Strengthening collaborations for water-related risk communications

Collaborations between water utilities, public health and clinical personnel are essential during water contamination events. Few formal mechanisms are in place, however, to ensure that effective risk communications will occur either on an emergency or routine basis. The focus of this AwwaRF-sponsored project is on advancing three-way collaborations by building on lessons learned from recent initiatives, developing a Framework for Action to facilitate collaborations, and evaluating it under different scenarios. The foundation for the Framework includes literature reviews, surveys, interviews, workshops, and tabletop exercises. More that 100 utilities, 160 health departments and 40 clinicians have contributed to this project. Most of the utilities were publicly owned and served up to 100,000 customers. Ninety percent had worked with local public health agencies (LPHAs); one-third with clinicians. The participating clinicians were mostly environmental health specialists. Although they were willing to work with utilities, very few clinicians had ever done so. Utility, LPHA and clinical personnel felt that the public's concerns about drinking water issues are growing. Key themes that emerged across all project activities relate to establishing and sustaining long-term, trust-based relationships; identifying appropriate organizations and individuals with whom to interact; developing mechanisms to institutionalize relationships; and building knowledge about each others' interests, priorities, roles, and responsibilities. Utilities and clinicians prefer health departments to inform clinicians about water issues, but LPHAs do not have the resources for this role. Our Framework for Action assists potential partners with: ascertaining their current resources, roles, and responsibilities; creating routine and emergency response plans; and evaluating collaborations. The Framework was evaluated in tabletop exercises. The project results related to emergency conditions are the focus of this paper.