A robust scenario analysis approach to water recycling quantitative microbial risk assessment.

AIMS: The growing need to access recycled water as a source for drinking water supply necessitates management of perceived risks. This study aimed to use quantitative microbial risk analysis (QMRA) to evaluate microbiological risks of indirect water recycling. METHODS AND RESULTS: Scenario analyses of risk probabilities of pathogen infection were conducted to investigate four key quantitative microbial risk assessment model assumptions: treatment process failure, drinking water consumption events per day, inclusion or exclusion of an engineered storage buffer, and treatment process redundancy. Results demonstrated that the proposed water recycling scheme could meet WHO pathogen risk guidelines of ∼10-3 annual risk of infection under 18 simulated scenarios.

Unraveling the Causes of Excess Lead in Drinking Water Supply Systems of Densely Populated High-Rise Buildings in Hong Kong.

Excess concentrations of lead (Pb) were found in tap water from drinking water supply systems of high-rise buildings in 11 public rental housing (PRH) estates in Hong Kong, posing threats to public health. The copper supply lines are fitted with lead-soldered connections and brass fixtures and faucets. The causes of excess lead are studied through field sampling on occupied households, experiments on prototype supply chains, and 3D numerical modeling. The tap water lead concentration of 129 households in the PRH estates was sampled using a specially designed protocol, revealing the highly variable lead concentration variations induced by sources along the supply chain. Lead concentration variation at consumer tap and its relation with various lead sources are studied in a full-scale test rig. A 3D computational fluid dynamics (CFD) model is successfully developed to interpret the time variation of lead concentrations at the consumer tap. Model predictions of the complex variation of dissolved lead are in good agreement with data and confirm lead solder in copper pipe connections as a major cause of the "lead water" episode in Hong Kong. The CFD calculations demonstrate the importance of turbulent diffusion and shear flow dispersion in the modeling of lead; the use of a "plug flow" approximation can result in significant overestimation of lead concentration. The findings provide a basis for lead risk assessment of different water sampling strategies in densely populated high-rise buildings in Megacities.

Understanding the impact of crop and food production on the water environment--using sugar as a model.

The availability of fresh water and the quality of aquatic ecosystems are important global concerns, and agriculture plays a major role. Consumers and manufacturers are increasingly sensitive to sustainability issues related to processed food products and drinks. The present study examines the production of sugar from the growing cycle through to processing to the factory gate, and identifies the potential impacts on water scarcity and quality and the ways in which the impact of water use can be minimised. We have reviewed the production phases and processing steps, and how calculations of water use can be complicated, or in some cases how assessments can be relatively straightforward. Finally, we outline several ways that growers and sugar processors are improving the efficiency of water use and reducing environmental impact, and where further advances can be made. This provides a template for the assessment of other crops.

Chemicals in the water environment. Where do the real and future threats lie?

There are many potential sources of chemical constituents and contaminants in water that can reach drinking water. Not all substances will be present in any particular water. Some substances may be of benefit to health but others can be a threat. However, very few have been clearly shown to cause adverse health effects in humans through drinking water and evidence may be complicated by simultaneous exposure through food. Our knowledge of contaminants in water is, however, incomplete as additional contaminants emerge with advancing analytical methods. Most of these emerging contaminants are present as a consequence of day to day use by the wider human population and control requires a different approach to the substance by substance regulation prevalent at present.

Too much or too little? A review of the conundrum of selenium.

Chemical elements such as selenium, fluoride, iron, calcium and magnesium are essential to the human being, although some are toxic when absorbed in high doses. In this paper, the risks associated with insufficient and excessive intake of selenium in the diet are reviewed, focusing on drinking water. Two different approaches are used to derive recommended nutrient intakes (RNI) for adequate nutritional status and guideline values to prevent excessive exposure. The former is based on the daily intake which meets the nutrient requirements of 97.5% of the population. The latter is a value derivation based on an assumed daily per capita consumption at the individual level, a conservative approach used where there is any uncertainty and is related to a negligible risk to health at population level across life stages. There is an increasing need to develop a conceptual framework bringing together aspects of toxicity and essentiality especially for elements apparently exhibiting narrow or overlapping ranges between essentiality and toxicity and to provide guidance on the nature and severity of risks in order to better protect human. While there are a number of frameworks available, these generally only consider food. There is a need to include water, which can be a significant source in some circumstances.

Chlorination disinfection by-products and risk of congenital anomalies in England and Wales.

BACKGROUND: Increased risk of various congenital anomalies has been reported to be associated with trihalomethane (THM) exposure in the water supply. OBJECTIVES: We conducted a registry-based study to determine the relationship between THM concentrations and the risk of congenital anomalies in England and Wales. METHODS: We obtained congenital anomaly data from the National Congenital Anomalies System, regional registries, and the national terminations registry; THM data were obtained from water companies. Total THM (< 30, 30 to < 60, > or =60 microg/L), total brominated exposure (< 10, 10 to < 20, > or =20 microg/L), and bromoform exposure (< 2, 2 to < 4, > or =4 microg/L) were modeled at the place of residence for the first trimester of pregnancy. We included 2,605,226 live births, stillbirths, and terminations with 22,828 cases of congenital anomalies. Analyses using fixed- and random-effects models were performed for broadly defined groups of anomalies (cleft palate/lip, abdominal wall, major cardiac, neural tube, urinary and respiratory defects), a more restricted set of anomalies with better ascertainment, and for isolated and multiple anomalies. Data were adjusted for sex, maternal age, and socioeconomic status. RESULTS: We found no statistically significant trends across exposure categories for either the broadly defined or more restricted sets of anomalies. For the restricted set of anomalies with isolated defects, there were significant (p < 0.05) excess risks in the high-exposure categories of total THMs for ventricular septal defects [odds ratio (OR) = 1.43; 95% confidence interval (CI), 1.00-2.04] and of bromoform for major cardiovascular defects and gastroschisis (OR = 1.18; 95% CI, 1.00-1.39; and OR = 1.38; 95% CI, 1.00-1.92, respectively). CONCLUSION: In this large national study we found little evidence for a relationship between THM concentrations in drinking water and risk of congenital anomalies.

Approaches to determining regulatory values for carcinogens with particular reference to bromate.

There are challenges in developing standards for substances that are carcinogenic in laboratory animals. In general, acceptable levels of substances that are shown to act through a mechanism that involves direct genotoxicity are determined by applying a mathematical model to extrapolate the risk at high doses to the risk at low environmental exposures. Most such models assume linearity at the low doses, which is not experimentally verifiable. Levels for substances that act through an indirect mechanism for which there is an experimentally verifiable threshold, such as cytotoxicity and regenerative hyperplasia, are generally determined by applying an uncertainty factor to a no effect level or a benchmark dose. Bromate is a potentially important contaminant in hypochlorite, and also as a consequence of the use of ozone in drinking water treatment. Although it has been used for many years as a flour improver it is known to cause cancers of the kidney, tunica vaginalis testis and thyroid in laboratory rodents. There are species differences in the sensitivity to bromate and differences in the tumours observed. The mechanism by which bromate causes cancer in laboratory animals is uncertain. There is evidence that bromate is a genotoxin but there is also indication that the dose response is not linear at low doses and that bromate may act through an intermediate mechanism. There is also evidence to suggest that bromate may be inactivated by antioxidants in the gastrointestinal tract and blood and so may not reach the sensitive tissues at low doses. Bromate has been considered by WHO, USEPA and Canada with slightly differing outcomes depending on the assumptions made. Because the acceptable levels determined are close to or below the concentrations that can be practically achieved in drinking water, even small differences have become very important. Determining whether it is appropriate to use a linear assumption and which is the most relevant tumour site are important steps in refining the risk assessment to for drinking water disinfection with hypochlorite and ozone.

Relation of trihalomethane concentrations in public water supplies to stillbirth and birth weight in three water regions in England.

We investigated the association between total trihalomethanes (TTHMs) and risk of stillbirth and low and very low birth weight in three water regions in England, 1992-1998; associations with individual trihalomethanes (THMs) were also examined. Modeled estimates of quarterly TTHM concentrations in water zones, categorized as low (< 30 microg/L), medium (30-59 microg/L), or high (> or = 60 microg/L), were linked to approximately 1 million routine birth and stillbirth records using maternal residence at time of birth. In one region, where there was a positive socioeconomic deprivation gradient across exposure categories, there was also a positive, significant association of TTHM with risk of stillbirth and low and very low birth weight. Overall summary estimates across the three regions using a random-effects model to allow for between-region heterogeneity in exposure effects showed small excess risks in areas with high TTHM concentrations for stillbirths [odds ratio (OR) = 1.11; 95% confidence interval (CI), 1.00-1.23), low birth weight (OR = 1.09; 95% CI, 0.93-1.27), and very low birth weight (OR = 1.05; 95% CI, 0.82-1.34). Among the individual THMs, chloroform showed a similar pattern of risk as TTHM, but no association was found with concentrations of bromodichloromethane or total brominated THMs. Our findings overall suggest a significant association of stillbirths with maternal residence in areas with high TTHM exposure. Further work is needed looking at cause-specific stillbirths and effects of other disinfection by-products and to help differentiate between alternative (noncausal) explanations and those that may derive from the water supply.

Modelling exposure to disinfection by-products in drinking water for an epidemiological study of adverse birth outcomes.

We are conducting an epidemiological study on the association between disinfection by-product concentrations in drinking water and adverse birth outcomes in the UK, using trihalomethane (THM) concentrations over defined water zones as an exposure index. Here we construct statistical models using sparse routinely collected THMs measurements to obtain quarterly estimates of mean THM concentrations for each water zone. We modelled the THM measurements using a Bayesian hierarchical mixture model, taking into account heterogeneity in THM concentrations between water originating from different source types, quarterly variation in THM concentrations and uncertainty in the true value of undetected and rounded measurements. Quarterly estimates of mean THM concentrations plus estimates of the water source type (ground, lowland surface or upland surface) were obtained for each water zone. THM concentration estimates were typically highest from July to September (third quarter), and varied considerably between water sources. Our exposure estimates were categorized into 'low', 'medium' and 'high' THM classes. Our modelled quarterly exposure estimates were compared to a simple alternative: annual means of the raw data for each water zone. In all, 15-25% of exposure estimates were classified differently. The modelled THM estimates led to slightly stronger and more precise estimates of association with risk of still birth and low birth weight than did the raw annual means. We conclude that our modelling approach enabled us to provide robust quarterly estimates of ecological exposure to THMs in a situation where the raw data were too sparse to base exposure assessment on empirical summaries alone.

Description of trihalomethane levels in three UK water suppliers.

Samples of drinking water are routinely analysed for four trihalomethanes (THMs), which are indicators of by-products of disinfection with chlorine, by UK water suppliers to demonstrate compliance with regulations. The THM data for 1992-1993 to 1997-1998 for three water suppliers in the north and midlands of England were made available for a UK epidemiological study of the association between disinfection by-products and adverse birth outcomes. This paper describes the THM levels in these three supply regions and discusses possible sources of variation. THM levels varied between different suppliers' water, and average THM levels were within the regulatory limits. Chloroform was the predominant THM in all water types apart from the ground water of one supplier. The supplier that distributed more ground and lowland surface water had higher dibromochloromethane (DBCM) and bromoform levels and lower chloroform levels than the other two suppliers. In the water of two suppliers, seasonal fluctuations in bromodichloromethane (BDCM) and DBCM levels were found with levels peaking in the summer and autumn. In the other water supplier, chloroform levels followed a similar seasonal trend whereas BDCM and DBCM levels did not. For all three water suppliers, chloroform levels declined throughout 1995 when there was a drought period. There was a moderate positive correlation between the THMs most similar in their structure (chloroform and BDCM, BDCM and DBCM, and DBCM and bromoform) and a slight negative correlation between chloroform and bromoform levels.

Contaminants in drinking water.

An adequate supply of safe drinking water is one of the major prerequisites for a healthy life, but waterborne disease is still a major cause of death in many parts of the world, particularly in children, and it is also a significant economic constraint in many subsistence economies. The basis on which drinking water safety is judged is national standards or international guidelines. The most important of these are the WHO Guidelines for Drinking Water Quality. The quality of drinking water and possible associated health risks vary throughout the world with some regions showing, for example, high levels of arsenic, fluoride or contamination of drinking water by pathogens, whereas elsewhere these are very low and no problem. Marked variations also occur on a more local level within countries due, for example, to agricultural and industrial activities. These and others are discussed in this chapter.