Overview

The Drinking Water Advisory Communication Toolbox provides information on how to plan for, develop, implement, and evaluate communication activities with the public and stakeholders during drinking water notifications and advisories. The approach presented in this document recognizes the differences in scope, scale, and severity of situations that trigger advisories and notifications—a main break, a hurricane, a drop in pressure, or intentional contamination. These differences affect the types of tools, planning, and communication used by drinking water systems and locality often affects the terminology (e.g., “incidents,” “notices,” “alerts,” “orders,” etc.) used to describe these situations.

This toolbox includes instructions on how to prepare for communication activities before an incident, how to communicate during an incident, templates and tools to use, and recommendations for follow-up actions and assessments after an incident. The purpose of the toolbox is to enable water systems to communicate effectively with partners and the public in order to protect public health.

Remember to use Federal Public Notification language when developing advisories when there are violations of National Primary Drinking Water Regulations under the Safe Drinking Water Act. This information can be found in 40 Code of Federal Regulations Part 141 (subpart Q, appendix B).

Figure 1 shows the process for preparing for, issuing, and following up after a drinking water advisory.

Figure 1: Toolbox Flow Chart

Each toolbox section includes a checklist of steps. Not every step applies in all circumstances. Each section has a set of tools that applies to its content. The tools can be adapted by water systems to fit their needs.

This toolbox complements the EPA’s Revised Public Notification Handbook.

Different Names for Different Advisories

Individual states have different names for drinking water advisories depending on the situation. Advisories are frequently called “notices,” “alerts,” and “orders.”

While the original purpose of this toolbox was to focus on communications related to drinking water advisories resulting from microbiological contamination, recent events—including chemical spills and increases in the incidence of harmful algal blooms (HABs)— demonstrated the need to expand the breadth of this document to encompass other timely issues related to drinking water advisories.

To address these needs, this edition contains information regarding chemical contamination, toxin contamination, high rise buildings, and extreme weather events, as well as new fact sheets that provide specific guidance for various types of facilities (e.g., childcare facilities, healthcare facilities). Additional flushing recommendations have also been included and will continue to be updated as more robust guidelines around flushing are developed in the future.

It is our hope that this third edition of the Drinking Water Advisory Communication Toolbox will provide partners and stakeholders with content that addresses current and future needs as they work to effectively communicate with their audiences and protect public health in the event of a drinking water advisory.

This edition contains a number of updates within the text, as well as new pages to address gaps and enhance the usefulness of the toolbox. Below you will find a list of the new pages in this edition, as well as a brief description of each.

Third Edition (2016) Updates:
A description of the topics that have been expanded upon or added in this edition.
Last-minute Planning and Response for Water Advisories:
A quick guide to help water utilities, who haven’t had a chance to pre-plan, address their most pressing communication priorities in the event of an unexpected water advisory.
Frequently Asked Questions About Do Not Drink Water Advisories [DOCX – 4 pages]:
A Q&A document with common questions likely to be asked by the public during a Do Not Drink Advisory.
Frequently Asked Questions About Cyanobacterial Blooms/ Cyanotoxins/HABs and Drinking Water [DOCX – 3 pages]:
A Q&A document with common questions likely to be asked by the public when Cyanobacterial Blooms/Cyanotoxins/HABs are found in the water supply.
Frequently Asked Questions about Nitrates and Drinking Water [DOCX – 4 pages]:
A Q&A document with common questions likely to be asked by the public about nitrates in the water supply.
Guidelines for Schools and Childcare Facilities During a Boil Water Advisory [PDF – 3 pages]:
Water use guidelines for decision makers and providers at childcare facilities during a boil water advisory to ensure the safety of the children under their care.
Guidelines for Hotels and Motels During a Boil Water Advisory [DOCX – 1 page]:
Water use guidelines for hotel/motel owners and staff during a boil water advisory to ensure the safety of the customers.
Guidelines for Food Service Facilities During and After a Boil Water Advisory [PDF – 3 pages]:
Water use guidelines for food service facility (restaurants, etc.) proprietors during and after a boil water advisory to ensure the safety of their customers.
Recommendations for High Rise Buildings Before and During a Water-related Emergency [DOCX – 2 pages]:
Advice for building managers, superintendents, and others in charge of high rise buildings to help residents prepare for emergency situations in which safe, running water for drinking, sanitation, hygiene, and other essential uses might not be available.
Guidelines for Healthcare Facilities During and After a Boil Water Advisory [DOC – 2 pages]:
Water use guidelines for decision makers at healthcare facilities during and after a boil water advisory to ensure the safety of their patients.
Considerations for Dialysis Centers Before and During a Water Advisory [DOCX – 2 pages]:
Advice and planning recommendations for dialysis centers regarding considerations that must be taken into account before determining the safety of dialysis during various water advisory situations.
Website Information Checklist [DOCX – 1 page]:
A list of relevant information that should be included when developing a website to communicate with the public, media, and other stakeholders during a water advisory.
Website Example [DOCX – 1 page]:
An example of what the typical front page of a water advisory website could look like, with descriptions and explanations.
Sample Agenda for an After Action Review [DOCX – 1 page]:
This sample agenda provides an example of what to cover in an after action review session with your stakeholders.

Help! We are issuing a water advisory and we need to alert the public now. We’ve done very little/no planning. Where do we start?

The goal: Communicate in a timely manner by maximizing all of the communication channels you have.

Communicate the essential information to the critical individuals and organizations as soon as possible.
Reach as much of the population as you can by as many communication channels as possible.
Focus your resources on reaching the greatest number of people in a timely manner.
Keep your messaging consistent across all channels.

Step 1: Determine a basic chain of command.

Who will make the determination of when the water is safe to drink?
Who will be the key spokesperson?
How will updates be communicated?

Step 2: Identify critical partners who need to be informed immediately and who will, in turn, contact a number of other stakeholders and members of the public. Ensure that your message remains consistent across partners. These critical partners may include:

Local Emergency Manager (enlist that person’s immediate support to make the critical phone calls and connections that are listed below)
Local Health Department
Regional Hospital Coordination Unit
Hospital facility managers
Local elected officials
Police chief(s)
Fire chief(s)
Medical examiner
Animal control
Environmental health
Vulnerable Populations groups
- Assisted living facilities
- Nursing homes
- Dialysis centers
- Refugee centers
- Deaf advocacy groups
Neighborhood pages (Nextdoor, Neighborhood Civic Associations, etc.)
Dept of Transportation (they may agree to put announcements on highway message boards)
IPAWS (phone alert system coordinated by FEMA)

Step 3: Identify core channels that will maximize communication efforts. Ensure consistent messaging across channels:

County communications staff and possibly a Joint Information Center (JIC) under IMS structure
Mass media/news
Social media (cell phone/text/Facebook)
Wireless Emergency Alert
CodeRED alert
Websites
Reverse 911

Grab and go tools:

Many of the Section 1 (“Before an Incident”) and Section 2 (“During an Incident”) Tools & Templates found in Appendix B can be used as a “Go Kit” in situations where pre-planning activities may have been incomplete. A number of these tools and templates are listed below and can be helpful resources in the coming days. If you are online, you can access each document listed below by clicking on its name. In addition, all of the tools and templates can be found in a zip file on the Tools and Templates page.

Tools and Templates “Go Kit”

Water systems and state or local agencies issue drinking water advisories when they believe water quality is or may be compromised. Advisories tell individuals, schools, hospitals, businesses, and others about the situation and how to take immediate action, if necessary.

Drinking water advisories and notifications:

Provide information—A notification may be issued when consumers need to receive important information but do not need to take any action. For example, a water system may issue a notification to inform households about seasonal changes in water taste or when utility work may cause a loss of pressure.
Encourage preparedness—Advisories may help customers prepare for planned disruption in service or anticipated water quality threats. Advisories may affect a small area, such as during distribution system construction or repair. Advisories also can urge customers to prepare for a large area incident, such as an approaching hurricane. This type of advisory alerts people to watch or listen for more information.
Recommend action—Advisories may tell customers to take specific actions, such as to boil water or use bottled water. These advisories may be issued as a response to poor water testing results, reports of a waterborne disease outbreak, chemical contamination, or a loss of distribution system integrity.
Meet public notification requirements—Advisories are required by the Safe Drinking Water Act (SDWA) when specific circumstances exist. The SDWA requires communication with customers when the water system does not comply with a regulation.

Consult with your state primacy agency when developing drinking water advisory protocols.

Precautionary and Mandatory Advisories

State and federal regulations specify when drinking water advisories are required. In other instances, water systems or the local public health department may issue advisories at their discretion.

Advisory Information

Advisories can include information about preparing food, beverages, or ice; dishwashing; and hygiene, such as brushing teeth, bathing, and flushing toilets.

Main Types of Advisories

Informational—Communicate planned or anticipated changes in water quality or unanticipated loss of service and provide advice on appropriate action.
Boil Water—Tells customers to boil water before use. This is the most common type of advisory. They may be precautionary if there is a potential threat to the drinking water supply, or they may be mandatory as required by state and federal regulations. Boil water advisories typically are issued because of concern about microbial contamination.
Do Not Drink—Tells customers to use an alternate source of water. Do Not Drink advisories are typically issued for chemical and toxin contamination when boiling water is not effective for making water safe.
Do Not Use—Warns customers not to use tap water for any purpose, including bathing. Do Not Use advisories are typically used only in cases of known microbial, chemical, toxin, or radiological contamination when any contact, even with the skin, lungs, or eyes, can be dangerous. Such advisories are rare because of the risks associated with the lack of water for other purposes (e.g., sanitation).

Figure 2 shows the range of situations that might trigger a drinking water advisory and the type of advisory that would be issued in each situation.

Figure 2. Range of Situations for Drinking Water Advisories

figure 2 showing the range of situations for drinking water advisories. Informational, boil water, do not drink, and do not use.

Note: These are examples of potential reasons to issue an advisory; this is not intended to be a comprehensive list. Consult your primacy agency for more information.

¹ Turbidity has no health effects. However, turbidity can interfere with disinfection and provide a medium for microbial
growth. Turbidity may indicate the presence of disease causing organisms. These organisms include bacteria, viruses, and
parasites that can cause symptoms such as nausea, cramps, diarrhea, and associated headaches.

² Do not drink advisory should be focused on infants below the age of six months consistent with the Public Notification
Standard Health Language (40 Code of Federal Regulations Part 141 (Subpart Q, appendix B).

Note: Incident Command System (ICS) training videos and other ICS resources for water and wastewater utilities are available on EPA’s Resilience Training and Exercises for Drinking Water and Wastewater Utilities page.

Because small water systems often have less capacity to implement advisory protocols than larger systems, this toolbox also was designed and tested with small water systems in mind.

Implementing the actions described in this toolbox generally should not require outside support from consultants or others. However, building an effective network by collaborating with other public sector partners, community organizations, and adjacent cities and counties, will help small systems succeed in their efforts.

Suggestions for Small Systems

Identify and prioritize specific tools, templates, or sections from this toolbox to use.

Note: EPA’s Water/ Wastewater Agency Response Networks (WARN) are mutual aid and assistance networks that provide water and wastewater utilities with the means to quickly obtain help in the form of personnel, equipment, materials, and associated services from other utilities to restore critical operations impacted during an emergency.

More information is available at the EPA’s Value of Water and Wastewater Agency Response Networks Membership for Water Utilities page.

Incorporate water advisory protocol planning into regular activities, such as sanitary surveys and updating emergency response plans (ERPs).
Build water advisory protocols into regular communications, such as customer updates.
Partner with
- local public health authorities and neighboring water systems.
- your local emergency response coordinator(s).
- someone who is FEMA Incident Command System (ICS) trained.
Create an organizational hierarchy chart to lay out plans for a team.
Develop a strategic communication plan as outlined in “Organizing for Drinking Water Advisories” in Section 1: Before an Incident— Preparing for an Advisory.
Determine the best communication channels to use for message delivery.
Develop an emergency response plan that would be activated during a contamination incident.
Make adjustable measures to allow public health professionals to come in and take samples or conduct interviews during an incident.

Page last reviewed: June 30, 2022

Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED)