Evaluation of the probable synergistic toxicity of selected potentiated antiretroviral and antibiotics on some aquatic biomarker organisms.

Environmental effects of active pharmaceutical compounds (APCs) in the environment are not well characterized, hence the need for comprehensive evaluation. This study employed three bioassays using three organisms, namely, Allium cepa, Daphnia magna, and Salmonella typhimurium, in the ecotoxicity study of lone and a mixture of selected APCs, namely, lamivudine (L), an antiretroviral, and ciprofloxacin (C) and sulfamethoxazole (S), antibiotics, at a concentration range between 10 and 100 ppb, in order to evaluate the potential of the lone and ternary mixture to exert synergistic toxicity. Study results from exposure to lone APCs showed that the L, C, and S trio individually had fatal impacts on daphnids, with mortality rates of 100, 75, and 95%, respectively, after 48 h. Sulfamethoxazole showed a mutagenic tendency, with a mutation ratio (background/sample ratio) of 2.0. Lamivudine showed a lethal impact on the root length of A. cepa (p > 0.05, p = 3.60E-3). Further microscopic examination of the A. cepa root tip revealed chromosomal aberrations on exposure to each compound. The LCS-mix ecotoxicology bioassays indicated a synergistic effect on the daphnids, probably due to potentiation. Although the LCS mix had a cytotoxic effect (evidenced by the absence of bacteria colonies) on exposed TA 98 P450 Salmonella typhimurium strain, this effect was not observed in other bacterial strains. Microscopic examination of A. cepa exposed to the LCS-mix revealed an aberration in the mitotic stage of the cell. The impact of combination of the pharmaceuticals in aqueous ecosystems was greater than when exposed to the tested individual pharmaceutical compounds. Study result showed that these compounds have tendencies to pose a higher risk to exposed living entities when in combined/potentiated forms, and this could lead to distortion of the regular functioning of the ecosystem, particularly bacterial and other microbial populations that are listed among primary producers of the aquatic food web.

Estrogenic activity, selected plasticizers and potential health risks associated with bottled water in South Africa.

Potential endocrine disrupting chemicals (EDCs) are present in bottled water from various countries. In South Africa (SA), increased bottled water consumption and concomitant increases in plastic packaging create important consequences for public health. This study aimed to screen SA bottled water for estrogenic activity, selected target chemicals and assessing potential health risks. Ten bottled water brands were exposed to 20 °C and 40 °C over 10 days. Estrogenic activity was assessed using the recombinant yeast estrogen screen (YES) and the T47D-KBluc reporter gene assay. Solid phase extracts of samples were analyzed for bis(2-ethylhexyl) adipate (DEHA), selected phthalates, bisphenol-A (BPA), 4-nonylphenol (4-NP), 17ß-estradiol (E2), estrone (E1), and ethynylestradiol (EE2) using gas chromatography-mass spectrophotometry. Using a scenario-based health risk assessment, human health risks associated with bottled water consumption were evaluated. Estrogenic activity was detected at 20 °C (n = 2) and at 40 °C (n = 8). Estradiol equivalent (EEq) values ranged from 0.001 to 0.003 ng/L. BPA concentrations ranged from 0.9 ng/L to 10.06 ng/L. Although EEqs and BPA concentrations were higher in bottled water stored at 40 °C compared to 20 °C, samples posed an acceptable risk for a lifetime of exposure. Irrespective of temperature, bottled water from SA contained chemicals with acceptable health risks.

Environmental health outcomes and exposure risks among at-risk communities living in the Upper Olifants River Catchment, South Africa.

Potential exposure to water and air pollution and associated health impacts of three low-income communities in the Upper Olifants River Catchment, South Africa, was investigated through a cross-sectional epidemiological study comprising a household survey. Water samples were collected and analysed for microbial indicators and pathogens. Ambient air-monitoring included some of the criteria pollutants, as well as mercury and manganese. Associations between environmental exposure and health outcomes were analysed by means of logistic regression. Despite poor water and air quality episodes, the communities' self-perceived health was good with relatively low prevalence of reported health outcomes. Hygiene practices with respect to water collection and storage were often poor, and most likely contributed to the regularly contaminated water storage containers. Community proximity to the polluted stream was associated with increased prevalence in adverse health outcomes. This paper reports on preliminary results and additional multivariate analyses are necessary to further understand study results.

Removal and risk assessment of emerging contaminants and heavy metals in a wastewater reuse process producing drinkable water for human consumption.

This study focuses on the removal and risk assessment of twenty emerging contaminants (ECs) and heavy metals in a REMIX water treatment plant (RWTP) that produces drinking water from combination of wastewater reuse and desalination. The membrane biological reactor (MBR) exhibit removal rates exceeding 95% of pharmaceuticals like acetaminophen, trimethoprim, diclofenac, naproxen, and emtricitabine. The efficiency of brackish reverse osmosis (BWRO) in removing ECs is highlighted, showing substantial efficacy with reduction rates of 99.5%, 75.5%, and 51.2% for sulfamethoxazole, venlafaxine, and benzotriazole, respectively. The advanced oxidation process based on Fenton process reveals removal (>95%) of emtricitabine, efavirenz, and carbamazepine. The study confirms that the combination of treatment units within the RWTP effectively removes heavy metals (>90%), complying with acceptable limits. Risk quotient (RQ) calculations indicate the efficiency of the RWTP in EC removal, serving as benchmarks for public acceptance of reclaimed water. In the context of heavy metals, the study concludes negligible cancer risks associated with reclaimed water consumption over a lifetime. Quantitative structure-activity relationship and occurrence, persistence, bioaccumulation and toxicity (OPBT) models were used to assess EC risk. The study screened and identified potential persistant, bio accumulating and toxic PBT ECs. Critical control points (CCPs) in the RWTP are identified, with brackish and seawater reverse osmosis (BWRO and SWRO) and advanced oxidation process (AOP) recognized as pivotal in hazard management. The study provides valuable insights on the removal of ECs and heavy metals in a wastewater reuse process and demonstrates potential of adopted process configuration in supplying safe drinking water from wastewater recycling.

Water-Based Epidemiological Investigation of Hepatitis E Virus in South Africa.

Hepatitis E virus (HEV) is an emerging zoonotic pathogen that exhibits great host diversity. The primary means of transmission of the virus in low- and middle-income countries is contaminated water, often due to a lack of access to proper sanitation, which leads to faecal contamination of water sources. Environmental surveillance is an important tool that can be used to monitor virus circulation and as an early warning system for outbreaks. This study was conducted to determine the prevalence and genetic diversity of HEV in wastewater, surface water (rivers and standpipe/ablution water), and effluent from a piggery in South Africa. A total of 536 water samples were screened for HEV using real-time reverse transcription-polymerase chain reaction. Overall, 21.8% (117/536) of the wastewater, river, and ablution water samples tested positive for HEV, whereas 74.4% (29/39) of the samples from the piggery tested positive. Genotyping revealed sequences belonging to HEV genotypes 3 (98%, 53/54) and 4 (2%, 1/54), with subtypes 3c, 3f, and 4b being identified.

Removal of Antibiotics Using an Algae-Algae Consortium (Chlorella protothecoides and Chlorella vulgaris).

The intensive use of antibiotics (for human, veterinary, and agricultural purposes) has steadily increased over the last 30 years. Large amounts of antibiotic residues are released into aquatic systems, mostly due to inefficient wastewater treatment. Conventional wastewater treatments are not designed to remove emerging contaminants (such as antibiotics) from wastewater. Therefore, algae treatment (phycoremediation) has emerged as a promising choice for cost-effective, eco-friendly, and sustainable wastewater treatment. For this reason, we investigated the removal performance of a well-established algal consortia (Chlorella protothecoides and Chlorella vulgaris) used in passive wastewater treatment ponds (Mosselbay, South Africa). Five antibiotics (sulfamethoxazole, amoxicillin, trimethoprim, ofloxacin, and clarithromycin) were selected for their ubiquity and/or low removal efficiency in conventional wastewater treatment plants (WWTPs). For each antibiotic, two concentrations were used: one environmentally relevant (10 ppb) and another 10 times higher (100 ppb), tested in triplicate and collected at two-time points (7 and 10 days). The algae remained viable over the exposure period (which is similar to the retention time within maturation ponds) and exhibited the capacity to remove sulfamethoxazole (77.3% ± 3.0 and 46.5% ± 5.3) and ofloxacin (43.5% ± 18.9 and 55.1% ± 12.0) from samples spiked with 10 and 100 ppb, respectively. This study demonstrates the potential and innovation of algal remediation for contaminants in a developing country context, where minimal infrastructure is available.

Enteric Pathogens Risk Factors Associated with Household Drinking Water: A Case Study in Ugu District Kwa-Zulu Natal Province, South Africa.

The occurrence of diarrheal infections depends on the level of water and sanitation services available to households of immunocompromised individuals and children of less than five years old. It is therefore of paramount importance for immunocompromised individuals to be supplied with safe drinking water for better health outcomes. The current study aimed at ascertaining the probability of infection that Escherichia coli, Salmonella typhimurium, Shigella dysenteriae, Vibrio cholerae, and rotavirus might cause to rural dwellers as compared to urban dwellers. Both culture-based and molecular-based methods were used to confirm the presence of target microorganisms in drinking water samples, while Beta-Poisson and exponential models were used to determine the health risk assessment. Results revealed the presence of all targeted organisms in drinking water. The estimated health risks for single ingestion of water for the test pathogens were as follows: 1.6 × 10-7 for S. typhimurium, 1.79 × 10-4 for S. dysenteriae, 1.03 × 10-3 for V. cholerae, 2.2 × 10-4 for E. coli O157:H7, and 3.73 × 10-2 for rotavirus. The general quantitative risk assessment undertaken in this study suggests that constant monitoring of household container-stored water supplies is vital as it would assist in early detection of microbial pathogens. Moreover, it will also allow the prompt action to be taken for the protection of public health, particularly for immunocompromised individuals and children who are prone to higher risk of infections.

Environmental Risk Characterization of an Antiretroviral (ARV) Lamivudine in Ecosystems.

Antiretroviral drugs for the treatment of human immunodeficiency virus (HIV) and other viral infections are among the emerging contaminants considered for ecological risk assessment. These compounds have been reported to be widely distributed in water bodies and other aquatic environments, while data concerning the risk they may pose to unintended non-target species in a different ecosystem (environment) is scanty. In South Africa and other developing countries, lamivudine is one of the common antiretrovirals applied. Despite this, little is known about its environmental impacts as an emerging contaminant. The present study employed a battery of ecotoxicity bioassays to assess the environmental threat lamivudine poses to aquatic fauna and flora. Daphnia magna (filter feeders), the Ames bacterial mutagenicity test, Lactuca sativa (lettuce) germination test, and the Allium cepa root tip assay were conducted, testing lamivudine at two concentrations (10 and 100 µg/L), with environmental relevance. The Daphnia magna toxicity test revealed a statistically significant response (p << 0.05) with a mortality rate of 85% on exposure to 100 µg/L lamivudine in freshwater, which increased to 100% at 48-h exposure. At lower concentrations of 10 µg/L lamivudine, 90% and 55% survival rates were observed at 24 h and 48 h, respectively. No potential mutagenic effects were observed from the Ames test at both concentrations of lamivudine. Allium cepa bioassays revealed a noticeable adverse impact on the root lengths on exposure to 100 µg/L lamivudine. This impact was further investigated through microscopic examination, revealing some chromosomal aberration in the exposed Allium cepa root tips. The Lactuca sativa bioassay showed a slight adverse impact on both the germination rate of the seeds and their respective hypocotyl lengths compared to the control. Overall, this indicates that lamivudine poses an ecological health risk at different trophic levels, to both flora and fauna, at concentrations previously found in the environment.

Child dysentery in the Limpopo Valley: a cohort study of water, sanitation and hygiene risk factors.

The objective of this cohort study was to assess risk factors for child dysentery and watery diarrhoea. The study participants consisted of 254 children aged 12-24 months in rural South Africa and Zimbabwe in households where drinking water was collected from communal sources. The main outcome measure was the most severe diarrhoea episode: dysentery, watery diarrhoea or none. For dysentery, drinking water from sources other than standpipes had a relative risk ratio of 3.8 (95% CI 1.5-9.8). Poor source water quality, as indicated by Escherichia coli counts of 10 or more cfu 100 ml(-1), increased risk by 2.9 (1.5-5.7). There were no other significant risk factors for dysentery and none for watery diarrhoea. In this study, endemic dysentery is associated only with faecal contamination of source water. Sources other than standpipes, including improved groundwater, are of greater risk. Remediation of water quality by treatment at source or in the household will be required to achieve access to safe drinking water in accordance with the 7th Millennium Development Goal.

Multi-residue method for the determination of selected veterinary pharmaceutical residues in surface water around Livestock Agricultural farms.

A multi-residue method for the determination of the occurrence and prevalence levels of selected veterinary pharmaceutical residues in surface water was developed on a high performance liquid chromatography coupled to ultraviolet-visible (HPLC-UV) detector, and tested with the intent of profiling their distribution. The limit of detection (LOD) and limit of quantitation (LOQ) achieved for the selected pharmaceuticals; acetaminophen, diclofenac, salicylic acid, tetracycline, chloramphenicol, ciprofloxacin, bisphenol-A, 17ß-estradiol, estriol, and ivermectin ranged between 0.06-3.45 µg L-1 and 0.17-10.35 µg L-1 respectively. Other International Conference on Harmonization (ICH) parameters for validation of analytical procedures were also evaluated and discussed. Pharmaceutical residues were recovered from surface water samples collected from around livestock farms in Cape Town, South Africa by solid phase extraction (SPE), and thereafter separated and quantified using a validated method on a HPLC-UV-detector. Most frequently detected residues were: acetaminophen (56%), diclofenac (53), tetracycline (72%), 17ß-estradiol (73%); chloramphenicol (68%), and salicylic acid (67%), with significantly high (p > 0.05) spatial variability in the concentration distributions of the pharmaceuticals in the surface waters.

The reach of human health risks associated with metals/metalloids in water and vegetables along a contaminated river catchment: South Africa and Mozambique.

BACKGROUND: Anthropogenic pollution was identified as an environmental problem of concern when, in 2008, dozens of crocodiles died in the Olifants River catchment near the border of South Africa and Mozambique. Given the close proximity of households to the river and their making use of river water, we aimed to determine to what extent water pollution has an impact on health of indigent communities in South Africa and Mozambique in the catchment area. METHODS: Water and vegetable samples were collected from the study areas. Biota samples were washed with double de-ionized Milli-Q water and freeze-dried. Heavy metal analyses in water and vegetables were done by means of Inductively Coupled Plasma Optical Emission Spectroscopy. Metal concentrations were applied in a human health risk assessment to estimate health risks. RESULTS: Mean concentrations of antimony, arsenic, cadmium, chromium, mercury, molybdenum, nickel and selenium in water samples from South Africa exceeded the World Health Organization guidelines for safe levels of intake. Only iron exceeded the recommended guidelines in water samples from Mozambique. Metals/metalloids were found in lower concentrations at Mozambique sites downstream of South African sites. In vegetables, uranium was between 10 and 20 times above safe guidelines in South Africa and between 3 and 6 times in Mozambique. Arsenic in water samples posed the highest cancer risk. CONCLUSIONS: Even with a reduction in the metal concentrations in river water from South Africa to Mozambique, the potential to cause adverse human health impacts from direct use of polluted river water is evident in both countries.

Estrogenic activity, chemical levels and health risk assessment of municipal distribution point water from Pretoria and Cape Town, South Africa.

Endocrine disrupting chemicals (EDCs) are ubiquitous in the environment and have been detected in drinking water from various countries. Although various water treatment processes can remove EDCs, chemicals can also migrate from pipes that transport water and contaminate drinking water. This study investigated the estrogenic activity in drinking water from various distribution points in Pretoria (City of Tshwane) (n = 40) and Cape Town (n = 40), South Africa, using the recombinant yeast estrogen screen (YES) and the T47D-KBluc reporter gene assay. The samples were collected seasonally over four sampling periods. The samples were also analysed for bisphenol A (BPA), nonylphenol (NP), di(2-ethylhexyl) adipate (DEHA), dibutyl phthalate (DBP), di(2-ethylhexyl) phthalate (DEHP), diisononylphthalate (DINP), 17ß-estradiol (E2), estrone (E1) and ethynylestradiol (EE2) using ultra-performance liquid chromatography-tandem mass spectrophotometry (UPLC-MS/MS). This was followed by a scenario based health risk assessment to assess the carcinogenic and toxic human health risks associated with the consumption of distribution point water. None of the water extracts from the distribution points were above the detection limit in the YES bioassay, but the EEq values ranged from 0.002 to 0.114 ng/L using the T47D-KBluc bioassay. BPA, DEHA, DBP, DEHP, DINP E1, E2, and EE2 were detected in distribution point water samples. NP was below the detection limit for all the samples. The estrogenic activity and levels of target chemicals were comparable to the levels found in other countries. Overall the health risk assessment revealed acceptable health and carcinogenic risks associated with the consumption of distribution point water.

Defining episodes of diarrhoea: results from a three-country study in Sub-Saharan Africa.

The study was conducted to assess the effect of definition of episode on diarrhoeal morbidity and to develop a means of adjusting estimates of morbidity for the definition of episode used. This paper reports on a cohort study of 374 children, aged 9-32 months, in three African countries, which recorded frequency and consistency of stool over a seven-month period. Different definitions of episode were applied to these data to assess their effect on annualized diarrhoeal morbidity. Adjustment factors were then derived that corrected morbidity for non-standard definitions of episode. Applying non-standard definitions of episode gave estimates of an annualized number of episodes between 38% and 137% of the internationally-accepted definition. Researchers should be encouraged to use the standard definition of episode of diarrhoea and to use appropriate field protocols. Where this is not possible, correction factors should be applied, particularly where estimates of diarrhoeal morbidity are pooled in systematic reviews.

Quantitative microbial risk assessment (QMRA) shows increased public health risk associated with exposure to river water under conditions of riverbed sediment resuspension.

Although higher microbial concentrations have been reported in sediments than in the overlying water column, most quantitative microbial risk assessment (QMRA) studies have not clearly indicated the contribution of sediment-borne pathogens to estimated risks. Thus, the present study aimed at determining the public health risk associated with exposure to pathogenic bacteria in polluted river water under undisturbed conditions and conditions of sediment resuspension in the Apies River, Gauteng, South Africa. Microbial pathogens were isolated and identified using culture and molecular methods. The beta-Poisson dose-response model was used to estimate the probability of infection (Pi) with the various pathogens, following accidental/intentional ingestion of 1mL or 100mL (or 50mL) of untreated river water. Mean wet season Escherichia coli counts ranged between 5.8E+01 and 8.8E+04MPN/100mL (water column) and between 2.40E+03 and 1.28E+05MPN/100mL (sediments). Mean dry season E. coli counts ranged between 5.11E+00 and 3.40E+03MPN/100mL (water column) and between 5.09E+00 and 6.30E+03MPN/100mL (sediments). Overall (water and sediments) Vibrio cholerae was the most detected pathogen (58.8%) followed by Salmonella spp. (23.9%) and Shigella (10.1%). Ingestion of 1mL of river water could lead to 0%-4% and 1%-74% Pi with E. coli during the dry and wet season, respectively. During the dry season, the Pi with V. cholerae, Salmonella spp. and Shigella spp. were 0%-1.39%, 0%-4.11% and 0%-0.16% respectively, depending on volume of water ingested. The risks of infections with all microorganisms increased during the wet season. A 2-log increase in water E. coli count following sediments disturbance led to approximately 10 times higher Pi with E. coli than when sediments were undisturbed. Therefore, the use of the untreated water from the Apies River for drinking, household purposes or recreational activities poses a potential health risk to the users of the river.

The potential of selected macroalgal species for treatment of AMD at different pH ranges in temperate regions.

The metal bioaccumulation potential of selected macroalgae species at different pH ranges was study for usage as part of a possible secondary passive acid mine drainage (AMD) treatment technology in algae ponds. Two separate studies were conducted to determine the suitability of macroalgae for passive treatment when metabolic processes in macrophytes and microorganisms in constructed wetlands decrease during winter months. In the field study, the bioconcentration of metals (mg/kg dry weight) measured in the benthic macroalgae mats was in the following order: site 1. Oedogonium crassum Al > Fe > Mn > Zn; site 2. Klebsormidium klebsii, Al > Fe > Mn > Zn; site 3. Microspora tumidula, Fe > Al > Mn > Zn and site 4. M. tumidula, Fe > Mn > Al > Zn. In the laboratory study, cultured macroalgae K. klebsii, O. crassum and M. tumidula isolated from the field sampling sites were exposed to three different pH values (3, 5 and 7), while bioaccumulation of the metals, Al, Fe, Mn and Zn and glutathione S-transferase (GST) activity were measured in the different selected algae species at a constant water temperature of 14 °C. Bioaccumulation of Al was the highest for O. crassum followed by K. klebsii and M. tumidula (p < 0.0001). From the study it was evident that the highest metal bioaccumulation occurred in the macroalgae O. crassum at all three tested pH values under constant low water temperature.

Valuing the subsurface pathogen treatment barrier in water recycling via aquifers for drinking supplies.

A quantitative microbial risk assessment (QMRA) was performed at four managed aquifer recharge (MAR) sites (Australia, South Africa, Belgium, Mexico) where reclaimed wastewater and stormwater is recycled via aquifers for drinking water supplies, using the same risk-based approach that is used for public water supplies. For each of the sites, the aquifer treatment barrier was assessed for its log(10) removal capacity much like for other water treatment technologies. This information was then integrated into a broader risk assessment to determine the human health burden from the four MAR sites. For the Australian and South African cases, managing the aquifer treatment barrier was found to be critical for the schemes to have low risk. For the Belgian case study, the large treatment trains both in terms of pre- and post-aquifer recharge ensures that the risk is always low. In the Mexico case study, the risk was high due to the lack of pre-treatment and the low residence times of the recharge water in the aquifer. A further sensitivity analysis demonstrated that human health risk can be managed if aquifers are integrated into a treatment train to attenuate pathogens. However, reduction in human health disease burden (as measured in disability adjusted life years, DALYs) varied depending upon the number of pathogens in the recharge source water. The beta-Poisson dose response curve used for translating rotavirus and Cryptosporidium numbers into DALYs coupled with their slow environmental decay rates means poor quality injectant leads to aquifers having reduced value to reduce DALYs. For these systems, like the Mexican case study, longer residence times are required to meet their DALYs guideline for drinking water. Nevertheless the results showed that the risks from pathogens can still be reduced and recharging via an aquifer is safer than discharging directly into surface water bodies.