Hand hygiene and water quality assessment in schools of Muthanna province, Southern Iraq.

INTRODUCTION: The severe drought and prolonged heat waves in Iraq have adversely affected the water quality supplied to public facilities. Schools are among the most affected facilities by water scarcity. This work aims to evaluate the level of students' hand hygiene, and the quality of municipal (MW) and drinking water (DW) in some schools of Al-Muthanna Province, Iraq. METHODOLOGY: Between October 2021 and June 2022, a total of 324 water samples from 162 schools and 2,430 hand swabs (HSs) from 1,620 students (1,080 males and 540 females) were collected. Some physicochemical standards of water were assessed besides investigating faecal contamination in water and students' hands using Escherichia coli as an indicator. RESULTS: All MW samples were faecally contaminated with poor standards of pH, turbidity, total dissolved solids, color, and chlorine. Despite the good physicochemical standards of all DW samples, E. coli was observed in 12% of samples. Hand hygiene levels dropped by 2.5-fold within a few hours after school entry compared to early-morning levels (before school entry). Male students were 1.5- and 1.7-fold more prone to hand contamination than female students either inside or outside school, respectively. An increasing chlorine tolerance by E. coli was observed in water samples with turbidity > 5 NTU and pH > 8. CONCLUSIONS: The students' hand hygiene level decreases within a few hours of entering school, particularly among male students. Residual-free chlorine < 0.5 mg/L with high turbidity and alkalinity in water is insufficient for 100% prevention of E. coli contamination.

Water stable isotopes reveal a complex rainfall to groundwater connectivity in central Honduras.

The inter-mountainous region of central Honduras has been experiencing abrupt urban drinking water shortages during the last decade. Land use fragmentation and rainfall deficits have rapidly reduced surface water quality and quantity in this region. Here we present a 3-yr (2018-2020) tracer study within the headwaters of the Choluteca River basin (2949 km2). We sampled rainfall (weekly N = 156; daily N = 270), drilled wells (N = 166; up to ~300 m depth), boreholes (N = 70; ~4-12 m depth), and springs (N = 128) to assess the spatiotemporal connectivity between rainfall and mean groundwater recharge elevations (MREs). Clear W-shaped incursions characterized rainfall isotopic seasonality from the dry to the wet season. Air mass back trajectory analysis revealed three primary moisture sources: 73 % (east, Caribbean Sea), 17 % (southwest, Pacific Ocean), and 10 % (north; Gulf of Mexico). Groundwater sources exhibited a strong meteoric origin with evidence of secondary evaporation evolution, characterized by low d-excess values. MREs for the drilled wells ranged from 821 to 2018 m asl with a mean value of 1570 ± 150 m asl. Seasonal isotopic variability during dry-wet transitions and the influence of rapid infiltration limited the performance of the MRE method in springs and boreholes. MREs coincided primarily with coniferous forests, pasture, and crop areas, within regions of moderate to high transmissivity. These results are intended to guide the mapping and delineation of critical recharge areas in central Honduras to enhance municipal water regulations, effective environmental protection, and long-term conservation practices.

A review of legionnaires' disease and public water systems - Scientific considerations, uncertainties and recommendations.

Legionella is an opportunistic premise plumbing pathogen and causative agent of a severe pneumonia called Legionnaires' Disease (LD). Cases of LD have been on the rise in the U.S. and globally. Although Legionella was first identified 45 years ago, it remains an 'emerging pathogen." Legionella is part of the normal ecology of a public water system and is frequently detected in regulatory-compliant drinking water. Drinking water utilities, regulators and public health alike are increasingly required to have a productive understanding of the evolving issues and complex discussions of the contribution of the public water utility to Legionella exposure and LD risk. This review provides a brief overview of scientific considerations important for understanding this complex topic, a review of findings from investigations of public water and LD, including data gaps, and recommendations for professionals interested in investigating public water utilities. Although the current literature is inconclusive in identifying a public water utility as a sole source of an LD outbreak, the evidence is clear that minimizing growth of Legionella in public water utilities through proper maintenance and sustained disinfectant residuals, throughout all sections of the water utility, will lead to a less conducive environment for growth of the bacteria in the system and the buildings they serve.

Plastics in municipal drinking water and wastewater treatment plant effluents: challenges and opportunities for South Africa-a review.

Pervasive plastic wastes, pollution and detrimental environmental ethics are a serious threat in South Africa. Compared with global trends, most studies undertaken on plastic pollutions in water bodies across South Africa have generally been limited to marine and coastal waters. A literature review, for the last 40 years, demonstrated the scanty studies on the economic, social, health and cost implications of plastic entrainment into fresh water (sources of drinking water) and wastewater systems in South Africa. Hence, demonstrating a knowledge gap on this imperative issue, the inadequate and limited frameworks needed in assessing, evaluating and re-evaluating the menace of plastic pollution and entrainments into consumable water and wastewater treatment plants. This has hampered the local capacity, manpower, knowledge and understanding direly needed for mitigating these challenges. This work is necessitated because of the dire need in bridging the knowledge gap locally by adaptively reviewing possible challenges and opportunities for South Africa in meeting up the mandate of addressing this global threat. The emerging agreement amongst global policy-makers, educators and scientists is that environmental challenges, such as this, require, now more than ever, renewed ways of effective knowledge production and decision-making in tackling, holistically the menace of mismanaged plastic wastes and pollutions. These include but not limited to plastic education curriculum, synergised policies in fostering a circular plastic economy, overriding political will, innovative waste management systems, inclusive independent monitoring of plastic wastes, robust laws and effective enforcement strategies that are needed to promote better environmental ethics, mitigation and a sustainable environment.

Quality and safety of municipal drinking water in Addis Ababa City, Ethiopia.

BACKGROUND: In low resourced countries, water-associated diseases have still impact on public health. Poor quality of water can cause waterborne diseases through bacteria, viruses, protozoa, and parasites that has been responsible for millions of morbidity and mortality. Therefore, this study aimed to assess quality and safety of public municipal drinking water in Addis Ababa City. METHODS: Descriptive epidemiological study design that used quantitative approach was carried out at Addis Ababa City Administration from June 2016 to October 2016. Pre-tested and standardized aseptic sample collection technique was utilized to collect a total of 2976 samples (2951 water samples for bacteriological analysis by Presence-Absence (P-A) culturing method and 25 samples for parasites identification through direct microscopy examination). Descriptive data were summarized and cleaned by the SPSS version 20 software and presented in table and graph. RESULTS: The study revealed that 10%, 7% and 3% were positive for bacteriological, total coliforms, and fecal coliforms respectively through Presence-Absence Broth test. The bacterial distribution trends from 1st to 13th weeks of wet season were slight increment of total coliforms and slight decrement for fecal coliforms. All tested for parasitological samples from selected reservoirs were free from parasitological species. CONCLUSION: This study reflects that there were positive for bacterial, total coliforms, and fecal coliforms during the study period. It needs continuous screening and treating water sources to utmost important for prevention and control waterborne disease.

Silicon Nanomembrane Filtration and Imaging for the Evaluation of Microplastic Entrainment along a Municipal Water Delivery Route.

To better understand the origin of microplastics in municipal drinking water, we evaluated 50 mL water samples from different stages of the City of Rochester's drinking water production and transport route, from Hemlock Lake to the University of Rochester. We directly filtered samples using silicon nitride nanomembrane filters with precisely patterned slit-shaped pores, capturing many of the smallest particulates (<20 µm) that could be absorbed by the human body. We employed machine learning algorithms to quantify the shapes and quantity of debris at different stages of the water transport process, while automatically segregating out fibrous structures from particulate. Particulate concentrations ranged from 13 to 720 particles/mL at different stages of the water transport process and fibrous pollution ranged from 0.4 to 8.3 fibers/mL. A subset of the debris (0.2-8.6%) stained positively with Nile red dye which identifies them as hydrophobic polymers. Further spectroscopic analysis also indicated the presence of many non-plastic particulates, including rust, silicates, and calcium scale. While water leaving the Hemlock Lake facility is mostly devoid of debris, transport through many miles of piping results in the entrainment of a significant amount of debris, including plastics, although in-route reservoirs and end-stage filtration serve to reduce these concentrations.

Reduction of DBPs in synthetic water by indoor techniques and its implications on exposure and health risk.

Disinfection byproducts (DBPs) in municipal supply water have been a concern. Many DBPs have been characterized as possible and probable human carcinogens, which can pose elevated cancer risks through lifetime exposure to municipal supply water. Few DBPs are regulated in many countries to control human exposure and risk from DBPs. In risk assessment studies, concentration of DBPs in water distribution systems is often used, whereas populations are typically exposed to indoor tap water. Through employing several techniques, DBPs can be reduced prior to water consumption, which is likely to reduce human exposure and risk of DBPs. This study investigated six indoor techniques in reducing trihalomethanes (THMs) and haloacetic acids (HAAs) in synthetic water and the effects of these techniques on exposure and risk. The techniques are: S1, S2: storing water in a refrigerator with and without lids respectively; S3, S4: boiling water for 1 min followed by storing in a refrigerator with and without lids respectively; S5, S6: filtering water using new and used granular activated carbon (GAC) filters and storing in a refrigerator without lids. Storing of water (S1, S2) reduced THMs in the range of 14.8-47.2% while boiling (S3, S4) and filtration (S5, S6) reduced THMs in the range of 77.3-92.8%. In S1-S4 techniques, HAAs were not reduced significantly while in S5 - S6 techniques, HAAs were reduced in the range of 64.7-69.8%. In S3-S6 techniques, overall cancer and non-cancer risks were reduced by 45.5-82.6% and 26.3-80.0% respectively. The findings might prove useful in understanding DBPs exposure, associated risks, strategies to minimize exposure to these contaminants and updating regulatory guidelines for better protection of health risks from DBPs.

Microbial Interaction as a Determinant of the Quality of Supply Drinking Water: A Conceptual Analysis.

This conceptual analysis elucidates the microbial interaction inside municipal distribution pipes, subsequent deterioration in the quality of the supply water, and its impacts on public health. Literature review involved a total of 21 original reports on microbiological events inside the water distribution system were studied, summarizing the current knowledge about the build-up of microbes in treated municipal water at various points of the distribution system. Next, original reports from the microbiological analysis of supply water from Bangladesh were collected to enlist the types of bacteria found growing actively. A schematic diagram of microbial interaction among the genera was constructed with respect to the physical, chemical, and microbiological quality of the supply water. Finally latest guidelines and expert opinions from public health authorities around the world are reviewed to keep up with using cutting-edge molecular technology to ensure safe and good quality drinking water for municipal supply.

Internal (blue) water footprint of municipal consumption: a case study for Turkey.

This study aimed to develop a common approach to investigate (blue) water footprint of consumption of municipalities. Analysis framework consists of two distinct phases as: water abstraction profile and water distribution and water use profile. In the proposed approach municipal water footprint (WFmunicipal) comprises three components: domestic water footprint (WFdomestic), industrial/commercial water footprint (WFindustrial/commercial), and public water footprint (WFpublic). The application of the methodology was demonstrated in Turkey. The overall objective was to identify water consumption profile regarding model components and assess spatial and temporal distributions in the country scale. In this scope, each component was determined for 81 cities. After the investigation of spatial differences, an answer to the question of, "whether water use is increasing or decreasing over time" was found. Results investigated that WFmunicipal was 140 L/ca.day in average and reached up to 300 L/ca.day in some cities. WFdomestic was about 100 L/ca.day and cities having lower values mostly located on north-west, south-east of the country. Furthermore, few spots with high values were observed for WFindustrial/commercial (with 10 L/ca.day average), and relatively lower values belonged to the cities in south-eastern region. WFpublic having 30 L/ca.day mean value had extremes in eastern part. Based on water consumption characteristics, cities were grouped using factor analysis and results created four groups of cities. Although eastern and western cities had no trends in water abstraction rate, other regions had decreasing trend in last 20 years. Investigation of (blue) water footprint of consumption of municipalities is believed to assist water managers to identify water use profiles and assess spatial and temporal distributions. This is important because water resources are becoming increasingly stretched to accommodate continued population and economic growth and to restore environmental flows.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Cutaneous Manifestations of Mycobacterium kansasii Infection.

Purpose of Review: Mycobacterium kansasii is a slow-growing member of the nontuberculous mycobacterial species that manifests clinically with pulmonary, cutaneous, or disseminated forms. Most cases of M. kansasii infection occur in immunocompromised hosts including HIV/AIDS, solid-organ transplantation, anti-interferon-γ antibody disorder, or among those with pulmonary disorders such as chronic obstructive pulmonary disease or cystic fibrosis. In this review, we aim to discuss relevant literature regarding the clinical manifestations of this infection with a particular emphasis on the clinical spectrum and treatment of the cutaneous manifestations of this mycobacterial infection. Recent Findings: Infection caused by M. kansasii is associated with exposure to contaminated municipal water systems since this organism thrives in human-engineered environments. Chronic or subacute skin lesions may represent the primary source of entry of the organism due to open sores or traumatic injuries. Alternatively, cutaneous lesions may occur secondary to dissemination of the organism to the skin from pulmonary infection. The diagnosis of M. kansasii of the skin and soft tissues should be entertained among immunocompetent or immunocompromised individuals presenting with subacute or chronic lesions. The differential diagnosis of M. kansasii infection includes infections of skin and soft tissues caused by rapidly growing mycobacteria, subcutaneous mycosis, pyogenic bacterial infections, nocardiosis, free-living amoebas, and protothecosis. Summary: Cutaneous lesions caused by M. kansasii most commonly manifest in the setting of concomitant pulmonary disease or in the setting of disseminated infection among immunocompromised hosts. When clinicians suspect a cutaneous mycobacterial infection either due to slow-growing mycobacteria such as M. kansasii or due to rapidly growing mycobacteria, obtaining a skin biopsy of chronic nonhealing lesions for histopathologic evaluation and for microbiological assessment is crucial. Mycobacteriology assessment of clinical specimen includes acid-fast bacilli staining, culture in solid/liquid media, and molecular assays for confirmation. Treatment of M. kansasii infection of the skin and subcutaneous tissues follows the same management recommendations as those for the treatment of isolated pulmonary forms or disseminated disease.

Assessment of the municipal water cycle in China.

Water produced from municipal utilities accounts for nearly 10% of the sum water demand in China. The municipal water cycle that integrates processes of urban water supply, water use, sewage treatment, and water reclamation has been assessed for 655 cities across nine drainage areas in mainland China in 2012. These cities in total extracted 55km3 raw water for municipal use from surface waterbodies and ground aquifers, approximate to the countrywide freshwater extraction of Russia or Italy. After purification and transmission, 45km3 water was distributed to industrial, service, and domestic users. 36km3 of post-use sewage was collected and environmentally safely treated; merely 3.2km3 of the treated water was reclaimed. Driven by increasing urbanization, the municipal water demand in cities of China may grow 70% by 2030. The Hai River and the Huai River basins, which harbor 137 cities and occupy a majority of the densely populated North China Plain, are most exposed to physical water scarcity. The municipal water abstraction in these cities can remain constant by promoting demand-side and process conservation in the next two decades. Interbasin transfer and unconventional sources will provide municipal water double than the cities' need. Whereas the urban water security can be technically enhanced, the challenges are to better improve water use efficiency and mitigate economic and environmental costs of the municipal system.

Life cycle assessment of a commercial rainwater harvesting system compared with a municipal water supply system.

Building upon previously published life cycle assessment (LCA) methodologies, we conducted an LCA of a commercial rainwater harvesting (RWH) system and compared it to a municipal water supply (MWS) system adapted to Washington, D.C. Eleven life cycle impact assessment (LCIA) indicators were assessed, with a functional unit of 1 m3 of rainwater and municipal water delivery system for toilets and urinals in a four-story commercial building with 1000 employees. Our assessment shows that the benchmark commercial RWH system outperforms the MWS system in all categories except Ozone Depletion. Sensitivity and performance analyses revealed pump and pumping energy to be key components for most categories, which further guides LCIA tradeoff analysis with respect to energy intensities. Tradeoff analysis revealed that commercial RWH performed better than MWS in Ozone Depletion if RWH's energy intensity was less than that of MWS by at least 0.86 kWh/m3 (249% of the benchmark MWS energy usage at 0.35 kWh/m3). RWH also outperformed MWS in Metal Depletion and Freshwater Withdrawal, regardless of energy intensities, up to 5.51 kWh/m3. An auxiliary commercial RWH system with 50% MWS reduced Ozone Depletion by 19% but showed an increase in all other impacts, which were still lower than benchmark MWS system impacts. Current models are transferrable to commercial RWH installations at other locations.

Urolithiasis, Urinary Cancer, and Home Drinking Water Source in the United States Territory of Guam, 2006-2010.

We reviewed patient records with a first-listed diagnosis of urolithiasis-also known as urinary tract or kidney stone disease, nephrolithiasis-upon discharge from Guam's sole civilian hospital during 2006 to 2010 and urinary cancer mortality records from the Guam Cancer Registry for 1970 to 2009 to determine the source of municipal water supplied to the patients' residence. The objective was to investigate a possible relationship between the sources of municipal water supplied to Guam villages and the incidence of urolithiasis and urinary cancer. We analyzed hospital discharge diagnoses of urolithiasis or renal calculi by calculating the incidence of first-mentioned discharge for urolithiasis or renal calculi and comparing rates across demographic or geographic categories while adjusting by age, sex, and ethnicity/race. We reviewed cancer registry records of urinary cancer deaths by patient residence. The annual incidence of hospitalization for urolithiasis was 5.22 per 10,000. Rates adjusted for sex or age exhibited almost no change. The rate of 9.83 per 10,000 among Chamorros was significantly higher (p < 0.05) than the rates among any other ethnic group or race. When villages were grouped by water source, rates of patients discharged with a first-listed diagnosis of urolithiasis, adjusted for ethnicity/race, were similar for villages using either well water (5.44 per 10,000) or mixed source water (5.39 per 10,000), and significantly greater than the rate for villages using exclusively reservoir water (1.35 per 10,000). No statistically significant differences were found between the water source or village of residence and urinary cancer mortality. Some Guam residents living in villages served completely or partly by deep well water high in calcium carbonate may be at increased risk for urolithiasis compared with residents living in villages served by surface waters. Although the risk appears to be highest in villagers of Chamorro ethnicity, residents should be aware of other contributing risk factors and steps to take to avoid developing this health problem.

Influence of seasonal variation on water quality in tropical water distribution system: is the disease burden significant?

Recent evidence shows that water distribution system (WDS) is a major risk factor in piped water supply system and the degree of contamination of water in WDS is usually influenced by seasonal variation. Risk assessment studies eliminate the effect of seasonality whenever annualized estimate of concentration of contaminants in water is used to determine the risk to health. In tropical climate where strong seasonal variation prevails, the excess risk during dry and hot season, above the annualized risk can be significant. This study investigates what impact seasonal adjustment may have on health improvement targets for WDS. Water quality data of two Nigerian water supply schemes were used to estimate the impact of WDS on water quality. Seasonal deviation from the annualized impact was quantified as the latent risk in disability-adjusted life years (DALYs). The hazards identified in both WDSs were cadmium and lead, and the estimated 95th-percentile risk of the metals, over the course of dry season was about 31-38%, and 1-3% higher than the estimated yearly average risk, respectively. Wilcoxon signed-rank test showed that the risk distributions during the dry season was significantly higher (p < 0.05) than the yearly average. The median latent risks (5th, 95th-percentiles), for both WDS were 0.014 (7.6 × 10(-3), 0.023) and 4.8 × 10(-3) (-, 7.6 × 10(-3)) DALYs/person/year for cadmium and 0.87 × 10(-3) (0, 0.1 × 10(-3)) and 0.16 × 10(-3) (0, 0.031 × 10(-3)) DALYs/person/year, respectively, for lead. These risks are substantially higher than the WHO limit (1 × 10(-6) DALYs/person/year). Therefore, to achieve effective health improvement target, mitigation measures should be planned and executed by season.

Copper Tube Pitting in Santa Fe Municipal Water Caused by Microbial Induced Corrosion.

Many copper water lines for municipal drinking water in Santa Fe, New Mexico USA, have developed pinhole leaks. The pitting matches the description of Type I pitting of copper, which has historically been attributed to water chemistry and to contaminants on the copper tubing surface. However, more recent studies attribute copper pitting to microbial induced corrosion (MIC). In order to test for microbes, the copper tubing was fixed in hexamethyldisilazane (HMDS), then the tops of the corrosion mounds were broken open, and the interior of the corrosion pits were examined with scanning electron microscopy (SEM). The analysis found that microbes resembling actinobacteria were deep inside the pits and wedged between the crystallographic planes of the corroded copper grains. The presence of actinobacteria confirms the possibility that the cause of this pitting corrosion was MIC. This observation provides better understanding and new methods for preventing the pitting of copper tubing in municipal water.