1. Mohammad N. Akhter, MD, MPH August 8, 2018
Clean water for All what is next? “You are the first line in defense of your water and your health” John Austin
Mohammad N. Akhter, MD, MPH
August 8, 2018

2. Disclosure I am a Public Health Physician
I am not against the industry
My Presentation is NON POLITICAL
I am not paid by anyone
I am not looking for a job
I am not looking for business opportunity for myself or my family.
I am here to provide my personal and professional opinion and to promote and protect Public’s Health
Mohammad Akhter MD;MPH

3. Nitrate in Sussex County Groundwater The FACTS
The Environmental Protection Agency (EPA) has set the Maximum Contaminant Level (MCL) of nitrate at 10 mg/L for the safety of drinking water.
60% of Delaware’s population gets their water from wells
For Delaware only 4.5% of 30,000 wells tested were greater than 10 mg/L in All those >10 were in Sussex County.
In the Indian River Watershed 32% were >10 mg/L in 2003.
(255 samples)
The median residential well was 7.01 mg/L. (200 samples)

4. Sussex County

5. Millsboro, DE

6. Milton, DE

7. New Studies, Health effects (Unborn and Newborn)
Blue Baby Syndrome
Case-control California study found anencephaly (absence of a major part of the brain and skull) doubles in risk above 5 mg/L.
The National Birth Defects Prevention Study found:
Spina Bifida was 2.0 times more likely at 2.5 mg/L
Limb deficiency, cleft palate, & cleft lip were also nearly twice as likely at mg/L
High levels have been associated with miscarriages, preterm birth, fetal distress, low birth weight.
Increased infant deaths observed in regions >20 mg/L

8. Health Effects
Nitrate/nitrite are converted into uric acid in the liver.
Higher quantities of uric acid can trigger a gout attack and may
inflame arthritis
A new study has found a substantial link between increased levels of nitrate in our environment and food with increased deaths from diseases including Alzheimer's, diabetes mellitus and Parkinson's.

9. What to do GET YOUR WELL TESTED!!!
You are the first line in defense of your water and your health.
Many suppliers of home treatment systems will do it for free to match their product to your problem.
Test your well yearly for chemicals and Bacteria.
Groundwater in shallow wells have become acidic due to acid rain. Average Delaware rain pH 4.4.

10. How do we protect the public? Cape Gazette 2/22/2018
Our water supply is plentiful but also vulnerable. State health and environmental agencies must do their part to protect and, where necessary, improve that supply, and work with the agriculture industry to help resolve chronic hot spots.
One solution is a public water system in the areas of greatest nitrate concentrations, funded by state and county agencies in partnership with the poultry industry. All three entities have a long-term economic and environmental stake in keeping our water healthy.
All consumers - especially everyone with private wells - must understand the vulnerability of our plentiful fresh water and make sure the water they drink meets safe drinking water standards.

11. How Communities Respond to a Public issue
Elected /appointed Official : if No Response /Unsatisfactory Response
News Media: if Defensive Response by Agencies
Federal Government Agencies: (EPA, CDC) Non- response
Non Profits: Limited response
Courts: Action

12. Water Pollution and Law State of Michigan
Law suit by citizens of Flint Michigan against state for not enforcing Federal Clean Water Act
Citizens prevailed, State agreed to spend 87 million dollars to fix the problem and to provide clean water for 6 months or longer if needed.
Criminal lawsuit by citizens against 15 government employees including the director of the department of health and human services for involuntary manslaughter and misconduct in office
It is being heard in the courts

13. Water Pollution and Law State of Michigan
Class action Law suit against government officials including the Governor Rick Snyder.
Government Officials claimed Immunity
A Federal Appeals Court decided that immunity does not protect against violation of Federal law and Violation of the constitutional rights of the citizens. and allowed the case to proceed.
It is going to take several years to resolve these cases

14. What is expected of our Elected and appointed Officials and the Polluter
Governor: Appoint state monitor to coordinate between all agencies.
DNREC: Stop Immediately the current practices of Polluters until a better and environmentally safe solution is implemented.
Polluter/State government: Provide Clean drinking water to affected communities in the interim.
State Department of Health and Human Services: Health survey of the communities located in Nitrate Vulnerable Zones and medical care for sick.

15. Responsibility of our elected and appointed Officials
Local Government: Should restrict contamination of water through ordinances
and should have robust enforcement to protect public heath.
State and county governments and Polluters: Financial assistance to households to fix their water supply.
Local , State and Federal Governments: Consider relocation of Industry or of the community.
Local Government , DNREC and Health Department: Better monitoring, better enforcement of existing regulations, timely investigation of community complaints and prompt and firm action against violators by government agencies.
Elected officials: Adequately fund all agencies responsible for clean water.

16. Thank you