{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T19:07:28Z","timestamp":1767985648407,"version":"3.49.0"},"reference-count":29,"publisher":"IWA Publishing","issue":"6","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Porter Novelli Public Services"}],"content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Tap water that is safe to consume may cause respiratory illness (e.g., Legionnaires\u2019 disease) when water conditions allow for proliferation and aerosolization of biofilm-associated pathogens. This study assessed household tap water consumption, exposure to aerosolized tap water, and associated demographics. A nationally representative FallStyles survey administered by Porter Novelli Public Services was sent to 4,677 US adult panelists in October 2019. There were 3,624 adults who completed the survey (77.5% response rate). Respondents were asked about self-reported use of household tap water for consumption (i.e., drinking, rinsing produce, or making ice) and use through water-aerosolizing devices (e.g., showerheads, humidifiers). Demographics included gender, age, race\/ethnicity, education, income, region, and health status. Weighted analyses using complex sample survey procedures were used to assess tap water exposure by route and demographics. Most US adults are exposed to aerosolized tap water through showering (80.6%), and one in five are exposed through other water-aerosolizing devices (20.3%). Consumption and showering were greatest among older, White, higher educated, and higher-income adults. Aerosolized tap water can transmit waterborne pathogens and cause respiratory illness, especially among older age groups and people with weakened immune systems. These results will help target health messages for using water-aerosolizing devices safely.<\/jats:p>","DOI":"10.2166\/wh.2021.118","type":"journal-article","created":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T12:04:52Z","timestamp":1635509092000},"page":"1014-1020","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":4,"title":["Demographic differences in use of household tap water in a representative sample of US adults, FallStyles 2019"],"prefix":"10.2166","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-3087","authenticated-orcid":false,"given":"Kayla","family":"Vanden Esschert","sequence":"first","affiliation":[{"name":"Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-4194","authenticated-orcid":false,"given":"Catherine E.","family":"Barrett","sequence":"additional","affiliation":[{"name":"Epidemiology and Statistics Branch, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2358-8743","authenticated-orcid":false,"given":"Sarah A.","family":"Collier","sequence":"additional","affiliation":[{"name":"Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda G.","family":"Garcia-Williams","sequence":"additional","affiliation":[{"name":"Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5476-0345","authenticated-orcid":false,"given":"Elizabeth","family":"Hannapel","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan S.","family":"Yoder","sequence":"additional","affiliation":[{"name":"Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5715-5327","authenticated-orcid":false,"given":"Katharine M.","family":"Benedict","sequence":"additional","affiliation":[{"name":"Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"945","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"issue":"22","key":"2021120717163335700_JWH-D-21-00118C1","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.2169\/internalmedicine.9055-17","article-title":"Hypersensitivity pneumonitis caused by a home ultrasonic humidifier contaminated with Candida guilliermondii","volume":"56","year":"2017","journal-title":"Internal Medicine"},{"key":"2021120717163335700_JWH-D-21-00118C3","first-page":"621","article-title":"Achievements in public health, 1900\u20131999: control of infectious diseases","volume":"29","author":"Centers for Disease Control and Prevention","year":"1999","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2021120717163335700_JWH-D-21-00118C4","unstructured":"Centers for Disease Control and Prevention\n          2021a\n          Legionella (Legionnaires\u2019 Disease and Pontiac Fever): Causes, How It Spreads, and People at Increased Risk. Available from: https:\/\/www.cdc.gov\/legionella\/about\/causes-transmission.html (accessed 27 April 2021)."},{"key":"2021120717163335700_JWH-D-21-00118C5","unstructured":"Centers for Disease Control and Prevention\n          2021b\n          Drinking Water: Preventing Waterborne Germs at Home. Available from: https:\/\/www.cdc.gov\/healthywater\/drinking\/preventing-waterborne-germs-at-home.html (accessed 27 April 2021)."},{"key":"2021120717163335700_JWH-D-21-00118C6","unstructured":"Centers for Disease Control and Prevention\n          2021c\n          Legionella (Legionnaires\u2019 Disease and Pontiac Fever): Overview of Water Management Programs. Available from: https:\/\/www.cdc.gov\/legionella\/wmp\/overview.html (accessed 27 April 2021)."},{"key":"2021120717163335700_JWH-D-21-00118C7","unstructured":"Centers for Disease Control and Prevention\n          2021d\n          Legionella (Legionnaires\u2019 Disease and Pontiac Fever): Toolkit for Controlling Legionella in Common Sources of Exposure. Available from: https:\/\/www.cdc.gov\/legionella\/wmp\/control-toolkit\/index.html (accessed 27 April 2021)."},{"issue":"1","key":"2021120717163335700_JWH-D-21-00118C8","doi-asserted-by":"crossref","first-page":"140","DOI":"10.3201\/eid2701.190676","article-title":"Estimate of burden and direct healthcare cost of infectious waterborne disease in the United States","volume":"27","year":"2021","journal-title":"Emerging Infectious Diseases"},{"key":"2021120717163335700_JWH-D-21-00118C9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1353\/dem.2005.0002","article-title":"The role of public health improvements in health advances: the twentieth-century United States","volume":"42","year":"2005","journal-title":"Demography"},{"key":"2021120717163335700_JWH-D-21-00118C10","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1186\/1471-2458-13-1068","article-title":"Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005\u20132010","volume":"13","year":"2013","journal-title":"BMC Public Health"},{"issue":"3","key":"2021120717163335700_JWH-D-21-00118C11","doi-asserted-by":"crossref","first-page":"419","DOI":"10.3201\/eid1703.101510","article-title":"Nontuberculous mycobacteria from household plumbing of patients with nontuberculous mycobacteria disease","volume":"17","year":"2011","journal-title":"Emerging Infectious Diseases"},{"issue":"2","key":"2021120717163335700_JWH-D-21-00118C12","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2166\/wh.2008.232","article-title":"Mycobacterium avium in a shower linked to pulmonary disease","volume":"6","year":"2008","journal-title":"Journal of Water and Health"},{"key":"2021120717163335700_JWH-D-21-00118C13","unstructured":"Fedinick\n            K.\n          , TaylorS. & RobertsM.2019Watered Down Justice, Report NRDC\/Coming Clean\/EJHA. 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Examining perceptions of tap water and bottled water at Purdue University","volume":"48","year":"2011","journal-title":"Environmental Management"},{"issue":"18","key":"2021120717163335700_JWH-D-21-00118C23","doi-asserted-by":"crossref","first-page":"5826","DOI":"10.1016\/j.watres.2011.08.031","article-title":"An in-premise model for Legionella exposure during showering events","volume":"45","year":"2011","journal-title":"Water Research"},{"issue":"8","key":"2021120717163335700_JWH-D-21-00118C24","doi-asserted-by":"crossref","first-page":"207","DOI":"10.15585\/mmwr.mm6908a2","article-title":"Fatal case of Legionnaires\u2019 disease after home exposure to Legionella pneumophila serogroup 3\u2014Wisconsin, 2018","volume":"69","year":"2020","journal-title":"Morbidity and Mortality Weekly Report"},{"issue":"9","key":"2021120717163335700_JWH-D-21-00118C25","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1128\/JCM.00899-13","article-title":"Isolation of nontuberculous mycobacteria (NTM) from household water and shower aerosols in patients with pulmonary disease caused by NTM","volume":"51","year":"2013","journal-title":"Journal of Clinical Microbiology"},{"key":"2021120717163335700_JWH-D-21-00118C26","unstructured":"U.S. Environmental Protection Agency\n          2018\n          Edition of the Drinking Water Standards and Health Advisories. EPA 822-F-18-001, Washington, DC. Available from: https:\/\/www.epa.gov\/sites\/production\/files\/2018-03\/documents\/dwtable2018.pdf (accessed 27 April 2021)."},{"key":"2021120717163335700_JWH-D-21-00118C27","author":"U.S. Environmental Protection Agency","year":"2019"},{"key":"2021120717163335700_JWH-D-21-00118C28","unstructured":"U.S. Food and Drug Administration\n          2019\n          Bottled Water Everywhere: Keeping It Safe. 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