Drinking Water Initiatives I Technical Bulletins Medical

1
Drinking Water Initiatives I Technical
Bulletins -Medical
U S A C H P P M Water Supply Management Program
TB MED 575 Swimming Pools And Bathing
Facilities TB MED 576 Sanitary Control and
Surveillance of Water Supplies at Fixed
Installations TB MED 577 Sanitary Control and
Surveillance of Field Water Supplies
Presented at the 5th Annual Force Health
Protection Conference14 August 2002
CPT(P) Thomas C. Timmes, P.E. Chief, Field Water
2
UPDATE OF TB MED 575SWIMMING POOLS AND BATHING
FACILITIES
U S A C H P P M Water Supply Management Program
John K. Brokaw Supervisory Microbiologist
3
Status of TB MED 575

• Current edition dated Jul 1993, superceded Jun
  1982 version.
• WSMP will prepare new draft for
  distribution/comment targeting early 2003.
• TB MED 575 Revision will address several new
  issues and concerns identified in last 10 years.
• Will incorporate latest guidance and criteria
  available from such agencies as the EPA, CDC,
  APHA, NSF.

4
Swimming Pool Concerns

• FECAL, BLOOD, and VOMIT ACCIDENTS
• Fecal contamination special concern due to
• Cryptosporidium and ineffectiveness of chlorine.
• Guidance in 1997 575 addendum. Steps to
• clean pool.
• More recent guidance from CDC.

5
Swimming Pool Concerns

• MAINTAINING LIFEGUARDS AT ARMY
• LODGING FACILITIES
• Initiative of Army Community and
• Family Support Center (USACFSC).
• Treat Army lodging like public hotels. No
• lifeguard on duty and swim at your own risk.
• CHPPM does not support this position.

6
Natural Swimming Area Concerns

• USE OF APPROPRIATE INDICATOR TEST
• Many states still use fecal coliform test.
• TB MED 575 presents options of enterococci group
  or E.coli as the preferred indicator.
• EPA re-emphasizing the alternatives as better
• indicator for health consequence compared to
  fecal coliforms.

7
Summary

• 575 REVISION ON ITS WAY!
• Preventive Medicine opportunity to comment on
  draft in early 2003.
• Anticipate important changes to be incorporated.
• Water Supply Management contacts
• Ms. Sara Birkmire sara.birkmire_at_apg.amedd.army
  .mil
• Mr. John Brokaw john.brokaw_at_apg.amedd.army.mil
  

8
UPDATE OF TB MED 576SANITARY CONTROL AND
SURVEILLANCE OF WATER SUPPLIES AT FIXED
INSTALLATIONS
U S A C H P P M Water Supply Management Program
Mr. Todd Richards, P.E. Chief, Fixed Water Section
9
Status of TB MED 576

• Implements SDWA
• Current Version Dated March 1982
• Major Amendments to SDWA 1986 and 1996
• Lead Contamination Control Act 1988
• Draft Revision Underway
• For Internal Review 19 Aug 02
• Early FY03 for PM Community Review

10
Other Guidance Available

• USACHPPM TG 179, Nov 95 Other USACHPPM Guidance
  Documents
• - Unregulated systems - Bottled water
• - Bacteriological surveillance - Wellhead
  protection
• - Emergency/contingency planning - Lead and
  copper
• DOD SDWA Handbook, Sep 99
• DOD SDWA Compliance Document, Sep 99
  http//www.denix.osd.mil/denix/DOD/Library/Water/S
  DWA/guidanc3.doc
• USACHPPM WSMP Website http//chppm-www.apgea.mil
  /dwater/index.html

11
TB Med 576 Update Elements

• New Section on Privatization
• New Section on Aesthetics and Palatability
• Updated Policy and Responsibilities
• Unregulated Water Systems
• Expanded Discussion on Distribution System OM
• Updated/Expanded Treatment Section
• POE/POU Treatment Devices
• Updated WQ Standards and Criteria
• Updated WQ Surveillance
• Updated Planning/Preparedness/Response

12
UPDATE OF TB MED 577 SANITARY CONTROL AND
SURVEILLANCE OF FIELD WATER SUPPLIES
U S A C H P P M Water Supply Management Program
CPT(P) Thomas C. Timmes Chief, Field Water
Section
13
Status of TB MED 577

• The last official version is dated March 1986
• Efforts to make it a Joint Document in early
  1990s
• Revisions in mid-late 1990s never finalized and
  signed by all the services
• The May 1999 draft version was available and
  incorporated by reference by the Air Force and
  Navy
• Resource constraints and mission priority
  delayed work
• We recognize the clear need for an updated version

14
Status of TB MED 577

• Decision made to continue revision to incorporate
  newer Joint/Army policy and doctrine and better
  capture the way we do business
• JCS 1 Feb 02 Memo, Subject Updated Procedures
  for Deployment Health Surveillance and Readiness
• DASA-ESOH HQDA Ltr, 27 Jun 01 Memo, Subject
  Force Health Protection (FHP) Occupational and
  Environmental Health(OEH) Threats
• DOD Directive 6490.2, 30 Aug 97, Subject Joint
  Medical Surveillance
• DODI 6490.3, 1 Aug 97, Subject Implementation
  and Application of Joint Medical Surveillance for
  Deployments

15
Current Revision Concepts

• Revision to focus on Field Drinking Water
• Incorporates concept of Echelons of PVNTMED
  support to better answer the question of who does
  what, where, and how often
• Adds a risk-based methodology to address a
  broader array of chemicals for acute and chronic
  health concerns
• Current Tri-Service Standards are for acute
  concerns that could impact mission due to soldier
  performance degradation
• Appropriate use of other water quality
  guidelines
• Operational Risk Management model incorporated
  perFM 100-14, Risk Management and TG 248, Guide
  for Deployed Military Personnel on Health Hazard
  Risk Management

16
Current Revision Concepts

• Section on Pre-Deployment planning (IPB) and
  PVNTMED estimate planning
• Addresses topic of Environmental Baseline Survey
  requirements during deployment
• More information on ROWPU capabilities for
  removal of chemical and NBC agents
• More on bottled water use and PVNTMED
  responsibilities
• Introduction of Field Water Vulnerability issues
• Fixes problems of MRE Spoonfuls in chlorination
  table
• Additional guidance on field water sampling
  equipment, collection procedures, and
  surveillance reporting requirements

17
Current Revision Status

• Document will undergo Tri-Service review in
  October 02 and OTSG/MEDCOM review in Jan 03
• Earliest time available on CHPPM Website is Feb
  03
• Considering publication on CD to include
  additional references for PVNTMED and deployed
  units

18
Questions?
Questions
? USACHPPM Water Supply Management Program ATTN
MCHB-TS-EWS 5158 Blackhawk Rd Aberdeen Proving
Ground, MD 21010-5403 Phone [phone] DSN
584-3919 WSMP Email water.supply_at_apg.amedd.army
.mil