发病率为520.9（每年1522种疾病），对于与集群1至集群3相关的私有井用户，预测为532.1（每年2211种疾病）和605.5（每年5345种疾病）病例/每年100,000个私有井用户。建立的模型将能够开发针对特定风险井用户群体的必要工具，允许对私人地下水源进行预防性公共卫生管理。
