This toolkit is designed to guide health departments and labs interested in building productive partnerships with wastewater utilities for wastewater surveillance programs. It provides strategies, best practices, and resources for initiating and sustaining those partnerships based on the ideas that came out of a series of workshops hosted by the WEF in collaboration with the U.S. CDC and U.S. EPA in 2023. All outputs from the workshops can be found on this dashboard, but the solutions are summarized by category below. Click one of the buttons below to learn more.
Ideas for recruiting utilities to participate in your wastewater surveillance programs
Strategies for maximizing retention of utilities in your program
Concepts for staying connected with your program partners
Included below are some potential strategies to facilitate utility recruitment for wastewater surveillance programs.
Do a Little Homework
Become familiar with the role of wastewater professionals in wastewater surveillance programs (Figure 1) and the barriers they have faced when participating in these programs.
Reach Out in the Right Way
Contact your prospective utility partners with a friendly introduction by:
No matter how you reach out, your potential partner will want to understand the goals of your program, the expected sample collection frequency, what you will be able to offer in terms of logistical support, how long you intend to keep the program running, and the potential benefits to them.
You may find it helpful to gather information on your prospective partner to learn how you can better support them. This repository of survey questions (courtesy of the Minnesota Department of Health and Oregon State University/Oregon Health Authority) may be helpful in creating your own utility needs survey. While digital administration of surveys is convenient, it might be more productive to review these questions with your prospective utility partner during an in-person meeting.
Figure 1. The Utility's Role in Wastewater Surveillance from WEF; click on image to download infographic. Access the text alternative for web accessibility infographic here
Share Success Stories
Share real case studies about how wastewater surveillance has positively impacted public health in your jurisdiction to demonstrate the value of utility participation in your program. If you don’t have success stories specific to your jurisdiction, you could share this PBS News video on how California uses wastewater to make public health decisions, this CBC News video highlighting the role of wastewater professionals, or this ABC News video on how El Paso joined NWSS. Feel free to scan WEF’s Sewer Stories and the NWBE YouTube Channel for helpful videos and playlists including wastewater surveillance in the news. Also check out WEF’s Sewer Signals, a podcast highlighting utility experiences with wastewater surveillance. Or get creative and make your own video or podcast episode!
The Council of State and Territorial Epidemiologist (CSTE) “Stories from the Field” website now features a dedicated section on how CDC’s Epidemiology and Laboratory Capacity (ELC) Program is making a real difference in communities. This section showcases the innovative work supported by the CDC ELC Program across various public health departments and topics including Advanced Molecular Detection, Outbreak Response, and Wastewater Surveillance.
Highlight Mutual Benefits
Wastewater surveillance offers mutual benefits for both utilities and health professionals. Participation not only strengthens a utility’s commitment to public health, aligning with the mission statements of most wastewater agencies, but also enhances their role as community service providers dedicated to promoting the well-being of the communities they serve.
To help underscore these mutual benefits, you can share this infographic on “How Wastewater Surveillance Works” and this video that highlights the value of wastewater surveillance, both from the CDC. For those interested in practical uses of wastewater data, the National Academies report on Wastewater-based Disease Surveillance for Public Health Action may be of interest.
It’s helpful to emphasize that wastewater surveillance isn’t just about COVID-19. You can share this infographic describing other pathogen markers that can be monitored in wastewater or direct them to the nwbe.org FAQ page for more details on future NWSS targets.
Figure 2. Wastewater Surveillance Programs Map. Click the image above to launch an interactive map with contact information for wastewater surveillance programs in the U.S.
Get Local
In some cases, state health departments have found greater success in recruiting utilities when they engage local health departments (LHDs). If you’re having trouble connecting with a specific utility, consider asking the LHD in that area to reach out on your behalf. Some LHDs have even stepped in to support utilities by collecting samples when the utility staff are short-handed.
Have a Single Point of Contact
Finding the right person to talk to can sometimes feel like navigating a maze for both public health and utility professionals. You can simplify this process by designating a single point of contact at your health department. WEF offers a map (Figure 2) to help utilities identify their jurisdiction’s point of contact for wastewater surveillance. If you’d like to add a point of contact for your program to the map, or update the name already in there, please email us at nwbe@wef.org. It’s also good practice to have a designated point of contact on the utility side, which is a question that’s included in the repository of survey questions.
Building wastewater surveillance systems that truly serve tribal communities can only be achieved by ensuring tribal representation and input from the very beginning. Here are key steps to consider when engaging with tribes and tribe-serving organizations on wastewater surveillance:
Do you have questions or want to learn more? Reach out to nwbe@wef.org!
To encourage your utility partners to take part in wastewater surveillance, aim to make it as easy as possible. The simpler you make it, the more likely they’ll be to include sampling at their facility. Here are some options for health professionals to consider:
Offer Supplies and Equipment
Offering sampling and shipping supplies is critical for enabling your utility partners to fold wastewater surveillance sampling into their daily routines. Supplies can be provided as a kit containing everything needed to collect, package, and ship one sample. Shipping two to four weeks of kits at a time is ideal, but you’ll want to confirm how much space your utility partner has for storing the sample kits. The contents of your sampling kits will depend on your program needs but could include sample collection tubes, ice packs, sealable biohazard bags, absorbent pads, and packing material as shown in Figure 3. WEF will be offering sampling supplies to utilities in 2024. Please email us to discuss how we can help get supplies to utilities in your jurisdiction.
When providing shipping, consider the following based on advice from the Wisconsin State Laboratory of Hygiene:
Certain equipment, such as an autosampler, may be necessary for your utility partners to participate in wastewater surveillance. Even if your utility partner already has an autosampler, it may not be located at the influent or may need replacement, but your partner will be able to tell you what their facility needs are. Also, check out WEF’s free autosampler and flow meter program to see if your utility partners qualify for participation.
Provide a Stipend
Money talks! Offering a stipend is a nice gesture of goodwill to offset the 20 to 40 minutes (minimum) required of your utility partner per sampling event (see Figure 4). About one in five jurisdictions participating in NWSS already offer stipends, ranging from $100 to $150 per sample, paid on a per-sample, monthly, quarterly, or yearly basis using contracts or an invoice based-system. Read our memo summarizing our conversations with 44 jurisdictions with NWSS funding to decide if offering a stipend is right for you.
Obtain Contact Hour Approval
Offering supplies or a financial incentive is not the only way to support your utility partners. Wastewater operators and engineers usually need to obtain a certain number of contact hours (such as continuing education units, professional development hours, operator contact hours, training contact hours) to remain licensed within a jurisdiction. In most jurisdictions, the approval of contact hours for a given training course is made by the department of environment (such as the Department of Environmental Quality, the Department of Environmental Management, or the Department of Environmental Protection). You could consider working with your jurisdiction’s environmental department to obtain contact hour approval for either participation in your wastewater surveillance program or attending free wastewater surveillance training courses on your health department’s website, similar to what New York does. WEF is currently developing training materials that would be eligible for contact hours and hosted on nwbe.org.
Provide Multiple Training Opportunities
Even if a training program isn’t eligible for contact hours, it still may be of value for maintaining utility interest in wastewater surveillance. Here are a few options for free wastewater surveillance training that you can share with your partners:
Figure 3. Supplies and equipment wastewater utilities need to participate in wastewater surveillance programs. Click on image to download infographic. Access the text alternative for web accessibility infographic here.
Figure 4. Average time it takes for a utility professional to collect a sample for wastewater surveillance. Click on image to download infographic. Access the text alternative for web accessibility infographic here.
Here are some ideas for implementing regular, consistent communication to help sustain your utility partnerships.
Share the Data
Your utility partner wants to see what is going on with the wastewater data just as much as you. Although uploading data directly to a dashboard (such as those linked from this map) may be the easiest way to share data, utility professionals may appreciate receiving an email report of the data, too. This is something you can discuss with your utility partners during your initial conversations.
Speak the Language
Just like in any field, effective communication in wastewater is challenging without knowing the terminology. You can become wastewater literate with WEF’s Wastewater 101 lessons focused on the ‘what’, ‘how’, ‘where’, and ‘who’ of wastewater collection and treatment.
Host Regular, Virtual Community of Practice Meetings
These meetings, which can be monthly or less frequent, can be geared towards updating wastewater professionals and local health departments with the latest wastewater surveillance news and success stories in your jurisdiction. Arizona, California, Colorado, Illinois and others are already hosting meetings like this with their local partners.
Keep the Conversation Going
Send email updates, pick up the phone, or visit in person. Keep the communication short and sweet, but frequent enough that your partners don’t feel forgotten. Ask them how often they prefer to be contacted (weekly, biweekly, monthly, quarterly) and keep a spreadsheet to track their preferences and incorporate this communication into you routine.
Foster Utility Champions
If possible, it’s helpful to identify a wastewater utility champion within your jurisdiction who is a seasoned wastewater professional actively involved in your program. At your program’s outset, this champion might not stand out immediately, but you’ll likely notice someone over time who not only understands the program but also shows a genuine eagerness to help other utilities. You could consider reaching out to this individual to ask if they’d be willing to mentor other utilities in your region to help address various challenges and promote a sense of community among utilities participating in your program, and participate in program leadership discussions.
Figure 5. Map representing all wastewater data submitted directly to CDC's NWSS DCIPHER platform through March 2022.
Figure 6. A series of videos explaining all things wastewater aimed towards health department professionals. Click on image to access video series.
Below are a few strategies for engaging the public and utility partners to raise awareness of wastewater surveillance’s vital role in safeguarding public health.
Have an Appreciation Week
This doesn’t have to be anything elaborate, but should be designed to show that you value your utility partner’s participation in your program. Ideas for what to include in your appreciation week based on what Colorado Department of Public Health and Environment (CDPHE) and Oregon Health Authority (OHA) have done include:
You can also consider encouraging LHDs to reach out and express gratitude, and timing the appreciation week to coincide with a particularly challenging time of year for your utilities. For example, CDPHE scheduled their utility appreciation week for the week after Thanksgiving when wastewater flow rates are highest in their jurisdiction.
Be Active on Social Media
Leverage social media for engagement; a search for “wastewater data” on platforms like Twitter shows significant interest. View examples from departments like the CDPHE and the OHA for inspiration in effective engagement. Respond to local residents’ concerns on social media for transparency. Share recent wastewater surveillance news and data trends to inform and engage the public, showcasing collaboration with utility partners. Feel free to use templates adapted from the Ohio Department of Health to facilitate public communication.
Take Part in Face-to-Face Community Engagement
Presenting during town hall or other community meetings can be valuable. You could consider asking a LHD professional to attend these meetings on your behalf to bring awareness to wastewater surveillance in their community. This is an excellent opportunity to advocate for the program, sway naysayers, and highlight the work of your utility professionals.
Another great opportunity for face-to-face engagement is in schools. You can consider partnering with local schools to educate students about wastewater treatment and surveillance. Share how samples are collected, why it matters for community health, and encourage young minds to spread the word to their families.
Encourage public participation in wastewater surveillance. Invite community members to engage by observing sample collection, taking facility tours, and learning about how utilities protect public health. This direct involvement demystifies wastewater surveillance, fostering community ownership and support for the program’s success.
Encourage Utilities to Communicate with the Public
Provide utilities with effective talking points and messaging they can distribute through bill stuffers or other communication channels. These materials should explain the significance of wastewater surveillance, how it’s useful for so much more than COVID-19, and its role in safeguarding community health. By proactively sharing this information, utilities can keep the public informed and engaged in the program, building trust and support within the community.
Figure 7. Talking points for wastewater utility professionals. Click image to download infographic. Access the text alternative for web accessibility infographic here.
Figure 8. Example bill stuffer to send to ratepayers. Click image to download infographic. Access the text alternative for web accessibility infographic here.
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