Survey #: 100
Organization: Hawaii Department of Health

A public health team from the Hawaii Department of Health (DOH) and the Centers for Disease Control and Prevention (CDC) is conducting a survey to learn more about the experience of people who have been affected by the petroleum contamination in the U.S. Navy’s Joint Base Pearl Harbor-Hickam drinking water system.

Questions will cover water use, health symptoms, and more
The team will ask questions about ways you used the contaminated water, any health symptoms you have experienced, and medical care you have sought. There will also be questions about the impacts on you, your children, and pets. Your identity will be kept confidential.  

The information will help officials better respond to this and future incidents
The information the team collects will help DOH better understand the impacts of this contamination event and determine what steps are needed to protect the health of people who were exposed. It will also help DOH prepare for future incidents. Results will be summarized in a report that will be made publicly available.  

If you have any questions regarding the survey, please contact the HDOH/CDC team at


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Survey Starting Date: Friday, January 7, 2022 12:00 AM

Survey Closing Date: Monday, February 7, 2022 11:59 PM

Notice to Respondents:

This Epi Info™ Secure Web Survey system is approved for the collection of Personally Identifiable Information (PII) and Protected Health Information (PHI) as described in 45 CFR 160.103 and summarized at Summary of the HIPAA Privacy Rule  and HHS Office of Civil Rights: Summary of the HIPAA Privacy Rule PDF .  The survey that follows *MAY* collect your personally identifiable information. If you have any questions about how your data will be used, protected, and possibly shared, please contact the survey authors listed in the survey.