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Valuing the Cancer Mortality Risk Reduction from Lowering the Arsenic Maximum Contaminant Level in New Hampshire Municipal Water Supplies

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Abstract

This study uses a 2018 stated preference survey to elicit a willingness to pay (WTP) to reduce the cancer morbidity and mortality risk from arsenic exposure through drinking water. Respondents who use a public water supply are willing to pay $35.43 per month for the risk reduction associated with lowering the maximum allowable level of arsenic in drinking water from 10 to a hypothetical level of 3 ppb; households on private wells are willing to pay $29.19. Respondents from households with children were willing to pay significantly more than respondents from households without children. We derive values of a statistical life (VSL) of $4.61 million and $3.48 million per household member, respectively, in households using municipal or well water. Shortly after the initial release of these findings, New Hampshire became the second state to set a maximum allowable level for arsenic below the national limit of 10 ppb.

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Notes

  1. Bellinger (2012) estimates that each loss of one IQ point decreases average lifetime earnings capacity by about €12,000 or $18,000 US in 2008 dollars (adjusting by the CPI, this is equivalent to in US$21,565).

  2. The term community water system allows for the possibility that some respondents obtain water from a shared community well rather than a municipal system or private (single household) well. Community wells that serve at least 25 people are subject to standards regarding water testing and contaminant levels that are similar to the standards faced by municipal systems.

  3. No end to the monthly payments was either specified or assumed.

  4. The median bid amount ($20) was chosen to roughly match a 5-year repayment given a preliminary cost estimate per household of lowering the maximum allowable level of arsenic to 3 ppb.

  5. 47.6% of respondents report drinking bottled water at least “a couple of times per week”.

  6. These risk values we used in constructing the risk ladder were used in our survey.

  7. VSL is computed as annual WTP divided by the annual risk reduction implied by the 70-year risk reduction. This formulation means that we do not need to specify a discount factor. If respondents had instead discounted the monthly payments and the future risks, we would need to specify (perhaps different) discount rates for money and risks.

  8. An important test for internal validity is to verify that WTP increases with income; the parameter estimate on income is positive and significant. Mean household income in our sample is $63,290. Using the parameter estimate for HH Income from Model 1 in Table 2, we find that for the average respondent, a 10% increase in income (about $6239) would lead to an increase in WTP of $1.28 per month.

  9. We have also experimented with partitioning the data by household size and estimating different WTP by subsample. Small subsamples make it difficult to discern clear patterns in this way.

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Acknowledgements

The authors would like to thank participants at the Western Economic Association meetings for helpful comments and suggestions on this work and the anonymous reviewers for helpful comments in revising our final manuscript. Financial support for this research is provided by the NHDES, the New Hampshire Agricultural Experiment Station and the NHDES. This is scientific contribution number 2832. This work was supported by Hatch Multistate Project NE 1749. Any opinions, findings, and conclusions or recommendations expressed are those of the authors and do not reflect the view of the funding agency. All remaining errors are our own.

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Correspondence to Scott Lemos.

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Appendix: Survey Details

Appendix: Survey Details

Introduction

Arsenic in drinking water is a substantial public health issue in New Hampshire, according to the NH Department of Environmental Services (NHDES). Arsenic occurs naturally in groundwater in New Hampshire, and it has the potential to increase the risk of a wide range of health effects, including bladder and lung cancer. The current regulatory limit of 10 parts per billion (ppb) was chosen by the US EPA in 2000 as a reasonable level at which to balance the risk of harmful health effects with the cost of treating water to remove arsenic in public water systems. A good deal of scientific research has been done since then, which has only served to increase concern about harmful health effects in New Hampshire. In 2018, the NH Legislature directed NHDES to review the federal 10 ppb standard and to determine whether NH should establish a lower level, considering both the benefits and the costs to public water system and their customers. Our research team from the University of New Hampshire is conducting a survey to gather information on perceptions and preferences related to risks associated with arsenic in residential drinking water in New Hampshire. This survey is funded by the NHDES. In order to participate in this survey, you must be at least 18 years old. This survey will take ~10–15 min to complete. Survey participation is voluntary and you will not receive any compensation for participating. There are no potential risks for participating in this study. We seek to maintain the anonymity of all data and records associated with your participation in this research. We will report the data in aggregate, assessing trends in individual preferences and perceptions related to arsenic in drinking water. The results may be used in reports, presentations, and publications. If you have questions about your rights as a research subject you can contact Melissa McGee at UNH Research Integrity Services at 603-862-2005 or melissa.mcgee@unh.edu. If you have questions about this research project or would like more information, you may contact project leader John Halstead, Professor of Environmental and Resource Economics, University of New Hampshire, at 603-862-3914 or john.halstead@unh.edu.

In order for you to help us with this study, you must be at least 18 years old. Are you at least 18 years old?

 Yes

 No

Do you consume at least 50% of your drinking water from the tap?

 Yes

 No

How do you receive tap water in your home?

 Public or community water supply (incl. community well)

 Private well

Self-Protection and Perceptions of Safety of Tap Water

This portion of the survey will focus on options for the provision of cleaner and safer drinking water. First, would like some information about the water you drink.

Apart from receiving water from the municipal water utility, what are the other sources of your drinking water? Check all that apply.

 Purchased bottle water

 Water delivery service

 Natural well

 Other (please specify) ______________________

 I don’t know

What is the source of your tap water? (Select all)

 Groundwater (e.g. underground water source)

 Surface water (e.g. river of lake)

 I don’t know

How often do you personally drink bottled water that you have purchased?

 Never or rarely (once per year)

 Occasionally (a couple of times per year)

 Sometimes (a couple of times per month)

 Frequently (a couple of times per week)

 Once per day

 Several times per day

How much money do you estimate that your household spends on purchased drinking water (i.e. bottled water) per month?

______________________

When purchasing drinking water, you do so mostly because of

 convenience.

 taste.

 health concerns about tap water.

Do you use a home water filtration system of any kind?

 Yes

 No

How much did your water filtration system cost to purchase? ____________

Do you use a container style water filter (e.g. a Brita)?

 Yes

 No

We would like to get a sense of the percentage of the water you consume from different sources. In the table below, please fill in your best guess of the percentage of water you personally consume from the different sources identified below. (The total from all sources should add to 100%)

 Water direct from tap without any home filtering or treating: _______

 Home filtered or treated tap water: _______

 Purchased drinking water (e.g. bottled water): _______

We would like to know whether you have any health concerns about drinking your tap water. Please choose the one statement that best reflects your personal opinion.

 No health concerns. I feel that tap water does not pose a problem for my personal or my family’s health.

 Minor health concerns. I feel that drinking tap water may pose a minor problem for my personal or my family’s health.

 Moderate health concern. I feel that drinking tap water may pose a moderate problem for my health or my family’s health.

 Serious health concern. I feel that drinking tap water may pose a serious problem for my health or my family’s health.

Health Effects of Arsenic Exposure in Tap Water

One of the benefits of increasing the drinking water standard (i.e., lowering the maximum allowable level of arsenic) in public water systems in New Hampshire is the reduction in the chance of contracting and dying from diseases like lung and bladder cancer. In particular, lowering the level of arsenic in drinking water from 10 to 3 ppb lowers the risk of contracting lung and bladder cancer by 70% and lowers the risk of dying from those same cancers by 50%. To put this in perspective, we have included a visual representation of this risk change in relation to other commonly understood risks. These risks are displayed as a the prevalence of the risk out of 10,000 people. To get a sense of these chances, consider that the town of Conway, NH, has a population of about 10,000 residents. Please review this graphic carefully before moving on to the next section.

figure a

Valuation of Health Risk Reductions from Increased Water Quality

We would like to know your opinions about the management of tap water quality in New Hampshire. The following section will ask a series of questions on your WTP to increase drinking water quality in New Hampshire, and thus lower your chances of contracting lung and bladder cancer. Please note, we know that responses from surveys are often not a reliable indication of how people will actually choose. In surveys, some people ignore the sacrifices they would need to make if their choice actually meant they would have less money to spend. We would like you to respond to the following questions as if this were a real choice—imagine that you actually have to dig into your pocket and pay the additional charges on your water bill if the majority agreed with your choice. Note that by paying more on your water bill you would have less money to spend on other things.

Assume for a moment that the current level of arsenic in your drinking water is 10 ppb. This is associated with a 67 out of 10,000 chance of eventually getting bladder or lung cancer and a 34 out of 10,000 chance of dying from that cancer due to the arsenic by age 70. What if a water treatment system could be used to reduce the level of arsenic in your water to 3 ppb? This would lower the risk of eventually getting bladder or lung cancer to 20 out of 10,000 and dying from bladder or lung cancer to 10 out of 10,000. Again, this represents a 70% reduction in your chances of getting lung or bladder cancer and a 50% reduction in your chances of dying from that cancer. Would you be willing to pay $___ per month for use of this water filtration system, which would lower the level of arsenic in your drinking water from 10 to 3 ppb?

 Yes

 No

Given your response to the question above, would you be willing to pay $___ per month for use of this water filtration system, which would lower the level of arsenic in your drinking water from 10 to 3 ppb?

 Yes

 No

Respondent Demographic Information

What is your gender?

 Male

 Female

What is your current age? __________

How many people live in your household, including yourself?

 0

 1

 2

 3

 4

 5

 6

How many children under the age of 18 live in your household?

 0

 1

 2

 3

 4

 5

 6 or more

What is the highest level of schooling you have completed?

 Some high school

 High school

 Some college

 Associates

 Bachelors

 Graduate/Professional

What is your current employment status?

 Student

 Retired

 Full time

 Part time

 Self-employed

 Unemployed

What is your approximate annual household income from all sources, before taxes?

 less than $15,000

 $15,000–$29,999

 $30,000–$44,999

 $45,000–$59,999

 $60,000–$74,999

 $75,000–$89,999

 more than $90,000

What is your household zip code? _________

Do you have any of the following long-term health conditions?

 Food allergies

 Any other allergies (Please specify) ______________________

 Asthma

 Arthritis or rheumatism

 Back problems, excluding arthritis

 High blood pressure

 Migraine headaches

 Chronic bronchitis or emphysema

 Sinusitis

 Diabetes

 Epilepsy

 Heart Disease

 Cancer (Please specify type) ______________________

 Stomach or intestinal ulcers

 Effects of stroke

 Any other long-term condition that has been diagnosed by a health professional (Please specify) ______________________

In your opinion, how do you think the safety of tap water should be paid for? Check all that apply.

 Increase federal, state, or municipal taxes

 Increase fees to tap water users

 Charge polluters of the water

 Other (please specify) ___________

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Lemos, S., Halstead, J.M., Mohr, R.D. et al. Valuing the Cancer Mortality Risk Reduction from Lowering the Arsenic Maximum Contaminant Level in New Hampshire Municipal Water Supplies. Environmental Management 65, 725–736 (2020). https://doi.org/10.1007/s00267-020-01288-3

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