New York State Water Resources Institute, Cornell University, NY, USA.
New York State Water Resources Institute, Cornell University, NY, USA.
Water Res. 2016 May 1;94:136-145. doi: 10.1016/j.watres.2016.02.014. Epub 2016 Feb 12.
Water utilities that generally provide continuous and reliable service to their customers may sometimes issue an advisory notification when service is interrupted or water quality is compromised. When the contamination is biological, utilities or the local public health agencies issue a 'boil water advisory' (BWA). The public health effectiveness of a BWA depends strongly on an implicit public understanding and compliance. In this study, a meta-analysis of 11 articles that investigated public compliance to BWA notifications was conducted. Awareness of BWA was moderately high, except in situations involving extreme weather. Reported rates of compliance were generally high, but when rate of awareness and non-compliant behavior such as brushing teeth were factored in, the median effective compliance rate was found to be around 68 percent. This does not include situations where people forgot to boil water for some part of the duration, or ingested contaminated water after the BWA was issued but before they became aware of the notification. The two-thirds compliance rate is thus an over-estimate. Results further suggest that timeliness of receipt, content of the advisory, and number of sources reporting the advisory have a significant impact on public response and compliance. This analysis points to improvements in the phrasing and content of BWA notices that could result in greater compliance, and recommends the use of a standard protocol to limit recall bias and capture the public response accurately.
为其客户提供持续可靠服务的自来水公司，在偶尔遭遇服务中断或水质受影响时，可能会发布公告通知。若污染是生物性的，自来水公司或当地公共卫生机构会发布“沸水警示”（Boil Water Advisory，BWA）。BWA 的公共卫生效果强烈依赖于公众的隐性理解和遵守。本研究通过荟萃分析了 11 篇探讨公众对 BWA 通知遵守情况的文章。除了极端天气情况外，公众对 BWA 的认识度处于中等偏高水平。报告的遵守率普遍较高，但考虑到意识率和不遵守行为（如刷牙）的因素后，发现有效的遵守率中位数约为 68%。这还不包括人们在一段时间内忘记煮沸部分水的情况，或者在发布 BWA 后意识到通知但仍摄入受污染水的情况。因此，三分之二的遵守率是高估的。结果还表明，及时收到通知、公告的内容以及报告公告的消息源数量，对公众的反应和遵守情况有重大影响。本分析指出，BWA 通知的措辞和内容可以改进，以提高遵守率，并建议使用标准协议来限制回忆偏差并准确捕捉公众的反应。
