Abstract

Boil-water advisories (BWAs) are one of the several methods to prevent the spread of infectious diseases through contaminated water. However, for BWAs to be effective, consumers need to be aware of, understand and comply with the advisories. Although BWAs are a widely used preventive public health measure, compliance with BWAs is scarcely examined. In Norway, only one previous study on compliance with BWAs has been conducted. Therefore, we conducted a cross-sectional study to estimate consumers’ perception of and compliance with a BWA following a contamination incident at an elevated reservoir in Konnerud (population 10,314), Norway. In total, 2,451 of the 9,312 (26.3%) invited residents responded to the questionnaire. Among the respondents, 97.6% remembered receiving the BWA, and of the latter, 94.6% complied with the advice. Effective compliance with the BWA was thus 92.3%. Only 130 (5.4%) respondents did not comply with the BWA. The main reason for non-compliance was perceived low or no risk of getting sick from the water (34.2%). Our study revealed high awareness of and compliance with the BWA, but the people who did not comply maintained several misconceptions about waterborne infections and transmission. The findings can be used by local health authorities to improve future BWAs.

HIGHLIGHTS

  • We investigated perception and compliance to boil-water advisories (BWAs); it is rarely studied.

  • Findings show high BWA compliance and increased trust.

  • Lack of trust had a negative impact on compliance.

  • Non-compliance was associated with misconceptions regarding waterborne infections and transmission.

  • Recommendations include having guidelines and regulations to unify BWA in different communities.

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