Quality and management status of the drinking water supplies in a semiarid region of Northeastern Brazil.

Surface and groundwater resources in the Seridó Region (Brazilian semiarid) were investigated to evaluate their current quality conditions and suitability for domestic use. The water was characterized in terms of physical, chemical, and radiological parameters; including those required by the Brazilian Drinking Water Quality Standard (DWQS). Information about major and trace elements and radiological aspects of the water are reported for the first time. Salinization was confirmed as a key problem in the region, driven natural and anthropogenic. Overall, water has poor organoleptic characteristics. The concentration of most trace elements was below the recommended level, except for uranium and selenium in groundwater. Gross alpha and beta activities higher than the recommended levels were also recorded in several water samples, mostly from the investigated aquifers. In these samples, a detailed radionuclide analysis is required to estimate the effective dose received by the local population. Overall, the results show that water from the investigated region is not suitable for human consumption unless proper treatment is applied. Water requires proper treatment to decrease the content of dissolved salts, toxic elements, and radionuclides responsible for the high gross alpha and beta activities.

Prevention and control strategies for children Kashin-Beck disease in China: A systematic review and meta-analysis.

BACKGROUND: To evaluate prevention and control strategies for children with Kashin-Beck disease (KBD) in China through a systematic review and meta-analysis. METHODS: We conducted literature searches of articles indexed in Web of Knowledge, PubMed, Springerlink, Elsevier, the Chinese National Knowledge Infrastructure, and Wanfang data until February 2019. Search terms included "Kashin-Beck disease" or "KBD," and "improvement of water" or "change of grain" or "salt-rich selenium" or "comprehensive measures." Eligible studies were prospective trials of interventions in endemic area. Data extraction was performed by 2 independent authors using predefined data fields that also included quality evaluation. RESULTS: We screened 1183 potentially relevant articles, and included 22 studies that reported 24 trials, with data from 3700 healthy children and 2961 children KBD. The pooled odds ratios (ORs) and confidence intervals (95% CIs) for primary prevention new incidence in healthy children following interventions to comprehensive measures, change of grain, salt-rich selenium, and improvements of water were 0.15 (0.02, 0.95), 0.15 (0.03, 0.70), 0.19 (0.09, 0.38), and 0.20 (0.09, 0.42), respectively. The OR (95% CI) for clinical improvement in children KBD following interventions to improvement of water, salt-rich selenium, comprehensive measures, and change of grain were 5.03 (3.21, 7.89), 4.39 (3.15, 6.11), 2.98 (1.61, 5.52), and 2.35 (1.59, 3.47), respectively. All interventions showed significant differences and were effective (P < .05). CONCLUSION: Comprehensive measures and change of grain were the most effective measures in preventing new case, whereas improvement of water and salt-rich selenium resulted in clinical improvements in children KBD.

Legionella Colonization of Hotel Water Systems in Touristic Places of Greece: Association with System Characteristics and Physicochemical Parameters.

This study aimed to assess the colonization of hotel water systems in central Greece and Corfu by Legionella, and to investigate the association between physicochemical parameters and Legionella colonization. Standardized hygiene inspection was conducted in 51 hotels, and 556 water samples were analyzed for Legionella spp. Free chlorine concentration, pH, hardness, conductivity, and trace metals were defined in cold water samples. The results of inspections and chemical analyses were associated with the microbiological results using univariate and logistic regression analysis. According to the score of the checklist used for the inspections, 17.6% of the hotels were classified as satisfactory, 15.7% as adequate, and 66.7% as unsatisfactory. Moreover, 74.5% of the hotels were colonized by Legionella spp. and 31.4% required remedial measures according to the European guidelines. Legionella spp. were isolated in 28% of the samples. Unsatisfactory results of inspections were associated with Legionella presence (relative risk (RR) = 7.67, p-value = 0.043). In hot-water systems, <50 °C temperatures increased the risk of Legionella colonization (RR = 5.36, p-value < 0.001). In cold-water systems, free chlorine concentration <0.375 mg/L (odds ratio (OR) = 9.76, p-value = 0.001), pH ≥ 7.45 (OR = 4.05, p-value = 0.007), and hardness ≥321 mgCaCO3/L (OR = 5.63, p-value = 0.003) increased the risk, whereas copper pipes demonstrated a protective role (OR = 0.29, p-value = 0.0024). The majority of the hotels inspected were colonized with Legionella. Supplementary monitoring of the risk factors that were identified should be considered.

Animal influence on water, sanitation and hygiene measures for zoonosis control at the household level: A systematic literature review.

INTRODUCTION: Neglected zoonotic diseases (NZDs) have a significant impact on the livelihoods of the world's poorest populations, which often lack access to basic services. Water, sanitation and hygiene (WASH) programmes are included among the key strategies for achieving the World Health Organization's 2020 Roadmap for Implementation for control of Neglected Tropical Diseases (NTDs). There exists a lack of knowledge regarding the effect of animals on the effectiveness of WASH measures. OBJECTIVES: This review looked to identify how animal presence in the household influences the effectiveness of water, hygiene and sanitation measures for zoonotic disease control in low and middle income countries; to identify gaps of knowledge regarding this topic based on the amount and type of studies looking at this particular interaction. METHODS: Studies from three databases (Medline, Web of Science and Global Health) were screened through various stages. Selected articles were required to show burden of one or more zoonotic diseases, an animal component and a WASH component. Selected articles were analysed. A narrative synthesis was chosen for the review. RESULTS: Only two studies out of 7588 met the inclusion criteria. The studies exemplified how direct or indirect contact between animals and humans within the household can influence the effectiveness of WASH interventions. The analysis also shows the challenges faced by the scientific community to isolate and depict this particular interaction. CONCLUSION: The dearth of studies examining animal-WASH interactions is explained by the difficulties associated with studying environmental interventions and the lack of collaboration between the WASH and Veterinary Public Health research communities. Further tailored research under a holistic One Health approach will be required in order to meet the goals set in the NTDs Roadmap and the 2030 Agenda for Sustainable Development.

Management strategies for trace organic chemicals in water - A review of international approaches.

To ensure an appropriate management of potential health risks and uncertainties from the release of trace organic chemicals (TOrCs) into the aqueous environment, many countries have evaluated and implemented strategies to manage TOrCs. The aim of this study was to evaluate existing management strategies for TOrCs in different countries to derive and compare underlying core principles and paradigms and to develop suggestions for more holistic management strategies to protect the environment and drinking water supplies from the discharge of undesired TOrCs. The strategies in different industrial countries were summarized and subsequently compared with regards to three particular questions: 1) Do the approaches different countries have implemented manage all or only specific portions of the universe of chemicals; 2) What implementation and compliance strategies are used to manage aquatic and human health risk and what are their pros and cons; and 3) How are site-specific watershed differences being addressed? While management strategies of the different countries target similar TOrCs, the programs differ in several important aspects, including underlying principles, the balance between aquatic or human health protection, implementation methods, and financing mechanisms used to fund regulatory programs.

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014.

BACKGROUND: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. OBJECTIVE: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. METHODS: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. RESULTS: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries' progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [-3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. CONCLUSIONS: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings.

Human Health Risk Assessment Applied to Rural Populations Dependent on Unregulated Drinking Water Sources: A Scoping Review.

Safe drinking water is a global challenge for rural populations dependent on unregulated water. A scoping review of research on human health risk assessments (HHRA) applied to this vulnerable population may be used to improve assessments applied by government and researchers. This review aims to summarize and describe the characteristics of HHRA methods, publications, and current literature gaps of HHRA studies on rural populations dependent on unregulated or unspecified drinking water. Peer-reviewed literature was systematically searched (January 2000 to May 2014) and identified at least one drinking water source as unregulated (21%) or unspecified (79%) in 100 studies. Only 7% of reviewed studies identified a rural community dependent on unregulated drinking water. Source water and hazards most frequently cited included groundwater (67%) and chemical water hazards (82%). Most HHRAs (86%) applied deterministic methods with 14% reporting probabilistic and stochastic methods. Publications increased over time with 57% set in Asia, and 47% of studies identified at least one literature gap in the areas of research, risk management, and community exposure. HHRAs applied to rural populations dependent on unregulated water are poorly represented in the literature even though almost half of the global population is rural.

Developing a Water Quality Index (WQI) for an Irrigation Dam.

Pollution levels have been increasing in water ecosystems worldwide. A water quality index (WQI) is an available tool to approximate the quality of water and facilitate the work of decision-makers by grouping and analyzing numerous parameters with a single numerical classification system. The objective of this study was to develop a WQI for a dam used for irrigation of about 5000 ha of agricultural land. The dam, La Vega, is located in Teuchitlan, Jalisco, Mexico. Seven sites were selected for water sampling and samples were collected in March, June, July, September, and December 2014 in an initial effort to develop a WQI for the dam. The WQI methodology, which was recommended by the Mexican National Water Commission (CNA), was used. The parameters employed to calculate the WQI were pH, electrical conductivity (EC), dissolved oxygen (DO), total dissolved solids (TDS), total hardness (TH), alkalinity (Alk), total phosphorous (TP), Cl-, NO3, SO4, Ca, Mg, K, B, As, Cu, and Zn. No significant differences in WQI values were found among the seven sampling sites along the dam. However, seasonal differences in WQI were noted. In March and June, water quality was categorized as poor. By July and September, water quality was classified as medium to good. Quality then decreased, and by December water quality was classified as medium to poor. In conclusion, water treatment must be applied before waters from La Vega dam reservoir can be used for irrigation or other purposes. It is recommended that the water quality at La Vega dam is continually monitored for several years in order to confirm the findings of this short-term study.

Using a relative health indicator (RHI) metric to estimate health risk reductions in drinking water.

When a new drinking water regulation is being developed, the USEPA conducts a health risk reduction and cost analysis to, in part, estimate quantifiable and non-quantifiable cost and benefits of the various regulatory alternatives. Numerous methodologies are available for cumulative risk assessment ranging from primarily qualitative to primarily quantitative. This research developed a summary metric of relative cumulative health impacts resulting from drinking water, the relative health indicator (RHI). An intermediate level of quantification and modeling was chosen, one which retains the concept of an aggregated metric of public health impact and hence allows for comparisons to be made across "cups of water," but avoids the need for development and use of complex models that are beyond the existing state of the science. Using the USEPA Six-Year Review data and available national occurrence surveys of drinking water contaminants, the metric is used to test risk reduction as it pertains to the implementation of the arsenic and uranium maximum contaminant levels and quantify "meaningful" risk reduction. Uranium represented the threshold risk reduction against which national non-compliance risk reduction was compared for arsenic, nitrate, and radium. Arsenic non-compliance is most significant and efforts focused on bringing those non-compliant utilities into compliance with the 10 µg/L maximum contaminant level would meet the threshold for meaningful risk reduction.

Accounting for the Impact of Management Scenarios on Typha Domingensis (Cattail) in an Everglades Wetland.

The coupled regional simulation model, and the transport and reaction simulation engine were recently adapted to simulate ecology, specifically Typha domingensis (Cattail) dynamics in the Everglades. While Cattail is a native Everglades species, it has become invasive over the years due to an altered habitat over the last few decades, taking over historically Cladium jamaicense (Sawgrass) areas. Two models of different levels of algorithmic complexity were developed in previous studies, and are used here to determine the impact of various management decisions on the average Cattail density within Water Conservation Area 2A in the Everglades. A Global Uncertainty and Sensitivity Analysis was conducted to test the importance of these management scenarios, as well as the effectiveness of using zonal statistics. Management scenarios included high, medium and low initial water depths, soil phosphorus concentrations, initial Cattail and Sawgrass densities, as well as annually alternating water depths and soil phosphorus concentrations, and a steadily decreasing soil phosphorus concentration. Analysis suggests that zonal statistics are good indicators of regional trends, and that high soil phosphorus concentration is a pre-requisite for expansive Cattail growth. It is a complex task to manage Cattail expansion in this region, requiring the close management and monitoring of water depth and soil phosphorus concentration, and possibly other factors not considered in the model complexities. However, this modeling framework with user-definable complexities and management scenarios, can be considered a useful tool in analyzing many more alternatives, which could be used to aid management decisions in the future.

Health Effects and Environmental Justice Concerns of Exposure to Uranium in Drinking Water.

We discuss the recent epidemiologic literature regarding health effects of uranium exposure in drinking water focusing on the chemical characteristics of uranium. While there is strong toxicologic evidence for renal and reproductive effects as well as DNA damage, the epidemiologic evidence for these effects in people exposed to uranium in drinking water is limited. Further, epidemiologic evidence is lacking for cardiovascular and oncogenic effects. One challenge in characterizing health effects of uranium in drinking water is the paucity of long-term cohort studies with individual level exposure assessment. Nevertheless, there are environmental justice concerns due to the substantial exposures for certain populations. For example, we present original data suggesting that individuals living in the Navajo Nation are exposed to high levels of uranium in unregulated well water used for drinking. In 10 out of 185 samples (5.4 %), concentrations of uranium exceeded standards under the Safe Drinking Water Act. Therefore, efforts to mitigate exposure to toxic elements in drinking water are warranted and should be prioritized.

Managing Scarce Water Resources in China's Coal Power Industry.

Coal power generation capacity is expanding rapidly in the arid northwest regions in China. Its impact on water resources is attracting growing concerns from policy-makers, researchers, as well as mass media. This paper briefly describes the situation of electricity-water conflict in China and provides a comprehensive review on a variety of water resources management policies in China's coal power industry. These policies range from mandatory regulations to incentive-based instruments, covering water withdrawal standards, technological requirements on water saving, unconventional water resources utilization (such as reclaimed municipal wastewater, seawater, and mine water), water resources fee, and water permit transfer. Implementing these policies jointly is of crucial importance for alleviating the water stress from the expanding coal power industry in China.

Global challenges in acute diarrhea.

PURPOSE OF REVIEW: Childhood diarrhea is the most common cause of morbidity and mortality, especially in the low and middle-income countries. The burden of child mortality because of diarrhea has declined, but still a lot is desired not only to reduce diarrhea-specific mortality but reduce the overall incidence, and hence the morbidity associated with childhood diarrhea. RECENT FINDINGS: A recent Lancet series on diarrhea suggests that amplification of the current interventions can eliminate virtually all preventable diarrhea deaths. A refocused attention and strategy and collective effort from the multilateral entities to promote water sanitation and hygiene, rotavirus vaccination, nutrition, and improved case management can bridge gaps and tackle the existing undue burden of deaths because of diarrhea. SUMMARY: Investment toward preventing and controlling childhood diarrhea should be a priority, especially when the existing solution is plausible for implementation at scale and in underprivileged settings.

HTM advocates 'holistic approach'.

Dr Nick Hill, a fellow of IHEEM, and chair of the Institute's Water Technical Platform, whose career encompasses over 25 years' experience working on all aspects of water, considers some of the key guidance contained in the new Health Technical Memorandum, HTM 04-01, Safe Water in Healthcare Premises (2016), which was published last month.

Impact of short-term climate variation and hydrology change on thermal structure and water quality of a canyon-shaped, stratified reservoir.

Climate variation can have obvious effects on hydrologic conditions, which in turn can have direct consequences for the thermal regime and quality of water for human use. In this research, weekly surveys were conducted from 2011 to 2013 to investigate how changes of climate and hydrology affect the thermal regime and water quality at the Heihe Reservoir. Our results show that the hydrology change during the flooding season can both increase the oxygen concentration and accelerate the consumption of dissolved oxygen. Continuous heavy rainfall events occurred in September 2011 caused the mixing of the entire reservoir, which led to an increase in dissolved oxygen at the bottom until the next year. Significant turbid density flow was observed following the extreme rainfall events in 2012 which leading to a rapid increase in turbidity at the bottom (up to 3000 NTU). Though the dissolved oxygen at the bottom increased from 0 to 9.02 mg/L after the rainfall event, it became anoxic within 20 days due to the increase of water oxygen demand caused by the suspended matter brought by the storm runoff. The release of compounds from the sediments was more serious during the anaerobic period after the rainfall events and the concentration of total iron, total phosphorus, and total manganese at the bottom reached 1.778, 0.102, and 0.125 mg/L. The improved water-lifting aerators kept on running after the storm runoff occurred in 2013 to avoid the deterioration of water quality during anaerobic conditions and ensured the good water quality during the mixing period. Our results suggest preventive and remediation actions that are necessary to improve water quality and status.

Global and local health burden trade-off through the hybridisation of quantitative microbial risk assessment and life cycle assessment to aid water management.

Life cycle assessment (LCA) and quantitative risk assessment (QRA) are commonly used to evaluate potential human health impacts associated with proposed or existing infrastructure and products. Each approach has a distinct objective and, consequently, their conclusions may be inconsistent or contradictory. It is proposed that the integration of elements of QRA and LCA may provide a more holistic approach to health impact assessment. Here we examine the possibility of merging LCA assessed human health impacts with quantitative microbial risk assessment (QMRA) for waterborne pathogen impacts, expressed with the common health metric, disability adjusted life years (DALYs). The example of a recent large-scale water recycling project in Sydney, Australia was used to identify and demonstrate the potential advantages and current limitations of this approach. A comparative analysis of two scenarios - with and without the development of this project - was undertaken for this purpose. LCA and QMRA were carried out independently for the two scenarios to compare human health impacts, as measured by DALYs lost per year. LCA results suggested that construction of the project would lead to an increased number of DALYs lost per year, while estimated disease burden resulting from microbial exposures indicated that it would result in the loss of fewer DALYs per year than the alternative scenario. By merging the results of the LCA and QMRA, we demonstrate the advantages in providing a more comprehensive assessment of human disease burden for the two scenarios, in particular, the importance of considering the results of both LCA and QRA in a comparative assessment of decision alternatives to avoid problem shifting. The application of DALYs as a common measure between the two approaches was found to be useful for this purpose.

Energy and water quality management systems for water utility's operations: a review.

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts.

Holistic assessment of a secondary water supply for a new development in Copenhagen, Denmark.

Increasing stress on water resources is driving urban water utilities to establish new concepts for water supply. This paper presents the consequences of proposed alternative water supply options using a unique combination of quantitative and qualitative methods from different research fields. A former industrial harbor area in Copenhagen, Denmark, is currently under development and all infrastructure will be updated to accommodate 40,000 inhabitants and 40,000 jobs in the future. To reduce stress on water resources it has been proposed to establish a secondary water supply in the area as an alternative to the conventional groundwater-based drinking water supply. Four alternative concepts for a secondary water supply have been considered: 1) slightly polluted groundwater for use in toilets and laundry, 2) desalinated brackish water for use in toilets, laundry, and dishwashers, 3) desalinated brackish water for all uses, including drinking water, and 4) local reclamation of rain and gray water for use in toilets and laundry. The concepts have been evaluated for their technical feasibility, economy, health risks, and public acceptance, while the concepts' environmental sustainability has been assessed using lifecycle assessment and freshwater use impact methods. The holistic assessment method exposes conflicting preference solutions depending on assessment criteria, and reveals multi-faceted consequences for choices in urban water management. Not one concept turns out unambiguously positive based on the evaluation criteria included here, but the systematic evaluation will leave decision-makers informed on the consequences of their choices.

Physicochemical properties of some bottled water brands in Alexandria Governorate, Egypt.

BACKGROUND: Many people use bottled water instead of tap water for many reasons such as taste, ease of carrying, and thinking that it is safer than tap water. Irrespective of the reason, bottled water consumption has been steadily growing in the world for the past 30 years. In Egypt, this is still increasing to reach 3.8 l/person/day, despite its high price compared with tap water. OBJECTIVE: The purpose of this study was to evaluate the physicochemical quality of some bottled water brands and to compare the quality with that reported on manufacture's labeling, Egyptian, and International standards. MATERIALS AND METHODS: Fourteen bottled water brands were selected from the local markets of Alexandria city. Three bottles from each brand were randomly sampled, making a total sample size of 42 bottles. Sampling occurred between July 2012 and September 2012. Each bottle was analyzed for its physicochemical parameter and the average was calculated for each brand. The results obtained were compared with the Egyptian standard for bottled water, Food and Drug Administration (FDA), and with bottled water labels. RESULTS: In all bottles in the study, pH values ranged between 7.21 and 8.23, conductivity ranged between 195 and 675 µs/cm, and total dissolved solids, sulfate, chloride, and fluoride were within the range specified by the FDA. Calcium concentrations ranged between 2.7373 and 29.2183 mg/l, magnesium concentrations ranged between 5.7886 and 17.6633 mg/l, sodium between 14.5 and 205.8 mg/l, and potassium between 6.5 and 29.8 mg/l. For heavy metals such as iron, zinc, copper, and manganese, all of them were in conformity with the Egyptian standards and FDA, but nickel concentration in 11 brands was higher than the Egyptian standards. Twelve brands were higher than the Egyptian standards in cadmium concentration, but on comparison with FDA there were only five brands exceeding limits. Lead concentrations were out of range for all brands. On comparison with the labeled values, the quality of bottled water was not complying with labeled values. CONCLUSION: Physicochemical parameters in all bottled water examined brands were consistent with the Egyptian Standard and FDA, except for total dissolved solids, nickel, cadmium, and lead. Statistical analysis showed that there was significant difference (P<0.05) in all parameters tested between different brands. Values on the bottled water labels were not in agreement with analytical results.