Issues surrounding water infrastructure, access, and quality are well documented in the Central Appalachian region of the United States. Even in cases where residents have in-home piped point-of-use (POU) water, some rely on alternative drinking water sources for daily needs—including water collection from roadside springs. This effort aims to better understand and document spring usage in this region by identifying the factors that influence drinking water source selection and comparing household and spring water quality to Safe Drinking Water Act (SDWA) health-based and aesthetic contaminant recommendations. Households were recruited from communities surrounding known springs in three states (Kentucky, Virginia, and West Virginia). First- and second-draw, in-home POU tap water samples were collected from participating households and compared to samples collected from local springs on the same day. Samples were analyzed for fecal indicator bacteria and inorganic ions. Study participants completed surveys to document perceptions of household drinking water and typical usage. The majority of survey participants (82.6%) did not trust their home tap water due to aesthetic issues. Water quality results suggested that fecal indicator bacteria were more common in spring water, while several metallic ions were recovered in higher concentrations from household samples. These observations highlight that health risks and perceptions may be different between sources.

Significant challenges in the provision of safe drinking water and appropriate, effective sanitation remain in the United States, particularly among communities with few financial resources and/or situated in challenging terrain. Though previous formal research is limited, anecdotal reports suggest that some households in Appalachia may rely on untreated, unregulated roadside “springs” as a primary source of potable water. This effort monitored the water quality at twenty‐one of these springs in Central Appalachia and identified potential motivations for this behavior through volunteer surveys in order to better define community challenges and to establish communication for future outreach. The majority (>80%) of spring samples collected were positive for E. coli, indicating a potential risk of exposure to waterborne pathogens; measured concentrations of metals and nutrients were generally in accordance with USEPA recommendations for drinking water. Survey respondents generally had a piped source of in‐home water available yet primarily collected the water due to “taste” and “quality/health” and used it directly for drinking. Multiple respondents included extra written information indicating that they either did not trust their in‐home water source or considered it unreliable. Collectively these results suggest that these roadside springs do serve as a regular source of household water for some communities though they generally do not meet federal drinking water standards. Future efforts are encouraged to work with local municipal water authorities to rebuild community trust and/or to determine whether on‐site treatment at these springs is practicable.