Efficacy of chlorine-based disinfectants to control Legionella within premise plumbing systems.

Legionella is an opportunistic waterborne pathogen that causes Legionnaires' disease. It poses a significant public health risk, especially to vulnerable populations in health care facilities. It is ubiquitous in manufactured water systems and is transmitted via inhalation or aspiration of aerosols/water droplets generated from water fixtures (e.g., showers and hand basins). As such, the effective management of premise plumbing systems (building water systems) in health care facilities is essential for reducing the risk of Legionnaires' disease. Chemical disinfection is a commonly used control method and chlorine-based disinfectants, including chlorine, chloramine, and chlorine dioxide, have been used for over a century. However, the effectiveness of these disinfectants in premise plumbing systems is affected by various interconnected factors that can make it challenging to maintain effective disinfection. This systematic literature review identifies all studies that have examined the factors impacting the efficacy and decay of chlorine-based disinfectant within premise plumbing systems. A total of 117 field and laboratory-based studies were identified and included in this review. A total of 20 studies directly compared the effectiveness of the different chlorine-based disinfectants. The findings from these studies ranked the typical effectiveness as follows: chloramine > chlorine dioxide > chlorine. A total of 26 factors were identified across 117 studies as influencing the efficacy and decay of disinfectants in premise plumbing systems. These factors were sorted into categories of operational factors that are changed by the operation of water devices and fixtures (such as stagnation, temperature, water velocity), evolving factors which are changed in-directly (such as disinfectant concentration, Legionella disinfectant resistance, Legionella growth, season, biofilm and microbe, protozoa, nitrification, total organic carbon(TOC), pH, dissolved oxygen(DO), hardness, ammonia, and sediment and pipe deposit) and stable factors that are not often changed(such as disinfectant type, pipe material, pipe size, pipe age, water recirculating, softener, corrosion inhibitor, automatic sensor tap, building floor, and construction activity). A factor-effect map of each of these factors and whether they have a positive or negative association with disinfection efficacy against Legionella in premise plumbing systems is presented. It was also found that evaluating the effectiveness of chlorine disinfection as a water risk management strategy is further complicated by varying disinfection resistance of Legionella species and the form of Legionella (culturable/viable but non culturable, free living/biofilm associated, intracellular replication within amoeba hosts). Future research is needed that utilises sensors and other approaches to measure these key factors (such as pH, temperature, stagnation, water age and disinfection residual) in real time throughout premise plumbing systems. This information will support the development of improved models to predict disinfection within premise plumbing systems. The findings from this study will inform the use of chlorine-based disinfection within premise plumbing systems to reduce the risk of Legionnaires disease.

Overview of waste bank application in Indonesian regencies.

Managing municipal solid waste (MSW) is a critical for Indonesia, as the country produces a substantial amount of waste annually. However, Indonesia's recycling rate remains limited, less than 25% of its waste, with the rest ending up in landfills. To address this, waste banks have emerged as a community-based solution to enhance MSW management through recycling. Although waste banks currently contribute only 7% to recyclable waste management, they hold promising potential, especially considering their close ties to households, the primary waste producers in Indonesia. Unfortunately, documentation of waste bank successes in Indonesian regencies is scarce, as most success stories are limited to major cities. This article conducts a literature review on waste bank implementations across various regencies, evaluating their accomplishments, obstacles and potential contributions to local MSW management. The review draws upon scholarly publications and various government reports, regulations and websites dedicated to updates on waste bank activities. Waste banks play a crucial role in enhancing environmental quality by promoting proper waste disposal and reducing landfill waste. They create economic opportunities, increasing income for both customers and administrators. Additional services, such as banking facilities encompassing savings, loans, daily necessities and bill payments, amplify their significance. To fully harness the potential of waste banks, support is imperative. Establishing adequate infrastructure and providing capacity-building for administrators are essential. Although regulatory frameworks offer opportunities, the impact of regency-level regulations on waste bank growth varies and necessitates further examination. Support mechanisms should be tailored to align with local characteristics and requirements.

An Investigation into the Prevalence of Methamphetamine Related Enquiries to Local Government Environmental Health Officers.

Methamphetamine contamination of residential properties remains a serious public health concern for members of the public. External stakeholders including Environmental Health Officers (EHOs) and testing and remediation technicians are engaged on investigating whether contamination has occurred from manufacturing or smoking processes. More specifically, local council EHOs are responsible for managing clandestine drug laboratories when notified by police and also for responding to public enquiries. However, the full scope of these contaminated properties is not seen by any single stakeholder, making it very challenging to quantify these situations. To evaluate the prevalence of methamphetamine related enquiries from the general public to EHOs, this study surveyed and interviewed officers from around Australia. It was found that public enquiries were infrequent with only 6% of respondents having received enquiries in the last month, which indicates that people are seeking information from other sources. Interestingly, there were case study scenarios that also mentioned issues with awareness and the flow of information. Concerns regarding difficult cases, police notifications, and site visits were also highlighted. The results of this study provide a benchmark of how methamphetamine related cases are managed and highlight the need for trustworthy information that is available to EHOs, governments, industry members, and the public in a unified location.

Using staged teaching and assessment approaches to facilitate inter-university collaboration and problem-based learning.

This article describes the segmented module design and problem-based learning approaches employed to enable parts of a higher education environmental health module (course) to be shared between universities in Wales, Northern Ireland, and Australia. The module requires students to identify the needs and assets of a community then design community-based interventions to address problems and undertake an evaluation of those interventions. Accreditation body and the degree program learning outcome requirements in the UK and Australia were found to hold many comparable knowledge, skills, and graduate attribute criteria, eliminating a potential barrier for international learning and teaching collaboration between higher education institutions. Instead, barriers to collaboration were associated with institutional issues and practicalities such as timetabling and assessment requirements. Taking a segmented approach to module design allowed staged and varied levels of collaboration between participating institutions, all delivering modules (courses) with similar learning outcomes. This provided a more sustainable environment to facilitate shared learning and teaching and fostered closer relations between programs, within these constraining factors. Students using problem-based learning and its group-working component exhibited the development of leadership, communication, and independent learning skills.

Strongyloides questions-a research agenda for the future.

The Strongyloides genus of parasitic nematodes have a fascinating life cycle and biology, but are also important pathogens of people and a World Health Organization-defined neglected tropical disease. Here, a community of Strongyloides researchers have posed thirteen major questions about Strongyloides biology and infection that sets a Strongyloides research agenda for the future. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.

Climate Change and Health: Challenges to the Local Government Environmental Health Workforce in South Australia.

Climate change is the most urgent and significant public health risk facing the globe. In Australia, it has been identified that Environmental Health Officers/Practitioners (EHOs/EHPs, hereafter EHOs) are a currently underutilized source of knowledge and skills that can contribute to climate change adaptation planning at the local government level. The ability of local government EHOs to utilize their local knowledge and skills in human health risk assessment during a public health emergency was demonstrated through their role in the response to COVID-19. This study used a survey and follow up interviews to examine the roles and responsibilities of EHOs during the COVID-19 pandemic and used the results to examine the potential of the workforce to tackle climate change and health related issues. What worked well, what regulatory tools were helpful, how interagency collaboration worked and what barriers or hindering factors existed were also explored. A workforce review of EHOs in South Australia was also undertaken to identify current and future challenges facing EHOs and their capacity to assist in climate change preparedness. The findings demonstrated that the workforce was used in the response to COVID-19 for varying roles by councils, including in education and communication (both internally and externally) as well as monitoring and reporting compliance with directions. Notably, half the workforce believed they could have been better utilized, and the other half thought they were well utilized. The South Australian Local Government Functional Support Group (LGFSG) was praised by the workforce for a successful approach in coordinating multiagency responses and communicating directions in a timely fashion. These lessons learnt from the COVID-19 pandemic should be incorporated into climate change adaptation planning. To ensure consistent messaging and a consolidated information repository, a centralized group should be used to coordinate local government climate change adaptation plans in relation to environmental health and be included in all future emergency management response plans. The surveyed EHOs identified environmental health issues associated with climate change as the most significant future challenge; however, concerningly, participants believe that a lack of adequate resourcing, leading to workforce shortages, increasing workloads and a lack of support, is negatively impacting the workforce's preparedness to deal with these emerging issues. It was suggested that the misperception of environmental health and a failure to recognize its value has resulted in a unique dilemma where EHOs and their councils find themselves caught between managing current workload demands and issues, and endeavouring to prepare, as a priority, for emerging environmental health issues associated with climate change and insufficient resources.

The composition of planktonic prokaryotic communities in a hospital building water system depends on both incoming water and flow dynamics.

In recent years, the frequency of nosocomial infections has increased. Hospital water systems support the growth of microbes, especially opportunistic premise plumbing pathogens. In this study, planktonic prokaryotic communities present in water samples taken from hospital showers and hand basins, collected over three different sampling phases, were characterized by 16S rRNA gene amplicon sequencing. Significant differences in the abundance of various prokaryotic taxa were found through univariate and multivariate analysis. Overall, the prokaryotic communities of hospital water were taxonomically diverse and dominated by biofilm forming, corrosion causing, and potentially pathogenic bacteria. The phyla Proteobacteria, Actinobacteriota, Bacteroidota, Planctomycetota, Firmicutes, and Cyanobacteria made up 96% of the relative abundance. The α-diversity measurements of prokaryotic communities showed no difference in taxa evenness and richness based on sampling sites (shower or hand basins), sampling phases (months), and presence or absence of Vermamoeba vermiformis. However, ß-diversity measurements showed significant clustering of prokaryotic communities based on sampling phases, with the greatest difference observed between the samples collected in phase 1 vs phase 2/3. Importantly, significant difference was observed in prokaryotic communities based on flow dynamics of the incoming water. The Pielou's evenness diversity index revealed a significant difference (Kruskal Wallis, p < 0.05) and showed higher species richness in low flow regime (< 13 minutes water flushing per week and ≤ 765 flushing events per six months). Similarly, Bray-Curtis dissimilarity index found significant differences (PERMANOVA, p < 0.05) in the prokaryotic communities of low vs medium/high flow regimes. Furthermore, linear discriminant analysis effect size showed that several biofilm forming (e.g., Pseudomonadales), corrosion causing (e.g., Desulfobacterales), extremely environmental stress resistant (e.g., Deinococcales), and potentially pathogenic (e.g., Pseudomonas) bacterial taxa were in higher amounts under low flow regime conditions. This study demonstrated that a hospital building water system consists of a complex microbiome that is shaped by incoming water quality and the building flow dynamics arising through usage.

Utilising tourist-generated citizen science data in response to environmental challenges: A systematic literature review.

There has been a proliferation of studies that have examined the impacts of public participation in Citizen Science (CS) that respond to environmental challenges and the recovery of ecosystems, endangered species or other important natural assets. However, comparatively few studies have explored how tourists may play a critical role in the generation of CS data and thus it has been posited that many potential opportunities remain unrealised. By systematically analysing studies that have utilised tourist-generated data in response to environmental challenges or issues, this paper seeks to establish an appraisal of what has so far been established in extant literature and to identify future possibilities for the inclusion of tourists in CS. Via our literature search, a total of 45 peer-reviewed studies were identified via the PRISMA search protocol. Our findings reveal numerous positive outcomes were reported that highlight the significant, yet largely untapped, potential of tourist integration in CS, with studies also offering a range of recommendations on how tourists could be included more effectively to expand scientific knowledge. Notwithstanding, several limitations were observed, and it is critical that future CS projects that utilise tourists for data collection purposes are acutely aware of the challenges they may encounter.

Detection and quantification of viable but non-culturable Legionella pneumophila from water samples using flow cytometry-cell sorting and quantitative PCR.

Legionella pneumophila is a waterborne pathogen and, as the causative agent of Legionnaires' disease, a significant public health concern. Exposure to environmental stresses, and disinfection treatments, promotes the formation of resistant and potentially infectious viable but non-culturable (VBNC) Legionella. The management of engineered water systems to prevent Legionnaires' disease is hindered by the presence of VBNC Legionella that cannot be detected using the standard culture (ISO11731:2017-05) and quantitative polymerase reaction (ISO/TS12869:2019) methods. This study describes a novel method to quantify VBNC Legionella from environmental water samples using a "viability based flow cytometry-cell sorting and qPCR" (VFC + qPCR) assay. This protocol was then validated by quantifying the VBNC Legionella genomic load from hospital water samples. The VBNC cells were unable to be cultured on Buffered Charcoal Yeast Extract (BCYE) agar; however, their viability was confirmed through their ATP activity and ability to infect amoeba hosts. Subsequently, an assessment of the ISO11731:2017-05 pre-treatment procedure demonstrated that acid or heat treatment cause underestimation of alive Legionella population. Our results showed that these pre-treatment procedures induce culturable cells to enter a VBNC state. This may explain the observed insensitivity and lack of reproducibility often observed with the Legionella culture method. This study represents the first time that flow cytometry-cell sorting in conjunction with a qPCR assay has been used as a rapid and direct method to quantify VBNC Legionella from environmental sources. This will significantly improve future research evaluating Legionella risk management approaches for the control of Legionnaires' disease.

Climate Change and Health: Local Government Capacity for Health Protection in Australia.

Climate change is the greatest global health threat of the 21st century, with numerous direct and indirect human health consequences. Local governments play a critical role in communities' response to climate change, both through strategies to reduce emissions and adaption plans to respond to changing climate and extreme weather events. Australian local government environmental health officers (EHOs) have the relevant skills and expertise to inform and develop adaptation plans for health protection in the context of climate change. This study used an online survey followed by phone interviews of local government management to determine the extent to which EHOs are involved in adaptation planning in health protection climate change plans. Questions were also asked to determine whether local councils are aware of EHOs' capability to contribute and to gauge the willingness of management to provide EHOs with the workload capacity to do so. The findings demonstrated that although climate adaptation and mitigation planning is occurring in local government, it is not including or considering the public health impacts on the community. Primarily, it was found that this oversight was due to a lack of awareness of the health impacts of climate change outside of a disaster or emergency scenario. Currently, EHOs are an untapped source of knowledge and skills that can contribute to climate change adaption planning. To support this, a framework of local environmental health practice was developed to assist the reconceptualization of the scope of practice required for the planning and response to climate change.

A Review of Methods Used to Detect Methamphetamine from Indoor Air and Textiles in Confined Spaces.

Methamphetamine manufacture, use, and the resulting contamination is a significant issue that affects public health, the environment, and the economy. Third-hand exposure to methamphetamine can result in adverse health risks for individuals and first responders. Such exposures can result from the inhalation of airborne residues or from contact with contaminated objects. This review was conducted to determine the current methods used for methamphetamine extraction from indoor air and porous fabric materials. Dynamic solid phase microextraction (SPME) and sorbent sampling tubes have been applied to extract airborne methamphetamine residues from contaminated properties. SPME and solvent extraction have been applied to sample clothing and textiles for methamphetamine detection. This review demonstrates that there is limited literature on the detection of methamphetamine from indoor air and clothing. Supplementary and consistent methods to detect methamphetamine from air and porous surfaces should be developed and published to allow better assessment of the environmental risk to public health caused by third-hand exposure to methamphetamine.

Molecular screening and characterization of Legionella pneumophila associated free-living amoebae in domestic and hospital water systems.

Free-living amoebae are ubiquitous in the environment and cause both opportunistic and non-opportunistic infections in humans. Some genera of amoebae are natural reservoirs of opportunistic plumbing pathogens, such as Legionella pneumophila. In this study, the presence of free-living amoebae and Legionella was investigated in 140 water and biofilm samples collected from Australian domestic (n = 68) and hospital water systems (n = 72). Each sample was screened in parallel using molecular and culture-based methods. Direct quantitative polymerase chain reaction (qPCR) assays showed that 41% samples were positive for Legionella, 33% for L. pneumophila, 11% for Acanthamoeba, and 55% for Vermamoeba vermiformis gene markers. Only 7% of samples contained culturable L. pneumophila serogroup (sg)1, L. pneumophila sg2-14, and non-pneumophila Legionella. In total, 69% of samples were positive for free-living amoebae using any method. Standard culturing found that 41% of the samples were positive for amoeba (either Acanthamoeba, Allovahlkampfia, Stenamoeba, or V. vermiformis). V. vermiformis showed the highest overall frequency of occurrence. Acanthamoeba and V. vermiformis isolates demonstrated high thermotolerance and osmotolerance and strong broad spectrum bacteriogenic activity against Gram-negative and Gram-positive bacteria. Importantly, all Legionella positive samples were also positive for amoeba, and this co-occurrence was statistically significant (p < 0.05). According to qPCR and fluorescence in situ hybridization, V. vermiformis and Allovahlkampfia harboured intracellular L. pneumophila. To our knowledge, this is the first time Allovahlkampfia and Stenamoeba have been demonstrated as hosts of L. pneumophila in potable water. These results demonstrate the importance of amoebae in engineered water systems, both as a pathogen and as a reservoir of Legionella. The high frequency of gymnamoebae detected in this study from Australian engineered water systems identifies an issue of significant public health concern. Future water management protocols should incorporate treatments strategies to control amoebae to reduce the risk to end users.

Juncus sarophorus, a native Australian species, tolerates and accumulates PFOS, PFOA and PFHxS in a glasshouse experiment.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been identified as emerging contaminants of public health concern. With PFAS now detected globally in a wide range of environments, there is an urgent need for effective remedial treatment solutions at the field scale. Phytoremediation presents a potential remediation strategy for PFAS that would allow efficient and cost-effective remediation at large scales. This study examined the potential for the Australian native wetland plant Juncus sarophorus to tolerate, take up, and accumulate PFOS, PFOA and PFHxS. A 190-day glasshouse experiment was conducted, in which 0, 10 and 100 µg/L each of PFOS, PFOA and PFHxS were used to irrigate J. sarophorus in potted soil. The results suggest that J. sarophorus has a high tolerance to PFAS and is effective at accumulating and transferring PFHxS and PFOA from soils to above ground biomass. Together with its high growth rate, J. sarophorus appears to be, in principle, a suitable candidate for phytoextraction of short-chained PFAS compounds. It is, however, less efficient at uptake of PFOS, owing to the long chain-lengths of this compound and PFOSs' ability to sorb effectively to soils. The total accumulated PFAS mass at the end of the experiment was ~2000 µg/kg biota(wet weight) and ~170 µg/kg biota(wet weight) for soils irrigated with 100 µg/L and 10 µg/L for each PFAS compound, translating into overall PFAS removal rates of 11% and 9%.

Defining Food Safety Inspection.

 Food safety inspections are a key health protection measure applied by governments to prevent foodborne illness, yet they remain the subject of sustained criticism. These criticisms include inconsistency and inadequacy of methods applied to inspection, and ineffectiveness in preventing foodborne illness. Investigating the validity of these criticisms represent important areas for further research. However, a defined construct around the meanings society attributes to food safety inspection must first be established. Through critical examination of available literature, this review identified meanings attributed to food safety inspection and explicates some of the key elements that compose food safety inspection as a social construct. A total of 18 meanings were found to be attributed to food safety inspection. Variation in meanings were found between consumers, food business associates and food safety inspectors. For some, inspection meant a source of assurance, for others a threat to fairness, while most view inspection as a product of resources and inspector training. The meanings were then examined in light of common criticisms directed at food safety inspection, to expound their influence in how food safety inspection is realized, shaped, and rationalized. This review highlights the influence of sociological factors in defining food safety inspection. .

Examination of Australian backyard poultry for Salmonella, Campylobacter and Shigella spp., and related risk factors.

Worldwide, foodborne illness is a significant public health issue in both developed and developing countries. Salmonellosis, campylobacteriosis and shigellosis are common foodborne gastrointestinal illnesses caused by the bacteria Salmonella spp., Campylobacter spp. and Shigella spp. respectively. These zoonotic diseases are frequently linked to eggs and poultry products. The aim of this study was to investigate the presence of these pathogens in Australian backyard poultry flocks and to determine risk factors for these pathogens. Poultry faeces samples were collected from 82 backyards and screened for Salmonella spp., Campylobacter spp. and Shigella spp. using qPCR. A questionnaire was administered to the backyard poultry owners to assess their knowledge regarding management of poultry and eggs and to identify potential risk factors that may contribute to the presence of zoonotic pathogens in the flocks. One composite faecal sample was collected from each backyard (82 samples). Composite sampling here means taking one or more grab samples from a backyard to make up approximately 10 grams. Four per cent of samples, that is 4% backyards tested, were positive for Salmonella spp., 10% were positive for Campylobacter spp. and none were positive for Shigella spp. A higher infection rate was seen in multi-aged flocks (24%) compared with the single-aged flocks (3%). The survey found that many participants were engaging in risky food safety behaviours with 46% of participants responding that they washed their eggs with running water or still water instead of wiping the dirt off with a damp cloth to clean the eggs and 19% stored their eggs at room temperature. This study demonstrated that backyard poultry may pose a potential risk for salmonellosis and campylobacteriosis. Additionally, Australian public health and food safety regulations should be modified and effectively implemented to address the risks associated with backyard poultry husbandry.

Current knowledge of the degradation products of tattoo pigments by sunlight, laser irradiation and metabolism: a systematic review.

The popularity of tattooing has increased significantly over recent years. This has raised concerns about the safety of tattoo inks and their metabolites/degradation products. The photolytic and metabolic degradation of tattoo pigments may result in the formation of toxic compounds, with unforeseen health risks. A systematic literature review was undertaken to determine the current state of knowledge of tattoo pigments' degradation products when irradiated with sunlight, laser light or metabolised. The review demonstrates that there is a lack of knowledge regarding tattoo pigment degradation/metabolism, with only eleven articles found pertaining to the photolysis of tattoo pigments and two articles on the metabolism of tattoo pigments. The limited research indicates that the photolysis of tattoo pigments could result in many toxic degradation products, including hydrogen cyanide and carcinogenic aromatic amines.

Overview of Current Practices in the Methamphetamine Testing and Decontamination Industry: An Australian Case Study.

To better protect public health from third-hand exposure to methamphetamine, it is important to understand the techniques and current practices used within the methamphetamine testing and decontamination industry in Australia. A survey was conducted focusing on business owners that advertised testing and/or remediation services online. They were also invited to participate in a follow-up phone interview upon completion. The survey demonstrated that testing and decontamination methods were highly varied, which was expected for an industry with no regulation. Most companies offered methamphetamine testing and remediation which could be a conflict of interest. Participants also shared personal experiences, including the conduct of other industry members, demonstrating both poor practice and/or the competitive nature of the business. Participating business owners were following Australian guidelines to the best of their ability, and many are advocates for regulation to be implemented within the industry. This would address the inconsistencies between companies and establish trust for industry members and the public. It would also provide significant public health protection, which is currently lacking. A more consistent approach to the testing and remediation of methamphetamine contamination, aided by regulation, would address the significant risk to public health caused by third-hand exposure to methamphetamine.

How can Environmental Health Practitioners contribute to ensure population safety and health during the COVID-19 pandemic?

The COVID-19 pandemic highlighted the relevance of public health professionals all over the world, in particular Environmental Health Practitioners (EHPs), who played a major role in the containment of the novel coronavirus, SARS-CoV-2. However, as in past disasters, their involvement was oriented towards urgent tasks, and did not fully utilize EHPs' competences and skills. Additionally, due to limited resources, during emergencies EHPs may temporarily transition away from their day-to-day role, potentially increasing other public health and safety risk factors without appropriate surveillance or intervention. To overcome this and prepare for possible future pandemics, it is important to identify and discuss the key roles of EHPs in different countries, providing a common framework for practices that can contribute to population safety and health. To this end, an international workgroup was established to discuss current environmental health practices and challenges across different countries during the pandemic. Findings from discussions concluded that, despite the observed differences across the countries, EHPs are one of the main public health emergency preparedness and response actors. However, since resources are still lagging significantly behind need, we argue that the role of these professionals during pandemics should be focused on practices that have higher impact to support population health and safety.