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Girl at Sink getting glass of water

Policy urges pediatricians to ask families about water supply source, advise those with wells on testing

January 30, 2023

Access to safe, uncontaminated drinking water is a growing concern for the nearly 23 million U.S. households that get their water from private wells.

Chemicals and pathogenic organisms can contaminate private wells, but these wells are not subject to state and federal regulations that govern the quality of drinking water from municipal sources. Therefore, well owners are responsible for the safety of the water.

Since access to clean water is essential to the health of infants and children, inquiries about water are within the scope of pediatric primary care practice.

An updated AAP policy statement and accompanying technical report, Drinking Water from Private Wells and Risks to Children, address challenges facing families who obtain their drinking water from private wells and outline recommendations for inspection, testing and remediation to provide safe drinking water for children.

The policy and technical report, from the AAP Council on Environmental Health and Climate Change and the Committee on Infectious Diseases, are available at and and will be published in the February issue of Pediatrics.  

Threats from contaminants, disruptions

Private wells can be threatened by contaminants such as bacteria (e.g., Escherichia coli) and chemicals (e.g., per- and polyfluorinated alkyl substances).

There also are environmental justice issues regarding access to safe well water. Families living in poverty, especially in rural areas, are impacted disproportionately by threats to groundwater, such as those posed by hydraulic fracturing for oil or natural gas extraction (“fracking”) or by fertilizer runoff and animal wastes from agri-business operations.

Disruptions to the provision of safe drinking water also have been occurring more frequently due in part to the impacts of climate change. Chronic drought conditions and excessive groundwater draw-down by commercial enterprises can imperil families whose wells draw from the same fragile water table.

Disasters attributable to climate change, such as serious wildfires in the western U.S., and the increased frequency of severe weather events, like Hurricane Ian in Florida, can contaminate private wells and leave families without safe drinking water.

Recommendations for pediatricians, government

The policy encourages pediatricians to ask about the source of a family’s drinking water during well-child visits.

They can advise private well owners to test the water annually for coliforms and nitrates. A more extensive assessment for the presence of microbial pathogens, chemicals and other contaminants should be carried out every three to five years. The technical report describes many of the contaminants, both microbial and chemical, of private wells.

In the event of floods or other disruptions that may compromise the well’s integrity, families should be advised to use alternative sources of water until the well water has been tested and its safety assured.

The policy also recommends how governmental agencies can help private well owners with information about local groundwater conditions, sources of potential contamination and advice about the maintenance of their well.

Finally, the policy statement advocates for legislation to provide funding needed to test well water for contaminants and to help with the expense of remediating or maintaining the well.

Dr. Woolf is a lead author of the policy statement and technical report. He is a member of the AAP Council on Environmental Health and Climate Change Executive Committee and is director of the Region 1 Pediatric Environmental Health Specialty Unit.


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