Water Quality Problems: Health and HouseholdDale Dorman, MS Extension Housing & Environment Specialist, Department of Housing and Consumer Economics
Document Use:
When you fill a glass with water from your tap, you expect to drink water that is pure and safe.
But how safe is it?
Water contains impurities from natural and man-made sources, such as minerals, gases, bacteria,
metals and chemicals. Many of these impurities are harmless. However, some impurities can
adversely affect your health. Others can damage equipment, stain laundry and fixtures and emit
odors.
To protect the public health and ensure uniform standards for water quality nationwide, Congress
passed the Safe Drinking Water Act of 1974. This act and its amendments authorized the U.S.
Environmental Protection Agency (EPA) to establish limits on the concentration of certain
contaminants in public water supplies (systems serving more than 25 people or 15 year-round
connections). Private water supplies, including wells, are not regulated by drinking water
standards. The owner must test and treat the water as needed to avoid health risks.
The EPA standards for drinking water fall into two categories -- Primary Standards and
Secondary Standards.
Primary Drinking Water Standards regulate contaminants that affect the safety of drinking
water and may cause health problems. These standards are enforced by EPA. They protect you
from three classes of toxic pollutants: microbial pathogens, radioactive elements and
organic/inorganic chemicals. Many of these contaminants occur naturally in trace amounts in
ground or surface water. Primary Standards set a limit, called the Maximum Contaminant Level
(MCL) on the highest amount of a specific contaminant allowed in the drinking water supplied
by a public water system. The MCL is usually expressed in milligrams per liter (mg/L). See
Chart I for Primary Drinking Water Standards including organic/inorganic chemicals, radioactive
elements and microbial pathogens.
Secondary Drinking Water Standards regulate contaminants that affect the aesthetic qualities
of drinking water such as taste, odor, color and appearance. The concentration limit is called the
Secondary Maximum Contaminant Level (SMCL). SMCLs are established for chloride, color,
copper, corrosivity, foaming agents, iron, manganese, odor, pH, sulfates, total dissolved solids
and zinc. Secondary Standards are not enforced; water systems are not required to test for and
remove secondary contaminants. Secondary levels represent reasonable goals and serve as useful
guidelines for water suppliers who wish to ensure that their water is suitable for all household
uses. See Chart II for Secondary Drinking Water Standards including inorganic chemicals and
physical problems.
EPA regulations develop Primary Standards for drinking water based on three criteria:
- The contaminant causes adverse health effects.
- It is detectable in drinking water.
- It is known to occur in drinking water.
In setting Primary Standards for a drinking water contaminant, research scientists first look at all
the toxicological data on that contaminant. This data is usually the result of studies that have
been conducted on animals. Occasionally human clinical or epidemiological data are also
available. Scientists use this information to estimate the concentration of a drinking water
contaminant that may be toxic and the concentrations, if any, that may cause no adverse effects.
The levels of contaminants found in drinking water are seldom high enough to cause acute health
effects -- effects that occur almost immediately after exposure to a large dose of a substance.
Therefore, scientists are most concerned about chronic health effects such as cancer, birth
defects, miscarriages, nervous system disorders and organ damage. These health effects may
occur after prolonged exposure to small amounts of a substance. When scientists set drinking
water standards, they treat contaminants that cause cancer (carcinogens) differently from
contaminants that cause other health effects.
For non-cancer causing toxic substances, scientists set standards using a figure calculated from
animal studies called the reference dose. The reference dose is the amount of a substance that a
person can consume daily, over a lifetime, without suffering any adverse health effects. It
includes a conservative margin. The reference dose used to be called acceptable daily intake.
EPA regulators use the reference dose to establish a Maximum Contaminant Level Goal
(MCLG) for a contaminant. The MCLG is the concentration of a contaminant that experts
believe a person can consume safely over a lifetime. It is based entirely on health considerations
and is set at a level where no adverse health effects should occur. The MCLG is not enforced by
the EPA. It is the goal used to set enforceable drinking water standards.
The Maximum Contaminant Level (MCL) is the enforceable Primary Drinking Water Standard.
It is set as close as possible to the MCLG. In setting an MCL, EPA regulators consider, in
addition to health effects, the feasibility and the combined cost of analyzing water for a
contaminant and for treating water to remove the contaminant. Therefore, the MCL is often less
stringent than the MCLG.
In setting Primary Standards for substances believed to cause cancer, research scientists assume
that no concentration is safe. Consequently, the MCLG is set at zero. But a zero level is not
always possible to achieve, so regulators estimate toxicity by calculating a figure called a risk
estimate.
In theory, any concentration of a carcinogen in your drinking water may possibly cause cancer.
In practice, however, at very low concentrations the risk of cancer becomes so small that it is
considered negligible. Therefore, scientists must decide what level of risk is acceptable. It may
be one excess cancer in 10,000 persons or one excess cancer in 1 million persons exposed over a
lifetime (70 years). The concentration of the substance estimated to cause this acceptable level of
risks is the risk estimate. Based on the risk estimate, EPA regulators establish the MCLs for
cancer-causing contaminants.
Setting drinking water standards is an imperfect process. Data relating human health effects to
contaminants in drinking water are limited, and scientists have difficulty predicting the effects of
drinking small amounts of a substance for many years. In addition, regulatory decisions
frequently incorporate economic, political and social considerations.
Although current drinking water standards do not guarantee that the glass of water you draw
from your tap will be absolutely safe and pure, they do reflect sound scientific judgment.
Standards are based on all available knowledge.
Under the Safe Drinking Water Act, the primary role of the federal government is to develop
national drinking water regulations that will protect public health and welfare. The states have
the responsibility for monitoring public water systems and enforcing drinking water standards for
EPA - regulated contaminants and other contaminants. The local public water systems are
responsible for treating and testing drinking water to ensure that its quality consistently meets the
standards set by the regulation.
When levels go above a standard, the EPA requires that the contaminant levels be reduced to the
Maximum Contaminant Level. The corrective treatment is left to the public water system. In
addition, Federal law requires that the water system must notify the public when a drinking water
standard has been violated. Public notification must include clear explanations of the violations;
information on potential adverse health effects; the steps being taken to correct the problem; and
the need, if any, to seek alternative water supplies. This procedure is a safety precaution intended
to keep the public informed and call attention to deficiencies in the drinking water supply.
Under the Safe Drinking Water Act amendment of 1986, consumers have the right to obtain the
following information about their drinking water:
- its source,
- where it is purified,
- the contaminants for which it has been tested,
- past and present contamination problems,
- contamination levels that violate current federal drinking water standards, and
- how the public was notified about the violations.
Protection under the Safe Drinking Water Act of 1974 includes:
- the right to bring civil suits against the local water system, the state, or federal officials if they
fail to do their jobs;
- the requirement of public water systems to chemically treat contaminated water or install
clean-up equipment to remove the contaminant(s) to concentrations below the standard when
a violation occurs;
- the requirement for public notification of maximum contaminant level violations within 14
days of their detection and at least once every three months if the contamination continues.
For minor violations of standards, public notification must be made once a year.
Primary Drinking Water Standards -- Regulated
Contaminant
| Source
| Possible chronic
health effects
| MCL
| Acrylamide*
| drinking water treatment residue; well
drilling; food production and
processing; paper making and textile
manufacturing.
| cancer and nervous system
effects.
| MCL: 0.05% dosed
at 1 mg/L| Alachlor* (Lasso)
| agricultural herbicide
| cancer; damage to eyes and
liver
| MCL: 0.002 mg/L| Aldicarb* (Temik)
| agricultural insecticide
| cholinesterase inhibition.
| MCL: 0.003 mg/L| Aldicarb sulfoxide*
| agricultural insecticide
| cholinesterase inhibition.
| MCL: 0.004 mg/L| Aldicarb sulfone*
| agricultural insecticide
| cholinesterase inhibition.
| MCL: 0.002 mg/L| Benzene
| leaking underground fuel storage
tanks; industrial wastes; manufacture
of pesticides, detergents and solvents.
| leukemia and other cancers;
nerve, lung, and kidney
damage; blood disorders and
reproductive effects.
| MCL: 0.005 mg/L| Carbofuran*
(Furadan 4F)
| agricultural insecticide
| cholinesterase inhibition;
reproductive and immune
system effects.
| MCL: 0.04 mg/L| Carbon Tetrachloride
| chemical disposal sites, contaminated
soils, and landfills; aerosol sprays,
cleaning agents and coolants; laundry
and dry-cleaning operations.
| cancer; central nervous
system depression; liver and
kidney damage.
| MCL: 0.005 mg/L| Chlordane*
| insecticide; hazardous waste sites
| cancer; nerve and liver
effects.
| MCL: 0.002 mg/L| 2,4-D* (Formula 40,
Weedar 64)
| agricultural herbicide and aquatic
weeds control.
| liver and kidney damage; skin
irritations and muscle effects.
| MCL: 0.07 mg/L| Dibromochloropropane* (DBCP, Wemafume)
| soil fumigant.
| cancer, kidney and liver
damage; infertility.
| MCL:0.0002 mg/L| p-Dichlorobenzene
| dye and pesticide manufacturing.
| liver and kidney damage;
blood disorders.
| MCL: 0.075 mg/L| 1,2-Dichloroethane
| vinyl manufacturing; drycleaning
solvent, metal degreasers, and
adhesives; gasoline additive.
| cancer; central nervous
system depression; kidney
and liver damage; lung and
heart damage.
| MCL: 0.005 mg/L| 1,1-Dichloroethylene
| industrial solvent, cleaning and
degreasing agent.
| central nervous system
depression; liver, kidney and
heart damage.
| MCL: 0.007 mg/L| trans-1,2-Dichloroethylene*
| transformed from other chlorinated
hydrocarbons in drinking water
supplies; industrial cleaning and
degreasing agents.
| liver and kidney damage.
| MCL: 0.1 mg/L| cis-1,2-Dichloroethylene*
| transformed from other chlorinated
hydrocarbons in drinking water
supplies; industrial cleaning and
degreasing agents.
| liver and kidney damage.
| MCL: 0.07 mg/L| 1,2-Dichloropropane*
| industrial solvent and cleaning agents;
dry cleaning fluid components, soil
fumigants.
| liver and kidney damage.
| MCL: 0.005mg/L| Endrin
| insecticide and rodenticide.
| liver and nervous system
effects; birth defects.
| MCL: 0.0002mg/L| Epichlorohydrin*
| resin and rubber product
manufacturing; contamination of
materials used to process food and
treat or store drinking water.
| cancer; central nervous
system, lung, liver and kidney
effects; damage to male
reproductive organ.
| MCL: 0.01% dosed
at 20 mg/L| Ethyl benzene*
| hazardous waste sites and styrene
production.
| nerve, brain, liver and kidney
effects.
| MCL: 0.7 mg/L| Ethylene dibromide*
| pesticide and soil fumigants; leaded
gasoline additives.
| nerve, brain, kidney, nervous
system, gastrointestinal, and
reproductive effects.
| MCL: 0.00005
mg/L| Heptachlor expoxide*
| insecticide and hazardous waste sites.
| cancer, liver damage and
central nervous system
effects.
| MCL: 0.0002 mg/L| Heptachlor* (H-34,
Heptox)
| insecticide and hazardous waste sites.
| cancer, liver damage and
central nervous system
effects.
| MCL: 0.0004 mg/L| Lindane*
| pesticides.
| liver and kidney damage.
| MCL: 0.002 mg/L| Methoxychlor*
| insecticides.
| nervous system, kidney, and
liver effects.
| MCL: 0.04 mg/L| Pentachlorophenol*
(PCP)
| herbicides and insecticides; water
contact with PCP-treated wood;
industrial waste sites.
| liver and kidney damage;
nervous system, immune
system, and reproductive
effects; blood disorders.
| MCL: 0.001 mg/L| Polychlorinated
biphenyls* (PCBs,
Aroclor)
| hazardous waste sites; disposal and
manufacture of electrical transformers,
electromagnets, fluorescent lights and
plastic
| cancer; liver damage.
| MCL: 0.0005 mg/L
| Styrene*
| manufacture of plastics, synthetic
rubbers, resins and insulators.
| liver damage.
| MCL: 0.1 mg/L
| Tetrachloroethylene*
| industrial metal, textile and dry-cleaning solvent.
| cancer; liver and kidney
damage; central nervous
system depression.
| MCL: 0.005 mg/L
| Toluene*
| paint, oil, resin manufacturing; leaking
fuel storage tanks; jet fuel.
| central nervous system
depression; kidney damage.
| MCL: 1 mg/L
| Toxaphene*
| insecticides.
| cancer, liver and kidney
damage.
| MCL: 0.003 mg/L
| 2,4,5-TP* (Silvex)
| herbicides.
| liver and kidney damage.
| MCL: 0.05 mg/L
| 1,1,1-Trichloroethane
| hazardous waste sites; industrial
solvent and degreasers; drycleaning
solvents.
| central nervous system
depression; liver and
cardiovascular damage.
| MCL: 0.20 mg/L
| Trichloroethylene
(TCE)
| hazardous waste sites, drycleaning
solvent; manufacturing of chemicals
and drugs.
| cancer, nervous system
depression and heart effects;
liver and kidney damage.
| MCL: 0.005 mg/L
| Total Trihalomethanes
| formed when residual chlorine in
treated drinking water combines with
naturally occurring organic matter.
| cancer; heart, lung, kidney
and liver damage.
|
MCL: 0.100 mg/L
MCLG: - | Vinyl Chloride
| manufacturing of plastics and synthetic
rubber; corrosion of plastic pipes and
soldering.
| cancer; central nervous
system depression; liver,
reproductive, and digestive
tract effects; birth defects.
| MCL: 0.002 mg/L
| Xylene*
| leaking underground fuel storage
tanks; manufacturing of chemicals and
drugs.
| nervous system and
reproductive effects.
| MCL: 10 mg/L
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
The units of measurement are milligrams per liter (mg/L), micrometers (um) and picoCuries (pCi).
*New standard - Effective 1992 with monitoring requirements to begin January 1, 1993.
Contaminant
| Source
| Possible chronic
health effects
| MCL
| Arsenic
| rocks and soil; may contaminate
commercial phosphates in fertilizers
and laundry detergents; pesticide
residues; smelting, glass making and
coal mining.
| skin and lung cancer; liver
and kidney damage.
| MCL: 0.05 mg/L| Asbestos*
| corrosion of asbestos-cement pipe in
water distribution systems;
manufacture of cement products,
paper, floor tiles, paint, caulking,
textiles and plastics.
| lung cancer; gastrointestinal
cancer when swallowed
fibers exceed 10um.
| MCL: -7 million fibers
(>10um long)/liter
(MFL)| Barium*
| rocks and soil; coal and gas mining;
coal burning; diesel fuel combustion
and jet fuel; paints, bricks and tiles.
| hypertension and heart
damage.
| MCL: 2.0 mg/L | Cadmium*
| rocks, coal, and petroleum; by-product
of mining, smelting, refining and
electroplating; discarded batteries,
paints, and plastics; corrosion of
galvanized pipe; landfills and
industrial waste sites; fertilizers and
sewage sludge.
| kidney damage.
| MCL: 0.005 mg/L| Chromium*
| rocks and soil; mining sites; chrome
plating, cement production; waste
incineration; contaminated laundry
detergent and bleaches; septic systems.
| liver, kidney and lung
damage.
| MCL: 0.1 mg/L| Copper*
| rocks and soil; coal burning; iron and
steel production; industrial and sewage
treatment plant wastes; corrosion of
brass and copper pipes.
| anemia; digestive
disturbances; liver and
kidney damage.
| MCL: 1.3 mg/L (action
level)| Fluoride
| rocks and soil; industrial wastes.
| mottling of teeth; bone
damage.
| MCL: 4.0 mg/L| Lead*
| rocks and soil; corrosion of lead pipes
and lead-soldered pipe joints;
combustion of leaded gasoline; smelter
emissions and discarded storage
batteries.
| brain and nerve damage,
especially in children;
kidney damage; digestive
disturbances; blood
disorders; hypertension.
| MCL: 0.015 mg/L
(action level)| Mercury
| soil and rocks; mining, smelting, coal
burning; electrical equipment and
fungicides
| brain and nerve damage;
kidney damage; birth defects
and skin rash.
| MCL: 0.002 mc/L| Nitrate
| soils and mineral deposits; fertilizers,
sewage and animal wastes.
| Methemoglobinemia in
infants.
| MCL: 10 mg/L nitrate-nitrogen, 45 mg/L
nitrate| Selenium*
| soil and shales; coal burning, mining,
smelting; manufacture of glass, paints
and drugs; fungicides and feed
additives.
| growth inhibition; skin
discoloration; dental and
digestive problems; liver
damage and psychological
disorders.
| MCL: 0.05 mg/L| Silver
| soil, coal and mineral deposits; ore
mining and manufacture of alloys;
photographic procedures and jewelry
making.
| agyria, a permanent blue-gray discoloration of skin,
mucous membranes and
eyes.
| MCL: 0.05 mg/L | | | | | | | | | | | | |
The units of measurement are milligrams per liter (mg/L), micrometers (um) and picoCuries (pCi).
*New Standard - Effective 1992 with monitoring requirements to begin January 1, 1993.
Contaminant
| Source
| Possible chronic
health effects
| MCL
| Coliform Bacteria (an
indicator organism for
fecal coliform,
streptococcal, and
other pathogenic
bacteria).
| sewage, animal wastes; backflow or
improper pipe connections in water
systems; improperly sealed or
constructed wells.
| gastroenteritis, salmonella
infection, dysentery, typhoid
fever and cholera.
| MCL: <1/100 ml| Giardia lamblia
| sewage and animal wastes.
| giardiasis (a gastrointestinal
infection causing diarrhea,
abdominal cramps and gas).
| MCL: Treatment 99.9%
effective| Viruses
| sewage
| gastroenteric and other viral
diseases; hepatitis.
| MCL Treatment 99.9%
effective. | | | |
The units of measurement are milligrams per liter (mg/L), micrometers (um) and picoCuries (pCi).
*New Standard - Effective 1992 with monitoring requirements to begin January 1, 1993.
Contaminant
| Source
| Possible chronic
health effects
| MCL
| Gross Alpha Particles
| natural decay or uranium in rocks
and soil.
| cancer; bone and kidney
damage.
| MCL: 15 pCi/L| Radium-226,-228
| natural decay of uranium in rocks
and soil.
| bone cancer; bone and
kidney damage; birth defects.
| MCL: 5 pCi/L| Radon
| decay of uranium in soils and
rocks.
| lung cancer, when released
as a gas and inhaled.
| MCL: pending| Uranium
| soil and rocks
| cancer and kidney damage.
| MCL: pending | | | | |
The units of measurement are milligrams per liter (mg/L), micrometers (um) and picoCuries (pCi).
Secondary Drinking Water Standards -- Unregulated
Contaminant
| Source
| Symptoms
| SMCL*
| Chloride
| natural minerals; seawater; road
salt; fertilizers; industrial wastes
and sewage.
| salty taste; corroded pipes,
fixtures and appliances;
blackening and pitting of
stainless steel.
| 250 mg/L| Copper
| leaching from copper water pipes
and tubing; industrial and mining
wastes.
| bitter or metallic taste; blue-green stains on plumbing
fixtures.
| 1.3 mg/L| Fluoride
| natural minerals and industrial
wastes.
| brownish discoloration of teeth.
| 2 mg/L| Iron
| natural deposits in rocks and soil;
leaching of cast iron pipes in water
distribution systems.
| brackish color; rusty sediment;
bitter metallic taste; brown-orange stains; iron bacteria and
discolored beverages.
| 0.3 mg/L| Manganese
| natural deposits in rocks and soil.
| brownish color, black stains on
laundry and fixtures; bitter taste;
altered taste of water-mixed
beverages.
| 0.05 mg/L| Sulfate
| natural deposits or salts; by-products of coal mining; industrial
wastes and sewage.
| bitter, medicinal taste; scaly
deposits; corrosion; laxative
effects; "rotten-egg" odor from
hydrogen sulfide gas formation.
| 250 mg/L| Total Dissolved Solids
(TDS)
| dissolved minerals; iron and
manganese.
| hardness, scaly deposits;
sediment; cloudy, colored water;
odor; staining; salty or bitter
taste.
| 500 mg/L| Zinc
| natural deposits; leaching of
galvanized pipes and fittings.
| metallic taste.
| 5 mg/L | | | | | | | | |
The units of measurement are milligrams per liter (mg/L), micrometers (um) and picoCuries (pCi).
Contaminant
| Source
| Symptoms
| SMCL
| Color
| iron, copper, or manganese; organic
chemicals; organic matter
| visible tint.
| 15 color units| Corrosivity
| depends on temperature, acidity,
hardness, and oxygen content of
water.
| pitted or leaking pipes; metallic
taste; staining due to lead,
copper, iron or zinc dissolved
from plumbing.
| noncorrosive| Detergents/
Foaming Agents
| household and industrial wastes.
| frothy, cloudy appearance;
soapy taste and unpleasant odor.
| 0.5 mg/L| Odor
| dissolved gases, minerals, chemicals;
leaking underground storage tanks;
landfill or septic run-off; organic
matter.
| "rotten-egg," septic, musty or
chemical smell.
| 3 Threshold Odor
Number (TON)| pH
| dissolved acid and alkaline materials.
| pitting of pipes and fixtures,
bitter or metallic taste (low pH);
slippery feel, soda taste, scaly
deposits (high pH).
| 6.5 to 8.5 on pH
scale. | | | | | |
Water hardness does not have a Secondary Maximum Contaminant Level. It is included here, however,
because it is a common water quality problem and testing for water hardness is frequently necessary to
evaluate and treat other problems. The source is naturally dissolved calcium and magnesium from soil
and limestone. The symptoms are soap deposits; scaly deposits in plumbing and appliances; and
decreased cleaning action of soaps and detergents. The degree of water hardness is classified as follows:
Water Hardness
| Grains per Gallon
| Parts per Million (ppm)
| Soft
| 0 to 3
| 0 to 60| Moderate
| 3 to 7
| 60 to 120| Hard
| 7 to 10
| 120 to 180| Very Hard
| more than 10
| more than 180 | | | | |
The units of measurement are milligrams per liter (mg/L, micrometers (um) and picoCuries (pCi).
1985. National Primary Drinking Water Regulations; Volatile Synthetic Organic Chemicals. Federal
Register 50(219): 46879-46934.
1985. National Primary Drinking Water Regulations; Synthetic Organic Chemicals, Inorganic
Chemicals and Microorganisms. Federal Register 50(219): 46935-47022.
1987. National Primary Drinking Water Regulations; Synthetic Organic Chemicals; Monitoring for
Unregulated Contaminants. Federal Register 52(130): 25690-25734.
Boyd, S., A. Jones, A Knaus and C. McGrath (eds.). 1986. Drinking Water: A Community Action
Guide. Concern, Inc., Washington, D.C.
"Drinking Water: Present Problems, Future Directions." Nutrition Clinics. Woodruff, Sandra L., Vol. 5,
No. 2, 1990: 1-21.
Funingsland, S. and Lundstrum, D. Drinking Water and Health, North Dakota Cooperative Extension
Service, North Dakota State University, Fargo, ND, 1988.
Stewart, J.C., Lemley, A.T., Hogan, S.I., and Weismiller, R.A. Health Effects of Drinking Water
Contaminants, Cornell University and The University of Maryland under the
sponsorship of the USDA Extension Service, 1988.
"The Phases II Rule." EPA Fact Sheet. U.S. Environmental Protection Agency. September 1991.
"The Volatile Organic Chemicals Rule." EPA Fact Sheet. U.S. Environmental Protection Agency.
September, 1991.
Partial funding for this publication was provided by the Georgia Department of Agriculture and the Environmental
Protection Agency.
The University of Georgia and Ft. Valley State College, the U.S. Department of Agriculture and counties of the state
cooperating. The Cooperative Extension Service offers educational programs, assistance and materials to all people
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Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, The University of Georgia
College of Agricultural and Environmental Sciences and the U.S. Department of Agriculture cooperating.
Gale A. Buchanan, Dean and Director
Document use:
Permission is granted to reproduce these materials in whole or in part for
educational purposes only (not for profit beyond the cost of reproduction)
provided that the author and the University of Georgia receive
acknowledgement and the notice is included:
Reprinted with permission from the University of Georgia.
Dorman, D. (1996). Water Quality Problems: Health and Household. Athens, GA: University of Georgia, Cooperative Extension Service. Available from:
In Georgia:
Contact your local County Extension Office.
Out of state:
Distribution Center
Cooperative Extension Service
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Fax: (706) 542-2162
Phone: (706) 542-8946
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Content Person Contact: Jorge Atiles, Ph.D. jhatiles@fcs.uga.edu Copyright Permission: (706) 542-4860 Document Review: level 3: State/Regional Peer Review
Document Size: 28k Publication Date: 1996-03-01 Entry Date: 1997-08-01 Pull Date: 1999-08-01 Pub #: C819-8
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