Current Environmental Health Reports (2020) 7:129–139

https://doi.org/10.1007/s40572-020-00267-4

WATER AND HEALTH (T WADE, SECTION EDITOR)

Private Wells and Rural Health: Groundwater Contaminants

of Emerging Concern
Debbie Lee 1 & Heather M. Murphy 1

Published online: 28 January 2020

# Springer Nature Switzerland AG 2020

Abstract
Purpose of Review Approximately 12% of the population in the US and Canada rely on federally unregulated private wells,
which are common in rural areas and may be susceptible to microbiological and chemical contamination. This review identifies
and summarizes recent findings on contaminants of emerging concern in well water across the US and Canada.
Recent Findings Private well water quality modeling is complicated by the substantial variability in contamination sources, well
construction, well depth, and the hydrogeology of the environment surrounding the well. Temporal variation in contaminant
levels in wells suggests the need for monitoring efforts with greater spatial and temporal coverage.
Summary More extensive private well monitoring will help identify wells at greater risk of contamination, and in turn, public
health efforts can focus on education and outreach to improve monitoring, maintaining, and treating private wells in these
communities. Community interventions need to be coupled with stricter regulations and financing mechanisms that can support
and protect private well owners.

Keywords Privatewells . Domestic wells . Ruralhealth . Groundwater . Microbiological contamination . Chemical contamination

Introduction people) in 2010 relied on domestic wells for household water

The regulation of municipal drinking water has had profound
implications for public health in the United States (US) and
Canada. In the US, municipal drinking water regulation oc-
curs at the federal level under the US Environmental
Protection Agency (EPA) while in Canada, regulation occurs
at the provincial and territorial level although the Federal-
Provincial-Territorial Committee on Drinking Water (CDW)
has established Guidelines for Canadian Drinking Water
Quality. Most people in these two countries are served by
public water systems, which are federally regulated and regu-
larly tested for potential harmful contaminants such as micro-
organisms, disinfectants, disinfectant byproducts, organic
chemicals, inorganic chemicals, and radionuclides. However,
an estimated 12–14% of the US population (37.3–43.2 million
This article is part of the Topical Collection on Water and Health
* Heather M. Murphy
heather.murphy@temple.edu
1
Department of Epidemiology and Biostatistics, College of Public
Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter
Annex – 9th Floor, Philadelphia, PA 19122, USA
use (a map estimating the density and distribution of private
wells in the US can be found in Fig. 1) [2•, 3]. In Canada, an
estimated 12% of the population (4.1 million people) relied on
domestic wells in 2011 [4•]. Domestic wells are most com-
monly used in rural settings in the US and Canada though
some suburban and peri-urban populations also rely on these
water sources.
In the US and Canada, private, or domestic, wells (serving
fewer than 25 residents) are not federally regulated although
many states/provinces/counties regulate standards for well
construction and testing prior to real estate transactions.
Even so, households with private wells are responsible for
regularly monitoring and maintaining their wells. In one study
in Pennsylvania, which does not regulate private wells, 30%
of participants reported never testing their wells and 44% re-
ported testing their wells just once [5]. In a survey in
Wisconsin, approximately half of respondents reported testing
their wells in the past 10 years and only 10% reported testing
in the past year [6]. Researchers across various disciplines
have examined well water quality but these efforts are often
limited to the local and regional scale because different geo-
graphic and geologic areas face region-specific water quality
challenges. Furthermore, studies on private wells focus on
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Fig. 1 Estimated density and distribution of the contiguous US population served by private wells in 2010. Map produced by Tyler D. Johnson and
Kenneth Belitz (US Geological Survey) using a Block-Group Method (BGM) with a spatial resolution of 1 km [1]
specific contaminants and their concomitant fate and transport
processes. These disparate studies, while necessary, compli-
cate efforts to estimate the multi-faceted public health burden
associated with untreated well water.
For this review, we present the most recent research on
contaminants of public health concern in well water in the
US and Canada (a summary of the major contaminants of
concern and key recent literature can be found in Table 1).
In light of the low prevalence of private well monitoring,
maintenance, and treatment, a large portion of the population
in the US and Canada is at elevated risk of chronic and acute
exposure to numerous groundwater contaminants in private
well water supplies.
Mechanisms of Private Well Contamination
There is a wide range of private well construction in the US
and Canada. Dug wells, often found at older homes, are the
Curr Envir Health Rpt (2020) 7:129–139
most prone to contamination—they lack continuous casing
and are shallow [7]. Driven wells are constructed by driving
a pipe into the ground and, while they have continuous casing,
they also source water from shallow aquifers [7]. Drilled wells
are the deepest of the three types and some are cased the entire
depth, but practices vary by state/province [7].
Private wells can become contaminated when pollutants
are transported through the environment (via surface and
sub-surface transport) and enter wells as a result of vulnera-
bilities in well construction (e.g., gaps in casing, grout seals)
or contamination of the aquifer itself [8–10]. In rural areas,
sources of contamination include agricultural activity (e.g.,
animal feeding operations, biosolid/fertilizer application), in-
dustrial activity, and septic and sewer systems [11–13, 14, 15•,
16]. Aging septic systems can leach contaminants into the
environment. Setback distances are often implemented to min-
imize the influence of septic system leachate on well water
quality but these distances may be insufficient depending on
Curr Envir Health Rpt (2020) 7:129–139 131

Table 1 Major contaminants of concern for private wells and key recent literature on these contaminants

Major sources of contamination Key recent literature

Microbiological Bacteria Agriculture; septic system leachate; sewer leakage Murphy et al. 2016
Fout et al. 2017
Viruses Agriculture; septic system leachate; sewer leakage Murphy et al. 2016
Fout et al. 2017
Protozoa Agriculture; septic system leachate; sewer leakage Murphy et al. 2016
Stokdyk et al. 2019
Chemical Nitrates Agriculture; septic system leachate Ward et al. 2018
Arsenic Geogenic; anthropogenic (e.g., industrial, agricultural) Ayotte et al. 2017
Ying et al. 2017
Manganese Geogenic Ying et al. 2017
Lead Plumbing materials Jurgens et al. 2019
PFAS Firefighter training/fire response sites; industrial sites; Hu et al. 2016
wastewater treatment plants/biosolids; landfills Guelfo et al. 2018

PFAS Per- and Polyfluoroalkyl Substances

well construction and the surrounding hydrogeology [17, 18].
Soil acts as a natural filter for many contaminants but certain
aquifers are associated with rapid routes for pathogen trans-
port. For example, in regions with karst or fractured bedrock,
contaminants may be easily transported via fractures and con-
duits [11, 19]. These geological influences exacerbate issues
of well contamination.
Microbiological Contaminants and Disease Risk
Groundwater in the US and Canada is often presumed to be
free of waterborne pathogens, while surface water or ground-
water under the direct influence of surface water (GWUDI)
are considered susceptible to contamination. Under the
Surface Water Treatment Rules, the US EPA requires all pub-
lic water systems using surface water or GWUDI comply with
treatment standards. However, human pathogens of concern,
including viruses, bacteria, and protozoa, are detected in
groundwater across North America—even in supplies not un-
der the influence of surface water [20].
The small size of viruses makes them particularly suited for
transport in the environment [21]. The conventional under-
standing is that deep aquifers are protected from microbial con-
tamination; however, viruses have been detected in deep water
supplies [13]. Of 1204 water samples from homes using mu-
nicipal wells in Wisconsin, 24% were PCR-positive for at least
one virus type (adenovirus, enterovirus, norovirus, hepatitis A,
rotavirus) [22]. The knowledge of the occurrence of enteric
viruses in groundwater is not novel [10, 23, 24] but there remain
significant knowledge gaps regarding the extent of viral patho-
gen presence in groundwater across North America.
Larger microbes are also detected in wells. Cryptosporidium,
a protozoan typically considered a surface water contaminant,
has been detected in 40% (n = 58) of public groundwater wells
in Minnesota and prevalence was not associated with surface
water influence of these wells [25•]. Cryptosporidium in the
environment is of particular concern because these organisms
form oocysts that resist degradation [26, 27] and can contam-
inate groundwater sources. In a study of 180 private wells in
an area of Ohio where dairy farms are prevalent, 4% were
PCR-positive for Escherichia coli O157:H7 [28]. Bacterial
contamination (from both pathogens and indicator microor-
ganisms) of well water has been associated with wells that are
either shallow, poorly designed, or poorly constructed
while viral contamination is associated with various well
types [9, 20].
In the US and Canada, drinking water monitoring efforts
are largely limited to chemical contaminants, such as nitrates
and arsenic, and when microbiological contamination is
assessed, indicator organisms, such as total coliform bacteria
or E. coli, are used. Similarly, private well testing is also often
limited to testing for coliform bacteria. Unfortunately, in ad-
dition to the gaps in our understanding of microbiological
contamination of groundwater, there are also knowledge gaps
in the utility of specific indicators of groundwater quality.
Weak correlations continue to be found between fecal indica-
tors and pathogens in private wells [20, 29, 30•]. In a similar
vein, indicators may vary in efficacy for assessments of wells in
different hydrogeological settings. In a meta-analysis of 12 in-
ternational studies of public well water quality, the associations
between indicators and infectious viruses were specific to the
hydrogeology of the area surrounding the well [30•]. These
results suggest that site-specific measures of microbial water
quality may be more appropriate for examining groundwater.
Further research is also necessary to better understand the
presence of opportunistic pathogens in private water supplies.
Following flooding in Louisiana, Legionella spp.,
L. pneumophila, and Naegleria fowleri were detected in
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77.5%, 15.0%, and 20.0% of 40 homes with private wells
even when coliform detection frequency was not notably high
[31]. Legionella and Naegleria fowleri are normally found in
fresh surface water but they can be transported into wells
through sub-surface transport and flooding during extreme
rainfall events. Exposure to community well water was cited
in several Legionella outbreaks in the US from 2013 to 2014
[32]. Most studies of Legionella focus on its presence in large-
scale settings, such as cooling towers and healthcare environ-
ments [33]. Less is known about the risks of Legionella expo-
sure in households relying on private wells. A column study
simulating infiltration under recharge basin conditions in
Arizona demonstrated that, compared to E. coli, Legionella
infiltrated the basins more slowly, likely due to the pleomor-
phism of Legionella, but Legionella persisted at low concen-
trations in the column [34]. Further work on Legionella fate
and transport into private water supplies is necessary to esti-
mate the potential for Legionella exposure through this
pathway.
As previously noted, the geology of the region surrounding
the well may also dictate pathogen contamination. Pathogen
levels in water are attenuated during sub-surface transport
through a combination of adsorption, filtration, straining, di-
lution, and die-off [35]. However, pathogens may be more
quickly transported through the preferential pathways of frac-
tured bedrock than through more porous media [13, 18,
35–37]. These preferential pathways may help pathogens of
various shapes and sizes avoid the filtration processes of po-
rous media and enter private water supplies.
Another emerging concern regarding microbiological con-
tamination of groundwater is the presence of antimicrobial
resistant organisms (ARO) and the transfer of antibiotic resis-
tance genes (ARG). Organisms exhibiting resistance to sever-
al antibiotics have been detected in private well samples in the
US and Canada [16, 38]. The presence of AROs and ARGs in
soil, and ultimately in groundwater supplies, may be initiated
and exacerbated by the loading of human and animal waste in
the environment from wastewater treatment plants, septic sys-
tems, concentrated animal feeding operations, and soil amend-
ments [39].
In addition to recent studies of private well water quality,
there have been several epidemiologic studies of waterborne
disease associated with groundwater in North America. From
1971 to 2008, 30.3% of the 818 waterborne disease outbreaks
in the US were attributed to drinking water sourced from un-
treated groundwater, including private wells [40]. In a system-
atic review of waterborne disease outbreaks related to small,
non-community drinking water systems in Canada and the
US, 81.4% of outbreaks that reported a water source were
attributed to groundwater [41]. One study estimated that
0.027 cases of acute gastrointestinal illness per person-year
could be associated with the consumption of contaminated
groundwater from untreated private wells in Canada [42].
Curr Envir Health Rpt (2020) 7:129–139
Our crude application of this estimate to the US results in an
estimate of 1.29 million annual cases of AGI attributed to
untreated private well water consumption.
In one study of the risk factors for child enteric infection in
Washington State, using a private well for drinking was asso-
ciated with a sixfold increase in the risk of Salmonella infec-
tion and the use of a residential septic system was associated
with the elevated risk of infection with Salmonella and E. coli
[43]. In a North Carolina study, 99% of emergency department
visits for acute gastrointestinal illness attributed to drinking
water were estimated to be associated with private well water
consumption [44].
While microbiological contamination has been continually
detected in groundwater [24, 30•, 45] and an increasing num-
ber of studies are beginning to focus on the health implications
of this issue for private well users, there is still a paucity of
evidence on which we can base any robust estimates of the
burden of disease attributed to exposure to waterborne patho-
gens in private well water in the US and Canada.
Chemical Contaminants
Nitrates
The US EPA and Canada’s CDW set the maximum contami-
nant level (MCL; EPA) or maximum acceptable concentration
(MAC; CDW) of nitrate in drinking water to 10 mg/L to
address methemoglobinemia or blue-baby syndrome in in-
fants [46]. Chronic exposure to even low levels of nitrates is
associated with adverse health outcomes in adults, including
colorectal cancer and thyroid disease [47•]. Public water sys-
tems in the US are obligated to monitor nitrate levels and
notify the US EPA of instances of MCL violations. Nitrate
level violations in public water systems using groundwater
in the US have generally increased since 1994 [48].
Nitrates are naturally found in the environment but can be
present at high levels in wells that are constructed improperly
or proximal to the application of fertilizers and disposal of
human, animal, and industrial waste. Recent models of nitrate
concentrations in private wells in Iowa indicate that some of
the most important risk factors for nitrate contamination are
well depth (shallower wells have a higher risk for contamina-
tion) and distance to animal feeding operations [49]. Nitrate
contamination of private wells may also be attributed to septic
system leachate [50].
Monitoring wells across the US provide information on
nitrate concentrations but evidence shows that groundwater
supplies exhibit spatiotemporal variation that may not be cap-
tured by these monitoring efforts. In one comparison of mon-
itoring and private wells in North Carolina, monitoring wells
had highly variable and sometimes high levels of nitrates
while private wells had widespread low levels of nitrates
[51]. More extensive efforts to characterize nitrate levels in
Curr Envir Health Rpt (2020) 7:129–139
private well water supplies will help improve estimates of the
risk of nitrate exposure across the US and Canada.
Lead
Lead exposure can have profound effects on the cognitive
development of children [52] but chronic exposure to even
low levels of lead can have adverse health outcomes for
adults, such as cardiovascular disease and cancer [53, 54].
The US EPA Action Level for lead concentrations in drinking
water is 15 μg/L and Health Canada recently lowered their
maximum acceptable lead concentration to 5 μg/L in
March 2019. Groundwater does not typically have high levels
of lead but elevated (≥ 7.5 μg/L) and high (≥ 15 μg/L) con-
centrations in groundwater are often found in the eastern and
southeastern US [55•]. Lead exposure through drinking water
is more commonly linked to leaching from leaded plumbing
materials in the distribution system (connections from water
main to house) as well as in premise plumbing. To address the
potential for lead contamination of drinking water, under the
US EPA’s Lead and Copper Rule, public water systems are
responsible for monitoring lead concentrations at customer
taps and ensuring that concentrations at 10% of taps do not
exceed 15 ppb. The Reduction of Lead in Drinking Water Act
(RLDWA) was enacted in 2014 to reduce the amount of lead
allowable in materials, devices, and components of water sys-
tems previously deemed to be “lead-free.” However, these
regulations do not apply to private water supplies and house-
holds relying on these drinking water sources continue to be
vulnerable to lead contamination.
Pipe corrosion leads to the leaching of lead into drinking
water and so, when necessary, water utilities also apply a
corrosion inhibitor, such as orthophosphate [56]. The recent
concerns of lead exposure in Flint, Michigan, occurred when
the utility switched to a more corrosive water source but did
not implement corrosion control measures. The crisis in Flint
demonstrated a scenario resulting from a confluence of issues
(the presence of leaded plumbing materials and corrosive wa-
ter and an absence of corrosion control) that, while rare for a
typical public water system, can be a concern for private wells.
These issues of corrosion are of particular concern for older
homes with older private wells and plumbing systems—many
homes built before 1986 used lead pipes, plumbing, and/or
solder—and in areas where water is naturally corrosive.
Corrosive water has been noted in eastern regions of the US
and Canada [57, 58]. Acidic groundwater, which is common in
shallow wells, is associated with greater lead levels in drinking
water [59, 60]. Prior work on the risks of lead exposure have
focused mainly on municipally-sourced water (which is often
less corrosive) and thus, risk estimates based off of these lead
concentrations may underestimate risk for private well users.
Even when states regulate well construction standards,
there are no regulations for materials within the well and the
133
onus is on well drillers to promote best practices, including the
use of lead-free plumbing materials. People living in older
homes, in particular, should be encouraged to test and treat
their drinking water, but even those in newer homes may
benefit from testing if they live in areas where the geochemical
conditions are amenable to lead leaching. Geochemical
models have been used to map lead solubility potential in
untreated groundwater across the US, which may help indicate
regions where private well users may be more susceptible to
lead exposures [55•]. These types of models can be incorpo-
rated into environmental health initiatives to identify popula-
tions at greater risk.
Per- and Polyfluoroalkyl Substances
Per- and polyfluoroalkyl substances (PFAS) including
perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate
(PFOS) pose increasing water quality and environmental
health concerns. PFAS are used for myriad purposes, includ-
ing non-stick coating for cookware and firefighting foam.
Once released into the environment, they are highly resistant
to degradation and conventional forms of treatment [61–63]. It
is still unknown how long PFAS may persist in the environ-
ment. PFAS exposure has been associated with adverse health
outcomes, such as kidney and testicular cancer, ulcerative co-
litis, high cholesterol, and thyroid disruption [64–67].
As part of the US EPA’s Unregulated Contaminant
Monitoring Rule (UCMR), every 5 years, certain public water
systems in the US monitor a set list of unregulated contami-
nants in their water. In the third and most recent round of this
monitoring (UCMR3), water samples were examined for six
PFAS species, including PFOS and PFOA. The presence and
levels of PFAS contamination in monitored public water sys-
tems were associated with proximity to military fire training
sites, industrial sites that manufactured or used these com-
pounds, and wastewater treatment plants [15•]. Of samples
containing PFAS, 72% came from public water systems with
groundwater sources [68•]. PFAS composition differed de-
pending on the water system’s source water type (groundwater
vs. surface water). Public water systems with groundwater as
their source had higher ratios of perfluoroalkane sulfonates
(PFSA), which include aqueous film-forming foams (AFFF;
a type of firefighting foam), while systems that sourced from
surface water were predominantly composed of perfluoroalkyl
carboxylates (PFCA), associated with fluoropolymer
manufacturing. These differences in composition may be at-
tributed to the mode by which these contaminants are intro-
duced into the environment. AFFF, predominant in ground-
water sourced systems, are diffusely applied to land and can
subsequently contaminate groundwater sources through sub-
surface transport. PFCA on the other hand, is commonly
linked to manufacturing and landfill leachate. These charac-
terizations of PFAS composition in surface and groundwater
134
can point to key sources of contamination in these water
sources.
PFOS and PFOA, which are long-chain PFAS, are current-
ly being phased out but are being replaced by short-chain
PFAS instead. These short-chain PFAS have higher water sol-
ubility and increased mobility in water. Further work is nec-
essary to determine how these shifts in PFAS use may impact
PFAS composition and levels throughout the environment and
in turn, PFAS exposure through groundwater.
Prior monitoring efforts have focused on large public water
systems and less is known about private well water quality. In
the UCMR3, smaller systems had a lower probability of hav-
ing PFAS but when PFAS was detected, the levels were higher
(average concentration of 0.30 μg/L vs. 0.17 μg/L) [68•]. It is
not certain if this could be extrapolated to private wells, but
there are several instances where major contamination of
PFAS has impacted private wells. In one study in Ohio and
West Virginia, PFOA was detected in private drinking wells
near a fluoropolymer manufacturing facility—the median
concentration was 0.2 μg/L, below the US EPA’s provisional
health advisory (PHA) level of 0.4 μg/L, but some private
wells near the facility had levels ranging from 2.1 to
13.3 μg/L [69]. In another study in Decatur, Alabama, where
wastewater treatment plant biosolids were applied onto agri-
cultural fields, PFOA was detected in samples from nearby
private drinking water wells at concentrations ranging from
0.6 to 2.1 μg/L [70]. These studies indicate that proximity to
major PFAS sources may be important risk factors in PFAS
contamination in private well water. Evidence also suggests
that PFAS in septic system leachate may also ultimately enter
private water supplies [14].
Arsenic and Manganese
Arsenic is naturally present in the sub-surface environment
across North America. Chronic exposure to arsenic is associ-
ated with numerous negative health effects, including cardio-
vascular disease, adverse pregnancy outcomes, and infant
mortality [71, 72]. Local- and regional-scale models of arsenic
concentrations in groundwater have been developed but few
studies have estimated these concentrations at the national
scale. One recent assessment serves to fill this knowledge
gap and estimates that 2.1 million people in the contiguous
US are exposed to high levels of arsenic (> 10 μg/L) [73•].
The presence of arsenic in groundwater has long been docu-
mented in several regions of the US and Canada, notably in
the northeastern parts of the US and Canada and southwestern
regions of the US [74, 75]. Geogenic arsenic levels in ground-
water are driven by geologic sources, geochemical factors,
and hydrology, and thus, there is substantial geographic vari-
ation in arsenic levels across North America. However, an-
thropogenic sources, such as industrial and agricultural activ-
ities, can also contaminate groundwater [76].
Curr Envir Health Rpt (2020) 7:129–139
At the local level, arsenic concentrations can vary widely
between neighboring wells and recent evidence suggests that
temporal variation may be present within some wells [77–80].
Private wells are associated with lower variability in arsenic
concentrations, which may be due to low pumping rates, but
variability in both public and private wells may be largely
influenced by geochemical conditions, such as redox changes
[77]. These results have implications for monitoring efforts—
repeat sampling may be necessary to adequately capture the
extent of arsenic contamination at any given well, public or
private.
Manganese, like arsenic, is geogenic and once dissolved
into groundwater, can be mobilized and transported into pri-
vate water supplies [81]. The adverse health impacts of occu-
pational exposure to high manganese levels have been known
for nearly 200 years [82]. Animal and occupational exposure
studies have demonstrated the neurotoxic effects of manga-
nese exposure [83, 84]. However, less is known about the
impacts of chronic low-level exposure to manganese through
drinking water. In one cross-sectional study of children from
Quebec, Canada, manganese levels in drinking water were
inversely associated with lower IQ scores [85]. However, in
another cross-sectional study of children from New
Brunswick, Canada, low-level exposure was not associated
with lower cognitive development though results suggest that
exposure may be disproportionately detrimental to women—
girls exhibited lower Performance IQ scores but the opposite
was true for boys [86].
In one study of 43,334 wells across the US, elevated man-
ganese concentrations (> 300 μg/L) were detected in 12.9% of
samples and it was estimated that 7% of people relying on
domestic wells potentially consume groundwater with elevat-
ed manganese levels [87]. Dissolved manganese concentra-
tions are inversely related to well depth [81, 87, 88•] and thus,
those relying on shallow aquifers may be at heightened risk of
exposure. Redox parameters, while potentially useful for in-
dicating arsenic contamination, are not indicative of manga-
nese contamination [88•]. Furthermore, manganese may indi-
rectly impact exposure to other contaminants: high levels of
iron and manganese in groundwater can lead to scaling of
household water treatment methods, thereby limiting their ef-
fectiveness [89, 90].
Conclusions
Large-scale monitoring of private wells is significantly lack-
ing. Studies of private water supplies are often limited in
scope, in terms of surveillance period, geography, and the
contaminant of interest. Differences in the types and sources
of contaminants, hydrogeologic factors, and well construction
necessitate monitoring efforts at the national scale. Better
characterizing the vast array of potential physical, chemical,
Curr Envir Health Rpt (2020) 7:129–139
and biological contaminants in private water supplies will in-
form our estimates of the risks associated with private well
water consumption, which can in turn, effectuate policy mea-
sures to improve rural, suburban, and peri-urban health.
Further research is needed on the impacts of climate on
groundwater contamination. Precipitation can mobilize con-
taminants in soil and transport them into groundwater supplies
through infiltration. Numerous studies in the US have pointed
to the elevated risk of contaminant exposure through ground-
water following elevated precipitation [12, 13, 31, 36, 91].
However, for some contaminants, increased precipitation
may be associated with a lower risk of exposure. Increased
precipitation may result in the dilution of groundwater con-
taminants [92, 93]. Additionally, precipitation may be inverse-
ly related to arsenic concentrations in groundwater due to
geochemistry [73•, 77]. As the water table drops, there is
increased potential for oxidation of arsenic-bearing sulfides,
which may ultimately result in increased arsenic concentra-
tions in groundwater [93]. Projected changes to precipitation
levels, extreme event frequency, and patterns of wetting and
drying may pose hazards that disproportionately impact rural
communities relying on private wells. It is important to note
that many of the issues associated with private wells are also
faced by small, rural water systems that rely on compromised
groundwater sources but often do not have the resources to
adequately address these issues. Groundwater contamination
is thereby of serious concern for both private and public water
systems in rural communities.
Households can use various methods to address the con-
taminants previously described. For private wells contaminat-
ed with PFAS, granular activated carbon (GAC) filters or an-
ion exchange resins (AER) can be used for long-chain PFAS
[94, 95]. For wells with microbiological contamination, re-
verse osmosis, UV, and chlorination are efficacious forms of
treatment [96]. Various treatment options also exist for arse-
nic, manganese, lead, and nitrates [96]. However, as indicated
by previous studies of private well stewardship, private well
users rarely test their water [5, 97•] and thus may be unaware
of their potential exposures.
Because private well regulations only exist at the state/
province/county level and are largely limited to the drilling
and testing of new wells (with a few areas requiring testing
during property sales), testing is mostly done at the well user’s
discretion. Obstacles to testing and treating well water include
cost, knowledge of site-specific water quality issues, and
awareness of ways to test and treat well water [5, 6, 97•, 98].
Awareness of water quality issues may motivate households to
seek treatment options. In one study, after notifying house-
holds of at least one health-based water quality issue, 76%
of these households proceeded to treat or better manage their
wells [5]. However, another analysis in Ontario, Canada, in-
dicated that water testing behavior change through knowledge
alone was limited [99]. Thus, a multi-faceted approach that
135
includes outreach, education, regulations, and financial assis-
tance is likely necessary to promote private well stewardship.
To address some of these obstacles in the immediate term,
local public health and environmental protection agencies can
provide comprehensive information to homeowners on ways
to manage wells to prevent contamination, recommend
accredited water quality testing laboratories, identify region-
specific water quality contaminants of concern, and recom-
mend efficacious, yet affordable treatment options. Water
quality testing laboratories can ensure that test results are ac-
companied by accessible explanations of results and sugges-
tions for treatment. One potential method of promoting testing
frequency may be to provide a service, either privately or
publicly, through which households receive regular water test-
ing. Local government groups, non-profits, and foundations
can also provide financial assistance to help low-income
households access both water quality tests and water treatment
systems. Many provinces in Canada provide free water testing
for private water systems. In the longer term, stricter regula-
tion of private wells is required (construction and water qual-
ity and treatment regulations) by state/province and federal
agencies. However, to inform appropriate regulations, more
research is needed on what policy solutions are feasible and
what solutions will protect the health of private well owners.
These combined actions will help develop the longer term
infrastructure through which rural households will receive
the support they need to properly manage their wells.
It is also important to note that private well water quality is
an environmental justice issue in many parts of North
America. Socioeconomic status is inextricably linked to ac-
cess to unsafe drinking water quality. Socioeconomic status
can effectuate and exacerbate the public health issues associ-
ated with private wells. For many American households living
near public water systems, reliance on domestic wells arose
from policies that effectively excluded certain communities
from municipal water on the basis of race and socioeconomic
status [100–102]. Households forced to rely on domestic wells
may be exposed to drinking water inferior in quality to the
water available from neighboring community water systems
[103]. Furthermore, for low-income households relying on
private wells, the financial burdens of testing and treating well
water may result in continued exposure to contaminated well
water [104]. In California and Nevada, following water qual-
ity violations at community water systems, many consumers
avoided their tap water and turned to purchasing bottled water
[105]. Similarly, well contamination—and even the percep-
tion of well contamination—may pressure many rural house-
holds to purchase bottled water instead, further straining these
households.
Di Pelino et al. call for a coupled-systems approach that
interweaves our understanding of the physical aspects of im-
proving well water quality (e.g., identifying points of patho-
gen ingress into well water) with the social components
136
underlying these issues (e.g., managing perceptions of well
water quality) [106•]. It is thereby incumbent upon water qual-
ity researchers to continue to elucidate private water supply
hazards and interventions that can mitigate the risks of expo-
sure to these hazards. However, this coupled systems ap-
proach must also incorporate our understanding of the dispar-
ities in exposure to groundwater contaminants driven by race
and socioeconomic status. Given the complexity of water
quality challenges that private well owners face, better under-
standing the full range of social factors related to the manage-
ment of well water is essential to developing efficacious
context-specific treatment and monitoring strategies.
Compliance with Ethical Standards
Human and Animal Rights This article does not contain any studies
with human or animal subjects performed by any of the authors.
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