A-ANCEMENT OF THE SCIENCE
eorts have called for strengthening of external partnerships (U.S. EPA, 2020), collaborative eorts and nontraditional partnerships are needed with disci- plines that are not routinely engaging the onsite wastewater profession. For example, sharing with the medical com- munity geospatially explicit information for failing decentralized systems can help identify potential causative rela- tionships when increasing clinical rates of an illness (e.g., hookworm) are identi- fied in local communities (McKenna et al., 2017). Partnerships with community health education specialists in health departments and joint programming at technical and education conferences of environmental science and engineering, public health, and rural and community medicine represent an opportunity to facilitate interdisciplinary exchange. Conclusion NOW-R 2 presents a unique opportunity to better understand current and future chal- lenges and opportunities facing decentral- ized wastewater and distributed water reuse, which serves at least 20% of the U.S. popula- tion and is increasingly common around the world. After receiving input from more than 450 professionals with dierent backgrounds who are working in dierent sectors and roles within this field, we provide much-needed information on the demographics and pro- fessional characteristics of the U.S. onsite wastewater workforce. We further report 10 problem statements related to workforce education, training, and outreach—and oer perspectives to meet these needs. We specifically identify common issues in the onsite and distributed water reuse workforce similar to those recently identified for the public health workforce in general through the Public Health Workforce Inter- ests and Needs Survey (PH WINS). PH WINS suggests high turnover rates among public health workers—similar to the onsite waste- water industry—along with training needs and focused recruitment and retention eorts (Bogaert et al., 2023; McCullough & Rob- ins, 2023).Our findings here similarly align with environmental public health workforce challenges identified during the UNCOVER EH initiative (Brooks et al., 2019; Brooks & Ryan, 2021; Gerding et al., 2019, 2020).
PH WINS, UNCOVER EH, and NOW-R 2 collectively identify a public health system in the U.S. that is understaed, underfunded, and not equipped to address future chal- lenges, which limits the eectiveness of deliv- ering essential health services (McCullough & Robins, 2023). These workforce issues have been further exacerbated by the COVID- 19 pandemic, as public health workers have spent at least 20% of their time on pandemic response activities regardless of their given sector, which limits their progress and pro- ductivity in other services (McCullough & Robins, 2023), including impacts on continu- ing education opportunities for decentralized wastewater professionals (Table 1). Though robust workforce assessments have not been performed for the practice of environmental engineering, observations reported here suggest a need to understand the challenges and opportunities facing the broader water and wastewater engineering community, particularly as the One Water approach progresses at the global scale. Strategic education, training, and outreach activities are needed to ensure workforce pre- paredness, promote education with owners of onsite technologies, and expand advanced training and translational research programs in decentralized/onsite wastewater and dis- tributed water reuse systems, particularly in the face of climate change and disasters. We anticipate our findings can specifically support decision making aimed at sustain- ing and advancing the onsite wastewater and distributed water reuse workforce, which is essential for protecting public health and the environment across the urban–periur- ban–rural gradient. Acknowledgements: Baylor University pro- vided support for our study. In-kind support was provided by NOWRA. We also thank the decentralized wastewater and distributed water reuse professionals who took the time to participate in our study. BWB and SFH dedicate the preparation of this manuscript to Ronald J. Suchecki, Jr. Corresponding Author: Bryan W. Brooks, Dis- tinguished Professor and Director, Environ- mental Health Science Program, Department of Environmental Science, Baylor University, One Bear Place #97266, Waco, TX 76798- 7266. Email: bryan_brooks@baylor.edu.
suggest holding training sessions for property owners and training real estate agents to communicate the requirements of maintaining a septic system to poten- tial homeowners. Mechanisms also need to be developed to aord service provid- ers with opportunities to communicate with existing customers about dierent onsite wastewater treatment systems. For example, it is not clear the extent to which performance of decentralized wastewater and distributed water reuse technologies are specifically examined during housing inspections prior to completion of real estate transactions within and across states, tribes, and ter- ritories. Improving this process through public (e.g., local public health) and private (e.g., real estate lending and insurance) partnerships could provide a consistent mechanism to facilitate assessment and communication of sys- tem performance when property owner- ship changes through time. 9. Consistent funding approaches and incentive programs for implementing best practices in the operation and main- tenance of advanced onsite wastewater technologies are lacking at the local level. Survey respondents specifically indicated a need for funding at both the state and fed- eral levels to administer onsite programs. The 2020 U.S. EPA MOU established as a priority the pursuit of public and pri- vate funding options to help communi- ties maintain systems (U.S. EPA, 2020). Funding for local programs, however, is not consistently available, and environ- mental public health delivery systems are not equitable within and among counties, states, tribes, and territories. Incentives are needed to establish improved structures to provide oversight and to assure continuing education for professionals. 10.Lack of information exchange with other disciplines (e.g., medicine) and programs (e.g., environmental health disease tracking) limits opportunities to address emerging issues in onsite waste- water and distributed water reuse. External partnerships with professionals outside of onsite and distributed water reuse are needed to successfully engage major issues in public health and envi- ronmental protection. Though previous
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