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Thursday, October 9, 2025

Acute Health Risks - Can it happen to you?

The below article is a re-run and update from an article published in the 2007 Summer Aqua Talk newsletter. Since then, the water sector has navigated many acute and emergency situations in partnership with the WQCD. We value your continued partnership and vigilance as you protect the public health and environment for our communities. 

We could all learn a little something from the Boy Scouts, especially when it comes to acute health risks in drinking water systems. Acute health risks that must be reported can be caused by events such as:

  • Acute total coliform maximum contaminant level violations (when fecal or E. Coli is present);
  • Failure to collect repeat samples after a fecal or E. Coli positive sample;
  • Failure to test for fecal or E. Coli in a total coliform positive repeat sample;
  • Nitrate, nitrite or total nitrate nitrite maximum contaminant level violations;
  • Failure to take nitrate or nitrite confirmation sample within 24 hours after receipt of the first sample showing exceedance of the maximum contaminant level;
  • Surface water treatment rule violations, such as not using a filter cartridge, not feeding coagulant, or a single exceedance of the maximum allowable turbidity limit or failure to maintain chlorine level entering the distribution system; etc).
  • Suspected waterborne disease outbreak;
  • Situations such as depressurization of a distribution system due to a line break or loss of power;
  • Uncontrolled cross connections that contaminate the water supply;
  • A treatment or supply emergency (for example, failure or significant interruption of key water treatment processes, a natural disaster that disrupts water supply, chemical spill or unexpected loading of pathogens);
  • Tampering or vandalism that could have contaminated the water supply

Preparing for these situations can save lives, not to mention save you time and money. To help you keep your cool in a stressful situation, consider preparation measures such as:

  • Plan: Gather necessary forms and phone numbers, including the 24-Hour incident reporting hotline (877) 518-5608. 
  • Be familiar with the Public Notice wizard to create public notice templates and think through possible acute situations.
  • Designate people responsible for specific activities, make sure your Operator Delegation Plan is up to date.
  • Practice with benchtop exercises/drills. Use this coaching request form to request a  Local Assistance Unit benchtop exercise for your facility.

If your system has experienced tampering or suspected tampering, including a cyber attack, you are required to notify the Colorado Department of Public Health and Environment immediately. For details, see section 11.2(1) of the Colorado Primary Drinking Water Regulations and visit the Drinking Water Security Response Toolbox. Report physical and cyber security incidents to the WQCD Tampering Threat and Incident Report Form

For more information about acute procedures, please check Drinking Water Policy DW-0001 Response to Acute Health Threats from Public Water Systems, the Pressure Loss and Main Break Guidance and the Drinking Water Emergency information website.

CoWarn, the statewide Water/Wastewater Agency Response Network (CoWARN) of utilities helping utilities to prepare for the next natural or human-caused emergency is also a resource to help public water systems.

By being prepared, water suppliers can effectively handle emergency situations and potential acute situations to protect public health. 

➽ Heather Young, PE, CWP, Field Services Section Section Manager 

➽ Emily Clark, Drinking Water Enforcement Unit Manager