EPA/600/R-12/020

NEED TO KNOW:

Anticipating the Public’s Questions 

during a Water Emergency

United States Environmental Protection Agency

National Homeland Security Research Center

Cincinnati, OH

Oak Ridge Institute for Science and Education

Oak Ridge, TN

U.S. Environmental Protection Agency

Office of Research and Development

Water Infrastructure Protection Division

Threat and Consequence Assessment Division

National Homeland Security Research Center

Cincinnati, OH

EPA/600/R-12/020

April 2012

Recycled/Recyclable

Printed with vegetable-based ink on paper that contains 

a minimum of 50% post-consumer fiber content.
The U.S. Environmental Protection Agency, through its Office of Research and Development, funded and collaborated 

in the research described herein with the Oak Ridge Institute for Science and Education (ORISE) through an 

interagency agreement with the U.S. Department of Energy (DOE). It has been subjected to the Agency’s peer and 

administrative review and has been approved for publication as an EPA document. The views and opinions of authors 

expressed herein do not necessarily state or reflect those of the U.S. Government or any agency thereof. Mention of 

trade names or commercial products does not constitute endorsement or recommendation for use. 

The Information Collection Request for this research, required in accordance with the Paperwork Reduction Act, 

was approved by the Office of Management and Budget August 16, 2010. The OMB Control Number is 2080-0079. 

The study was determined by the EPA Human Subjects Research Review Official to qualify as research with human 

subjects that is exempt from EPA Regulation 40 CFR 26.101(b).

The Oak Ridge Institute for Science and Education is a U.S. Department of Energy facility focusing on scientific 

initiatives to research health risks from occupational hazards, assess environmental cleanup, respond to radiation 

medical emergencies, support national security and emergency preparedness, and educate the next generation of 

scientists. ORISE is managed by Oak Ridge Associated Universities. 

This document was prepared for the U.S. Environmental Protection Agency by ORISE through an interagency 

agreement with the U.S. Department of Energy (DOE). ORISE is managed by Oak Ridge Associated Universities 

(ORAU) under DOE contract number DE-AC05-06OR23100. 

The opinions expressed herein do not necessarily reflect the opinions of the sponsoring institutions or ORAU. 

This report was prepared as an account of work sponsored by the United States Government. Neither the United 

States Government nor the U.S. Department of Energy, nor any of their employees, makes any warranty, expressed 

or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any 

information, apparatus, product, or process disclosed, or represents that its use would not infringe on privately owned 

rights. Reference herein to any specific commercial product, process, or service by trade name, mark, manufacturer, 

or otherwise, does not necessarily constitute or imply its endorsement or recommendation, or favor by the U.S. 

Government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or 

reflect those of the U.S. Government or any agency thereof.

Disclaimers

ii ii
Executive Summary...........................................................................................................................................v

Introduction........................................................................................................................................................1

Methods..............................................................................................................................................................2

Findings – Professionals....................................................................................................................................3

Findings – Public ...............................................................................................................................................4

Conclusions and Recommendations..................................................................................................................7

Appendices

A. Moderator’s Guides.................................................................................................................... A-1

B. Screening Instruments..................................................................................................................B-1 

C. Participant Information Sheets.....................................................................................................C-1

D. Summary of “Immediate” and Other Questions Listed by Professionals................................... D-1

E. Raw List of All Potential Questions Generated by Professionals................................................E-1

F. Summary of Additional Questions Raised by Public Respondents..............................................F-1

G. Raw List of Questions Generated by the Public......................................................................... G-1

H. Message Testing: Messages, Testing Frequency, and Comments.............................................. H-1

I. Contacts for More Information ......................................................................................................I-1

Contents

iii
EPA wishes to acknowledge and express deep appreciation for the time and significant 

contributions of the water utility professionals interviewed and the members of the public 

who participated in focus groups as part of this study.

Participating utilities included:

City of Chicago Department of Water Management

City of San Diego Public Utilities Department

Charlotte-Mecklenburg Utilities

Massachusetts Water Resources Authority

The authors also wish to acknowledge staff of the Association of Metropolitan Water 

Agencies and WaterISAC for their invaluable contributions as advisors, including 

arranging the participation of utilities and reviewing this report.

Technical reviews of the report were performed by:

Ms. Chrissy Dangel, USEPA, Office of Ground Water and Drinking Water

Dr. Dan Petersen, USEPA, National Center for Environmental Assessment

Dr. Kevin Garrahan, USEPA, National Homeland Security Research Center

Acknowledgements

iv
Since the events of September 11, 2001, improving the 

security of our nation’s drinking water and wastewater 

infrastructure has been a high priority. As critical 

infrastructure, water systems can be subject to intentional 

attacks as well as unintentional contamination and must be 

protected. The U.S. Environmental Protection Agency (EPA) 

plays a critical role in this effort as the lead federal agency for 

water security.

This investigation was undertaken at the request of EPA to 

conduct research to: (1) compare public and drinking water 

professional personnel’s assessments of critical information 

needs arising from the intentional contamination of a 

municipal water supply; and (2) obtain public evaluation of 

draft messages developed for such an occasion. The Oak 

Ridge Institute for Science and Education provided technical 

assistance.

Information was collected from both utility professionals 

and members of the public (water consumers) in four 

metropolitan areas in the United States (northeastern, 

southeastern, midwestern and western). Twenty-four one-hour 

discussions were held with a total of 38 drinking water utility 

professionals. Four two-hour focus groups with members of 

the general public who use the municipal water supply were 

conducted in each of the four study cities, with a total of 113 

respondents participating.

Executive Summary

Findings from the utility professionals were as follows:

PRO-1. Professionals generated a substantial list of 

questions which they thought might be asked 

by the public in the event of a contamination 

incident. This list went beyond questions 

raised by the public.

PRO-2. Professionals identified several aspects 

of municipal water systems they thought 

likely to be misunderstood by the public.

PRO-3. Professionals anticipated challenges in 

convincing the public that the water supply 

was once again safe following remediation.

Findings from the public were as follows:

PUB-1. Members of the public recognized the 

importance of the city water supply.

PUB-2. A number of respondents questioned the 

authenticity of a reverse 911 call used in a 

scenario with each group.

PUB-3. Members of the public readily generated an 

extensive list of questions, similar to the list 

generated by professionals.

PUB-4. The questions by the public most frequently 

cited by them as important focused on time 

until normal water service was restored, 

getting safe water, and personal safety.

PUB-5. Public respondents perceived an intentional 

contamination involving a biological agent to 

be more alarming than one involving a 

pesticide.

PUB-6. The term “attack” carried strong, negative, 

 emotive connotations.

PUB-7. There was widespread belief among public 

respondents that a return to “safe” water 

meant the level of a contaminant is zero.

PUB-8. Public respondents offered a variety of 

suggestions for improving the messages 

tested.

Questions arising in response to a water-supply 

emergency were quite similar for professionals and 

the public, although there were some differences in 

emphases.

The detection and identification of the contaminant(s) 

used in an attack on a water supply form a critical 

information linkage for both the utility and the public. 

For the professionals, it is necessary for control, 

remediation, and public health protection. For the 

public it is a matter of maintaining personal safety and 

determining appropriate actions. Thus professionals 

and the public have the same high priority for somewhat 

different reasons.

v
There is the belief among some members of the public that 

water utilities frequently test for all possible contaminants. 

Water utilities may benefit from being transparent and 

proactive in educating consumers regarding testing procedures 

and their results.

Following an attack and remediation, convincing the public 

that their water supply is again safe poses substantial 

challenges. Professionals recognize that verification by 

multiple credible authorities will be required. Testing 

procedures are poorly understood by the public.

Most public respondents demonstrated little knowledge of 

reverse 911 call systems. Some questioned the veracity of the 

call put forth in the exercise. This can likely be diminished by 

including in the call message information addressing who is 

sending the message and where to go for confirmation, as well 

as utilization of multiple channels of communication.

If an intentional water contamination incident occurs 

elsewhere, water authorities must be prepared to address 

questions regarding security issues for their own systems. 

Consumers will be concerned that another attack is possible 

and will want to be assured of the safety of their water supply.

Using terms such as “terrorist” and “attack” tend to have some 

benefit in getting the attention of the public and increasing 

compliance with directives, but at a very high emotive cost. 

Limiting the use of these terms as much as possible is likely to 

be beneficial.

Future message development and refinement will benefit 

from attending to message features perceived by the public 

as positive -- such as being directive rather than providing 

“recommendations” and emphasizing protective actions.

vi
Introduction

1. US EPA. Effective Risk and Crisis Communication during Water 

Security Emergencies: Summary Report of EPA Sponsored Message 

Mapping Workshops. EPA/600/R-07/027. http://www.epa.gov/NHSRC/

pubs/600r07027.pdf 

Since the events of September 11, 2001, improving the 

security of our nation’s drinking water and wastewater 

infrastructure has been a priority. As critical infrastructure, 

water systems can be subject to threats and intentional attacks 

and must be protected. The U.S. Environmental Protection 

Agency (EPA) plays a critical role in this effort as the lead 

federal agency for water security. Other occurrences such 

as natural disasters and unintentional contamination can also 

threaten the safety of water supplies.

A critical need has been identified for the development of 

methodologies to effectively communicate risks associated 

with intentional contamination of a drinking water supply. 

EPA sponsored three crisis communication workshops in 2005 

and 2006 during which draft messages were prepared for such 

emergencies. Anticipated questions were identified and draft 

messages developed through the cooperative efforts of experts 

from water agencies, public health, emergency response, law 

enforcement, as well as risk communication1. 

This investigation was undertaken at the request of EPA to 

conduct research to (1) compare public and water utility 

professional assessments of critical information needs and 

(2) evaluate draft messages developed during the abovementioned workshops for appropriateness and effectiveness. 

Data were collected by means of structured interviews with 

one to four professionals per session and focus groups with 

six to eight members of the general public. The Oak Ridge 

Institute for Science and Education provided technical 

assistance.

1

The study included facilitated focus group discussions at each location.
Objectives and Target Audiences

The overall objective of this study was to provide practical 

information that crisis communicators can directly apply to 

planning and response. There were two target audiences: 

(1) drinking water utility professionals (those employed by 

an agency providing drinking water, hereafter referred to as 

“professionals”), and (2) consumers (members of the general 

public who use drinking water supplied by the respective 

agencies, hereafter referred to as “public”).

More specifically, the objective for professionals was to 

explore the perceived information needs and priorities of the 

public following intentional contamination of their municipal 

drinking water supply. Objectives for consumers included 

exploring their anticipated information needs and priorities 

following intentional contamination of their drinking water 

supply, and exploring the appropriateness and effectiveness of 

messages drafted by EPA for delivery by utilities to the media 

and general public.

Recruiting and Data Collection

Locations

Information was collected from both drinking water 

utility professionals and water consumers across diverse 

geographical areas, including a large metropolitan area in the 

northeastern United States, a medium sized metropolitan area 

in the southeastern United States, a large metropolitan area in 

the midwestern United States, and a large metropolitan area 

in the western United States. All utilities serve more than 

100,000 customers.

Professionals

To recruit professionals, the Association of Metropolitan Water 

Agencies provided contact information for an individual in the 

water utility for each city. ORISE coordinated planning with 

that contact. The contact scheduled interviews at the market 

research firm at which interviews were conducted.

Typically, members of senior management were interviewed 

individually, and other respondents were interviewed in pairs, 

with respondents being from different job classifications. A 

moderator conducted one-hour guided discussions. A total of 

24 interviews were conducted, with a total of 38 professionals 

participating. The job classifications of professionals 

interviewed is summarized in Table 1. 

Table 1. Job classifications of professionals

Job Classification Number of Respondents

Public Information 6

Emergency Management 7

Plant Operations 8

Field Operations 7

Call Center 1

Senior Management 5

Other 4

Total 38

Professionals were acting in their official capacity and did not 

receive any financial incentives for participation in the study.

The Moderator’s Guide for professionals is included in 

Appendix A. The screening instrument for professionals is 

included in Appendix B.

Public

Data from the public were collected by means of focus 

groups. Up to eight participants per group were assembled 

at a commercial market-research facility. There, a moderator 

guided a two-hour discussion. Four focus groups were 

conducted in each city. The Moderator’s Guide for the public 

is included in Appendix A.

Members of the public (consumers) were recruited from 

an extensive database of perspective respondents by the 

professional market research firm at which focus groups were 

conducted. They received a financial incentive commensurate 

with the local rate for such a group. The screening instrument 

for members of the general public is included in Appendix B. 

Consumer participants were selected as follows:

■ All were at least 18 years of age,

■ None of the participants reported working in the media,

■ None of the participants reported working in a healthrelated field, and

■ None of the participants had participated in a marketresearch study within the last six months.

A total of 113 respondents participated in the 16 groups. Their 

demographic characteristics are summarized in Table 2.

Methods

2
Table 2. Summary of demographic characteristics 

of public-respondents (n = 113)

Age (years) Number Percent

18-34 32 28

35-44 29 26

45-54 24 21

55-64 21 19

65+ 7 6

Minimum 19 --

Maximum 82 --

Gender

Male 54 48

Female 59 52

Education

High School 

Diploma

46 41

College Degree(s) 67 59

Race/Ethnicity

Caucasian 79 70

African-American 17 15

Hispanic 10 10

Asian-American 4 3

Mixed 2 2

Other 0 0

Professionals and the Public

For both professionals and the public:

■ All sessions were conducted in English, 

■ An audio recording of each session was made,

■ No transcripts were prepared,

■ Up to three professionals from EPA and ORISE observed 

from behind a one-way mirror, and

■ An EPA representative was available to express 

appreciation and answer questions at the completion of 

each discussion. 

Participant Information

Prior to participating in the study, each prospective respondent 

received a Participant Information Sheet providing such 

information as sponsorship of the study, their rights as a 

participant, risks and benefits in participating, and contacts 

for more information. Information sheets are included in 

Appendix C.

Findings – Professionals

PRO-1. Professionals generated a substantial list of 

questions which they thought might be 

asked by the public in the event of a 

contamination incident. This list went 

beyond questions raised by the public.

Professionals began by providing a list of questions addressing 

what information they thought the public would want or need 

to know in a drinking water contamination incident. The 

initial scenario was non-specific. Respondents first based 

their questions on knowing only that the water supply was 

unfit for use, with the cause unknown. Later they were asked 

to add issues likely to arise if the incident were known to 

be intentional, i.e., a terrorist attack. When their lists were 

complete, the professionals were provided five “votes” to 

indicate questions that they thought were most important/

urgent – those which would have the greatest need to be 

addressed immediately in the course of events. One or more 

votes could be applied to any question, with multiple votes for 

a question indicating especially high importance.

From across the 24 interviews came a list of almost 400 

questions, including duplicates and variants. Appendix D 

provides a summary of questions generated by professionals, 

including those they ranked as “Immediate” and other 

questions. For this summary, duplicates were removed 

and minor variants of questions with the same core issue 

combined. Additionally, a check mark under “Public” 

indicates that the question was raised at least once by public 

respondents. Questions were sorted into the following 

categories:

■ The Incident,

■ Who is Affected,

■ Uses of Tap Water,

■ Alternate Sources of Safe Water,

■ Consumers Making Tap Water Safe,

■ Exposure to Contaminant,

■ Additional Information,

■ Response and Recovery, and

■ Terrorism.

A cursory review of the table addressing “Immediate” 

questions in Appendix D reveals that virtually all of the 

questions ranked highly by professionals were asked by the 

public. A review of the table addressing additional questions 

shows that professionals went somewhat beyond the public 

in the questions they felt professionals should be prepared to 

address.

3
Two additional observations arise from review of the 

professionals’ questions. First, professionals readily 

recognize, and often expressed, the need for the participation 

of a number of agencies in responding to a drinking water 

contamination event. Examples include the participation of 

public health (e.g., “What are the symptoms of exposure?”) 

and law enforcement (e.g., “Have you caught the terrorists?”). 

Second, in their thinking, the professionals went beyond 

residential use of water (e.g., fire protection and business 

issues) more so than the public.

Typical statements regarding the importance of informing the 

public include the following:

“It’s imperative that we get as much information out as 

quickly as possible.”

 “The more information you give them, the better.”

“If you can keep the...public informed...you can help the 

public to manage the situation.”

Quotes of Public

“I don’t know if I believe it could be that isolated.”

Professionals perceived that the public was likely to 

misunderstand the complexity of a municipal water system. 

This includes, for example, the concept of pressure zones in 

such a system. 

Also perceived as likely to be misunderstood was the potential 

ability to isolate portions of the system, thereby limiting the 

spread of contamination. This includes the presence of systems 

of valves to prevent backflow and to open or close access of 

water to specific areas. For those systems having multiple 

supplies of water, professionals generally believed that the 

public is unaware of the flexibility available in the source from 

which water is drawn. These aspects of systems are especially 

important given the public’s intense desire to know exactly the 

area and persons potentially affected, and their assumption that 

contaminants were most likely to be introduced at the water 

source (see Findings PUB-6 on page 6).

The extent and limitations of the protection of water quality 

were also expected to be misunderstood, and discussions with 

members of the public were consistent with this (See Findings 

PUB-7 on page 6).

Quotes of Professionals

“’Why can’t you just reboot the system?’”

“They take most of this for granted.”

“[People have little idea] of the complications of getting it 

from [the source], purified, and pumped to their house at...

psi.”

PRO-2. Professionals identified several aspects 

of drinking water systems they thought likely 

to be misunderstood by the public.

PRO-3. Professionals anticipated challenges in 

convincing the public that the water supply 

was once again safe.

Professionals widely agreed that convincing the public that 

the water supply is usable after a major contamination event 

posed substantial challenges. They expressed the belief that 

confidence in water quality cannot be achieved by the water 

utility alone. External validation by public health agencies 

(local and state public health departments, and the U.S. 

Centers for Disease Control and Prevention) was seen as 

crucial. Elected officials, such as the governor or mayor, were 

also perceived to have credibility essential to success, with the 

perceived best choices for the situation varying somewhat by 

location. Professionals also perceived a clear demonstration 

of the extent of testing would be critical. This was consistent 

with issues raised in the public groups (see Findings PUB-7 on 

page 6).

Professionals

“The health information must come from health officials.”

 “That’s going to be the key thing – who delivers the 

message.”

“I think people are re-assured when they see the leaders ... 

including senior scientists.”

“You’ve got to test the heck out of it.”

“...and you’ve got to test all the other places, too.”

Public

“I need someone other than a government official.”

“Prove it to me.”

“I’d wait for someone else to drink it first.”

“I’d have to have someone come out to my neighborhood, 

open the faucet, and drink it.”

Findings – Public

PUB-1. Members of the public recognized the 

importance of the drinking water supply.

As a warm-up exercise, members of the focus groups were 

asked to rank the severity of the disruption of city services 

for two to three days. A score of one meant not at all severe, 

and a score of ten indicated very severe (See Appendix A.). 

Almost three-quarters of respondents scored water services 

at either nine or ten. In subsequent discussion they noted the 

necessity of water for life itself, as well as disposal of sewage 

and diverse other uses.

4
“You can’t live without water.”

“Losing water – that’s devastating.”

professionals identified as being of immediate importance. 

This was especially so for questions addressing alternate water 

supplies and exposure to the contaminant. 

PUB-2. A number of respondents questioned the “As long as you’re well informed, you’re better off.”

authenticity of a reverse 911 call used in a 

scenario with each group.

Respondents were read the following scenario: “You have just 

come home from work or running errands. The phone rings. 

When you pick up the phone you hear a recorded emergency 

announcement that there has been an attack on the water 

supply for [name of city]. Someone has purposely released a 

pesticide [or biological agent] into the water. The announcer 

says that, for now, the water may be unsafe and cannot be used 

for any purpose.”

A number of respondents noted that if they received such 

a call, they would wonder if it was a hoax. There was 

widespread unfamiliarity with a reverse 911 system.

Additionally, respondents raised questions about the efficacy 

of such a system. More specifically, they doubted the efficacy 

if the system addressed only land lines and did not include cell 

phones. Further, they raised the issue of cell-phone customers 

having out-of-the-area numbers. Several respondents referred 

positively to systems now in use on some college campuses 

where a text message can be sent to all cell phones registered 

with the system. Respondents also spoke of the need to use 

diverse channels of communication (e.g., television, radio) 

to help ensure reaching as many members of the public 

as possible, as well as confirming the validity of the call. 

Professionals recognized this need as well. 

“Is this real?”

“[I thought] ‘It’s a hoax.’”

“How did you get my number?”

PUB-3. Members of the public readily generated an 

extensive list of questions, similar to the list 

generated by professionals.

The 16 groups generated lists which totaled more than 300 

questions, including duplicates and variants. As described 

above (Findings PRO-1 on page 3) there was substantial 

overlap with questions anticipated by professionals. Public 

respondents also raised some additional questions which 

professionals did not. These are summarized in Appendix F. 

A substantial number of the questions raised by the public but 

not by professionals were more specific versions of questions 

PUB-4. The questions by the public most frequently 

cited by them as important focused on time 

until normal water service was restored, 

getting safe water, and personal safety.

After generating a list of questions, public respondents were 

given six adhesive dots as votes and asked to indicate the 

questions they thought most important to them. They could 

use one vote on each of six questions, or multiple votes for a 

question they perceived as especially important, as they chose. 

The 12 questions which received the most votes were (from 

most to least) as follows:

■ How long will it be until the tap water is safe again?

■ How does one get safe water?

■ Can something be done in the home to make the tap 

water safe?

■ How dangerous is the contaminant?

■ What is the contaminant?

■ Who is affected?

■ What if I have already drunk some of the contaminated 

water?

■ What are the symptoms and long-term effects of 

exposure?

■ What are the plans and processes for restoring the water 

supply?

■ Where can I get additional information?

■ What uses of tap water are safe?

■ How long has the contaminant been in the water system?

Appendix G provides a raw list of all questions raised by the 

public.

Public

“I would definitely go into an action mode.”

“I’m looking out for myself and my family.”

Professional

“The big thing is duration for everybody.”

“It always comes back to, ‘Is the water safe to drink?’”

PUB-5. Public respondents perceived an intentional 

contamination involving a biological agent 

more alarming than one involving a pesticide.

6 5
Respondents remarked that biological agents were more 

alarming because of the possibility of the virus or bacterium 

replicating, increasing rather than decreasing the threat over 

time. They also believed that remediation of a biological 

agent was likely to be more difficult.

An intentional contamination involving pesticides was 

considered less alarming because pesticides are more familiar. 

Respondents remarked that pesticides already occur on fruit 

and are used by the public in their gardens.

“Big difference...we eat pesticides.”

“Pesticides are used for a lot of things.”

“[A biological agent] is much more scary.”

“A biological agent will grow rather than be diluted.”

“[Biological agent] automatic...sick, gut-wrenching 

feeling.”

Professional

“I think the questions stay the same; the anxiety goes up.”

“When you bring that up you’ve got a whole different ball 

game,”

“’If they did that, they got into my house.’”

PUB-6. The term “attack” carried strong, negative, 

 emotive connotations.

The consideration of intentional contamination of the supply 

of drinking water typically produced a pronounced emotional 

response, primarily anxiety. Professionals anticipated this 

response from the public. When the word “attack” was used, 

public respondents associated it with terrorism and the events 

of September 11, 2001. Consequently, if an attack were to 

occur on another municipal water supply, public respondents 

reported perceiving that all supplies are vulnerable. They 

envision a coordinated attack at multiple points and are 

“waiting for the other shoe to drop.” They draw some comfort 

from having time to prepare. Consideration of an attack on a 

drinking water system elsewhere in the country brings about a 

strong desire to know how their supply is being protected.

Generally, when members of the public discussed how a 

municipal water supply would be attacked, they perceived 

the most likely point of attack to be at the source from which 

water was drawn (e.g., reservoir, river, aqueduct). They 

anticipate that contamination will spread throughout the 

system. This relates to the perceived inability to isolate a 

contaminant to a specific portion of the system (See Findings 

PRO-2 on page 4). The idea of dilution – of how much of a 

contaminant would be required to effectively contaminate a 

large body of water – seldom arose in discussion.

Public

“It made me scared.”

“anger...panic...will there be others?”

“It’s over there. You can prepare.”

PUB-7. There was widespread belief among public 

respondents that a return to “safe” water 

meant the level of contamination is zero.

Respondents demonstrated little knowledge of contaminants 

for which drinking water is routinely tested, the frequency of 

testing, or the idea of maximum allowable levels. Professionals 

recognized this (see Findings PRO-2 on page 4). Rarely a 

respondent referred to test results provided along with a water 

bill. 

“You didn’t figure this out until enough people got sick? 

What in hell’s up with that?”

PUB-8. Public respondents offered a variety of 

suggestions for improving the draft messages 

tested.

Broadly, public respondents typically expressed preferences 

for:

■ Direct answers to the questions,

■ Short concise sentences in active voice,

■ Protective actions for self and family,

■ Directive (e.g. do/don’t) information rather than 

“recommendations,”

■ Information on results rather than process (“studying”, 

“assessing”, “investigating”),

■ Imparting a sense of time/predictability to the extent 

possible, and

■ Utilization of diverse media (e.g., TV, radio, web, social 

media, 911).

Appendix H presents the number of groups with which each 

draft message was tested, the messages, and comments made 

by the groups about them.

6
Questions arising in response to an emergency involving a 

drinking water supply were quite similar for professionals and 

the public. Both groups emphasized:

■ Identification of the contaminant,

■ The expected duration of the disruption of service,

■ A very specific description of who/what area was 

affected,

■ The possibility and consequences of exposure to the 

contaminant,

■ The possible uses of tap water,

■ The availability and logistics associated with alternative 

water supplies, and

■ Regularly updated information.

There were some differences in emphasis. Professionals 

tended to more regularly address services other than 

residential (e.g., medical care, fire protection, businesses) 

– which of course they must do. The most frequently asked 

questions by the public focused on time, getting safe water, 

and personal safety. Obviously, drinking water utilities and 

other involved agencies will benefit from closely attending to 

information desired by the public.

The critical first link for both the utilities and the public 

involves the detection of the presence and identity of a 

contaminant used in an attack on a water supply. For the 

professionals, it is necessary for control, remediation, and 

public health. For the public, it is a matter of personal safety 

and helps determine their actions. Thus both have the same 

high priority for somewhat different reasons. 

A related issue is the belief among some members of the 

public that water utilities frequently test for all possible 

contaminants. This disconnect could undermine the credibility 

of water utilities in case of intentional contamination and 

aggravate the challenges associated with rapid identity 

of contaminants. Water utilities can benefit from being 

transparent and proactive in educating consumers regarding 

testing procedures and their results. This may create more 

realistic expectations. Inclusion of a list of substances for 

which tests are conducted, the frequency of those tests, and 

results along with water bills form an example that may be 

helpful.

Following an attack and remediation, convincing the public 

that their water supply is again usable poses substantial 

challenges. Professionals recognize that verification by 

multiple credible authorities will be required. Testing 

procedures are poorly understood by the public, and the use of 

many test descriptions and numbers could engender confusion. 

Comparisons of test results to federal and state standards for 

safe drinking water may be helpful.

Most public respondents demonstrated little knowledge of 

reverse 911 call systems. Some questioned the veracity of the 

call put forth in the exercise. This can likely be diminished by 

including in the call message:

■ Who is sending the message,

■ Where to go for confirmation, and

■ Using multiple channels of communication.

If there is intentional contamination of a water supply 

elsewhere, water authorities must be prepared to address 

questions regarding security issues for their systems. 

Associating an attack on a water supply with the terrorist 

attacks of September 11, 2001, the public will readily 

anticipate multiple coordinated attacks. They will want to be 

assured of the safety of their own water supply.

Using terms such as “terrorist” and “attack” tend to have some 

benefit at high emotive cost. Their use will get immediate 

and intense focus by the public, and probably more intention 

to comply with directives. On the other hand, public anxiety 

is likely to substantially increase. Among the consequences 

of such increased anxiety would be a decreased ability to 

assimilate information. Moreover, public trust in the utility 

is likely to be diminished because of the perception that it did 

not protect its citizens. On the whole, limiting the use of these 

strongly emotive terms as much as possible is likely to be 

beneficial.

The draft messages tested will benefit from revision, attending 

to both message features perceived as positive by the public, 

as well as those perceived negatively.

Conclusions and Recommendations

7
8
EPA Water Security

Moderator’s Guide – Professionals

1. Introductions (5 minutes)

A. Introduce moderator

B. EPA sponsorship

1. Opportunity, importance of participation

C. Audio recording, observers

1. For reporting only

2. No personal or city identifiers used

D. Respondent introductions

1. First name

2. How long with the utility and description of job 

responsibilities

E. Plan for the session: discuss issues the public would 

want/need to know in the event of a major water 

 emergency.

2. Important Questions during a Disruption 

of the Water Supply (35 minutes)

A. Exercise: What should people know?

1. Imagine it’s been discovered that the water supply is 

 no longer safe

a. Could be chemical, biological, or mechanical

b. Could be intentional (terrorism) or unintentional

2. What do you think people should know?

(LIST ON FLIPCHART)

Probes: Incident

Response/Authorities

Response/Public

Recovery

 

B. Ranking of questions

1. Ask interviewee to rank questions

a. Five most immediately important that they think 

 the public should know

b. Five less immediately important that the public 

 should know.

3. Issues Thought Most Likely to be Misunderstood 

by the Public (10 minutes)

A. Providing safe water is a complex operation. It seems 

 likely that a fair percentage of the general public 

 doesn’t think often about how the system works or what 

 the issues are if the system is not providing safe water. 

 Based on your experience...

B. What are some issues in a water-supply emergency that 

the public is most likely to misunderstand?

1. Probes Incident

Government response

Personal protection

Following directives

Recovery

4. Wrap-Up (5 minutes)

A. Anything else EPA should know about this subject?

B. Thank you.

C. Introduce EPA representative: __________ would be 

glad to answer questions about the study or EPA 

 activities.

Appendix A

A-1
EPA Water Security

Moderator’s Guide – Public

I. Introduction (5 minutes)

■ Introduce moderator

■ EPA sponsorship – opportunity, importance of 

participation

■ Recording, observers – for reporting only, no personal 

identifiers used

■ Respondent introductions – first name, favorite hobby

■ Plan for the session

 ○ Discuss public safety issue

 ○ Identify information people might want, actions 

people might take

 ○ Review some draft information sheets

 ○ About two hour session

II. City Services (10 minutes)

NOTE: Hand out worksheet: “City Services”

In the left-hand column of this worksheet is a list of city 

services. There is also space at the bottom for you to list other 

city services that are important to you. Let’s assume that there 

is a terrorist attack and these city services are lost for several 

days. For each item, please rate how severe the impact would 

be, for you and your family, if service were disrupted for 

several days.

Please rate each item from 1, not at all severe, to 10, very 

severe. You can use any number from 1 to 10. When you’re 

finished, we will talk about the scores you gave and the 

reasons for those scores. 

NOTE: Respondents will work in pairs. Provide time for 

them to discuss each item, then debrief, getting responses from 

each dyad.

■ Did you list any other city services?

■ Which item was most important to you? What factors 

made it most important?

■ Which item was least important to you? What factors 

made it least important?

■ Was water a high priority for you, a low priority or 

somewhere in the middle? What factors did you consider 

in deciding on this position?

III. Exercise: Attack on the Water Supply – 

Questions and Information Needs (40 minutes)

[NOTE: If someone asks---the spokesperson is someone they 

trust and feel would do the best they could to keep people 

safe—who the person is providing the information is not an 

issue to them]

We want to focus the next several minutes of our discussion 

today on one of those city services – the water supply. I would 

like for you to get comfortable in your chair, close your eyes, 

and create in your mind’s eye a vivid image of the following 

situation: Imagine it is a weekday evening. 

You have just come home from work or running errands. The 

phone rings. When you pick up the phone you hear a recorded 

emergency announcement that there has been an attack on 

the water supply for [name of city]. Someone has purposely 

released a pesticide into the water. The announcer says that, 

for now, the water may be unsafe and cannot be used for any 

purpose. In your mind, make a note of the specific questions 

you have.

When you are ready, open your eyes.

You have probably come up with some really important ideas 

during this exercise. Take a few minutes to write on your pad 

anything that is so important that you want to make sure you 

don’t forget it. Also, write down questions you would most 

want officials to answer at this point.

[NOTE: provide time for note-taking] 

■ Now, let’s talk a little bit about this experience. First, 

 what questions did you have, when you first heard the 

 phone announcement about a pesticide in the water? 

What did you want or need to know from officials about 

this situation at that point?

Now, I would like to understand the relative importance of 

these questions. I’m going to give each of you two sets of 

five colored dots. I want you to use these five dots as votes, 

placing them on the flip chart paper next to the questions that 

are most important for you. If a question is really important 

to you, you may place more than one dot by that question to 

indicate how important it is.

NOTE: Count dots and debrief results

■ What would be your greatest concern in this situation? 

Please tell me a little about your reaction to the situation 

you visualized a few minutes ago.

 ○ What are the reasons?

 ○ What did you think when you heard the information?

 ○ How did you feel when you heard the information?

A-2
 ○ What kinds of information would you most want to 

receive during an event such as this

 ○ What kinds of information would you want if the 

event happened in a neighboring community ten miles 

away? [if time permits]

 ○ What if it were in another more distant city in your 

state? [if time permits]

IV. Materials Testing (50 minutes)

One thing we can be certain about is that if there is an attack 

on the water supply, people will want lots of information. It’s 

important to EPA that people get information that effectively 

addresses their concerns. An important part of doing that is 

preparing now, rather than during an urgent situation. EPA 

has identified a number of topics – questions people are likely 

to ask or information they feel people would want to know. 

For most of the rest of our time together, we will be reviewing 

some of these.

We’ll read one together. I’ll ask you to mark it up – 

underlining the things you like, circling the things you don’t 

like or want to change. 

There are a few things I would like you to keep in mind for 

purposes of this exercise:

1. It’s important to put yourself in the situation. Continue 

 to imagine the situation as you did in the last exercise. 

 Stay in touch with what you are feeling, as well as what 

 you are thinking. Both parts are important.

2. Keep in mind that the questions you are seeing are a 

sample. There are many more questions likely – too many 

 for one group to look at in a reasonable amount of time. 

We can note other questions you have but remember that 

 you are not seeing them all.

3. Remember that in the event of a terrorist attack on a 

 water supply there will likely be a lot of press 

conferences and interviews with public health officials, 

elected officials, and others. TV, radio, newspapers, and 

 the Internet will have lots and lots of coverage. All the 

 issues will be addressed in a variety of ways. 

Exercise

 ○ Assign partners so respondents are working in teams 

of 2+ people.

 ○ Hand out fact sheet

 ○ Provide background: As we work through some of 

these fact sheets together, you’ll notice that all of these 

are set up the same way. First, there is a question at 

the top of the page. Second, there are three “key 

messages” in bold print. Third, for each key message 

there are three pieces of supporting information – 

examples, details that provide more information.

■ Read through first fact sheet

 ○ What did you underline as important? Can you tell me 

the reasons why this information is important?

 ○ What did you circle? What changes should we make 

to this information?

 ○ What other reactions do you have to this fact sheet?

■ Repeat for other fact sheets as time allows, rotating order.

V. Wrap-Up (15 minutes)

■ What additional advice would you give someone who 

has to prepare or provide information to the public during 

a terrorist attack on the water supply?

■ All the issues for today.

■ Thank you.

■ Introduce EPA representative: discussion may have 

raised some questions, _____ will be happy to try to 

address questions or concerns.

Worksheet: City Services

Some City Services Impact of Service Disruption

Electricity

Telephone

Water

Sewage Treatment

Trash Collection

1 = not at all severe

10 = very severe

City: _____________________ Date: _______________

Time: __________

A-3
A-4
Screening Instruments

EPA Water Security -- Professionals

In each city, recruit as follows:

■ 1 IDI with member of Senior Management

■ 6 dyads (groups of two) 

 ○ Within each dyad, respondents are to be from 

two different job categories as listed in Question 2, job 

classifications 01-05 below

 ○ Across dyads, all job classifications (Question 2, 01-

05) should be represented.

■ The seven interviews (1 IDI and 6 dyads) will be 

scheduled as follows

 ○ Day 1

□ 12:00 – 1:00 p.m.

□ 1:00 – 2:00

□ 3:00 – 4:00

□ 4:00 – 5:00

 ○ Day 2

□ 1:00 – 2:00

□ 3:00 – 4:00

□ 4:00 – 5:00

City: _____________________ Local Water Works 

Contact: ________________________

Hello. My name is __________________ and I am calling 

from the Oak Ridge Institute for Science and Education 

(ORISE). We are assisting the US Environmental Protection 

Agency in conducting a study about municipal water supplies. 

I understand __________ (EPA or local contact) has spoken to 

you about participating in this study [confirm]. We are calling 

to schedule your interview and ask a few brief questions for 

our records. I expect this will take less than five minutes.

1. First, are you an employee of the municipal 

 water works for ________ (city)?

01 Yes

02 No (THANK AND TERMINATE)

2. Which of the following activities best describes 

 your primary duties at the water works?

 (DOCUMENT ON GRID)

01 Public Information

02 Emergency Management

03 Plant Operations

04 Field Operations

05 Senior Management

06 Other (THANK AND TERMINATE)

3. How many years’ experience do you have in this 

 type of work – at this facility or similar ones? 

 (DOCUMENT ON GRID)

 

01_____ years

 

 (IF LESS THAN 1, THANK AND TERMINATE)

4. Are you willing to participate in the study?

01 Yes

02 No

5. Are you available for the interview on 

 __________ at ________AM/PM? The location 

 is ____________________________________

 (address). We will send directions to you.

These are all of my questions.

The discussion will last about one hour.

Thank you for agreeing to participate in the study.

If you have any questions, or if scheduling conflicts arise, 

please contact _________ (name) at __________ (phone 

number). 

Appendix B

B-1
Screening Instruments

 

EPA Water Security -- Public

In each city recruit

■ 8 per group

■ 4 groups 

 ○ 6:00 and 8:00 p.m. Day 1 and Day 2

Good evening. My name is __________________ and I am 

calling from _______________, a market research firm. We 

are talking today with people in the area as part of a study 

being done by the US Environmental Protection Agency. We 

are not selling anything. We have a few brief questions and if 

you qualify and are interested, we will invite you to take part 

in a discussion group with other people in your area that will 

take place at a later date. I expect that answering these initial 

questions will take less than five minutes.

1. First, do you or does anyone in your household 

 work for any of the following? (THANK AND

 TERMINATE IF YES TO ANY OF THE 

 FOLLOWING)

01 Advertising, public relations and/or market research

02 Any form of media – TV, radio, newspaper, magazine

03 A health clinic, doctor’s office or hospital

04 Other health related field

2. Have you ever participated in a market research 

 study?

01 Yes → When was that? (THANK AND 

 TERMINATE IF LESS THAN SIX 

 MONTHS AGO)

02 No

3. How old are you? (RECRUIT A MIX) 

 (DOCUMENT ON GRID)

01 Under 18 (THANK AND TERMINATE)

02 18-34

03 35-44

04 45-54

05 55-64

03 65 or older 

96 Refused (THANK AND TERMINATE)

5. VERIFY: Conversant in English?

01 Yes (CONTINUE)

02 No (THANK AND TERMINATE)

6. Document gender (RECRUIT A MIX) 

 (DOCUMENT ON GRID)

01 male

02 female

7. What was the highest grade or degree you 

 achieved in school? (RECRUIT A MIX) 

 (DOCUMENT ON GRID)

01 High School Diploma or less

02 College Degree

8. What is your race? (RECRUIT A MIX)

 (DOCUMENT ON GRID)

01 Caucasian

02 African-American

03 Hispanic

04 Asian

05 Mixed Race

06 Other __________________

That is all of my questions. You do qualify for our discussion 

group and we would like to invite you to join us on _______ 

at ______ PM. The discussion will last about two hours. In 

appreciation for you time, you will be paid $XX at the time of 

the discussion.

Are you willing to participate?

01 yes

02 no

B-2
Participant Information Sheets

U. S. Environmental Protection Agency

Research: Opinions about a Public Health Issue

Information for Participants -- Professionals

Purpose of this survey

You are being asked to participate in a discussion being done 

by the U.S. Government’s Environmental Protection Agency, 

with the assistance of The Oak Ridge Institute for Science 

and Education. In the discussion, you will be asked: (1) your 

opinions about communication materials that the Agency is 

developing to inform people about a public health issue; (2) 

your knowledge, attitudes, and beliefs about the issue; and 

(3) related issues. Your answers can help us develop materials 

to better inform the public. The discussion will be recorded 

(audio only) to be sure we get all the information.

Please remember that:

You choose to participate.

You are not required to answer the questions.

This session should last about one hour.

You are free to leave at any time without penalty.

Risks

The risks you take by taking part in the discussion are the 

same as you encounter in daily life.

Benefits

You will be better informed about a public health issue.

You may have a sense of satisfaction from civic participation.

Your answers may help us better inform the public and others 

about a public health issue. 

Confidentiality

We will keep the information you give us private and 

confidential to the extent allowed by law. Your name will 

not be used in the reports, presentations, or publications. No 

statement you make will be linked to you by name. Only 

members of the research staff will be allowed to look at the 

records. When we present this study or publish its results, 

your name or other facts that point to you will not show or be 

used.

Persons to Contact

If you have questions about this session, or taking part in it, 

you may call:

Scott Minamyer 

US Environmental Protection Agency 

Cincinnati, OH 

513-569-7175

If you need more information about your rights as a study 

participant, you may contact:

Chair, Oak Ridge Site-Wide Institutional Review 

Board, Oak Ridge Institute for Science and 

Education, Oak Ridge, TN 37831-0117 

865- 576-1725

Appendix C

C-1
U. S. Environmental Protection Agency

Research: Opinions about a Public Health Issue

Information for Participants -- Public

Purpose of this survey

You are being asked to participate in a discussion being done 

by the U.S. Government’s Environmental Protection Agency, 

with the assistance of The Oak Ridge Institute for Science 

and Education. In the discussion, you will be asked: (1) your 

opinions about communication materials that the Agency is 

developing to inform people about a public health issue; (2) 

your knowledge, attitudes, and beliefs about the issue; and 

(3) related issues. Your answers can help us develop materials 

to better inform the public. The discussion will be recorded 

(audio only) to be sure we get all the information.

Please remember that:

You choose to participate.

You are not required to answer the questions.

This session should last about two hours.

You will receive a cash incentive for participating in the 

discussion.

You are free to leave at any time without losing the cash 

incentive or other penalty.

Risks

The risks you take by taking part in the discussion are the 

same as you encounter in daily life.

Benefits

You will be better informed about a public health issue.

You may have a sense of satisfaction from civic participation.

Your answers may help us better inform the public and others 

about a public health issue. 

Confidentiality

We will keep the information you give us private and 

confidential to the extent allowed by law. Your name will 

not be used in the reports, presentations, or publications. No 

statement you make will be linked to you by name. Only 

members of the research staff will be allowed to look at the 

records. When we present this study or publish its results, 

your name or other facts that point to you will not show or be 

used.

Persons to Contact

If you have questions about this session, or taking part in it, 

you may call:

Scott Minamyer 

US Environmental Protection Agency 

Cincinnati, OH 

513-569-7175

If you need more information about your rights as a study 

participant, you may contact:

Chair, Oak Ridge Site-Wide 

Institutional Review Board

Oak Ridge Institute for Science and Education 

Oak Ridge, TN 37831-0117 

865- 576-1725 

C-2
Summary of “Immediate” and Other Questions Identified by Professionals

Professionals: “Immediate” Questions to be Addressed

(A check mark in “Public’s Questions” indicates the question was also raised by at least one member of the public)

Topics Public’s 

Questions

Professionals’ Questions

The Incident 3

3

What happened?

How did it happen?

Who is Affected? 3

3

What are the specific areas affected?

What about special-needs customers? What should they do?

 hospitals • school cafeterias • dialysis units • assisted living communities • immune- 

 compromised individuals • elderly • disabled • children • day care • restaurants 

 • manufacturers

Uses of Tap 

Water

3

3

Is the water drinkable?

Specifically, what can people do and not do with tap water?

 baby formula • drinking • pets • laundry • dish-washing • bathing • flush toilet 

 • ice • cooking

Alternate Sources 

of Water

3

3

3

Where and how can I get water that is ‘safe’?

Is bottled water ‘safe’?

Is well-water ‘safe’?

Consumers 

Making Tap 

Water ‘Safe’

3

3

3

What actions do I need to take?

Will boiling the water make it ‘safe’?

Is there anything the public can do to make their tap water ‘safe’ (e.g., filters, purification 

tablets, etc.)?

Exposure to 

Contaminant

3

3

3

3

3

3

3

3

3

What is the contaminant?

How long has the water been contaminated? (already used it for drinking, baby formula, etc.)?

What is going to happen if I drank some of this?

What are the potential health effects?

What are the symptoms of exposure?

Am I in danger?

How do I know if I have been exposed?

Have there been any illnesses or fatalities so far?

If manufacturers (e.g., bottlers) made and distributed product, what should they do?

Will fire protection still be available? (Is is ‘safe’ to spray this on a house?

Obtaining 

Additional 

Information

3

3

3

Where can I go for updates?

How often will you update?

Who will be giving updates?

Response and 

Recovery

3

3

3

3

3

3

3

3

How long will it be until the water supply returns to normal?

How am I going to be sure when the water is ‘safe’ again?

What is the utility and government doing to respond to this?

Who is in charge?

What are you doing to prevent this from happening again?

Are there other agencies involved?

Do you have emergency response plans for the system?

Is there something we [the public] can do to help?

Terrorism 3

3

3

Could this be a terrorist act?

How did they get in?

What should the public do if they see something suspicious?

What are you doing to protect us, prevent further occurrences?

Who did it? Has someone claimed responsibility?

 

Appendix D

D-1
Professional: “Other” Questions to be Addressed

(A check mark in “Public’s Questions” indicates the question was also raised by at least one member of the public)

Topics Public’s 

Questions

Professionals’ Questions

The Incident 3

 

3

3

How could this have been prevented?

Whose fault is it?

When will I know what happened?

Why don’t you know what happened?

Why did it happen?

Could it happen somewhere else? 

How did you come to know it [the supply] was contaminated?

Has this ever happened before?

Who is Affected? Where does my water come from?

Uses of Tap 

Water

No Questions

Alternate Sources 

of Water

3 Is there access to another water supply?

How long will you provide bottled water?

Consumers 

Making Tap 

Water ‘Safe’ 3

3

How long should I boil water?

Can you run the water?

Can contamination be treated at the treatment plant?

Will dilution help?

Exposure to 

Contaminant

3

3

3

3

3

3

3

What do I do if I have already been exposed?

What do I do if I have symptoms?

Can the fire department use the water to spray my house now?

What if I inhale the fumes?

What if I get the water on my skin?

What are you doing to protect the workers?

Are first responders in jeopardy?

How do I get tested?

I watered my garden; is the food contaminated?

What are schools doing?

Is it ‘safe’ to pick my children up from school?

How will this harm my pets?

Should I get my child tested?

Do I need to evacuate? To where?

Additional 

Information

Can I stay open for business? When can I re-open?

How are you making sure that all of the community is being reached (e.g., non-English 

speaking)?

D-2
Professional: “Other” Questions to be Addressed

(A check mark in “Public’s Questions” indicates the question was also raised by at least one member of the public)

Topics Public’s 

Questions

Professionals’ Questions

Response and 

Recovery

3

3

3

3

3

Have you prepared for this emergency?

What do I do to flush the system in my house (e.g., water heater, dishwasher, pipes)?

What are you testing? How often?

Do you have enough resources to deal with this emergency?

What resources are there for clean-up after event?

Is there an issue with flammability of the contaminant?

What will be done for fire protection?

How do you eradicate the agent?

Will there be residual contamination in my pipes?

Is there something we [the public] can do to help?

What will you do with the contaminated water?

Who is paying for this?

What is this going to cost me? (plumbing, medical, rate increases)

How will you determine that the water is ‘safe’ to drink again?

What are emergency personnel doing?

What are long-term effects (e.g., replace water mains)?

Terrorism

3

3

3

Are we under attack?

Why do you think it is terrorism?

Were the terrorists embedded in the water department?

What kind of background checks do you do on your employees?

Where did your security breakdown that allowed this to happen?

Have other areas or other cities been attacked?

Is the rest of the system protected?

Are there other attacks locally? 

Have other water systems been attacked? 

Are there other threats (e.g., electricity)?

Have you caught the terrorist(s)?

D-3
D-4
Raw List of All Potential Questions 

Generated by Professionals

(Not Listed by Categories) 

List of Questions Generated by the Professionals 

■ What areas are impacted?

■ Can we use water?

■ If drinking water, what should they do?

■ How long for water department to remedy situation?

■ Anything public can do to make water drinkable? 

■ Who should they complain to?

■ Who will be giving information? How?

■ Do we know what the problem is? 

■ Is it okay for my pets? 

■ Will home treatments devices treat the water sufficiently 

to drink?

■ What can they do with water?

■ How do you know if corrected situation?

■ Where can get potable water?

■ Uses for water the public receives?

■ If terrorist have you caught people?

■ How come system was not protected? 

■ Terrorists- localized or multi-faceted?

■ Terrorists embedded at water department?

■ What should public do if they see something suspicious

■ What did they do to compromise water system -- what 

contaminant?

■ How long will impact last? 

■ Can I use the water and to what extent?

■ If I can’t use the water, where do I get water; when will I 

be able to use water again? 

■ When was the water contaminated? I just used water 

(baby formula)?

■ What are we doing to fix the problem?

■ Who screwed up? How did this happen?

■ Can we shower, wash dishes, dog uses it, flush toilet?

■ Special need customers: hospitals, school cafeteria; 

dialysis, assisted living; cancer and HIV patients; health 

issues sensitive to water quality 

■ Is there a risk of infection?

■ What’s wrong with the water? 

■ Can I drink it; wash my hands, how can I use it? 

■ How long until I can use it again?

■ How long has this been a problem?

■ What do I do if I’ve already been drinking/using it? 

■ How did you let this happen? 

■ What are you going to do to fix it? What do I do in the 

mean time? 

■ Do I have to buy bottled water? Are you providing 

water?

■ How am I going to be sure when it is ‘safe’ again?

■ How am I going to be confident – be sure water continues

to be ‘safe’?

■ How is it going to harm my pets?

■ What is this going to cost me? Plumbing issues; medical 

issues, rates increase?

■ How will you prevent from happening again?

■ Bottling companies made products -- what do I do?

■ Industrial processes-impact? 

■ Do not use- can I still operate? Businesses, daycares 

(4 hour limit), schools, restaurants

■ How do I know I’ve been exposed? Symptoms?

■ What steps being taken to correct action?

■ What public should do/not do? Can I drink water? 

Shower?

■ Specific areas affected? 

■ How often communication will be sent out?

■ How it happened?

■ How long ago it happened?

■ Symptoms?

■ How handling situation?

■ What are you doing to protect us?

■ Should I evacuate?

■ What are emergency personnel doing?

■ How did we let it happened?

■ What changes will you make to stop from happening 

again?

■ Water ‘safe’ to drink/use, bathe, ice cubes, pets?

■ How will it affect me? What do I do?

■ When ‘safe’ to drink and use? When is the water lifted? 

Safe to drink again? 

■ When did it happen? When did you tell me? (already 

used contaminated water) 

■ How did it happen?

■ How to prevent 

■ Whose fault? 

■ What do I do to flush my system in house? (water heater, 

dishwasher)

■ How long has it been in the system? Timing? What to 

do if recent water used? Important for industries such as 

meat producers etc. 

■ If terrorist what is contaminant and what are symptoms? 

Does water treatment take care of contaminant?

■ What are you testing? What are you doing to figure out 

what happened?

■ What about immunocompromised patients? Special need 

patients?

■ Resources for detailing what clean up after event?

Appendix E

E-1
■ How do I get bottled water to elderly? Where do I get 

bottled water?

■ I have young children. What should I do? 

■ When will I know what happened? 

■ Is water safe to drink? 

■ When will water be safe to drink again? 

■ Why don’t you know what happened? 

■ Is the water hazardous to me, am I at risk?

■ Where can I get bottled water? 

■ How long has water been unsafe? (made baby formula 

yesterday, dogs were given water, ice trays)

■ Hand washing, is water safe for hand washing, does soap 

do it? Do you have to boil water to wash hand?

■ How long boil water? Wait to cool off? 

■ Terrorist: How did it happen? 

■ Terrorist: Where did your security breakdown that 

allowed this to happen?

■ Terrorist: Can you run water? 

■ Terrorist: Is there and issue with flammable contaminant?

■ Terrorist: What to do for fire protection? 

■ Terrorist: How long will it take? When can I use it again?

■ Terrorist: How do you eradicate agent

■ Terrorist: When is this going to be over?

■ Terrorist: Scope of issue? Other cities? Area of 

contamination?

■ Can we drink the water?

■ What can we use it for?

■ When will we know specifics of the problem?

■ When will it be resolved?

■ What areas are affected?

■ Hospitals/high risk -- What is being done to assist them?

■ What are you doing to prevent?

■ How often is water monitored?

■ What security measures you have in place?

■ What kind of background check do you do on your 

employees?

■ Is it safe? 

■ How long have you know about this?

■ What steps taking to solve crisis?

■ What the extent of affected area?

■ How long do you think it’s going to last?

■ Who is responsible?

■ How did you let this happen?

■ Are there other agencies involved?

■ Do other public officials know?

■ What do hospitals need to know?

■ Who’s managing the crisis? Who’s in charge?

■ Is it biological?

■ What are symptoms people should look for?

■ Does risk exist throughout system?

 ○ Isolate?

■ Can we boil water?

■ Affect children, dialysis, hospital patients, and seniors?

■ Restaurants Is it safe for cooking and food preparation?

■ Are first responders in jeopardy?

■ How do you remediate contaminant?

■ What are long-term effects? Replace water mains?

■ Do you have enough resources to deal with emergency?

■ Is it safe to drink? 

■ If not safe, when will you have it fixed?

■ My dog drank water?

■ I didn’t hear about it until after have I been exposed?

■ If not safe; what can I do with water?

 ○ Can we flush toilet?

 ○ Take shower?

 ○ Do I need to boil water?

 ○ Formula for child?

■ Are we in the affected area? How big is area impacted?

■ Where can I get more information?

■ Was it intentional? What caused it? 

■ Terrorist: is the rest of the system protected (if one tank 

contaminated) what have you done about it?

■ Terrorist: What about adjacent area?

■ Terrorist: Is this an isolated event? Terrorist: What 

happened to cause contaminated? What’s contaminated?

■ Terrorist: What are you doing to make sure this doesn’t 

happen again?

■ System contaminated -- What do I do about it?

■ Is it ‘safe’ to drink?

■ Can I boil water to make it ‘safe’?

■ Can I bathe with it?

■ Do I need to stop using the water?

■ Where can I get water that is ‘safe’ to drink -- well, 

bottled?

■ How long will it last?

■ When did you first notice it?

■ What happens when I drink some of this?

■ Add chloride to make water drinkable?

■ Is it terrorist?

■ Where is source of contamination?

■ Why did happen?

■ How to prevent it?

■ Have you caught terrorist?

■ Ability to treat water?

■ Is contamination localized/countywide?

■ Will dilution take care of problem? 

■ Why didn’t you have safeguards in place to keep 

terrorists out?

■ What will you do with contaminated water?

■ Who is going to pay for this?

■ Who is going to help us?

■ Is the water ‘safe’ to drink?

■ What happened? What do you suspect?

■ How did you come to know what was contaminated?

■ What is in the water?

■ What does the public need to do?

E-2
■ When will you have more information?

■ How will public get information?

■ What is water department doing about it?

■ What are potential health effects?

■ Has this happened anywhere else?

■ How isolated/dispersed throughout system?

■ How are you keeping this from happening again?

■ Why do you think it’s terrorist or intentional?

■ Law enforcement actions?

■ Can we drink water?

■ Why not drink the water?

■ Any injuries or medical affects thus far? Is so where 

were they taken? Nature of injuries? 

■ What was the cause?

■ What are the geographical boundaries of your order?

■ Could this be terrorism?

■ What’s the nature of the emergency? Chemical, 

biological?

■ Is this the same as boil order?

■ Who is to blame?

■ Where’s the mayor?

■ If drank water, what to do now?

■ Can people cook?

■ How long is this going to last?

■ Does this supply to suburbs as well? Has their water 

been affected?

■ What’s being done to correct it?

■ When will we get more information?

■ Are we under attack?

■ What can people do to make themselves safe?

■ Are you evacuating?

■ Have there been other episodes, other cities?

■ Is it safe for parents to pick up children from school?

■ What are symptoms people should look for?

■ Can I drink water?

■ Can I shower; bodily contact?

■ Can I run tap at all?

■ Fire department spray my house now?

■ Can I make ice? Coffee? 

■ Give it to my dog?

■ Where does water come from? Who is supplier?

■ Can I use my toilet? 

■ When will I be able to use water again?

■ How will you provide us bottle water?

■ How long to be back to normal?

■ How do we clean after incident (flushing lines, replace 

water heater)?

■ Specialty uses -- hospitals (dialysis), restaurants (food 

prep), nursing homes, labs?

■ If I’ve been exposed, what could happen to me? What are 

symptoms of exposure? 

■ Can I stay open for business?

■ Is my water ‘safe’?

■ How long until water is ‘safe’? If consumed water -- 

what to do?

■ How long will it be in affect?

■ What are symptoms?

■ Extent of area being affected?

■ What happened? How did water get contaminated?

■ Who contaminated water?

■ What step taken to make sure it doesn’t occur again?

■ What can I do to help? Flushing water?

■ What type of harm if I’ve consumed tainted water?

■ Do you expect more occurrences?

■ What are you doing to prevent future attacks?

■ Will my water be safe in the future?

■ What can I do to make my water ‘safe’?

■ When will I hear more information -- schedule?

■ Steps taking to alleviate situation?

■ Has this ever happened before? Historical?

■ Who coordinated with? Public health, other experts?

■ Have you prepared for this emergency?

■ What technology are you using to help you make this 

determination?

■ Am I affected?

■ How am I affected?

■ How long am I going to be affected?

■ What should I do?

■ What do I have to do?

■ How impacts my life?

■ What steps city taken to remediate?

■ Am I in danger?

■ How could this have been prevented?

■ How it happened?

■ Why happened?

■ Could it happen somewhere else?

■ Could it happen again?

■ Who did it?

■ Why they did it?

■ Are we vulnerable?

■ Bottled water or no bottled water?

■ Do I have to move? If so will facilities be provided?

■ Severity of issue-safe to drink water?

■ What’s happening? Why can’t drink water?

■ What can I do in it? Bathe, drink, contact, water my 

plants? What is “use” if I can’t use it? 

■ When will the issue be resolved? How long?

■ Is there more threats? What about electricity, nuclear?

■ How can I get water?

■ Where will I go for dialysis?

■ Is there something we can do to help?

■ Is water ‘safe’ to drink?

■ Bathe in?

■ Cooking?

E-3
■ Feed my pets?

■ Fumes -- what if I inhale?

■ Residual contamination in my pipes?

■ Infant formula?

■ Immunocompromised people?

■ How long will this last?

■ Safe to flush toilet?

■ Terrorist: Does this affect water supply elsewhere?

■ Terrorist: Other terrorist acts locally as well?

■ What in water did you find that makes it unsafe?

■ Is it terrorism?

 ○ What was poison? What was contaminant?

 ○ When did it start? How long been in system?

 ○ How do I get tested?

 ○ Drank water already am I okay?

 ○ Is food contaminated? Watered my tomatoes.

 ○ Will boiling work?

 ○ Will filters help?

 ○ Who did this? Why?

 ○ How many people are sick?

 ○ How did you allow this to happen? 

How did they do it?

 ○ What will you do to prevent this?

 ○ Do I need to evacuate? Where?

 ○ Where can I go to say updated?

 ○ What are schools doing?

■ Can I get rid of it by boiling it?

■ Can contamination be treated at treatment plant?

■ What is the effect of this chemical on various people?

■ Where do I get water?

■ Is it safe to drink?

■ How do I get water to pets?

■ When will it be ‘safe’?

■ When can I re-open business?

■ What areas are affected?

■ Why didn’t water department tell me?

■ What can I do with water? Bathe, wash dishes, wash 

clothes?

■ What harm can it cause?

■ How did this happen?

■ Why did you allow this to occur?

■ How can the public stay informed, get updates?

■ Is the water ‘safe’ for consumption?

■ Is the water ‘safe’ for use?

 ○ Hospitals

 ○ Kidney centers

 ○ Reactor manufacturers

 ○ Restaurants

 ○ Day cares

■ If not drinking, can I bath and use for other things?

■ Who’s impacted-specific geography?

■ How long affected?

■ Any other water providers available? Places I can get 

water?

■ What happened? What caused emergency?

■ What measure to make sure it won’t happen again?

■ What is utility doing to respond?

■ How restore service?

■ Protecting system from further incidents?

■ How determine if safe to drink again? Testing entity? 

Credentials?

■ Health Impact: What do I do if I’ve drank the water? 

Bathed? Got it on my skin?

■ Impact on animals?

■ Who to contact about health issues; where to get 

information?

■ Protecting system from further incidents?

■ Extent of problem, one community, service area?

■ Notify as soon as possible, get message out right away

■ Terrorism

 ○ Status of threat: How vulnerable are we to other acts?

 ○ How did they contaminate (at source, in water, 

internal or external)? Type of threat?

 ○ Still ongoing? Is it contained?

 ○ What caused it? Emergency preparedness procedures 

system-wide?

■ How is public being protected?

 ○ How are employees being protected?

■ Cause of incident: What happened bacterial? Terrorist 

attack?

 ○ Post attack: Is there anywhere else other areas of state 

that may be vulnerable?

■ Access to other water supply?

■ How long before services restart?

■ What they can and cannot do specifically (Can they wash 

dishes and clothes, bath/shower, drink, baby formula? 

Can you wash hands with water? If so do you need 

antibacterial soap? Extent of how they can use water 

(protective actions)?

■ Simple messages

■ What to do if tainted water, how it affects them?

■ Want to know government or officials are doing 

something; the amount of control you have over 

situation. Coordination: local state feds

■ Magnitude of problem?

■ Timing?

■ How can I purify water?

■ Alternate water sources?

■ Where to go for help; website for basic information? 

■ Need disability information for public?

■ Post: what to do with water heater, what to do after water 

is safe?

■ What’s the geographical boundary of event?

■ Is it a do not drink or do not use?

E-4
■ What can I do to make it ‘safe’?

■ How long will it last?

■ What caused it?

■ What is the contaminant?

■ Who did it?

■ What are you doing to protect us?

■ What is it? 

■ When did it occur? Did I drink it? What happens if I 

drank it?

■ Anybody get sick so far? 

■ How did you know you had an issue?

■ Where is it localized?

■ How long will it take to get back to normal?

■ Special need: Will hospitals have water?

 ○ If not, have to evacuate?

■ Are you monitoring? What monitoring for?

■ Who? What terrorist group? Who claimed it?

■ How are you remediating it?

■ Is our water ‘safe’?

■ Will it be ‘safe’ in future?

■ How did they get in? How was contaminant introduced?

■ Are we continuously testing?

■ Are we working with health department, other agencies?

■ Will filters at home secondary treatment help?

■ Get child tested?

■ What are the symptoms?

E-5
E-6
Summary of Additional Questions Raised by Public Respondents

(But Not Professionals)

Additional Questions Raised by the Public

Topics Questions

The Incident How long have you known about this before telling us?

What else has been affected?

Who is Affected? --

Uses of Tap Water How much of our food supply requires water?

Alternate Sources of Safe Water Where can I go that’s not contaminated?

How do I get out of the contaminated area?

Is rainwater safe to use?

How long will you provide water?

What can we drink?

Is there a back-up water supply?

Making Tap Water ‘Safe’ --

Exposure to Contaminant What will be the environmental impact?

How will it affect wildlife?

Is there any effect on local produce?

Is the water in my pipes contaminated? How can I tell?

Is there danger in being near the water supply [lake]?

Does this apply to beaches, swimming pools?

If the water is shut off can we use what we have in reserve [pipes, water heater]?

Should I flush the toilet?

Should I turn my water off?

Can we fish?

Should we avoid grocery store [produce sprayed with water]?

What do I do with the water I already have [e.g., in dog bowl]?

Will the contaminant dissipate over time?

Additional Information How are people being notified other than by telephone?

Is this real?

How did you get my number?

Who authorized this?

Who do I contact if I have questions?

Response and Recovery How long has this [do not use order] been in effect?

Do we have to clean our filter system? Will they pay for it?

Terrorism Does this constitute a crime? Will the person(s) be punished?

What are you doing to find out who did it?

Appendix F

F-1
F-2
Raw List of Questions Generated by the 

Public

(Not Categorized)

List of Questions Generated by the Public

■ How serious is this event? Is it deadly or something that 

will make you sick? Is it life threatening?

■ How long has water been contaminated before 

announcement?

■ Will stores that run out of bottled water be stocked 

quickly and on daily basis?

■ How can we be sure that it is ‘safe’ after?

■ Will it be somewhere to pick up fresh water?

■ What should you do if have drank water?

■ Can we boil water? Can we shower?

■ Estimate of how long regular water service will be 

restored?

■ Who did it? Will happen again?

■ What’s the radius of damage?

■ Are they attacking anything else?

■ Is this all water supplies? Well water?

■ Has anyone died or become sick?

■ Will affect entire population the same? 

Immunocompromised, infants, elderly

■ How do we protect water so don’t happen again?

■ What can someone do if infected?

■ Does this constitute as a crime? Will person be 

punished?

■ What kind of contaminant is in water? Is it transferrable?

■ How much water I have on hand? Where can get 

containers filled?

■ How long will I be without water?

■ Does the city have an emergency response plan so we 

can follow certain steps?

■ Where can I purchase water?

■ What if I drink water? What are the consequences?

■ Can I boil water to make it ‘safe’?

■ How long has this been in effect?

■ How did it happen?

■ Who did it?

■ Where can I go that’s not contaminated?

■ What’s the poison? Is it just in the water?

■ How much of food supply requires water to make it?

■ Do I have baby wipes to clean myself?

■ What’s the context of attack and what are ramifications? 

Is air safe?

■ How are people being notified besides telephone?

■ What preventative measures could be used to counteract 

attack? Water purification? Antidote? Offset attack?

■ Are public leaders doing something?

■ Where to tune in to find out information on what’s 

happening?

■ What harm could the pesticide cause and can it harm 

skin?

■ How long have you known about pesticide

■ What preventative measures will be taken so it won’t 

happen again?

■ Will my family be okay?

■ Estimated length of disruption?

■ Level of danger -- low to severe?

■ What do we do in the interim?

■ What steps of going to be taken for water to be available?

■ Is this real? How did you get my number? Who 

authorized this?

■ Is it really that bad? Are my insides going to melt?

■ How could we leave this resource unprotected?

■ Who should I be mad at? Is it a terrorist organization?

■ What are you doing to find out who did it?

■ What is pesticide?

■ What are the next steps to make water usable again?

■ What is the water safe for? Shower? Boiling?

■ Already drank water, what are affects?

■ Are populations more vulnerable than others to this 

pesticide? Seniors, pregnant women, kids, those with 

health conditions?

■ When did it happen (date/time)?

■ Where can I go for additional information?

■ How long (hold on usage)?

■ Any home treatment

■ Where’s the boundary of the water affected

■ Is it deadly if I drink it? Is it drinkable?*

■ Where distribute clean water?

■ What’s being done to fix problem?*

■ How long has this been going one? Side effects?

■ What is in the water?

■ Water distribution-priority to children ‘Safe’ to shower?

■ How long will this be effect?

■ ‘Safe’ to use boiled?

■ Environmental impact?

■ Impact on local produce?

■ Water effect pets?

■ Who’s responsible for it?

■ How long will this affect my job (lifeguard)?

■ When did it get discovered and how?*

■ Are we in any danger? Was it caught in time?

■ What treatment applied to counteract event?

■ Is there an antidote available?

Appendix G

G-1
■ Recovery time? How long before water restored?

■ Act of terrorism?

■ What was chemical?

■ How will be sure it is ‘safe’ again?*

■ How will you prevent this from happening again?*

■ Can it be filtered? Can you do something at home to 

remedy situation?

■ Is water in pipes contaminated? How can I tell? How 

wide spread was contamination?*

■ Signs and symptoms you are contaminated?

■ Where can you get ‘safe’ water?

■ Is there a plan for this disaster?

■ Will this affect well water?

■ Can I take a shower?

■ How will it affect wildlife?

■ Where can I get water for my animals?

■ Do we have a clean filter system? Will they pay for it?

■ Where? Just city water?

■ Can the water be boiled and later used?

■ What do I do if I’ve already drank water?*

■ Projected length of time to clear this up?

■ Where to buy water fast? Supply of safe water?

■ How will I be notified? Updates?

■ What happens if I bathe or have bathed in it?

■ How pesticide affects people?

■ Long term affects of contaminated pipes? Will 

infrastructure have to be replaced?

■ What area is contaminated?

■ Quarantine area? How do I get out of contaminated 

area?

■ What’s the emergency procedure plan?

■ What can the water be used for?

■ Who did it? How?

■ How do you prevent it?

■ Contact information for questions?

■ Who is head agency? Who is in charge? (cleanup) EPA 

CDC

■ Who exactly is it?

■ What type of contaminant?

■ How widespread is the problem?

■ How long will affect water supply?

■ What are you doing to contain problem? Steps being 

taken?

■ What steps city taking to provide ‘safe’ water?

■ Side effects if contaminated by water? Signs I have been 

poisoned?

■ Where is nearest water supply? Nearest source of 

uncontaminated water?

■ How authentic is message?

■ Where can we get more information?

■ Will filter or boiling get rid of contamination?

■ What’s being done to prevent it from happening again?

■ What will city be doing to help us in meantime?

■ What solutions have they came up with so far? How will 

you fix this?

■ Is there a treatment for side effects of drinking 

contaminated water?

■ Where can you get treatment?

■ Effect on environment, not just us?

■ When I did it happen?

■ Do they need volunteers to help?

■ What do I need to do to get through this?

■ Treatment for you after exposure-hospitals, etc?

■ What are long term effects to exposure?

■ What is alternate source and how often will be available?

■ What sources okay to use?

■ Is there danger for being near water supply (lake)?

■ Is there a hotline or website for questions about what and 

what not to do?

■ Should I buy water?

■ How long going to last?

■ Can you purify at home?

■ Is there going to be distribution centers to pick up water?

■ Is rain water ‘safe’ to use?

■ How much emergency water do I have? Where is it?

■ How long was contaminated before we found out?

■ What are effects if exposed?

■ What is ‘safe’ to use -- well water, cans, soda?

■ Is harmful to animals?

■ Bottled water?

■ What kind of plans to resolve issues?

■ When did it happen?

■ Surrounding areas impacted? If so where?

■ What was the contamination?

■ When will be ‘safe’ again?

■ What’s source of contamination? 

■ Which treatment plant is contaminated?

■ Who did this? Are there any other threats?

■ How was it discovered?

■ Purified/distilled water okay? 

■ How long before back to normal?

■ Will they be able to filter pesticide out of water?

■ Where can we get uncontaminated water? Will city 

provide safe water?

■ What steps can make water safe?

■ What would happen if I drank water?

■ Can the water be purified by boiling?

■ How long will this go on?

■ How long will it take to fix problem?

■ How long before dissipate? Will it be airborne?

■ What affects of contaminated water? 

■ Where is closest well?

■ How long will we provide with water?

■ How much inventory do I have?

■ Do they turn water off? How can we use facilities?

■ Are dishes affected?

■ Is my dog water ‘safe’?

■ Has it affected coastal area?

■ If water shut off, can we use what we have in reserves?

■ Can I combine my resources with neighbors?

G-2
■ At what point did detect contamination? Is it the entire 

system?

■ Does this only affect the city only or suburbs?

■ When did you find out?

■ What does unsafe mean? Death?

■ What if I have a filter, will it protect me?

■ Can I boil it?

■ Should flush toilet to let stored water out?

■ Can we shower? Brush teeth?

■ What areas affected? Suburbs?

■ How did this happen?

■ What is outcome? 

■ What’s being done to fix?

■ How to prevent from happening again?

■ Are there water stations? 

■ How will know ‘safe’ again?

■ Where go to get water? How far do I have to travel?

■ How long was it before noticed contaminated?

■ Has any fatalities occurred?

■ Is there an age range? Are children more vulnerable?

■ Has it happened before?

■ What can we drink?

■ Is it just tap water? Bottled?

■ Is there a manufacturing plant affected? Restaurants?

■ Who do I contact if I have questions? 

■ What are side effects?

■ Can you filter water (coffee filter) to make safe?

■ Does this include Lake Michigan?

■ Can we fish?

■ What contamination source?

■ What if I’m already contaminated?

■ What are symptoms?

■ What should we avoid? Grocery store?

■ How severe is it?

■ When did I last consume water? Does this affect me? 

Affect my kids?

■ Is there a back up supply of water?

■ How will they get water to people?

■ Will it continue to be dangerous after given the all clear?

■ What other areas are affected?

■ How much water do I have right now in my house?

■ If contaminated water has been consumed what is going 

to happen?

■ Have there been any fatalities thus far?

■ How could it have happened?

■ What plans does the city have?

■ What is specific issue? What contaminated the water?

■ How fast can I get to the store?

■ How was it determined that contamination took place?

■ When did it happen?

■ Who did it?

■ What can we be doing to help?

■ How will we survive without water?

■ How did you get my phone number?

■ What causes the problem? Touching water, drinking it, 

bathing?

■ Does it apply to beaches, swimming pools?

■ Is it true? Is it a hoax?

■ How will agent be removed from water sources?

■ What exactly is agent?

■ What is the duration -- How long to get it out?

■ Can I get updates?

■ Where can I get some water?

■ How long has government known before telling us?

■ How will this affect us in the long run?

■ What communities and water systems are affected?

■ What is effect of agent on a person?

■ Who is following up the investigation?

■ Who is responsible?

■ When do we call EPA? Do we need to call them for 

guidance?

■ When will water be safe to drink?

■ Anything we can do to kill this agent?

■ Why and how did it happen?

■ What alternative water resources are there? Bottled 

water?

■ Was the water I consumed affected?

■ What in the water?

■ How quickly before water is available again?

■ What’s the geographical area affected?

■ How will you get rid of contaminated water in pipes?

■ Can we boil water?

■ Will we be informed when problem is fixed?

■ How reliable is the information we’re getting?

■ Should we be watching for side effects if you have been 

in contact with water?

■ How long will the water be out?

■ What do I do if already drank water?

■ What happens next?

■ What is the nature of unsafe condition? Can I drink it, 

bathe, water plants, etc?

■ Is anyone working on a resolution? Who?

■ Can I boil water or add purification tablets to it?

■ Who and when?

■ What else has been affected?

■ Is city/government going to be providing water?

■ What do I do with the water I already have? Dog dish?

■ Is bottle water safe?

■ Am I going to be harmed by contact of water?

■ Where was water contaminated?

■ Do I have a contingency plan?

■ Can it be corrected and when?

■ What areas is this affecting?

■ Is phone message legitimate?

■ Who is responsible for reporting from this point?

■ Is there a website, other sources of information

■ Is contamination more harmful to specific groups 

(children)?

G-3
■ Is ground water/well water contaminated?

■ What is the contaminant?

■ Who’s calling? Is this a hoax?

■ How long will this situation last? How soon will 

problem be fixed?

■ Did I drink the water?

■ When did it happen?

■ Do I have supplies on hand?

■ What is being done to fix the problem?

■ How wide-spread is the problem?

■ Can this agent be removed or neutralized?

■ What kind of contaminant? How harmful?

■ How will we know when it’s safe?

■ Which reservoir was contaminated?

■ Is there anything else going on?

■ Should I turn my water off?

■ What happens if we drink the water?

■ Should we go to the doctor?

■ Where can I get more information? TV? Internet?

■ Do they know who did the attack?

■ Was it an attack/an accident/deliberate?

■ What do I need to do? Where do I go?

■ What is the contaminant?

■ Can water be used if boiled?

■ Is there and additive to sterilize the water?

■ How long is this going to last? When will we be able to 

use again?

■ How much drinking water do I have at home?

■ How have authorities responded -- state, local, federal?

■ How did this happen?

■ Is there anything I can do personally to help situation?

■ Are they going to provide water? bottled water?\

■ Who did it? When?

■ What do we do if we drank the water?

■ Will the contaminant dissipate over time?

■ Who’s calling me?

■ Can showers and bathes be taken if water tainted?

■ What’s the extent of problem? one part of city? 

G-4
Message Testing: Messages, Testing Frequency, and Comments

by Public Respondents

Number Question Number of Focus 

Groups to Review

Pesticide Scenario

5-1 What can you tell us about the water contamination? 4

5-2 What is the water utility doing now about the pesticide contamination? 4

5-3 How many people may have been contaminated? 4

5-4 What are the symptoms of exposure? 4

5-5 What should people do to protect children and the elderly? 2

5-6 If people cannot drink or touch the water, is there anything people can do with it? Do you 

accept responsibility for what happened?

2

5-7 Do you accept responsibility for what happened? 4

5-8 What should people do now for water? 4

5-9 How are you going to clean the system? 1

5-10 Once it is cleaned up, how will you know if the water system is safe? 4

5-11 How do you normally know the water is safe to drink? 4

Biological-Agent Scenario

6-1 What happened? 2

6-2 What can you tell us about this contamination event? 4

6-3 Do you know exactly where the contaminant is within the drinking water system? 4

6-4 How did public health find out there was contamination? 2

6-5 Can people in the affected area use the water at all (bathing, washing dishes, making 

coffee)?

2

6-6 What are the health effects associated with exposure to [Insert biological agent] 4

6-7 How did the city find out there was contamination? 2

6-8 How or where can people in the affected area get safe water? 4

6-9 How did this happen? 2

Appendix H

H-1
5-1: What can you tell us about the water contamination? Participant Comments

We have confirmed the presence of a pesticide in the 

drinking water.

■ The pesticide is [insert name of pesticide], which is used 

for [insert use].

■ Levels of the pesticide are above recommended drinking 

water standards.

■ The drinking water in the following locations has been 

affected [insert locations].

An investigation is underway to determine the source and 

amount of the pesticide.

■ We are taking samples and conducting tests throughout 

 the system.

■ Public health and hospitals are tracking and treating those 

who are ill.

■ Law enforcement is investigating the cause.

Effective immediately, people should not use the water.

■ People and pets should not drink the water.

■ People should not use the water to bathe, shower, or 

wash.

■ Alternative sources of drinking water will be made 

available at the following locations [insert locations and 

show map].

Important Information

■ Pretty good, had timeframe.

■ Effective immediately most important.

■ Keep water locations bullet.

■ Affected immediately should have been first response.

■ Second group very vague.

■ First will worry about health—is there something we can 

do to prevent.

■ Want to hear results of testing after time (show 

decreasing).

■ “Levels of drinking water” too vague, take out because 

we can’t test.

■ Tell us not to drink first.

Change/Modification

■ Narrowed down location, liked it.

■ Should be third, first, and second.

■ 1, 3, 2 as order.

■ Concerned that people would still drink if they say above

water drinking standards, so say how far above

recommended. Remove recommended.

■ Wouldn’t warn us not to drink water if below level;

eliminate bullet “above recommended level’ -- sounds

optional.

Questions

■ Third bullet of first question: what if people can’t get to 

locations for water?

■ What to do if you already drank water?

■ Is there food on store shelves that was prepared using the 

 water? Ice?

■ How often you going to give me updates?

■ How often are they testing water?

H-2
5-2: What is the water utility doing now 

about the pesticide contamination?

Participant Comments

We are testing water quality throughout the system.

■ We are taking samples at various locations.

■ [Insert laboratory name] is testing those samples.

■ The results of these tests will determine our next steps.

We have begun recovery operations.

■ Our recovery operations are being coordinated with local, 

state, and federal agencies.

■ The CDC and other public health experts are advising us 

on potential health effects.

■ The US Environmental Protection Agency and other 

experts are advising us on how to clean the system.

Effective immediately, people should not use the water.

■ People should not drink the water.

■ People should not use the water to bathe, shower, or 

wash.

■ Alternative sources of drinking water will be made 

available at the following locations [insert locations].

Important Information

■ Shows a logical set of steps.

■ First two bullets “don’ts”, but last gives a sense of hope.

■ Peace of mind that they are monitoring water

■ CDC sounds serious

■ After Katrina make feel leery of agencies.

■ Know that utility people are working now: reactive

■ Testing and recovery should be happening at the same 

 time.

■ This would make me think there is information that they 

 are not sharing.

■ Laboratory name not significant.

■ “Result will determine next steps” makes me feel like 

 they don’t know enough to be definitive

■ I take it as they haven’t got a clue; doesn’t tell us 

 anything 

■ No timeframe of situation (how long water affected; how 

long will testing take)

Change/Modification

■ Recovery should be last paragraph.

■ More like diagnostic would be better because recovery 

means fix it to most people

Questions

■ What about pets?

■ Call information?

■ How credible is this laboratory? Have they tested before?

■ When is this going to be taken care of?

H-3
5-3: How many people may have been contaminated? Participant Comments

We are assessing the number of people who might be 

affected.

■ Health officials are tracking calls and complaints.

■ Samples have been sent to state laboratories for testing.

■ Results of the tests will help us better determine affected 

 areas.

We are working closely with local hospitals.

■ Hospitals are prepared to provide treatment.

■ Hospitals are also providing medical advice.

■ The CDC is providing advice to us and the hospitals.

We are coordinating our response efforts with other 

organizations.

■ In special cases, we will make door-to-door visits.

■ Hospitals and nursing homes will receive priority 

 attention.

■ Other communities have offered resources and support.

Important Information

■ Three main bullets are important.

■ Sounds very serious.

■ Sounds really bad.

■ I want to know exact symptoms and where to go for 

 treatment.

 ○ If not exact then everyone will be worried and go to 

 ER for cold, nausea, headache

■ Begins to answer question but they don’t yet have 

 answer.

■ I want to see how many people have died: are all in same 

neighborhood or area.

■ Wordy, they could all be condensed “hospital are 

providing treatment and advice” I’m a skimmer.

■ Pretty generic answer

■ Believe it’s an initial statement so it is vague.

Change/Modification

■ Add who gets priority regarding care

■ Exact name of hospitals for which side of city

■ If pesticide is known identify symptoms

Questions

■ What are you suppose to do, go to hospital and sit in 

ER?

■ They’re testing it. How are hospitals prepared?

■ Who to contact -- CDC or hospital?

■ How quickly will they will recognize what it is?

■ What are special cases? What qualifies someone for 

 having authorities go door to door?

■ Which communities?

■ What is a special case to go door to door?

H-4
5-4: What are the symptoms of exposure? Participant Comments

Symptoms depend on exposure.

■ Because of the unusual smell and taste, most people will 

not drink the water.

■ Because of the small amounts of pesticide involved, most 

people will not breathe amounts large enough to cause 

 harm.

■ Skin penetration is unlikely unless there has been 

prolonged contact with the water.

The pesticide can enter the body through drinking, 

breathing, or skin contact.

■ Exposure is typically not life threatening.

■ Most people who have been exposed and have symptoms 

will fully recover.

■ The biggest concern is exposure by drinking a large 

amount of contaminated water.

There are many symptoms.

■ People who drank more than a quart of the water may 

experience nausea, an upset stomach, and vomiting.

■ People who are experiencing symptoms should not be 

encouraged to vomit.

■ Call 911 immediately or go to an emergency room if you 

have symptoms.

Important Information

■ Center section is right to the point.

■ Call 911 is important.

■ Hopeful message :most people will recover

■ Second two paragraphs are more important.

■ Third point is most important.

■ Middle statement is most important.

■ First section is hypothetical -- “most people won’t’ drink 

the water.”

■ Don’t want people to make own decisions and

determinations, want them to do this and that.

■ First bullet allows people to make own judgment -- not 

good.

■ Contradicting information about vomiting

■ Don’t understand first section

■ Too much speculation

■ Didn’t really tell symptoms if didn’t drink more than 

quart.

■ Keep it simple.

■ Hear people being contaminated with pesticides all the 

time and it doesn’t seem immediate or threatening.

Change/Modification

■ Third, second, first paragraph should be new order

■ Order how we read pill bottles; mirror way used to 

reading.

■ Reorder to 2, 3, 1

Questions

■ Giving us characteristics of water rather than symptoms; 

symptoms are common with other illnesses

■ What is prolonged contact?

H-5
5-5: What should people do to protect 

children and the elderly?

Participant Comments

Children and the elderly need special protection.

■ Children and the elderly are more vulnerable to illness 

than other populations.

■ Children are more vulnerable because they have less 

developed body defenses.

■ The elderly are more vulnerable because they may have 

weakened immune systems.

Children and the elderly should be especially careful not to 

contact the water.

■ Children and the elderly should not bathe using the water.

■ Children and the elderly should not swim in the water.

■ Children and the elderly should not wash dishes using the

water or use dishes washed in the water.

Children and the elderly should be especially careful not to 

drink the water.

■ Children and elderly should drink only bottled water.

■ Children and the elderly should not drink beverages 

prepared with the water.

■ Parents should not prepare infant formula using the 

water.

Important Information

■ Felt last bullet was most important.

■ Three headlines most important.

■ Second paragraph most important.

■ Last paragraph; 1st bullet is important.

■ Last two sections most important; tell me what I can do 

and what I can’t do.

■ First section really off on tangent, not addressing specific

 issue.

■ Excluding other populations (immunocompromised,

other ill)

■ Make short: no bathing, no washing.

■ First bold line is vague.

■ Last two bullets of third section are very specific.

■ Need to add “tap” water to distinguish from bottled.

Change/Modification

■ Eliminate second section completely.

■ Reword: only drink beverages with “bottled” water.

■ Reword: Do not bathe using tap water, do not swim, do 

not wash dishes, etc.

■ Could combine some bullets about bathing, swimming, 

 etc.

■ Add: you can’t use this for anything, so no one can 

misinterpret that; clear and concise.

■ Move first section to bottom.

Questions

■ What about everyone else?

H-6
5-6: If people cannot drink or touch the water, is there 

anything people can do with it?

Participant Comments

Our primary concern is the pesticide entering the body 

through drinking.

■ People should not drink the water or cook with it. Boiling

does not remove a pesticide.

■ People should not drink beverages prepared with the 

water or make infant formula.

■ People should keep children and pets away from the 

water.

People can water their plants, gardens, and lawns with the 

water.

■ People should wear gloves to prevent skin contact with 

the water when using a hose.

■ Avoid breathing aerosolized water from sprinklers.

■ Avoid creating run-off that could contaminate the sewer 

 system.

Skin contact should be avoided, especially if contact is 

prolonged.

■ People should not use the water for washing dishes.

■ People should not use the water to take baths or showers.

■ It is okay to flush toilets.

Important Information

■ First and third are great, very descriptive; second less 

 critical.

Feedback

■ Like order of first and third paragraphs.

■ Like language such as AVOID.

■ Tell people what not to do, because it’s confusing to add 

what you can do. 

■ Be direct and to the point.

■ Keep all “do’s” together and don’t’s” together.

Change/Modification

■ Take out second paragraph.

Questions

■ Wondering about flushing toilets. Wouldn’t that splash 

something around?

■ Who in a crisis is going to be wondering about my 

garden?

■ Using language such as should remove; use stronger 

 language

H-7
5-7: What should people do now for water? Participant Comments

At this time, people should not use the water.

■ People should not drink the water.

■ People should not use the water to bathe, shower, or 

wash.

■ Boiling the water will not make it safe.

We will provide regular updates on our testing.

■ Updates are available on our Web site [insert Web site].

■ Updates will be broadcast through local radio and TV.

■ Updates are available from our information line at [insert 

number].

People from affected areas should drink only bottled water.

■ Free bottled water will be available at the following 

locations [insert location] at [insert times].

■ Bottled water should be used for cooking and other uses.

■ Bottled water should be used for pets.

Important Information

■ Thee mediums of communication

■ Some important information

■ Second bullet under updates is positive.

■ Nice, to the point

■ Simple and more to the point

■ Not everyone has internet access.

■ Use reverse 911.

■ Provide a timeline.

■ Tells me to not touch water.

■ The middle section has nothing to do with question; good

information just not answering question.

■ Last couple of bullets are common sense

■ Bathe, shower, wash -- repetitive

Change/Modification

■ Add something about formula.

■ “Don’t’ use water under any circumstance” (rewrite 1st 

bullet).

■ Condense bullet points; simpler and to the point

■ Put “don’t touch water!”

■ Add website, TV can be delayed.

■ Say this is dangerous; serious; wording should be more 

 intense.

■ Reword: tap water has been affected, bottled water safe. 

Questions

■ Want to know where to buy water and what the limit is 

 per household

H-8
5-8: Do you accept responsibility for what happened? Participant Comments

Our most immediate concern is the safety of the water.

■ We are working to identify impacted areas.

■ We are working to minimize the spread of the pesticide in

 the system.

■ Our goal is to restore normal service throughout the 

system as quickly and safely as possible.

We will help determine the cause of the incident.

■ It is possible that the contamination was unintentional.

■ We are working closely with law enforcement as they 

conduct their investigation of the incident.

■ The investigation should identify the source of

 contamination.

We are responsible for making changes in our operations, 

if needed.

■ After the incident has been addressed, standard procedure

is to review our emergency response plan and make any 

necessary changes to improve it.

■ We will review the actions we took following the 

discovery of the pesticide.

■ We will know more once the investigation is complete.

Important Information

■ Shouldn’t they know what to do (continuity plan)?

■ Feel insecure and unsettling

■ Reassuring because they have made it seem like they 

 have a plan and were double checking.

■ “Our goal” too vague; they should know what the 

problem is.

■ Part two was scary because obviously something is bad 

-- alarming?

■ Seems like they are scrambling.

■ Feel nervous because nothing’s been done yet.

■ Makes me feel optimistic.

■ Working on finding impacted area -- you have no idea 

about affected area.

■ Language is too vague.

■ Want public to know it’s a problem, but make everyone 

feel like they are part of impacted area until you can 

 verify exactly.

■ Doesn’t really answer question.

■ I want to hear what you are doing. What are you working

on?

■ Not really telling us anything; doesn’t speak to the 

question of responsibility.

■ More details

■ Need to know what you are doing now.

■ Low priority question

Change/Modification

■ First section, first and second bullet could be combined; 

can get rid of second bullet

■ Third bullet actually answers the question.

H-9
5-9: How are You Going to Clean the System? Participant Comments

We are evaluating which parts of the distribution system 

need to be cleaned.

■ We will take samples from throughout the distribution 

 system.

■ We will analyze the samples to determine where pesticide

is present in the system

■ We will also use water-flow models to determine which 

parts are affected.

We will use flushing and other cleaning methods as 

applicable.

■ We are consulting with experts at federal, state, and local 

 agencies.

■ We will select methods that are safe and effective for 

dealing with pesticides.

■ We will select cleaning methods that will enable us to 

meet regulatory requirements for this pesticide.

We will selectively replace pipes if needed.

■ We will replace pipes based on results from the testing 

program.

■ Replacement pipes are readily available.

■ We have extensive experience replacing pipes.

Important Information

■ Secondary message

■ Could have just said we are working hard to fix situation.

■ See it as a secondary press release; add link for more 

 information.

■ Doesn’t seem really important in the scheme of things.

5-10: Once it is cleaned up, how will you know 

if the water system is safe?

Participant Comments

Testing will confirm the absence of harmful levels.

■ We will collect water samples at multiple locations along

the distribution system.

■ Samples will be tested for [insert pesticide name] at 

laboratories.

■ The tests are highly accurate in detecting the pesticide.

Federal and state agencies determine what level is 

considered safe.

■ The water system will not be put back into service until 

the contamination is reduced below this level.

■ This cleanup level is based on protecting human health 

against long-term effects for all age groups.

■ The public health department will verify that levels are 

 safe.

We will continue testing to ensure that levels remain safe.

■ We will monitor for elevated levels of the pesticide.

■ We will report any problems and take necessary actions.

■ Water users should report any unusual odors, coloration,

or other problems by calling our hotline at [insert 

number].

Important Information

■ Last bullet makes people worry; after you did all this 

 testing, it gets to my house and still smells.

■ Where the hell else are they going to test water?

■ Don’t need too much information, just enough.

■ Some details are important but don’t leave room for more

questions.

■ This is conforming to federal standards not my state.

■ Reduce below safe level, still not using water; sounds

vague! Give me a number of how far below safe level it 

will be. 

Change/Modification

■ Feels like federal and state should be first.

■ Move procedural information up front.

Questions

■ IS there a standard process?

■ How often and how long? Give specific numbers.

 

H-10
5-11: How do you normally know 

the water is safe to drink?

Participant Comments

We continuously test the water for safety.

■ The law requires us to check water safety daily.

■ We continually meet or do better than water quality

standards set by the U.S. Environmental Protection 

 Agency.

Testing is done in partnership with the local health 

department.

■ The water utility and the local health department

have experts on staff with specialized knowledge of 

testing procedures.

■ Our experts test the water daily.

We will inform you when testing shows that the water is 

safe to drink and use.

■ We will provide updates through the media.

■ We also post updates on water quality on our Web site at 

[insert Web address].

■ People can also call our telephone hotline for updates at 

[insert number].

Important Information

■ It’s good that it gives someone without computer access a

number to call.

■ Define what agency is talking -- “us.”

■ The law requires to test water daily. Who wouldn’t do 

that?

■ Does daily need to be said twice? 

■ Was surprised they checked water daily; thought it was 

once a week, monthly.

■ For the most part do like 3 statements.

■ Pretty reassuring

■ Like phone number information.

Change/Modification

■ Change order to 2, 3, 1

■ Reword: tested throughout the day

Questions

■ How many times daily?

6-1: What happened? Participant Comments

Terrorists contaminated part of the water system with 

[insert biological agent].

■ People have reported gastrointestinal illness.

■ [Insert biological agent] causes nausea, vomiting, and 

diarrhea, but it is generally not life threatening.

■ If you are experiencing symptoms, please seek immediate

medical attention.

We have contained the contamination [insert map showing 

system and indicating affected area].

■ The affected area has been isolated from the rest of the 

water system.

■ Sampling for additional contaminants is currently being 

performed.

■ Additional public announcements will be made as more 

information becomes available.

We recommend people living in this area [insert 

boundaries] boil their water.

■ Bring your water to a rolling boil for [insert number] 

minutes and let cool before drinking.

■ Fact sheets and other information are available on 

the following Web site [insert Web site] or at our toll-free

telephone line [insert telephone number].

■ Alternative drinking water is available at [insert address 

of location].

Important Information

■ Who understands gastrointestinal? Understand reading 

level and target audience.

■ It’s too broad saying terrorist contaminated -- 

 try to narrow it down.

■ I will call doctors office but some people will go to ER 

because they don’t have insurance.

■ “Additional public announcements” could be alarming. 

You mean there’s more? 

■ The word “terrorist” illicits fear; until sure do not raise 

 fear.

■ Terrorist -- people think of 9/11 immediately.

Change/Modification

■ Add media for adding facts on this message.

Questions

■ How severe is this?

■ What is alternative drinking water? Be more clear.

H-11
6-2: What can you tell us about this contamination event? Participant Comments

There has been an intentional contamination of the water 

system.

■ We are currently working with local law enforcement and

the FBI in response to this event.

■ We know the location of the point of introduction [insert

location], and are currently working to define the area 

affected.

■ We are also working to sample our entire system for 

indication of other areas that may be contaminated.

Most people infected with this bacterium will have mild to 

moderate illness.

■ [Insert biological agent] infection can cause diarrhea and 

 vomiting.

■ The very young and old, and people with weakened 

immune systems are typically most at risk.

■ If people are having symptoms, they should consult their 

physicians.

We have issued a “do not use” notice in response.

■ “Do Not Use” means do not use the water for drinking, 

bathing, or cooking. It is safe to flush toilets.

■ We are recommending the use of alternative sources

(such as bottled water) until we lift the “do not use” 

 notice.

■ We are working to contain and clean up this

contamination and will provide more information as soon 

as it becomes available.

Important Information

■ Hits a lot of important points.

■ Covered base really well; but it’s a premature script.

■ Need to say “will keep you updated.”

■ Makes me nervous: infection and symptoms; knowing

people getting sick and you don’t know how severe it’s 

going to be doesn’t make me feel good.

■ Saying they don’t know if other areas are affected may 

make people more worried.

■ “Biological agent” most people won’t understand and it 

can cause more questions.

■ Very last bullet is a good conclusion.

Change/Modification

■ “Do not use” part should be moved up before people 

getting sick.

Questions

■ I want to know how long.

H-12
6-3: Do you know exactly where the contaminant 

is within the drinking water system?

Participant Comments

We know the source of the contamination.

■ The police and FBI have identified a location in the

[insert name] neighborhood where the contaminant was 

introduced.

■ The police are currently treating this contamination event

 as an act of terrorism.

■ Evidence collected at the scene confirms that the source 

of the water contamination came from this location.

We are currently working to clearly define the area 

affected.

■ We are sampling and analyzing the water system around 

 that location.

■ We are looking at the water distribution system to 

specifically define the affected area.

■ Sample results can be expected from the laboratory 

within 48 hours.

At this time, illness has been reported only in this area 

[insert boundaries].

■ In addition to the localized sampling, we are sampling 

throughout the system for evidence of contamination.

■ Preliminary water quality testing indicates that this 

contamination has not spread throughout the system.

■ If you have questions as to whether or not you may be

affected by this event, please call our 24 hour hotline at 

[insert number].

Important Information

■ Letting us know you know the source helps with anxiety 

 level.

■ Third bullet under first section was confusing; sounds 

redundant and unnecessary.

■ “Preliminary testing” makes me wonder if water really 

 safe.

■ Like hotline information

■ If they saying they are trying to find affected area, it 

contradicts the entire first section about finding it.

■ Terrorist makes panicky; but we are so in tune to hearing 

that now.

■ Be transparent.

■ Makes it more serious; can get attention of people.

■ Sounds like it’s under control; reassured.

■ The hotline will be crowded; use internet and other 

methods.

■ Last bullet point not sufficient.

■ Don’t feel like it’s under control.

■ Concerned that it’s going to take me 48 hours to tell me 

what’s in the water; say we are on it right now, as quickly 

as we can.

■ Inconsistency saying you found it because you name 

neighborhood; then you say you are looking for it

■ Tell me where it is right now.

Questions

■ Do you know what area it’s in?

■ I want to know if CDC is involved.

H-13
6-4: How did public health find out 

there was contamination?

Participant Comments

RODS – our public health surveillance system – showed a 

higher than normal number of illnesses in the community.

■ The Real-time Outbreak Disease Surveillance (RODS) 

system examines emergency department data from area 

hospitals and over-the-counter drug sales.

■ Recent RODS data has shown an increase in the number 

of emergency room patients with diarrhea and GI 

symptoms.

■ RODS data has also shown an increase in the sale of 

over-the-counter anti-diarrheal medications from local 

drug stores.

Water samples were collected by the water utility.

■ Samples were collected within the impacted areas.

■ Samples were collected throughout the distribution 

 system.

■ Additional sampling and analysis will be conducted as 

needed.

Further investigation indicates that the public water 

system is the likely source.

■ The health department interviewed patients to investigate

 the cause of their illness.

■ Clinical laboratory tests supported the diagnosis.

■ The health department worked with the water department

to verify the cases occurred within the water department’s

 service area.

Important Information

■ Third bullet statement is most important.

■ First bullet gives too much information.

■ Can’t believe this would be the first thing they would say.

■ Need stats: How many people hospitalized for GI 

problems?

■ I want to know severity.

■ Felt like they were working on situation.

■ I like them giving symptoms.

■ These symptoms aren’t ones that make people run to 

doctor, can just get over the counter medicine.

■ Makes me feel like this was in water for a while.

■ Monitoring system should be within water system.

■ Unfamiliar with RODS

■ Had to interview patients to understand is not good 

because it means it’s been in water for awhile.

Change/Modification

■ “Samples are collected throughout distribution system” 

should say have collected or are collecting.

■ Get rid of third bullet of first section

■ Third statement should be second.

Questions

■ Would like to know how recent; how long has testing 

been going on?

■ How long have people had symptoms?

■ Just because I have these symptoms doesn’t mean I

automatically go to doctor and the pharmacy (how many 

days could this be)?

■ Do we really rely on the RODS system for diagnosis of 

incident?

H-14
6-5: Can people in the affected area use the water at all 

(bathing, washing dishes, making coffee)?

Participant Comments

If you live in the affected area (see map), your water may 

still contain [insert biological agent].

■ This bacterium can cause illness when people come in 

direct contact with it.

■ The “do not use” notice is based on taking a conservative

stance to protect against any resulting illness.

■ The protection of public health and safety is the basis for 

all aspects of this advisory and response.

This should not affect fire fighting.

■ The fire department has informed us that they will 

continue to use this water as needed to fight fires.

■ Bacteriological contamination of this type does not 

prohibit its use for firefighting purposes.

■ Fire protection will continue during the emergency.

People should avoid direct contact with this water at this 

time.

■ People in this area are advised to not drink, cook, bathe, 

give to pets, or otherwise use the water where personal 

 contact may occur.

■ We are working as quickly as possible to resolve this 

issue and restore full use of the drinking water system in 

the affected areas.

■ We will inform you of any change in the use advisory.

Important Information

■ The third section answers the question

■ First section very important because it’s saying we can’t 

drink or bathe.

Change/Modification

■ Second bullet in first part irrelevant

■ Firefighter information is irrelevant

■ No information about cleaning stuff

■ Think they are giving us a good picture.

■ The firefighting statement is inconsistent. How can you 

use contaminated water for fire? Wouldn’t it spread in 

soil and air? This comes out of left field.

■ Third bullet should be first.

H-15
6-6: What are the health effects associated with exposure to 

[Insert biological agent]

Participant Comments

[Insert agent] is a bacteria that affects the gastrointestinal 

system.

■ Frequent hand washing will help control the spread of 

[insert agent].

■ The water utility has treated the water with higher but 

safe levels of chlorine to kill the [insert agent].

■ Use alcohol-based hand cleaners until the water is safe to 

drink.

Symptoms will generally last for 7 – 10 days.

■ Primary symptoms include nausea, vomiting, and 

diarrhea.

■ People with symptoms should contact their health care 

providers for treatment information.

■ People can call the public health hotline at [insert 

number] for more information about [insert biological 

contaminant].

[Insert agent] does not typically cause long-term health 

effects.

■ [Insert agent] is generally not life threatening.

■ The most vulnerable groups include small children, the 

elderly, and people with weak immune systems.

■ [Insert biological contaminant] infection is treatable by 

[insert treatment].

Important Information

■ Telling me to wash with antibacterial hand washing 

doesn’t compute.

■ Suggest washing hands frequently but not telling why use

antibacterial.

■ Last paragraph was reassuring.

■ Language such as “typically” not settling.

■ Counterintuitive to say water is contaminated but clean 

yourself; verify with consumption, etc.

■ Want percentage.

■ First paragraph bullets don’t support bold statement

Change/Modification

■ Get rid of first bullet or put first and third bullet together.

■ Add web link

Questions

■ You’re putting chlorine in my water. What are the side 

effects?

■ Why not list serious side effects?

■ When will it be safe? Provide date.

■ What’s generally not life threatening? What does that 

mean? List information about severe symptoms.

H-16
6-7: How did the city find out there was contamination? Participant Comments

Hospital reports from [insert names of hospitals] indicate 

higher numbers of cases of ill patients than normal.

■ [Insert number] hospitals have reported a total of [insert 

number] cases during a [insert number]-day period.

■ The number of hospital patients with gastrointestinal 

symptoms is well above normal.

■ The reports were provided to the health department as 

part of the community’s medical tracking system.

The health department identified [insert biological 

contaminant] in the water system as the cause.

■ The health department conducted interviews with ill 

patients to determine the cause.

■ The health department’s investigation also included 

laboratory tests.

■ The health department contacted the water authorities 

and indicated there may be a waterborne problem.

The water utility reports [insert biological contaminant] in 

samples collected from the water system.

■ The water utility initiated testing after notification from 

the health department.

■ The water utility is identifying impacted areas.

■ The water utility will continue to sample and test the 

water, and we will keep you posted.

Important Information

■ Can follow the process and it answers questions but it’s 

not what you want to hear.

■ Proactive to interview ill patients; thought it was positive.

■ Don’t want possibilities tell me yes or no.

■ The water authority only initiated testing after health

department contacted them. Don’t they test water daily, 

and shouldn’t they have found it first?

Change/Modification

■ Add CDC has been notified

■ Restate: would intensify testing; because “initiated” 

 makes it seem as water not tested often.

Questions

■ Why did they wait to do testing until health department 

initiated the call?

■ Isn’t EPA the first agency to deal with biological agent?

H-17
6-8: How or where can people in the 

affected area get safe water?

Participant Comments

Water is being made available to households in the affected 

area [insert boundaries].

■ The city is setting up distribution centers for the affected 

 area.

■ We are able to distribute [insert number] gallons of water

per person.

■ Disabled or other individuals who cannot get to a 

distribution center should call [insert number] for 

 assistance.

Hospitals in the affected area will have supplies of safe 

drinking water.

■ The water utility has arranged for the provision of water 

treatment units for the hospital system.

■ People should not go to a hospital for their household’s 

supply of emergency water.

■ Health clinics in the area are also receiving supplies of 

emergency drinking water.

Please follow the “do not use” drinking water order.

■ People are not to use the water for cooking, bathing, or 

any other personal contact uses, including for pets.

■ Ongoing samples of the water system are being taken.

■ We will let you know when the water is again safe to use.

Important Information

■ Makes me feel good.

■ They have to let us know that they are going to tell us 

when water is safe again. Isn’t that obvious?

■ Do not use: first bullet is confusing; think I can drink it 

 but they don’t want the supply to run low; I think it is 

 referring to bottled water--confusing.

■ Give me the basics: tell me what I can or can’t do .

■ Use social media.

Change/Modification

■ Swap bullets two and three because they are giving two 

different messages

■ Third section: Is this referring to bottled water or tap? 

Add do not use TAP water not bottled water.

Questions

■ Where are distribution centers being set up?

■ Who can they distribute to?

■ So can you go to health centers for water?

■ How are you going to let me know water is safe -- text, 

email, news? Tell me how I will find out; use as many 

mediums as possible.

H-18
6-9: How did this happen? Participant Comments

A terrorist group has claimed responsibility.

■ Police found a note at [insert location].

■ The group who left the note is on the FBI watch list.

■ The investigation to find the perpetrators is ongoing.

Terrorists introduced the bacteria into the location’s 

plumbing system.

■ Police found equipment at the location.

■ Laboratory results verify traces of [insert bacterial agent

in containers near the equipment.

■ Initial tests by the water utility confirm traces of [insert 

bacterial agent] in the water system in the vicinity of this 

 location.

Authorities have found the contamination source.

■ Residents reported suspicious activities in and around 

 this location.

■ Equipment at the location is consistent with this kind of 

attack

■ Fact sheets related to [insert biological agent] bacteria 

were found as well.

Important Information

■ As soon as you give us terrorist information you are 

opening it to copy cat to do it again.

■ Not a fan of word terrorist.

■ I don’t’ care who did it. Bottom line I want to know how

this is affecting me and when will it stop.

■ Opens questions about what other things may be 

happening.

■ Noting contaminated source was positive.

■ Let us know if there are other anticipated dangers.

H-19
H-20
Contacts for More Information

Scott Minamyer

U.S. Environmental Protection Agency

National Homeland Security Research Center

Cincinnati, OH 45268

minamyer.scott@.epa.gov

Cynthia Yund, Ph.D.

U.S. Environmental Protection Agency

National Homeland Security Research Center

Cincinnati, OH 45268

yund.cynthia@epa.gov

Appendix I

Dick Tardif, Ph.D.

Oak Ridge Institute for Science and Education

Oak Ridge, TN 37830

Richard.Tardif@orise.orau.gov

I-1
I-2

Notes
Notes
Notes

PRESORTED STANDARD

POSTAGE & FEES PAID

EPA

PERMIT No. G-35

Office of Research and Development

National Homeland Security Research Center

Cincinnati, OH 45268

Official Business

Penalty for Private Use

$300

EPA/600/R-12/020

April 2012

www.epa.gov/ord

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