1

Effective Risk Communication: A Guide to Best Practice

Techneau, December 2010

2

© 2009 TECHNEAU TECHNEAU is an Integrated Project Funded by the European Commission under the Sixth Framework Programme, Sustainable Development, GloBal Change and Ecosystems Thematic Priority Area (contract number 018320). All rights reserved. No part of this book may be reproduced, stored in a dataBase or retrieval system, or published, in any form or in any way, electronically, mechanically, by print, photoprint, microfilm or any other means without prior written permission from the publisher

TECHNEAU Effective Risk Communication: A Guide to Best Practice

Techneau, July 2010

3

Colofon

Title

Effective Risk Communication: A Guide to Best Practice

Authors

Dr Tanika Kelay Prof Chris Fife-Schaw Quality Assurance

Dr Jonathan Chenoweth Deliverable number D 6.3.1 D 6.3.2

4

Table of Contents

Executive Summary...............................................................................................................................6 1 Introduction.........................................................................................................................................8 1.1 Approach ......................................................................................................................................8

2 Risk Perception and Communication ..............................................................................................9 2.1 Trust and Confidence................................................................................................................10 2.2 How to Promote Trust and Confidence..................................................................................12 2.3 The Role of Emotion ..................................................................................................................14 2.4 Clarity about the goals of communication and the target audience...................................15

3 Handling Crises ................................................................................................................................18 3.1 Advanced Planning ...................................................................................................................19 3.2 Timing of Communications......................................................................................................20 3.3 Responsiveness ..........................................................................................................................22 3.4 Develop Partnerships with the Media ....................................................................................23 3.5 The Role of the Web and Mobile Communications Technologies ......................................24 3.6 Summary and Conclusions ......................................................................................................25

4 Promoting Acceptance of Longer Term Initiatives: Re-use and Desalination .........................26 4.1 Why do you want to communicate with the public?............................................................26 4.2 Options for Participation ..........................................................................................................30 4.3 Potential Problems with Participative Approaches ..............................................................32 4.4 The ‘Yuck Factor’ .......................................................................................................................34 4.5 Summary and conclusions .......................................................................................................35

5 References ..........................................................................................................................................37 Appendix 1. Short-term Contamination Events: Case Studies from the Water Sector ..............46 Case Study 1: Bergen Giardia Outbreak, Norway ......................................................................47 Case Study 2: Milwaukee Cryptosporidium Outbreak..............................................................52 Case Study 3: Lilla Edet, Sweden ..................................................................................................57 Case Study 4: The Sydney Water ‘Crisis’ ....................................................................................62 Case Study 5: Burncrooks Diesel Incident, Scotland, United Kingdom...................................65 Case Study 6: Walkerton E Coli Outbreak ...................................................................................70 Case Study 7: Pitsford Cryptosporidium Outbreak, Northampton, UK .................................75 Case Study 8a: The Cwellyn incident, Wales, United Kingdom..............................................78 Case Study 8b: Suspected Cryptosporidium Outbreak, Gwynedd, Wales .............................83 Case Study 8c: Suspected Cryptosporidium Outbreak, North Wales, UK..............................85 Case Study 8d: Suspected Coliform Contamination, Flintshire and Denbighshire, Wales...87 Case Study 9: E.Coli Outbreak, Dublin.........................................................................................89 Case Study 10: Bramham Incident, Yorkshire, England ............................................................91 Case Study 11: Pittfield, Massachusetts Giardiasis Outbreak ...................................................93 Case Study 12: The WEM Incident, Worcester, United Kingdom ............................................94 Case Study 13: Mythe Incident, Gloucestershire, England ........................................................97 Case Study 14: North Battleford, Saskatchewan Cryptosporidium Outbreak.....................100 Case Study 15: Gideon, Missouri Salmonella Outbreak...........................................................102 Case Study 16: The Oslo Tap Water Case, Oslo, Norway........................................................104 Case Study 17: Leidsche Rijn, The Netherlands ........................................................................108 Case Study 18: Waterborne Salmonella Outbreak, Alamosa, Colorado, USA ......................110 Case Study 19: Noord--Holland Incident, the Netherlands.....................................................112 Case Study 20: The Nokia Water Crisis ......................................................................................114

Appendix 2. Long-Term Project Implementation Scenarios: Case Studies from the Water Sector ...................................................................................................................................................119 Case Study 21: Redwood Shores Recycled Water Project, California, USA ..........................120

5

Case Study 22: East Valley Water Reclamation Project, USA..................................................125 Case Study 23: Orange County Water District & Orange County Sanitation District Groundwater Replenishment System, USA...............................................................................127 Case Study 24: NEWater, Singapore ...........................................................................................129 Case Study 25: Irvine Ranch Water Recycling Program, California, USA.............................131 Case Study 26: Monterey County Water Recycling Project, California, USA .......................132 Case Study 27: San Diego Water Purification Project, California, USA ................................134 Case Study 28: San Gabriel Valley Groundwater Recharge Project, California, USA..........136 Case Study 29: Caloundra and Maroochy Wastewater Project, Australia.............................138 Case Study 30: Water Futures Project, Toowoomba, Australia...............................................140 Case Study 31: Denver Water Department Potable Reuse Demonstration Project, Colorado..........................................................................................................................................................144 Case Study 32: Tampa Water Resource Recovery Project, Florida, USA...............................145 Case Study 33: Noosa, Queensland, Australia ..........................................................................147 Case Study 34: Kernell Desalination Plant, Australia...............................................................148 Case Study 35: Beckton Desalination Plant, United Kingdom................................................150 Case Study 36: Dhekelia & Larnaca Desalination Plants, Cyprus ..........................................153

6

Executive Summary

To compile this guide we have looked at a range of case studies that can be broadly put into two categories; short term crisis handling scenarios and longer term planning and development scenarios. In the former we look at how people have handled what are usually contamination events. In the latter we look at attempts to introduce new treatment processes, usually re-use or desalination. In both cases citizen’s continued good will needs to be maintained or regained so that either information is acted on appropriately or that major decisions are accepted and projects are not derailed. We have drawn on a range of sources to compile the case studies including existing published reviews, the literature relating to specific cases, media reports and personal communications with water companies. The main body of the text discusses a range of communication practices and attempts to identify best practice for the two broad scenario categories. The Appendices provide brief overviews of the case studies used to generate the report and are of interest in their own right. From the case studies we are able to draw some general conclusions and recommendations. For crisis events:

• Have contingency plans prepared in advance and make sure these are shared with other agencies likely to be involved in incident handling.

• Planned joint incident handling (e.g. with hospitals, national safety bodies, the police etc.) will suggest to the public a high degree of foresight and competence and it is unlikely that all the bodies involved will be simultaneously regarded as untrustworthy by the public.

• Ensure that there are contingency plans to allow sufficient means available for the public to get in contact with you using the methods they are likely to want to use.

• Use the web and SMS technologies to your advantage by ensuring regularly updated information is available during an incident.

• Consider having a single human face of the company or municipality as the primary conduit to the media.

• Empathise with consumers and make it clear that you understand the inconvenience being caused.

7

• Do not issue information unless you are certain of its accuracy. Explaining that you do not know something but are investigating it is preferable to issuing inaccurate information.

• Consider exploiting social networks and SMS technologies to facilitate quick communications.

• Build good relations with the news media over time so that they are sympathetic to your problems when you need them to help in a crisis.

For longer-term major investment scenarios:

• A number of major infrastructure investment schemes have failed due to public opposition in the last two decades.

• In general, attempts to engage the public actively in the decision making process lowers the likelihood of expensive project implementation failures.

• A number of engagement options are available though a successful campaign is unlikely to rely on just one of these.

• Active public engagement is likely to be more expensive than simple, one-way communication strategies.

• Active public engagement needs to be planned and is likely to slow down the decision making process.

• As a result of the above careful consideration needs to be given to the aims and scope of communication exercises and these need to be weighed against the available resources and other political and time constraints.

• Collaborating openly with other trusted information sources may enhance your credibility.

Finally, to help the industry in the future better understand what contributes to successful and unsuccessful communication campaigns we encourage companies to publish their own in-house evaluation research and reviews.

8

1 Introduction

This TECHNEAU report is intended to give an update on best practice in communicating with the public. In particular it deals with communicating about risks in both the short term, during incidents, and in the longer term, in the context of seeking support for major developments and other initiatives such as introducing water recycling schemes. The risk communication literature is now relatively large and a lot of effort in recent years has been devoted to this as governments, industries and businesses have come to recognise that public views and consequent behaviours may have substantial impacts on their activities. Various attempts have been made to produce sets of guidelines but risk communication, by its nature, is not a simple matter. In this respect we agree with the OECD which, in its guidance document on risk communication for the chemical industry concluded that “…this document is not a recipe book. Even if one was to piously follow all the advice given, the success of communication could not be guaranteed. Communication deals with individuals and groups. All efforts of communicating with them are attempts to initiate a rational and fair dialogue about the potential benefits and risks of certain activities and products, but cannot determine by itself the outcome of this dialogue” (OECD, 2002, 14). Having made this cautionary opening remark there is nonetheless plenty of useful guidance in the literature and the case studies that we present here that highlights what tends not work and what, if adopted with due care, is more likely to succeed in achieving communication goals. We start with a review of what is already regarded as good practice and follow this up by linking this with our case studies. The case studies themselves are in the appendix and are worth reading in their own right.

1.1 Approach

To compile this guide we have looked a range of case studies that can be broadly put into two categories; short term crisis handling scenarios and longer term planning and development scenarios. In the former we look at how people have handled what are usually contamination events. In the latter we look at attempts to introduce new treatment processes, usually re-use or desalination. In both cases citizen’s continued good will needs to be maintained or regained so that either information is acted on appropriately or that major decisions are accepted and projects are not derailed. We have drawn on a range of sources to compile the case studies including existing published reviews (e.g. Hrudey and Hrudey, 2004; Southern California Water Recycling Projects Initiative [SCWRPI] 2004), the literature relating to specific cases, media reports and personal communications with water companies. What is notable about the published literature is that with rare exceptions (e.g. AWWARF, 2004; SCWRPI, 2004; Marks, 2006) the orientation of reports has not been on

9

communication issues per se but is usually concerned with more technical matters that focus on what went wrong (or right) rather than how relationships with the public were conducted. As such it is often difficult to assess exactly what was done to communicate with the public and nor is it straight forward to work out whether the approaches adopted actually ‘worked’ or not. In some cases it is very clear that things went wrong (e.g. projects had to be abandoned, key figures had to resign) but it is rare for there to be any formal, published research assessing the impact of water companies’ communications on their consumers even when there are formal post-event inquiries. While such assessments are sometimes made by companies these are usually regarded as commercially or politically sensitive and are thus not readily accessible. We are grateful to those companies who have felt able to share their research with us and would encourage others to make their research available to future researchers. With these caveats in mind what follows is a discussion of what we know about good communications practice in crisis management and longer term planning and development scenarios. Though the water supply has some unique features much of what has been learned in other risk domains is relevant and we have not attempted to unnecessarily re-invent the wheel. So, we draw on the wider literature on risk communication and the theories it has generated and try to link these to our water industry-specific case studies. The cases are to be found in appendix 1 and are numbered for quick reference.

2 Risk Perception and Communication

Getting risk communication right is necessary in order to ensure that people and institutions behave in ways that promote their well being and safety, and in order to ensure that people and institutions accept changes (e.g. technological, political, legal, economic etc) that others deem necessary (Breakwell, 2007). The risk communication literature primarily deals with how to communicate with citizens about hazards and the greater part of the research initiative has focussed on man-made technological hazards more so than naturally occurring ones, though many of the principles elucidated are similar. A theme running through much of the early literature was how to persuade lay people that the risks associated with a hazard were not as high as they thought and that they should therefore accept expert assessors’ lower risk estimates. A typical example is the finding that many people regard the citing of a nuclear power plant in their locality as more likely to lead to their premature death than a lifetime’s worth of crossing the road. Actuarial assessments would suggest a greater likelihood of death from crossing the road yet people worry much more about nuclear power stations than crossing the road and are thus more likely to engage in action to avoid exposure to nuclear power stations (see Slovic, 1987). Without going into a full history of risk perception and risk communication research (see Breakwell, 2007 for an overview) a key idea that emerges again and again is that

10

personal feelings of control are important to people. People can choose when to cross the road but generally speaking they have little control over where power stations are built. When personal control is lost or is not possible then people are forced to hand over control to others and they have to believe that these other agents have their best interests at heart – they have to trust them. This is particularly so in the case of water supplies. Most people have no real alternative but to rely on water suppliers to deliver safe water to them and to deliver it to them in sufficient quantities, for them to carry on with their day to day lives.

2.1 Trust and Confidence

Trust is a key factor in encouraging cooperative action generally – this is a well-understood psychological phenomenon (Siegrist, Earle & Gutscher, 2003). It is therefore usually assumed that public trust is important in determining the acceptability of any proposal from an agent to change the status quo. Where such agents have to deal with critical incidents agents that are trusted will be able to contain negative public reactions much more effectively than those that are not and that it is vital to safeguard existing levels of trust in the way that such events are handled. Thus much emphasis in risk communication is actually placed on attempts to enhance public trust rather than simply to communicate information about risks. Indeed risk contexts are usually characterised by uncertainty so that believing a communication often relies on the public trusting that what is being said is complete and accurate. Trust, however, is not a single unitary construct and often this is ignored in the way we talk about enhancing trust in risk communications. Following Siegrist et al. (2003) it is important to recognise the distinction between social trust, which involves some judgement of similarity of values and intentions - so-called ‘morality’ information - and confidence which is a belief based on past experience that events in the future will occur as expected – i.e. somebody is in control and knows what they are doing. Social trust, in handing over control to someone else, is a feature of a social relationship where one has to impute openness, fairness and integrity to this other agent. You have to ask ‘does this agent have my best interests at heart?’ Confidence that something will happen on the other hand does not necessarily involve trusting the motives or values of the agents involved; it does, however, involve assessments of that agent’s competence.

To take a water-related example, after a lifetime of uninterrupted good quality water supplies a consumer might have developed confidence that there will continue to be good water coming out of their tap. It may not be necessary to have to trust the motives and values of the water company to continue to feel safe when using tap water. In the context of electricity supplies Siegrist et al. (2003) show that where past good performance has led to high confidence in the supply, trust in the supplier is essentially unimportant.

Social trust comes into play when something goes wrong and it is no longer possible

11

to be confident about the future on the basis of past performance. Similarly in situations where there is little past experience upon which to assess competence and thus confidence, social trust will become more important and may be used to guess at the likely competence of the supplier. Where a change is proposed, say the introduction of waste water recycling, there will be no direct experience for consumers to use as a basis for their confidence estimates and thus social trust based on an assessment of the supplier’s motives becomes important.

Earle and Siegrist’s (2006) Trust, Confidence and Cooperation (TCC) framework is a general model intended to be applicable to all aspects of trust between an individual and both known and unknown agents including utilities. The framework is presented in Figure 1.

Figure 1 Earle and Siegrist’s (2006) Trust, Confidence and Cooperation Framework.

The model is focused on explaining why people might cooperate with another agent. Cooperation implies any compliance or acceptance behaviour and could include acceptance of supply interruptions, complying with boil water notices, willingness to use recycled water etc. The model suggests that social trust is based on morality-relevant information, while confidence is based on performance–relevant information. In times of low uncertainty, when morality information is less relevant, social trust does not play the main role in cooperation – people will cooperate without questioning the motives of the company. It also suggests that social trust becomes more important in times of uncertainty, when morality information becomes more relevant and it hypothesises that social trust will affect judgments of confidence both directly and via effects on perceived performance (Earle and Siegrist, 2006, p388, see also Haddad, 2004; Po et al., 2005).

12

Social trust is more fundamental than confidence and judgements of confidence presume pre-existing relations of trust. It is assumed that where social trust levels are high some performance failings might lower confidence but would not fundamentally undermine a willingness to cooperate. As a corollary, when social trust is low, performance failures should lead to a quick negative response from consumers, such as complaints or a lack of cooperation. We draw on these ideas when looking at some of the case studies.

In most risk communication contexts social trust comes to the fore since by definition risk communication is about some form of uncertainty. It is well understood that it is easy for people to lose trust in agencies when things go wrong especially if the agent’s motives are in question (see Case Studies CS2: Milwaukee; CS3: Lilla Edet; CS6: Walkerton, and CS14: North Battleford). It is also well understood that rebuilding trust takes considerably longer than it does to lose it. The reasons for this are probably related to survival mechanisms developed when humans first came to live in organised societies that devolved specialised functions to individuals. Individuals who could not be trusted to execute these functions posed a threat to the common good and so after a failure of some sort it was important to be very sure that their motives were genuine before they were allowed to resume their responsibilities. From this perspective it is understandable that agents that lose the citizens’ trust can expect to have to work hard to restore it.

2.2 How to Promote Trust and Confidence

The things that promote trust and confidence are likely to differ. The following list some of the more obvious approaches that have been discussed in the past (e.g. OECD, 2002; Seeger, 2006; Venette, 2006; Sellnow, Ulmer, Seeger and Littlefield, 2009).

Some things that can promote social trust: • Honesty. Accept responsibility for a failure that you are responsible for as this

indicates honesty and ethical behaviour. In the current climate the threat of litigation may serve as an incentive to be less than completely honest but if the public come to believe that you are primarily motivated to avoid litigation they are unlikely to trust you. If information subsequently emerges to show that information had been intentionally withheld serious damage to trust levels will be done.

• Candour. Communicate the entire truth even when it does not reflect well on you. If

you do not know answers to questions admit that you do not know and are either in the process of finding out the answer or will be in the very near future. Not knowing something may lead people to question your competence and thus lower confidence but it reinforces people’s assessment of your honesty and enhances assessments of social trust which is ultimately more important.

• Acknowledge the public’s problems. Being clear that you understand the impact of

your actions (or inaction) on the public, both practically and emotionally, indicates that you are aware of their interests and are concerned for their well-being. Appearing to regard the public’s problems as trivial or an inconvenience raises questions about the degree to which you are concerned for their interests.

13

• Linked to the above, be prepared to listen to other people’s problems

sympathetically even if this appears time consuming. • Avoid blaming others for problems. Even if a problem is actually the fault of

someone else, enthusiastic finger-pointing suggests an eagerness to escape any responsibility and a concern with avoiding litigation.

• Be available to be questioned by the public and the media at times which suit them.

The CEO of BP, Tony Hayward, was famously caught watching a yacht race in the UK during the height of the Deepwater Horizon oil spill in the Mexican Gulf when most of the world’s media had expected him to be in the USA available for comment on the disaster. The negative press coverage was particularly damaging.

• Help others to help themselves. Offering useful, practical advice can reflect well on

your motives as well as suggesting some level of competence. • Use a single visible spokesperson. People are more likely to trust a known

individual than a faceless institution or company. Motives can be inferred from (trustworthy) non-verbal cues and speech mannerisms as well as what is actually said. If you are a company or authority, having a single human face to represent you will allow the public to assess your motives more readily.

• Build relationships with customers over a period of time so that people understand

your motives in advance of crises or events. • Build relationships with the media so that they know that your intentions are

honourable.

Some things that can promote confidence: • Release statements only when you are confident that they are true. Releasing

information that you are not certain about for the sake of saying something runs the risk of the information being contradicted later on making you look less competent.

• Point to your successful actions where they are real (“we had water bowsers in

place within 24 hours”). • Have contingency arrangements to deal with incidents planned in advance and

ready to deploy. Let people know what these are….. • ….but do not claim that these are foolproof. The foolproof contingency plan

probably does not exist so if/when it fails to live up to expectations people will regard you as incompetent.

• Have sufficient means available for the public to contact you. For example

having insufficient helpline operators available during an incident suggests a lack of planning for emergencies.

• Liaise with other responsible bodies to avoid presenting contradictory messages. • Collaborate openly with other trusted information sources. If multiple credible

bodies can endorse the same message it is a confirmation that your message is reasonable and it is unlikely that even if you are not trusted that the public will also not trust the other groups.

14

2.3 The Role of Emotion

A good deal of research shows that trust is related to the perception and acceptance of risk (e.g. Bord and O’Connor, 1992; Freudenburg, 1993; Siegrist, 1999) and it is usually assumed that trust influences perceptions of risk which in turn influence acceptability. Broadly, if an organisation or authority is trusted then perceptions of risk arising from any proposals they make will be lower and thus the public will be more accepting of these. Numerous studies show correlations between trust, risk perception and acceptance but this merely demonstrates that the three constructs are linked; it does not indicate how they are linked.

Eiser, Miles & Frewer (2002) and Poortinga and Pidgeon (2005) both address this issue and define two alternative models of the relationship between trust, risk perception and acceptance. The model suggesting that trust leads to lowered risk perception which leads to acceptance is referred to as the ‘causal chain’ account of trust and is illustrated in figure 2.

Figure 2. The Causal Chain Model

The alternative view, referred to as the ‘associationist view’, argues that trust can be an outcome of acceptance rather than a factor implicated in promoting it. Here it is proposed that people initially respond to a potential proposal on the basis of how they feel about it and their willingness to accept it is made on the basis of affective reactions which are made before extensive cognitive processing of other relevant information (cf. Finucane, Alhakami, Slovic & Johnson, 2000). This is referred to as the ‘affect heuristic’ – that affect precedes cognition and in certain situations emotional responses precede thought.

Figure 3. The Associationist Model

Both Eiser et al’s. (2002) and Poortinga and Pidgeon’s (2005) studies suggest that in the context of genetically modified food the associationist model seemed to give a better account of the data. While there was, in the latter study a small residual direct influence of trust on risk perceptions it seemed that people’s existing evaluations of gene technologies seemed to drive levels of trust.

15

If it is true that sometimes people will respond to a potential hazard using something like an affect heuristic and this response influences both trust and risk perceptions then the water industry’s concern to work on improving consumer relations in order to enhance trust is unlikely to have the effect of lowering perceptions of risks from potential water supply hazards.

This is not to suggest that fostering trust is pointless - there are plenty of good reasons to have trusting relationships with consumers – but there may be a case for limiting expectations of positive knock-on effects in terms of acceptance of change or technological advance. The implication of what we have said is that the role of trust and the likelihood of acceptance will be different for proposals such as direct potable re-use proposals where the ‘yuck factor’ may be higher than where, for example, desalination is proposed (Haddad, 2004; Marks, 2006).

2.4 Clarity about the goals of communication and the target audience

Communications, even mundane, day-to-day ones, are usually more successful when they are planned and have a clearly understood purpose (or purposes). Clarity about who the audience(s) for the message is essential. In times of rapid dispersed communication via the web and mobile telephones it is relatively rare to be able to communicate something to a target audience with no possibility of other audiences also being exposed to the message so it is important to consider alternative interpretations of your messages that may be made by others. Risk communication comprises more than simply communicating information about risks to the public; it can also include communication via public participation, mutual decision-making and two-way opportunities for dialogue and consultation. A similar typology is used by AWWARF (2004), who classify public engagement according to purpose, for example: Getting information to the public Getting information from the public Methods for exchanging information Methods for making decisions collaboratively

Source: AWWARF Public Involvement Strategies: A Managers Handbook, 2004

One-way communication tends to be more appropriate to short term scenarios e.g. contamination events, where information needs to be disseminated to the public quickly and time for meaningful exchange is limited. Two-way communication emphasises dialogue which tends to be more relevant to long-term planning scenarios (Seeger, 2006). In the context of short term risk events, Seeger (2006) says that risk communication is most effective when it is part of an ongoing and integrated process, “when crisis

16

communication follows a process model, it is more comprehensive and systematic in addressing the entire range of strategies from pre- to post-event” ( 237). Here, pre-event communication activities may include communication planning, and educating the public about preparation, whilst post-event activities include communication activities that include lessons learned, and rebuilding any damaged relationships. Seeger (2006), while focussing more on crisis management nonetheless points to the importance of strategic planning, considering the goal of communication, and developing pro-active strategies such as developing partnerships with the public which are equally applicable to long-term scenarios. Strategic planning should be an evolving process that allows for new developments, with continuous evaluation and updates. In the case of both short and long term scenarios, agencies should identify the potential hazards that they face, and have plans in place for preventing or managing them should they occur. The National Center for Food Protection and Defense the following cyclical process model for communication:

Best Practices in Risk and Crisis Communication

National Center for Food Protection and Defense (Source: Seeger, 2006).

Such ongoing processes are the steps to building public perceptions of trust, confidence and credibility, where previous research has shown that establishing positive relationships before risk events is critical to successful management (Ulmer, 2001). Indeed favourable past experience will “translate into believability and trust between the public and those seeking to manage the event. Conversely, organisations that fail

17

to develop credible, trusting relationships prior to a crisis will have an exceptionally difficult time doing so after a crisis occurs. In fact, lack of credibility may significantly enhance the probability of harm.” (Seeger, 2006, 234). In cases where public trust is already low, agencies may need to rethink communication strategies, perhaps by enlisting independent information sources that command a higher level of trust (Kasperson & Kasperson, 2005, 24), and will need to work towards rebuilding and recovering trust and confidence. The OECD (2002) also draws attention to the importance of enhancing trust and credibility saying that: “Establishing and gaining trust is a complex task that cannot be accomplished simply by applying certain operational guidance (such as declaring empathy) in a mechanical fashion. There is no simple formula for producing trust. Trust grows with the experience of trustworthiness. Nobody will read a brochure, attend a lecture, or participate in a dialogue if the purpose is solely to enhance trust in the communicator. Trust is the invisible product of a successful and effective communication on issues and concerns. The less the word is alluded to in a communication, the more likely it is that trust will be sustained or generated. There is only one general rule for building trust: listening to public concerns and, if demanded, getting involved in two-way communication. Information alone is never sufficient at building or sustaining trust. Without systematic feedback and dialogue there will be no atmosphere in which trust can grow” (our emphasis)

Source: OECD (2002) 51

For the purposes of this report we have divided the types of communication into those appropriate for short term crisis handling and those appropriate in the context of longer term planning and the introduction of new proposals. In the former the communication goal is usually to alert the public to a potential problem and make them ready to take harm avoiding action (usually not consuming contaminated water). Issues to do with trust maintenance are somewhat secondary. In the latter the goals are more complex and can involve attempts to engage in genuine dialogue and promote joint decision making or, less ambitiously, to persuade the public that a particular proposal is acceptable or the least bad option available.

18

3 Handling Crises

In a review of crisis communication, the World Health Organisation (2004) recognised that effective communication during an outbreak poses many challenges, often unique to the contaminant in question, as well as the broader political, economic, and cultural context in which the outbreak occurs. The added feature of outbreaks is that they are usually alarming events that can elicit anxiety amongst the general public which can endure even after threats to health have subsided. The effects of outbreaks may be long lasting, incurring economic losses and social disruption. The WHO (2005) adds that outbreaks often gain a high political profile, depending on how the incident is handled. In negative terms, “outbreak control can be severely impeded when political authorities, motivated by economic rather than public health concerns, decide to withhold information about an outbreak, downplay its significance, or conceal it altogether” (WHO, 2005, 8). Case Studies (CSs) 2: Milwaukee; 3: Lilla Edet, 5: Burncrooks, 6: Walkerton and 14: North Battleford, are examples of this. Linked with the characteristics of unfolding events and the high political profile attached to outbreak events is the media attention that such events naturally attract. The impact and implications of the media interest varies immensely; on a positive level the media can be used effectively, especially at the onset of an outbreak in order to inform the public quickly. Good reporting can create an ‘informed public’, which “translates technical information into lay language and can help the public understand the situation, including its implications for their own health and behaviours” (WHO, 2005, 8). On the other hand media reports can also fuel public anxiety: “Exaggerated coverage of an outbreak is far more likely to occur when official information is either absent or considered untrustworthy. In the absence of constantly flowing information from a respected source, rumours will fill the void and take on a life of their own. If officials are not available for comment, reporters will find their own experts and launch their own investigations. Even when the flow of official information is rapid, media competition to be the first to report a new development means that press reports will often pre-empt official communications, placing great pressure on officials to demonstrate that they are fully informed and in control of the situation” (WHO, 2005, 8). Generic principles of best practice as promoted by the World Health Organisation, in the context of handling outbreaks are as follows:

1. Build trust 2. Announce early 3. Be transparent 4. Respect public concerns 5. Plan in advance

Source: Outbreak Communication. Best Practices for Communicating With the Public During an Outbreak,

WHO, 2005

19

In reviewing risk communication in the context of chemical risks, the OECD, recognise that even in organisations with excellent performance records, unexpected crisis events may occur, including technical failures such as explosions or accidental release of chemicals, human or organisational errors caused by negligence, external natural events (e.g. flooding, earthquake), external human events (e.g. sabotage, terrorism, or due to social unrest or public outrage based on false or distorted information (OECD, 2002, 24). The case studies demonstrate a range of causes of incidents, a range of official responses to incidents, and subsequent range of public responses, outcomes and implications for risk communication. Also, as seen in the Milwaukee case, CS2, the ways in which an incident is handled by officials can have both positive and negative implications for the overall outcome of the outbreak itself (Sellnow et al. 2009, 68). The case studies also show that incidents can have broader implications for the water sectors involved; of course technical lessons learned will have regulatory and legislative impacts but there can also be social impacts in terms of the potential to influence future decisions and proposals due to diminished levels of public trust and confidence. For example, the Sydney Water ‘Crisis’ (CS4), although a ‘non event’ in the sense that there was no major illness outbreak, later influenced the planning of a future proposal, due to public misgivings about the company. Similarly, the Leidsche Rijn (CS17) incident lead indirectly to the abandonment of large-scale dual supply systems in the Netherlands. Moreover, in accordance with the objectives of this document, the lessons learned from incidents show gaps in existing communications approaches. For example, in addition to technical and regulatory recommendations, after the Nokia Water Crisis (CS: 20), the Accident Investigation Board of Finland (2007) recommended that plans in relation to “preparedness and readiness” should be properly developed, and in particular should specifically address issues of leadership and communications during waterborne outbreaks.

3.1 Advanced Planning

Critical incident planning is required of most water suppliers and procedures for dealing with contamination events are usually embedded in legislation and regulations. What is apparent from the case studies (e.g. CS12: the WEM Incident, CS13: The Mythe Incident, and CS16: The Oslo Tap Water Case) is that where such events have to be managed by joint crisis management teams, good advanced planning is important to avoid communicating contradictory messages. Contradictory messages emanating from multiple sources will confuse the public so it is important to agree well in advance which body will lead on public announcements and to make sure that all parties know which body will be saying what and when. They also need to agree mechanisms for handling public and media enquiries and to ensure that there is consistency in the messages and responses given. The aim is for consistency in the messages that are provided to the public as opposed to contradictory statements. For example, in Bergen (CS1), the public were in receipt

20

of contradictory information about the safety of tap water at a time when there was uncertainty about whether water was the source of the outbreak. Lack of co-ordination within an agency, and with other relevant stakeholders (e.g. CS5: The Burncrooks Diesel Incident; CS6: The Walkerton E Coli outbreak) can lead to the breakdown in communications and co-ordination within the agency, between senior management and call centre staff. In the case of the Burncrooks incident, co-ordination with other agencies including the police was poor. Such lack of co-ordination hindered the overall management of the event, created confusion and added further uncertainty for the public. Suppliers need to work strategically to establish partnerships – “collaborative relationships allow agencies to co-ordinate messages and activities…to maintain effective networks, crisis planners and communicators should continuously seek to validate sources, choose subject-area experts, and develop relationships with stakeholders at all levels” (Seeger, 2006, p240). Joint crisis management teams (e.g. CSs 12: the WEM Incident, 13: The Mythe Incident, and 16: The Oslo Tap Water Case) as well as involving key stakeholders have an advantage over agencies acting independently in that decisions (e.g. such as when to withdraw a boil water notice) can be seen to have greater legitimacy and authority. It is unlikely that the public will have come to distrust all the individual bodies involved so it should be easier for people to trust the motives behind decisions that come out of a joint body. This of course will only be beneficial if the public are aware of the existence and joint nature of the team. The clear implication is that the public should be told about the existence of the team very early in the course of the incident. A single spokesperson, preferably with good social and media skills, should be allocated to make all public pronouncements on behalf of the joint team as this allows the public to put a face to the team and can enhance its effectiveness. Having a single point of public contact worked well in CS3: Lilla Edet, and is likely to have been even more effective had the media not over-emphasised apparently contradictory comments from the local mayor.

3.2 Timing of Communications

Early in the life course of contamination events there is usually uncertainty about whether there is actually an event to alert the public about at all. In many of our cases (CS2: Milwaukee; CS6; Walkerton; CS11: Pittfield Massachusetts; and CS14: North Battleford) there was a considerable time lag between initial cases of illness being identified and sufficient hard evidence being available to warrant issuing boil water notices or messages to avoid drinking the water at all. There is an obvious problem here and no simple answer. Do you adopt a precautionary approach and issue advisories and notices at the first hint of a problem and run the risk of creating false alarms, or do you wait for lab test confirmation by which time many people could potentially be ill? The cases studies in Wales (Case Studies 8a, 8b, 8c and 8d) characterise this dilemma well, since on the basis of the scientific status of water quality, the water company opted for a precautionary approach in each case, with the viewpoint of protecting public health, whilst at the same time running the risk of causing inconvenience to the public and eroding levels of confidence in the supply

21

system. By the time of the third suspected outbreak, much attention was placed in media reports about the fact that the company had announced three boil water notices in as many years, leading to suggesting that there were underlying problems in the water system that needed remedying. In the risk communication literature in general there is well-documented evidence that risk managing agencies understandably tend to be concerned not to create unnecessary panic or make people’s lives any more difficult than is necessary. There is evidence to suggest that this concern might be unfounded and that withholding information may actually decrease the likelihood that people will respond appropriately (Tierney, 2003). However, in the Sydney Water ‘Crisis’, (CS4), there was evidence of considerable public anxiety being caused by multiple alerts about contamination incidents. The ‘incident’ was actually three incidents occurring in quick succession relating to Giardia and Cryptosporidium contaminations which nonetheless involved no major outbreaks of illness. Although a major health crisis was averted – in this sense Sydney Water’s actions were successful - many people thought that the subsequent alerts were false alarms and many failed to follow the precautionary advice. There were also knock on consequences for public support for Sydney Water’s other activities and public misgivings in relation to this incident lead to the shelving of a potable water recycling research and demonstration plant in Quaker’s Hill, north west of Sydney (Stenekes et al., 2006). Our case studies show that often an increase in customer complaints is generally the first indicator of an incident. In several of the case studies (e.g. CS2: Milwaukee; CS5: Burncrooks; CS6: Walkerton; CS10: Bramham; CS11: Pittfield; CS12: The WEM Incident; and CS17: Leidsche Rijn and CS20: The Nokia Water Crisis), public complaints about taste, odour and turbidity rose in the days leading up to the first health surveillance reports of illnesses. In these examples, the consumers’ observations provided important indications for the water companies about unexpected changes in water quality. In the case of CS20: Nokia, consumer complaints about taste and smell were the first indicators of the outbreak; initially staff at the waterworks attributed consumer complaints to operational issues (recent pipe repair work), and took actions in accordance with this. However it was not until two days afterwards that the cause of the contamination (leakage of sewage effluent into the drinking water network) and the subsequent reason for the complaints was discovered. This incident was characterised by an estimated 8000 people suffering illnesses as a result of the contamination. Although there is little information about complaints for the Walkerton case, public concerns and suspicions about tap water lead to the initial reporting of the outbreak and some groups began to boil their water before the boil notice was issued. CS17: The WEM Incident showed that the water company regarded the sharp increase in consumer complaints as consistent with a problem at a local treatment works, the operator of the waterworks confirmed that there was indeed a taste and odour problem and the company took action by promptly shutting down the pumps in the geographical area concerned. In the above examples, consumers’ observations provide timely, important messages to organisations about unexpected changes in water quality, and importantly about the onset of potentially life threatening water contamination incidents. Sellnow et al.

22

(2009) state that “effective listening” is one of the most important features of risk communication, where “risk communicators are open to receiving warning signs of effective risk” ( 73), and they recognise that “consumer complaints are one of the first places that risk surfaces and can be identified. Effective risk communicators consistently monitor the environment for potential risk. They take complaints seriously and pay attention to the dynamic nature of risk” ( 73-74). We are not in a position to offer unambiguous advice about whether it is better to alert early or wait for lab-test confirmation before going public. Given that the primary purpose of such communication is to protect life adopting a precautionary approach seems more natural. Boil water advisories and notices are not only measures to reduce potential harm; they are also implicit messages of reassurance that communicate that a potential problem has been successfully detected by someone who was actively looking out for a problem. They also make it clear that investigations are going on and that even if the problem is not yet fully understood someone is taking action. In CS4: The Sydney Water Crisis, and CS15: The Gideon Salmonella Outbreak, surveys conducted with the public have shown inconsistent compliance with orders and advisories. In the case of Gideon, non-compliance was related to forgetting, not believing the notification, or not understanding that ice should be made with boiled water. The authors of the survey, Angulo et al. (1997), recommended that it is most likely that residents did not appreciate the severity of the situation; the initial boil order gave no reason for its being issued and it did not mention associated illness. They went on to say that compliance improved only after the provision of information sheets, which clearly explained the rationale and boiling procedure. This would suggest that taking a precautionary approach will only work well if a clear explanation of the event can provided at the time.

3.3 Responsiveness

When announcements are made the public will naturally seek to resolve any ambiguity or uncertainty. During times of uncertainty there may be a time-lag where scientific investigations are underway to determine the levels of risks and extent of the threat to the public. This time lag may give opportunities for conflicting interests between key stakeholders to become manifest, as well as for the amplification of risks, by the media though increasingly also by individuals using social networking websites. While investigations are underway to establish the nature of the incident, politicians in particular may make public statements in attempts to diminish growing public concern, often encouraged by the media (e.g. Bergen CS1). Fischbacher-Smith et al. (2009) note that the mismatch of objectives between scientists and politicians is a constant source of difficulty. The importance of consistency cannot be over-emphasised. The announcement of any short-term incident, possibly coupled with conflicting information in the media as above, is usually met with an intensified demand for

23

more information from the public. This is demonstrated in case studies such as Oslo (CS16), where website visits rose from approximately 200 to over 35,000 the day after an incident. Water companies need to be prepared to provide timely and accurate web-based updates. Customers will also call the water company directly for information, in which case staff need to be available to meet demands. Even in cases where the number of illnesses is negligible, the ways in which the incident is handled have the capacity to cause alarm amongst the local community, especially if they are provided with limited information, or when they cannot get in touch with the company through conventional channels. In the Burncrooks Incident (CS5), due to there being too few call centre staff to handle escalating levels of calls members of the public began to call the local police instead. Opinion polls conducted after the incident demonstrated that the public simply wanted accurate information about the status of events, in particular whether their immediate area was contaminated. Although there were no illnesses in relation to this event, how the events were handled, coupled with negative media coverage served to undermine public confidence in the company. In other examples (e.g. CS8a: The Cwellyn Incident) increased levels of customer calls were met with the installation of additional helpline numbers, or in CS3: Lilla Edet, telephone manning hours were extended in order to meet call demand. Providing well-manned call centres is not in itself a guarantee of successful communication. Cases such as the Oslo incident (CS16) show that call centre staff have to not only have information ready to give to the public but also need to be trained in dealing with the media. While the call handlers felt confident in dealing with general enquiries from the public they did not have the answers to the media’s more probing questions. If the media are not treated well or are left feeling that they are being fended off their relationship with the company can deteriorate and potentially become hostile.

3.4 Develop Partnerships with the Media

The media can be used as a resource to facilitate and aid the management of the risk event. This is illustrated most clearly in CS12: The WEM incident, where the water company found that the television media were vital in their ability to warn the public about possible risks via local and national radio and television. In this supporting role, the TV media were invaluable. The company noted, however, that the print media were not as helpful especially as time passed after the incident. Indeed, the media can also generate much negative publicity as in CS4: The Sydney Water ‘Crisis’. Of course, these examples are context specific; in the Sydney case, it is likely that the repeated issuing and withdrawal of notices, coupled with negative publicity gave rise to much confusion amongst the public, as well as decreased levels of confidence. So the role of the media can be either invaluable in providing a supporting role (e.g. communicating updates about the incident via carefully planned press releases), or can hamper developments and lead to a further deterioration of public trust in the authorities (particularly in relation the reporting about the cause of the incident). Seeger (2006) recommends that when communicating with the media, agencies should avoid inconsistency by accepting

24

uncertainty, and avoiding attempts to assuage the situation by being overly reassuring. Moreover, as part of the strategic planning process, he recommends that relevant spokespeople should be identified and trained in readiness for such events, as in the case of the Chief Environmental Officer in Lilla Edet (CS3).

3.5 The Role of the Web and Mobile Communications Technologies

Bennett et al. (2009) draw attention to the internet as an increasing source of information where the popularity of blogs, social networks, and online forums has led to significantly increased levels of active participation in the dissemination of views and opinion. These developments have increased access to ‘real time’ information and have placed pressures on other media where increased demands for 24-hour rolling news coverage places pressures on journalists to produce news content without having time to research and check stories for accuracy prior to broadcast. Heath (2006) notes that any kind of media coverage is likely to be continuous during an event and that some sources of information may be counter productive to the community’s understanding and the public interest so the water company or joint crisis management team must commit itself to be the first and best source of information. In the Oslo Case (CS16), for example, various parties used Facebook to circulate inaccurate stories about the incident and this was only later addressed by the creation of a ‘friend’ of the municipality who placed corrective messages on Facebook putting the municipality’s side of the story (Grimsby, personal communication). Similarly in the Nokia incident (CS20) malicious SMS text messages were circulated ostensibly from the water company urging people not to flush their toilets which were only belatedly challenged by the company in the traditional media. There is almost nothing that can be done to prevent inaccurate information being circulated on the web or by SMS and even where legal redress is possible the time taken to get this through the courts makes it essentially useless as a response. The primary response has to be regularly updated web pages that make it very clear that that they have been updated regularly. The server on which the pages are mounted also needs to be capable of taking large numbers of ‘hits’ simultaneously since web pages that are unavailable are worse than non-informative (see CS13: The Mythe Incident). New technologies offer some potential new communication routes to assist in communicating with customers during crisis events. SMS messaging allows the possibility for consumers to sign up for alerts and invitations to do this could be made without raising concerns if presented along with routine information that comes with water bills. Those who sign up could receive SMS alerts almost instantaneously and could then easily pass this information to friends and neighbours increasing the penetration of the alert message.

25

3.6 Summary and Conclusions

From the case studies, some of which are examples of successful incident handling and some which were not, we are able to draw some general conclusions and recommendations.

• Have contingency plans prepared in advance and make sure these are shared with other agencies likely to be involved in incident handling.

• Planned joint incident handling (e.g. with hospitals, national safety bodies, the police etc.) will suggest to the public a high degree of foresight and competence and it is unlikely that all the bodies involved will be simultaneously regarded as untrustworthy by the public.

• Ensure that there are contingency plans to allow sufficient means available for the public to get in contact with you using the methods they are likely to want to use.

• Use the web and SMS technologies to your advantage by ensuring regularly updated information is available during an incident.

• Consider having a single human face of the company or municipality as the primary conduit to the media.

• Empathise with consumers and make it clear that you understand the inconvenience being caused.

• Do not issue information unless you are certain of its accuracy. Explaining that you do not know something but are investigating it is preferable to issuing inaccurate information.

• Consider exploiting social networks and SMS technologies to facilitate quick communications.

• Build good relations with the news media over time so that they are sympathetic to your problems when you need them to help in a crisis. They will be a useful ally if they are sympathetic to you but potentially very unhelpful if you are not sympathetic to their needs.

26

4 Promoting Acceptance of Longer Term Initiatives: Re-use and

Desalination

This chapter focuses on risk communication as it assists – or otherwise – the implementation of major new water supply initiatives. In the literature the main focus of interest has been on initiatives to introduce re-use schemes in areas of water stress and this is because there have been some quite well-publicised failures to introduce such schemes that have been undermined by a hostile response from the public (e.g. CS22: East Valley Reclamation Project; CS27: San Diego Water Purification Project; CS28: San Gabriel Valley Groundwater Recharge Project; CS29: Caloundra and Maroochy Wastewater Project ; and CS30: The Water Futures Project, Toowoomba). Relatively little is known about communication issues relating to other kinds of initiative since these have tended not to attract widespread publicity or research interest. The introduction of desalination has raised concerns in some locations recently (CS35: Beckton, England and CS36: Larnaca, Cyprus), since current desalination technologies are energy intensive and thus are regarded by some as less than desirable given environmental and financial concerns. In the context of water reuse, organisations must communicate with many types of stakeholders, including public agencies, landowners, industry, commerce special interest groups, customers, potential customers, community leaders and the community in general. Several projects have either failed or been abandoned as a direct result of lack of community support for the projects, where community misgivings have been partially attributed to inadequate communication, or where communities have suspected that projects and plans where being undertaken covertly, with little consideration for their concerns (Khan and Gerrard, 2006). Other project failings have occurred due to organisations’ oversights in promoting the benefits of their operations, and a failure to allay fears about the possible health and environmental risks associated with water re-use (e.g. CS34: Kernell).

4.1 Why do you want to communicate with the public?

Until relatively recently, consideration of community attitudes was not regarded as a critical component of recycled water projects, however, after a number of projects failed due to the lack of community support this has changed (Hurlimann, 2008). Previously, as with the case of adopting new technologies generally, those implementing change were often of the opinion that the community might interfere with the decisions and therefore adhered to the ‘DAD’ - Decide, Announce, Defend - model of communication with relatively little consideration of the social or political implications of such proposals. Public opinions were to be regarded as either misinformed or irrational, or of little substantive importance. It has since been recognised that such approaches are counterproductive, often generating conflict and a loss of social trust. This has lead to an awareness of the need to engage with the public, and allow them to be involved in at least parts of the decision-making process.

27

Many of the problems identified in the case studies and existing reviews of re-use scheme communications (e.g. SCWRPI, 2004; Marks, 2006) point to a lack of clarity in the goals of the communicators. Broadly speaking there are the following potential goals of communication and a campaign is likely to involve more than one of these at a time:

Information provision (one-way information flow)

1. To inform the public about a decision that has already been taken or is about to be made 2. To defend a decision that has already been taken (‘decide, announce, defend’, DAD) 3. To gain support for a decision that has already been taken 4. To inform the public about the range of proposals/options that have been considered so

that they know you have considered other options 5. To ‘correct’ misperceptions about the options (for example, in response to material put out

by those against a proposal)

Consultation (two-way information flow)

6. To assess public views about a specific proposal (would it be acceptable or not?) 7. To inform the public about a range of proposals/options and allowing the public to seek

clarification/evidence for each 8. To seek public preferences from among a range of proposals/options 9. To find out which sectors of the public support various options 10. To involve the public in generating new options to be considered 11. To involve the public making decisions so that they ‘own’ the decisions and thus accept

them and/or are willing to pay for them 12. To give the public a full partnership role in the decision making process More cynically: 13. To make the public believe that they have been openly consulted about a decision that

has in fact already been taken 14. To be seen to comply with legislative requirements Which of these are the goals of communication will not only depend on the communication philosophy adopted by the company but also on the local context, resources and political realities. It will also depend on whether the decision is regarded as likely to be in anyway controversial. For some investment decisions, say for increasing the capacity of an existing plant, there may be little public concern or need to get explicit public support for the scheme. For others, like re-use schemes, public support will be crucial. Some of the goals towards the bottom of the list require there to be time to allow public participation as well as resources to fund such exercises neither of which may be available. However, in some countries bodies and organisations are facing increased pressure for enhanced public participation in decision making. It has come to be expected that the public should be engaged in debates about technological change, environmental risk and policy (Petts et al., 2003) and, of course, it is now a requirement under the Water Framework Directive that stakeholders are actively included in decision making processes relating to river basin management (European Commission, 2002, 2004).

28

In our review of the cases and the other reviews to date the evidence seems to suggest that participatory approaches are generally more effective than one-way communications in the case of re-use schemes. In CS22: East Valley; CS23: Orange County; CS28: San Gabriel; and CS31: Denver), the project proposals all involved the recharging of groundwater. However, in spite of assurances of safety, in all cases except Orange County, the proposals were met with public opposition and were subsequently withdrawn or placed on hold. Marks (2006) stated that of all cases, Orange County had been the most successful, since the County set up and maintained an extensive public consultation exercise. However, she also states that “Overall, a lack of transparency at the earliest planning stages, and limited community outreach, characterises the public consultation efforts at each of these sites [the ones where the project was withdrawn]. There seemed to be ample opportunity for sharing the concept with the public, especially during pilot, demonstration phases” (Marks, 2006, 139). She noted that in each of these cases, public consultation focused upon marketing the proposals, as opposed to keeping the public fully informed and offering opportunities for deliberative consultation. Following these and other unsuccessful schemes various sets of good practice have been drawn up. In the case of controversies including public opposition in Australia, a report prepared for the Australian Parliament (Dimitriadis, 2005) recommends that, depending on the scale of operations, the decision to undertake indirect potable water recycling should ideally be a local decision based on community values, complete and accurate information, and an assessment of the water supply options. Their principles for ensuring adequate public participation include the following: - Transparency of decision making processes - Opportunities for involvement in all phases of project planning & development - Problems clearly defined — i.e. goals for improvement stated - Concerns and fears considered real and valid, noted and responded to appropriately (embracing potential conflict and opposition to schemes)

- Social values and needs are incorporated into decision criteria - Alternatives are openly stated for comparison — choices are open - Accurate information and adequate research is made available - Projects are justified by real needs - Environmental principles applied e.g. prevention of water pollution, and - Costs and benefits of projects are equitably shared.

Source: Dimitriadis, 2005

29

Khan and Gerrard (2006) recognise that water utilities may be suffering from a general decline in community trust and confidence. They state that in instances where communities associate a water reuse project with high levels of risks, trust has been maximised when the following conditions are met: - Dialogue is sustained - The community has independent sources of information, not linked to the sponsoring

agency - The community can ask questions - The community is involved early in the decision making process - Information is available to everyone - Behaviour is non coercive. It is considered a reasoned and fair way to make a decision - Everyone’s opinion matters and there is a willingness to listen to all views and expand

the discussion if necessary - Citizens have some level of control in the process (such as by contributing to the agenda

or ground rules)

Source: Khan and Gerrard (2006).

Two-way flow and exchange of information forms of engagement are also advocated by the Southern California Water Recycling Projects Initiative (2004), which concluded that it is important to work with all stakeholders in order to understand the basis for any opposition, in order to provide an opportunity to initiate a dialogue with the stakeholder and to illustrate that the project sponsor is concerned about stakeholder concerns. This dialogue also provides an opportunity to work with stakeholder groups in order to increase their understandings of, in this case, recycled water and its uses. Public involvement should be based on the following key principles: - The public should be allowed to participate in the decision or actions that affect their lives. - The public should have the opportunity to influence the decision-making process. - The public involvement process should communicate the interests and meet the needs of all participants. - The public involvement process should seek out and facilitate the involvement of all who are potentially affected. - The public involvement process should allow the public to assist in defining how they participate. - The public involvement process should explain how the public’s input was or

30

was not used. - The public should be provided with information that enables them to participate in the process in a meaningful manner.

Source: Southern California Water Recycling Projects Initiative, 2004

4.2 Options for Participation

Methods by which companies provide information to the public (one-way flow of information) may include care lines, websites, reports, and advertising. Consulting with the public may involve methods such as surveys and focus groups, whilst public meetings may be used to interact with members of the public. Two-way public participation requires less traditional methods. These include citizen juries, consensus conferences and other deliberative methods. Specific types of methodologies that aim to encourage mutual understanding and learning include deliberative approaches and social impact assessment. The main feature of deliberative approaches is that they involve members of the public to help make decisions after the receipt of information from various sources. Unlike ‘one-way’ methods, deliberative approaches offer the potential for procedural transparency, participatory deliberation and subsequent citizen advocacy (Wakeford, 2002, Abelson et al., 2003). Citizen Panels involve a representative sample of citizens (usually no more than 24). Participants are told about the potential consequences of options by experts. This is followed by formal hearings, lectures, videotapes, inspection tours, written information and discussions that participants use to generate and evaluate decision options. They are told that they might enjoy or suffer the consequences of their decisions and that the exercise is part of the decision process. Participants list their major concerns with respect to a development project and these are discussed in smaller groups of 6 or 7 guided by a facilitator. They are asked to prioritise their concerns and reach a consensus on action to be taken. Consensus Conferences involve a group of citizens with varied backgrounds who meet to discuss a proposal or issue. Initially small groups meet with key experts to discuss the issues. The panellists are expected to reach a consensus view which, since they were selected to be representative of the population ought to reflect how the population might view the issue were they to spend long enough thinking about it. A second stage brings everyone together in a public conference to present main observations and conclusions to a wider audience that includes the media and general public. Deliberative Polling attempts to incorporate deliberative features into the traditional opinion poll. The poll combines elements of a large representative, random sample while providing opportunities for discussion and deliberation over a 2-3 day period. People’s views are assessed before and after the deliberation phase which gives

31

some idea of the likely impact of thinking about the issues on support for any proposals. The merit of these approaches is that groups of people thought to be representative of the target population are offered the chance to spend a relatively long time thinking about the issue deeply and their views are therefore assumed to be better thought through and evidence based. Also, more ‘data’ can be extracted from panellists than with other procedures. Other methods that encourage mutual learning involve case study approaches, and would be relevant to the proposed implementation of change. Social Impact Assessment (SIA) involves a more structured and formalised kind of case study. There are several phases in the development and application of a social impact assessment by a project team. In the initial phase the problem is analysed and a communication strategy is developed in order that it involves all parties, including the public. Thereafter there is an analysis of the social system potentially affected by the change. This would include identification of the principal actors, their behaviour and objectives and the constraints, which any initiative will face. This may involve a review of the historical background to any change and any future changes that may have an impact (e.g. Becker, 1997). The main phase of any project starts with a scenario design, mapping out future contexts within which any actors or changes may occur, including those which may have a critical impact, and the steps required to meet any challenge. This will include an assessment of alternatives. Once the impact of any developments is assessed strategies are ranked per scenario and per critical incident and changes made to the proposed action before final reporting. The auditing of an SIA project provides information on its performance, cost effectiveness and fit between plan and actual process. Elicitation of material for SIA is obtained by a number of sources:

- Surveys and Interviews - Questionnaires - Focus groups - Press and media reports - Public meetings

The technique can be applied on the behaviour of large numbers of individuals (micro-level), behaviour within organisations, as well as impacts at a national level (macro-level). The technique has been used extensively in environmental and technology assessment such as large scale development projects (Becker, 1997). Within the process of SIA a number of methodologies are applied for analysing data including:

- An assessment of strengths, weaknesses, opportunities and threats - Cost benefit analysis to rank strategies - Trend analysis - Discursive analysis

32

The advantage of SIAs is that a great deal of data can be collected on a single issue or event that could give considerable insights into the way the issue is managed and responded to. However, a large social impact assessment may be costly in terms of time and resources and they may fail to achieve full co-operation among all the main players. Other issues that need to be taken into account are cultural sensitivities and environmental justice considerations. Cooley et al. (2006) state that, in the context of desalination projects in California, proposed projects are likely to be located in existing industrial areas, due to the nature of the local infrastructure and resources. They acknowledge that as low-income populations tend to reside in such areas, desalination plants for example may have a disproportionate impact on these communities, particularly in terms of air quality. They may also suffer as a result of the plant’s impact on water-quality, since local fish may have elevated levels of metals or other toxins. In addition, the Environmental Justice Coalition for Water (2005) state that low income and ethnic minority groups may also bear disproportionate effects of increases in water rates. They argue that local and state requirements for public hearings, comment periods, and public notice often fail to engage members from these groups.

4.3 Potential Problems with Participative Approaches

While the above points to the value of participative approaches and promoting the right of citizens these approaches present their own new and different problems. There are the obvious ones relating to the extra time and resources required to mount participative campaigns. In the case of the Cypriot decisions to invest in desalination plants (CS36) serious recent droughts have made delaying investment for further consultation potentially unwise. Major campaigns are not cheap and those funding new schemes, be they the public via their governments or private companies may not feel that the investment is worthwhile or may simply not have the funds to run them in the first place. Less obvious problems concern the conceptualisation of the ‘public’ as a single entity with an assumed set of common interests. In the case of Californian re-use schemes some groups in the population have objected to the schemes on the basis that they thought they were being justified as a ruse to allow the building of more cheap homes in their areas (SCWRPI, 2004). Their objections were primarily based on concerns about immigration and population growth rather than re-cycled water per se. When assessing the acceptability or tolerability of certain levels of risk exposure to the risk is likely to vary between sections of the public which then presents problems of equity and deciding whose views ought to be given more weight in any decision making. In CS27: San Diego for example some objected to the scheme as they thought that it was being foisted on their relatively poor neighbourhood so that those living in more affluent areas could avoid using re-cycled water. Values, rather than

33

‘facts’ tend to underpin how people frame risks. Stenekes et al. (2006) illustrates this nicely with an example from the Caloundra-Maroochy case (CS29), where in relation to an assumed level of acceptable risk, a community interest representative involved with the proposal concluded that , “[t]heir opinion of safe and mine are two different versions of what it means” ( 121). It is also generally the case that when a consultation is opened about a topic it is those with strong views and vested interests in it that engage with it most enthusiastically. This means that the ‘public’ that is being engaged with may not be particularly representative of the population likely to be affected by the scheme so efforts have to be directed to reaching out to all sectors of the population. In the risk field generally, although there have been attempts to apply participatory processes to policy and planning decisions, experience is actually quite limited. Petts et al. (2003) suggest that the less committed/interested citizens only tend to become involved in the later stages of decision making process one the risks have already been identified and evaluated and thus fairly close to the point where the final decision has to be made. They recommend that the involvement of the public needs to be much earlier in decision making processes – indeed the case studies show that the primary pitfall of not including the public at the earlier stages can be withdrawal or abandonment of projects, even when considerable resources have already been invested. Likewise deliberative panels are often regarded as among the most involving forms of public engagement yet necessarily they involve only a tiny number of people who have the time and motivation to take part. Deliberative panels have their value in allowing members of the public to examine the evidence for project options and to seek clarification of areas of uncertainty but to regard them as a sufficient form of public participation would be a mistake. Their virtue lies in other members of the public being able to examine the outcomes of the panel’s deliberations so efforts need to be directed toward publicising these outcomes. Renn (2008) offers a useful categorisation of the various publics that might be the targets of communication: Stakeholders: Socially organised groups who are or will be either affected by or have a strong interest in the outcome of the event or the activity from which the risk originates and/or by the risk management options taken to counter the risk. Directly affected public: individuals and non-organised groups who will experience positive or negative impacts from the outcome of the event or the activity from which the risk originates and/or by the risk management options taken to counter the risks. Observing public: the media, cultural elites and opinion leaders who may or may not comment on the risk issue or influence public opinion. General public: all individuals who are not directly affected by the risk or risk management and are part of the emerging public opinion on the issue.

Source: Renn, 2008

34

The risk communication literature has shown that conflicts that have arisen in public participation efforts can be based upon differing expectations placed on participation process itself (Khan and Gerrard, 2006). Historically some agencies have viewed participation in instrumental terms, as a means to achieve their own immediate goals, for example as set by agency mandates (e.g. to protect public heath and safety) or bureaucratic objectives (e.g. legal requirements to consult) or indeed commercial goals (Kasperson and Kasperson, 2005). Citizens may view an invitation to participate as signifying that their views will be acted upon or that they may have the right of veto over the decisions. Thus the setting of ground rules has to be especially well thought through and transparent to all involved. Participants need to know who will be taking the final decision. Being open will not guarantee constructive cooperation. Some actors may argue about the framing of the problem at hand and disagree with its premises (for e.g. “is there really a shortage of water or is someone wasting it?”). Others may want to see the exercise fail as that would be the quickest way to maintain the status quo. It is also the case that putting people with differing backgrounds and interests together will not guarantee harmonious social interactions and dysfunctional group dynamics can undermine such exercises.

4.4 The ‘Yuck Factor’

In section 2.3 we discussed the role of emotional responses and whether initial emotional responses to re-use schemes – the ‘yuck factor’ – in some senses might over-ride considered evaluations and the acceptance of such schemes. The Associationist model is consistent with what has been observed in cases such as CS27: San Diego; CS26: San Gabriel; CS28: Caloundra and Maroochy and CS30: Toowoomba, where a proposal to introduce direct potable re-use which some consumers found unpleasant had the effect of degrading consumer trust (see also Marks, 2006). Unfortunately from the view point of water companies attempting to introduce re-use schemes those objecting to them have little trouble playing on people’s emotions. The following cartoons and buttons from Australia and the USA illustrate this very clearly.

Source - Wilcox, Sydney Morning Herald. Button from www.zazzle,com

35

Some campaigns like those launched in Toowoomba, Australia (CS28) are very sophisticated and employ a scientific discourse to the issues such as those contained in the booklet Think Before you Agree to Drink: Is Sewage a Source of Drinking Water? http://www.valscan.com.au/tbyatdBris.pdf. Nonetheless hidden within this kind of reasoned and academic approach to putting the anti-re-use case they still make none-too-subtle fear appeals such as: “Turning a blind eye must surely be a terribly dangerous action.”(p2, our emphasis) “We should remind ourselves about what goes into a sewer. Domestic, commercial and industrial toxic chemicals together with both prescription and illicit drugs from human waste or from dumping unwanted or out of date drugs down toilets, tubs and kitchen sinks. This joins liquid waste from morgues, hospitals and any other place connected to a sewer as well as paints, solvents and acids. Sewers are used to dispose of all manner of substances which arrive at the city’s sewage treatment plant as one massive, horrendous toxic cocktail.”(p17, our emphasis). Countering this kind of fear appeal is particularly problematic but some attempts have used familiarity and a light hearted approach to suggest the fact that water is always recycled in some sense. The billboard image below given a recent example form Australia.

4.5 Summary and conclusions

The focus of both our case studies and the published literature is predominantly about re-use schemes and this is indicative of how little public research there is on communication with the public about other major water investment issues. This probably reflects the fact that investment in water infrastructure projects usually carries little perceived risk for the public and thus generates little public interest. This is likely to change in the future as water shortages and other threats to treatment systems (e.g. the need to remove pharmaceutical agents, changes in the nature of pathogens, terrorism) mean that big infrastructure projects will be needed and these are likely to be expensive and will have to be paid for by consumers in one

36

way or another. As we see from the Cyprus and Beckton cases proposals to introduce desalination plants can generate public concerns and political objections just as much as the re-use cases have. Indeed in the Kernell case (CS34) public resistance to a desalination scheme even led to the acceptance of an alternative re-use scheme. There seems to be a general theme suggesting that forms of true public participation in decision making are more likely to lead to successful implementation of new schemes than Decide, Announce, Defend approaches. This has to be tempered by a recognition that participatory approaches are both expensive and time consuming and thus planners need to factor these considerations into their proposals right from the beginning.

37

5 References

Abelson, J., Pierre-Gerlier Forest, P.G., Eyles, J., Smith, P., Martin, E. & Gauvin, F.P.

(2003). Deliberations about deliberative methods: issues in the design and evaluation of public participation processes. Social Science & Medicine, 57, 239–251.

Angulo, F. J., Tippen, S., Sharp, D. J., Payne, B. J., Collier, C., Hill, J. E., Barrett, T. J.,

Clark, R. M., Geldreich, E. E., Donnell, H. D. Jr., & Swerdlow, D. L. (1997). A Community Waterborne Outbreak of Salmonellosis and the Effectiveness of a Boil Water Order. American Journal of Public Health. 87, 580–584.

AWWARF Public Involvement Strategies: A Managers Handbook (2004). In

Southern California Water Recycling Projects Initiative. Successful Public Information and Education Strategies: Technical Memorandum, 53-55. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

Becker, H. A. (1997). Social Impact Assessment: Method and Experience in Europe, North

America and the Developing World. London: UCL Press. Bennett, P., Calman, K., Curtis, S., & Fischbacher-Smith, D. (Eds) (2009) Risk

Communication and Public Health. 2nd Edition. Oxford: Oxford University Press.

Blair, K. (1995). Cryptosporidium and Public Health. Drinking Water and Health

Newsletter. Available at: http://waterandhealth.org/newsletter/old/03-01-1995.html

Bord, R. J. & O’Connor, R. E. (1992). Determinants of Risk Perceptions of a

Hazardous Waste Site. Risk Analysis, 12, 411-416. Bratanova, B., Morrison, G., Fife-Schaw, C., Chenoweth, J., & Mangold, M. (2010)

Restoring Satisfaction following a Water-borne Disease Outbreak: The Role of Trust, Blame, Risk Perception, and Communication. (Under Review)

Breakwell, G.M. (2007). The Psychology of Risk. Cambridge: Cambridge University

Press. Christensen, T, Fimreite, A L, & Lægreid, P. (2007). Crisis Management: The Case of

internal security in Norway. Stein Rokkan Centre for Social Studies. Working Paper. Available at: https://bora.uib.no/dspace/bitstream/1956/2485/1/N08-07_Cristensen_Fimreite_Laegreid.pdf

38

Clark, R. M., Geldreich, E. E., Fox, K. R., Rice, E. W., Johnson, C. H., Goodrich, J. A., Barnick, J. A., Abdesaken, F., Hill, J. E., & Angulo, F. J. (1996). A Waterborne Salmonella Typhimurium Outbreak in Gideon, Missouri: Results from a Field Investigation. International Journal of Environmental Health Research. 6, 187-193.

Cooley, H., Gleick, P. & Wolff., P. (2006). Desalination, With a Grain of Salt: A

California Perspective. Pacific Institute for Studies in Development, Environment, and Security. Available at: http://www.pacinst.org/reports/desalination/desalination_report.pdf

Cosla (1998). Focusing on Citizens: A Guide to Approaches and Methods. Available

at: http://www.dundeecity.gov.uk/ce/approaches.pdf Corso, P. S., Kramer, M. H., Blair, K. A., Addis, D.G., Davis, J.P & Haddix, A. C.

(2003). Cost of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin. Emerging Infectious Diseases, 9, 426 -431.

Dalheim, E. (2009). Kommunal krise – nasjonal vekker. En studie av Bergen

kommunes håndtering av giardiautbruddet høsten (2004). Department of Administration and Organization Theory. Bergen: University of Bergen. (In Norwegian). Available at: http://rokkan.uni.no/fniv/files/Masteroppgave,%20Eirik%20Dalheim.pdf

Dimitriadis, S. (2005). Issues Encountered in Advancing Australia’s Water Recycling

Schemes. Parliament of Australia, Department of Parliamentary Services: Research Brief No. 2. Available at: http://www.aph.gov.au/library/pubs/rb/2005-06/06rb02.pdf

Dolnicar, S., Hurlimann, S. & Nghiem, L. D. (2010). The Effect of Information on

Public Acceptance - The Case of Water from Alternative Sources. Journal of Environmental Management. 91, 1288-1293.

DTI (2006). Water Recycling and Reuse in Singapore and Australia. Report of a DTI

Global Watch Mission: Global Watch Mission Report. Available at: http://www.bvsde.paho.org/bvsacd/cd65/water-recycling/content.pdf

Earle, T. C. & Siegrist, M. (2006). Morality Information, Performance Information,

and the Distinction between Trust and Confidence. Journal of Applied Social Psychology, 36, 383-416.

Eikebrokk , B, Gjersatd, K O, Hindal, S, Johanson, G, Røstum, J, & Rytter, E, (2006).

Giardia-utbruddet i Bergen høsten 2004, Rapport fra det eksterne evalueringsutvalget. Available at: http://www.sintef.no/upload/Teknologi_og_samfunn/Sikkerhet%20og%20pålitelighet/Rapporter/Sluttrapporten%20Giardia.pdf

Eiser, J.R., Miles, S. & Frewer, L.J. (2002). Trust, Perceived Risk and Attitudes

Towards Food Technologies. Journal of Applied Social Psychology, 32, 2423-2433.

39

Environmental Justice Coalition for Water. (2005) Thirsty for Justice: A People’s

Blueprint for California Water. Oakland, California: The Environmental Justice Coalition for Water. Available at: Thirsty for Justice: A People’s Blueprint for California Water.

Ekvall, A. (2008). Logbook of Events Chronicling the Lilla Edet Waterbourne

Outbreak (personal correspondence). Ellis, K. (2007). Cryptosporidium in Milwaukee’s Water Supply Caused Widespread

Illness. Infectious Disease News. Available at: http://www.infectiousdiseasenews.com/200709/eistories.asp

European Commission, (2002). Guidance on Public Participation in Relation to the

Water Framework Directive: Active Involvement, Consultation, and Public Access to Information. Available at: http://www.eau2015-rhin-meuse.fr/fr/ressources/documents/guide_participation- public.pdf

European Commission, (2004). The EU Water Framework Directive - Integrated

River Basin Management for Europe. Available at: http://europa.eu.int/comm/environment/water/water-framework/index_en.html

Falco, R. & Williams, P. E. (2009). Waterborne Salmonella Outbreak In Alamosa,

Colorado March and April 2008. Outbreak and Identification, Response, and Investigation: Colorado Department of Public Health and Environment. Available at: http://www.marlerblog.com/uploads/file/AlamosaInvestRpt.pdf

Fawell, J. (2003) “Burncrooks Diesel Incident” In “Water Contamination Emergencies.

Can We Cope?”. Gray, J. & Thompson, K. C. (Eds). The Royal Society of Chemistry.

Fernandes, T. M. A., Schout, C., Human, D. R., Eliander, A., Vennema, H &

Duynhoven, T.T.H.P. (2007) Gastroenteritis Associated with Accidental Contamination of Drinking Water with Partially Treated Water. Epidemiology and Infection, 135, 818-826.

Fessas, Y. (2001). The Strategic Position of Desalination in the Overall Water Policy of

Cyprus. Desalination, 136, 125-131. Fife-Schaw, C., Kelay, T., Vloerbergh, I., Chenoweth, J., Morrison, G. & Lundehn, C.

(2007). Consumer Preferences: An Overview. Techneau Deliverable D6.2.1. Available at: http://www.techneau.org/fileadmin/files/Publications/Publications/Deliverables/D6.2.1.pdf

40

Fife-Schaw, C.R., Barnett, J., Morrison, G., Åström, J. & Hartung, J. (2009). Enhancing consumer relations: The role of trust and confidence. IWA/TECHNEAU: Safe Drinking Water from Source to Tap: State of the Art and Perspectives Conference. Maastricht, Netherlands, 17-19 June 2009.

Finucane, M.L., Alhhakami, A.S., Slovic, P. & Johnson, S.M. (2000). The Affect

Heuristic in the Judgement of Risks and Benefits. Journal of Behavioural Decision Making, 13, 1-17.

Fischbacher-Smith, D., Irwin, A. & Fischbacher-Smith, M. (2009). Bringing Light to

the Shadows: Risk, Risk Management and Risk Communication. In, Bennett, P., Calman, K., Curtis, S., and Fischbacher-Smith, D. (Eds) (2009) Risk Communication and Public Health. 2nd Edition. Oxford: Oxford University Press.

Fraser, R. (1998). The Burncrooks Inquiry. Report on the Disruption to the Public

water Supplies in Areas Served by Burncrooks Waterworks, December 1997. The Scottish Office. Available at: http://www.scotland.gov.uk/library/documents5/burn-00.htm

Freudenburg, W.R. (1993). Risk and Recreancy: Weber, the Division of Labor and the

Rationality of Risk Perceptions. Social Forces, 71(4), 909-932. Furness, M. (2003). ‘The WEM Incident’. In “Water Contamination Emergencies. Can

We Cope?”. Gray, J. & Thompson, K. C. (Eds), The Royal Society of Chemistry.

Gray, J. & Thompson, K. C. (2003). Water Contamination Emergencies. Can We Cope?.

The Royal Society of Chemistry. Griffin, R. J., Dunwoody, S. & Zabala, F. (1998). Public Reliance on Risk

Communication Channels in the Wake of a Cryptosporidium Outbreak. Risk Analysis. 18, 367-375.

Grimsby, E. (2010a). Maintaining Community Trust in a Water Quality Crisis:

Experiences from Oslo. Presentation at the 3rd International Utility Management conference from 10th- 12th May, Barcelona, Spain.

Haddad, B. (2004). WateReuse Foundation Summary of Research Needs Assessment

Workshop: Human Reactions to Water Reuse. (Appendix I in Southern California Water Recycling Projects Initiative (2004). Successful Public Information and Education Strategies: Technical Memorandum). Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

Hartlid, C. (2009). Microbial Risk Assessment of Drinking Water in Lilla Edet

Municipality – Possible Reasons for the Waterborne Outbreak (in Swedish), Göteborg University, unpublished Masters thesis.

41

Heath, R. L. (2006). Best Practices in Crisis Communication: Evolution of Practice through Research. Journal of Applied Communication Research. 34, 245-248.

Heinicke, G., Hartlid, C., & Bergstedt, O. (2009). Application of a QMRA Model for

Surface Water Treatment to Investigate a Waterborne Outbreak of Calcivirus. (Submitted to Water Science and Technology, Under Review).

Hrudey, S. E. & Hrudey, E. J. (2004). Safe Drinking Water: Lessons from Recent

Outbreaks in Affluent Nations. London; IWA Publishing. Huffman, D. (2003). ‘The City of Milwaukee Cryptosporidium Outbreak: What

Really Happened and Hw Vulnerable Are We?’. In Water Contamination Emergencies: Can We Cope? Gray, J. & Thompson, K. C. (Eds) The Royal Society of Chemistry.

Hurlimann, A. & Dolnicar, S. (2010). When Public Opposition Defeats Alternative

Water Projects – The Case of Toowoomba Australia. Water Research, 44, 287-297.

Hurlimann, A., Hemphill, E., McKay, J. & Geursen, G. (2008). Establishing

Components of Community Satisfaction through a Structural Equation Model. Journal of Enviornmental Management. 88, 1221-1232.

Hurlimann, (2008). Community Attitudes to Recycled Water Use: An Urban

Australian CS– Part 2. Research Report No. 56. The Cooperative Research Centre for Water Quality and Treatment.

Hurlimann, A. C. & McKay, J.M. (2004). What Attributes of Recycled Water Make it

Fit for Residential Purposes? The Mawson Lakes Experience. Desalination. 187, 167-177.

Hurlimann, A. C. & McKay, J. M. (2007). Urban Australians using Recycled Water for

Domestic Non-Potable Use – An Evaluation of the Attributes, Price, Saltiness, Colour and Odour Using Conjoint Analysis. Journal of Environmental Management. 83, 93-104.

Ingram, P. C., Young, V.J., Millan, M., Chang, C. & Tabucchi, T. (2006). From

Controversy to Consensus: The Redwood City Recycled Water Experience” Desalination. 187, 179-190.

Jones, L. (2007). Freedom Advocated (Website): Australia Water History. Available

at: http://www.freedomadvocates.org/articles/water/australia_water_history_20071212269/

Kasperson, R. & Kasperson, J. (2005). The Social Contours of Risk. Volume 1: Publics,

Risk Communication and the Social Amplification of Risk. The Earthscan Risk in Society Series: London.

42

Khan, S. J. & Gerrard, L. E. (2006). Stakeholder Communications for Successful Water

Reuse Operations. Desalination, 187, 191-202. Larsson C. & Ekvall A. (2009). Report on Lilla Edet Water-Borne Disease Outbreak

(In Swedish). Svenskt Vatten, 3, 16-17. Mac Kenzie, W.R., Hoxie, N.J., Proctor, M. E., Gradus, M.,Blair, K. Peterson, D.E.,

Kazmierczak, J. J., Addiss, D. G., Fox, K. R. B., Rose, J. & Davis, J. P. (1994). A Massive Outbreak in Milwaukee of Cryptosporidium Infection Transmitted through the Public Water Supply, The New England Journal of Medicine, 331, 161-167.

Marks, J. S. (2003). The Experience of Urban Water Recycling and the Development

of Trust. The Flinders University of South Australia: PhD Thesis. Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable

Reuse. Desalination, 187, 137-147. Nygård, K, Schimmer B, Søbstad O, Walde, A, Tveit, I, Langeland, N, Hausken, T, &

Aavitsland P, (2006). A Large Community Outbreak of Waterborne Giardiasis-Delayed Detection in a Non-Endemic Urban Area. BMC Public Health, 6, 141.

Nygård ,K, Schimmer B, Søbstad Ø, & Tveit I. (2004). Waterborne Outbreak of

Giardiasis in Bergen, Norway. Euro Surveillance, 8, 2583. Oesterholt, F., Martijnse, M., Medema, G. & van der Kooij, D. (2007). Health Risk

Assessment of Non-Potable Domestic Water Supplies in the Netherlands. Journal of Water Supply: Research and Technology-AQUA. 56, 171–179.

Oesterholt, F., Sluijs, A., Mons M., & Medema G. J. (2003). Evaluation of Practical

Experiences with Household Water. H2O, 36, 22 – 25. Organisation for Economic Co-operation and Development (OECD) (2002). OECD

Guidance Document on Risk Communication for Chemical Risk Management. Available at: http://www.oecd.org/officialdocuments/displaydocumentpdf?cote=env/jm/mono(2002)18&doclanguage=en

Petts J., Horlick-Jones T. & Murdoch, G. (2001). Social Amplification of Risk, the

Media and the Public. Health and Safety Executive Contract Research Report 329/2001. Sudbury: HSE Books.

Petts, J., Wheeley, S., Homan, J. & Niemeyer, S. (2003). Risk Literacy and the Public.

MMR, Air Pollution and Mobile Phones, Final Report for the Department of Health.

43

Petts, J., Homan, J., & Pollard, S. (2003). Participatory Risk Assessment: Involving Lay Audiences in Environmental Decisions on Risk: Literature Review and Stakeholder Interviews. R&D Technical Report E2-043/TR/01: Environment Agency.

Perrow, C. (1999). Normal Accidents: Living with High Risk Technologies. Princeton, NJ:

Princeton University Press. Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors

Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO.

Po, M., Nancarrow, B., Leviston, Z., Porter, N., Syme, G., & Kaercher, J. (2005).

Predicting Community Behaviour in Relation to Wastewater Reuse: What Drives Decisions to Accept or Reject? Melbourne: CSIRO.

Poortinga, W. & Pidgeon, N.F. (2005). Trust in Risk Regulation: Cause or

Consequence of the Acceptability of GM Food? Risk Analysis, 25, 199-209. Regester, M. & Larkin, J. (2008) Risk Issues and Crisis Management in Public

Relations : A Casebook of Best Practice (4th Edition). Kogan Page, Limited Renn, O. (2008). Risk Governance: Coping with Uncertainty in a Complex World. London;

Earthscan. Robertson, L. J., Hermansen, L., Gjerde, B. K., Strand, E., Alvsvag, J. O., & Langeland,

N. (2006) Application of Genotyping during an Extensive Outbreak of Water-Borne Giardiasis in Bergen, Norway, During Autumn and Winter 2004. Applied and Environmental Microbiology, 72, 2212–2217.

Røstum, J. &Eikebrokk, B. (2008). Cost Report: Proactive Crisis Management of

Urban Infrastructure. Case B1: Bergen’s Giardia- Outbreak Autumn 2004: Results from the External Accident Investigation Committee, 130 -140.

Røstum, J., Aasen, A., & Eikebrokk, B. (2009). Risk and Vulnerability Assessment

(‘Ros-Analysis’) of the Bergen Water Supply System: A Source to Tap Approach. Risk Management of Water Supply and Sanitation Systems, NATO Science for Peace and Security Series C: Environmental Security, Part 1.

Rowe, G., & Frewer, L. (2005). A Typology of Public Engagement Mechanisms.

Science, Technology and Human Values, 30, 251–290. Salveson, A. T., Requa, D. A., Whitley, R. D. & Tchobanoglous, G., (2000) Potable

versus Reclaimed: Water Quality, Regulatory Issues, Emerging Concerns. WEFTEC 2000: Session 31 through Session 40, 546-558(13) (Abstract Only).

Seeger, M.W. (2006). Best Practices in Crisis Communication: An Expert Panel

Process. Journal of Applied Communication Research, 34, 232-244.

44

Sellnow, T.L., Ulmer, R.R., Seeger, M.W. & Littelfield, R.S. (2009). Effective Risk

Communication: A Message Centered Approach. Springer: New York. Siegrist, M. (1999). A Causal Model Explaining the Perception and Acceptance of

Gene Technology. Journal of Applied Social Psychology, 29, 2093-2106. Siegrist, M, Earle, T. C. & Gutscher, H. (2003). Test of a Trust and Confidence Model

in the Applied Context of Electromagnetic Field (EMF) Risks, Risk Analysis, 23, 705-716.

Slovic, P. (1987). Perception of risk. Science, New Series, 236, No. 4799. 280-285. Smith, S. (2005). Desalination, Waste Water, and the Sydney Metropolitan Water

Plan. NSW Parliamentary Library Research Service:: Briefing Paper No 10/05. Available at: http://www.parliament.nsw.gov.au/prod/parlment/publications.nsf/0/d92db6f939eac6feca2570680025da5e/$FILE/Desalination and index.pdf

Stenekes, N., Colebatch, H.K., Waite, T.D. & Ashbolt, N.J. (2006). Risk and

Governance in Water Recycling: Public Acceptance Revisited. Science, Technology and Human Values, 31, 107-134.

Southern California Water Recycling Projects Initiative (SCWRPI) (2004). Successful

Public Information and Education Strategies: Technical Memorandum. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

Terragni,, L., Bahr Bugge, A., & Jensen, H. M. (2008) Ikke drikk vann fra springen!

Reaksjoner og implikasjoner etter drikkevannsaken i Oslo, Oktober 2007. Oppdragsrapport nr. 1-2008. Available at: http://www.sifo.no/files/file73137_oppdragsrapport2008-1-web.pdf

Tierney, K. (2003). Disaster Beliefs and Institutional Interests: Recycling Disaster

Myths in the Aftermath of 9-11. In L. Clarke (Ed.), Terrorism and Disasters: New Threats, New Ideas. Research in Social Problems and Public Policy. London: Elsevier.

Ulmer, R.R. (2001). Effective Crisis Management through Established Stakeholder

Relationships: Malden Mills as a Case Study. Management Communication Quarterly. 14, 590-615.

Venette, S.J. (2006). Special Section Introduction: Best Practices in Risk and Crisis

Communication. Journal of Applied Communication Research. 34, 229-231. Wakeford, T. (2002). Citizens Juries: A Radical Alternative for Social Research. Social

Research Update, University of Surrey, Department of Sociology. Issue 37. Available at: http://sru.soc.surrey.ac.uk/SRU37.html

45

Woo, D. M. & Vicente, K. J. (2003). Socio-Technical Systems, Risk Management, and Public Health: Comparing the North Battleford and Walkerton Outbreaks. Reliability Engineering System Safety, 80, 253–269.

World Health Organization (WHO) (2005). Outbreak Communication: Best Practices

for Communicating with the Public During an Outbreak. Report of the WHO Expert Consultation on Outbreak Communication held in Singapore, 21-23 September, 2004.

46

Appendix 1. Short-term Contamination Events: Case Studies from the

Water Sector

47

Case Study 1: Bergen Giardia Outbreak, Norway

Location Bergen, Norway

Date

October to December, 2004

Nature of Incident

The Bergen Giardia outbreak was located in the city centre. Investigations attributed the incident to a combination of leaking sewage pipes and insufficient water treatment. Although the public water supply that provided drinking water to the central areas of the city of Bergen (Lake Svartediket) was identified as the source of the outbreak, there was a considerable delay in locating the precise source of the outbreak. The incident lead to an estimated 4000-6000 illnesses; although only 1400 cases were confirmed, many went unconfirmed.

On 29th October 2004, an increase in laboratory cases of Giardiasis was confirmed to the municipal authority of Bergen and the Haukeland University Hospital alerted the municipal medical officer about an increase in patient diagnoses of the illness, and a possible outbreak of the infection. The alert was based upon 27 cases of Giardia that had been confirmed by laboratory testing of patients in the preceding two weeks, a figure which would usually constitute the total annual incidence of Giardiasis in Bergen. During this time, medical general practitioners in the area had also reported an increase in patients with symptoms of gastroenteritis, where patients had cited no recent travel related history. The number of cases and the fact that most affected individuals had been infected in their own communities, predominantly in central Bergen, gave grounds for treating the incident as an outbreak caused by something in the local environment (Eikebrokk et al., 2006).

On 1st November 2004 the municipal authorities convened a meeting with relevant professional representatives and a crisis management plan was established in accordance with the council contingency plans (Eikebrokk et al., 2006). The municipal authorities launched an immediate investigation in order to determine the source and extent of the outbreak with a view to implementing control measures. The outbreak team included members of the municipal health authorities, the regional food safety authority, and the regional water and sewage authorities. The specific aims and objectives of the investigatory team were; a) to ascertain the extent of the outbreak, b) to identify the source of the outbreak and, c) to develop and implement both short-term and long-term control measures (Nygren et al., 2006).

As part of the investigation and in addition to epidemiological and parasitological studies that were carried out after the onset of the outbreak had been identified, an environmental investigation was also initiated. Firstly, existing water quality analyses pertaining to the period August to November 2004 were reviewed and compared with corresponding analyses from the previous year. The parameters of the investigation were turbidity, Bacterial counts, and counts of coliform Bacteria, E.Coli and

48

other spores. In addition, beginning on 3rd November, the water and sewage authority carried out surveys in the area in order to identify the possible sources contamination of the water supply. The results of the environmental investigation and related inspections demonstrated that, within the sewage system the pipes were old, with signs of leakage. It was found that in times of heavy rainfall, overflow from the pipes would lead to seepage into the surface lake that served one of the water supply systems (Nygren et al., 2006). The source of infection was later identified as drinking water, specifically water from the Svartediket water treatment works (Eikebrokk et al., 2006).

Hospital files demonstrate that the epidemic probably started some six weeks before the outbreak was officially recognized (Steen and Damsgaard 2007), and it has been stated that the large public health impact of the outbreak was due to late detection and passive surveillance of confirmed cases (Nygård et al. (2006). In 2006 it was reported that 1,300 laboratory cases of Giardiasis had been confirmed, while 2,500 people received medical treatment (Nygren et al., 2006). It is thought that considerably more cases remained unreported, while Giardia infections considered to be related to the outbreak continued to be diagnosed up till June 2005 (Robertson et al., 2006).

Public Response

Due the delay in locating the source of the outbreak, most initial information was provided by local media. Thematic analysis of newspaper reports documenting the outbreak demonstrated much uncertainty; authorities were portrayed as having little control of locating the source of the outbreak, while the number of illnesses was rising. Attempts were also made to explain or place ‘blame’ in tracing the source of the contamination. The issue of uncertainty in relation to the municipality and the safety of its water was propagated. The municipality were portrayed as uncertain about the source of contamination, and since Svartediket was a suspected source, the issue of how Lake Svartediket came to carry Giardia became a main concern in the articles. Newspaper articles tended to amplify the possible risks of tap water to the health of the national population. The local outbreak of Giardiasis in Bergen was used as being indicative of problems within the water sector issues across Norway, with claims that up to 235 water works were at risk of infection, primarily due to the lack of appropriate water treatment techniques. In addition, during the incident, newspaper reports featured conflicting statements from experts as to the safety of tap water (Kelay & Fife-Schaw, 2010).

Actions taken

Consistent with the municipality crisis management plan, with the extent and the possible source of the outbreak identified by the epidemiological findings and results from water samples, measures were introduced to control the outbreak. On 5th November (a week after the first reports of illnesses), a boil notice was issued to residents who received drinking water from the affected water works. Instructions were also issued to institutions about water use and preventative measures to curb the spread of the illness. In addition, the waterworks redirected supplies to the affected area from other water networks; the provision of drinking water from the affected water supply system was therefore restricted and from

49

5th November 2004, the number of drinking water recipients from the affected water supply system was reduced from 25,000 to 6,700. In addition, the water distribution network in central Bergen was flushed in order to eliminate any remaining Giardia cysts. In the interim, both public and private sewage pipes were inspected and repaired if required (Nygren at al., 2006).

The public were kept informed about the situation via a mapping system featured on the municipality website. The tool was used to inform the public about when it would be safe to drink tap water. By 21st December 2004, the boil notice was lifted on the grounds that water sample tests had demonstrated that contaminants had been eliminated. However, many members of the public remained unwell, and as a result the health authorities advised the public to maintain high levels of hygiene.

Other municipal responses included the announcement of plans to implement an interim UV disinfection facility by early 2005 and planning new treatment facilities for 2007.

Outcome

In the case of Norwegian citizens’ trust in governmental bodies’ abilities to manage crises, there is evidence to suggest that the outbreak of Giardia in Bergen may have served to diminish levels of trust and perceived levels of competence in the short term. In a questionnaire study carried out two years after the outbreak in 2006, Christensen et al., (2007) asked people how they assessed the government’s ability to prevent and handle various crises and accidents, including natural accidents (e.g. flooding, avalanches), other accidents (e.g. air, railways) and infections related to food, drinking water or other contamination. Amongst the sample (n=1368), Christensen et al. found that overall citizens’ ratings of trust and competence were high for government crisis management, and that they had more trust in the authorities’ abilities to handle crises than to prevent them. However, regarding the types of incidents, high levels of trust and competence in government handling were linked primarily with transport crises and accidents, whilst ratings of incompetence were highest for epidemics and infection related incidents. The authors acknowledged that this finding may have been in the light of the recent Giardia outbreak. Recent within company surveys (Røstum, 2010, personal communication) suggest that consumer satisfaction levels with the company are now back to pre-outbreak levels.

Documented Evaluation of Action

After the outbreak two evaluation reports were commissioned, firstly by the key actors in the crisis management group (i.e. the municipal health authorities, the regional food safety authority, and the regional water and sewage authorities; and secondly by the municipal authorities who commissioned a report by an independent accident investigation committee (Eikebrokk, 2006). The purpose of the latter report was to investigate the likely causes and contributing factors leading up to the outbreak, and to evaluate the management and handling of the crisis. The committee concluded that, once the source of the outbreak was located, the authorities managed the outbreak of Giardia positively, in accordance with the municipality’s emergency plans for crisis and critical situations. The committee concluded that the municipality of Bergen kept

50

residents well informed about the outbreak via their own website and in cooperation with the local media. Although it was concluded that large audiences were reached by the internet, one of the many outcomes of the investigation was that the municipality has since established agreement with the Post Office to send out printed information to residents at short notice (Eikebrokk et al., 2006). In-depth investigations lead to the conclusion that the outbreak could have been prevented if important drinking water regulations had been adhered to. On the basis of the investigations, the committee believed that the direct cause of the Giardia outbreak was leaky sewer systems in the settlement areas of Knatten, Starefossen and Tarlebøvegen. They placed emphasis on the fact that the deficiencies identified were not specific to the Svartediket treatment works, since similar incidents could occur in other waterworks in Norway. It concluded that major provisions in the national regulations of drinking water had not been met and that the maintenance of some of the public and private drainage facilities in connection with the settlement areas had been deficient. In addition, the evaluation brought to light lack of control and inspection of the waterworks facilities. As part of the evaluation, the committee also investigated the extent to which technical and political responsibilities had been met, with particular emphasis upon medical and epidemiological practices. Here, the committee aimed to investigate whether the outbreak could have been detected sooner. Evaluative methods involved interviewing general practitioners, emergency service workers, specialist health service workers, hospital representatives, and health agency officials. It was found that medical practitioners did not comply with official reporting guidelines and that specific epidemiological monitoring and ‘surveillance’ tools for reporting communicable diseases were not used efficiently suggesting that the outbreak could have been identified earlier. In addition, communication between doctors and health authorities was found to be ineffective, due to a lack of information about the fax number and e-mail addresses of the offices. In the light of such issues, the committee concluded that the outbreak could have been identified two to four weeks earlier. They stated this could have reduced the number of infected individuals, and prevented many people from becoming infected. Since the outbreak the municipality has focused on proactive risk management of the complete water supply system, involving all elements, from source to tap (Røstum et al., 2009).

Sources Christensen, T, Fimreite, A L, and Lægreid, P. (2007). Crisis Management: The Case of internal security in Norway. Stein Rokkan Centre for Social Studies. Working Paper. Available at: https://bora.uib.no/dspace/bitstream/1956/2485/1/N08-07_Cristensen_Fimreite_Laegreid.pdf Dalheim, E. (2009). Kommunal krise – nasjonal vekker. En studie av Bergen kommunes håndtering av giardiautbruddet høsten (2004). Department of Administration and Organization Theory. Bergen: University of Bergen. (In Norwegian). Available at: http://www.rokkansenteret.uib.no/fniv/files/Masteroppgave, Eirik Dalheim.pdf

51

Eikebrokk , B, Gjersatd, K O, Hindal, S, Johanson, G, Røstum, J, and Rytter, E, (2006). Giardia-utbruddet i Bergen høsten 2004, Rapport fra det eksterne evalueringsutvalget (In Norwegian). Available at: http://www.sintef.no/upload/Teknologi_og_samfunn/Sikkerhet%20og%20pålitelighet/Rapporter/Sluttrapporten%20Giardia.pdf Kelay, T. & Fife-Schaw, C. (2010). A Waterborne Outbreak of Giardasis: Bergen, Norway, 2004. Techneau Deliverable D7.11.1 Nygård, K, Schimmer B, Søbstad O, Walde, A, Tveit, I, Langeland, N, Hausken, T, and Aavitsland P, (2006). A Large Community Outbreak of Waterborne Giardiasis-Delayed Detection in a Non-Endemic Urban Area. BMC Public Health, 6 (141). Nygård ,K, Schimmer B, Søbstad Ø, and Tveit I. (2004). Waterborne Outbreak of Giardiasis in Bergen, Norway. Euro Surveillance, 8, 2583. Robertson L J, Hermansen L, Gjerde B K, Strand E, Alvsvag J O, and Langeland N (2006) Application of Genotyping during an Extensive Outbreak of Water-Borne Giardiasis in Bergen, Norway, During Autumn and Winter 2004. Applied and Environmental Microbiology, 72, 2212–2217. Røstum, J and Eikebrokk, B (2008) Cost Report: Proactive Crisis Management of Urban Infrastructure. Case B1: Bergen’s Giardia- Outbreak Autumn 2004: Results from the External Accident Investigation Committee, 130 -140. Røstum, J, Aasen, A, and Eikebrokk, B (2009). Risk and Vulnerability Assessment (‘Ros-Analysis’) of the Bergen Water Supply System: A Source to Tap Approach. Risk Management of Water Supply and Sanitation Systems, NATO Science for Peace and Security Series C: Environmental Security, Part 1.

52

Case Study 2: Milwaukee Cryptosporidium Outbreak

Location Milwaukee, USA

Date

1993

Nature of Incident

The Milwaukee Cryptosporidium outbreak is reported to be the largest epidemic of waterborne disease documented US history (Blair, 1995; Ellis, 2007). It is estimated that over 400,000 of the 1.61 million residents of the Milwaukee area were affected during the outbreak. (Mac Kenzie et al., 1994), while others have reported that 39% of the local population suffered (Griffin et al., 1998). It is estimated that the outbreak contributed to the premature deaths of 100 people, including the elderly and immuno-compromised members of the population (AIDS and cancer patients); it is further estimated that 4000 people were hospitalized as a result of the outbreak (Griffin et al., 1998).

The total cost associated with the illness is estimated to be $96.2 million (Corso et al., 2003). The incident has been the focus of many studies regarding the cause of the outbreak, as well as learning lessons from the incident in terms of developing methods to prevent further outbreaks of a similar magnitude (Huffman, 2003).

In the events leading up to the outbreak, the affected region experienced heavier than normal rainfall. Increasing amounts of run off from agricultural areas, as well as storm water and sewage catchments were diverted into Lake Michigan. Turbidity levels fluctuated dramatically, and drinking water treatment plants whose intakes were located along Lake Michigan noted peaks in turbidity in the raw water. There was a marked, increase in customer complaints regarding taste and odour, and treatment plant operators responded by adjusting levels of powdered activated carbon (PAC) and other treatment processes (Huffman, 2003). On April 5th, the Milwaukee Department of Health contacted the Wisconsin Division of Health in relation to reports of a number of cases of gastrointestinal illnesses. On April 7th, laboratory tests identified cryptosporidium in samples from seven local residents. Also, a survey revealed that nursing home residents in southern areas of the city were 14 times more likely to have had diarrhea than those in the northern part of the city. On April 8th the Mayor issued an advisory notice to the customers of Milwaukee Water Works to boil their water, and shortly afterwards the water treatment plant was ordered to be closed down (Huffman, 2003).

Public Response

Sellnow et al. (2009) reported that by March 29th, customer complaints had reached a peak, and that the local health department had observed a high level of absenteeism in schools and hospitals, while local pharmacies had sold out of anti-diarrheal medications.

53

The outbreak also received considerable media attention (Griffin et al., 1998). Including the provision of health warnings and information about the parasite, symptoms, and about how widespread the illness had become. Coverage also focused upon speculation as to how the parasite came to be in the water supply (theories included runoff from farms and the water utility’s lack of experience with a new water treatment chemical. Griffin et al. (1998) also reported that the local news media also ran stories about the perceived lack of responsiveness to complaints made by members of the public about water quality prior to the peak of the outbreak. One newspaper reported that 62 people had called the Milwaukee Water Works between March 27th and 29th (nearly a week before the first cases of illnesses were reported) to complain that their tap water was “dirty, smelly, cloudy, and bad tasting”. Griffin et al. (1998) stated that these people were assured the water was safe to drink, and were told that someone would call them back, or were given what they regarded as excuses for the quality of the water. Many of the people who complained subsequently became unwell. Sellnow et al. (2009) also stated that during the incident, the public were “frustrated” by the slow response of officials – “when the public needed risk communication, they received none. No one was available to answer or return residents’ calls. In fact city officials avoided dealing with the problem simply because they did not know enough about it” (Sellnow et al, 2009, 66-67). Public response has also been characterized as “outrage”. Griffin et al. (1998 report that a survey conducted nearly six months after the incident showed that about 29% of respondents believed that the tap water in their house was not safe; also 27% reported that they had less confidence in local authorities, due to the incident. They reported that this lack of confidence continued for a further year, and even three years afterwards, the question of how well the local authorities had protected citizens during the outbreak a campaign issue in mayoral elections. In their own study based on 610 telephone interviews, Griffin et al. (1998) found that four years after the outbreak, worry about becoming ill in the future was related more strongly to public use of the media than variables related to risk perception and experience.

Actions taken

By the evening of April 7th, The Milwaukee Water Works issued its’ customers with an advisory statement to boil their water. Griffin et al. 1998) report that residents were advised to boil their tap water for five minutes before using it for potable purposes; residents were also advised not to brush their teeth with tap water. People who were ill were advised to keep hydrated and to practice good hygiene. Sellnow et al (2009) also state that efforts were made in the local media to warn people.

One of the two plants (the southern plant) was temporarily closed on April 9th

The boil advisory was lifted on April 14th, after tests showed that the parasite was no longer in the water system.

54

Outcome

By 1995 The Milwaukee Health Department had opened a "Crypto Lab," to allow regular testing for Cryptosporidium and Giardia (Blair, 1995). In terms of lessons learned, it has been reported that this outbreak, and public disquiet brought about improvements, standards and safeguards in the US. ‘Ripple effects’ occurred, whereby municipalities began to filter their sources of water more effectively (Ellis, 2007). The outbreak was described as a “wake-up call” to the US, particularly in relation to inadequacies in watershed protection programs, public health surveillance and drinking water standards. Furthermore, the incident prompted the formation of new partnership arrangements between water utilities and public health agencies (Blair, 1995).

On a more operational level, since the incident, precautionary boil-water orders became more common across the United States (CNN, 1996).

Documented Evaluation of Action

The Milwaukee Incident and the treatment plant concerned has come to exemplify system vulnerability – events leading up to the incident included climatic change, ageing infrastructure and a lack of adequate watershed protection (Huffman, 2003).

As reported by Sellnow et al. (2009), the incident lead to changes in public health, surveillance and water treatment, leading to the development of specific guidelines and protocols for handling waterborne outbreaks in the United States. They also state that the incident served as a “wake up call because it exposed flaws in the public health system”, and that subsequent guidelines emphasized the need for open communication networks with several types of stakeholders, including public health officials and health physicians (Sellnow et al., 67).

An independent report submitted to the City of Milwaukee in 1995 recommended the need for long-term investment in the infrastructure and technology used to supply Milwaukee’s water (as well as the US at large).

Sellnow et al. (2009) examined the incident in detail, in relation to best practices in risk communication. In terms of how the incident was handled, they observed that officials failed to recognize that there was a problem with the water supply, in spite of consumer complaints and a rise in illnesses. They stated that if communications between officials had been stronger, the problem would have been identified sooner. In terms of providing the public with information, they stated that officials “avoided dealing with the problem simply because they did not know enough about it” (Sellnow et al., 2009, 67). They went on to state that the ways in which officials handled the event had various implications for the outcome of the epidemic. In applying principles of best practice in risk communication, Sellnow et al. (2009) recommended the following: Account for the uncertainty inherent in risk Lessons learned:

55

- “initial signs were not perceived to pose a threat. - the signs were not handled with the immediacy they should have been. - officials were not communicating effectively about the need to better monitor the system. - the company did not consider and communicate about potential threats. Not having proper systems and practices in place set the Milwaukee officials up for disaster during their crisis response” (Sellnow et al., 2009, 70). Collaborate and coordinate about risk with credible information sources Lessons learned: - “city officials waited to communicate with the public until they could attribute the sickness to a definite source”, rather than making statements to reduce fears or uncertainties, and demonstrating a willingness to participate in answering questions (Sellnow et al., 2009, 70). - “city officials did not have a clear message and this left stakeholders in a greater sense of uncertainty” (Sellnow et al., 2009, 71).

Sources Blair, K. (1995). Cryptosporidium and Public Health. Drinking Water and Health Newsletter. Available at: http://waterandhealth.org/newsletter/old/03-01-1995.html CNN (1996). Milwaukee Learned its Water Lesson, but Many Other Cities Haven’t. Available at: http://www.cnn.com/HEALTH/9609/02/nfm/water.quality/ Corso, P. S., Kramer, M. H., Blair, K. A., Addis, D.G., Davis, J.P & Haddix, A. C. (2003). Cost of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin. Emerging Infectious Diseases, 9, 426 -431. Ellis, K. (2007). Cryptosporidium in Milwaukee’s Water Supply Caused Widespread Illness. Infectious Disease News. Available at: http://www.infectiousdiseasenews.com/200709/eistories.asp Griffin, R. J., Dunwoody, S. & Zabala, F. (1998). Public Reliance on Risk Communication Channels in the Wake of a Cryptosporidium Outbreak. Risk Analysis, 18, 367-375. Huffman, D. (2003). ‘The City of Milwaukee Cryptosporidium Outbreak: What Really Happened and Hw Vulnerable Are We?’. In Water Contamination Emergencies: Can We Cope? Gray, J. & Thompson, K. C. (Eds) The Royal Society of Chemistry. Mac Kenzie, W.R., Hoxie, N.J., Proctor, M. E., Gradus, M.,Blair, K. Peterson, D.E., Kazmierczak, J. J., Addiss, D. G., Fox, K. R. B., Rose, J. and Davis, J. P. (1994). A Massive Outbreak in Milwaukee of Cryptosporidium Infection Transmitted through the Public Water Supply, The New England Journal of Medicine, 331, 161-167.

56

Sellnow, T.L., Ulmer, R.R., Seeger, M.W. & Littelfield, R.S. (2009). Effective Risk Communication: A Message Centered Approach. Springer: New York.

57

Case Study 3: Lilla Edet, Sweden

Location Lilla Edet, Sweden

Date

September 2008

Nature of Incident

In September 2008 at least 2000 people of a population of approximately 9000 people served by the Lilla Edet municipal water supply fell ill in a calicivirus outbreak. The unfolding nature of events were as follows: A week prior to the first reports of illnesses, high levels of turbidity were detected in the Göta River, which supplies drinking water to approximately 700,000 people through six drinking water treatment plants. The water intake serving the city of Göteborg was closed on the 6th of September and drew on its reserve sources, the Rådasjön and Delsjön lakes. Consequently, Göteborg was effectively protected from this faecal contamination event. Lilla Edet had no reserve and so increased the chlorine dose to protect their drinking water from microbial contamination. On the 11th of September 150 cases of gastro-intestinal illness were reported in TTELA, a web-based news source. As later verified by an epidemiological survey, most cases of illnesses occurred on the evening of the 9-10th of September. Due to several reports of illness during the day of the 11th of September the environmental chief of Lilla Edet was informed of the situation by the county doctor for infectious diseases at the regional hospital in Uddevalla. Water samples were taken and nothing was found for the analysis of pathogenic viruses but mapping of cases commenced under the auspices of the Swedish Institute for Infectious Disease Control (SMI). In the evening of the 11th of September the public were informed by the municipality through the media that they should not drink tap water unless it was boiled first. By 12th of September the number of notified cases rose to 350 and consumers were told to continue boiling water and raise general hygiene standards (thorough hand washing etc.). However on the same day TTELA reported that the Lilla Edet municipal supply had no alternative reserve water source and had already been aware of indications of faecal contamination (E.coli) in the river. They also noted that Göteborg had avoided the problem by taking water from other reserve sources on the 6th of September. Ironically, there was also an article in TTELA on 11th September concerning the problem of sewer overflows in Trollhätten municipality which is upstream the Lilla Edet intake. On 15th September TTELA reported that the outbreak might be attributed to an illegal discharge into the Göta river. Two people had seen a belt of

58

sewage and toilet paper in the river two kilometres upstream of the Lilla Edet intake on the 6th of September. A police report to this effect had been made by the environmental chief on the 13th of September and she commented in the media on the possibility of a ship, a septic tank or a private discharge as causes. The police also received reports that a travelling circus had been seen emptying a septic tank into the river though later investigations question the reliability of these reports and by 22nd September it is known that the circus had not been in the area at the time. It is also noted by the police on the 22nd that there is no independent evidence that the belt of sewage and toilet paper reported by the public was in fact sewage. In part of a longer interview with TTELA the political leader of the municipality (the equivalent of the mayor) stated that he was still drinking the tap water. The environmental chief responded the next day (the 17th of September) saying that the advice to the public was still to boil the water. A week later (the 22nd of September) an expert committee including representatives from SMI, the national food administration, the Lilla Edet municipality, and the national water catastrophe group, put forward their finding that it was most likely that drinking water was the cause of the outbreak. A decision was made to send out a questionnaire to determine the temporal and spatial spread of the gastrointestinal illness. On the 18th of September samples from 11 of 15 individuals with reported gastrointestinal illness in the municipality were positive for calicivirus. Preliminary positive results from the analysis of calicivirus in the source water however were not confirmed by later analyses. In the source water sampling regime (three times per week for microbial analysis) the highest E. coli levels were detected on the 8th of September. Sixteen days after the notification of the outbreak on the 27th of September the municipality home webpage declared that samples had shown the water was now free from microbial contaminants and it was now possible to drink tap water without boiling it first. This decision was made jointly with the SMI, the national water catastrophe group and the national food authority. By 27th September test results showed that there was no contamination in the water and the recommendation to boil the water could be raised. Press release and information was posted on the homepage (Chief Environmental Officer’s Logbook, 2008). TTELA reports on 26th of November that the questionnaire showed that at least 2000 people had been affected by the outbreak. The county infectious disease doctor at Uddevalla hospital stated that water was the most likely cause of the outbreak as judged from the results of the epidemiological investigation based on the questionnaire. The municipal environment chief also says in the media that tap water is the likely cause and that those who have municipal water were more represented among the affected than those with private wells. Also she notes that the first cases were in Lilla Edet, followed later by Lödöse and then Nygård which is consistent with the nature of the supply infrastructure. None of these statements confirm whether the source of viral contamination of drinking water was from the source water or the pipe infrastructure. Some six weeks passed without any further clear statements in the media

59

about the source and exact nature of the outbreak until on the 9th of January 2009 when representatives of the water treatment plant presented their version to the public via TTELA. They did not believe that the sickness was waterborne as no calicivirus was detected in water samples. They claimed that the detection of somatic coliphages reported earlier were due to the use of non sterilised sampling bottles although this possibility had been excluded by the expert committee. They make it clear in the media that feel that they had been blamed unfairly (Fife-Schaw et al., 2009). The exact source of the outbreak remains the subject of uncertainty and no conclusive public declaration identifying the source has been made at the time or writing.

Public Response

Prior to the incident, the municipality of Lilla Edet had experienced an overall reliable supply service of high quality water. In 2005 Lilla Edet received a prize for tastiest water in Sweden in the Swedish Water’s yearly competition. Anecdotally, it is believed that Lilla Edet inhabitants had very high satisfaction levels concerning the water supply in the municipality and generally high trust in the authorities involved in the service provision (Bratanova et al., in preparation). Records of municipality website hits (which increased from a normal 2000-2500 per day to 3000-6000 during the outbreak) and telephone calls (with extra opening hours on the telephone exchange during the outbreak) demonstrated a marked increase during the outbreak. A survey conducted in January 2009 amongst a sample of 392 respondents demonstrated that during the incident, the local public relied heavily on media reporting and on the response of politicians, municipality employees and utility workers. Newspaper reporting was thought to be generally accurate and informative (Fife-Schaw et al., 2009). In the questionnaire respondents were asked to reflect on how they felt about their water supply at that time (e.g. just after the incident), compared to how they felt before the outbreak. The pattern of findings suggested that while there are minor shifts in the direction of being less happy with those responsible for the supply, generally levels of support are high as are views about the quality of their supply. For example, in response to a question asking people to indicate their level of agreement with the statement "The quality of the tap water is a low priority issue among the municipality's politicians" only 26.8% agreed with this statement after the event. This should be compared to 20.8% who indicated that they would have agreed with it anyway before the event.

Actions taken

A boil notice was issued by the municipality on the first day of reports of illnesses (11th September). The authorities acted swiftly. The contamination protection unit (Smittskyddsenheten, SME), the municipality, Livsmedelsverket, Länsstyrelsen, Nationella vattenkatastrofgruppen (VAKA), Smittskyddsinstitutet, the virological laboratory at the Sahlgrenska university hospital, and Vårdcentralen formed a crisis group. Regular telephone meetings were held and clear directions were given to the inhabitants (Larsson & Ekvall, 2009). The existence of this group was

60

made known to the public. By 12th September a number of precautions were taken in schools and in homes for the elderly. The restaurants in the area were contacted and informed about how to handle food and water. Notices were posted to inform people traveling through not to drink the water in the tap. By 13th September water distribution system had been flushed and the public were informed to turn on their taps in order to flush these systems as well. This is done through the homepage and through the local radio station. (Chief Environmental Officer’s Logbook, 2008). Information on the outbreak, including a press releases, was continuously updated by the Västra Götaland County Medical Office on their website. The municipality were proactive in dealing with the media, (particularly through the chief environmental officer) and providing relevant information (Fife-Schaw et al., 2009). Also, calls from the media were handled throughout the incident, and radio interviews were given (Chief Environmental Officer’s Logbook, 2008).

Documented Evaluation of Action

Fife-Schaw et al. (2009) observed that the municipality’s handling of this event, while not sufficient to prevent a large proportion of the population becoming ill, demonstrated a genuine concern for the well-being of the public. Once cases were notified, the decision to tell people to boil their water was made quickly through the media. The senior environmental officer in Lilla Edet made a public announcement that the tap water was not to be drunk before boiling only 2 hours after the first alarm about people falling ill and she was visible in the media throughout the incident. However, the nature of events nonetheless presented the public with a number of indicators or potential performance failings of those involved bringing into question their competence and thus challenging confidence. The media made it clear that high levels of contamination were noted on the 6th of September and that Göteborg had been able to draw on alternative supplies while Lilla Edet had none to draw on. Consumers might ask why this safeguard was not in place to protect the public in Lilla Edet and this suggests a lack of resilience in the supply system and adequate risk management. Although it seems that the municipality acted appropriately in warning consumers, departments within the municipality did not agree on the source or seriousness of the outbreak. The comments of the political leader of the municipality indicating that he would drink tap water thus implicitly not accepting the advice of the municipality’s own experts caused some public consternation as indicated by responses to the survey conducted on behalf of the TECHNEAU project. Similarly the environment chief claiming that the incident was waterborne while the waterworks engineers challenged this in the media was unlikely to have instilled confidence in the public since it suggested blame avoidance in parts of the municipality. The fact that disputes were being played out in public two months after the outbreak may have given the impression that those responsible for identifying the cause of the outbreak had not done their jobs properly. In most situations confidence is likely to be enhanced by knowing that the cause of a negative event is clearly identified and understood, however, well over a year after the incident, the cause of the outbreak had not been

61

formally identified. In order to assess the impact on public trust and confidence, a follow-up survey was conducted in September 2009. The results of the study demonstrated that inhabitants’ experience of sickness had no significant influence on their trust in the water supply authorities. Awareness that the cause for the outbreak was the presence of calicivirus in the water did not affect trust in the authorities, nor did the inhabitants’ reliance on municipal water supply in their homes. That is, the aspects of the incident related to the direct physical contact with the source of the contamination and the experience of its negative consequences had little influence on the level of trust in the water supply authorities. In absolute terms, while levels of satisfaction with the water supply had yet to return to pre-event levels, the levels were relatively high one year after the event. Bratanova et al. (2010) show that although a water contamination event which results in sickness for a large proportion of the population can be expected to elicit a strong and negative affective reaction, in this context, those who had pre-existing high levels of trust in the authorities were more likely to be satisfied and feel safe irrespective of whether they were directly adversely affected in the outbreak.

Sources Bratanova, B., Morrison, G., Fife-Schaw, C., Chenoweth, J., & Mangold, M. (2010). Restoring Satisfaction following a Water-borne Disease Outbreak: The Role of Trust, Blame, Risk Perception, and Communication. (Under Review) Ekvall, A. (2008). Logbook of Events Chronicling the Lilla Edet Waterbourne Outbreak (personal correspondence). Fife-Schaw, C.R., Barnett, J., Morrison, G., Åström, J. & Hartung, J. (2009). Enhancing consumer relations: The role of trust and confidence. IWA/TECHNEAU: Safe Drinking Water from Source to Tap: State of the Art and Perspectives Conference. Maastricht, Netherlands, 17-19 June 2009. Larsson C. & Ekvall A. (2009). Report on Lilla Edet Water-Borne Disease Outbreak (In Swedish). Svenskt Vatten, 3, 16-17.

62

Case Study 4: The Sydney Water ‘Crisis’

Location Sydney, Australia

Date

1998

Nature of Incident

The “crisis” involved three major bacterial contamination episodes between 21st July and 19th September. High concentrations of Cryptosporidium oocysts and Giardia cysts were reported in the city’s drinking water. The incident coincided with preparations for the 2000 Summer Olympic Games, to be held in Sydney. Episode One – 21st July to 4th August On 21st July routine water monitoring revealed Giardia and Cryptosporidium in the water supply. By 27th July officials issued a boil water notice for areas of the water distribution system; after various parts of the system were flushed, water samples were negative, and the notice was lifted on 4th August. No significant increases in gastric-related illnesses were reported before or after the boil notice was issued. Episode Two – 24th August to 5th September Following a period of negative readings after the first episode, positive sample readings were detected from 14th August onwards, and were significantly high towards 24th August. Boil water notices were issued to areas of the water distribution system between 25th August and 28th August. By 1st September tests yielded negative readings and the boil water notices were cleared by 4th September. Episode Three – 5th September to 19th September After positive readings on 4th September the boil water notice was reissued. It was lifted on 19th September.

Public Response

Media reports after the first boil notice was issued suggested chaos amongst Sydney residents, including a rush for purchasing bottled water, and local clinics were ‘inundated’ with queries from concerned citizens. Later report headlines included the headlines “Contaminated”; “Do Panic! There’s a Bug in the System”; “Polluted Water Crisis”; “End of an Era for Reliable, Safe Water”. Events were reported as an unprecedented health crisis in Sydney. The issuing and withdrawal of boil notices, coupled with the strong media input gave rise to much public confusion. By September 19th an informal survey of the local population demonstrated inconsistent compliance with the boil water advisory notices; when asked what water they consumed, 65% said they drank on bottled or boiled tap water; 19% said they sometimes drank unboiled tap water; and 14% said they always drank unboiled tap water. It was estimated up to a

63

million people were not observing the warnings in place.

Actions taken

Over a period of nine weeks, boil water notices were issued and later withdrawn three times.

Outcome

Although high levels of cryptosporidium were detected in the drinking water supplied to consumers during this time period, extensive surveillance demonstrated a negligible impact on public health, with no consistent evidence of increases in gastro-intestinal illness, or any increase in laboratory-diagnosed cases of the disease. The incident has since been reported as a “non-outbreak”, since there were no increases in illnesses across the areas concerned. A public inquiry was launched after the first incident. The inquiry focused primarily upon the causes of contamination. Particular attention was focused on the validity of the monitoring results, and whether the crisis was in fact a false alarm. This case study exemplifies the emergence of a ‘crisis’ at two levels. Firstly how water and health officials managed events as they unfolded, and secondly the significant impact of the media. Negative media reports coincided with the emerging water-related events, and served to question the credibility of public service institutions. Water officials, health officials and politicians received strong criticism from the media throughout the incident, especially the Chairman of Sydney Water, who had attempted to withdraw the first boil water notice issued by health officials. These events served to culminate in his later resignation. It has since been suggested that ‘sparring’ between the water company and the health department did little to assure the public that their interests and welfare were being taken into account. The Chairman and Managing Director of the Sydney Water Corporation resigned, senior managers were removed from their responsibilities and the company lost responsibility for various other assets including dams, reservoirs and catchments. The incident was estimated to have cost the Sydney Water Corporation over $37 million in direct costs, while contingency costs were estimated at over $100 million. It has since been reported that public misgivings in relation to this incident lead to the shelving of a potable water recycling research and demonstration plant in Quaker’s Hill, north west of Sydney (Stenekes, 2006).

Documented Evaluation of Action

Given the presence of high concentrations of Giardia and cryptosporidium in the public water supply, which were of a public health concern, officials acted by issuing boil water notices. However, there was no evidence of an increased incidence of cryptosporidiosis among drinking water consumers at any time during the crisis, despite increased surveillance by health authorities. This “non-outbreak” demonstrates limitations of the reliance on monitoring and surveillance as the chief tools for protecting public health from waterborne outbreaks.

Sources Hrudey, S. E. & Hrudey, E. J. (2004). Safe Drinking Water: Lessons from Recent Outbreaks

64

in Affluent Nations. IWA Publishing. Stenekes, N., Colebatch, H.K., Waite, T.D. & Ashbolt, N.J. (2006). Risk and Governance in Water Recycling: Public Acceptance Revisited. Science, Technology and Human Values, 31, 107-134.

65

Case Study 5: Burncrooks Diesel Incident, Scotland, United Kingdom

Location Scotland

Date

December 1997

Nature of Incident

Burncrooks Water Treatment Works – a surface water abstraction and drinking water treatment works – experienced and incident whereby diesel oil contaminated the public water supply. The incident occurred on 9th December 1998. Between 10th to 17th December the water supply system was contaminated with diesel oil. Fawell (2003) documented the events as follows: The incident was one of the most serious water supply failures in the UK in the 1990’s. It affected about 60,000 customers, many of whom had to carry water from bowsers in the streets for all purposes except toilet flushing for periods of up to 6 days. About 2,000 special needs customers received a total of about 5,500 deliveries. 23 primary schools and 6 secondary schools were closed affecting the education and domestic arrangements of some 10,700 pupils. Some 60 food businesses had to close or restrict their operations. The incident was not life threatening, with few grounds to believe that any significant injury or illness occurred as a result of the contamination. Moreover, there was no major or lasting damage done to property, buildings or businesses. The fact that water supply for toilet flushing was maintained throughout the incident meant that a major threat to public health was avoided. The water company was severely criticised in the media for its management of the incident. The way the company managed its relations with the media became a cause for criticism in its own right. It was later concluded in an independent inquiry the poor press probably undermined public confidence in the water company (Fraser, 2007).

Public Response

Customer complaints regarding taste were received on 10th December. As the number of complaints increased, the management declared an emergency. Due to inadequacies of the water company’s telephone service system, the local councils estimated that their emergency helplines handled some 20,000 telephone calls from the public about the effect of the incident on areas such as education, environmental health and social work. The public also called the local police as they were unable to contact their water company, often using the emergency 999 number.

Actions taken

Fawell (2003) documented that, due to the number of complaints the management declared an emergency, whereby the water company established an internal incident control team to manage the response to the

66

incident. There was no defined role in them for other agencies such as the Police or Councils however. The procedures involved the distribution of leaflets and the issue of news releases alerting the public to the contamination. The advice was that the use of water should be restricted to toilet flushing only. Telephone enquiry lines were set up and arrangements to provide alternative supplies of water were put in place. Later in the afternoon the water company informed the local councils, health board and other local water companies about the problem. However, at that time the water company did not know the extent and severity of the contamination. Communication with these agencies reflected the assumption that it would be a relatively small scale incident. The water company did not contact the local police or fire brigade. However, a large number of calls about the contamination were received by the police from customers unable to make contact with the water company, due to the volume of calls it had to handle. This prompted the local police to contact the water company and suggest that representatives from the local authorities, health board and the police, should convene to discuss the incident at the water company’s headquarters. A series of formal and informal meetings among the various parties took place, however there was confusion as to the extent and severity of the contamination. In terms of communication, the volume of customer calls to the water company meant that the agencies were unable to maintain contact with staff, except by using mobile telephones. Moreover, the water company did not take and circulate formal minutes of the meetings. As a result, communication among the parties was hindered and confusion persisted. The water company called upon the UK Water Industry Mutual Aid Scheme to supply additional road tankers, bowsers, bottled water and water containers. It arranged for bowsers to be distributed throughout the affected area. Throughout the incident, the water company and the local councils distributed supplies of bottled water to vulnerable consumers with special needs, who would otherwise have had difficulty in getting water. The work of the councils was described as essential to the success of this operation. In addition to distributing bottled water, the council staff were involved in providing advice to food businesses and ensuring that the water supplies to schools and other council premises were satisfactory after the incident. There was little understanding of the cause of the problem. On 12th December customer complaints were confirmed by samples to show that the areas were contaminated. It was later found that a boundary valve was open. The process of informing such a large number of consumers was described as complex and “did not go smoothly”, resulting in “some confusion and an increase in complaints”. In addition, it was stated that it was a “bad start for media involvement and the media, who had not been brought on board sufficiently early’; as a result, the media “took a very hostile stance”. At the time of the incident the Chief Executive of the water company was on annual leave and unable to return immediately due to lack of availability of flights – this was popularly reported by the media. The incident was managed over an extended period of time, due to the fact that the source of the contamination was in the supply, requiring the replacement of contaminated filters and cleaning of the system.

67

Outcome

In February 1998, the water company offered a payment of £50 to each domestic customer whose supply had been contaminated during the incident. By mid-March approximately 26,000 payments had been made. In July 1998 the chairman of the water company resigned, after the company was fined £15,000 over the incident. He was quoted in the media as stating, “With so many customers inconvenienced I felt it proper that the chairman accept responsibility for the incident and resign. I accept that mistakes and errors of judgment were made and in view of the court's decision and the findings of the independent report I have tendered my resignation." (BBC News, 1998)

Documented Evaluation of Action

An independent inquiry was carried out to investigate the incident (Fraser, 1998). Of particular relevance to the inquiry was how communication with customers was handled. The inquiry provided a comprehensive appraisal of how communication with customers was handled, the key points of which are summarized below: - the water company were alerted to the possibility of contamination via telephone calls from customers. As a result, the authority used the information based from the calls to help them to determine the degree of contamination. - the level of calls was high, and at the peak period, many were not answered. - on December 10th, in order to deal with the escalating level of telephone calls from concerned members of the public, the water company arranged to set up a call centre. By 20.30 in the evening, 12 telephone lines were in operation, however the team were unable to deal with the increasing amount of calls. A call handling facility with 30 lines was set up; although the lines were in operation there were only 23 members of staff available to take calls, as personnel had left the work premises in accordance with their usual work patterns. In response, the water company recalled staff to the office. - also on 10th December, local policy expressed concern in relation to the numbers of calls they were receiving from concerned members of the public. Some members of the public had used the emergency 999 number and subsequently the police were concerned that calls in relation to the incident may interfere with their other operational duties. In response, an independent specialist call handling agency was used to take all incoming calls from the public – the service was available from 08.00 on 11th December, till 22.00 on 12th December, after which the number of calls had decreased to a level that the water company could resume call handling. The inquiry report provided survey findings, conducted with people calling the water company. The reported findings demonstrated that: - 51% wanted accurate information about the incident. - 11% wanted information about whether their own immediate area was affected. - 7% wanted to know where they could obtain alternative water supplies from. - 5% were calling to request bottled water to be delivered to them by the

68

authority. The survey also found that: - 23% of their respondents who had attempted to make contact with the water company during the incident were unable to, due to busy telephone lines. - 48% were dissatisfied with the amount of time it took them to get in touch with the water company (e.g. telephone waiting times). - 47% stated that they were given inaccurate information. - on the basis of the survey findings, the inquiry observed that the public identified the water company as the agency responsible for the incident. Subsequently, they felt the water company were responsible for providing information about the incident. The inquiry concluded that organizations and agencies must meet such public expectations in future incidents. - on the basis of public reports of erroneous information, the inquiry concluded that inaccurate information provided by staff to the public (e.g. via the telephone helplines) revealed confusion within the company. - the survey also reported that 49% of respondents initially heard about the incident via their friends, neighbours, relatives and so on. In response, the inquiry recommended that water utilities should consider designing information leaflets in ways that encourage people to share information and help each other in terms of making sense of and understanding the information, and how to act in response to the information. - in terms of the provision of leaflets by the water company to the public, although attempts were made by the water company, the survey demonstrated that information did not reach households quickly enough. The inquiry therefore concluded that the lack of accurate information about the extent of the contamination meant that people were not notified in a timely manner. As a result, it was recommended that water companies should be able and prepared to produce and administer clear information about developing events and incidents. In relation to this, it was suggested that companies should have links with local printers, in order to guarantee that leaflets can be printed at short notice, and in large quantities. - in terms of communication within the company, the inquiry concluded that communication about the incident was limited to management, and did not filter to other staff (e.g. those handling customer calls), and as a result, basic questions from the public could not be answered sufficiently. - the inquiry concluded that although the water company had communicated with other agencies by declaring an emergency situation, they did not communicate how serious the problem was, and subsequently the agencies were unaware as to the scale of the problem. As a result, efforts to develop plans e.g. issuing advice to health professionals were delayed. The inquiry also concluded that there were no provisions in place to take calls from other agencies, and as a result this meant delays in sharing information between relevant stakeholders, and possible delays in developing coordinated responses. - the inquiry also discussed communication via the media, concluding that although the water company took actions to apologize for inconveniences via leaflets, it would have been beneficial if these statements were supported with apologies from senior company representatives, via the

69

broadcast media. It was also recognized that the water company’s inability to provide accurate, timely information regarding the cause, extent and possible duration of the incident may have had negative consequences in media reporting. It was concluded that negative media reports and critical coverage of the incident may have served to undermine public confidence, particularly in terms of the water company’s ability to respond effectively to the incident. Such reports may have lead to a heightened sense of frustration and anxiety amongst the public.

Sources BBC News (1998) Water Boss Quits After Contamination. Available at: http://news.bbc.co.uk/1/hi/uk/129027.stm Fawell, J. (2003). Burncrooks Diesel Incident In “Water Contamination Emergencies. Can We Cope?”. Gray, J. & Thompson, K. C. (Eds) The Royal Society of Chemistry. Fraser, R. (1998). The Burncrooks Inquiry. Report on the Disruption to the Public Water Supplies in Areas Served by Burncrooks Waterworks, December 1997. The Scottish Office. Available at: http://www.scotland.gov.uk/library/documents5/burn-00.htm

70

Case Study 6: Walkerton E Coli Outbreak

Location Ontario, Canada

Date May 2000

Nature of Incident

The groundwater supply became contaminated by bacterial pathogens from farm runoff. The pathogens were later identified as E Coli and Campylobacter jejuni. Hrudey and Hrudey (2004) documented the events as they occurred: Events Leading up to the Outbreak From 8th - 12th May Walkerton experienced unusually heavy levels of rainfall (approximately 134mm, 70mm on the last day). The heavy rainfall resulted in localized flooding. The Inquiry Report revealed that the general manager of the Walkerton Public Utilities Commission, who was responsible for the overall management and operation of the drinking water supply and the electrical power utility, was away from his duties from 5th May to 14th May, during which time he had left instructions with his brother, the foreman for the utility, to replace a non-functioning chlorinator in one of the wells (it transpired that the well in question had provided Walkerton with unchlorinated water for 6 days, in contravention to local water treatment requirements). When the general manager returned on 15th May, he had assumed that the new chlorinator had been installed, and resumed use of the well. When he learned that the chlorinator had not been installed, he nonetheless continued to allow the well to pump unchlorinated water into the water supply system, up until 20th May. The unchlorinated water was the only source of water for Walkerton at this time, as the other well had been shut down from operation. By 17th May, laboratory testing of routine water sample tests carried out by utility employees confirmed E Coli and the presence of coliforms. Detection of the Outbreak On 18th May, local health practitioners noted the first signs of illness linked with the contamination. Residents of the town (population 5,000) began to experience symptoms of E. Coli infection (bloody diarrhea, gastrointestinal upset). Two children were admitted to hospital, and at least 20 children were absent from a local school. By 19th May, the attending pediatrician doctor alerted the responsible public health agency about community members’ growing concerns about the safety of the local drinking water supply. Difficulties in Confirming the Cause of the Outbreak There was initial confusion amongst health officials as to the cause of the illnesses in Walkerton, some suspected contamination of the water supply, whilst others suspected a food-borne cause, which was assumed to be a more common explanation for the types of illnesses reported. The public health agency contacted the general manager of the Walkerton

71

Public Utilities Commission on 19th May. By this time the chlorinator had been installed in the well, thus the town was receiving chlorinated drinking water. The manager claimed that there was no problem with the water, despite being in possession of laboratory tests that had found evidence of contamination. The Inquiry Report concluded that the manager’s lack of honesty seriously hindered the health agency’s abilities to investigate and respond to the initial stages of the outbreak. At this time the agency were still not aware of the waterborne basis of the illnesses, due to the utility manager’s consistent assurances as to the safety of the drinking water supply. The Inquiry Report later learned that after his conversation with health officials, the manger raised chlorine levels in the water supply and flushed parts of the water distribution system (notably near the local school), using hydrants. By 20th May a local hospital determined a positive stool sample result for E Coli, the health agency officials were able to inform other hospitals in the region about treatment guidelines. Health officials contacted the general manager of the utility again, to ensure that chlorine levels were monitored efficiently. The manager assured health officials that there were measurable chlorine levels in the water distribution system, leading health officials to deem the drinking water as safe. However, later, local radio stations had began to warn residents not to drink the tap water. When asked by health officials to call the radio station and provide assurance about the safety of the water, the general manager of the utility was reluctant. An anonymous employee of the water utility reported his concerns about the safety of the drinking water to the Ministry of the Environment (MOE). When the MOE contacted the manager of the utility, he did not disclose any information about the presence of pathogens in drinking water samples. Control Measures Introduced By May 21st an escalation in the number of patients with related symptoms lead the Medical Officer of Health to issue a boil water advisory notices, warning residents not to drink the water directly. The notice was delivered via the morning and evening radio bulletins only – additional publicity by the television station or by direct door-to-door notification was not followed. The health agency initiated a strategic outbreak team. One of their tasks was to notify public institutions about the boil advisory. However, notable public places (nursing and retirement homes) were overlooked. Due to confusions, one hospital had not introduced measures to address the safety of water - this proved to exacerbate the extent of the illness further, since health workers routinely advised patients to drink fluids (usually water) in order to prevent dehydration; this had the effect of increasing exposure to the contaminated water. Once notified however, the hospital introduced measures that involved alternative water supplies, the shutting down of public fountains, and elimination of food prepared with Walkerton water. Confirmation of the Waterborne Cause of the Outbreak By 22nd May up to 100 cases of E Coli infection were confirmed. After the local Medical Officer of Health stressed the urgency of situation, the MOE launched an official investigation. The manager of the utility provided the

72

MOE with documentation and reports regarding the operation of the utility. Using epidemiological data of the cases of illness, the health agency noted that the date of contamination was likely to have been 12th-14th May. Geographical plotting of affected residents revealed that the cases coincided with the water distribution system. Although there was no tangible evidence to confirm suspicions, health agency members suspected that the cause of the outbreak was the water supply. On 23rd May laboratory tests of water samples taken from the water distribution area by the health agency confirmed E Coli and total coliforms. When the agency contacted the utility manager to inform him of the results, the manager admitted that he was aware of bacteriological contamination. Upon conformation by the utility manager, the local Medical Officer of Health convened a meeting with the local mayor, and the local council. It was advised that an independent agency should take over the operation of the water system. The boil water advisory was lifted 5 December 2009, nearly six months after it had been introduced.

Public Response

Public concerns and suspicions about the safety of the drinking water supply were the basis for the initial reporting of the outbreak. Concerns spread amongst the community rapidly, and local institutions such as nursing homes began to boil water on 19th May, prior to the issue of the boil notice. By 20th May Walkerton hospital reported that they had received 120 calls from concerned residents, half of them reported bloody diarrhea. On the same day, local radio stations were reporting that Walkerton water should not be consumed. By 21st May, although the boil advisory had been issued, the hospital received 270 calls from members of the public in relation to gastrointestinal lllnesses. It later transpired that many had not heard the advice (see ‘Evaluation of Actions’ below). The community was reported as shocked that such an incident could occur in their community, which otherwise had a high standard of living, where citizens expected that their well established regulatory and public health institutions would protect them from such an incident. The consequences were described as devastating, since in the small community all residents knew somebody who had been affected. Public trust in local officials and the local government to guarantee the safety of the drinking water supply was eroded to a great extent. Furthermore, the local residents were said to be stigmatized by neighboring communities, since it was claimed that they were thought to be ‘infectious’, thus posing a threat to other’s health.

Actions taken

A boil water advisory was issued

After the cause of the outbreak was confirmed, the Ontario Clean Water Agency took over the operation of the water system; using continual flushing and chlorination, and a transportable water treatment plant to

73

ensure the safety of the water.

Outcome

Approximately 2,500 people suffered related illnesses. Of these, 65 were hospitalized, 27 developed hemolytic uremic syndrome, a serious and potentially fatal kidney-related illness, and seven people died from drinking the E Coli contaminated water. In 2004, the manager and water foreman of the Walkerton Public Utilities Commission pleaded guilty to a charge of "common nuisance" for failing to monitor and treat the town's water supply adequately. As part of a plea bargain, the prosecutors dropped more serious charges of breach of trust and falsifying documents. The Government of Ontario launched a public inquiry into the tragedy, in order to determine the causes of the disaster, the role of government policies, procedures and practices, and steps required to ensure the safety of the drinking water supply in the future. In Canada, this is the most through inquiry undertaken in the context of drinking water safety. Although the government of Ontario argued that the blame for the tragedy rested solely upon the utility employees, the commissioner of the inquiry maintained that an appreciation was required of the scale of institutional failures linked with the actions of the utility employees. The inquiry estimated the economic impact of the incident on the local community to be more than $64 million, with contributory factors including restaurant closures, loss of bookings in accommodation, decline in retail sales and decline in property values.

Documented Evaluation of Action

The health unit was criticized by town officials for not issuing a boil water advisory sooner. However, given the scale of mis-reporting and misinformation provided by the water utility, their actions were seen to be understandable. Lessons learned include the need for better advance preparation and coordination among institutions and key actors in order to ensure effective action and management on the onset of an incident. Although the boil advisory had been issued, due to the fact that information was disseminated via a morning and evening radio bulletin only (television bulletins and direct door-to-door notifications were not deployed), many members of the public stated that they were not aware of the notification (a later community survey confirmed that only 34% of the local public had heard the announcement, and 44% were not aware of the advisory notice). The health agency stated that public information could have been handled more efficiently. The inquiry revealed that the Ministry of Environment (MOE) did not act in collaborating (informing, involving) with the health unit in drinking water safety issues prior to, and during the Walkerton incident. Given the serious health implications involved, this was considered to be a major critique. The MOE had previously undergone significant budget cuts, resulting in decreased personnel and operating expenditures (including laboratory testing services). These issues were reported as contributing to the fact that the MOE were less efficient in recognizing and acting upon deficiencies in water provision in Walkerton leading up to the incident. In addition, the fact that there was no requirement in place for reporting adverse laboratory results directly to the health authorities or the MOE

74

was raised as an issue, since such a requirement would have alerted the authorities much sooner, and would have also negated the need for dependency on information from the water utility. Lessons learned - the inquiry estimated that earlier detection, and an earlier boil water advisory might have prevented 300-400 cases of illness. In the inquiry, although the water utility employees were found to have basic competence in delivering water to local residents, it was stated that they lacked a comprehensive understanding of water quality and water safety issues, or how to respond to a serious threat to the water supply. It was concluded that operator training should have clearly addressed and emphasized the public health aspects of delivering safe drinking water. However, such training was not required or provided by the Ontario authorities prior to the incident.

Sources Hrudey, S. E. & Hrudey, E. J. (2004). Safe Drinking Water: Lessons from Recent Outbreaks in Affluent Nations. IWA Publishing.

75

Case Study 7: Pitsford Cryptosporidium Outbreak, Northampton, UK

Location Northampton, United Kingdom

Date

June 2008

Nature of Incident

After routine tests carried out by the water authority revealed traces of cryptosporidium in the water supply (at the Pitsford Water Treatment Works, 25 June at 01.00 BST), the authority, Anglian Water, issued a boil notice alert, and advised their customers to boil their tap water prior to drinking. The alert was issued to 258,000 households (DWI 2008), whilst 100,000 homes were said to be affected (Northampton Chronicle, 2008a). Since the alert, the Health Protection Agency confirmed 15 cases of people who had suffered symptoms associated with cryptosporidiosis, six of which had the same ‘genetic fingerprint’ associated with the initially identified contaminant. Media reports on 25th June indicated that Anglian Water were conducting further tests to identify the source of the contamination. Anglian Water worked with the Health Protection Agency, and advised customers with health related concerns to contacts their local GP or NHS Direct. By 4 July, 2008, after the investigations, the boil notice was lifted, and water supplies were declared to be safe from contamination. Health surveillance that was implemented after the alert found that 22 people had contracted cryptosporidiosis (DWI, 2008).

Public Response

Twenty schools in the area that relied on tap water drinking fountains were shut. Media reports on 25th June suggested that local supermarkets had run out of bottled water due to ‘panic buying’ (BBC News, 2008a). Some supermarkets began to restrict sales of bottled water. By 17.00 BST media reports stated that people were coping, but some were ‘angry’ at the lack of information, or ‘annoyed’ that they were not informed directly by the water company. Supermarkets also reported that they were organising extra deliveries of bottled water as consumers were reacting to the contamination alert (BBC News, 2008b). There were also reports that Anglian Water was unable to supply bottled water to schools; members of care homes, doctor’s surgeries and hospitals were identified as being priority bottled water recipients (BBC News, 2008a). According to local media reports one month after the incident, up to 700 people had reported symptoms to their doctor (Northampton Chronicle, 2008b).

76

Actions taken

Anglian Water issued a boil notice alert to 258,000 consumers. Customers were advised to boil their water for ten days, until the source was found and removed. Anglian Water vans equipped with loudspeakers circulated the relevant areas in order to alert the public about the problem. Press releases were issued by Anglian Water announcing that an investigation was taking place and that laboratory tests were being conducted in order to establish the source of the problem. The public were advised that they may be required to boil their tap water prior to consumption for ‘some time’. It was announced in the media that after the boil notice was issued, 1,000 miles of pipes were flushed out, 2,500 customers visited mobile support units for advice and 3,000 customers were helped through the WaterCare Register, with more than 500 staff involved in the operation (Northampton Chronicle, 2008b). The WaterCare Register is a service provided by the water company that provides services to registered customers about supply interruptions, particularly in the case of: - blind or partially sighted customers, the water company will visit

to tell them when interruptions are planned and what to expect - deaf or hard of hearing customers, the company will visit during

an emergency, as they may not hear loudspeaker announcements. - customers with medical conditions who may require a constant

water supply and special arrangements The company says that if water supply needs to be turned off for more than 24 hours they will provide alternative water supplies (Anglian Water. 2010). The Health Protection Agency announced in the media that they had contacted local medical General Practitioners and hospitals, asking them to be vigilant for signs and symptoms related to cryptosporidiosis. Also, local members of parliament also publicly stated that a full independent investigation should be carried out by the government body Defra (BBC News, 2008a).

Outcome

By 14 July 2008, Anglian Water confirmed that a small rabbit had entered the treatment process through a remote ancillary tank, and that the animal was considered to be the source of the problem. The chief operating officer of the company stated that their investigations had revealed that the incident was caused by a combination of unusual circumstances, and had taken steps to ensure that such an occurrence did not happen again (Northampton Chronicle, 2008b). Anglian Water agreed that it would pay up to £30 per household in compensation for customers affected by the incident (Northampton Chronicle, 2008c)

Documented

An independent assessment of the incidents, conducted by the Drinking Water Inspectorate “concluded that the cause of the incident was a failure

77

Evaluation of Action

of basic water supply hygiene arrangements at Pitsford works operated by Anglian Water. It was stated that prompt action by the company had ensured an appropriate and effective multi agency health protection response. Although a large number of consumers were inconvenienced by the need to boil their drinking water, it was concluded that this precautionary advice played a vital role in keeping the adverse consequences for human health to a minimum” (DWI, 2008).

Sources Anglian Water (2010). WaterCare Services. Available at: http://www.anglianwater.co.uk/household/special-assistance/watercare/index.aspx BBC News (2008a). Sickness Bug Found in Tap Water. Available at: http://news.bbc.co.uk/1/hi/england/northamptonshire/7472619.stm BBC News (2008b) People ‘Coping’ with Bug Concerns Available at: http://news.bbc.co.uk/1/hi/england/northamptonshire/7474035.stm BBC News (2008c) Rabbit Contaminated Water Supply. Available at: http://news.bbc.co.uk/1/hi/england/northamptonshire/7505911.stm DWI (2008) Drinking Water Inspectorate Press Release. Available at: http://www.dwi.gov.uk/pressrel/2008/pr0308.shtm Northampton Chronicle (2008a). Six Taken Ill Following tap Water Crisis. Available at: http://www.northamptonchron.co.uk/news/Six-taken-ill-following-tap.4275737.jp Northampton Chronicle (2008b). Tap Water Crisis: Rabbit Blamed as 13 Cases Confirmed. Available at: http://www.northamptonchron.co.uk/news/Water-latest--Bugs-Bunny.4286365.jp Northampton Chronicle (2008c) Water Crisis: All Clear for Tap Water – and up to £30 Compensation! Available at: http://www.northamptonchron.co.uk/news/25-each-compensation-for-water.4255069.jp

78

Case Study 8a: The Cwellyn incident, Wales, United Kingdom

Location Wales, United Kingdom

Date

November 2005

Nature of Incident

The incident involved an outbreak of illnesses caused by cryptosporidium in the tap water supplied to parts of north Wales via the Cwellyn water treatment works, which supplies 30,000 customers in the Caernarfon and Bangor areas. In Novermber 2006 it was reported that the incident was caused by insufficient treatment procedures (BBC News, 2006a). The number of cases of cryptosporidiosis since the beginning of the outbreak was confirmed to be 231. A boil notice was issued in November 2005 and the outbreak was declared clear (and thus the notice was lifted) by January 2006.

Public Response

NHS Direct Wales was commissioned to handle calls from the public enquiring about cryptosporidium. The helpline was open as soon as the boil notice was issued. It was reported that 1500 calls were taken over an 11 week period. Initially one number was set up, and as a result of increasing demand a second helpline number was set up on 2nd December (Outbreak Control Team’s Report, 2006). Media reports documented that the lengthy boil notice had caused problems for local households and businesses (BBC News, 2006). In response to reports of compensation, the media quoted members of the public stating that they were pleased some compensation had been offered, but that £25 was not enough:

- "It's better than a smack in the mouth I suppose, but I can guarantee I've spent more than that on bottled water and the increase in the electricity bill that we're probably going to get," she said.

- "But it's fair play to them (Welsh Water), offering something. You hear a lot of cases where you don't get anything back (BBC News, 2005).

Actions taken

The Welsh Assembly Government (2006) provided an account of actions taken: - In the beginning of November, Welsh Water began monitoring water

supplies for cryptosporidium on a daily basis, due to increased illness in the area. They also mapped local cases. GPs were also asked to monitor people with symptoms of cryptosporidiosis

- On 7th November an Incident Management Team of public health

experts and Welsh Water staff discussed findings and plans to conduct

79

more detailed investigations. The results so far showed that the levels of disease were higher for people living in the Cwellyn area.

- On 24th November the Incident Management Team asked doctors to

remind their immuno-compromised patients to boil their tap and bottled water prior use, in order to account for patients who may be at a higher risk. In order to ensure that all relevant parties were aware of the advice, a press statement was released. In addition, helplines were set up via NHS Direct

- On 29th November, a questionnaire study demonstrated an association

between diarrheal illness due to cryptosporidium and tap water. - According to records, the water treatment works for Cwellyn reservoir

had been operating normally, and concentrations of cryptosporidium remained within treatment standards.

- However, in the last week of November a sharp rise in illnesses was

found to correspond with residents supplied with water from the Cwellyn reservoir. This rise, or relationship was not detected in other parts of the region.

- On 29th November an outbreak was announced. As a precautionary

measure the Outbreak Control Team advised the water company to issue a ‘boil water notice’ to residents who received water from the Cwellyn reservoir.

- In mid December, the media reported that the company would

compensate its 37,000 affected customers with £25 each. The article reported: “But Welsh Water said the payout did not mean the water supply was to blame, as investigators are yet to find the source of the illness”. (BBC News, 2005).

- The boil notice was extended on 4th January, since the possibility of a

“continuing risk could not be ruled out” - The local Outbreak Control Team advised the water company to lift the

boil water notice to residents with effect from 30th January (Information sourced from Appendix: Background, Welsh Assembly Government, 2006). In the Outbreak Control Team’s Report (2006), details on communication with included: - Letters administered by the water company to consumers (30th

November, 13th December, 5th January, and 30th January), to issue, provide update and lift the boil notice.

- Letters administered to managers of public swimming pools,

businesses serving and processing food and other businesses. - Head teachers of schools and managers of nursing homes were sent

specific letters. - Nursery operators were advised of the importance of hygiene in order

to reduce the chance of person-to-person spread of the disease.

80

- The water company hand delivered letters to several bodies e.g. dentists, university, pharmacists, leisure centers, post offices, swimming pools, supermarkets, nursing homes.

- The water company’s call centre number was also promoted in letters

and press releases as a source of information, especially for customers in need of confirmation about whether they lived in an area affected by the boil water notice. Call centre staff provided customers with information based on briefing notes. Any technical or more detailed questions that could not be readily dealt with were passed to technical or operational staff. Customers who raised specific medical or health queries were referred to the NHS helpline.

- Other information provision included websites, advertising in the local

newspapers, and proactive communication with the media: “The outbreak control team adopted the strategy of proactively using the media during the outbreak and of being open in its approach. Notwithstanding the legitimate public and news interest of the outbreak, it was agreed that the media was an essential vehicle for promoting public health messages to such a large number of affected people at high speed. It was agreed that media communications should be managed so that there was ‘one voice’ for the team. This would be more likely to deliver clear and consistent messages”. (Outbreak Control Team’s Report, 2006).

Outcome

By January 2006 the media reported that the company had admitted that they had to work to restore consumer confidence after the incident. The head of the company announced that £1m on improved treatment techniques had been spent in order to prevent a repeat of the incident. He was quoted as saying that the company knew the problem had caused "enormous upset, inconvenience and cost" to customers. In the same report it was also stated that people in the affected area would receive £25 compensation, which was said to be "almost exactly equivalent to the cost for an average household in Wales for two months' water supply" (BBC News, 2006b).

In November 2006 the media reported that the water company had not needed measures to kill the ‘bug’ because it was thought it would be diluted in a reservoir. However, there had been "no effective barriers" to stop it reaching the mains supply. In the article, it was reported that Welsh Water said its new ultra-violet treatment would kill the bug (BBC News, 2006a).

In the Outbreak Control Team’s report, observations and lessons learned included the issue of the boil water notice, with respect to the fact that some public health experts have questioned the value of a boil water notice, due to evidence of poor levels of compliance. In response to this they state that:

- “an alternative water supply (e.g. through re-zoning) is not an option, and where there is evidence of a continuing risk, then it is essential to ensure that the notice is issued as quickly and as effectively as possible. It is important to recognise the right of individuals to make an informed choice whether to boil or not. Even with poor compliance fewer people will be exposed to infection. This issue needs to be reviewed by the Group of Experts or equivalent body” (Report of the

81

Outbreak Control Team, 2005, 8).

In June 2007 the Drinking Water Inspectorate announced that it planned prosecute the water company, on the grounds of supplying water unfit for consumption. In October 2007 Welsh Water was prosecuted and fined £60,000 (DWI Press Release, 2007).

In a document made publicly available on their website, the company said that important lessons have been learned from this incident. Regulations were introduced following the incident, which set new regulatory standards for the abstraction, treatment and testing of potable water. The company said that in applying lessons learned from the incident, they were developing plans for 18 water treatment works, “where some £100 million investment in additional stages of treatment will further mitigate water safety risk” (Welsh Water, 2008). The company has since been engaged in a broad major capital investment programme, which amongst other key areas includes the completion of a £13 million extension of the Cwellyn water treatment works in Snowdonia, which aims to reduce the risk of a repeat of the issues that arose in this incident (Welsh Water, 2010).

Documented Evaluation of Action

After the hearing in 2007, the Chief Inspector of the Drinking Water Inspectorate stated: “this was a serious incident. Many consumers were affected at the time and for some, the consequences were severe” (DWI, 2007).

Sources BBC News (2005). Water Bug Customers Get Payout. Available at: http://news.bbc.co.uk/1/hi/wales/north_west/4526430.stm BBC News (2006a) ‘No Barriers’ Let Bug into Water Available at: http://news.bbc.co.uk/1/hi/wales/north_west/6188764.stm BBC News (2006b). Water Firm Fights to Regain Trust. Available at: http://news.bbc.co.uk/1/hi/wales/north_west/4660116.stm BBC News (2007). Water Company Prosecuted Over Bug. Available at: http://news.bbc.co.uk/1/hi/wales/north_west/6224108.stm DWI (2007) Drinking Water Inspectorate Press Release. Available at: http://www.dwi.gov.uk/press-media/press-releases/11 October 2007 - DWR prosecution.pdf Outbreak Control Team (2006). Report on Outbreak of Cryptosporidiosis in North West Wales, 2005. Available at:

82

http://www.anglesey.gov.uk/upload/public/attachments/51/cryptosporidiumenglish.pdf Welsh Assembly Government (2006). Cabinet Statements, 2006. http://wales.gov.uk/about/cabinet/cabinetstatements/2006/950555/?lang=en Welsh Water (2008). Dwr Cymru Cyfyngedig, Regulatory accounts for the year ended 31 March 2008. Available at: http://www.dwrcymru.com/english/library/reports/companyreports/dwrcymru/Annual Reports/2008/regulatory2008.pdf Welsh Water (2010). Press Release Available at: http://www.dwrcymru.com/English/news/announcements/prelim2010.asp

83

Case Study 8b: Suspected Cryptosporidium Outbreak, Gwynedd, Wales

Location Gwynedd, Wales

Date

August 2008

Nature of Incident

5,000 households were advised to boil their drinking water or use bottled water as a precaution, after heavy rainfall affected water quality. The Penybont water treatment works closed operation for 24 hours on a Saturday (8th August) due to deterioration in river water quality, caused by heavy rainfall. Welsh Water spokespeople stated in the media that the water treatment works was restarted on Sunday morning in order to ensure that tap water supplies to the local area were not interrupted (BBC News, 2008). On Tuesday 12th August, It was stated on the media that, after the heavy rainfall, river water quality had still not returned to normal, and that the UV treatment stage would not be operational for around eight hours; in the interim, traces of cryptosporidium had been detected. As a precautionary strategy, residents were advised to boil their tap water (BBC News, 2008).

Public Response

By 13th August, local media issued headlines such as “Cryptosporidium bug affects thousands in Gwynedd” (Daily Post, 2008a), where it was reported that householders were waiting for confirmation of cryptosporidium in their water supply. A day later the same media outlet ran the headline: “Cryptosporidium bug no longer in Gwynedd water” (Daily Post 2008b), reporting that householders were no longer required to boil their tap water”.

Actions taken

Customers were advised to boil their water for 48 to 72 hours. The head of water quality at Welsh Water was reported as saying that results from samples taken from the water showed levels of cryptosporidium that were higher than what would normally be seen in the supply - "We need to give time for the water that did not receive the ultra violet

treatment to pass through the supply. We need to do some checks to ensure the cryptosporidium parasite levels are much lower or hopefully not present at all." (BBC News, 2008).

- "We felt it was sensible as a precautionary measure to advise

customers in the area to boil their water for the next 48 to 72 hours," - "Boiling the water will kill the bug. You do not have to boil it for 10 to 15

minutes. Just make sure you bring it to the boil”. - "Hopefully we will be able to tell people everything is fine by Thursday

84

or possibly Friday”. (BBC News, 2008)

Sources BBC News (2008). Residents Urged to Boil Tap Water. Available at: http://news.bbc.co.uk/1/hi/wales/7555133.stm Daily Post (2008a). Cryptosporidium Bug Affects Thousands in Gwynedd. Available at: http://www.dailypost.co.uk/news/north-wales-news/2008/08/13/cryptosporidium-bug-affects-thousands-in-gwynedd-55578-21521730/ Daily Post (2008b). Cryptosporidium bug no longer in Gwynedd water. Available at: http://www.dailypost.co.uk/news/breaking-news/2008/08/14/cryptosporidium-bug-no-longer-in-gwynedd-water-55578-21535077/

85

Case Study 8c: Suspected Cryptosporidium Outbreak, North Wales, UK

Location North Wales, UK

Date

August - September 2008

Nature of Incident

Routine water quality monitoring revealed increased levels of cryptosporidium in reservoirs supplying the local area. This resulted in 45,000 households being advised to boil their tap water prior to consumption. Customers were advised to boil their water for at least a fortnight. In the local media the incident was highlighted as the third boil notice issued by Welsh Water in three years, with the headline “Welsh Water under fire over latest ‘boil’ order (Wales Online, 2008).

Public Response

Although there is little in terms of documented of public response, at the time a spokesperson for the UK’s consumer body for water, CCWater, was quoted in local media saying that although prompt action taken by the company has meant that the situation was better than previous incidents, action was needed to remedy the underlying problem:

- “Customers don’t want to be boiling their water and it is important in the long term that this is sorted out. I guess people would rather boil their water than go down sick but they would rather neither happened. We will be challenging the company to get this sorted immediately and – not make sure it doesn’t happen again, because you can never be 100% safe – as best as they can.” (Wales Online, 2008)

In the article, the consumer body spokesperson also said that she was not critical of the company’s reaction:

- “It’s a precautionary thing and the company is not being complacent,” she said. “It is issuing this because they think there is an increased risk. That’s good.” (Wales Online, 2008)

- “The good thing is that this action is being taken before anybody was taken ill. Last time people were taken ill before the bacteria was detected. So perhaps it’s better than last time.” (Wales Online, 2008)

Actions taken

A boil notice alert was issued by Welsh Water, and this was described as a ‘precautionary measure’ to protect public health by company spokespeople (BBC News, 2008). In local media, a spokesperson for the company apologized for the inconvenience caused to customers and was quoted as stating that it was

86

a precautionary measure to protect public health: - “This is a precautionary step and it could be up to two weeks”. (Wales

Online, 2008)

- “We are hoping we can resolve the situation sooner than that but we have to be realistic and tell people that two weeks is a possibility”. (Wales Online, 2008)

The National Public Health Service for Wales asked local General Practitioners to report cases related to cryptosporidiosis. The company also contacted consumers on their special needs register, and administered bottled water on consumer request.

Documented Evaluation of Action

Due to the fact that Welsh Water had announced three boil notices in as many years, much emphasis was placed in media reports about this. Further emphasis was placed by spokespersons e.g. from the Consumer Council for Water (Wales), about the ‘precautionary’ nature of the alerts (Wales Online, 2008).

Sources BBC News (2008). ‘Boil Water’ Warning to Thousands. Available at: http://news.bbc.co.uk/1/hi/wales/7589501.stm Wales Online (2008). Welsh Water Under Fire Over Latest ‘Boil’ Order. Available at: http://www.walesonline.co.uk/news/wales-news/2008/09/01/welsh-water-under-fire-over-latest-boil-order-91466-21645316/

87

Case Study 8d: Suspected Coliform Contamination, Flintshire and

Denbighshire, Wales

Location Flintshire and Denbighshire, Wales

Date

April, 2009

Nature of Incident

Welsh Water advised 70,000 customers to boil their water after bacteria coliform was found at the Alwen water treatment works. A precautionary boil notice was issued and withdrawn a week later.

Public Response

The national media reported that the incident had been raised by a politician who was quoted as saying: - "I am disappointed that this is yet another serious water quality issue

affecting people in north Wales”. - "This is despite recent increases in water prices where consumers

were told this would safeguard and improve water quality." (BBC News, 2009a)

Actions taken

The water company issued a boil water notice, and vehicles with loudspeakers toured local areas and communicated information to the public. Hundreds of advisory posters were delivered to supermarkets and libraries, and information packs were delivered to schools. Information was also made available via websites and a helpline was made available unsure as to whether the boil notice affected their area (BBC News, 2009a). In the media, the water company stated that they did not have evidence of ay illnesses in relation to the bacteria. Also, a company spokesperson said that compensation was being considered for causing disruption to customers (BBC News 2009b). When the boil notice was withdrawn a week later, the operations director of the water company was quoted in local media: - “Since we discovered the problem at the water treatment works we

have taken over 200 samples of water from throughout the supply area and none of these have shown any cause for concern. Protecting public health has to be, always, our top priority and having found a problem with water quality at our Alwen water treatment works we judged the safest thing to do was to issue a precautionary boil water notice.” (Flintshire Chronicle, 2009).

The local media also reported that in recognition of the inconvenience caused for six days by the boil notice, the company would write to all

88

affected 70,000 customers, with plans for an ex gratia payment of £10 per customer (Flintshire Chronicle, 2009).

Sources BBC News (2009a). Bacteria Probed After Water Alert. Available at: http://news.bbc.co.uk/1/hi/wales/8024014.stm BBC News (2009b). Boil Water Notice Stays in Place. Available at: http://news.bbc.co.uk/1/hi/wales/8026660.stm Daily Post (2009). 70,000 in Flintshire and Denbighshire Told to Boil Water. Available at: http://www.dailypost.co.uk/news/north-wales-news/2009/04/30/70-000-homes-in-flintshire-and-denbighshire-told-to-boil-water-55578-23507661/ Flintshire Chronicle (2009). Boil water notice lifted in Flintshire and Denbighshire. Available at: http://www.flintshirechronicle.co.uk/flintshire-news/local-flintshire-news/2009/05/05/boil-water-notice-lifted-in-flintshire-and-denbighshire-51352-23543945/

89

Case Study 9: E.Coli Outbreak, Dublin

Location Knocksedan Housing Estate, Dublin, Ireland

Date

August - September 2007

Nature of Incident

Residents of a housing estate were advised not to drink their tap water after E.Coli was identified in the water supply. The source of the outbreak remains unknown. Approximately 160 homes were affected. The Fingal Independent (2007) reported the events as follows: - On 8th August a precautionary notice warning people to boil the water

was issued.

- On 9th August samples confirmed contamination. Thereafter a full boil water notice was issued.

- On 10th August the water supply was shut off while the supply to the storage tank in the estate was flushed and disinfected.

- On 11th August, the water supply from the storage tank to the stopcocks outside each house was flushed.

- On 13th August and 14th August samples taken showed no further E.Coli contamination. However, there was evidence of residual contamination in the supply.

- By 23rd August, samples showed that despite extensive flushing and chlorination of the water supply, there was still contamination.

- Samples taken on 30th, 31st August and 2nd September showed the drinking water to be fit for human consumption.

Public Response

A helpline set up to help identify affected people received 150 calls, with general enquiries and information about people who had or stayed in the locality and were subsequently unwell. Those who complained of symptoms would be followed up in order to pin-point the source of the contamination (RTE News, 2007). Local media reported that water supplies of the housing estate were still contaminated two weeks after it was thought that the problem had been eliminated. Other media outlets in the Dublin area reported that the local council were “calming fears” after others in the area became concerned: - “People in the Dublin area have nothing to fear by drinking water

90

straight from the tap as there are no indications the contamination has spread past the location in Swords, according to the council” (Independent, 2007).

Actions taken

A boil water alert was issued by the water company and tankers made water available to the public. Since the source of the outbreak was unknown, via the local media, the health authority requested people who had visited, stayed in or ate food in the locality and subsequently became ill with diarrhea, vomiting or abdominal pain to contact their helpline (RTE News, 2007) After investigations suggested that the bacteria were eliminated from the water supply, consumers were still advised not to drink tap water. According to local media reports, although the system had been flushed and chlorinated a number of times, tests showed the bacteria to be still present in the water supply. The local council had said that the contamination occurred within 1km of the estate, but that the exact cause has not yet been identified. (RTE News, 2007). Media reports claimed that a third party had tapped into the water supply (legally), and the supply had been polluted by a form of backwash (BBC News, 2007).

Sources BBC News (2007). Tap Water Hit By E.Coli Attack. Available at: http://news.bbc.co.uk/1/hi/northern_ireland/6947343.stm Fingal Independent (2007). Knocksedan Water Gets the All-Clear. Available at: http://www.fingal-independent.ie/frontpage/knocksedan-tap-water-gets-the-allclear-1076370.html Independent.ie (2007). Hundreds Hit By New Water Scare. Available at: http://www.independent.ie/opinion/letters/hundreds-hit-by-new-water-scare-1059523.html RTE News (2007). E.Coli Still Present in Swords Area Water. Available at: http://www.rte.ie/news/2007/0829/ecoli.html

91

Case Study 10: Bramham Incident, Yorkshire, England

Location Bramham, Yorkshire, England

Date

July 1980

Nature of Incident

In late July, 1980 the local Department of Environmental Health received reports of a rise in gastrointestinal illnesses amongst residents of the local communities, who were served by the same water source in Bramham. By 23rd July bacteriological samples found widespread fecal contamination including coliforms and E. Coli. One of 4 wells was identified as the likely source of contamination. The water in the wells was chlorinated; however due to the fact that the wells were located in the village of Bramham, and there was no treated water storage, consumers had complained about the taste of the freshly chlorinated water. As a result, the operators of the water utility had maintained the chlorine residual as low as possible. The identification of contamination led to an immediate advisory to boil water. Of the population of 12,000 at risk an estimated 3,000 people suffered illness through the outbreak.

Public Response

Initial accounts of illness were reported on 21st July. The first incidence of disease was found to be 18th July. Investigations found that illness coincided with consumer complaints about the water supply.

Actions taken Boil advisory issued.

Outcome

The well thought to be the source of contamination was closed thereafter. The remaining three wells were later decommissioned when a treated water service from Leeds was put into place in October, 1980. Following lengthy investigations, measures were introduced in 1988 to manage such incidents. These measures included investigating presumptive positive results immediately; water sampling and analysis outside regular hours; use of computerized laboratory management systems; the need to notify senior managers immediately about positives; co-operating with health-related officers; maintaining chlorine levels at a standard level; and automated shutdown of water pumps if chlorine levels drop below the minimum level.

Documented Evaluation of Action

It is reported that the water utility staff intentionally maintained low levels of chlorine, in order to avoid consumer complaints, particularly from those residing close to the dosage point.

92

Sources Hrudey, S. E. & Hrudey, E. J. (2004). Safe Drinking Water: Lessons from Recent Outbreaks in Affluent Nations. London; IWA Publishing.

93

Case Study 11: Pittfield, Massachusetts Giardiasis Outbreak

Location Pittfield, Massachusetts

Date

November 1985 – January 1986

Nature of Incident

Between 1st November 1985 and 31st January 1986, 703 cases of Giardiasis were confirmed, with an estimated 3800 of residents suffering from gastrointestinal illnesses. The authorities became aware of the outbreak in the first week of December, when 70 cases of laboratory confirmed Giardiasis were reported. This was significantly higher than the annual average, where in the previous 12 months only 5 cases had been reported.

Public Response

The outbreak peaked on 28th November. In the previous 2 weeks residents had noticed and complained about a marked increase in water turbidity.

Actions taken A boil water order was issued on 12th December.

Outcome

The outbreak was caused by the operation of an auxiliary reservoir while construction of a new filtration system was underway. Operation began on 5th November; the reservoir had not been used for over 3 years prior. On 14th November flow from the reservoir was increased, while the flow from the usual reservoir was decreased, and eventually taken off-line. These actions served to increase water turbidity, leading to consumer complaints. The increase in turbidity was explained by flow reversal in the piping system, leading to disturbance and suspension of sediments in the water system. Further investigation revealed that there had been a malfunction in the chlorination equipment.

Documented Evaluation of Action

Hrudey and Hrudey (2004) reported that the initial signs of the outbreak were demonstrated by the rise in consumer complaints. Here, consumer observations provide important messages to end-users about water quality.

Sources Hrudey, S. E. & Hrudey, E. J. (2004). Safe Drinking Water: Lessons from Recent Outbreaks in Affluent Nations. London; IWA Publishing.

94

Case Study 12: The WEM Incident, Worcester, United Kingdom

Location Worcester, United Kingdom

Date April 1994

Nature of Incident

On 15th April, 1994 Severn Trent Water experienced higher than normal complaints regarding abnormal taste and odour. By 16th April, on the basis of reports of a strong solvent smell at a local sewage works the location of the discharge was identified, and procedures were implemented to remedy the situation. On 17th April there was a rapid improvement of the situation – by 12.35 the National Rivers Authority reported that the River Severn had no remaining traces of odour.

Public Response

A rise in customer complaints of unusual tasting water and water were the first indicators of the incident. Complaints about the water supply were received by the water company from 7.50am onwards. Initially, 15 complaints were received, by later on in the morning the number of complaints had risen to 60. Helplines were set up from 3pm on 15th April to the morning of 18th April. During this time an estimated 3,500 calls were handled.

Actions taken

On the first day of the incident, the Customer Services Bureau of Severn Trent Water regarded the complaints as consistent with a problem at a local water treatment works. The operator of the water works confirmed that there was a taste and odour problem, and immediately took action to shut down the pumps. The Worcester and District Health Authority were informed by the Severn Trent Quality Assurance Dept of the 15 complaints of abnormal taste and odour of water in the local area. The water company set up an Emergency Team, beginning with the provision of alternate water supply by water tankers. By the time 60 complaints had been received, the water company, in collaboration with the Consultant in Communicable Disease Control of Worcester Health Authority, took the decision to advise customers in the local area not to drink the tap water. Representatives from the company noted that, at this point, the health risk assessment was made difficult by lack of consistency in odour descriptions made by the public (these included descriptors such as: ‘sweet’, ‘sewage’, ‘paint stripper’). By 12.30pm representatives from health authorities, local authorities the water company and scientific experts convened (the Worcester Health Emergency Incident Team). The team were provided with regular information by the water company. A helpline was made available by the

95

health authority, providing health advice to the public. Press statements and media interviews were also given. A Crisis Management Team chaired by the managing director of the water company worked closely with the Worcester Health Emergency Incident Team. During this time, local media reports broadcasted warnings not to drink the tap water, and local hospitals, schools and businesses were also notified. Potentially vulnerable groups in particular such as nursing homes, the local infirmary, schools and residential homes, schools were all alerted through pre-arranged cascade systems. General Medical Practitioners were also contacted. In the first press statement, customers were advised that an organic chemical had entered the water supply system, that the first indications were that this did not pose any serious threat to health. The public were advised however not to drink the water or use it for food preparation until further information became available. Meanwhile, a second and third water treatment works were shut down due to taste and odour tests. Affected water had penetrated one of the two works, and here was some indication that this may have spread to other areas. A ‘letter drop’ was implemented to 30,000 customers. The letters were printed in the afternoon and distributed by local members of water company staff. In addition, television interviews were given, providing information about the extent of the problem, and advising that broader areas might also be affected. Appeals were also made to the public to conserve water where possible since a local Aqueduct had been closed as a precautionary measure. Sever Trent Water made requests to other water companies (Thames Water, Welsh Water and Wessex Water) for additional tanks and bowsers. By 20.00 the regional health authority advised that the water was safe for bathing purposes. By 17th April customer complaints rapidly subsided, consistent with action taken to remedy the situation, and water quality sampling. The bowsers were progressively withdrawn.

Outcome

Severn Trent Water was prosecuted for the WEM Incident for ‘supplying water not fit for consumption”. The judge did however comment on the effectiveness of the emergency response. On the basis of the inquiry, a number of recommendations were made for the UK water industry. In reaching the final decision in court, the judge decided that if customers did not like the taste, then water was unfit. This ruling had only previously applied where there were health implications. The ruling of unfit has been applied to water quality incidents since the WEM incident.

Documented Evaluation

The water company listed the key challenges (that had particular impact on consumers) as:

96

of Action

provision of alternative water supplies In total, 250 bowsers were placed at strategic points on streets. A large number of tankers and drivers were deployed to fill and replenish the bowsers with treated water from unaffected sources within the Severn Trent area. Severn Trent Water acknowledged that valuable assistance was provided by other water companies in the United Kingdom (Thames Water, Welsh Water and Wessex Water), as well as other owners of suitable tankers. Thus, the Mutual Aid scheme, set up across the water companies, worked effectively. ‘information clamour’ The water company said that from the first few hours of the incident the demand for information grew in intensity and quickly became an exhaustive process. In addition to communicating to the three emergency teams and supporting groups, there was a need to communicate to: a) the public b) the regulators c) the health team d) members of parliament e) the media The company said that the media were vital to their ability to warn the public via radio and television. In this supporting role, the media were described as invaluable. However, the company noted that the print media did not always reflect this, especially as time passed after the incident. Listing negative headlines such as ‘Water Woe to Continue’, the water company described how local newspaper articles provided the first hints of the need for investigations and compensation, as well as panic buying of alternate water. National newspapers also became involved in the story, with questions such as “why the water company failed to detect the chemical spill’. health risk assessment One of the problems encountered by the Health Emergency Incident Team was the variable nature of customer complaints. Descriptors of the odour included ‘sewage’, ‘bad eggs’, ‘paint stripper’ or ‘paint’.

Sources Furness, M. (2003). ‘The WEM Incident’. In “Water Contamination Emergencies. Can We Cope?”. Gray, J. & Thompson, K. C. (Eds), The Royal Society of Chemistry.

97

Case Study 13: Mythe Incident, Gloucestershire, England

Location Gloucestershire, England

Date July – August 2007

Nature of Incident

The incident was documented in a House of Commons (2008) publication, which included how the event was handled, as documented by the managing director of the water company (the submission was based on an Initial Interim Report which was prepared for external parties who were interested in how the company handled the incident): On 21st July, river levels rose due to heavy rainfall, the Mythe Water Treatment works were shut down under carefully controlled conditions due to river flooding. This flooding caused major damage to property and the impact on the waterworks was just one of a number of problems caused by the incident. The flooding was the topic of major TV and media coverage for about a week. By 24th July approximately 140,000 properties were without a piped water supply. The incident was exceptional in terms of the number of people without water and the time period that people were without mains drinking water. Rundblad et al (2010) reported that customers were without drinking water for a total of 17 days, and that “no other water company has experienced loss of supply on such a large scale before ( 3). Alternate supplies were provided for approximately two weeks. In total, an estimated 350,000 people were affected.

Public Response

Based on the submission provided by the water company (House of Commons, 2008), at the time the waterworks was shutdown, the service reservoirs were approximately 75% full (equivalent of 36 hours supply normally). Following the first news broadcast warning of imminent loss of supplies at 9am, water usage more than quadrupled. Deployment of bowsers began at 5.15 pm on 22nd July – in the initial 48hours demand was high, suggesting that some customers were taking more water than needed for daily use and were stockpiling instead. The water company website failed on 22nd July due to the number of people attempting to access the site.

Actions taken

An incident management team was established by the water company, Severn Trent Water on 22nd July. Customers were provided with alternative supplies (e.g. via bottled water, bowsers and tankers). Severn Trent Water deployed 1,400 water bowsers (said to be the largest number of bowsers deployed to date in an incident in the UK and 5 million litres of bottled water were delivered per day), in 1,100 locations. Severn Trent Water made full use of the Mutual Aid scheme. Bottled water was purchased from Water Direct (part of the Mutual Aid scheme}.

98

Customers were kept informed via various forms of communication including the media and the internet. Broadcast media was the preferred means of communication over individual contact, due to the scale of the incident. Daily press conferences were given, including senior representatives of the water company. When the water company’s website failed, they increased the capacity and restored the service by 9pm the same day. Customer enquiries were handled by the Customer Operations Service Centre. A second, more specific customer contact centre was set up on 26th July in order to deal with calls specifically related to the incident. Customers with special needs e.g. hospitals, prisons and individual customers e.g. patients on dialysis, were contacted to confirm specific supply arrangements. Contact was maintained with these consumers throughout the incident. An estimated 1,800 water company employees, suppliers and other agencies worked in response to the incident. Logistical support included local councils and the army. Restoration of the works began on 25th July. As a precautionary measure, the water company assumed that the water was not safe to drink, until sufficient tests confirmed that it was of drinkable quality. Approximately 1,450 samples were taken and 13,000 test results were related to the incident. After the initial “Do Not Drink” notice, a “Boil Water” notice was given on 3rd August. Supplies were restored on a phased basis. All customers were reconnected to piped water supply by 2nd August and were declared safe to drink by 7th August.

Outcome

The water company estimated that the costs of dealing with the incident were in the range of £25 to £35 million. The company liased with relevant authorities (CC Water, Ofwat) as to the possible implementation of a compensation scheme. It was decided that the scheme was not applicable to the circumstances due to the exceptional nature of the weather, and the unprecedented scale of the flooding. Severn Trent Water allocated a fund of £3.5 million to benefit the affected communities.

Documented Evaluation of Action

On the basis of investigation findings in 2008, the Chief Inspector of the DWI stated that inspectors were generally satisfied with the actions taken by the water company to restore the treatment works. It was stated that the piped supply could have been restored more quickly, and acknowledged that the delay was due to the decision to issue a health and safety notice (DWI, 2008). Rundblad et al (2010) conducted a survey to investigate customer compliance with the “Do Not Drink” and “Boil Water” notices that were issued by the water company. The study was conducted 18 months after the incident, involving a sample of 159 customers who were affected by the incident. The results demonstrated that: - approximately 31% of customers received information about the incident cia the local radio station, while 30% heard from family or friends. Approximately 14% did not receive any information, and became aware of the incident when they tried to run their taps and had no water. - a reported 40% of customers used leaflets provided by the water company as a source of information. When asked to rank which information source they preferred, the local radio option yielded the highest response, with family and friends, local

99

newspapers and telephone/internet services provided by the water company following. - 41% of customers felt that the boil water advice was ‘clear, while 29% said it was ‘understandable’. - in terms of compliance with the notices, the authors noted that approximately 47% did not comply with the “Do Not Drink” notice, while approximately 29% did not comply with the “Boil Water” notice. Furthermore, they found that some customers did not use tap water for actions not associated with the notices, including hand washing, showering and bathing and flushing toilets. Therefore, “individuals’ tap water actions commonly included both risky and over-cautious behaviour” ( 7). On the basis of their findings, Rundblad et al (2010) acknowledged that although the time-lag of 18 months since the incident may have placed some constraints on the survey findings and subsequent conclusions drawn from them, the results suggested that: - customers seek different types of information from different sources during times of uncertainty; “Dissemination plans should be revised in order to tap into family/friends/neighbours as a potential information stream, e.g. personal networks and nomination of local ‘disaster contact persons’ can be established through local community organisations, and dissemination through these networks should be given prominence” ( 9). - customers’ understandings of boil notices may differ from the intended purposes, since some were “not aware of the exclusive nature of notices (i.e. only one can be in place at a time) or that there are several different types of notices. This could indicate that they construe water as either safe or not safe” ( 10). - in terms of compliance with the boil notices, risky and over-cautious behaviour could be explained by customers being unsure or misinterpreting the intention of the notices – “the title of the notice ‘Do Not Drink’ is highly misleading as it fails to highlight all ingestion actions listed on the notice…an alternative title, such as ‘External Use Only’ could prove more informative” ( 10). They went on to state that, “It is vital that the titles of notices be reviewed and that the public’s classification of water and beliefs about precautionary actions such as boiling be addressed through public health education” ( 10).

Sources DWI (2008). Drinking Water Inspectorate Incident Assessment Letter On Mythe Water Treatment Works. Available at: http://www.dwi.gov.uk/pressrel/2008/pr0108.shtm House of Commons. (2008). Flooding: Oral and Written Evidence, Volume 2: By Great Britain. Parliament. Environment, Food and Rural Affairs Committee. Fifth Report of Session 2007-2008, Rundblad, G., Knapton, O. & Hunter, P. R. (2010). Communication, Perception and Behaviour During a Natural Disaster Involving a ‘Do Not Drink’ and a Subsequent ‘Boil Water’ Notice: A Postal Questionnaire Study. BMC Public Health, 10, 641

100

Case Study 14: North Battleford, Saskatchewan Cryptosporidium Outbreak

Location Saskatchewan, Canada

Date

2001

Nature of Incident

Events were documented by Woo et al. (2003): In March 2001 the North Saskatchewan River experienced large turbidity fluctuation as well as high concentrations of fecal material during the spring. Accordingly, the distribution system in North Battleford became contaminated with Cryptosporidium, however, this went undetected, as no bacteriological samples were submitted for analysis. However, on 20th March, settling problems were noticed, and units were drained and cleaned, apparently leaving no sludge behind. On 9th April, the director of the plant authorized the purchase of bentonite, in order to encourage the formation of floc. By 4-5th April, the first cases of infection were reported, confirmed as cryptosporidiosis on 12th April. Health professionals (one who became unwell himself) were responsible for recognizing the link between illnesses and the water; they were aware of cases of C.Parvum, but unaware as to the cause. On 24th April, the public health inspector asked the director of the waterworks if there were any problems with the water treatment plant; the response was no, but the director mentioned that there was a problem with the floc blanket; the health inspector was unaware of the implications for public health. On the same day, the director of the company met with health officials and reemphasized that the inability to form a floc blanket was not related to the quality of water being produced. The body responsible for the operation of water systems Saskatchewan Environment and Resource Management (SERM) was not notified about the situation until 24th April; by 25th April a precautionary boil notice was issued, and a day later the boil notice was made compulsory (Woo et al, 2003). Amongst the population of 15,000 inhabitants, an estimated 6000 – 7000 residents, along with many from other communities and areas became ill (Woo et al., 2003).

Public Response

During the initial stages of the illness, sales of anti-diarrheals increased. This increase in sales was used by health professionals to confirm a possible outbreak of cryptosporidiosis.

Actions taken

It was not until 25th April that a precautionary drinking water advisory was issued; this was upgraded to compulsory by 26th April (Woo et al., 2003).

101

Outcome

Over 79 boil water advisories were issued during the last seven months of 2001 following the North Battleford outbreak (Woo et al., 2003). An inquiry was conducted in 2002.

Documented Evaluation of Action

On the basis of material made available in the Inquiry, Woo et al (2003) stated that the major contributing factor in terms of technical and operational management was lack of education, expertise and a “local culture of non-compliance” in the waterworks, since the majority of the operators and the management staff did not have any knowledge concerning the relationship between water quality and Cryptosporidium (Woo et al., 258). They went on to state that continuing education and adequate operator training programs were both lacking within the plants department, and that prior to December 2000, “none of the employees had attended any additional water treatment courses beyond the initial basic correspondence course required by the city” (Woo et al., 262).. In addition, it was stated that “there were no manuals or protocols for the operation of the plant that could help inform the operators about how a problem with turbidity or settlement could be handled, based on procedure or past experience” (Woo et al., 262).. Instead, operators were left to their own limited knowledge to solve the problem. Woo et al (2003) also stated that the local government played a significant role in the “propagation of the events” (Woo et al., 263). Although the municipality had a legal responsibility to provide potable water to its population, they stated that it was the “city’s culture and unspoken policy to maintain non-involvement in the operation of the water- works department” (Woo et al., 263). They argued that the cause of the outbreak was not determined in a timely manner partially due to a lack of investigation policy, which should be part of the city’s responsibilities. They went on to state that a further deficiency at the local government level was the “lack of communication and feedback between the city, SERM, and the Battlefords Health District” (Woo et al., 263)..

Sources Woo, D. M. & Vicente, K. J. (2003). Socio-Technical Systems, Risk Management, and Public Health: Comparing the North Battleford and Walkerton Outbreaks. Reliability Engineering System Safety. 80, 253–269.

102

Case Study 15: Gideon, Missouri Salmonella Outbreak

Location Gideon, Missouri, USA

Date December 1993

Nature of Incident

The incident involved a waterborne outbreak of salmonella. The United States Centers for Disease Control and Prevention estimated that 44% of the local population of 1104 developed gastroenteritis in relation to the outbreak (Clarke et al., 1996). It is reported that 7 people died (Angulo et al., 1997). Angulo et al. (1997) provided an overview of events: - In late November, 1993, seven cases of salmonella related

gastroenteritis were confirmed amongst local residents, and reported to the Missouri Department of Health. Affected residents did not have recent similar food intake histories, but all had drunk water in Gideon.

- The water was tested and found to contain fecal coliforms.

Public Response

Angulo et al. reported that school absenteeism increased by 250% in early December. The sales of anti-diarrheal medicines rose by 600%. They reported that by the end of December, 15 residents had been hospitalised. Illnesses were reported amongst 28 of 68 nursing home residents. Of these, 7 died. Angulo et al. conducted a household survey (sample, 246), where all family members aged 18 years and above were asked about the occurrence of stomach related illness during the time of the outbreak. They were also asked about compliance with the boil water order. More than half of the sample reported symptoms that matched the case definition. Of the 92 households studied, 91 were aware of the boil notice. Nine had not heard about the notice until an information sheet was delivered a day after the notice was issued. Thirty of the 92 households reported that at least one member of the family had drank unboiled water during the notice period. Angulo et al. (1997) reported that the most common reasons for noncompliance were "forgetting" (44%), “not believing the initial notification” (25%), and “not understanding that ice should be made with boiled water” (17%).

Actions taken

Residents were told to boil their drinking water, via a local radio station and a leaflet. An investigation was started to determine the source of contamination, scope and magnitude of the outbreak, and the effectivness of the boil water order (Angulo et al., 1997)

103

Outcome

Investigations suggested that the likely cause of the contamination was from bird feces or feathers inside a stagnant water storage tank that was subsequently flushed into the water distribution system.

Documented Evaluation of Action

Angulo et al. (1997) stated that the outbreak could have been avoided with proper water system maintenance and adequate ongoing disinfection. Angulo et al. (1997) found in their survey that many residents continued to drink unboiled water after the order to boil water had been issued. They stated that the most likely reason that people did not comply was that they did not appreciate the severity of the situation; the initial boil order gave no reason for its being issued and did not mention the associated illness. They went on to note that compliance improved only after the provision of information sheets, which clearly explained the rationale and boiling procedure. They suggest that when boil orders are issued, water supply operators, local movements, and public health officials should ensure that all residents are adequately informed about the health risks and consequences of non-compliance. They further recommend that boil orders should be issued with easy to understand instructions.

Sources Angulo, F. J., Tippen, S., Sharp, D. J., Payne, B. J., Collier, C., Hill, J. E., Barrett, T. J., Clark, R. M., Geldreich, E. E., Donnell, H. D., & Swerdlow, D. L. (1997). A Community Waterborne Outbreak of Salmonellosis and the Effectiveness of a Boil Water Order. American Journal of Public Health. 87, 580-584. Clark, R. M., Geldreich, E. E., Fox, K. R., Rice, E. W., Johnson, C. H., Goodrich, J. A., Barnick, J. A., Abdesaken, F., Hill, J. E., & Angulo, F. J. (1996). A Waterborne Salmonella Typhimurium Outbreak in Gideon, Missouri: Results from a Field Investigation. International Journal of Environmental Health Research. 6, 187-193.

104

Case Study 16: The Oslo Tap Water Case, Oslo, Norway

Location Oslo, Norway

Date

October 2007

Nature of Incident

In October 2007 the Giardiasis was detected in the main drinking water source in Oslo. Four water treatment plants deliver tap water to Oslo. The parasites were found in the water from Oset water treatment plant (from the lake Maridalsvannet), that supplies 85 percent of the city’s households (Terragni et al., 2008). As a precautionary measure, the residents of Oslo were advised not to drink water straight form the tap unless it was first boiled for 3 minutes. Initially, there was great confusion, with the Bergen incident (CS1) which was fresh in people’s minds. Terragni et al. (2008) reported that given the Bergen events, it was reasonable to ask whether the same health risks were relevant to Oslo. News coverage was said to be almost continuous on the radio, on TV and in newspapers, with regular updates about which areas of town were required to boil water, and the places that were not affected, as well as further recommendations (Terragni et al., 2008). Public authorities' recommendations to boil water were a precautionary measure, pending the results of several investigations. Forecasts for how long the notice could last, however, were uncertain, with the possibility that the affected residents would be required to boil water for weeks. Grimsby (2010a) reported that at the peak of the incident, there were 149 online news articles. A spokesperson for the company reported that, in terms of lessons learned for the municipality, although call centre staff had been trained to deal with public requests for information, they were not sufficiently prepared to handle requests from journalists for information (Grimsby, 2010b, personal communication). Five days after the boil advisory, after the results of several samples were made available, the recommendation was lifted. Although no one was sick, there is no question that the situation could have lead to a serious disease outbreak. (Terragni et al., 2008).

Public Response

Many members of the public telephoned the Water and Sewerage Department Directly. In addition, they visited the agency website. Grimsby (2010a) reported that the number of visits to the agency website rose from 226 (a day prior to the incident), to 37,798 visits. The number of visits, indicating need for information waned over the subsequent week. Public response was also assessed in a survey conducted a month after the incident. In November 2007 a survey was conducted by Terragni et al, 2008, amongst the residents of Oslo. The web-survey yielded a sample of 865

105

responses. The main results of the survey demonstrated that: Information - Public authorities gave adequate and trustworthy information - Media coverage played a decisive and invaluable role in disseminating

information and advice According to the survey findings, at the beginning of the outbreak 40% of residents did not know or were unsure about which plant they were supplied water from. People who did not know were most active in searching for further information by calling, or searching the websites of Oslo municipality or other authorities. A large majority of the respondents (70 %) knew that the water was contaminated within a few hours of the press release being published. Almost 90% were aware by the very same day. The mass media was the most important source of information to the public. The information received was positively evaluated: 20% were very satisfied and 61% were rather satisfied. Information was regarded as trustworthy. Most respondents indicated that they did not feel that experts, authorities, and mass media withheld important information. In addition, almost 80% were confident that the government would supply necessary information about future problems related to drinking water. Evaluation of the situation - The incident was regarded as serious matter but was not considered to

be a ‘crisis’ The fact that parasites were found in the tap water was considered to be serious matter. Only 4% of residents said that they did not care at all about it. By large, respondents perceived the situation to be very or quite serious (64%). However, fewer were anxious about their own or their closest relatives health (22%). Aftermath in everyday routines - Most people followed the recommendations, although women did so to

a greater extent than men Oslo residents followed the advice they received through mass media and the Internet; 91% indicated that they adopted the given advice to a large or rather large extent. 75% of residents boiled the water for three minutes or longer, while 17 percent stated that they warmed the water until it started boiling. Very few stated that they drank water directly from the tap, most people used cold, boiled, or purchased water. Also, most people chose to avoid using tap water when brushing their teeth. The survey showed that gender was an important dimension in the experience of, and the reaction to the incident. Women were significantly more concerned about the incident than men; they were more anxious and also followed the given advice more closely. People in households with small children did not find the situation to be more serious or critical than people with older, or no, children in the household. Parents however followed the advice on use of water even more carefully.

106

After the incident, most people went back to their old habits of using tap water. Some changed their habits to a small extent (27%). Only 9% responded that their water consumption habits had changed to a certain or large extent. Amongst those reporting changes in routines, an increase in consumption of bottled water was most often mentioned. Evaluation of the public authorities’ handling of the incident - Oslo’s residents thought that the public authorities were in control of

the situation Most respondents stated that they thought the public authorities had the situation under control. 23% completely agreed in the statement that the authorities had the situation under control, while 41% answered that they "partly agreed". That fact that the public authorities adopted a precautionary approach e.g. they warned about the potential health risks of tap water, even if it was later was found that the danger to the public health was not particularly large, was considered positive by almost all the respondents (96%). In addition, most people (75%) also stated that it was positive to advise the public to boil the tap water for drinking during this period. However, many respondents expressed that the information should have been given earlier (67%). Trust and Confidence in Water Safety - Assessments of the safety of water for drinking purposes could

improve After the incident 41% completely agreed that tap water was safe to drink, and 35% partly agreed, while 11% partly or completely disagreed. 12% of respondents had no clear opinion (neither agreed or disagreed or did not know). The authors of the study noted that since there were no previous studies it is was not possible to determine whether general confidence in the tap water had been reduced due to the incident. However, they noted that their findings indicated that there was scope for improvement in levels of confidence. 67% did not think or were unsure that this was a one-off event, while 63% felt that the control routines to ensure safe tap water were not good enough. Only 17% said that tap water is definitely safer than bottle water. 17% did not exclude that they would consider purchasing a water filter for home use.

Actions taken

As a precautionary measure, the residents of Oslo were advised not to drink water straight form the tap unless it was first boiled for 3 minutes. The measure was in force for five days.

Outcome

No one was seriously ill during the stage of water contamination.

Documented Evaluation of Action

Terragni et al. (2008) state that in terms of how the incident was managed and handled, positive lessons can be learned. During the incident the relevant information was quickly communicated to consumers. Advice and

107

recommendations on precautions were largely followed, and the authorities emerged as credible. Terragni et al. (2008) go on to state that given these issues, the incident was a positive example of handling a serious situation. However, with respect to their survey findings, Terragni et al. (2008) recommended that authorities consider the role of trust and confidence in more depth. Whilst they acknowledged that the lack of corresponding data could not allow are definitive answer to the question “has the water issue in Oslo led consumers to have less confidence in tap water?”, given that fact that 41% of respondents believed that it is safe to drink tap water, there is reason to consider whether this is good enough. Terragni et al. (2008) observed that the proportion of respondents expressing confidence in tap water was similar to data from other surveys on food safety. However, they state that tap water has a special position in relation to other foodstuffs: whereas it is possible to replace a food product if one no longer has confidence in the product, the same does not apply to tap water, since the individual consumer cannot choose to get water from another waterworks. However, they make the point that people do have other options if they do not perceive the water to be safe: in the survey, respondents reported that they had changed their drinking habits after the incident. Many believed that the control procedures were not good enough, and many believed that tap water was less safe than bottled water. In addition, a small proportion considered purchasing a water filter.

Sources Grimsby, E. (2010a). Maintaining Community Trust in a Water Quality Crisis: Experiences from Oslo. Presentation at the 3rd International Utility Management conference from 10th- 12th May, Barcelona, Spain Grimsby, E. (2010b). Personal communication. Terragni,, L., Bahr Bugge, A. & Jensen, H. M. (2008). Ikke drikk vann fra springen! Reaksjoner og implikasjoner etter drikkevannsaken i Oslo, Oktober 2007. Oppdragsrapport nr. 1-2008. (in Norwegian) Available at: http://www.sifo.no/files/file73137_oppdragsrapport2008-1-web.pdf

108

Case Study 17: Leidsche Rijn, The Netherlands

Location Leidsche Rijn, The Netherlands

Date

2001

Nature of Incident

A cross connection of a dual water supply system occurred in Leidse Rijn, a green field housing development. The cross connection between grey water and drinking water caused 200 people to be infected with gastroenteritis. Note, in Dutch law grey water is defined as used water e.g. from the shower that is used for other purposes. The term ‘household water’ is more appropriate in this sense. Household water is non-potable water centrally produced from surface water, groundwater or an alternative source such as rain water and intended for ‘no direct contact’ use for toilet, washing of clothes, garden watering and car washing. The incident occurred in a new housing estate of 30,000 households. Fernandes et al. (2007) provided an overview of events: The incident was caused by human error. On 29 November, after maintenance work, the drinking water system had been connected to the grey water system for flushing purposes. Due to an oversight, the cross-connection was not removed when the grey water system was again put into operation, and accidental higher pressure in the grey water system caused grey water to circulate into the drinking water pipes. On 3rd December 2 residents complained about unusual taste and odour of the tap water. A second incident occurred at January 4th 2002. After complaints about the taste of the drinking water of the owners of a single home, inspection showed that the house was connected incorrectly to the drinking water system and the grey water system in the street. After this second incident the connections of all the houses connected to the dual water supply system were checked. Five additional houses with incorrect connections were found in Leidsche Rijn. Subsequently two incorrectly connected houses were found in another project in Wageningen (Project Noordwest Wageningen) (Oesterholt, 2010)

Actions taken

The water company took samples of the tap water on 4 December, which showed an abnormal count of total coliform bacteria. On the 5th and 6th December, boil water advice was issued by the water company On 6th December a local doctor from the affected area informed the public health service of an excessive number of patients with nausea, vomiting and diarrhea over the previous days. On 6 December, the connection between the two dual systems was removed.

109

On 17 December, after 5 days of total E. coli counts below the mandatory level, the boiling advice was withdrawn.

Outcome

After the incidents at Leidsche Rijn and Noordwest Wageningen all dual water supply projects in The Netherlands that were run by drinking water companies were terminated immediately. In the summer of 2003 new legislation prohibited the use of dual water supply systems on larger scales. The only exception was the use of rainwater for toilet flushing on a local scale (one building, one house) (Oesterholt, 2010). Fernandes et al. (2007) reported that the decision was based on extensive environmental studies and risk assessments on six study locations.

Documented Evaluation of Action

This example demonstrates how one mistake can be detrimental to a wider project (Hurlimann and McKay, 2007).

Sources Fernandes, T. M. A., Schout, C., Human, D. R., Eliander, A., Vennema, H & Duynhoven, T. T. H. P. (2007). Gastroenteritis Associated with Accidental Contamination of Drinking Water with Partially Treated Water. Epidemiology and Infection, 135, 818-826. Hurlimann, A. C. & McKay, J. M. (2007). Urban Australians using Recycled Water for Domestic Non-Potable Use – An Evaluation of the Attributes, Price, Saltiness, Colour and odour Using Conjoint Analysis. Journal of Environmental Management, 83, 93-104. Hurlimann, A. C. & McKay, J.M. (2004). What Attributes of Recycled Water Make it Fit for Residential Purposes? The Mawson Lakes Experience. Desalination, 187, 167-177. Kiwa Water Research. Policy supporting monitoring household water. Research on the quality of household water and the effects on the environment and customers. KWR reports 02.095 A till D, March 2003. (In Dutch) Oesterholt, F. (2010). Personal information. Oesterholt, F., Martijnse, M., Medema, G. & van der Kooij, D. (2007). Health Risk Assessment of Non-Potable Domestic Water Supplies in the Netherlands. Journal of Water Supply: Research and Technology-AQUA, 56, 171–179. Oesterholt, F., Sluijs, A., Mons M., & Medema G. J. (2003). Evaluation practical experiences with Household water. H2O, 36, 22–25. (In Dutch).

110

Case Study 18: Waterborne Salmonella Outbreak, Alamosa, Colorado, USA

Location Alamosa, Colorado, USA

Date March-April 2008

Nature of Incident

In 2008 the city’s public water system that provides drinking water to a population of 8900 inhabitants became contaminated with salmonella bacteria. The waterborne outbreak resulted in 442 reported illnesses. Of these, 122 were confirmed by laboratory tests. One person is reported to have died. Subsequent epidemiological estimates have suggested that as many as 1300 may have fallen ill (Falco and Williams, 2009). Reports of illnesses emerged on March 12th. By March 17th epidemiologists contacted the SDW (Safe Drinking Water) team to discuss the outbreak and the possibility that the outbreak was related to the drinking water supply (Falco and Williams, 2009).

Public Response

Numerous ‘blogs’ have featured items in relation to the outbreak, and provided their own documentations of events. (e.g. salmonellalawsuit.com, salmonellablog.com). In addition, ttwo years after the incident there have been recent reports of legal action being taken. In one ‘blog’ it was reported that, “The city of Alamosa has been named in a lawsuit by 29 families who have been adversely affected by the salmonella outbreak in the city’s water supply. The plaintiffs filed the lawsuit on Monday, March 1, 2010” (justicenewsflash.com).

Actions taken

Falco and Williams (2009) stated that, after illnesses had been identified, and the outbreak was suspected to be linked with the drinking water supply, the SDW team assembled an Acute Team (this was part of a broader emergency response team), and began to plan a response. Firstly, water samples were collected and sent for analysis on March 17th. On March 19th, results showed evidence of coliform bacteria. The SDW team and Colorado’s Chief Medical Officer advised the public not to drink water straight from the tap. By March 24th, the presence of Salmonella in the public water system was confirmed by laboratory tests. A bottled water order was issued. Falco and Williams (2009) claim that the fact that the area has a history of naturally occurring arsenic in the water was decisive in not issuing a boil water order. Amongst other factors, “boiling water would concentrate arsenic and potentially other contaminants in the water to an unknown extent” (Falco and Williams, 2009, 12). They note that “a bottled water order for such a large system in response to such an outbreak was unprecedented in Colorado and presented a major public health challenge along with severe community disruption and economic impacts” (Falco and Williams, 2009, 13). Mutual Aid partnerships helped establish a prompt response. It also was

111

reported that organisations donated “truckloads” of water to Alamosa residents at the request of the Colorado Department of Health (CBS, 2009). News outlets reported that the Alamosa Mayor had said that the community had received $300,000 in state aid. The 8,000 gallons of bottled water handed out daily was donated, while the Governor applied for federal assistance (NewsInferno, 2009). After a lengthy process of disinfecting and flushing the entire water distribution, in order to eliminate any remaining bacteria in the water system (see Falco and Williams, 2009), the boil order was lifted on April 11th.

Sources CBS Denver (2009). Alamosa Avoids Tap Water After Salmonella Outbreak. Available at: http://cbs4denver.com/health/Salmonella.outbreak.tap.2.681143.html Coyotegulch (2010). Alamosa: Lawsuit Filed Monday Over Salmonella Outbreak. Availabe at: http://coyotegulch.wordpress.com/2010/03/01/alamosa-lawsuit-filed-monday-over-salmonella-outbreak/ Falco, R. & Williams, P. E. (2009). Waterborne Salmonella Outbreak In Alamosa, Colorado March and April 2008. Outbreak and Identification, Response, and Investigation: Colorado Department of Public Health and Environment. http://www.marlerblog.com/uploads/file/AlamosaInvestRpt.pdf Justice Newsflash (2010). Alamosa Sued over Contaminated Drinking Water: 2,000 residents infected with Salmonella. Available at: http://www.justicenewsflash.com/2010/03/04/city-alamosa-sued-contaminated-drinking-water-2000-residents-infected-salmonella_201003043557.html NewsInferno (2009). As Alamosa Outbreak Grows, Residents Told it Could be Weeks Before Water is Safe. Available at: http://www.newsinferno.com/archives/2805 Salmonella Blog (2008). Colorado Blames Alamosa Water for Salmonella Outbreak. Available at: http://www.salmonellablog.com/2008/03/articles/salmonella-outbreaks/colorado-blames-alamosa-water-for-salmonella-outbreak/ Salmonella Lawsuit (2008). Bottled Water Advisory Issued for Alamosa Residents. Available at: http://salmonellalawsuit.com/2008/03/19/march-19-2008-bottled-water-advisory-issued-for-alamosa-residents/

112

Case Study 19: Noord--Holland Incident, the Netherlands

Location North Holland, The Netherlands

Date 2007

Nature of Incident

E.Coli was detected in water samples on 15th May, 2007. Advice to boil water was issued on the same day by the water company. Approximately 180,000 households were affected in the area, which comprised 13 municipalities. The advice to boil water was lifted a week later on 22nd May (Karagiannis et al., 2009). Karagiannis et al. (2009) reported that in September 2007, the water company issued a press release stating that the cause of the water contamination was linked with run-off of rainwater contaminated by faeces of gulls on the roof that had leaked into one of the storage rooms.

Public Response

Karagiannis et al., (2009) investigated how people complied with the boil water advice issued by the water company, following the incident. On behalf the water company, in June 2007, a few weeks after the incident, they sent a questionnaire to 300 households. Half of the sample comprised households where the boil water advice was applicable, half comprised households served by the same water company, but where the boil water advice did not apply. 189 respondents completed the survey (99 in the area affected by the incident, 90, in the area where households were not affected). They found that: - overall, 93.7% felt that the water company had handled the incident well in terms of informing them about the incident. in the area affected by the incident: - all respondents had been informed about the boil water advice. - 9.3% felt fearful of the contamination, 45.3% responded ‘with self-control’, and 45.3% intended to take measures. - 48.5% stated that they had tried to find more information after hearing the boil water advice. - 14.1% were more disappointed by the water company’s choice to use the mass media for issuing advice. - 81.8% stated that they complied with the advice (e.g. by buying bottled water, or boiling tap water for two minutes prior to consumption) - none of the respondents stated that they has stopped drinking tap water completely.

113

in the unaffected area: - all respondents had been informed about the boil water advice. - 15.7% felt fearful of the contamination, 72.9% responded with self-control, and 11.4% intended to take measures. - 8.9% stated that they had tried to find more information after hearing the boil water advice. - 2.2% were more disappointed by the water company’s choice to use the mass media for issuing advice. - 5.6% of respondents opted to buy bottled water, and 3.3% boiled their water on the basis of the advice issued. Karagiannis et al., (2009) reported that the higher levels of compliance with the advice to boil water was linked with advice from the internet (90%), and advice from friends (89.5%).

Actions taken

On the same day that E.Coli was identified in water samples (15th May, 2007), the water company issued advice to consumers to “boil tap water for two minutes before consumption but that this was not necessary for taking a shower or washing”. The order was advice issued as a preventative measure. Information was conveyed via the media (e.g. national and regional television), radio and newspapers. Also, information was provided via a public website crisis that is used in crisis situation (eee.crisis.nl)

Documented Evaluation of Action

Karagiannis et al., (2009) concluded that consumers felt that they had been informed in a timely manner, and that the response of the water company in ensuring that the information would reach the public was satisfactory. They went on to state that as a result the incident did not lead to dissatisfaction amongst customers, or a ‘degradation of the company’s image’.

Sources Karagiannis, I., Schimmer, B., & Roda Husman, A. M. (2009). Compliance With Boil Water Advice Following a Water Contamination Incident in the Netherlands in 2007. Eurosurveillance, 14, 1-3.

114

Case Study 20: The Nokia Water Crisis

Location Nokia, Finland

Date November 2007 – February 2008

Nature of Incident

The contamination resulted in an extensive outbreak of gastrointestinal illness. The main pathogens were Norovirus and Campylobacter (nb. other pathogens were also found, including E.Coli; Salmonella; Giardia), and more than 1000 people had to seek care in health centres or the local hospital emergency department (Hulkko et al., 2007). A boil water order was in place from December 2007 to February 2008; the incident was reported as the largest waterborne outbreak ever recorded in Finland (Health Stream, 2008). It is estimated that approximately 8000 people in Nokia and surrounding areas became suffered illnesses in relation to the incident (Accident Investigation Board of Finland, 2007). The contamination occurred due to an ‘inappropriate’ cross-connection between sewage effluent and drinking water pipes (Laine et al., 2010). Between 28th and 30th November, 2007, approximately 400,000 litres of treated wastewater leaked into the clean water supply in Nokia city (Hulkko et al., 2007). Health Stream (2007) reported that the contamination occurred “when a worker carrying out repairs opened a valve, which separated drinking water from water used to clean the sewage treatment plant. A pressure differential between the systems caused sewage effluent to enter the drinking water supply”. It was also suggested that the pipe connecting the two systems had been in place for 20 years, and contrary to the relevant regulations the valve that controlled the connection had allowed water to flow in either direction (Health Stream, 2008).

Public Response

The contamination was discovered two days after the cross-connection, which coincided with reports of severe cases of gastroenteritis (Health Stream, 2007). However, in their investigation report, the Accident Investigation Board of Finland (2007) stated that on the 28th November, the waterworks received consumer complaints of abnormal smell and taste associated with the tap water. Laine et al. (2010) state that in total, 1222 people sought medical care. Estimates suggested that the number of people made ill by the contamination was in the region of 5000 (Health Stream, 2008). However, on the basis of a study designed to establish the true extent of illness, on the basis of a questionnaire sent to the local population, Laine et al. (2010) estimated that 8453 residents fell ill during the outbreak. Newspaper reports documented events, including the nature and extent of illness, and the cause of the incident. By 3rd December 2007 a newspaper reported that, “The fact that processed effluent was accidentally mixed with drinking water has been known since Friday” (Helsing Sanomat, 2007a).

115

On 10th December a newspaper reported that “malicious SMS messages had been sent in the name of the Nokia waterworks. The City of Nokia announced on its website on Saturday 15th December that the water utility did not send out information by SMS message. In the article, a spokesperson for the City of Nokia was quoted as stating "I have learned of one kind of text message, according to which people should not flush their toilets. This kind of sick hooliganism can be dangerous if someone takes it seriously", (Helsing Sanomat, 2007b). According to other media reports, thousands of residents demanded the resignations of top local officials - by 12th December 2007 a petition was circulating calling for the resignations of the town manager, the head of public administration and the director of waterworks. It was reported at this stage that the petition has been signed by over 9,000 of the town's 30,000 residents (YLE, 2007a). Newspapers reported on 15th December that Finland's Accident Investigation Board had appointed an investigation committee to probe the outbreak; in the newspaper report, the Investigation Board were quoted as stating that the contamination was “a major disaster” (YLE, 2007b). By 19th December, newspaper reports addressed possible links between recent deaths and the water contamination. Featuring conflicting information, it was reported that representatives of the City of Nokia had denied that the stomach disorders would have led to any deaths. However, the same article reported that police officials were investigating the deaths (Helsing Sanomat, 2007c). Local police investigating the incident were also reported as saying that they believed the contamination was accidental, however they did investigate whether the pipe which permitted the cross- connection to occur was illegally installed (Health Stream, 2007). Newspaper reports also said that the police were investigating two senior officials from the water authority for possible breach of duty in relation to the existence of an illegal pipe connection (Health Stream, 2008). Newspaper reports also documented the impact on local residents’ lifestyles. On 28th January, 2008 it was reported that parents were reluctant to send their children to day care (Helsing Sanomat, 2008a). Spiegel Online (2008) reported that the contamination had also had an impact on a local spa and brewery, which had been closed until the water supply was deemed potable. After learning of the contaminated water, the brewery was said to have destroyed 100,000 bottles of beer. When the boil water order was lifted on 19th February, newspapers reported that many residents were still cautious about drinking the water, in spite of declarations of safety. One resident was quoted as stating he would continue to get water from the distribution centre for a further week: "Let's see for a while what happens to our neighbours who drink tap water." (Helsing Sanomat, 2008b).

Actions taken

In the investigation report, the Accident Investigation Board of Finland, (2007) stated that consumer complaints about poor smell and taste associated with the tap water were received on 28th November. On this day, due to failures in relation to information-technology maintenance, the waterworks had decided to obtain water from the Tampere city. Staff

116

therefore associated consumer complaints with the opening of the water network, and with pipe repair work that had recently been completed in the vicinity. In response to the complaints, decisions were made to flush the water network (Accident Investigation Board of Finland, 2007). In response to the rising consumer complaints, the local health inspector issued a boil water advisory on 30th November, recommending that residents boiled their water prior to consumption. The cause of the contamination was also noticed on the same day. The advice to boil water was issued via the media e.g. radio news, and the town’s website. On 3rd December, a newspaper reported that, the Nokia Health Centre and the Nokia Waterworks tried to warn the 10,000 residents living in the area of the tainted water network. In addition the Finnish Broadcasting Company, text television services, the Nokian Sanomat daily, as well as the City of Nokia Internet pages warned people of the danger. Nevertheless, some never received the message” (Helsing Sanomat, 2007a). In the same article, it was announced that written instructions about the use of water would be sent to all households. The water company initiated a program to hyperchlorinate and flush the water distribution system in order to clear the contamination (Health Stream, 2007). In addition, residents were required to run their taps in order to ensure that the contamination was free from all internal plumbing (Health Stream, 2008). Residents were advised to run their taps for 15 minutes twice a day (Helsing Sanomat, 2007a). Water distribution points were made available for residents to collect bottled water (Helsing Sanomat, 2008b). In addition, the Finnish Defence Forces were called in to supply water tankers and assist with door-to-door deliveries of bottled water to residents. Schools were closed for a week. In an effort to limit secondary transmission of infections, health authorities urged people who were unwell not to return to work or school for at least two days after their symptoms had resolved (Health Stream, 2007). The Accident Investigation Board of Finland announced during the outbreak that they had appointed a committee to examine the causes of the incident and the subsequent response by relevant authorities. Although the water authorities had aimed to declare the water supply as safe by 22nd January, water tests revealed the persistence of Norovirus in some areas of the city; in response decontamination efforts were extended for a further four weeks (Health Stream, 2008). In addition to technical and regulatory recommendations, the Accident Investigation Board of Finland (2007) recommended that plans in relation to “preparedness and readiness” should be properly developed, and in particular should specifically address issues of leadership and communications during waterborne outbreaks.

Outcome

The boil water order was lifted on 19th February 2008, more than 10 weeks after it was implemented (Health Stream, 2008).

117

Documented Evaluation of Action

Health Stream (2007) reported that the health ministry admitted that the outbreak had highlighted deficiencies in emergency response procedures, especially in relation to communication with the public during the crisis. A spokesman for the National Public Health Institute also stated that hospitals and local governments had trouble coping with the outbreak and more resources were needed for outbreak and emergency response programs. In terms of how the incident was handled, the Accident Investigation Board of Finland (2007) stated that, from the beginning, the approach was piecemeal and inadequate. The contingency plan was insufficient, and staff at the waterworks had little training or education to provide the skills or leadership in handling such an event. They stated that crisis management and communications specialists should have been consulted.

Sources Accident Investigation Board of Finland (2007). “Entry of Treated Wastewater into the Drinking Water Network in Nokia on 28–30 November 2007”. Investigation Report (In Finnish). Available at: http://www.onnettomuustutkinta.fi/en/1210772987844 Health Stream (2007). “Waterborne Outbreak in Finland”, Public Health Newsletter of the CRC for Water Quality and Treatment: Issue 48 Heath Stream (2008). “Nokia boil Water Alert Ends”, Public Health Newsletter of the CRC for Water Quality and Treatment: Issue 49 Helsing Sanomat (2007a). “A Thousand Nokia Residents Believed to have had Symptoms after Consuming Contaminated Drinking Water” Available at: http://www.hs.fi/english/article/A+thousand+Nokia+residents+believed+to+have+had+symptoms+after+consuming+contaminated+drinking+water/1135232307520 Helsing Sanomat (2007b). “Nokia Water Crisis Eases”. Available at: http://www.hs.fi/english/article/Nokia+water+crisis+eases/1135232483252 Helsing Sanomat (2007c). “Investigation Underway into Deaths Possibly Linked to Tainted Nokia City Water”. Available at: http://www.hs.fi/english/article/Investigation+underway+into+deaths+possibly+linked+to+tainted+Nokia+city+water/1135232706082 Helsing Sanomat (2008a). “Norovirus Still Found in Nokia City Water Despite Chlorination”. Available at: http://www.hs.fi/english/article/Norovirus+still+found+in+Nokia+city+water+despite+chlorination/1135233606773 Helsing Sanomat (2008b). “Municipal Water Use Restrictions Finally Lifted in City of Nokia” Available at: http://www.hs.fi/english/article/Municipal+water+use+restrictions+finally+lifted+in+city+of+Nokia/1135234185232 Helsing Sanomat (2008c). “Police Suspect Nokia Municipal Water Crisis Could have Caused

118

Two Deaths”. Available at: http://www.hs.fi/english/article/Police+suspect+Nokia+municipal+water+crisis+could+have+caused+two+deaths/1135235675717 Hulkko, T., Lyytikäinen, O., Kuusi, M. Iivonen, J. & Ruutu, P. (Eds) (2008). Infectious Diseases in Finland, 2007. Publications of the National Public Health Institute (B 9/2008). Juuti, P. & Rajala, R. (2008). in Vesitalous: “Tautia Hanasta [Disease from the Tap” (in Finnish). Available at: http://www.vesitalous.fi/upload/lehtiarkisto/2008/5_2008.pdf Laine, J., Huovinen, E., Virtanen, M. J., Snellman, M., Lumio, J., Ruutu, P., Kujansuu, E., Vuento, R., Pitkänen, T., Miettinen, I., Herrala, J., Lepistö, O., Antonen, J., Helenius, J., Hänninen, M. L., Maunula, L., Mustonen, J. & Kuusi, M. (2010). “An Extensive Gastroenteritis Outbreak After Drinking-Water Contamination by Sewage Effluent, Finland”. Epidemiology and Infection, 15, 1-9. (Abstract Only). Spiegel Online (2008). “The Nokia Virus: Finnish Town Faces Fecal Foul-Up” Available at: http://www.spiegel.de/international/europe/0,1518,527057,00.html YLE (2007a). “Call For Accountability In Nokia Water Contamination”. Available at: http://www.yle.fi/uutiset/news/2007/12/call_for_accountability_in_nokia_water_contamination_260593.html YLE (2007b). “Committee to Examine Nokia Water Disaster” Available at: http://www.yle.fi/uutiset/news/2007/12/committee_to_examine_nokia_water_disaster_260981.html

119

Appendix 2. Long-Term Project Implementation Scenarios: Case Studies

from the Water Sector

120

Case Study 21: Redwood Shores Recycled Water Project, California, USA

Location Redwood City, California, USA

Date

2000-2004

Nature of Scheme/Proposal

The project involved proposed water conservation and recycling in order to reduce water demand. A pilot recycling project and feasibility studies were carried out in 2000 and 2001. These studies identified the Redwood Shores area as the most practical area for implementation of an urban irrigation recycling system (SCWRPI, 2004).

Public Response

Documented by SCWRPI (2004) and Ingram et al. (2006), initial public outreach activities in June 2002 resulted in low attendance and minimal comments; only 2 citizens attended an initial workshop, which aimed to initiate public outreach for the project in general. The negligible public feedback received during the public outreach attempts lead to the project being placed on a ‘fast track schedule’. Decisions were announced in a public hearing, where again, no opposition to the project was voiced. The next decision was to be the Council’s approval of the project. Ingram et al. (2006) stated that, by the time the city council reviewed the proposals In August 2002, public interest had emerged, in the form of the “Safewater Coalition”. The group was organized and led by the 2 citizens who had attended the first workshop. In response to the increasing levels of public interest, the council decided to postpone their approval process, and planned instead to enhance their public outreach and education efforts (Ingram et al, 2006, 182).

Actions taken

In response to public opposition and in order to allay public concerns (particularly in the context of public health and safety), “Redwood City Council implemented a number of measures, including, creating a Community Task Force and technical/legal team; conducting a public hearing; producing a draft California Environmental Quality Act…and establishing a ‘no mandatory use’ policy” (SCWRPI, 2004, 14). The following account is sourced from Ingram et al’s. (2006) detailed documentation of the subsequent participatory processes: - In September, 2002, a Public Information Forum was held, involving attendance from 100 members of the public. The forum was hosted as a panel discussion facilitated by the Council. This involved 13 panelists who responded to the public’s questions about public health and safety, landscaping and water reuse, implementation and regulatory standards, and public perception and acceptance. - After the Public Information Forum, public interest in the project

121

remained high. Project opponents were particularly concerned about the proposed ‘mandatory use’ of recycled water in residential areas. In February 2003, in response to such concerns, the City Council announced an alternative policy involving non-mandatory use of recycled water. The introduction of the revised policy meant that an alternative recycled water system needed to be developed. - Other areas of public opposition included the possible health risks in relation to the use of recycled waster in public areas, especially where children were exposed (e.g. schools, parks, playgrounds etc). The council responded to such concerns by initiating a review of research, (including reviews of technical reports and expert testimonials) in order that the information could be presented to the public to enable them to further participate in decision-making processes. - Public dialogue and information dissemination was described as an ongoing process. One meeting in July 2003 lasted 8.5 hours. Creation of Community Task Force - Later, the Council approved a project that met project requirements in terms of water needs. However, they were aware that the ongoing opposition could undermine the successful implementation of the project. Therefore, the council opted to provide the opponents with the opportunity to work together with the council, in order to find ways to address and satisfy their concerns. The council therefore created a Community Task Force., which was approved in August 2003. - The purpose of the task force included identifying ways to meet the required quantity water e.g. via recycled water, or by finding alternate methods such as water conservation, in the relevant timeframe (e.g. by 2010), in an financially viable manner, whilst concurrently helping to educate, inform and advocate recommendations to the community. - The structure of the Task Force included a community task force of 12-15 members of the public. Members were appointed by the council, and the task force aimed to include a broad base of members, including those opposed and in favor of recycled water. in addition, a professional facilitator was included, who had no professional background in recycled water. The application process for participation in the task force was open to the public. The final group comprised 20 members, including 9 members in favour of recycled water, 9 in opposition, and 2 neutral members. In terms of backgrounds, the group included members of the Safewater Coalition, local residents, representatives from school councils and childcare and park user groups, the business community, potential customers, and the Chamber of Commerce. - The first meeting of the group was held in October 2003, and they aimed to meet twice a month over a period of five months. - With the aid of the facilitator, the group expressed their viewpoints. Participation was encouraged from all task force members; ground rules for the operating the group were decided, as well rules for decision-making. - No members of the Council participated in the task force – “this was part of the Council’s strategy, to reassure Task Force members that this was their process and their responsibility, and that the City would not try to

122

influence or sway any aspect of the Task Force’s work” (Ingram et al, 2006, 184). However, during the course of the Task Force meetings, members requested technical information and documents, and council staff were available via telephone and email to answer questions. The process was largely iterative, and the council was made aware that additional analysis and research were required from council staff. - A sub-committee was created in December 2003, where Task Force members worked with council staff and consultants in order to investigate the viability, cost, and potential water savings of the measures discussed. The results of the sub-committees findings were made available in January 2004. The final Task Force report was presented to the council in March 2004. The council accepted the report findings and recommendations with “great enthusiasm” ( 188). Outreach Efforts After the Task Force Ingram et al. (2006) stated that the council remained “committed to implementing a successful project that includes a proactive and responsive outreach method to stakeholders, residents…business, schools and the media’ (Ingram et al, 2006, 188). Ingram et al. (2006) also reported that although the Task Force did not remain operational, it continued to be an important community resource for the council, in terms of further outreach efforts. Ingram et al (2006) also documented the planned staged of the continuing outreach program ( 188), which included: - “ongoing needs assessment and information gathering in order to understand and respond to community sensitivities, at different stages as the project progresses, including design, construction and operation” - communications through various forms including newsletters, email, a website, and focus groups - a public webpage, via the council’s website, including an intranet portal, so as to “maximize communication and information sharing” between the tem members - a project office that demonstrates the council’s “commitment to customer service, and building trust and acceptance of the project” (Ingram et al., 2006, 188).

Documented Evaluation of Action

SCWRPI (2004) stated that this example shows that even proposals that would be considered as “generally accepted” can be met with opposition from the public – “A community that has not used recycled water, and is unfamiliar with the history and facts surrounding recycled water use, may require a more aggressive public outreach effort. Also, it is important to understand the underlying factors behind what is driving public opposition to a project so that the necessary steps can be taken to address these factors” (SCWRPI, 2004, 14).

In documenting ‘lessons learned’ by this example, SCWRPI (2004) also state that public involvement in project planning processes is vital - although the public may exhibit low interest in a project initially, relevant bodies and agencies still need to identify and address community concerns. In this context addressing community issues was regarded as

123

essential for developing public trust in the project, as well as gaining and maintaining support from elected officials for the project – “Rebuilding trust, once lost, is a very expensive and time-consuming process. It is also important to consider a full range of solutions, including nontraditional measures, when determining the economics of a project. This example illustrates that nontraditional measures may be employed as a solution when the public finds traditional approaches unsatisfactory” (SCWRPI, 2004, 14). Ingram et al. (2006) also provided extended insight about ‘lessons learned’, since council staff, elected officials, task force members and the community had the chance to reflect on the experience: a) Poor attendance in initial public meetings should not be used to infer public acceptance in relation to a project

- the council learned that people come to understand a project “in their own way and time”. In this example, although only a few people expressed opposition effort, their actions served to influenced the schedule, design and costs of the project – “those who are committed to an opposing view can create significant challenges to the process and focus of water recycling projects, but they must be heard and respected whenever they choose to participate (Ingram et al., (2006), 189). b) Responding to arguments taken out of context can present difficulties.

- in this case study, individuals who sought to “derail” the project used data and information from the internet to support their arguments. This served to heighten and amplify public reactions. The council learned that keeping the public informed is critical, and in so doing, they recognized that they as the council needed to be established and seen as the reliable and trustworthy source of information, in order to encourage positions of leadership rather than defensiveness. The council also learned that an opposition group that has time and resources will require equal (if not more) time and resources from their standpoint, in order to ensure that accurate counter information is disseminated. c) There is much scope for educating policy makers

- council members initially had a limited knowledge of issues related to drinking water, wastewater treatment and regulatory standards, which put them at a disadvantage, especially when opposition involved discussion of the wide range of contaminants and other issues gathered from the internet - “it is important to prepare elected officials for the nature of the debate, and to make sure they are kept informed of the continued development and challenges of the project, so they do not lose continuity with citizens or issues under discussion” (Ingram et al., 2006, 189). d) Engaging with the public can be seen as the next ‘logical step’

- the proposal represented an opportunity for the staff to approach the problem in the light of their purposes and values – “the approach fostered an appreciation for the critical nature of the water supply problem and planted the seeds for trust between the various interest groups. It was an engaging and healing process not only for Task Force participants but the entire community and city leadership” (Ingram et al., 2006, 189-190)

124

e Building community trust takes time

- The final lesson learned was that trust takes time to develop - “there was a general sense that the City needed to “slow down to go fast. It became essential to allow time for the Task Force and the community to understand the dimensions of the long-term water supply issue, and how best to approach its resolution. Taking time to review, reflect, learn, and assess enabled the project to ultimately move forward and will continue to affect its future” (Ingram et al, 2006, 190).

Sources Ingram, P. C., Young, V.J., Millan, M., Chang, C. & Tabucchi, T. (2006). From Controversy to Consensus: The Redwood City Recycled Water Experience” Desalination, 187, 179-190 Southern California Water Recycling Projects Initiative (2004). Successful Public Information and Education Strategies: Technical Memorandum. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

125

Case Study 22: East Valley Water Reclamation Project, USA

Location City of Los Angeles, USA

Date

1999-2002

Nature of Scheme/Proposal

The East Valley Water Recycling Project aimed to deliver disinfected tertiary-treated recycled water from a local reclamation plant to an area of the City of Los Angeles for groundwater recharge. A three-year demonstration project was officially approved, and began operation in 1999, the plan being that if water quality monitoring showed favorable results after the three-year period, groundwater recharge would be increased significantly.

Public Response

Public perception was initially positive, however public participation was not particularly high during the process. Environmental groups also supported the project because it assisted in protecting a local lake from ongoing degradation. Significant public opposition arose after the construction of the project had been completed and by this time recycled water deliveries had begun as part of pilot schemes. When the local media used the term “Toilet to Tap” to describe the project other media picked up on the story and it spread into the national media. At the same time the project entered the political arena as it coincided with a mayoral election year. Candidates used the topic of recycled water as a campaign issue.

Actions taken Public consultation was minimal (Marks, 2006)

Outcome

The use of the phrase ‘Toilet to Tap’ and the related implication that the public would be drinking treated wastewater caused the project to be put on hold, in spite of much investment. By April 2002, although $55 million had been invested in the project, resulting in its construction, operationalisation and testing, public opposition caused it to cease operation. In 2004 the City of Los Angeles began investigations to determine how to best utilise the existing infrastructure for urban irrigation, commercial/industrial and other non-potable uses.

Documented Evaluation of Action

This case study suggests that the success of a project depends upon a thorough and ongoing assessment of public opinion, public consent, as well as public and political involvement in processes such as project planning, design, construction, and operation. The outcome of this project also shows that if the public is not properly informed or believes that the project is unsafe, successful implementation will be unlikely.

126

Marks (2006) reported that in 2002, it was claimed that authorities had “failed to adequately inform residents”. In terms of ‘lessons learned’, SCWRPI (2004) state that this example highlights that public opinion can “derail” a proposal at any stage of a planning process. They suggest that “if strong opposition to a project arises, the public may need to be informed about the factors driving the project as well as have the steps taken to develop the project reviewed. For this reason, it is important to have a transparent well-documented process”.

Sources Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147. Southern California Water Recycling Projects Initiative (2004). Successful Public Information and Education Strategies: Technical Memorandum. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

127

Case Study 23: Orange County Water District & Orange County Sanitation

District Groundwater Replenishment System, USA

Location Orange County, California, USA

Date 1999-2008

Nature of Scheme/Proposal

Orange County’s main sources of drinking water supply are groundwater and imported water. The County recognised the need to provide an alternative source of water that is safe and reliable, in the light of projected water demand set to overshadow supply, and concerns about droughts. The need for alternative water supplies was identified, involving an investigation of various alternatives, including conservation and water purification techniques. The Groundwater Replenishment System website reports that, in March 1999 the environment review were “unanimously” certified. The project acquired a permit from the California Department of Health Services, water quality studies were conducted, project development studies were conducted, as well as widespread public outreach activities (GWRS, 2010). The website reports that the system takes highly treated sewer water and purifies it to standards that meet legal drinking water requirements. Technological processes include three-steps: reverse osmosis, microfiltration and ultraviolet light and hydrogen peroxide advanced oxidation treatment (GWRS, 2010). The system was built at an estimated capital cost of $485 million, and the project started in January 2008 (GWRS, 2010).

Public Response

Positive

Actions taken

Action was taken by Orange County Water District & Orange County Sanitation District. Public involvement and engagement efforts have been described as extensive. Marks (2006) reported that the form of consultation was a top-down process, involving 23 city councils and community groups. Information was distributed to 80,000 households and four workshops were held (Marks, 2006, 140). Outreach involved the public, as well as politicians and community leaders. Methods included focus groups, educational approaches, and surveys, whilst information was conveyed via the website, press releases, postal campaigns, tours, school visits, television advertisements and legislation based lobbying (SCWRPI, 2004). In addition, efforts were made to identify the demographic make up of potential opposition groups. The findings suggested that variations in cultural views within immigrant communities may result in differing levels of support, and women, the elderly, and the less educated were more

128

likely to oppose the project. In terms of gaining public support, the ‘yuck factor’ was specifically addressed, and the basis of the technologies were explained. In addition, emphasis was placed on explaining the need for the project, “and on reliability – why the people should trust the system” SCWRPI (2004, 19). SCWRPI (2004) report that focus groups continued to be held every two years in order to monitor public opinion, gauge levels of support and opposition, and check for new issues. They also reported that the outreach effort was expected to continue for at least a year after project implementation (SCWRPI, 2004). GWR (2010) state that public input is considered to be vital to the success of the project. On their website it is stated that the public Steering Committee meetings, and make information available on meeting schedules, agendas and the minutes. In addition it is stated on the website that “the public is encouraged to write or call the Orange County Water District and the Orange County Sanitation District Boards of Directors to let them know their thoughts on the project”, and weblinks are made available for contact purposes.

Outcome

The project is described by SCWRPI (2004) as having strong political support.

Sources Groundwater Replenishment System Website (2010). About The System. Available at: http://www.gwrsystem.com/about/overview.html Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147. Southern California Water Recycling Projects Initiative (2004). Successful Public Information and Education Strategies: Technical Memorandum. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

129

Case Study 24: NEWater, Singapore

Location Singapore

Date

1998- 2003

Nature of Scheme/Proposal

NEWater is an example of the successful implementation of indirect potable re-use. The majority of highly treated effluent is used by industry for operational processes. However, some is returned to storage reservoirs from which drinking water supplies are obtained. Due to the dilution in the reservoirs, the reclaimed water is estimated to make up only a very small proportion of the supplies but it is still classed as ‘planned’ IPR (DTI, 2006). The initiative is classed as world renowned and has been heavily promoted by the Singapore Public Utilities Board (PUB) (DTI, 2006). The PUB initiated a pilot in order to reclaim water from wastewater treatment plants. Following successful piloting of state-of-the-art technology, upgrades to four wastewater treatment plants to provide high-quality effluent for reuse were completed, the first in 2003 (DTI, 2006). The reclaimed water has been branded as ‘NEWater’. The PUB managed an extensive and expensive education and marketing drive to facilitate its acceptance. The DTI report that no expense has been spared, either with promotion of the scheme or with the attention to quality control and operational compliance. A visitor centre has been built to promote the initiative to the public.

Public Response

Positive – the visitor centre is popular with members of the local population (including educational school tours) and tourists. By 2004 more than 110,000 people had visited the facility (SCWRPI, 2004). It is claimed that over 60% of the population have visited the visitor centre (DTI, 2006).

Actions taken

After techniques and processes were checked and confirmed in terms of viability, and studies confirmed the health-based safety of the water, a major plant was commissioned. In order to enhance public understanding of NEWater, the Public Utilities Board embarked on an intensive public education programme, involving advertisements, posters and leaflets. In addition, briefings and exhibitions were held to disseminate information about the project. Plans for the NEWater facility also included a visitor center integrated into the plant, designed to acquaint visitors to the concept of ‘NEWater’ and to develop public acceptance. The visitor center aimed to be an enjoyable learning environment, whereby visitors can learn information via various techniques. The visitor center opened in February 2003, and has since been upgraded (PUB, 2008).

130

Outcome

The Public Utilities Board plan to continue use of NEWater for direct non-potable purpose by industries. In terms of indirect potable use, the board state that, “3 million gallons a day of NEWater, about 1% of the total volume of water consumed daily, has been blended with raw water in our reservoirs. The amount will be increased progressively to reach about 2.5% of the total volume of water consumed daily by 2011”.

Documented Evaluation of Action

According to SCWRPI (2004) communicating information related to indirect potable reuse is one of the most challenging water-related public acceptance issues. For this reason the Singapore NEWater case study is regarded as a positive example in the field since there has been little recorded public opposition. Previous case studies particularly in the USA have shown that public acceptance and understanding of water reuse is linked with the stigma associated with used wastewater. In Singapore the authorities were aware from the outset that a comprehensive education program would be crucial in order to engage with the public, particularly in terms of raising awareness about the need for the facility. The public’s lack of understanding about the water cycle, as well issues related to water reuse and membrane technology were key challenges. It was recognised that long-term public acceptance of these technologies was linked with developing a public understanding of the significance of fresh water supplies, as well as “an appreciation that all water is and always has been ‘used’. The DTI (2006) state that “if there was any public opposition to the scheme, it was not evident. It is concluded that a combination of PUB’s exacting approach to scheme implementation, coupled with the possible cultural acceptance of a desire to decrease dependency on external parties (e.g. water imports from Malaysia) resulted in acceptance of the approach to planned IPR.” ( 11-12).

Sources DTI (2006) Water Recycling and Reuse in Singapore and Australia. Report of a DTI Global Watch Mission: Global Watch Mission Report. Available at: http://www.bvsde.paho.org/bvsacd/cd65/water-recycling/content.pdf Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO. Public Utilities Board Website (PUB) (2008). Available at: http://www.pub.gov.sg/newater/faq/Pages/default.aspx Southern California Water Recycling Projects Initiative (2004). Successful Public Information and Education Strategies: Technical Memorandum. http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

131

Case Study 25: Irvine Ranch Water Recycling Program, California, USA

Location California, USA

Date

1991

Nature of Scheme/Proposal

The Irvine Ranch Water Recycling Program is regarded as one of the longest running and most successful multi-use recycling projects in California. The district imports 50% of water to meet domestic and irrigation needs across the district. In 1967 the authorities introduced recycled water for agricultural purposes, in order to reduce dependency on imported water (Po et al., 2003, 6).

Public Response Positive

Actions taken

As stated by Po et al., (2003) part of the success of the project has been attributed to the authorities’ “commitment to inform and educate the public about water efficiency and water reuse, thus creating enhanced awareness about water shortage issues” (Po et al., 2003, 6-7). Po et al (2003) exemplify this by stating that all members were informed about the value of water over a period of decades. In addition, they state that, over the years, water reuse has been promoted as a way of safeguarding the environment, saving money, energy, and providing a reliable form of water supply that is resistant to drought. They also report that water reuse is further promoted via methods such as intensive water conservation programs, including public tours, school education, outreach programs and community education programs.

Outcome

Recycled water is used for various non-potable purposes such as irrigating local crops, golf courses, parks, school grounds, as well as industrial uses. The IRWD also supplies homeowners recycled water for non-potable purposes, through a dual distribution system. In 1998 it was reported that recycled water accounted for 15% of the annual water needs of the district.

Documented Evaluation of Action

Successful implementation of non-potable water reuse scheme.

Sources Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO.

132

Case Study 26: Monterey County Water Recycling Project, California, USA

Location California, USA

Date

1998

Nature of Scheme/Proposal

The project was designed to minimize seawater intrusion into groundwater aquifers by using recycled water for irrigation purposes as opposed to groundwater. The project was operational in 1998, after 20 years planning. In 2004 it was reported that over 53 billion litres of recycled water is produced for irrigation of high quality crops in the region (Po et al, 2003).

Public Response Positive

Actions taken

Success of the project is linked with careful planning over 20 years and the emphasis on public involvement. During early stages of planning, public discussions were held with local farmers. On the basis of the discussions, the need for field studies was identified, which would explore “the safety and marketability” of produce irrigated with recycled water, a five year health study was conducted. The results showed that produce would be safe for consumption (SCWRPI, 2004, 57). Although initial support was gained from growers, two years prior to implementation, concerned growers formed a committee. Although they had previously been actively involved in the five year study, they expressed concern about project design and operation. The County reacted positively to such concerns, and conducted a study to investigate potential pathogen growth in the irrigation water. The study did not show any evidence of pathogens, and project implementation commenced (Po et al., 2003, 8). In order to provide further assurance to growers, the County provided information over a period of time. Support for the scheme was also garnered from the local environmental community, who endorsed the project for reducing wastewater discharge.

Outcome

Successful implementation of non-potable water reuse scheme Community support was said to be high due to the introduction of extensive educational programs, involving presentations at schools, treatment plant tours, project exhibitions at community events, and provision of leaflets to consumers with water bills (Po et al., 2003,.

133

Sources Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO. Southern California Water Recycling Projects Initiative (SCWRPI) (2004). Successful Public Information and Education Strategies: Technical Memorandum. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

134

Case Study 27: San Diego Water Purification Project, California, USA

Location California, USA

Date

1993-1999

Nature of Scheme/Proposal

The rationale for introducing recycled water as supplementary to San Diego’s drinking water supply was linked with the drought of 1991-1992. The project involved supplementing surface waters with reclaimed water. In the public sphere, the project was introduced as a means of protecting the city’s water supply from possible droughts in the future (Po et al., 2003).

Public Response Negative

Actions taken

The relevant authorities, San Diego City Council and San Diego County Water Authority, understood the importance of public acceptance and on the basis of this implemented a wide-ranging research project that aimed to investigate public willingness to use recycled water, and also to identify potential issues that needed to be addressed. Research was undertaken using public opinion polls, focus groups, as well as individual interviews with community leaders and policy makers (Po et al., 2003). Public consultation was carried out over a six month period, involving the distribution of 1800 packages, and 60 presentations to interest groups (Marks, 2006). Po et al. (2003, 10) reported the results from a telephone survey with over 300 residents of San Diego. The findings suggested that: - Participants expressed a significant level of interest and concern about water supply, quality and treatment. - Participants also indicated support for the use of recycled water, but preferred the term ‘purified’ water, as opposed to ‘recycled’ or ‘reclaimed’ water. - Participants also indicated after the concepts had been fully explained to them, they would be supportive of using re-purified water for drinking, cooking washing. Po et al. (2003) also reported that focus groups and interviews with community leaders also suggested positive results. In order to reassure residents further, the authorities submitted the project proposal to an Independent Advisory Panel, as well as a citizens’ review panel. It was concluded that recycled water was an acceptable option. Additional public outreach activities included the provision of fact-sheets, brochures, video presentations, a telephone enquiry service, as well as features in newspapers. However, in spite of positive feedback based on the programs, the project

135

was linked with political campaigns. “The campaigns claimed that the city planned to take wastewater from affluent communities, to distribute as drinking water to those less affluent”; furthermore, health related dangers associated with the project were highlighted (Po et al., 2003, 2003). Subsequently, the State Department of Health Services initiated a hearing in relation to the project. Po et al. (2003) reported that hundreds of concerned residents attended. It was assumed that they attended the hearing after seeing posters with the slogan “Toilet to Tap”. The project was put on indefinite hold by the San Diego City Council.

Outcome

The project was not implemented - the City of San Diego put the project on indefinite hold due to negative public perceptions regarding the project’s public health and safety (SCWRPI, 2004). Marks (2006) reports that San Diego is now planning to build a desalination plant.

Documented Evaluation of Action

Hurlimann (2008) cites this as an example of the ‘Decide, Announce, Defend’ approach although citizens were involved in some deliberative activities via the citizens’ panel. SCWRPI (2004) stated that in terms of lessons learned, project sponsors must be aware of and recognise the potential for strong controversy in association with indirect potable projects. They state that project timing must be considered in the broader sense to avoid political opportunism, if possible. With such projects, a thorough education and cooperation of politicians and potential users is mandatory for success.

Sources Hurlimann, (2008). Community Attitudes to Recycled Water Use: An Urban Australian CS– Part 2. Research Report No. 56. The Cooperative Research Centre for Water Quality and Treatment. Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147. Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO. Southern California Water Recycling Projects Initiative (SCWRPI) (2004). Successful Public Information and Education Strategies: Technical Memorandum. Available at: http://www.usbr.gov/lc/socal/reports/TM_PublicInfoStrategies.pdf

136

Case Study 28: San Gabriel Valley Groundwater Recharge Project, California,

USA

Location California, USA

Date

1989-2001

Nature of Scheme/Proposal

The project was proposed in 1989, the rationale was linked with a period of drought, and aimed to use recycled water to replenish the reserves in local aquifers.

Public Response

Largely negative. The project was initially met with significant opposition, exacerbated by newspaper advertisements placed by a citizens’ pressure group which questioned the safety and feasibility of the project.

Actions taken

Public consultation was minimal (Marks, 2006). Po et al., (2003) stated that, in an attempt to gain public acceptance, the project formed “alliances” with groups that supported the proposal. They also reported that public tours and meetings were organized, with the aim of informing the public about the project, and addressing public health concerns. This included information about how the water was treated, the measures of safety that were in place (Po et al., 2003, 11). Prior to a hearing related to the environmental review process, a citizens group named ‘Citizens for Clean Water’ labeled the project to as “Toilet to Tap’ via full page newspaper advertisements. Furthermore, Po et al. (2003) reported that the citizens group claimed that the project was unnecessary, and that the potential health risks associated with consuming reclaimed water were unacceptable and linked with risks for people as well as the environment. In addition, a local brewery initiated legal proceedings, claiming that the project posed serious environmental problems which might pollute their water supply. As a result, a lawsuit was lodged, designed to deter the project from being implemented. The project was downsized by 40%, and was moved away from the brewery (Po et al., 2003, 11). By 2003 the project had gone through planning, design and environmental permitting processes. Po et al. (2003) report that, in spite of opposition, the project has received support from organizations such as the California WateReuse Organisation, and the Los Angeles County Medical Association.

Outcome

Project was implemented, but at a smaller scale.

137

Sources Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147. Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO.

138

Case Study 29: Caloundra and Maroochy Wastewater Project, Australia

Location Queensland, Australia

Date

1995-1998

Nature of Scheme/Proposal

The Caloundra/Maroochy Strategic Wastewater Management Study was initiated in 1995.

Public Response

Largely negative. Community action groups were formed. There was particular concern about the risks associated with feminising and masculinising hormone-affecting substances (EDCs). Against the plans, an internet site was created by the Rivermouth Action Group, who launched a campaign, featuring articles with headlines such as “Men’s Worst Fear on Tap”. However, the local council still voted to implement an indirect potable recycling strategy.

Actions taken

Jones (2007), states that plans and options were not made public; he provided an overview of events, citing his source of information as the State Ombudsman. The overall strategy was said to include a $220,000 community consultation component, which included 60 focus group meetings. Jones says that the outcome was predetermined, stating that “Project Managers were given a list of 1600 people to contact and invite. Of these, 1200 successful contacts were made. About 380 attended. The list of invitees reads like a "Who's Who" of the environmental movement”. Jones (2007) stated that by 1996 the study went ahead “despite both Caloundra and Maroochy Councils prior acknowledgement that the environment groups were over-represented”. The councils adopted the study for planning purposes for 50 years. However, he stated that “The credibility of the support for potable reuse obtained from the study is therefore open to doubt” because environmental groups were believed to have had a disproportionate impact on the outcomes. These claims are corroborated by CSIRO (2003), who stated that, “the perceived fairness in the decision making process is also important. The Maroochy and Caloundra councils failed to initiate the reuse project because the lead up process was seen to be unfair by the community. … community members were not consulted and involved at the conception of the project”. 25-26).

Outcome

The project was modified due to the campaign by citizens against indirect potable water recycling.

139

Documented Evaluation of Action

Hurlimann (2008) cites this as an example of the ‘Decide, Announce, Defend’ approach. Po et al. (2003) also state that the argument against the proposal was intensified due to a lack of community involvement and consultation in the events leading up to the implementation the proposal (Stenekes et al., 2001). Opposition groups felt that the local council had voted for the proposal without consulting the local community adequately. In a report prepared for the Parliament of Australia, it is stated that the case was characterised by a perceived lack of adequate consideration of stakeholders in the decision-making process, but nevertheless, the council still voted to implement the strategy (Dimitriadis, 2005).

Sources Dimitriadis, S. (2005). Issues Encountered in Advancing Australia’s Water Recycling Schemes. Parliament of Australia, Department of Parliamentary Services: Research Brief No. 2. Available at: http://www.aph.gov.au/library/pubs/rb/2005-06/06rb02.pdf Jones, L. (2007). Freedom Advocated (Website): Australia Water History. Available at: http://www.freedomadvocates.org/articles/water/australia_water_history_20071212269/ Hurlimann, (2008). Community Attitudes to Recycled Water Use: An Urban Australian CS– Part 2. Research Report No. 56. The Cooperative Research Centre for Water Quality and Treatment. Po, M., Kaercher, J.D. & Nancarrow, B.E. (2003). Literature Review of Factors Influencing Public Perceptions of Water Reuse. Australian Water Conservation and Reuse Research Program. Perth: CSIRO. Rivermouth Action Group (RAG), (1998). Men’s Worst Fear On Tap. Available at: http://www.rag.org.au/sewage/sm18jan98.htm Stenekes, N., Colebatch, H.K., Waite, T.D. & Ashbolt, N.J. (2006). Risk and Governance in Water Recycling: Public Acceptance Revisited. Science, Technology and Human Values, 31, 107-134.

140

Case Study 30: Water Futures Project, Toowoomba, Australia

Location

Toowoomba, Australia.

Date

2005 - 2006

Nature of Scheme/Proposal

Toowoomba City Council proposed to implement a planned Indirect Potable Reuse scheme, in order to secure future supplies. The DTI (2006) state that the proposal aimed to “mimic world best practice” following examples such as Singapore (DTI, 2006, 12). The Toowoomba Council had lodged a submission to fund the project in mid 2005; after approval the council launched the “Water Futures Initiative” (1st July 2005), which detailed initiatives to provide solutions for the water challenges that the city faced. Solutions included the construction of an advanced water treatment plant to provide potable recycled water. The initiative was viewed in a positive light with political support. The DTI (2006) reported that from 1st July, 2005, the project was supported by all councilors. However, the initiative “was principally a policy document, not a public communication document. However, as part of the proposal, Toowoomba City Council was planning to undertake a three year community engagement program” (Hurlimann and Dolnicar, 2010, 289) The scheme stalled due to public opposition. Subsequently, politicians who had initially backed the project, demonstrated an unwillingness to proceed with funding, suggesting that the best course of action would be to hold a referendum (DTI, 2006).

Public Response

Public response was largely negative. Instrumental in forming public views was the formation of the lobby group CADS (‘Citizens Against Drinking Sewage’). The group was formed in response to the proposed initiative, and led by a former president of the Chamber of Commerce, a millionaire property developer and former local mayor. The group was formed on 21st July 2005, less than 4 weeks after the initiative was published. The first public meeting of CADS was held in August 2005 (Hurlimann and Dolnicar, 2010). By February 2006 10,000 people had signed a CADS petition, opposing the initiative (Hurlimann and Dolnicar, 2010). The whole event received extensive coverage in the media, especially in the time leading up to the public referendum, with headlines including: - “Pull Plug on Poo Water” - “Just Pretend it’s not Water from the Toilet” - Threat of Sec-Change Sewage” (source, DTI, 2006, 12) and

141

- “Don’t Poo-Poo It Until You Try It” - “Loo’king at Recycled Water” (source, DTI, 2006, 52) In March 2006 the residents of Toowoomba (approx 95,000) were invited to vote in a referendum regarding whether or not the IPR scheme should be implemented. After major campaigns on both sides of the debate, the majority of residents (62%) voted against the proposal in July, 2006 (Hurlimann and Dolnicar, 2010).

Actions taken

Hurlimann and Dolnicar (2010) provided a detailed overview of the events leading up to the public referendum. Actions taken by the Council - Toowoomba City Council were reported to be “not pleased” with the decision to hold a referendum (Hurlimann and Dolnicar, 2010, 290). However, they proceeded to launch a 10 week information campaign. - In March 2006 a booklet was distributed by the Council, detailing explanations about the water cycle, current levels of water supply and possible alternatives – “This put Toowoomba City Council in the situation of…having to condense a proposed three year community engagement program – consisting of public fora, flyers, taste testings of recycled water and on-request public presentations…into a three month local political campaign” (Hurlimann and Dolnicar, 2010, 290). - Information provided by the was factual, while the main messages in response to the CADS campaign argument were as follows: a) “Communities around the word use recycled water for drinking” Examples were provided, including Orange County and Virginia, USA (since 1970’s); Singapore (since 2003) and Namibia (since 1968). b) The reputation of the Toowoomba food industry will not be at risk”. Explanations were given to the end that water used in food production is legally required to meet national guidelines. c) “Recycled water is safe and will produce water as safe as existing drinking water because of the ‘Advanced Water Treatment Plant Purification Processes’”. Experts such as academics and medical doctors were also quoted regarding issues of safety in the campaign brochures (Hurlimann and Dolnicar, 2006, 290). Actions taken by CADS At the same time, leading up to the referendum, CADS continued with their lobbying, by holding public meetings. In addition, they had petitions and internet blogging sites to encourage residents to vote against the initiative. Some experts from the water industry and academics contributed to the blogging websites. In reviewing the campaign material, Hurlimann & Dolnicar (2010) reported that much was “driven by emotions and at discrediting sources of factual information’ (Hurlimann, and Dolnicar, 2010, 291. CADS main arguments against the initiative were as follows:

142

a) “People were concerned about the image of Toowoomba, and worried that their image as the ‘Garden City’ would change to being that of ‘Shit City’ or “Poowoomba””. b) “Toowoomba would become less attractive to business, industry, families” and other parties, such as potential tourists and house-buyers. c) “Residents had health concerns. They were not sure if they could trust science; they were ‘irritated’ that the Toowoomba City Council refused to state that the water was 100% safe and stated that they felt like “lab rats”. (Hurlimann and Dolnicar, 2010, 292).

Outcome

The water situation In 2006 the DTI reported that Toowoomba City Council faced an uncertain future in relation to water resources. Water restrictions (Stage 5, which means that mains water cannot be used for any outdoor use) were in place from September 2006, and in July 2008 dam levels were said to have dropped by 11% Hurlimann and Dolnicar, 2010). Hurlimann and Dolnicar (2010) also reported that in 2008 a decision was made to proceed with a large-scale recycled water project for Brisbane, involving the construction of a pipeline to Wivenhoe Dam - “Consequently Toowoomba will be supplied with recycled water (Western Corridor Recycled Water Project, 2008) despite the negative referendum vote”. (Hurlimann and Dolnicar, 2010, 292). Public attitudes In terms of public attitudes, Hurlimann and Dolnicar (2010) found that in interviews and focus groups held with the public two years after the referendum – “public resistance clearly expressed at the referendum was not mirrored in people’s attitudes towards recycled water” (Hurlimann and Dolnicar, 2010, 296). Their findings demonstrated that attitudes have changed and that public opposition has diminished. Discussions revealed that participants were very aware about water issues, and that they actively engaged in water conservation practices. When asked if they would drink recycled water if the drought worsened, most indicated that they would be “quite happy to drink it” ( 296). Reflecting on the referendum, participants stated that they felt that the information issued by the Council was a reaction to CADS. Given that there are plans for the construction of an additional large-scale recycling plant (Queensland), it was suggested that Toowoomba residents may not have wanted be the first location in Australia to drink recycled water and that knowing that other locations e.g. Brisbane would also be drinking recycled water may have allayed concerns.

Documented Evaluation of Action

The DTI cite this example as exemplifying “the derailment of a proposed planned IPR scheme due to public opposition” (DTI, 2006, 10), going on to state that it is a “textbook example of how proposed IPR schemes become politicized” (DTI, 2006, 51). The DTI state that – “The approach to this scheme has been the cause of much debate in the Australian water industry. Other water providers watched the referendum’s progress with interest, as a positive outcome would have been useful to all. However it has been argued that the implementation was not well handled and also

143

there was much criticism of the referendum approach. Toowoomba City Council saw the imposition of a referendum as an abrogation of political leadership and usurping its democratically elected mandate for making decisions relating to its community” (DTI, 2006, 13). The DTI reported that those who supported the scheme struggled to put their scientific arguments across. However, Hurlimann and Dolnicar (2010) observed that there were more, broader issues at stake, suggesting that the Council could be regarded as being at a disadvantage in terms of how events unfolded. In terms of communicating with the public, with regard to the proposal of the initiative, there had been no prior communication by the authorities since the original initiative document was not intended for public consumption. The council had planned to launch a public engagement program, but instead, CADS communicated their views about the project first, alongside arguments against the plans – “being the first to communicate with the public, [CADS] became the benchmark information source for matters relating to the proposed recycling project. This gave CADS significant market power and made it more and more difficult over time, for any positive message about recycled water to be communicated successfully to the residents of Toowoomba” (Hurlimann & Dolnicar, 2010, 289). Hurlimann and Dolnicar (2010) went on to state that, by the time the decision to hold a referendum was made and the council started to inform the public, CADS had already been communicating with the residents of Toowoomba for more than six months. Furthermore, they observed that, “as opposed to CADS, [the] Council were bound by Codes of Conduct, and thus had to ensure that campaign content was at all time ‘above board’” Hurlimann and Dolnicar, 2010, 290). In conclusion therefore, Hurlimann & Dolnicar (2010) stated that, “the failure of the Toowoomba indirect potable reuse plans, cannot just be attributed to public opposition to the plans. Politics, timing, vested interests and information manipulation also played a part. The case of Toowoomba raises fundamental questions regarding public participation in government decisions and the way in which democracy is exercised” (Hurlimann and Dolnicar, 2010, 296).

Sources DTI (2006). Water Recycling and Reuse in Singapore and Australia. Report of a DTI Global Watch Mission: Global Watch Mission Report. Available at: http://www.bvsde.paho.org/bvsacd/cd65/water-recycling/content.pdf Hurlimann, A. & Dolnicar, S. (2010). When Public Opposition Defeats Alternative Water Projects – The Case of Toowoomba Australia. Water Research, 44, 287-297.

144

Case Study 31: Denver Water Department Potable Reuse Demonstration

Project, Colorado

Location Denver, Colorado, USA

Date

1980-1990’s

Nature of Scheme/Proposal

The project involved the recharging of groundwater, and commenced in the 1980’s. The $1billion plant was withdrawn due to contradictory reports about the community’s response to potable reuse (Marks, 2003).

Public Response

Marks (2003) reported that focus groups carried out in the 1990’s suggested that “people did not want to know too much about where their water comes from: they wanted us to just get on with it”. However, contradictory reports suggested that residents were not prepared to accept the option unless other sources of freshwater had been exhausted.

Actions taken Public consultation was minimal.

Outcome

The project was abandoned. Official reports from Denver Water suggested that the project had been withdrawn on the grounds that it was not economically viable however (Marks, 2003). Marks reported that some 20 years after the first project, in 2001, non potable reuse was introduced to industrial and commercial users.

Documented Evaluation of Action

Marks says that although the public may have initially voiced some support for the scheme in surveys, increased publicity about the proposal may have fostered a wider and deeper consideration of the proposal. Also, she suggested that in addition to concern about the source of the water, “the cost of the investment may have been unpopular with service fee paying Denver Water customers”. Overall, Marks (2006) stated that, this is an example where public consultation efforts were characterized by a lack of transparency at the earliest stages, and limited community outreach.

Sources Marks, J. S. (2003). The Experience of Urban Water Recycling and the Development of Trust. The Flinders University of South Australia: PhD Thesis. Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147.

145

Case Study 32: Tampa Water Resource Recovery Project, Florida, USA

Location Tampa, Florida, USA

Date

1996 - 2003

Nature of Scheme/Proposal

The proposal initially involved supplementing surface waters with reclaimed water, and was supported by the City of Tampa, the West Coast Regional Water Supply Authority and the Southwest Water Management District.

Public Response

Surveys conducted revealed that the majority of the public supported an alternative option of desalination, with 77% believing it to be a safe source of water.

Actions taken

Marks (2003) stated that the focus of public outreach was to “develop the purification option as completely as possible, rather than compare it to alternative sources”. Marks (2003) also stated that interviews conducted with external stakeholders revealed the view that “negative perceptions of the co-sponsoring agencies needed to be addressed and improved; the perceived risk, safety and cost of ‘purified (reclaimed) water would be a concern; and that seawater desalination was popular although there were reservations about its cost, energy consumption and environmental impacts”( 111).

Outcome

Tampa Bay Water opted to explore desalination over indirect potable reuse. Marks (2003) reported that a spokesperson for the company stated that the Board was reluctant to pursue indirect potable reuse due to public preferences for desalination, as well as concerns in relation to other risks. However, Marks also reported that those in favour of the scheme felt that “elected officials put it to a ‘referendum’ when they should have made the decision themselves” ( 112).

Documented Evaluation of Action

Overall, public consultation efforts were characterized by a lack of transparency at the earliest stages, and limited community outreach (Marks, 2006). Marks (2006) reported that desalination was found to be the preferred alternative option amongst the Tampa population. By 2003, the Tampa Bay Seawater Reverse Osmosis Plant was producing desalinated seawater drawn from the Tampa Bay. However, financial setbacks, control of the project, and problems with the aquatic environment have hampered its operation. Cooley et al. (2003) stated that the experiences in Tampa Bay highlighted the need for transparency and accountability.

146

Sources Cooley, H., Gleick, P., and Wolff., P. (2006). Desalination, With a Grain of Salt: A California Perspective. Pacific Institute for Studies in Development, Environment, and Security. Available at: http://www.pacinst.org/reports/desalination/desalination_report.pdf Marks, J. S. (2003). The Experience of Urban Water Recycling and the Development of Trust. The Flinders University of South Australia: PhD Thesis. Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147.

147

Case Study 33: Noosa, Queensland, Australia

Location Noosa, Queensland, Australia

Date

1993-1994

Nature of Scheme/Proposal

The project involved supplementing surface waters with reclaimed water.

Public Response

Marks (2006) reported that around 45% of residents supported some form of potable reuse.

Actions taken

Marks (2006) reports that from June 2003, public consultation involved a Stakeholder Group, which involved 30 recognised community groups, regarded as ‘opinion leaders’ in the local community. In August, engineering consultants discussed options with the groups, e.g. water reuse for irrigation of private lawns and gardens. In addition, the Council issued newsletters and surveys to all residents. However, the survey that was administered had a 10% response rate limiting its utility. Two public meetings were held, attended by 260 people in total. A significant outcome of the newsletter was that it caused alarm amongst residents who had not been involved in the community consultation process. Locals said it was the only information they had received, that they were unaware of the council’s plans and they were unhappy to be excluded from the decision process (Marks, 2006).

Outcome

The project was abandoned.

Documented Evaluation of Action

The outreach team “concluded that the social change required for acceptance of potable reuse required more time for an effective education program to reach all of the community. Overall, public consultation efforts were characterized by a lack of transparency at the earliest stages, and limited community outreach (Marks, 2006).

Sources Marks, J. S. (2003). The Experience of Urban Water Recycling and the Development of Trust. The Flinders University of South Australia: PhD Thesis. Marks, J.S. (2006). Taking the Public Seriously: The Case of Potable and Non Potable Reuse. Desalination, 187, 137-147.

148

Case Study 34: Kernell Desalination Plant, Australia

Location Kernell, Australia

Date

2006

Nature of Scheme/Proposal

Proposed desalination plant

Public Response

Sutherland Shire Council formed important partnerships with a number of key environmental groups including The Kensington Group of Scientists, Sustainable Water Solutions and the Australian Services Union. A citizens’ alliance, named SCUD – “Sydney Community United against Desalination”, work alongside other groups such as SAAD (“Sydney Alliance to Avert Desalination”) to continue to protest and lobby the State Government in opposition to the desalination project. SCUD was formed as a result of the “government taking unilateral action to impose the desalination plant on the Sydney community”. Members of SCUD were participants in a Parliamentary Inquiry into the handling of the desalination plant proposal. Opposition ranged from concerns about environmental damage to high levels of energy use. One public meeting was attended by 200 people, including representatives from the proposed plant, local environmental groups, and political members. During the meeting, the Water Utilities Minister put forward the reasons for the plant, including environmental information (e.g. about variations in rainfall), growth in population, and the economic incentives. However, the public were said to be “unconvinced”, especially in relation to suggestions that the reasons for the proposal were an “emergency” solution. In addition, the audience was said to be “adamant” that alternative solutions such as renewable energy should be used in order to reduce present emissions, as opposed to what was described as an “energy intensive, unnecessary plant”. (NCCNSW, date unspecified).

Outcome

The project was withdrawn. SCUD succeeded in its campaign against the desalination plant after four months of lobbying. They hoped that the State Government would focus instead water recycling and conservation, and alternative eco-friendly measures that are more environmentally viable than a desalination plant (Cleanup.org, 2006).

Sources Cleanup.org (2006). Media Release: Desalination Shelved, Recycling Must Now Become a Priority. Available at: http://www.cleanup.org.au/au/NewsandMedia/water080206.html

149

Nature Conservation Council of New South Wales, (NCCNSW) (date unspecified). Desalination Protest Meeting: Desalination Protest Action. (Organised by Sydney Alliance to Avert Desalination). Available at: http://nccnsw.org.au/index.php?Itemid=890&id=1755&option=com_content&task=view Sutherland Shire Council (date unspecified). Kurnell Desalination Plant Campaign. Available at: http://www.sutherland.nsw.gov.au/ssc/home.nsf/Web+Pages/E2E213220EF39236CA257075001FEC54?OpenDocument

150

Case Study 35: Beckton Desalination Plant, United Kingdom

Location Beckton, London, United Kingdom

Date 2004 - 2010

Nature of Scheme/Proposal

As part of the rationale for the proposed plant Thames Water, which serves 6.2 million households, indicated that London's predicted population increase of 800,000 in the period up to 2016 would place strain on the water system's ability to maintain supplies. It stated that the increase of single-person households, coupled with the region’s low rainfall would mean that demand for water would be increasing with the average person using 160l per day. In order to counter these issues, the company proposed the construction of the Thames Gateway Desalination plant in Beckton, east London, on the North Bank of the Thames (Water-Technology, 2010). The project was proposed in June, 2004. The application was approved by the London Borough of Newham in March 2005, and in April planning officers from the Greater London Authority recommended approval. In the same month, the then Mayor of London directed Newham to refuse application. In July 2005, Thames Water lodged an appeal (Thames Water, 2007a). The Mayor of London opposed the proposal, primarily on environmental grounds. In his appeal document, which effectively refused permission for the plant, he stated that, in the context of the water company’s poor record on water leakages and water demand management, allowing a desalination plant would “send the worst possible message - not just to the water industry, but to water users in the city” (Greater London Authority, date unspecified). A five-week Public Inquiry was held in 2006, and the Mayor’s arguments were eventually dismissed by the planning inspector. The Mayor challenged this response in the High Court. The plant was granted permission in July 2007. In May 2008 the new Mayor of London withdrew the objection, and granted planning permission. In response, the chief executive of the water company said "Today's news is a victory for common sense. Our draft Water Resources Management Plan published only last week highlights how London's rapidly growing population will be at increased risk of water restrictions in future droughts if we don't have additional sources of water. The desalination plant is a vital part of our response to this situation, and we are committed to getting it built as quickly as possible, so it is available to provide more safe, clean drinking water to Londoners by 2010.” (Thames Water, 2008).

Public Response

Opponents, including environmental groups felt that the project was “energy hungry”, arguing that the plant would use too much energy and that Thames Water should be more active in stopping leaking pipes and

151

reducing the average water use of customers by installing more water meters and employing better promotional water saving campaigns. Activists also claimed that the plant would contribute to the very problem of climate change that Thames Water says it is responding to. There was also concern that the company would start use the plant more often than originally proposed – these concerns were said to have been fuelled by subtle changes in literature provided by the company, since initially it was stated that the plant would be used "during times of drought", but later it was stated that it would be used "mainly during times of drought" (Guardian, 2004, 2010). Thames Water then confirmed that the plant would only be used during times of drought or extended periods of low rainfall, or to maintain supplies in the event of an incident at its other water treatment facilities (Thames Water, 2007b).

Actions Taken

Thames Water responded to criticisms by assuring that 100% of the energy used by the desalination works would come from renewable biofuels. The Sustainability Director for the company said "We have recognised the Mayor's concerns about the environmental sustainability of the plant, and have made a commitment to provide 100 per cent of the plant's energy needs from renewable sources. By using Bio-diesel, from plant materials, we can provide all the power needed to run the plant." (Thames Water, 2007a). In relation to concerns about the energy required to grow some fuel crops, the company also suggested that in the future it would try to use waste cooking fat and oil from the London’s restaurants and homes (Guardian, 2010).

Outcome

Successful implementation. The plant was launched in June, 2010. Thames Water spent £250 million on the project. They announced that the equipment will only be used at times of drought, when it can supply up to 1 million people (Guardian, 2010). The plant is the UK's first water desalination plant and one of the largest of its kind in the world (Water-Technology, 2010).

Sources Greater London Authority (date unspecified). Proof of Evidence, Ken Livingstone. Appeal Reference: APP/G5750/A/05/1184751 Guardian (2004) Thames Tides set to Top Up London Tap Water. Available at: http://www.guardian.co.uk/environment/2004/jun/14/water.environment Guardian (2010). Thames Water Opens First Large-Scale Desalination Plant in UK. Available at: http://www.guardian.co.uk/environment/2010/jun/02/thames-water-desalination-plant Thames Water (2007a). Press Release: Thames Desalination Plant to be Powered by Green Energy. Available at: http://www.thameswater.co.uk/cps/rde/xchg/corp/hs.xsl/4989.htm Thames Water (2007b) Press Release: From Tide to Tap: Desalination Plant Given Go-Ahead.

152

Available at: http://www.thameswater.co.uk/cps/rde/xchg/corp/hs.xsl/4963.htm Thames Water (2008) Press Release: London’s Desalination Plant Clears Final Hurdle. Available at: http://www.thameswater.co.uk/cps/rde/xchg/corp/hs.xsl/6360.htm Water-Technology (2010) Thames Water Desalination Plant, London. Available at: http://www.water-technology.net/projects/water-desalination/

153

Case Study 36: Dhekelia & Larnaca Desalination Plants, Cyprus

Location Cyprus

Date

1997 and 2001

Nature of Scheme/Proposal

In Cyprus, water resource management is heavily dependent on seasonal rainfall. In order to reduce dependency on seasonal rainfall, and with a view to meeting the needs of increased water demand, the authorities commissioned the construction of two desalination plants, the Dhekelia Desalination Plant in 1997, and the Larnaca Desalination Plant in 2001. Both plants have been constructed using the BOOT (Built, Own, Operate and Transfer) self-financing method, whereby the contractors utilise their own funds to undertake design, implement and operate the plants for a fixed period of ten years. Using this method, the government is obliged to purchase a minimum quantity of desalinated water over the period of ten years, after which the desalination plants become the property of the government (Water Development Department, 2009). Other solutions to the water shortage issue have included floating desalination plants. In 2007 the local Ministry planned the operation of a floating unit, which would operate on a temporary basis (three years), with plans for the construction of a permanent unit in an alternative location. In addition, following an extended period of drought and extreme water shortages in 2008, which led to water being imported from Greece by tankers, plans for a second floating desalination plant were proposed in 2009.

Public Response

Response to the Permanent Desalination Plants At the time, there was local political opposition on the grounds of local environmental concerns, since the municipality was concerned that the plant would disrupt the habitat by creating local salt lakes. However, appeals to place an injunction on the construction of the Larnaca plant were rejected by the Supreme Court; the Court ruled that halting construction would be against the public interest (Cyprus Mail, 2000, 2001a). In addition, the launch of the Larnaca plant was linked with controversy when political opposition parties claimed that the unit had been inaugurated prior to the water being assessed as fit for human consumption. It was claimed that water was to be provided to the public two weeks after the official ceremony, after boron content was found to be twice the recommended safety level (Cyprus Mail, 2001b). Response to Floating Desalination Plants In response to the proposed floating desalination units in 2007, representatives from local community councils objected to proposed floating desalination plants. - Objections were based upon local environmental concerns, with calls for

154

environmental impact assessments, as required by law. Possible conflicts with tourism were also raised as objections. - The communities responded by recruiting consultants to research and suggest possible alternate locations for the unit. - In one media report, it was stated that the local ministry had previously responded to community concerns, by stating that there was insufficient time to conduct environmental impact assessments in the light of the urgency of the water shortage situation and the need for water (Cyprus Mail, 2007). - It was also reported that: “The Ministry has already offered £1.5 million in compensatory measures to Pyrgos community to make up for any impacts or land devaluation that may arise as a result of the desalination unit. Pyrgos has as a result come into line behind the project. It is being speculated that compensation may be offered to the other neighboring communities in order to silence their objections to the project” (Cyprus Mail. 2007). - In response to such developments, a spokesperson from the local Green Party maintained its position that environmental impact assessments should be carried out, as stipulated by legal requirements. She was quoted as stating: “An assessment should have been carried out, just as it has to be carried out for every project, every time. The state cannot bypass the law.”…“As for the compensatory measures, let the government provide that. However, the right way to do it is to have the environmental impact assessment first, and if it shows that there will be adverse impacts, then compensating measures should be offered” (Cyprus Mail, 2007). In the case of the proposal for a second floating desalination plant in 2009, local media reported that, “Council of Ministers had decided to keep the procedure for this project secret, and appoint a contractor directly, without following the bidding process provided by law. This was reportedly decided to win time and avoid time-consuming objections” (Cyprus Mail, 2009).

Outcome

Successful implementation of the Dhekelia & Larnaca desalination plants.

Documented Evaluation of Action

Fessas (2001) reported that opposition to desalination stemmed primarily from local and global environmental concerns, and policy issues (e.g. pricing and agricultural policies). He also stated that many forms of public ‘unrest‘ and concern stemmed from a lack of communication, especially with regard to the lack of a coherent underlying water management strategy, and the failure to provide justification for decision-making. Stakeholders interviewed as part of the TECHNEAU project felt that the public were initially reluctant to accept desalination plants. Public opposition was largely attributed to a lack of consumer awareness of, and information about the need for desalination. In terms of future plans, it was noted that the recently built plants had ameliorated consumer concerns about service disruption, and that public acceptance of additional desalination plants might be forthcoming. More importantly, it was thought

155

that the recent severity of the water shortages, and the extended drought would lead to less public opposition, since the view was that if the public are faced with the choice between no or limited water and desalination, they would accept and be willing to pay for more desalination plants in the future (Kelay et al., 2008). In focus groups conducted with the public during the extreme water shortage situation in 2008, discussants were highly supportive of desalination in terms of mobile floating units to provide quick solutions to water shortages, as well as the implementation of more permanent plants in Cyprus as a longer term solution. Although the implementation of more plants appeared to be an ideal solution that would make the island less dependent on decreasing levels of rainfall amongst some participants, others had thought more about the implications of this particularly in terms of financial, environmental and ecological issues. Also the fact that previous proposals for desalination plants had not been implemented was discussed within the broader context of political distrust. Moreover, some felt that desalination was not an appropriate long-term solution, since they felt water mismanagement was poor and there was unequal distribution between the tourism and agricultural sectors. They stated that a large scale overhaul of the current water management infrastructure was required (Kelay et al., 2009).

Cyprus Mail (2000). Court Rejects Town’s Appeal Against Desalination Plant. http://www.cyprus-mail.com/business/court-rejects-town8217s-appeal-against-desalination-plant Cyprus Mail (2001a). Larnaca’s Desalination Appeal Rejected Available at: http://www.cyprus-mail.com/business/larnacas-desalination-plant-appeal-rejected Cyprus Mail (2001b). Opposition Rounds on Government for Desalination Glitch. Available at: http://www.cyprus-mail.com/cyprus/opposition-rounds-government-desalination-glitch Cyprus Mail (2007). Communities Battle Floating Desalination Plant at Moni Available at: http://www.cyprus-mail.com/cyprus/communities-battle-floating-desalination-unit-moni Cyprus Mail (2009). Plans for Second Floating Desalination Plant in Limassol. Available at: http://www.cyprus-mail.com/cyprus/plans-second-floating-desalination-plant-limassol Cyprus Mail (2010). Desalination to Cover All Our Water Needs by 2011. Available at: http://www.cyprus-mail.com/cyprus/desalination-cover-all-our-water-needs-2011/20100302 Fessas, Y. (2001). The Strategic Position of Desalination in the Overall Water Policy of Cyprus. Desalination, 136, 125-131. Water Development Department (2009). Cyprus Water Development Department. Available at: http://www.cyprus.gov.cy/moa/wdd/WDD.nsf/All/D9DD3467701044CDC2256E44003D7207?OpenDocument

156

Kelay, T., Lundehn, C. Vloerbergh, I., Chenoweth, J., & Fife-Schaw, C. (2008). Stakeholder Interviews: Final Report. Techneau Deliverables D6.1.6 & D. 6.2.6. Kelay, T., Vloerbergh, I., Hagegard, K., Chenoweth, J., Capelos, T., Fife-Schaw, C. (2009) Consumer Focus Groups: Final Report. Techneau Deliverables D6.1.4 & D. 6.2.4.