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BACKGROUND: On August 2, 2014, microcystin toxin was detected in finished water at a water treatment plant serving Lucas County, Ohio resulting in approximately 450,000 people being placed under a ‘do not drink’ advisory. The Toledo-Lucas County Health Department and the Ohio Department of Health, with assistance from the Centers for Disease Control and Prevention, conducted a Community Assessment for Public Health Emergency Response (CASPER) 6 weeks after the event.
METHODS: We developed a two-page questionnaire to evaluate public health impact, messaging and preparedness. The sampling frame was defined as households who received water from the Collins Park Water Treatment Plant in Lucas County. A two-stage cluster sampling design was used to randomly select thirty census blocks and then seven households from each block for in-person interviews. Interviews were conducted over four days in September, 2014. We used weighted cluster analysis to estimate response frequency representative of the entire sampling frame.
RESULTS: We completed 171 interviews, an 81.4% completion rate. We found 9% of households indicated having 3-day alternative supplies of water prior to the ‘do not drink’ advisory. Ninety-six percent first learned of the advisory the same day it was issued. During the advisory, households attempted to get water from a large store or grocery (67.6%), or a convenience store or gas station (18.2%). Six percent stayed overnight away from home in order to access water. Additionally, 16.2% of households reported subjective health issues associated with the advisory including diarrhea, nausea, abdominal pain, vomiting, and skin irritation or itching. Seven percent reported feelings of anxiety or stress and 5% reported loss of appetite as a result of the advisory. Seventy-three percent identified television as the most reliable information source during the advisory. Immediately after the advisory was lifted, 87.4% of households continued to use an alternative source of water, and six weeks later, 58.0% continued to use an alternative water source.
CONCLUSIONS: The small proportion of households that had 3-day supplies of water highlights a need to promote household emergency preparedness. The high proportion of households which continued to use alternative sources of water six weeks post advisory suggests the need for enhanced community education on current water recommendations. Additionally, assessment findings indicate television should be used in public messaging.