Unequal geographic distribution of water and sanitation at the household and school level in Sudan.

The Sudanese Government launched the National SDG-6 Plan and commences its implementation to achieve and sustain universal and equitable access to basic WASH services by 2030. It is critical to understand the geographical heterogeneity of Sudan and patterns in the inequality of access to safe drinking water and sanitation. Through such research, the disease control strategy can be optimized, and resource allocation can be prioritized. We explored spatial heterogeneity and inequality in access to improved water and sanitation across Sudan by mapping the coverage at both the state and district levels. We decomposed the inequality across Sudan into within-state, between-state, within-district, and between-state inequalities using the Theil L and Theil T indices. We calculated the Gini coefficient to assess the inequality of access to improved water and sanitation, based on the deviation of the Lorenz curve from the line of perfect equality. The study population was 105,167 students aged 8-13 at 1,776 primary schools across the country. Geographical heterogeneity was prominent in the Central Darfur, South Darfur, East Darfur, Kassala, West Kordofan, and Blue Nile States, all of which showed severe inequality in access to an improved latrine at the household level in terms of the Theil T or Theil L index. The overall inequality in the coverage of improved sanitation went beyond the warning limit of 0.4 for the Gini coefficient. The inequality in terms of the Theil L and Theil T indices, as well as the Gini coefficient, was always higher for improved sanitation than for improved water at the household level. Within-state inequality accounted for 66% or more of national inequalities in the distribution of improved sanitation and drinking water for both the Theil L and Theil T indices. This is the first study to measure geographical heterogeneity and inequalities in improved water and sanitation coverage across Sudan. The study may help to prioritize resource allocation to areas with the greatest water and sanitation needs.

Drinking-water efficiency, cost of illness, and peri-urban society: An economic household analysis.

This study aims to measure the efficacy of drinking water in terms of the economic impacts and risk of illness involved in using perilous water sources. Socio-economic factors were also considered. A multidisciplinary approach was employed to analyze the data, including the cost of illness (COI), regression technique, and irrigation water efficiency methods. The primary data set consisted of 210 peri-urban and urban households. It was found that the average cost of illness was higher in peri-urban ($10.79 USD) areas, while willingness to pay for quality water was higher in urban residents. Social status, income, and family size was positively associated with the cost of illness, while education, the source of drinking water (ground water and others), and awareness about safe drinking were negatively associated with the cost of illness. Furthermore, urban residents were more efficient in terms of conveyance and water use. This is one of the first studies to apply irrigation water efficiency methods to measure drinking water efficiency. The results are timely and important with both practical and social implications, including guiding policy framework. It is suggested that family planning programs be made more effective to control family size. The filtration plants to enhance drinking water quality be installed in the central places of each town/division/union council. A public-private partnership could work to provide affordable quality drinking water.

Efficiency of Treatment Plant and Drinking Water Quality Assessment from Source to Household, Gondar City, Northwest Ethiopia.

Introduction: Access to safe drinking water is essential to health, and it is a basic human right. However, drinking water treatment plant efficiency and its water quality are not well investigated in low-income countries including Ethiopia. Methods: A laboratory-based cross-sectional study was conducted among 75 water samples. Data analysis was carried out using SPSS version 22 to generate descriptive statistics, and one-way ANOVA was used to test statistically significant difference. Results: Physicochemical qualities of the water samples from tap water sources were found to be pH (6.88 ± 0.05), turbidity (5.15 ± 0.006 NTU), electrical conductivity (170.6 ± 0.1 µS/cm), residual chlorine (0.19 ± 0.003 mg/L), and fluoride (1.17 ± 0.009 mg/L). The removal efficiency of turbidity, total hardness, and nitrate was found to be 94.4%, 52.3%, and 88.7%, respectively. Removal efficiency of the treatment plant for total coliforms up to 91.6% (15 ± 0.26 CFU/100 mL in tap water) and faecal coliforms up to 99% (1.51 ± 0.03 CFU/100 mL in tap water) was recorded. Parameters of pH, temperature, and faecal coliform were statistically significant different at p < 0.05 in tap water source. The overall efficiency of the treatment plant (68.5%) and the water quality index (76) were recorded. Conclusion: Based on the results, some of the investigated parameters of water quality (turbidity, residual chlorine, total coliform, and faecal coliform) were found to be not within the permissible limits of WHO guideline values for drinking water quality. The water quality index of the water samples was categorized under good water quality. To adequately treat drinking water and improve the treatment plant, adequate preliminary treatments like screening to reduce the incoming organic loading, proper chlorination of the drinking water system, and frequent monitoring and maintenance of the treatment plant system are required.

Inequalities in access to safe drinking water in Peruvian households according to city size: an analysis from 2008 to 2018.

BACKGROUND: Peru is one of the countries with the lowest percentage of population with access to safe drinking water in the Latin American region. This study aimed to describe and estimate, according to city size, socioeconomic inequalities in access to safe drinking water in Peruvian households from 2008 to 2018. METHODS: Secondary analysis of cross-sectional data using data from the 2008-2018 ENAHO survey. Access to safe drinking water, determined based on the presence of chlorinated water supplied by the public network, as well as socioeconomic variables were analyzed. A trend analysis from 2008 to 2018, and comparisons between 2008 versus 2018 were performed to understand and describe changes in access to safe drinking water, according to city size. Concentration curves and Erreygers concentration index (ECI) were estimated to measure inequalities in access to safe drinking water. RESULTS: In 2008, 47% of Peruvian households had access to safe drinking water, increasing to 52% by 2018 (p for trend < 0.001). For small cities, access to safe drinking water did not show changes between 2018 and 2008 (difference in proportions - 0.2 percentage points, p = 0.741); however, there was an increase in access to safe drinking water in medium (difference in proportions 3.3 percentage points, p < 0.001) and large cities (difference in proportions 12.8 percentage points, p < 0.001). The poorest households showed a decreasing trend in access to safe drinking water, while the wealthiest households showed an increasing trend. In small cities, socioeconomic inequalities showed an increase between 2008 and 2018 (ECI 0.045 and 0.140, p < 0.001), while in larger cities, socioeconomic inequality reduced in the same period (ECI: 0.087 and 0.018, p = 0.036). CONCLUSIONS: We report a widening gap in the access to safe drinking water between the wealthiest and the poorest households over the study period. Progress in access to safe drinking water has not been equally distributed throughout the Peruvian population. Promoting and supporting effective implementation of policies and strategies to safe drinking water, including equity-oriented infrastructure development and resource allocation for most vulnerable settings, including emerging small cities, is a priority.

Assessment of Drinking Water Sources for Water Quality, Human Health Risks, and Pollution Sources: A Case Study of the District Bajaur, Pakistan.

The focus of the present study was to assess the quality of different drinking water sources, impacts of poor water quality on human health, and to apportion pollution source(s) of the district Bajaur, Pakistan. Drinking water samples (n = 331) were randomly collected from springs, hand pumps, open wells, and tube wells and analyzed for physicochemical parameters including toxic elements, and bacteriological contamination (i.e., Escherichia coli). Furthermore, a questionnaire survey was conducted to record the cases of waterborne diseases in the study area. The results showed that total suspended solids and bacteriological contamination exceeded the permissible limits of the WHO in all four of the water sources. Among the potentially toxic elements, Cd, Pb, and Mn were above the permissible limits of the WHO in some samples. The hazard index for spring water was found to exceed the toxicity level (i.e., HI > 1) set by US EPA for both adults and children, while the sources from hand pumps, open wells, and tube wells were within the safe limit. The order for the overall safety level for water quality in the study area was tube wells > open wells > hand pumps > springs. The pollution source apportionment statistics revealed that both geogenic and anthropogenic activities are the sources of drinking water contamination. The results of the questionnaire survey indicated that reports of waterborne diseases were highest in respondents who took their drinking water from springs, whereas reports of diseases were moderate in respondents taking their water from open wells and hand pumps and lowest in respondents taking their water from tube wells. Based on the findings of the study, the tube well source of water is recommended for drinking water purposes.

Assessment of hydrogeochemical characteristics and quality of groundwater resources in relation to risk of gastric cancer: comparative analysis of high- and low-risk areas in Iran.

The chemical quality of groundwater supplies in two high-risk area (HRA) and low-risk area (LRA) for gastric cancer in Iran was assessed through hydrogeochemical analysis and water quality indices. For this aim, Piper and Schoeller diagrams and water quality index (WQI) were applied. In addition, exposure to nitrate via drinking water and its corresponding risk were also assessed using Monte Carlo simulation technique. Data on physicochemical properties of groundwater resources were obtained from Iran Water Resources Management Company. Sampling and analysis of tap water for nitrate concentration were conducted in two cities of Shiraz (as a representative of LRA) and Ardabil (as a representative of HRA). According to Piper diagrams, the dominant hydrogeochemical facies of groundwater supplies in HRA and LRA were Na-HCO3 (43.75%) and Ca-HCO3 (41.77%), respectively. The predominant cations in groundwater resources of HRA were found to be Na+ (68.06%) and Ca2+ (31.94%). For LRA, the typical cations were in decreasing trend: Ca2+ (39.64%) > Mg2+ (18.35%) > Na+ (17.26%). For two areas, HCO3-, SO42- and Cl- were, respectively, the most frequent anions. Two-sample Wilcoxon test showed that there were statistically significant difference between two areas in terms of anions and cations concentrations (p value < 0.05). The mean of total hardness (Ca2+ + Mg2+) concentration of water supplies in LRA (528.1 mg/L) was higher than HRA (263.1 mg/L), whereas the mean of Na+ concentration was found to be lower in LRA (90.6 mg/L) compared with HRA (108.1 mg/L). The sum of nitrate intake and its risk in LRA was higher than HRA. WQI results showed that drinking water quality in HRA and LRA ranged from excellent to poor and most water resources were of a good quality class. Further studies are suggested to investigate the role of drinking water in the etiology of gastric cancer in Iran.

Geospatial Distribution and Potential Noncarcinogenic Health Risk Assessment of Nitrate Contaminated Groundwater in Southern India: A Case Study.

Groundwater nitrate pollution is a serious threat to human health in many regions of the world. The present study was performed to assess the nitrate contamination in groundwater in the region of Nirmal province, South India, where people purely depend on groundwater for drinking purposes. The associated human health risks for different age groups (male, female, and children) also were evaluated based on the United States Environmental Protection Agency model. Results indicate that nitrate concentration in groundwater is in the range of 0.8-130 mg/L with a mean of 36.51 mg/L. Furthermore, 26.47% of groundwater samples exceeded the WHO drinking water guidelines for NO3- in the study region. The contribution of oral ingestion is very higher than the dermal contact in the total hazard quotient or noncarcinogenic health risk. The total hazard quotient values ranged from 0.02 to 3.13 for adult males, 0.02 to 3.70 for adult females, and 0.03 to 4.32 for children. The health risk assessment highlights that children are more exposed to the noncarcinogenic health risks of nitrate than adult females and males in the study region. Therefore, specific groundwater quality measures should be formulated to address the health risk problems for children in the study region.

Health Risk Assessment, Composition, and Distribution of Polycyclic Aromatic Hydrocarbons (PAHs) in Drinking Water of Southern Jharkhand, East India.

The studies on polycyclic aromatic hydrocarbons (PAHs) occurrence, distribution, health risk, and composition in drinking water are limited in India and worldwide. The main objective of this study was to find the contaminant sources, composition, health risk, and distribution of USEPA's 16 priority pollutant PAHs in the drinking water samples collected between July 2019 to September 2019 from six districts of Southern Jharkhand. The Σ16PAHs mean ± standard deviation [SD] concentration values were ordered as East Singhbhum (ES) (21.5 ± 14.8 ng L-1) > West Singhbhum (WS) (16.57 ± 13.21 ng L-1) > Saraikela Kharsawan (SK) (11.48 ± 9.92 ng L-1) > Khunti (KH) (10.32 ± 9.09 ng L-1) > Simdega (SM) (9.96 ± 7.85 ng L-1) > Gumla (GU) (9.41 ± 8.63 ng L-1). The results show that ES and WS districts' groundwater samples were more contaminated by the PAHs, which may be attributed to the presence of many small-, medium-, and large-scale industries and high vehicular density in these districts. The concentrations of lower molecular weight ring (3-rings) and middle molecular weight ring (4-rings) PAHs were dominant throughout all drinking samples. The concentration of the 3-ring PAH Anthracene and 4-ring PAH Fluoranthene were dominant in all districts. The molecular ratios suggested that the potential sources of PAHs are fuel combustion and coal, grass, and wood burning. Risk assessment shows that the incremental lifetime cancer risk and risk index (RI) were ranged from 0.02 × 10-10 to 4.93 × 10-10 for children and 0.01 × 10-10 to 2.98 × 10-10 for adults. The RI values for seven carcinogenic PAHs were 8.83 × 10-10 for children and 7.38 × 10-10 for adults. Although the carcinogenic risks were within the permissible values, chronic exposure to PAHs through the ingestion of drinking water could still be a human health concern.

Accounting for drinking water quality in measuring multidimensional poverty in Ethiopia.

The Multidimensional Poverty Index is used increasingly to measure poverty in developing countries. The index is constructed using selected indicators that cover health, education, and living standards dimensions. The accuracy of this tool, however, depends on how each indicator is measured. This study explores the effect of accounting for water quality in multidimensional poverty measurement. Access to drinking water is traditionally measured by water source types. The study uses a more comprehensive measure, access to safely managed drinking water services, which are free from E. coli contamination, available when needed and accessible on premises in line with Sustainable Development Goal target 6.1. The study finds that the new measure increases national multidimensional headcount poverty by 5-13 percentage points, which would mean that 5-13 million more people are multidimensionally poor. It also increases the poverty level in urban areas to a greater extent than in rural areas. The finding is robust to changes in water contamination risk levels and Multidimensional Poverty Index aggregation approaches and weighting structures.

Lack of Safe Drinking Water for Lake Chapala Basin Communities in Mexico Inhibits Progress toward Sustainable Development Goals 3 and 6.

BACKGROUND: Access to safe, affordable and accessible drinking water is a human right and foundational to the third and sixth World Health Organization's Sustainable Development Goals (SDGs). Unsafe drinking water is a risk factor for chronic and enteric diseases. Both chronic kidney disease (CKD) and diarrheal disease are highly prevalent in the Lake Chapala basin, Jalisco, Mexico, suggesting disparities in factors leading to successful achievement of these two SDGs. METHODS: This study aimed to assess progress towards SDG three and six in the Lake Chapala basin. Qualitative, quantitative, and geospatial data were collected between May and August of 2019 from three towns within the municipalities of Poncitlán and Chapala. RESULTS: Ninety-nine households participated in this study. Water sampling analyses determined 81.18% of samples from water jugs (garrafones) and 70.05% of samples from tap water were contaminated with total coliform bacteria, often including E. coli. Additionally, 32% of garrafón samples and 61.9% of tap water samples had detectable levels of arsenic. Approximately 97.94% of respondents stated that they believe clean water is a human right, but 78.57% feel the Mexican government does not do enough to make this a reality. CONCLUSIONS: This mixed methods approach highlights water quality as a serious issue in communities around Lake Chapala, and demonstrates inadequate drinking water as a key hazard, potentially perpetuating the high disease burden of both CKD and enteric disease in the region.

A comprehensive review of water quality monitoring and assessment in Nigeria.

Nigeria is the most populated black nation in the world with about 199 million people. About 66.3 million Nigerians do not have access to safe drinking water. In this study, research findings on water quality monitoring and assessment in Nigeria over the past two decades were systematically reviewed. There are still grave enforcement issues in Nigeria as quality guidelines are still being contravened at no cost to the infringer due to the corrupt socio-political circumstances of the country. The quality of surface water, groundwater, rainwater and commercially available water was discussed in line with their pollution sources. The quality of surface water was generally poor. Groundwater pollution has come due to landfill leachate, oil and gas exploration and production, sewage and hydrogeological interactions of the groundwater with the base rock. The hydrogeological effect has led to the observation of lead and barium in groundwater in many locations across the country. The main issue with rainwater in Nigeria is the low pH but it was observed to be fairly clean. Commercially available water (bottled or sachet) is currently the best source of drinking water for the Nigerian populace. Bottled water quality is higher than for sachet water and the latter largely influenced by microbe contamination. Future perspectives in water quality monitoring and assessment are suggested in the evaluation of emerging contaminants and micro-pollutants and the utilisation of internet-enabled technologies.

Children drinking private well water have higher blood lead than those with city water.

Although the Flint, Michigan, water crisis renewed concerns about lead (Pb) in city drinking water, little attention has been paid to Pb in private wells, which provide drinking water for 13% of the US population. This study evaluates the risk of Pb exposure in children in households relying on private wells. It is based on a curated dataset of blood Pb records from 59,483 North Carolina children matched with household water source information. We analyze the dataset for statistical associations between children's blood Pb and household drinking water source. The analysis shows that children in homes relying on private wells have 25% increased odds (95% CI 6.2 to 48%, P < 0.01) of elevated blood Pb, compared with children in houses served by a community water system that is regulated under the Safe Drinking Water Act. This increased Pb exposure is likely a result of corrosion of household plumbing and well components, because homes relying on private wells rarely treat their water to prevent corrosion. In contrast, corrosion control is required in regulated community water systems. These findings highlight the need for targeted outreach to prevent Pb exposure for the 42.5 million Americans depending on private wells for their drinking water.

Assessment of Groundwater Quality in the Talensi District, Northern Ghana.

A comprehensive chemical quality assessment of groundwater resources in the Talensi District has been conducted using conventional graphical methods and multivariate statistical techniques. The study sought to determine the main controls of groundwater chemistry and its suitability for domestic and irrigation purposes in the district. Silicate and carbonate mineral weathering were identified as the main controls on groundwater chemistry in the district, with reverse ion exchange also playing a role. High nitrate and lead levels observed have been associated with agrochemicals and wastewater from farms and homes. Three main flow regimes have been identified with Q-mode cluster analysis, in which mixed cation water types have been revealed, where areas designated as recharge zones are dominated by Na+ + K+-Mg2+-HCO3 - fresh water types characterised by low mineralisation and pH, which evolve into Mg2+- Na+ + K+- HCO3 - fresh water type with corresponding increased mineralisation of the groundwater. Based on the water quality index (WQI) technique modified for the district and an interpolation technique using ordinary kriging developed from a well-fitted exponential semivariogram for the estimated WQIs, the groundwater quality has been spatially classified as generally 'good' to 'excellent' for domestic purposes. Generally, the quality of groundwater for domestic usage deteriorates as one moves towards the north of the district, whereas waters in the east and west present the best quality. Classifications based on the United States Salinity Laboratory (USSL), Wilcox, and Doneen diagrams suggest that groundwater from the unconfined aquifers of the district is of excellent quality for irrigation purposes.

Sources, Fraction Distribution and Health Risk Assessment of Selenium (Se) in Dashan Village, a Se-Rich Area in Anhui Province, China.

Soil, rock, potable water, animal food and human hair samples were collected from the Dashan village, a typical selenium (Se)-rich area of China. Se content and fraction distribution were determined to trace the source of soil Se and evaluate the potential health risk to humans. Total Se contents in soils ranged from 0.60 to 10.46 mg kg- 1. The fractions of soil Se followed the order: residual Se (R-Se) > organic-bound Se (O-Se) > acid soluble Se (A-Se) > exchangeable Se (E-Se) > water soluble Se (W-Se). Total Se contents in rocks ranged from 0.07 to 24.8 mg kg- 1. The dietary Se intake of local residents was estimated to be 261.2 µg day- 1 and hair Se content varied from 0.34 to 1.35 mg kg- 1, suggesting that the potential health risk should be concerned. Weathering of carbonaceous rock was speculated to be the primary source of soil Se according to the contents of Se in rocks, the distribution of Se in soil profiles and the relationships between Se and other elements in soils and parent rocks.

Assessment of Heavy Metal Concentrations with Fractionation Method in Sediments and Waters of the Badovci Lake (Kosovo).

The concentrations of thirteen metals (Al, As, Ba, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, V, and Zn) were analyzed in waters and sediments of the Badovci Lake. The total metal concentrations in the water followed the descending order: Fe > Al > Mn > Cu > Ba > Zn > As > Ni > Pb > V > Co > Cd > Cr, and the total metal content in the sediments also followed the descending order: Fe > Al > Mn > Ni > Cr > Pb > Ba > Zn > V > Cu > As > Co > Cd. According to EC 98/83, Al, Fe, and Mn at some sampling sites exceeded safety limits for drinking water, whereas other elements were at acceptable levels. The total content of Cr, Cu, Ni, Pb, and V in the sediments exceeded the target values of the New Dutch List. Using pollution indicators such as the contamination factor (CF) and geoaccumulation index (Igeo), most of the samples were unpolluted to moderately polluted by Cu, Cr, Pb, V, and Ni. The values of the pollution load index (PLI) were more than one (>1), indicating progressive deterioration of the sediment quality. The enrichment factor (EF) for all the studied metals suggests their enrichments in sediments of the Badovci Lake. Most of the elements were found in the residual fraction strongly bonded to the crystalline component. Pb, Mn, and Cu were bound in the organic and exchangeable components. The extent of pollution by heavy metals in sediments of the Badovci Lake implies that the environmental condition is relatively stable, and attention should be paid to metals bonded in the extractable and organic phases. It is recommended to periodically monitor water and sediment quality.

Probabilistic risk assessment of water distribution system in Hyderabad, Pakistan reveals unacceptable health hazards and areas for rehabilitation.

Poor water quality exacerbates multidimensional poverty in developing nations. Often centralized treatment facilities generate acceptable water quality, but the water is contaminated during distribution. Methods to assess sources of contamination in water distribution systems are lacking. A case study of two methods, human risk assessment linked to water distribution system sampling was conducted in Hyderabad, Pakistan to determine areas requiring infrastructure rehabilitation. Water samples from source water (i.e., the Indus River), treatment plant effluent and from taps in the water distribution system were analyzed by atomic adsorption spectroscopy for metals and metalloids (As, Cd, Cr, Hg, and Pb) and water quality parameters (dissolved and suspended solids, pH, conductivity, and total organic carbon). Source water exceeded acceptable drinking water levels for As, Cd, total Cr, and Pb, while the treatment plant effluent concentrations were acceptable. Concentrations of all metals and metalloids, except Hg, increased in the water distribution system post-treatment, exceeding safe drinking limits in at least one location, suggesting contamination of the water during distribution. A deterministic and a probabilistic risk assessment were conducted to evaluate two scenarios: (1) unrestricted use of piped water for all household purposes, including as drinking water and (2) restricted use of the water for purposes other than drinking in the household, including only dermal and inhalation exposure pathways. The water was deemed unsafe for unrestricted use as the sole source of drinking water by both risk assessment methods. Yet when an alternative source of drinking water was assumed and the piped water was used only for bathing and dish washing, the probabilistic risk assessment revealed acceptable health risks to the population, while the overly conservative deterministic risk assessment suggested unacceptable risks. The combined methods of water sampling, risk assessment and correlation analysis suggested areas for rehabilitation of the water distribution system in Hyderabad, Pakistan and these methods can be adopted in other developing nations to target limited funds for infrastructure rehabilitation.

A Hybrid Bayesian Network Framework for Risk Assessment of Arsenic Exposure and Adverse Reproductive Outcomes.

Arsenic contamination of drinking water affects more than 137 million people and has been linked to several adverse health effects. The traditional toxicological approach, "dose-response" graphs, are limited in their ability to unveil the relationships between potential risk factors of arsenic exposure for adverse human health outcomes, which are critically important to understanding the risk at low exposure levels of arsenic. Therefore, to provide insight on the potential interactions of different variables of the arsenic exposure network, this study characterizes the risk factors by developing a hybrid Bayesian Belief Network (BBN) model for health risk assessment. The results show that the low inorganic arsenic concentration increases the risk of low birth weight even for low gestational age scenarios. While increasing the mother's age does not increase the low birthweight risk, it affects the distribution between other categories of baby weight. For low MMA% (<4%) in the human body, increasing gestational age decreases the risk of having low birthweight. The proposed BBN model provides 82% sensitivity and 72% specificity in average for different states of birthweight.

Sustainability assessment of long-term, widely used household Kanchan Arsenic Filters in Nepal.

This study revealed the status of 2833 Kanchan Arsenic Filters (KAFs), aged 2 months to over 10 years, distributed in Nepal. Thirty percent of the filters were being used, but usage status generally declined 4 years after installation. Lack of use was mostly due to breakage or leaks (74%), which users did not know how to repair. Some 1283 filters (65%) were abandoned, and users returned to drinking arsenic-contaminated water. Water quality tests showed that the average KAF arsenic removal rate was 75%, and 87 and 62% of the samples met Nepal's drinking water quality standards and World Health Organization guidelines, respectively. The KAF arsenic removal amount was significantly influenced by the arsenic and iron concentrations of influent water and KAF type. The concrete square type showed the best performance in usage status and arsenic removal capacity, namely 57 and 83%, respectively. Long-term use of KAFs (more than 4 years) was assumed to be a cause of the decreasing capacity of iron nails to supply ferric hydroxide to influent water, which led to decreased arsenic removal capacity. Thus, replacement of older iron nails may restore the arsenic removal capacity of KAFs.

Water Safety in California Public Schools Following Implementation of School Drinking Water Policies.

INTRODUCTION: Recent legislation requires public and charter schools in California to test drinking water for lead. Our objective was to describe 1) results from this testing program in the context of other available water safety data and 2) factors related to schools and water utilities associated with access to safe drinking water in schools. METHODS: Our study focused on a random sample of 240 California public and charter schools. We used multivariable logistic regression, accounting for clustering of tested water sources in schools, to examine school-level factors associated with failure to meet lead-testing deadlines and any history of water utility noncompliance. RESULTS: Of the 240 schools, the majority (n = 174) tested drinking water for lead. Of the schools tested, 3% (n = 6) had at least 1 sample that exceeded 15 parts per billion (ppb) (California action level) and 16% (n = 28) exceeded 5 ppb (bottled water standard). Suburban schools had lower odds of being served by noncompliant water systems (OR = 0.17; CI, 0.05-0.64; P = .009) than city schools. Compared with city schools, rural schools had the highest odds of not participating in the water testing program for lead (OR = 3.43; CI, 1.46-8.05; P = .005). Hallways and common spaces and food services areas were the most frequent school locations tested; one-third of all locations sampled could not be identified. CONCLUSION: In our study, geography influenced access to safe drinking water in schools, including both water utility safety standards and school lead-testing practices. Considerations for improving the implementation of state lead-testing programs include establishing priority locations for sampling, precisely labeling samples, and developing well-defined testing and reporting protocols.