{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:39:32Z","timestamp":1768293572528,"version":"3.49.0"},"reference-count":43,"publisher":"IWA Publishing","issue":"2","license":[{"start":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T00:00:00Z","timestamp":1548028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005612","name":"Water Research Foundation","doi-asserted-by":"publisher","award":["4572"],"award-info":[{"award-number":["4572"]}],"id":[{"id":"10.13039\/100005612","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Drinking water distribution system contamination incidents can prompt public agencies and drinking water utilities to issue do-not-drink and do-not-use advisories. After the contaminant is cleared from distribution mains, consumers are often directed to flush their plumbing. However, little validated guidance and few evaluated communications strategies are available on using flushing to decontaminate building water systems. Additionally, limited data support the effectiveness of current practices and recommendations. In this study, expert elicitation was used to assess existing flushing guidance and develop validated flushing guidance and communications for single-family residences. The resulting guidance recommends progressively opening all cold-water taps from the closest to point of entry to the furthest and allowing the water to run for at least 20 minutes. Hot-water taps should be opened progressively and run for at least 75 minutes. The guidance language and format conformed to grade-level and readability scores within recommended health communication ranges. The readability of eight other flushing guidance documents was also evaluated for contamination incidents from 2008\u20132015. Seven were written at a 10th\u201312th grade level, above the 6th\u20137th grade level recommended for health communications.<\/jats:p>\n               <jats:p>This article has been made Open Access thanks to the generous support of a global network of libraries as part of the Knowledge Unlatched Select initiative.<\/jats:p>","DOI":"10.2166\/wh.2019.024","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T10:44:35Z","timestamp":1548067475000},"page":"196-203","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":10,"title":["Analysis of building plumbing system flushing practices and communications"],"prefix":"10.2166","volume":"17","author":[{"given":"Lisa","family":"Ragain","sequence":"first","affiliation":[{"name":"Metropolitan Washington Council of Governments, 777 North Capitol St NE #300, Washington, DC 20002, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheldon","family":"Masters","sequence":"additional","affiliation":[{"name":"Corona Environmental Consulting, LLC, 4012 Ridge Avenue, Philadelphia, PA 19129, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy A.","family":"Bartrand","sequence":"additional","affiliation":[{"name":"Corona Environmental Consulting, LLC, 4012 Ridge Avenue, Philadelphia, PA 19129, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Clancy","sequence":"additional","affiliation":[{"name":"Environmental Science, Policy and Research Institute, 4012 Ridge Avenue, Philadelphia, PA 19129, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Whelton","sequence":"additional","affiliation":[{"name":"Division of Environmental and Ecological Engineering and Lyles School of Civil Engineering, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47907-2051, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"945","published-online":{"date-parts":[[2019,1,21]]},"reference":[{"key":"2021021416224169300_JWH-D-18-00024C1","unstructured":"AMWA (Association of Metropolitan Water Agencies)\n          2011\n          Multiagency Response to A Major Water Pipe Break: A Massachusetts Case Study and Evaluation. Washington, DC."},{"key":"2021021416224169300_JWH-D-18-00024C2","volume-title":"Flushing Guidance for Premise Plumbing and Service Lines to Avoid or Address A Drinking Water Advisory","year":"2018"},{"issue":"1","key":"2021021416224169300_JWH-D-18-00024C4","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10648-011-9181-8","article-title":"Reconstructing readability: recent developments and recommendations in the analysis of text difficulty","volume":"24","year":"2012","journal-title":"Educational Psychology Review"},{"key":"2021021416224169300_JWH-D-18-00024C5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.scs.2016.11.008","article-title":"There is no publicity like word of mouth\u2026 Lessons for communicating drinking water risks in the urban setting","volume":"29","year":"2017","journal-title":"Sustainable Cities and Society"},{"issue":"3","key":"2021021416224169300_JWH-D-18-00024C7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5991\/OPF.2012.38.0014","article-title":"Responding to contamination: where do I sample?","volume":"38","year":"2012","journal-title":"Opflow"},{"key":"2021021416224169300_JWH-D-18-00024C8","first-page":"787","article-title":"Decontaminating chemically contaminated residential premise plumbing systems by flushing","volume":"1","year":"2015","journal-title":"Environmental Science: Water Research and Technology"},{"key":"2021021416224169300_JWH-D-18-00024C9","unstructured":"CDC (Centers for Disease Control and Prevention)\n          2016a\n          The Drinking Water Advisory Communication Toolbox. Atlanta, GA. Available at: https:\/\/www.cdc.gov\/healthywater\/emergency\/dwa-comm-toolbox\/index.html."},{"key":"2021021416224169300_JWH-D-18-00024C10","unstructured":"CDC (Centers for Disease Control and Prevention)\n          2016b\n          The CDC Clear Communication Index. Atlanta, GA. Available at: https:\/\/www.cdc.gov\/ccindex\/index.html."},{"issue":"5","key":"2021021416224169300_JWH-D-18-00024C11","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1177\/1062860617751639","article-title":"Readability of online health information: a meta-narrative systematic review","volume":"33","year":"2018","journal-title":"American Journal of Medical Quality"},{"key":"2021021416224169300_JWH-D-18-00024C12","unstructured":"DuBay\n            W. H.\n          \n          2004\n          The Principles of Readability. ERIC Online Submission. Available at: https:\/\/files.eric.ed.gov\/fulltext\/ED490073.pdf."},{"issue":"3","key":"2021021416224169300_JWH-D-18-00024C13","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/1090198105277329","article-title":"A systematic review of readability and comprehension instruments used for print and web-based cancer information","volume":"33","year":"2006","journal-title":"Health Education & Behavior"},{"issue":"5","key":"2021021416224169300_JWH-D-18-00024C14","first-page":"ws2017234","article-title":"Comparing inhalation and ingestion exposure to chemical contaminants and odorants in mixtures","volume":"18","year":"2018","journal-title":"Water Science and Technology: Water Supply"},{"issue":"1","key":"2021021416224169300_JWH-D-18-00024C18","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12989-014-0060-6","article-title":"Role of microbial and chemical composition in toxicological properties of indoor and outdoor air particulate matter","volume":"11","year":"2014","journal-title":"Particle and Fibre Toxicology"},{"issue":"8","key":"2021021416224169300_JWH-D-18-00024C20","first-page":"E332","article-title":"Predicting contaminated water removal from residential water heaters under various flushing scenarios","volume":"109","year":"2017","journal-title":"Journal of the American Water Works Association"},{"issue":"5","key":"2021021416224169300_JWH-D-18-00024C21","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1017\/dmp.2016.193","article-title":"Hospital impact after a chemical spill that compromised the potable water supply: West Virginia, January 2014","volume":"11","year":"2017","journal-title":"Disaster Medicine and Public Health Preparedness"},{"key":"2021021416224169300_JWH-D-18-00024C22","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jhazmat.2017.06.015","article-title":"Crude oil contamination of plastic and copper drinking water pipes","volume":"339","year":"2017","journal-title":"Journal of Hazardous Materials"},{"key":"2021021416224169300_JWH-D-18-00024C23","doi-asserted-by":"crossref","unstructured":"Kincaid\n            J. P.\n          , FishburneJ., RogersR. L. & ChissomB. S.1975Derivation of New Readability Formulas (Automated Readability Index, fog Count and Flesch Reading Ease Formula) for Navy Enlisted Personnel. Naval Technical Training Command Millington TN Research Branch. Available at: https:\/\/apps.dtic.mil\/dtic\/tr\/fulltext\/u2\/a006655.pdf.","DOI":"10.21236\/ADA006655"},{"key":"2021021416224169300_JWH-D-18-00024C24","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1476-069X-9-19","article-title":"The use of expert elicitation in environmental health impact assessment: a seven step procedure","volume":"9","year":"2010","journal-title":"Environmental Health"},{"issue":"1","key":"2021021416224169300_JWH-D-18-00024C25","first-page":"33","article-title":"A preliminary examination of the readability of consumer pharmaceutical web pages","volume":"5","year":"2010","journal-title":"Journal of Marketing Development and Competitiveness"},{"key":"2021021416224169300_JWH-D-18-00024C26","volume-title":"The Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy","year":"2006"},{"key":"2021021416224169300_JWH-D-18-00024C27","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/978-3-319-63254-4","article-title":"Communicating imminent risk","volume-title":"Handbook of Disaster Research","author":"Rodriguez","year":"2018"},{"key":"2021021416224169300_JWH-D-18-00024C28","doi-asserted-by":"crossref","first-page":"EHI-S33383","DOI":"10.4137\/EHI.S33383","article-title":"Exposure path perceptions and protective actions in biological water contamination emergencies","volume":"9","year":"2015","journal-title":"Environmental Health Insights"},{"key":"2021021416224169300_JWH-D-18-00024C30","first-page":"925","article-title":"Community needs assessment after microcystin toxin contamination of a municipal water supply \u2013 Lucas County, Ohio, September 2014","volume":"65","year":"2016","journal-title":"MMWR"},{"issue":"14","key":"2021021416224169300_JWH-D-18-00024C31","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1021\/es980876u","article-title":"Volatilization of chemicals from tap water to indoor air from contaminated water used for showering","volume":"33","year":"1999","journal-title":"Environmental Science & Technology"},{"key":"2021021416224169300_JWH-D-18-00024C32","unstructured":"National Institutes of Health\n          2013\n          How to Write Easy-to-Read Health Materials. Available at: https:\/\/www.nlm.nih.gov\/medlineplus\/etr.html."},{"key":"2021021416224169300_JWH-D-18-00024C33","volume-title":"Drinking Water Distribution Systems: Assessing and Reducing Risks","author":"National Research Council","year":"2006"},{"key":"2021021416224169300_JWH-D-18-00024C35","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.envpol.2016.04.056","article-title":"Subtleties of human exposure and response to chemical mixtures from spills","volume":"214","year":"2016","journal-title":"Environmental Pollution"},{"key":"2021021416224169300_JWH-D-18-00024C36","volume-title":"Identifying the Gaps in Understanding the Benefits and Costs of Boil Water Advisories","year":"2014"},{"key":"2021021416224169300_JWH-D-18-00024C37","unstructured":"Rosen\n            J.\n          , WheltonA. J., McGuireM. J., ClancyJ. L., BartrandT., EatonA., PattersonJ., DoursonM., NanceP. & AdamsC.2014WV Tap Final Report. West Virginia Testing Assessment Project, Charleston, WV, USA."},{"issue":"3","key":"2021021416224169300_JWH-D-18-00024C38","doi-asserted-by":"crossref","first-page":"645","DOI":"10.2166\/wh.2015.194","article-title":"An evaluation of the readability of drinking water quality reports: a national assessment","volume":"13","year":"2015","journal-title":"Journal of Water and Health"},{"key":"2021021416224169300_JWH-D-18-00024C39","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1186\/1471-2458-10-641","article-title":"Communication, perception and behaviour during a natural disaster involving a \u2018Do Not Drink\u2019 and a subsequent \u2018Boil Water\u2019 notice: a postal questionnaire study","volume":"10","year":"2010","journal-title":"BMC Public Health"},{"issue":"11","key":"2021021416224169300_JWH-D-18-00024C40","doi-asserted-by":"crossref","first-page":"11915","DOI":"10.3390\/ijerph111111915","article-title":"The causes and circumstances of drinking water incidents impact consumer behaviour: comparison of a routine versus a natural disaster incident","volume":"11","year":"2014","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"2021021416224169300_JWH-D-18-00024C41","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.scitotenv.2015.08.050","article-title":"Assessing human exposure and odor detection during showering with crude 4-(methylcyclohexyl) methanol (MCHM) contaminated drinking water","volume":"538","year":"2015","journal-title":"Science of the Total Environment"},{"issue":"1","key":"2021021416224169300_JWH-D-18-00024C42","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1186\/s12889-015-2134-2","article-title":"Public response to the 2014 chemical spill in West Virginia: knowledge, opinions and behaviours","volume":"15","year":"2015","journal-title":"BMC Public Health"},{"issue":"5","key":"2021021416224169300_JWH-D-18-00024C43","doi-asserted-by":"crossref","first-page":"e0126744","DOI":"10.1371\/journal.pone.0126744","article-title":"Self-reported household impacts of large-scale chemical contamination of the public water supply, Charleston, West Virginia, USA","volume":"10","year":"2015","journal-title":"PLoS One"},{"key":"2021021416224169300_JWH-D-18-00024C44","volume-title":"Drinking Water Quality in Hospitals and Other Buildings","year":"2017"},{"key":"2021021416224169300_JWH-D-18-00024C45","unstructured":"US EPA\n          1973\n          Safe Drinking Water Act. Code of the Federal Regulations, 42U.S.C. \u00a7300f et seq. 1974, US Environment Protection Agency, Washington, DC, USA."},{"key":"2021021416224169300_JWH-D-18-00024C46","volume-title":"Removing Biological and Chemical Contamination From A Building's Plumbing System: Method Development and Testing","author":"US EPA","year":"2012"},{"key":"2021021416224169300_JWH-D-18-00024C47","volume-title":"Containment and Disposal of Large Amounts of Contaminated Water: A Support Guide for Water Utilities","author":"US EPA","year":"2012"},{"issue":"3","key":"2021021416224169300_JWH-D-18-00024C48","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1289\/ehp.1206229","article-title":"Assessing exposure and health consequences of chemicals in drinking water: current state of knowledge and research needs","volume":"122","year":"2014","journal-title":"Environmental Health Perspectives"},{"issue":"2","key":"2021021416224169300_JWH-D-18-00024C50","first-page":"813","article-title":"Residential tap water contamination following the Freedom Industries Chemical Spill: perceptions, water quality, and health impacts","volume":"49","year":"2014","journal-title":"Environmental Science & Technology"},{"issue":"2","key":"2021021416224169300_JWH-D-18-00024C51","first-page":"312","article-title":"Case study: the crude MCHM chemical spill investigation and recovery in West Virginia USA","volume":"3","year":"2017","journal-title":"Environmental Science: Water Research and Technology"},{"issue":"4","key":"2021021416224169300_JWH-D-18-00024C52","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1080\/08958370601144241","article-title":"Particle size distribution and inhalation dose of shower water under selected operating conditions","volume":"19","year":"2007","journal-title":"Inhalation Toxicology"}],"container-title":["Journal of Water and Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/iwaponline.com\/jwh\/article-pdf\/17\/2\/196\/845968\/jwh0170196.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/iwaponline.com\/jwh\/article-pdf\/17\/2\/196\/845968\/jwh0170196.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T16:30:22Z","timestamp":1613320222000},"score":1,"resource":{"primary":{"URL":"https:\/\/iwaponline.com\/jwh\/article\/17\/2\/196\/65542\/Analysis-of-building-plumbing-system-flushing"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,21]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,1,21]]},"published-print":{"date-parts":[[2019,4,1]]}},"URL":"https:\/\/doi.org\/10.2166\/wh.2019.024","relation":{},"ISSN":["1477-8920","1996-7829"],"issn-type":[{"value":"1477-8920","type":"print"},{"value":"1996-7829","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,21]]}}}