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Volume 31, Number 8—August 2025
Dispatch
Variance Among Public Health Agencies’ Boil Water Guidance
Megan Dorris
, Shanna Miko, Jasen M. Kunz, and Vincent R. Hill
, Shanna Miko, Jasen M. Kunz, and Vincent R. Hill
Table
Comparison of guidance from 5 public health agencies for study of variance among public health agencies’ boil water guidance*
| Agency | Target endpoint | End point definition | Duration at endpoint | Elevation adjustment | Cooling guidance |
|---|---|---|---|---|---|
| CDC drinking water advisories webpage (5) |
Full rolling boil |
Not defined |
1 min |
3 min at elevations above 1,981 m (6,500 ft) |
Allow boiled water to cool before you use it |
| Yellow Book (6) |
Boiling |
Not defined |
1 min, if fuel supplies are adequate |
No adjustment needed at common terrestrial travel elevations. |
Not addressed |
| EPA (7) |
Rolling boil |
Not defined |
1 min |
3 min at elevations 1,524 m (5,000 feet) |
Let water cool naturally |
| Health Canada (8) |
Rolling boil |
A vigorous boil, where bubbles appear at the center and do not disappear when the water is stirred |
1 min |
2 min at elevations above 2,000 m (6,562 ft) |
The water should then be cooled |
| Ready.gov (9) |
Rolling boil |
Not defined |
1 min |
Not addressed |
Let the water cool before drinking |
| WHO (11) | Rolling boil | Not defined | No additional time after reaching rolling boil | No adjustment at high elevation | Cool naturally, without the addition of ice |
*CDC, US Centers for Disease Control and Prevention; EPA, US Environmental Protection Agency; WHO, World Health Organization.
References
- State of North Carolina Office of State and Budget Management. Hurricane Helene damage needs assessment: Hurricane Helene recovery recommendations. December 13, 2024. [cited 2024 Dec 11]. https://www.osbm.nc.gov/hurricane-helene-dna/open
- Phillis MAJ, Peterson B. A week after Helene hit, thousands still without water struggle to find enough [cited 2024 Dec 11]. https://apnews.com/article/hurricane-helene-asheville-north-carolina-water-737bd51b1351315dc28522e36c425f18
- Espinosa MF, Sancho AN, Mendoza LM, Mota CR, Verbyla ME. Systematic review and meta-analysis of time-temperature pathogen inactivation. Int J Hyg Environ Health. 2020;230:
113595 . DOIPubMedGoogle Scholar - Centers for Disease Control and Prevention, US Environmental Protection Agency, American Water Works Association, Association of State and Territorial Health Officials, Association of State Drinking Water Administrators, National Environmental Health Association. Drinking water advisory communication toolbox. Updated 2016 [cited 2024 Dec 9] https://www.cdc.gov/water-emergency/media/pdfs/2024/08/dwact-2016.pdf
- Centers for Disease Control and Prevention. Drinking water advisories: an overview. [cited 2024 Dec 9]. https://www.cdc.gov/water-emergency/about/drinking-water-advisories-an-overview.html
- Backer H, Hill V. Water disinfection. 2023. In: CDC Yellow Book 2024: health information for international travel [cited 2024 Dec 9]. https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/water-disinfection
- US Environmental Protection Agency. Emergency disinfection of drinking water [cited 2024 Dec 9]. https://www.epa.gov/ground-water-and-drinking-water/emergency-disinfection-drinking-water
- Health Canada. Guidance for issuing and rescinding boil water advisories in Canadian drinking water supplies. 2015 [cited 2024 Dec 9]. https://www.canada.ca/en/health-canada/services/publications/healthy-living/guidance-issuing-rescinding-boil-water-advisories-canadian-drinking-water-supplies.html
- World Health Organization. Guidelines for drinking-water quality: 4th edition, incorporating the 1st addendum. 2017 [cited 2024 Dec 9]. https://www.who.int/publications/i/item/9789241549950
- World Health Organization. Boil water. 2015 [cited 2024 Dec 11]. https://iris.who.int/handle/10665/155821
- Sharvelle S, Ashbolt N, Clerico E, Holquist R, Levernz H, Olivieri A. Risk-based framework for the development of public health guidance for decentralized non-potable water systems. Proc Water Environ Fed. 2017;8:3799–809. DOIGoogle Scholar
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