Preventive Actions and Risk Culture Are Key Drinking Water Microbial Risk Management Indicators: Evidence from Canadian Stakeholders
Risk management systems are increasingly implemented by drinking water utilities to prevent contamination events. While some Canadian provinces have mandated these systems, evaluating their success remains challenging due to uncertainty about which indicators accurately reflect risk management effectiveness across different regulatory approaches. This study explores perceptions of appropriate risk management indicators through interviews with 21 drinking water regulators and utility staff from four Canadian provinces with varied regulations. Using inductive and deductive qualitative analysis, we found that regulatory compliance, while vital for public health protection, was universally perceived as an insufficient standalone indicator due to limited risk coverage and context-specificity. Respondents identified preventive measures in the themes of─risk assessment, control barriers, and preventive maintenance─as more accurate indicators because they demonstrate proactive identification and mitigation of potential risks. However, respondents emphasized that these indicators must be interpreted through the lens of utility motivation and risk culture. Crucially, understanding risk culture among frontline operational staff emerged as essential for discerning risk management quality, highlighting the importance of better supporting these personnel in their critical role of protecting public health.