More than 44.5 million people in the United States (approximately 14% of the population) rely on private domestic wells as their primary source of drinking water. The water quality of private wells is not regulated at the state or federal level, leaving homeowners with wells responsible for the safety of their water. Meanwhile, each year, an estimated 48 million people in the U.S. are sickened, 128,000 are hospitalized, and 3,000 die of gastrointestinal (GI) illnesses caused by microorganisms that are typically transmitted through contaminated food.

Given that the potential of private wells as a non-foodborne transmission pathway for these microorganisms is not well understood, my dissertation evaluated these relationships, as well as characterized the quality of private well water in Maryland. My objectives were to: 1.) Investigate the water quality of private wells in Maryland and the effect of animal feeding operations on this water quality using fecal indicator bacteria; 2.) Investigate associations between the prevalence of private wells and the incidence of campylobacteriosis in Maryland at the zip code level using data from the FoodNet active surveillance System; and 3.) Investigate associations between the prevalence of private wells and the incidence of salmonellosis in Maryland at the zip code level using FoodNet data.

My findings demonstrated that 43.2% of private wells tested in Maryland did not meet at least one federal health-based drinking water standard. Additionally, my data showed that the prevalence of private wells in Maryland is a risk factor for the incidence of campylobacteriosis and salmonellosis in the coastal counties of the state. The presence of broiler chicken operations in a zip code is also a risk factor for campylobacteriosis and salmonellosis in coastal counties. These findings provide evidence for the strengthening of private well water regulations and for improving education and outreach to private well owners on proper maintenance and testing for their wells.