QMRA and water safety management: review of application in drinking water systems.

Quantitative microbial risk assessment (QMRA), the assessment of microbial risks when model inputs and estimated health impacts are explicitly quantified, is a valuable tool to support water safety plans (WSP). In this paper, research studies undertaken on the application of QMRA in drinking water systems were reviewed, highlighting their relevance for WSP. The important elements for practical implementation include: the data requirements to achieve sufficient certainty to support decision-making; level of expertise necessary to undertake the required analysis; and the accessibility of tools to support wider implementation, hence these aspects were the focus of the review. Recommendations to support the continued and growing application of QMRA to support risk management in the water sector are provided.

Application of a QMRA Framework to Inform Selection of Drinking Water Interventions in the Developing Context.

The aim of this study was to develop a modified quantitative microbial risk assessment (QMRA) framework that could be applied as a decision support tool to choose between alternative drinking water interventions in the developing context. The impact of different household water treatment (HWT) interventions on the overall incidence of diarrheal disease and disability adjusted life years (DALYs) was estimated, without relying on source water pathogen concentration as the starting point for the analysis. A framework was developed and a software tool constructed and then implemented for an illustrative case study for Nepal based on published scientific data. Coagulation combined with free chlorine disinfection provided the greatest estimated health gains in the short term; however, when long-term compliance was incorporated into the calculations, the preferred intervention was porous ceramic filtration. The model demonstrates how the QMRA framework can be used to integrate evidence from different studies to inform management decisions, and in particular to prioritize the next best intervention with respect to estimated reduction in diarrheal incidence. This study only considered HWT interventions; it is recognized that a systematic consideration of sanitation, recreation, and drinking water pathways is important for effective management of waterborne transmission of pathogens, and the approach could be expanded to consider the broader water-related context.

Quantification of pathogen inactivation efficacy by free chlorine disinfection of drinking water for QMRA.

To support the implementation of quantitative microbial risk assessment (QMRA) for managing infectious risks associated with drinking water systems, a simple modeling approach for quantifying Log10 reduction across a free chlorine disinfection contactor was developed. The study was undertaken in three stages: firstly, review of the laboratory studies published in the literature; secondly, development of a conceptual approach to apply the laboratory studies to full-scale conditions; and finally implementation of the calculations for a hypothetical case study system. The developed model explicitly accounted for variability in residence time and pathogen specific chlorine sensitivity. Survival functions were constructed for a range of pathogens relying on the upper bound of the reported data transformed to a common metric. The application of the model within a hypothetical case study demonstrated the importance of accounting for variable residence time in QMRA. While the overall Log10 reduction may appear high, small parcels of water with short residence time can compromise the overall performance of the barrier. While theoretically simple, the approach presented is of great value for undertaking an initial assessment of a full-scale disinfection contactor based on limited site-specific information.

Quantitative Bayesian predictions of source water concentration for QMRA from presence/absence data for E. coli O157:H7.

A hierarchical Bayesian framework was applied for describing variability in pathogen concentration (with associated uncertainty) from presence/absence observations for E. coli O157:H7. Laboratory spiking experiments (method performance) and environmental sample assays were undertaken for a surface drinking water source in France. The concentration estimates were strongly dependent upon the assumed statistical model used (gamma, log-gamma or log-gamma constrained), highlighting the need for a solid theoretical basis for model choice. Bayesian methods facilitate the incorporation of additional data into the statistical analysis; this was illustrated using faecal indicator results of E. coli (Colilert) to reduce the posterior parameter uncertainty and improve model stability. While conceptually simple, application of these methods is still specialised, hence there is a need for the development of data analysis tools to make Bayesian simulation techniques more accessible for QMRA practitioners.

Viral risks associated with wastewater reuse: modeling virus persistence on wastewater irrigated salad crops.

A model for virus decay on lettuce and carrot crops has been derived as part of a comprehensive wastewater irrigation microbial risk assessment model under development. Results from the decay modeling indicated the presence of a very persistent sub-population of viruses evidenced by an initial rapid phase of decay followed by a very slow phase. In addition, virus counts fitted a negative binomial rather than Poisson distribution indicating over-dispersion. Hence the data indicated that viruses were not uniformly distributed over the surfaces of both crops. The aim of this paper was to investigate the implications of over-dispersion and the presence of a very persistent sub-population of viruses for assessing viral illness from the consumption of lettuces and carrots irrigated with secondary treated effluent. When over-dispersion or clumping of viruses was accounted for, a significant increase in the heterogeneity in the risk estimates arose. In addition, predicted infection rates were significantly underestimated if the presence of a persistent sub-population of viruses was not considered in the decay kinetics of the risk model. Hence, both viral clumping and persistence sub-populations should be accounted for in future risk assessments of enteric viruses associated with wastewater reuse.

Microbial risks from wastewater irrigation of salad crops: a screening-level risk assessment.

The potential health risk from viruses, associated with the consumption of lettuce crops spray irrigated with secondary-treated municipal effluent, has been evaluated in the first level investigation of a tiered microbial risk assessment. The study assessed the impact of two factors on the estimated risk of infection: a suitable probability density function for the occurrence of human enteroviruses in irrigation water and appropriate die-off rates for viruses on lettuce crops. A Monte Carlo simulation using a log-normal and a nonparametric, kernel estimated probability density function indicated that slight changes in the upper tail of the probability density function had a relatively low effect on the estimated infection rates. Predicted infection rates were much more sensitive to the decay rate of viruses than occasional high virus numbers. The median and 99th percentile risks of infection from the overall model were 0.10 and 0.51/10000 lettuce consumers, respectively, indicating possible human health concern, and the justification of a more detailed microbial risk assessment.

Modeling virus inactivation on salad crops using microbial count data.

Microbial counts of the persistent Bacteroides fragilis bacteriophage B40-8 from a virus decay experiment conducted under glasshouse conditions were used to model the decay of viruses on wastewater-irrigated lettuce and carrot crops. The modeling approach applied gave specific consideration to the discrete nature of microbial count data. The experimental counts were best fit by a negative binomial distribution indicating highly dispersed distribution of viruses on lettuce and carrot crops following irrigation with wastewater. In addition, there was evidence for biphasic inactivation of viruses, signifying the presence of a persistent subpopulation of viruses that decayed slowly, resulting in virus accumulation on the crop surface over subsequent irrigations. Maximum likelihood estimates of initial and persistent subpopulation inactivation rates were 2.48 day(-1) and 0.51 day(-1) for lettuces and 0.84 day(-1) and 0.046 day(-1) for carrots. Maximum likelihood estimates of the persistent virus subpopulation size were 0.12% and 2% for lettuce and carrots, respectively.