Progress on the health-related Sustainable Development Goals and targets in the Eastern Mediterranean Region, 2023: 2nd progress report

The 2030 Agenda for Sustainable Development includes a vision of healthy lives and well-being for all at all ages. This major report provides an update on progress towards the health-related Sustainable Development Goals (SDGs) in the WHO Eastern Mediterranean Region. It presents regional trends between 2010 and 2022 for 50 health-related SDG indicators using available data from WHO and estimates from other United Nations agencies. The report reveals some successes at the country level amid a marked slowdown regionally with setbacks across indicators on health health risks and determinants and access to services. We are at the halfway point for the 2030 Agenda for Sustainable Development: to reverse current trends and ensure the health and well-being of our population we must take bold steps now.

Framework development for the physical vulnerability assessment index of hand-dug Wells in Are-Ekiti, Southwestern Nigeria.

The article presents a comprehensive framework for assessing the physical vulnerability of hand-dug wells within the Are Community, Southwestern Nigeria. The study spans from March to April 2023 and meticulously examines 90 wells, focusing on critical parameters such as well collar, well cover, and well lining information. The analysis reveals significant variations in well collar construction materials and dimensions, emphasizing the community's adaptive strategies. The Well Collar Height Index (WCi), Well Cover Index (WCOi), Well Lining Index (WLi), and the derived Vulnerability Index categorize wells into vulnerability classes, offering a nuanced understanding of susceptibility levels. Notably, the study identifies wells with Very High vulnerability that demand urgent attention, as well as wells with effective protective measures categorized as Very Low vulnerability. The article emphasizes the need for a nuanced understanding of local practices and materials, highlighting the variability in well collar construction. It discusses the implications of well cover conditions and the critical role of well linings in assessing groundwater vulnerability. The Vulnerability Index combines these parameters, guiding targeted interventions based on risk severity. The study lays the groundwork for future interventions to enhance the safety and sustainability of water sources within the Are Community. It recommends immediate comprehensive measures for highly vulnerable wells, ongoing monitoring, community engagement, and knowledge sharing. The future scope includes incorporating geochemical analysis, targeted interventions, regular maintenance, community training, and exploring alternative water sources for sustainable improvements.

Groundwater recharge estimation using WetSpass-M and MTBS leveraging from HydroOffice and WHAT tools for baseflow in Weyib watershed, Ethiopia.

WetSpass-M model and multi-technique baseflow separation (MTBS) were applied to estimate spatio-temporal groundwater recharge (GWR) to be used to comprehend and enhance sustainable water resource development in the data-scarce region. Identification of unit Hydrographs And Component flows from Rainfall, Evaporation, and Streamflow (IHACRES) techniques outperform the existing 13 MTBS techniques to separate baseflow depending on the correlation matrix; mean baseflow was 5.128 m3/s. The WetSpass-M model performance evaluated by Nash-Sutcliff Efficiency (NSE) was 0.95 and 0.89; R2 was 0.90 and 0.85 in comparison to observed and simulated mean monthly baseflow and runoff (m3/s), respectively. The estimated mean annual water balance was 608.2 mm for actual evapotranspiration, 221.42 mm for the surface runoff, 87.42 mm for interception rate, and 177.66 mm for GWR, with an error of - 3.29 mm/year. The highest annual actual evapotranspiration was depicted in areas covered by vegetation, whereas lower in the settlement. The peak annual interception rates have been noticed in areas covered with forests and shrublands, whereas the lowest in settlement and bare land. The maximum annual runoff was depicted in settlement and bare land, while the lowest was in forest-covered areas. The annual recharge rates were low in bare land due to high runoff and maximum in forest-covered areas due to low surface runoff. The watershed's downstream areas receive scanty annual rainfall, which causes low recharge and drought. The findings point the way ahead in terms of selecting the best approach across multi-technique baseflow separations.

Physico-chemical characterisation of irrigation basin waters and inventory study of their algal communities.

To cope with the water shortage in Sous Massa region of Morocco, agricultural producers in the region have resorted to different types of water supply basins, known as "irrigation basins" but the phenomenon of eutrophication has hindered the continuity of agricultural productivity by altering the quality of the water used for irrigation on the one hand, and causing economic damage to agricultural producers due to the clogging of the water pumping network on the other. We began by characterising the physico-chemical quality of the water to determine the causes of its high nutrient content, then we determined the taxonomy of the algal species in the irrigation basins to which we had access. A qualitative study of the water in the irrigation basins in order to better explain the inventory obtained from the taxonomic identification of the algal biomass collected, which proved the existence of new species, not previously identified, characterising the freshwaters of the Moroccan region, is under the scope of this work. The species studied belong mainly to the following groups: green algae (11 genera of Chlorophyta and 7 genera of Charophyta), blue algae (7 genera of Cyanobacteria), brown algae (7 genera of Diatoms), and one genus of Euglenophyta.

For the occurrence of PPCPs from source to tap: A novel approach modified in terms of sample preservation and SPE cartridge to monitor PPCPs in our water supply.

BACKGROUND: The ongoing infusion of pharmaceutical and personal care products (PPCPs) into ecosystems sustains a perpetual life cycle and leads to multi-generational exposures. Limited understanding of their environmental impact and their intrinsic ability to induce physiological effect in humans, even at low doses, pose great risks to human health. Few scholarly works have conducted systematic research into the occurrence of PPCPs within potable water systems. Concurrently, the associated monitoring techniques have not been comprehensively examined with regards to the specific nature of drinking water, namely whether the significant presence of disinfectants may influence the detection of PPCPs. RESULTS: A modified approach in terms of detailed investigation of sample preservation and optimization of an in-lab fabricated solid phase extraction (SPE) cartridge filled with DVB-VP and PS-DVB sorbent was proposed. Favorable methodological parameters were achieved, with correlation coefficients spanning from 0.9866 to 0.9998. The LODs of the PPCPs fluctuated from 0.001 to 2 µg L-1, while the LOQs varied from 0.002 to 5 µg L-1. The analysis of spiked samples disclosed a methodological precision of 2.31-9.86 % and a recovery of 52.4-119 %. We utilized the established method for analyzing 14 water samples of three categories (source water, finished water and tap water) from five centralized water supply plants. A total of 24 categories encompassing 72 PPCPs were detected, with the concentrations of PPCPs manifested a marked decrease from source water to finished water and finally to tap water. SIGNIFICANCE: Our research meticulously examined the enhancement and purification effects of widely used commercial SPE cartridges and suggested the use of in-lab fabricated SPE cartridges packed with DVB-VP and PS-DVB adsorbents. We also conducted a systematic evaluation of the need to incorporate ascorbic acid and sodium thiosulfate as preservatives for PPCP measurement, in consideration of the unique characteristics of drinking water matrices, specifically, the significant concentration levels of disinfectants. Furthermore, the proposed method was effectively employed to study the presence of PPCPs in source water, finished water, and tap water collected from centralized water supply plants.

Incidence of per- and polyfluoroalkyl substances (PFAS) in private drinking water supplies in Southwest Virginia, USA.

Per- and polyfluoroalkyl substances (PFAS) are a class of man-made contaminants of human health concern due to their resistance to degradation, widespread environmental occurrence, bioaccumulation in living organisms, and potential negative health impacts. Private drinking water supplies may be uniquely vulnerable to PFAS contamination in impacted areas, as these systems are not protected under federal regulations and often include limited treatment or remediation, if contaminated, prior to use. The goal of this study was to determine the incidence of PFAS contamination in private drinking water supplies in two counties in Southwest Virginia, USA (Floyd and Roanoke) that share similar bedrock geologies, are representative of different state Department of Health risk categories, and to examine the potential for reliance on citizen-science based strategies for sample collection in subsequent efforts. Samples for inorganic ions, bacteria, and PFAS analysis were collected on separate occasions by participants and experts at the home drinking water point of use (POU) for comparison. Experts also collected outside tap samples for analysis of 30 PFAS compounds. At least one PFAS was detectable in 95 % of POU samples collected (n = 60), with a mean total PFAS concentration of 23.5 ± 30.8 ppt. PFOA and PFOS, two PFAS compounds which presently have EPA health advisories, were detectable in 13 % and 22 % of POU samples, respectively. On average, each POU sample contained >3 PFAS compounds, and one sample contained as many as 8 compounds, indicating that exposure to a mixture of PFAS in drinking water may be occurring. Although there were significant differences in total PFAS concentrations between expert and participant collected samples (Wilcoxon, alpha = 0.05), collector bias was inconsistent, and may be due to the time of day of sampling (i.e. morning, afternoon) or specific attributes of a given home. Further research is required to resolve sources of intra-sample variability.

Variation of total alpha and beta activities and Rn-222 concentrations in the water supply system of an Italian volcanic region: How safe is tap water for human consumption?

Total alpha and beta activities and Rn-222 concentrations were determined in water from different sections of seven aqueducts belonging to the water supply system of Campania region (Italy), known worldwide for its volcanism. Statistical analysis was performed on data to account for their variability across the aqueduct sections, and results were discussed considering the geology of reservoirs, the potential mixing processes occurring along the pipe network, the building/constituting materials of the aqueduct sections, and the integrity of the infrastructure. Guidelines proposed by Italian and international regulation entities were considered to determine if total alpha and beta activities and Rn-222 concentrations found at the taps of the different aqueducts should be considered detrimental to public health. Based on a deterministic and a stochastic approach, a health risk assessment was also tested for Rn-222, assuming direct ingestion and showering as potential exposure pathways. Results showed that applying guidelines returned an absence of hazard, whereas risk assessment returned a high probability of exposure to unacceptable Rn-222 doses for some aqueducts. Beyond the usefulness of obtained results to plan actions to improve the safety of drinking water in Campania, our outcomes represent a warning for bodies dealing with public health at any level: the use of guidelines can bring an underestimation of the risks exerted by the exposure to Rn-222 on human health. Further, using a probabilistic approach in risk assessment accounting for uncertainty can favor risk forecasts based on more "realistic" scenarios.

Investigation of innovative designs of high-velocity channels for damping kinetic energy of flows.

In our contemporary world, demanding sustainable resource management, the study focuses on innovative fast flow channel designs. It investigates their efficacy in reducing flow kinetic energy, aiming to optimize water and energy management and diminish flood risks. Employing diverse methodologies, it analyzes and develops these designs, proving their substantial impact on stream energy management. These innovations not only enhance energy efficiency but also mitigate risks associated with excess kinetic energy, promoting safer stream management. This research significantly contributes to fluid dynamics and engineering, deepening the understanding of kinetic energy control in flows and offering potential solutions for water supply, environmental sustainability, and infrastructure safety challenges.

Discharge coefficient of vertical sluice gates with broad crested weir under free-submerged orifice flows using best subset regression.

Accurate calculation of flow discharge for sluice gates is essential in irrigation, water supply, and structure safety. The measurement of discharge with the requirement of distinguishing flow regimes is not conducive to application. In this study, a novel approach that considers both free and submerged flow was proposed. The energy-momentum method was employed to derive the coefficient of discharge. Subsequently, the discharge coefficient was determined through the experiment which was performed on the physical model of a vertical sluice gate with a broad-crested weir. Feature engineering, incorporating dimensional analysis, feature construction, and correlation-based selection were performed. The best subset regression method was employed to develop regression equations of the discharge coefficient with the generated features. The derived formula was applied to compute the discharge coefficient in the vertical sluice gate and determine the flow discharge. The accuracy of adopted method was assessed by comparing it with recent studies on submerged flow, and the results demonstrate that the developed approach achieves a high level of accuracy in calculating flow discharge. The coefficient of determination for the calculated flow rate is 0.993, and the root mean square percentage error is 5.04%.

Occurrence of coliforms and biofilm-forming bacteria in raw, treated, and distributed water from two waterwork systems in Osun State, Southwestern Nigeria.

This study assessed the bacteriological quality of raw, treated, and distributed water from Ede-Erinle and Opa reservoirs in Osun State, Nigeria. This was to determine the potability of water from these waterwork stations. Eighteen sampling points were established across the two reservoir networks for this study. Samples were collected bi-monthly for two annual cycles. Serial dilution and pour plate methods were employed for the enumeration of bacterial load. Total heterotrophic bacteria count (THBC) and total coliform bacteria count (TCBC) were enumerated on nutrient and MacConkey agar at 37 °C, respectively. Bacterial isolates were characterized using biochemical identification methods with reference to Bergey's Manual of Determinative Bacteriology. Bacterial isolates and biofilm formation were further identified molecularly through the PCR method using specific universal primers. Mean values of THBC and TCBC in distributed water from Ede-Erinle (9.61 × 104 ± 1.50 × 104 CFU/mL; 69.56 ± 26.81 CFU/mL) and Opa waterworks (9.58 × 104 ± 2.55 × 104 CFU/mL; 142.94 ± 44.41 CFU/mL) exceeded permissible limits for drinking water. Paenibacillus lautus, Bacillus pseudomycoides, Pseudomonas aeruginosa, and Pseudomonas stutzeri showed biofilm-forming capacity. The study concluded that the presence of coliforms and biofilm-forming bacteria in distributed water implies that the water is unfit for consumption without further treatment.

Effects of wind-driven current and thermal dynamics in a temperate monomictic reservoir: Implications for manganese transport and treatment in water supply systems.

Increasing manganese (Mn) concentrations in source water contribute to aesthetic and health-related concerns in drinking water. The challenges with Mn in drinking water primarily arise from elevated Mn concentrations in the water supply reservoir, with the inefficacy of Mn treatment largely attributed to fluctuating Mn levels in the water source. A three-dimensional Mn cycle model in a temperate monomictic reservoir, Tarago Reservoir, and a decision support system reflecting Mn variations in the local water treatment plant have been established in previous research. This study aimed to examine Mn variations from the reservoir to raw water and treated water under the influence of wind conditions during different stages of thermal structure, and discover valuable recommendations for Mn treatment in the local water supply system. We crafted 12 scenarios to scrutinize the impact of varying intensities of offshore and onshore winds on hydrodynamic processes and Mn transport during strong thermal stratification, weak thermal stratification, and turnover. The scenario analysis revealed that, during the gradual weakening of thermal stratification, offshore wind induced a substantial amount of Mn to the upper layers near the water intake point. Conversely, onshore wind hindered the upward transport of Mn. The simulated Mn in the raw water under the 12 scenarios indicated that the timing of turnover in the Tarago Reservoir is the primary concern for Mn treatment in the water treatment plant. Additionally, close attention should be given to the frequency and intensity of offshore winds during the weakening of thermal stratification.

Innovative DIY drinking water disinfection for underserved communities.

Waterborne pathogens threaten 2.2 billion people lacking access to safely managed drinking water services, causing over a million annual diarrheal deaths. Individuals without access to chlorine reagents or filtration devices often resort to do-it-yourself (DIY) methods, such as boiling or solar disinfection (SODIS). However, these methods are not simple to implement. In this study, we introduced an innovative and easily implemented disinfection approach. We discovered that immersing aluminum foil in various alkaline solutions produces alkali-treated aluminum foil (ATA foil) that effectively adsorbs Escherichia coli (E. coli), Salmonella, and Acinetobacter through the generated surface aluminum hydroxide. For example, a 25 cm2 ATA foil efficiently captures all 104E. coli DH5α strains in 100 mL water within 30 min. Using a saturated suspension of magnesium hydroxide, a type of fertilizer, as the alkaline solution, the properties of the saturated suspension eliminate the need for measuring reagents or changing solutions, making it easy for anyone to create ATA foil. ATA foils can be conveniently produced within mesh bags and placed in household water containers, reducing the risk of recontamination. Replacing the ATA foil with a foil improves the adsorption efficiency, and re-immersing the used foil in the production suspension restores its adsorption capacity. Consequently, ATA foil is an accessible and user-friendly alternative DIY method for underserved communities. Verification experiments covering variations in the water quality and climate are crucial for validating the efficacy of the foil. Fortunately, the ATA foil, with DIY characteristics similar to those of boiling and SODIS, is well-suited for testing under diverse global conditions, offering a promising solution for addressing waterborne pathogens worldwide.

Detection of Pharmaceutically Active Compounds in Tap Water Samples by Direct Injection HPLC/MS-MS: A Danger Signal in Deficiency in Residue Management.

To date, there is an increased risk to public health and the environment due to the presence of pharmaceutically active compounds within drinking water supply and distribution networks. Owing to this, a direct injection-HPLC/MS-MS method was developed for the simultaneous determination of 16 active pharmaceutical compounds in tap water samples: amoxicillin, ampicillin, cephalexin, cefotaxime, cefuroxime, ciprofloxacin, clarithromycin, clindamycin, chloramphenicol, cyproterone, erythromycin, flutamide, spironolactone, sulfamethoxazole, tamoxifen, and trimethoprim. Limits of detection (LOD) ranged from 0.2 to 6.0 µg/L while quantification limits (LOQ) from 0.3 to 20 µg/L. Recovery percentages were between 70 and 125%. Total analysis time was short, with all compounds being resolved in less than 2.1 min. Of the 22 tap water samples collected and analyzed, the highest concentrations corresponded to amoxicillin (147 µg/L) and ciprofloxacin (44 µg/L). The findings could set a precedent for establishing safe levels of these compounds and increasing standards for tap water quality in this region.

Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020-2021: a cross-sectional study.

BACKGROUND: Water, sanitation, and hygiene (WASH) access is critical to public health and human dignity. People who inject drugs (PWID) experience stigma and structural violence that may limit WASH access. Few studies have assessed WASH access, insecurity, and inequities among PWID. We describe WASH access, social and geographic inequalities, and factors associated with WASH insecurity among PWID in the Tijuana-San Diego metropolitan area. METHODS: In this cross-sectional binational study, we interviewed PWID (age 18+) in 2020-2021 about WASH access and insecurity. City of residence (Tijuana/San Diego) and housing status were considered as independent variables to describe key WASH access outcomes and to assess as factors associated with WASH insecurity outcomes. Measures of association between outcomes and independent variables were assessed using log modified-Poisson regression models adjusting for covariates. RESULTS: Of 586 PWID (202 Tijuana; 384 San Diego), 89% reported basic access to drinking water, 38% had basic hand hygiene, 28% basic sanitation, and 46% access to bathing, and 38% reported recent open defecation. Participants residing in Tijuana reported significantly higher insecurity in accessing basic drinking water (aRR: 1.68, 95%CI: 1.02-2.76), basic hygiene (aRR: 1.45, 95%CI: 1.28-1.64), and bathing (aRR: 1.21, 95%CI: 1.06-1.39) than those living in San Diego. Participants experiencing unsheltered homelessness experienced significantly higher insecurity in accessing basic drinking water (aRR: 2.03, 95%CI: 1.07-3.86), basic sanitation (aRR: 1.68, 95%CI: 1.48, 1.92), bathing (aRR: 1.84, 95%CI: 1.52-2.22), and improved water sources for cleaning wounds (aRR: 3.12, 95%CI: 1.55-6.29) and for preparing drugs (aRR: 2.58, 95%CI: 1.36-4.89) than participants living in permanent housing. CONCLUSION: WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID-especially those who are unsheltered.

Water Supply Interruptions Are Associated with More Frequent Stressful Behaviors and Emotions but Mitigated by Predictability: A Multisite Study.

Water supply interruptions contribute to household water insecurity. Unpredictable interruptions may particularly exacerbate water insecurity, as uncertainty limits households' ability to optimize water collection and storage or to modify other coping behaviors. This study used regression models of survey data from 2873 households across 10 sites in 9 middle-income countries to assess whether water supply interruptions and the predictability of interruptions were related to composite indicators of stressful behaviors and emotional distress. More frequent water service interruptions were associated with more frequent emotional distress (ß = 0.49, SE = 0.05, P < 0.001) and stressful behaviors (ß = 0.39, SE = 0.06, P < 0.001). Among households that experienced interruptions, predictability mitigated these respective relationships by approximately 25 and 50%. Where the provision of continuous water supplies is challenged by climate change, population growth, and poor management, water service providers may be able to mitigate some psychosocial consequences of intermittency through scheduled intermittency and communication about water supply interruptions. Service providers unable to supply continuous water should optimize intermittent water delivery to reduce negative impacts on users, and global monitoring regimes should account for intermittency and predictability in post-2030 water service metrics to better reflect household water insecurity experiences.

Occurrence and Health Risk Assessment of Phthalates in Municipal Drinking Water Supply of a Central Indian City.

In this study, the occurrence of phthalates in the municipal water supply of Nagpur City, India, was studied for the first time. The study aimed to provide insights into the extent of phthalate contamination and identify potential sources of contamination in the city's tap water. We analyzed fifteen phthalates and the total concentration (∑15phthalates) ranged from 0.27 to 76.36 µg L-1. Prominent phthalates identified were di-n-butyl phthalate (DBP), di-isobutyl phthalate (DIBP), benzyl butyl phthalate (BBP), di (2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DNOP), and di-nonyl phthalate (DNP). Out of the fifteen phthalates analyzed, DEHP showed the highest concentration in all the samples with the median concentration of 2.27 µg L-1, 1.39 µg L-1, 1.83 µg L-1, 2.02 µg L-1, respectively in Butibori, Gandhibaag, Civil Lines, and Kalmeshwar areas of the city. In 30% of the tap water samples, DEHP was found higher than the EPA maximum contaminant level of 6 µg L-1. The average daily intake (ADI) of phthalates via consumption of tap water was higher for adults (median: 0.25 µg kg-1 day-1) compared to children (median: 0.07 µg kg-1 day-1). The hazard index (HI) calculated for both adults and children was below the threshold level, indicating no significant health risks from chronic toxic risk. However, the maximum carcinogenic risk (CR) for adults (8.44 × 10-3) and children (7.73 × 10-3) was higher than the threshold level. Knowledge of the sources and distribution of phthalate contamination in municipal drinking water is crucial for effective contamination control and management strategies.

Quantitative Microbial Risk Assessment Framework Incorporating Water Ages with Legionella pneumophila Growth Rates.

Water age in drinking water systems is often used as a proxy for water quality but is rarely used as a direct input in assessing microbial risk. This study directly linked water ages in a premise plumbing system to concentrations of Legionella pneumophila via a growth model. In turn, the L. pneumophila concentrations were used for a quantitative microbial risk assessment to calculate the associated probabilities of infection (Pinf) and clinically severe illness (Pcsi) due to showering. Risk reductions achieved by purging devices, which reduce water age, were also quantified. The median annual Pinf exceeded the commonly used 1 in 10,000 (10-4) risk benchmark in all scenarios, but the median annual Pcsi was always 1-3 orders of magnitude below 10-4. The median annual Pcsi was lower in homes with two occupants (4.7 × 10-7) than with one occupant (7.5 × 10-7) due to more frequent use of water fixtures, which reduced water ages. The median annual Pcsi for homes with one occupant was reduced by 39-43% with scheduled purging 1-2 times per day. Smart purging devices, which purge only after a certain period of nonuse, maintained these lower annual Pcsi values while reducing additional water consumption by 45-62%.