Removal of organic matter and nutrients from hospital wastewater by electro bioreactor coupled with tubesettler.

Wastewater consisting of different pharmaceuticals and drug residues is quite challenging to treat and dispose of. This situation poses a significant impact on the health aspect of humans and other biotic organisms in the environment. The main concern of hospital wastewater (HWW) is the resistivity towards treatment using the different conventional methods. For the treatment of HWW, this study was performed using an electro bioreactor using hospital wastewater. The electro reduction overcomes the effect of toxic elements in hospital wastewater, and biodegradation removes organic matter and nutrients from wastewater. This study investigated electro bioreactor performance for treating hospital wastewater connected with tubesettler. The parameters of chemical oxygen demand, nitrate, and phosphate concentration were analyzed to evaluate an influent and effluent from electro bioreactor and tubesettler. Also, Kinetic modelling for chemical oxygen demand, nitrate, and phosphate removal was done. The chemical oxygen demand was reduced by 76% in electro bioreactor, and 31% in tubesettler, 84%. The nitrate and phosphate were reduced within permissible discharge limits with a final effluent concentration of 1.4 mg L-1 and 3 mg L-1. Further studies are required to assess the impact of pharmaceutical compounds in hospital wastewater on the system's performance.

Efficient removal of ibuprofen and ofloxacin pharmaceuticals using biofilm reactors for hospital wastewater treatment.

Hospital wastewater is harmful to the environment and human health due to its complex chemical composition and high potency towards becoming a source of disease outbreaks. Due to these complexities, its treatment is neither efficient nor cost-effective. It is a challenging issue that requires immediate attention. This effort focuses on the treatment of hospital wastewater (HWW) by removing two selected drugs, namely ibuprofen (IBU) and ofloxacin (OFX) using individual biological treatment methods, such as moving bed biofilm reactors (MBBR) and physicochemical treatment, such as ozonation and peroxane process. The both methods are compared to find the best method overall based on effectiveness and removal efficiency. The optimal removal for ozone dosing range was nitrate (9.00% and 62.00%), biological oxygen demand (BOD) (92.00% and 64.00%), and chemical oxygen demand (COD) (96.00% and 92.00%) that required at least 10 min to reach considerable degradation. The MBBR process assured a better performance for ibuprofen removal, overall. The IBU and OFX removal was found to be 14.32-96.00% at a higher COD value and 11.33-94.00% at a lower COD value due to its biodegradation. This work strives to pave the way forward to build an HWW treatment technology using integrated MBBR processes for better efficiency and cost-effectiveness.

Occurrence and health risk assessment of arsenic and heavy metals in groundwater of three industrial areas in Delhi, India.

Groundwater is a primary natural water source in the absence of surface water bodies. Groundwater in urban environments experiences unprecedented stress from urban growth, population increase, and industrial activities. This study assessed groundwater quality in terms of arsenic and heavy metal contamination in three industrial areas (Shahdara, Jhilmil, and Patparganj), Delhi, India. The water quality was assessed over a 3-year time interval (i.e., 2015 and 2018). The groundwater constituents investigated were As, Fe, Cr, Cd, Ni, Zn, Mn, Cu, and Pb. Metal index and heavy metal pollution indexes were estimated to assess groundwater pollution. The health risk was evaluated in terms of non-carcinogenic and carcinogenic risk assessment. Patparganj industrial area saw increment in concentration for Cu 0.23 mg/L (2015)-0.85 mg/L (2018), Zn 0.51 mg/L (2015)-7.2 mg/L (2018), Fe 0.32 mg/L (2015)-0.9 mg/L (2018), Cr 0.21 mg/L (2015)-0.26 mg/L (2018), Mn 0.14 mg/L (2015)-0.25 mg/L (2018), Ni 0.04 mg/L (2015)-0.34 mg/L (2018), and As 0.01 mg/L (2015)-0.18 mg/L (2018). Cd and Pb concentrations were observed to decrease by 40-90 % and 85-99% for all the three industrial areas. Metal index and heavy metal index values were found to be >1 for all locations. The risk quotient value > 1 was observed for all locations in the year 2015 but was found to increase further to a range of RQ 10-62 in the year 2018, inferring increased non-carcinogenic risk to consumers. The carcinogenic risk was significant with respect to Fe (0.2-0.7), Zn (0.001-0.007), and As (0.002-0.003) for all locations in the year 2015. This study concludes that groundwater in the three industrial areas is highly polluted and is not fit for human consumption. Further studies are required to explore possible control measures and develop methods to mitigate groundwater pollution, sustainable management, and optimized use to conserve it for future generations.

Effect of seasonal variation on the occurrences of high-risk pharmaceutical in drain-laden surface water: A risk analysis of Yamuna River.

The occurrence of pharmaceutical residues in the aquatic ecosystem is an emerging concern of environmentalists. This study primarily investigated the seasonal variation of high-priority pharmaceutical residues in the Yamuna River, accompanied by 22 drains discharge from different parts of Delhi. Five sampling sites were selected for analyzing high-priority pharmaceuticals along with physico-chemical and biological parameters for 3 season's viz. pre-monsoon (PrM), monsoon (DuM), and post-monsoon (PoM), respectively. The maximum occurrences were detected during the PoM, compared to the PrM and DuM seasons. The maximum concentration of BOD, COD, and Phosphate was detected at the last sampling station (SP-5). Similarly, all targeted pharmaceuticals concentration were maximum at the last sampling point i.e. Okhla barrage (SP-5, max: DIC = 556.1 ng/l, IBU = 223.4 ng/l, CAR = 183.1 ng/l, DIA = 457.8 ng/l, OFL = 1726.5 ng/l, FRU = 312.2 ng/l and SIM = 414.9 ng/l) except at Barapulla downstream (SP-4, max: ERY = 178.1 ng/l). The mean concentrations of Fecal coliform (FC) ranged from 1700 to 6500 CFU/100 ml. The maximum colonies were detected in PrM season (6500 CFU/100 ml) followed by PoM (5800 CFU/100 ml) and least in DuM (1700 CFU/100 ml). Risk quotient (RQ) analysis of high-priority pharmaceuticals indicated high ecotoxicological risks exposure (>1) from DIC, DIA, OFL, and SIM in all seasons at all the sampling sites. However, lower risk was predicted for IBU, CAR, ERY, and FRU, respectively. This risk assessment indicated an aquatic ecosystem potentially exposed to high risks from these pharmaceutical residues. Moreover, seasonal agricultural application, rainfall, and temperature could influence the levels and compositions of pharmaceutical residue in the aquatic ecosystem. Hence, attention is required particularly to this stream since it is only a local lifeline source for urban consumers for domestic water supply and farmers for cultivation.

COVID-19 transmission, vulnerability, persistence and nanotherapy: a review.

End 2019, the zoonotic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), named COVID-19 for coronavirus disease 2019, is the third adaptation of a contagious virus following the severe acute respiratory syndrome coronavirus in 2002, SARS-CoV, and the Middle East respiratory syndrome virus in 2012, MERS-CoV. COVID-19 is highly infectious and virulent compared to previous outbreaks. We review sources, contagious routes, preventive measures, pandemic, outbreak, epidemiology of SARS-CoV, MERS-CoV and SARS-CoV-2 from 2002 to 2020 using a Medline search. We discuss the chronology of the three coronaviruses, the vulnerability of healthcare workers, coronaviruses on surface and in wastewater, diagnostics and cures, and measures to prevent spreading.

Recent technologies for nutrient removal and recovery from wastewaters: A review.

Water scarcity and its pollution has become a concern in recent times. The disposal of nutrient-rich (nitrogen and phosphorous) wastewater is also one of the main cause of water pollution through eutrophication, reduced dissolved oxygen that poses threat to aquatic ecosystems. As a result, nutrient removal has become a mandate apart from the removal of organics. However, the removal of nutrients from sewage is a challenging task. Conversely, conventional biological treatment processes provide little relief in nutrient removal. The treated effluents from conventional biological processes do not achieve the stringent nutrient removal disposal standard limits and become primary cause of pollution in the receiving water bodies. This has stressed upon the need for eco-friendly, low-energy and cost-efficient nutrient removal treatment technologies. Various biological treatment combinations or variants are in use for the efficient removal of nutrients. The biological processes in itself or in combination with chemical processes are preferred over technologies based solely on physico-chemical processes for its treatment performance at lower cost. This review summarizes the existing treatment processes and their possible up-gradation with the aim to accomplish the marked effluent standards for the nutrients. The concept of conventional systems and advanced systems for nutrients (nitrogen and phosphorous) removal which are already developed or under development are deeply discussed. Further, the challenges of each treatment systems are abridged. Finally, the possible suggestions for the modification/retrofitting of existing treatment systems for achieving stringent disposal standards are pointed out.

Horizontal sub surface flow Constructed Wetlands coupled with tubesettler for hospital wastewater treatment.

Hospital wastewater are a lurking threat to environment and human health security for any given moment of time owing to its complexity and high vulnerability to cause disease outbreak. Though there are a number of treatment process for wastewater., there is a high need for employing cost-efficient and sustainable method of treatment. Hence a pilot scale horizontal surface flow Constructed Wetland (HSFCW) coupled with Tubesettler was installed at New Delhi, India (February to may 2019). This study reports comparative pollutants removal from hospital wastewater using Constructed Wetlands and associated tubesettler dosed with Hospital wastewater. A pilot scale CW system was used for treating 10m3/day of hospital wastewater. The system was tested for 3 Months to evaluate its performance for removing pollutants from the wastewater. The HSFCW coupled with tubesettler achieved over all removal efficiency of 94% (COD), MLSS (97%), TSS (98%), BOD5 (96%), Phosphate (79%). However, process of nitrification was not observed and accumulation of Nitrate up to 197% was observed. The study concluded that it may be due to the presence of pharmaceuticals and other elements present in hospital wastewater. This conclusion was based on the fact that Alkalinity increased by 52% in effluent and pH value also exhibited an average increase of 12%. Further research studies are required to investigate effect of pharmaceutical originating from hospital on treatment efficiency, to incorporate anaerobic setup to complete denitrification-nitrification process and also to determine efficiency of thermophilic, mesophilic, and psychrophilic bacteria with respect to climate and temperature.

Association of air quality with respiratory and cardiovascular morbidity rate in Delhi, India.

The present study reports short-term impact of poor air quality on cardiovascular and respiratory morbidity rate in Delhi. The data on monthly count of patients visiting Out Patient Department (OPD) and hospital admission due to respiratory and cardiovascular illnesses from hospitals along with daily air quality data from air quality monitoring stations of Central Pollution Control Board (CPCB), Government of India, across Delhi were collected for the period 2008 to 2012. A semi-parametric Quasi-Poisson regression model was used to examine the association of high pollution episodes with relative risk of hospital OPD visit and hospital admission due to respiratory and cardiovascular diseases. This study has confirmed the substantial adverse health effects due to air pollution across criterion air pollutants. The study reports the short-term effects of air pollution on morbidity from a time-series study first time in India. The study findings illustrate the evidence of adverse health impact of air pollution from India to the global pool and can influence the policy makers to implement better air quality management system for Indian cities. ABBREVIATIONS: OPD: Out Patient Department; IPD: Inpatient Department; RD: Respiratory Disease; CVD: Cardiovascular Disease; COPD: Chronic Obstructive Pulmonary Disease; CPCB: Central Pollution Control Board; NAAQMP: National Ambient Air Quality Monitoring Programme; NAAQS: National Ambient Air Quality Standards; RR; Relative Risk; IMD: Indian Meteorological Department; PM10: Particulate Matter less than 10 µm in aerodynamic diameter; SO2: Sulphur dioxide; NO2: Nitrogen dioxide; CO: Carbon Monoxide; O3: Ozone; DCE: Delhi College of Engineering; GTB Hospital: Guru Teg Bahadur Hospital; VPCH: Vallabhbhai Patel Chest Hospital; RMLH: Ram Manohar Lohia Hospital; SJH: Safdarjung Hospital; LNJPH: Lok Narayan Jai Prakash Hospital; GTBH: Guru Teg Bahadur Hospital; AH: Ambedkar Hospital; HRH: Hindu Rao Hospital; ESIH: ESI Hospital; SGRH: Sir Ganga Ram Hospital.

The 2008 cholera epidemic in Zimbabwe: experience of the icddr,b team in the field.

During August 2008-June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009.

Epidemiology of rotavirus and cholera in children aged less than five years in rural Bangladesh.

Despite the known presence of rotavirus-associated diarrhoea in Bangladesh, its prevalence, including records of hospitalization in rural health facilities, is largely unknown. In a systematic surveillance undertaken in two government-run rural health facilities, 457 children, aged less than five years, having acute watery diarrhoea, were studied between August 2005 and July 2007 to determine the prevalence of rotavirus. Due to limited financial support, the surveillance of rotavirus was included as an addendum to an ongoing study for cholera in the same area. Rotavirus infection was detected in 114 (25%) and Vibrio cholerae in 63 (14%) children. Neither rotavirus nor V cholerae was detected in 280 (61%) samples; these were termed 'non-rotavirus and non-cholera' diarrhoea. Both rotavirus and cholera were detected in all groups of patients (<5 years). The highest proportion (41%; 47/114) of rotavirus was in the age-group of 6-11 months. In children aged less than 18 months, the proportion (67%; 76/114) of rotavirus was significantly (p < 0.001) higher than that of cholera (16%; 10/63). By contrast, the proportion (84%; 53/63) of cholera was significantly (p < 0.001) higher than that of rotavirus (33%; 38/114) in the age-group of 18-59 months. During the study period, 528 children were hospitalized for various illnesses. Thirty-eight percent (202/528) of the hospitalizations were due to acute watery diarrhoea, and 62% were due to non-diarrhoeal illnesses. Rotavirus accounted for 34% of hospitalizations due to diarrhoea. Severe dehydration was detected in 16% (74/457) of the children. The proportion (51%; 32/63) of severe dehydration among V cholerae-infected children was significantly higher (p < 0.001) compared to the proportion (16%; 18/114) of rotavirus-infected children. The study revealed that 12-14% of the hospitalizations in rural Bangladesh in this age-group were due to rotavirus infection, which has not been previously documented.

Phenotypic, genotypic, and antibiotic sensitivity patterns of strains isolated from the cholera epidemic in Zimbabwe.

This paper details the phenotypic, genotypic, and antibiotic sensitivity patterns of 88 Vibrio cholerae strains from Zimbabwe. Of the 88 strains, 83 were classified as "altered El Tor" and 5 as "hybrid El Tor" strains. All of the strains were susceptible to tetracycline, doxycycline, ciprofloxacin, and azithromycin by disc diffusion, but susceptibility to tetracycline and azithromycin diminished when observed using the MIC method.

Causes for hospitalizations at upazila health complexes in Bangladesh.

Morbidity and mortality data are important for planning and implementing healthcare strategies of a country. To understand the major causes for hospitalizations in rural Bangladesh, demographic and clinical data were collected from the hospital-records of five government-run rural health facilities (upazila health complexes) situated at different geographical regions of the country from January 1997 to December 2001. During this period, 75,598 hospital admissions in total were recorded, of which 54% were for male, and 46% were for female. Of all the admissions, diarrhoeal disease was the leading cause for hospitalization (25.1%), followed by injuries (17.7%), respiratory tract diseases (12.6%), diseases of the gastrointestinal tract (10.5%), obstetric and gynaecological causes (8.5%), and febrile illnesses (6.7%). A considerable proportion (8.3%) of the hospitalized patients remained undiagnosed. Despite the limitations of hospital-based data, this paper gives a reasonable insight of the important causes for hospitalizations in upazila health complexes that may guide the policy-makers in strengthening and prioritizing the healthcare needs at the upazila level in Bangladesh.

Rapid detection of early typhoid fever in endemic community children by the TUBEX O9-antibody test.

Typhoid remains a global public health problem, and quick accurate immunodiagnosis is needed. Here, we examined the performance of the 5-min TUBEX O9-antibody detection kit in 243 outpatients (mostly children and infants) in their first week of fever and 57 healthy subjects in the Bangladesh community. Based on culture results, TUBEX was 91.2% (31/34) sensitive and 82.3% (172/209) specific in febrile subjects. However, specificity was better in nonfebrile healthy subjects (89.5%, 51/57) or in febrile individuals who serologically had dengue fever (90.5%, 57/63), suggesting that some culture-negative febrile individuals could be truly typhoidal. These individuals were also positive in an anti-crude O9 enzyme-linked immunosorbent assay (ELISA) and the Widal test. Regression analysis of the TUBEX and ELISA results showed good concordance between them, better with the combined IgM-IgG ELISA than with IgM alone, suggesting that TUBEX detects IgM antibodies not necessarily by themselves, as previously reported, but with the help of IgG antibodies.

Childhood mortality due to drowning in rural Matlab of Bangladesh: magnitude of the problem and proposed solutions.

Drowning is an important cause of mortality among children in rural Bangladesh. Children aged 1-4 year(s) are at a high risk of death from drowning. Although deaths of children due to drowning in Bangladesh are acknowledged as an important cause of death, little effort has been made to address the issue of preventing deaths from this cause. This study has attempted to describe the problem and suggests possible prevention strategies, which may contribute to reducing childhood mortality from drowning. Data presented in this study were collected from Matlab where ICDDR,B has been maintaining a demographic surveillance since 1966. During the study period from 1985 to 2000, 989 deaths from drowning were reported, of which 796 (80.5%) were children in the age-group of 1-4 year(s), 48 (4.8%) were in the age-group of less than one year, and 145 (14.7%) in the age-group of 5-19 years. During 1985-2000, death rate per 1,000 children due to all causes among children of 1-4-year age-group decreased appreciably from 20.7% to 5.2%, while drowning-related deaths did not. Forty-five percent (n = 359) of drowning-related deaths occurred in ponds, 16.8% (n = 134) in ditches, 8.1% (n = 64) in canals, and 4.4% (n = 35) in rivers. The sites of more than 25% of drowning-associated deaths were not recorded. Analysis of seasonal variation revealed that most deaths due to drowning occurred during April-October, i.e. mostly during the monsoon months. It was also observed that the majority (67%) of mothers of victims had no formal education. Deaths due to drowning were mostly associated with children aged 1-4 year(s) and were 20% more common among boys than among girls (odds ratio = 1.2, 95% confidence interval 1.04-1.38, p < 0.012). The paper recommends some interventions to reduce the number of deaths due to drowning in rural Bangladesh, which include: (a) increasing awareness among mothers and close family members about the risk of drowning, (b) door-fencing, and (c) filling of unused ditches and water holes around households.