Small Victories - Our Culture of Health in Action!

Culture of Health in the drinking water industry means that we look at our daily routines and emergencies through a lens of protecting people’s health. We are an industry that works 24 hours a day to provide safe drinking water to everyone, and crucially to maintain societal functionality for sanitation and fire fighting. As we continue to promote our culture, we would like to share with you small examples that demonstrate how we put our culture into action! 

Newly Regulated Water System

Recently, we identified a newly registered public water system that was not disinfecting. The water system had indicated to the department that they would not be installing the disinfection system until they received approval from the department for the permanent design. Representatives of the water system reached out to the department to inquire if they could remove the two bathroom sinks in order to not provide human consumption and therefore not be regulated. While the department does not enforce the plumbing code, we are aware that not having sinks in the bathroom could create other sanitary health risks. We worked with the local public health officials and the city having jurisdiction to evaluate the situation further. We notified the water system that if the bathroom sinks were removed, the facility would be in violation of local building codes by not providing running water for sanitation in the bathrooms. The system decided to not remove the bathroom sinks. They installed the chlorination system and added a barrier to help lower bacterial contamination risk in their system. This is a small example of how we utilize our resources and partner with everyone involved to make sure that our water systems are well-informed. 

Broken Well Casing

During a sanitary survey, one of our inspectors identified that a water system's well was leaking significantly. The well cap was split open where an active electrical connection was penetrating the cap. The well was cycling every two minutes, causing water to pour out of the cap every time the well ran. The well pad and well cap was covered with water, algae, and leaves. When the well was not pumping, it was possible that water containing contaminants could leak back into the casing. This led to a concern that contaminated water could be entering the protected groundwater source. 

Our inspector referred the findings to our acute drinking water response team and coordinated with our compliance assurance section to evaluate the situation and identify a path forward. The system prioritized the well casing repair. However, we wanted to identify if there was an imminent health risk present. We requested that the system provide bacteriological samples from the source and at the entry point, increase the chlorine residual, and that the leak be addressed as soon as possible especially given an upcoming inclement sub-zero weather event. The next day, we followed up with the system to confirm that they had collected their samples as they were working to identify a repair contractor. All of the bacteriological samples came back absent for coliform and the water system repaired their casing very promptly. While the regulations officially allowed for a longer timeframe to respond, this quick action by everyone involved aligned with our culture of health and helped minimize risk to the public. 

➽ Drinking Water Compliance Team

Fluoride: A public health benefit and the role of the CDPHE

The Centers for Disease Control and Prevention (CDC) named fluoridation of drinking water one of the 10 great public health interventions of the 20th century. Since 1945, when the addition of fluoride to drinking water began, there has been a dramatic decline in tooth decay among children and reduction in tooth loss among adults. At optimal levels, water fluoridation improves the oral health of all residents, regardless of dental insurance coverage, access to health care, age, gender, income, race or ethnicity. 

What is drinking water fluoridation? 

Drinking water fluoridation is the adjustment of fluoride to an optimal level in accordance with scientific and dental guidelines. The US Public Health Service (PHS) has determined a fluoride concentration of 0.7 mg/L as the optimal concentration of fluoride in drinking water that maximizes fluoride’s oral health benefits while minimizing potential harms, such as dental fluorosis. Fluoride is a naturally occurring mineral present in varying amounts in almost all soil, water, plants and animals and a normal constituent of many diets. Naturally occurring levels of fluoride in drinking water sources are often too low for the benefit of cavity prevention and so water systems have the choice to add fluoride to the recommended optimal level. Water fluoridation is practical, cost-effective, and equitable for all members of the community. For every $1 invested by water systems in water fluoridation, Coloradans save an estimated $61 per person per year in dental care costs. Fluoride improves oral health by helping to prevent tooth decay through strengthening the tooth enamel and helping to remineralize tooth enamel lost to the acids in food and beverages. Fluoride also makes it harder for harmful bacteria to adhere to the teeth. Good oral health is an important part of good overall health and an essential part of our everyday lives. Diet, sleep, psychological status, social interaction, school and work are all affected by impaired oral health.

What is CDPHE’s role in water fluoridation?

The Colorado Department of Public Health and the Environment’s (CDPHE) Water Quality Control Division (WQCD) provides technical support to systems that add fluoride as part of their treatment process. WQCD also performs inspections of the fluoride treatment system as part of the sanitary survey process for regulated public water systems. WQCD performs these inspections under a “Memorandum of Understanding” with CDPHE’s Oral Health Unit (OHU) in the Prevention Services Division (PSD). Much like the monthly operating reports (MOR) surface water systems submit to show compliance with the Surface Water Treatment Rule, participating water fluoridating systems submit a monthly fluoride report to OHU for tracking optimal fluoride levels. CDPHE follows the PHS recommendation of 0.7 mg/L for the optimal fluoride level in drinking water. While water fluoridation in the state of Colorado is voluntary, the decision to add fluoride is held to the same drinking water standards; additives must meet NSF/ANSI standards, fluoride levels are monitored daily and reported monthly to OHU. 

The Environmental Protection Agency (EPA), through the Safe Drinking Water Act, has established national drinking water standards for public water systems. The EPA requires public water systems to comply with the maximum contaminant level (MCL) of 4.0 mg/L for fluoride in drinking water, with a secondary MCL of 2.0 mg/L. Public water systems that exceed the secondary MCL but are below the MCL are required to distribute public notice regarding the health effects of the elevated levels of fluoride. Recommended fluoride levels for the efficacy of cavity prevention are well below the EPA’s secondary MCL. A recent District Court case out of Northern California ordered the EPA to evaluate the public health risk of fluoride in drinking water under the amended Toxic Substances Control Act. Following the announcement of the Court’s opinion, the American Water Works Association, the American Dental Association, the American Academy of Pediatrics and the American Fluoridation Society have each reaffirmed support for optimal water fluoridation as safe, effective, and essential to the protection of the public’s health. CDPHE issued its own statement on October 14, 2024 in support of water fluoridation and will continue to review new and emerging research on water fluoridation.

For additional information about water fluoridation or further inquiries on the Court ruling, please reach out to the CDPHE OHU community water fluoridation program at cdphe.psfluoridationsmf@state.co.us.

➽ Aspen Coombs, P.E. WQCD Fluoride Liaison

Colorado Water Loss Initiative: Training and Technical Assistance for Water Loss Control

Water loss is water that is lost in a municipal distribution system between treatment and consumption. There are two types of water loss that lead to lost revenue and resources for systems and customers, real loss (leaky pipes) and apparent loss (metering inaccuracies, data handling errors). Real water loss typically occurs before any water meters, which are often located as the water enters buildings. This means that a utility is paying for all the cost of transporting the water from source to treatment plus treatment and distribution costs, but getting no revenue in return. 

Globally, water losses from drinking water supply networks account for 9 billion gallons a day of water use. Cost effective water loss management reduces cost and increases revenue, which improves a systems bottom line and better serves its customers. The Colorado Water Loss Initiative (CWLI) is a program developed by the Colorado Water Conservation Board (CWCB) that provides training and technical assistance to water providers. In November 2023, the Colorado Water Conservation Board instituted an annual water loss reporting requirement for systems supplying at least 2,000 acre feet of water per year to their customers. The CWLI was established to provide a comprehensive training program for systems as part of the Colorado Water Plan strategic objective to support water management activities for all water providers and drive water loss implementation to address future water needs.  The benefit to you, a training course on how to identify water loss, collect water loss data, audit and validate data, along with technical assistance to develop solutions to decrease water loss in your system. 

CWLI Training Program

The CWLI offers a training program to assist systems in learning the AWWA Free Audit Software and implementing the American Water Works Association (AWWA) M36 methodology to quantify water loss. Once systems have completed the data collection, auditing, and validation phase of training, they are then provided technical assistance opportunities to implement controls and tools to minimize water loss. Technical assistance can include activities such as meter testing and design analysis or billing data analysis and prorating. Grant assistance is available to program participants to remedy prioritized water loss interventions that were identified through the program.  

Who can benefit from the training?

All drinking water systems. Do you have a small system and aren’t required to report annual losses but still interested in water loss? No problem, small systems can benefit from the water loss program and are encouraged to register. Water loss best management practices can help all systems save water, money, prepare for water supply shortages, and prepare for future climate impacts. All systems will learn to take the appropriate steps toward effective water loss control management. 

How much is it? And where do I register for the program?

The program and materials are offered at no cost and are available to all eligible drinking water staff. See the below resources to learn more about the program

• Video interviewing participants about their experience
• CWCB Water Talk Podcast - CWLI staff discusses the program
• Register here for the program

Interested in helping to improve water loss control and management? Join the CWLI Committee!

The Colorado Water Loss Control & Management Committee was formally established in December 2023 by the Colorado Water Conservation Board. The committee's objective is to improve water loss control and management by planning water loss strategies, trade technical information, inform water loss policy discussions, train and educate water utilities on water loss, and support water loss goals of the Colorado Water Conservation Board. You can find more information at the Colorado Water Loss Control & Management Committee  website.  

➽ Angela Green Garcia, Drinking Water Training Specialist

➽ Kevin Reidy, DNR, Senior Water Efficiency Specialist