Do domestic animals contribute to bacterial contamination of infant transmission pathways? Formative evidence from Ethiopia.

Child stunting is associated with poor water, sanitation and hygiene (WASH), partly due to the effect of infection on intestinal nutrient absorption. WASH interventions, however, show little effect on growth. A hypothesis is that bacterial contamination of hands and floors from domestic animals and their faeces, and subsequent ingestion via infant hand-to-mouth behaviours, may explain this. This formative study used microbial testing and survey and observational data from 20 households in Ethiopia to characterise principle bacterial transmission pathways to infants, considering WASH facilities and practices, infant behaviours and animal exposure. Microbial swabbing showed the contamination of hands and floor surfaces from thermotolerant coliform bacteria. Animal husbandry practices, such as keeping animals inside, contributed significantly (all p < 0.005). There was no evidence that latrine facilities mitigated contamination across infant (p = 0.76) or maternal (p = 0.86) hands or floor surfaces (p = 0.36). This small study contributes to the evidence that animal faeces are an important source of domestic bacterial contamination. The results imply that interventions aiming to reduce pathogen transmission to infants should think beyond improving WASH and also consider the need to separate infants and animals in the home. Intervention studies will be required to determine whether this reduces infant infection and improves linear growth.

Estimation of particulate matter and gaseous concentrations using low-cost sensors from broiler houses.

Particulate and gaseous emissions from intensive poultry facilities are major public and environmental health concern. The present study was aimed at exploratively monitoring particulate matter (PM) and gaseous concentrations in controlled-environment facilities using low-cost sensors in Lahore, Pakistan. The indoors and outdoors of 18 broiler houses, grouped into three categories based on the age of birds: group I (1-20 days), group II (21-30 days) and group III (31-40 days), were examined. Low-cost sensors Dylos 1700 and Aeroqual 500 series with different gas sensor heads were used to monitor PM and different gases such as nitrogen dioxide (NO2), hydrogen sulphide (H2S), carbon dioxide (CO2) and methane (CH4), respectively. Overall, the mean PM and gaseous concentrations increased with the age and activity of birds as compared with the non-activity time of birds. Statistically significant differences were observed in all measured parameters among the groups. The negative correlation between indoor and outdoor environments for PM and gas concentrations at some broiler houses demonstrates the contribution of additional sources to emissions in outdoor environments. The findings contribute to our knowledge of temporal characteristics of particulate and gaseous concentrations from poultry facilities particularly in Pakistan and generally to the capability of using low-cost sensors to evaluate emissions from such facilities.

Thermodynamic analysis of a gamma type Stirling engine in an energy recovery system.

The demand for better hygiene has increased the need for developing more effective sanitation systems and facilities for the safe disposal of human urine and faeces. Non-Sewered Sanitary systems are considered to be one of the promising alternative solutions to the existing flush toilet system. An example of these systems is the Nano Membrane Toilet (NMT) system being developed at Cranfield University, which targets the safe disposal of human waste while generating power and recovering water. The NMT will generate energy from the conversion of human waste with the use of a micro-combustor; the heat produced will power a Stirling engine connected to a linear alternator to generate electricity. This study presents a numerical investigation of the thermodynamic analysis and operational characteristics of a quasi steady state model of the gamma type Stirling engine integrated into a combustor in the back end of the NMT system. The effects of the working gas, at different temperatures, on the Stirling engine performance are also presented. The results show that with the heater temperature of 390 °C from the heat supply via conduction at 820 W from the flue gas, the Stirling engine generates a daily power output of 27 Wh/h at a frequency of 23.85 Hz.

Probabilistic performance assessment of complex energy process systems - The case of a self-sustained sanitation system.

A probabilistic modelling approach was developed and applied to investigate the energy and environmental performance of an innovative sanitation system, the "Nano-membrane Toilet" (NMT). The system treats human excreta via an advanced energy and water recovery island with the aim of addressing current and future sanitation demands. Due to the complex design and inherent characteristics of the system's input material, there are a number of stochastic variables which may significantly affect the system's performance. The non-intrusive probabilistic approach adopted in this study combines a finite number of deterministic thermodynamic process simulations with an artificial neural network (ANN) approximation model and Monte Carlo simulations (MCS) to assess the effect of system uncertainties on the predicted performance of the NMT system. The joint probability distributions of the process performance indicators suggest a Stirling Engine (SE) power output in the range of 61.5-73 W with a high confidence interval (CI) of 95%. In addition, there is high probability (with 95% CI) that the NMT system can achieve positive net power output between 15.8 and 35 W. A sensitivity study reveals the system power performance is mostly affected by SE heater temperature. Investigation into the environmental performance of the NMT design, including water recovery and CO2/NOx emissions, suggests significant environmental benefits compared to conventional systems. Results of the probabilistic analysis can better inform future improvements on the system design and operational strategy and this probabilistic assessment framework can also be applied to similar complex engineering systems.

Design and commissioning of a multi-mode prototype for thermochemical conversion of human faeces.

This article describes the design and commissioning of a micro-combustor for energy recovery from human faeces, which can operate both in updraft and downdraft modes. Energy recovery from faecal matter via thermochemical conversion has recently been identified as a feasible solution for sanitation problems in low income countries and locations of high income countries where access to sewage infrastructures is difficult or not possible. This technology can be applied to waterless toilets with the additional outcome of generating heat and power that can be used to pre-treat the faeces before their combustion and to ensure that the entire system is self-sustaining. The work presented here is framed within the Nano Membrane Toilet (NMT) project that is being carried out at Cranfield University, as part of the Reinvent the Toilet Challenge of the Bill and Melinda Gates Foundation. For this study, preliminary trials using simulant faeces pellets were first carried out to find out the optimum values for the main operating variables at the scale required by the process, i.e. a fuel flowrate between 0.4 and 1.2 g/min of dry faeces. Parameters such as ignition temperature, residence time, and maximum temperature reached, were determined and used for the final design of the bench-scale combustor prototype. The prototype was successfully commissioned and the first experimental results, using real human faeces, are discussed in the paper.

Faecal-wood biomass co-combustion and ash composition analysis.

Fuel blending is a widely used approach in biomass combustion, particularly for feedstocks with low calorific value and high moisture content. In on-site sanitation technologies, fuel blending is proposed as a pre-treatment requirement to reduce moisture levels and improve the physiochemical properties of raw faeces prior to drying. This study investigates the co-combustion performance of wood dust: raw human faeces blends at varying air-to-fuel ratios in a bench-scale combustor test rig. It concludes with ash composition analyses and discusses their potential application and related problems. The study shows that a 50:50 wood dust (WD): raw human faeces (FC) can reduce moisture levels in raw human faeces by ∼40% prior to drying. The minimum acceptable blend for treating moist faeces without prior drying at a combustion air flow rate of 14-18 L/min is 30:70 WD: FC. For self-sustained ignition and flame propagation, the minimum combustion temperature required for conversion of the fuel to ash is ∼400 °C. The most abundant elements in faecal ash are potassium and calcium, while elements such as nickel, aluminium and iron are in trace quantities. This suggests the potential use of faecal ash as a soil conditioner, but increases the tendency for fly ash formation and sintering problems.

An experimental investigation of the combustion performance of human faeces.

Poor sanitation is one of the major hindrances to the global sustainable development goals. The Reinvent the Toilet Challenge of the Bill and Melinda Gates Foundation is set to develop affordable, next-generation sanitary systems that can ensure safe treatment and wide accessibility without compromise on sustainable use of natural resources and the environment. Energy recovery from human excreta is likely to be a cornerstone of future sustainable sanitary systems. Faeces combustion was investigated using a bench-scale downdraft combustor test rig, alongside with wood biomass and simulant faeces. Parameters such as air flow rate, fuel pellet size, bed height, and fuel ignition mode were varied to establish the combustion operating range of the test rig and the optimum conditions for converting the faecal biomass to energy. The experimental results show that the dry human faeces had a higher energy content (∼25 MJ/kg) than wood biomass. At equivalence ratio between 0.86 and 1.12, the combustion temperature and fuel burn rate ranged from 431 to 558 °C and 1.53 to 2.30 g/min respectively. Preliminary results for the simulant faeces show that a minimum combustion bed temperature of 600 ± 10 °C can handle faeces up to 60 wt.% moisture at optimum air-to-fuel ratio. Further investigation is required to establish the appropriate trade-off limits for drying and energy recovery, considering different stool types, moisture content and drying characteristics. This is important for the design and further development of a self-sustained energy conversion and recovery systems for the NMT and similar sanitary solutions.

Conceptual energy and water recovery system for self-sustained nano membrane toilet.

With about 2.4 billion people worldwide without access to improved sanitation facilities, there is a strong incentive for development of novel sanitation systems to improve the quality of life and reduce mortality. The Nano Membrane Toilet is expected to provide a unique household-scale system that would produce electricity and recover water from human excrement and urine. This study was undertaken to evaluate the performance of the conceptual energy and water recovery system for the Nano Membrane Toilet designed for a household of ten people and to assess its self-sustainability. A process model of the entire system, including the thermochemical conversion island, a Stirling engine and a water recovery system was developed in Aspen Plus®. The energy and water recovery system for the Nano Membrane Toilet was characterised with the specific net power output of 23.1 Wh/kgsettledsolids and water recovery rate of 13.4 dm3/day in the nominal operating mode. Additionally, if no supernatant was processed, the specific net power output was increased to 69.2 Wh/kgsettledsolids. Such household-scale system would deliver the net power output (1.9-5.8 W). This was found to be enough to charge mobile phones or power clock radios, or provide light for the household using low-voltage LED bulbs.

Storage duration and temperature affect pathogen load, heavy metals, and nutrient levels in faecal derived fertiliser.

There are debates regarding the safety of faecal derived fertiliser (FDF) due to notions that harmful substances may persist at undetectable levels. A major concern is the recolonisation of indigenous pathogens and nutrient changes while undergoing storage. Abiotic factors such as duration and temperature on indigenous pathogen re-growth and nutrient during FDF storage have received little research attention. In this study, we assess the effect of varying storage temperature conditions and duration on indigenous E. coli re-growth and NPK changes of different FDF (enriched co-compost, NECo and co-compost, Co) during storage. A 2 × 3 × 6 factorial design was used with factors: fertiliser, temperature, and duration. The factorial had 36 experimental conditions in a completely randomised design with three replications. FDF samples were collected monthly for 6 months and analysed for pH, EC, organic carbon, N, NH4-N, NO3-N, P, K, E. coli, and total coliform. Findings show storage temperature and duration did not affect indigenous E. coli re-growth and total N in stored NECo and Co. However, NH4-N concentrations of NECo decreased between 27% and 55% with increasing duration of storage at lower temperatures (5°C and 25°C). The significance of this study for the FDF industry is that it is safe after storage and longer storage do not necessarily influence nutrient losses in stored FDF. Future studies are recommended to investigate the effect of moisture on stored FDF.

Air quality and mental health: evidence, challenges and future directions.

BACKGROUND: Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. AIMS: We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them. METHOD: Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges. RESULTS: There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific mental disorders. Furthermore, pre-existing long-term conditions appear to deteriorate, requiring more healthcare. Evidence of critical periods for exposure among children and adolescents highlights the need for more longitudinal data as the basis of early preventive actions and policies. Particulate matter, including bioaerosols, are implicated, but form part of a complex exposome influenced by geography, deprivation, socioeconomic conditions and biological and individual vulnerabilities. Critical knowledge gaps need to be addressed to design interventions for mitigation and prevention, reflecting ever-changing sources of air pollution. The evidence base can inform and motivate multi-sector and interdisciplinary efforts of researchers, practitioners, policy makers, industry, community groups and campaigners to take informed action. CONCLUSIONS: There are knowledge gaps and a need for more research, for example, around bioaerosols exposure, indoor and outdoor pollution, urban design and impact on mental health over the life course.

Detection and characterization of bioaerosol emissions from wastewater treatment plants: Challenges and opportunities.

Rapid population growth and urbanization process have led to increasing demand for wastewater treatment capacity resulting in a non-negligible increase of wastewater treatment plants (WWTPs) in several cities around the world. Bioaerosol emissions from WWTPs may pose adverse health risks to the sewage workers and nearby residents, which raises increasing public health concerns. However, there are still significant knowledge gaps on the interplay between process-based bioaerosol characteristics and exposures and the quantification of health risk which limit our ability to design effective risk assessment and management strategies. This review provides a critical overview of the existing knowledge of bioaerosol emissions from WWTPs including their nature, magnitude and size distribution, and highlights the shortcoming associated with existing sampling and analysis methods. The recent advancements made for rapid detection of bioaerosols are then discussed, especially the emerging real time detection methods to highlight the directions for future research needs to advance the knowledge on bioaerosol emissions from WWTPs.

Faeces - Urine separation via settling and displacement: Prototype tests for a novel non-sewered sanitation system.

The development of novel, non-sewered sanitation systems like the Nano Membrane Toilet requires thorough investigation of processes that may seem well-understood. For example, unlike the settling of primary sludge, the separation of solids from liquids in a small-volume container at the scale of a household toilet has not been studied before. In two sets of experiments, the settling of real faeces and toilet paper in settling columns and the settling of synthetic faeces in a conical tank are investigated to understand the factors affecting the liquid quality for downstream treatment processes. Toilet paper is found to be a major inhibitor to settling of solids. While a lower overflow point results in better phase separation through displacement of liquid, a higher overflow point and frequent removal of solids may be more advantageous for the liquid quality.

Investigating awareness, fear and control associated with norovirus and other pathogens and pollutants using best-worst scaling.

Pollutants found in the water and air environment represent an ever-growing threat to human health. Contact with some air-, water- and foodborne pathogens (e.g. norovirus) results in gastrointestinal diseases and outbreaks. For future risk mitigation, we aimed to measure people's awareness of waterborne and foodborne norovirus relative to other environment-associated pollutants (e.g. pesticides, bioaerosols, antibiotic resistant bacteria) and well-known risks (e.g. diabetes, dementia, terrorist attack). We used an online survey, which included a best-worst scaling component to elicit personal levels of control and fear prompted by norovirus relative to 15 other risks. There was a negative correlation between levels of fear vs. control for all 16 measured risks. Perceived infection control levels were higher amongst women compared to men and correlated with age and the level of qualification in both groups. Participants who had sought advice regarding the symptoms caused by norovirus appeared to have more control over the risks. Norovirus is associated with high levels of fear, however, the levels of control over it is low compared to other foodborne illnesses, e.g. Salmonella. Addressing this deficit in the public's understanding of how to control exposure to the pathogen in an important health need.

Membrane distillation of concentrated blackwater: Effect of temperature, solids concentration and membrane pore size.

This study has elucidated the mechanisms governing water recovery from blackwater using membrane distillation, and has clarified the role of the organic particle fraction on membrane performance. Whilst fecal pathogen growth was initially observed at lower temperatures, pathogen inactivation was demonstrated over time, due to urea hydrolysis which liberated ammonia in excess of its toxic threshold. During the growth phase, membrane pore size <0.45 µm was sufficient to achieve high log reduction values for Escherichia coli, due to size exclusion complimented by the liquid-vapor interface which enhances selective transport for water. Higher feed temperatures benefitted rejection by promoting thermal inactivation and suppressing urea hydrolysis. Whilst the mechanism is not yet clear, suppression of hydrolysis reduced bicarbonate formation kinetics stabilizing the ammonia-ammonium equilibrium which improved ammonium rejection. Blackwater particle concentration was studied by increasing fecal content. Particle fouling improved selectivity for coarse pore membranes but increased mass transfer resistance which reduced flux. Particle fouling induced wetting as noted by an eventual breakthrough of feed into the permeate. We propose that by incorporating upstream solid-liquid separation for particle separation to limit wetting and mass transfer resistance, membrane distillation can be a reliable solution for the recovery of high-quality permeate from blackwater. PRACTITIONER POINTS: Membrane distillation demonstrated for concentrated blackwater. Multiple factors provide robust pathogen separation (pore size, vapor-liquid interface, temperature, free-ammonia). Excellent water quality produced for feed 40 times more concentrated than wastewater. Removing particle fraction will improve separation robustness and operating longevity.

A randomised controlled feasibility trial of a BabyWASH household playspace: The CAMPI study.

BACKGROUND: Water, sanitation and hygiene (WASH) interventions should support infant growth but trial results are inconsistent. Frequently, interventions do not consider behaviours or transmission pathways specific to age. A household playspace (HPS) is one intervention component which may block faecal-oral transmission. This study was a two-armed, parallel-group, randomised, controlled feasibility trial of a HPS in rural Ethiopia. It aimed to recommend proceeding to a definitive trial. Secondary outcomes included effects on infant health, injury prevention and women's time. METHODS: November 2019-January 2020 106 households were identified and assessed for eligibility. Recruited households (N = 100) were randomised (blinded prior to the trial start) to intervention or control (both n = 50). Outcomes included recruitment, attrition, adherence, and acceptability. Data were collected at baseline, two and four weeks. FINDINGS: Recruitment met a priori criteria (≥80%). There was no loss to follow-up, and no non-use, meeting adherence criteria (both ≤10%). Further, 48.0% (95% CI 33.7-62.6; n = 24) of households appropriately used and 56.0% (41.3-70.0; n = 28) cleaned the HPS over four weeks, partly meeting adherence criteria (≥50%). For acceptability, 41.0% (31.3-51.3; n = 41) of infants were in the HPS during random visits, failing criteria (≥50%). Further, the proportion of HPS use decreased during some activities, failing criteria (no decrease in use). A modified Barrier Analysis described good acceptability and multiple secondary benefits, including on women's time burden and infant injury prevention. INTERPRETATION: Despite failing some a priori criteria, the trial demonstrated mixed adherence and good acceptability among intervention households. A definitive trial to determine efficacy is warranted if recommended adjustments are made. FUNDING: People In Need; Czech Development Agency. TRIAL REGISTRATION: RIDIE-ID-5de0b6938afb8.

Size fractionation of bioaerosol emissions from green-waste composting.

Particle size is a significant factor in determining the dispersal and inhalation risk from bioaerosols. Green-waste composting is a significant source of bioaerosols (including pathogens), but little is known about the distribution of specific taxa across size fractions. To characterise size fractionated bioaerosol emissions from a compost facility, we used a Spectral Intensity Bioaerosol Sensor (SIBS) to quantify total bioaerosols and qPCR and metabarcoding to quantify microbial bioaerosols. Overall, sub-micron bioaerosols predominated, but molecular analysis showed that most (>75%) of the airborne microorganisms were associated with the larger size fractions (>3.3 µm da). The microbial taxa varied significantly by size, with Bacilli dominating the larger, and Actinobacteria the smaller, size fractions. The human pathogen Aspergillus fumigatus dominated the intermediate size fractions (>50% da 1.1-4.7 µm), indicating that it has the potential to disperse widely and once inhaled may penetrate deep into the respiratory system. The abundance of Actinobacteria (>60% at da < 2.1 µm) and other sub-micron bioaerosols suggest that the main health effects from composting bioaerosols may come from allergenic respiratory sensitisation rather than directly via infection. These results emphasise the need to better understand the size distributions of bioaerosols across all taxa in order to model their dispersal and to inform risk assessments of human health related to composting facilities.

Assessment of Respiratory Problems in Workers Associated with Intensive Poultry Facilities in Pakistan.

BACKGROUND: The poultry industry in Pakistan has flourished since the 1960s; however, there are scarce data regarding the impact of occupational exposure on the pulmonary health of farm workers in terms of years working in the industry. The objective of the present study was to assess the effect of poultry environment on the health of occupationally exposed poultry farmers in countries of warm climatic regions, such as Pakistan. This study will also show the effect of exposure to poultry facilities on the health of poultry farmers in the context of low-income countries with a relatively inadequate occupational exposure risk management. MATERIALS AND METHODS: The lung function capacity of 79 poultry workers was measured using a spirometer. Along with spirometry, a structured questionnaire was also administrated to obtain information about age, height, weight, smokers/nonsmokers, years of working experience, and pulmonary health of farm workers. The workers who were directly involved in the care and handling of birds in these intensive facilities were considered and divided into four groups based on their years of working experience: Group I (3-10 months), Group II (1-5 years), Group III (6-10 years), and Group IV (more than 11 years). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio were considered to identify lung function abnormalities. Statistical analysis was carried out using independent sample t test, Chi-square test, Pearson's correlation, and linear regression. RESULTS: Based on the performed spirometry, 68 (86 %) of workers were found normal and healthy, whereas 11 (14 %) had a mild obstruction. Of the 11 workers with mild obstruction, the highest number with respect to the total was in Group IV (more than 11 years of working experience) followed by Group III and Group II. Most of the workers were found healthy, which seems to be because of the healthy survivor effect. For the independent sample t test, a significant difference was noticed between healthy and nonhealthy farmers, whereas Chi-square test showed a significant association with height, drugs, and working experience. Linear regression that was stratified by respiratory symptoms showed for workers with symptoms, regression models for all spirometric parameters (FVC, FEV1, and FEV1/FVC) have better predictive power or R square value than those of workers without symptoms. CONCLUSION: These findings suggest that lung function capacity was directly related to years of working experience. With increasing number of working years, symptoms of various respiratory problems enhanced in the poultry workers. It should be noted that most of the poultry workers were healthy and young, the rationale being that there is a high turnover rate in this profession. The mobility in this job and our finding of 86% of the healthy workers in the present study also proposed healthy worker survivor effect.

Lysis Performance of Bacteriophages with Different Plaque Sizes and Comparison of Lysis Kinetics After Simultaneous and Sequential Phage Addition.

Background: Although bacteriophages see a revival for specifically removing undesired bacteria, there is still much uncertainty about how to achieve the most rapid and long-lasting clearance. Materials and Methods: This study investigated the lysis kinetics of three distinct environmental coliphages, reproducibly forming different plaque sizes (big, medium, and small). Lysis performance by individual phages was compared with the one obtained after simultaneous or sequential addition of all three phages. Kinetics was monitored by density absorbance or by flow cytometry, with the latter having the advantage of providing higher sensitivity. Results: Plaque size happened to correlate with lysis kinetics in liquid suspensions, with phages producing big (phage B), medium (phage M), and small (phage S) plaques showing maximal bacterial clearance under the chosen conditions within ∼6, 12, and 18 h, respectively. Use of a phage cocktail (all three phages added simultaneously) resulted in slower initial lysis compared with the fastest lysing phage with the greatest plaque size alone, but it showed longer efficacy in suppression. When adding phages sequentially, overall lysis kinetics could be influenced by administering phages at different time points. The lowest bacterial concentration after 36 h was obtained when administering phages in the sequence S, M, and B although this combination initially took the longest to achieve bacterial clearance. Conclusions: Results support that timing and order of phage addition can modulate strength and duration of bacterial suppression and, thus, influence the overall success of phage treatment.

Risk factors and transmission pathways associated with infant Campylobacter spp. prevalence and malnutrition: A formative study in rural Ethiopia.

Early infection from enteropathogens is recognised as both a cause and effect of infant malnutrition. Specifically, evidence demonstrates associations between growth shortfalls and Campylobacter infection, endemic across low-income settings, with poultry a major source. Whilst improvements in water, sanitation and hygiene (WASH) should reduce pathogen transmission, interventions show inconsistent effects on infant health. This cross-sectional, formative study aimed to understand relationships between infant Campylobacter prevalence, malnutrition and associated risk factors, including domestic animal husbandry practices, in rural Ethiopia. Thirty-five households were visited in Sidama zone, Southern Nations, Nationalities and Peoples' region. Infant and poultry faeces and domestic floor surfaces (total = 102) were analysed for presumptive Campylobacter spp. using selective culture. Infant anthropometry and diarrhoeal prevalence, WASH facilities and animal husbandry data were collected. Of the infants, 14.3% were wasted, 31.4% stunted and 31.4% had recent diarrhoea. Presumptive Campylobacter spp. was isolated from 48.6% of infant, 68.6% of poultry and 65.6% of floor surface samples. Compared to non-wasted infants, wasted infants had an increased odds ratio (OR) of 1.41 for a Campylobacter-positive stool and 1.81 for diarrhoea. Positive infant stools showed a significant relationship with wasting (p = 0.026) but not stunting. Significant risk factors for a positive stool included keeping animals inside (p = 0.027, OR 3.5), owning cattle (p = 0.018, OR 6.5) and positive poultry faeces (p<0.001, OR 1.34). Positive floor samples showed a significant correlation with positive infant (p = 0.023), and positive poultry (p = 0.013, OR 2.68) stools. Ownership of improved WASH facilities was not correlated with lower odds of positive stools. This formative study shows a high prevalence of infants positive for Campylobacter in households with free-range animals. Findings reaffirm contaminated floors as an important pathway to infant pathogen ingestion and suggest that simply upgrading household WASH facilities will not reduce infection without addressing the burden of contamination from animals, alongside adequate separation in the home.

Real time detection and characterisation of bioaerosol emissions from wastewater treatment plants.

Bioaerosol emissions from wastewater treatment plants may pose adverse health impact on workers and nearby communities. To detect and characterise bioaerosol emissions from wastewater treatment plant (WWTP), a novel real-time bioaerosol sensor, Spectral Intensity Bioaerosol Sensor (SIBS) was employed at a WWTP and a background site. The SIBS records a range of data (size, shape, and fluorescence emission across 16 wavelength bands from 298 to 735 nm for two excitation wavelengths (285 nm and 370 nm)) on single particles in real time. Additionally, excitation-emission matrix (EEM) of wastewater samples obtained by a spectrofluorometer was compared with SIBS spectra from WWTP. The results showed that the average number concentrations of total particles (NT) and fluorescence particles (NF) were both higher at the WWTP (NT = 2.01 cm-3, NF = 1.13 cm-3) than the background site (NT = 1.79 cm-3, NF = 1.01 cm-3). The temporal variation of NF and NT was highly variable at the WWTP and the concentration peaks were consistent with on-site activities. Moreover, the time-resolved number-size distribution of fluorescent particles revealed the predominance of fine scale particles (<1 µm) and the time-series channel by channel number concentrations demonstrated the temporal variability of dominant bio-fluorophores. Furthermore, the overall and size-segregated fluorescence spectra at two sites were multimodal. In particular, the fluorescence intensity increases with increasing particle size in WWTP spectra, which is not present in the background spectra. In addition, the highly resolved SIBS fluorescence spectra were broadly similar to EEM of wastewater. These findings confirmed that the spectrally resolved fluorescence detected by SIBS is capable of providing reliable bio-fluorophores information of bioaerosol emissions generated from wastewater, thus holding the potential for better characterisation of bioaerosols in real time.