Sammendrag
Background: Water advisories, especially those concerning boiling drinking water, are widely used to reduce risks
of infection from contaminants in the water supply. Since the effectiveness of boil water advisories (BWAs) depends
on public compliance, monitoring the public response to such advisories is essential for protecting human health.
However, assessments of public compliance with BWAs remain sparse. Thus, this study was aimed at investigating
awareness and compliance among residents who had received BWAs in Baerum municipality in Norway.
Method: We conducted a cross-sectional study among 2764 residents who had received water advisories by SMS
in the municipality of Baerum between January and September 2017. We analysed data from two focus group
discussions and an online survey sent to all residents who had received an advisory. We condu cted descriptive
analyses and calculated odds ratios (OR) using logistic regression to identify associations of compliance and
awareness with demographic characteristics.
Results: Of the 611 respondents, 67% reported that they had received a water advisory notificatio n. Effective
compliance rate with safe drinking water practices, either by storing clean drinking water or boiling tap
water, after a water outage was 72% among those who remembered receiving a notification. Compliance
with safe drink ing w ater a dvisories was lower amon g men than women (OR 0.53, 95% CI 0.2 9– 0.96), but was
independent of age, education and household type. The main reason for respondents ’ non-complian ce with
safe water practices was that they perceived the water to be sa fe to drink after letting it flush through the
tap until it became clear.
Conclusions: Awareness of advisories was suboptimal among residents who had received notifications, but
compliance was high. The present study highlights the need to impr ove the distribution, phrasing and
content of wa ter advisor y notifications to achieve greater a warene ss and co mplian ce. Future studies should
include hard-to-reach groups with adequate dat a collection approaches and examine the use of BWAs i n a
national context to inform future poli cies on BWAs.
Key words: Boil w ater advisori es, BWAs, Public com pliance, Water supply i nterrupti ons, Ad herence, Dri nking
water, Communication, Consumer trust
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