Water fluoridation in Australia: A systematic review.

Water fluoridation is considered a safe and effective public health strategy to improve oral health. This review aimed to systematically summarize the available evidence of water fluoridation in Australia, focusing on the history, health impacts, cost effectiveness, challenges, and limitations. A systematic search was conducted on the Ovid Medline, Web of Science, Scopus, ProQuest Central, Cinahl, and Informit databases to identify literature on water fluoridation in Australia. A grey literature search and backward snowballing were used to capture additional literature. Primary studies, reviews, letters, and opinion papers were included in the quantitative analysis and summarized based on the year of publication and geographical location. The data were extracted from primary studies and summarized under three subheadings: history, community health impacts and the limitations and challenges. Water fluoridation in Australia was first implemented in 1953 in Tasmania. Most states and territories in Australia embraced water fluoridation by 1977 and currently, 89% of the Australian population has access to fluoridated drinking water. Studies report that water fluoridation has reduced dental caries by 26-44% in children, teenagers, and adults, benefiting everyone regardless of age, income, or access to dental care. It has been recognized as a cost-effective intervention to prevent dental caries, especially in rural and low-income areas. Water fluoridation as a public health measure has faced challenges, including political and public opposition, implementation and maintenance costs, access and equity, communication and education, and ethical concerns. Variations in research activities on water fluoridation across Australian states and territories over the last seven decades can be due to several factors, including the time of implementation, funding, and support. Ongoing monitoring and research to review and update optimal fluoride levels in drinking water in Australia is warranted to ensure sustainable benefits on oral health while preventing any adverse impacts.

Performance of regional water purification plants during extreme weather events: three case studies from New South Wales, Australia.

Climate change is altering weather patterns, which affects water supply systems globally. More frequent extreme weather events like floods, droughts, and heatwaves are impacting the availability of raw water sources that supply cities. These events can lead to less water, higher demand, and potential infrastructure damage. Water agencies and utilities must develop resilient and adaptable systems to withstand shocks and stresses. Case studies demonstrating the impact of extreme weather on water quality are important for developing resilient water supply systems. This paper documents the challenges faced by regional New South Wales (NSW) in managing water quality and supply during extreme weather events. Effective treatment processes, such as ozone treatment and adsorption, are used to maintain drinking water standards during extreme weather. Water-efficient alternatives are provided, and critical water networks are inspected to identify leaks and reduce system demand. Local government areas must collaborate and share resources to ensure that towns can cope with future extreme weather events. Systematic investigation is needed to understand system capacity and identify surplus resources to be shared when demand cannot be met. Pooling resources could benefit regional towns experiencing both floods and droughts. With expected population growth in the area, regional NSW councils will require a significant increase in water filtration infrastructure to handle increased system loading. Continuous research, regular strategy reviews, and innovative approaches are essential to ensure a secure and reliable water supply during future extreme weather events.

The effectiveness of PFAS management options on groundwater quality in contaminated land using numerical modelling.

The concentrations of PFOS and PFHxS in a contaminated site in regional New South Wales, Australia, were above the human health screening values for industrial land use. In this study, the effects of different management options on the quality of groundwater were investigated through numerical modelling. At first, a complete transfer model including the main features of advection, dispersion, adsorption and decay, was developed to simulate the long-term migration of PFOS from topsoil subjected to full climate interaction for 100 years. The sorption isotherm characteristics of the contaminated soil were determined from chemical analysis using LC/MS equipment. The model results were confirmed by PFOS values measured from a monitoring well in the proximity of the site. The model showed that PFOS values in groundwater increased gradually and exceeded the guideline values for drinking water. Three management options were suggested: a do-nothing approach, cut and replacement, and immobilisation of the topsoil up to 2 m depth. The numerical models showed that although all these strategies reduced the PFOS level in the groundwater significantly, the values were still higher than the guideline values for drinking water. This was because PFOS migrated in the ground beyond the site location. The cut and replacement and immobilisation strategies ensured that the PFOS values were lower than the guideline values for soil screening, but PFOS levels in the groundwater were not necessarily lower than the guideline values for drinking water after a long time.

A review of the emerging treatment technologies for PFAS contaminated soils.

Contamination of soils with poly- and perfluoroalkyl substances (PFAS) has become a challenging issue due to the adverse effects of these substances on both the environment and public health. PFAS have strong chemical structures and their bonding with soil makes them challenging to eliminate from soil environments. Traditional methods of soil remediation have not been successful in their reduction or removal from the environment. This paper provides a comprehensive evaluation of existing and emerging technologies for remediating PFAS contaminated soils with guidance on which approach to use in different contexts. The functions of all remediation technologies, their suitability, limitations, and the scale applied from laboratory to the field are presented as a baseline for understanding the research need for treatment in soil environments. To date, the immobilization method has been a significant part of the remediation solution for PFAS contaminated soils, although its long-term efficiency still needs further investigation. Soil washing and thermal treatment techniques have been tested at the field scale, but they are expensive and energy-intensive due to the use of a large volume of washing solvent and the high melting point of PFAS, respectively; both methods need a large initial investment for their installation. Other remediation technologies, such as chemical oxidation, ball milling, and electron beams, have been progressed in the laboratory. However, additional research is needed to make them feasible, cost-effective and applicable in the field.

Risk factors associated with disease progression and mortality in chronic kidney disease of uncertain etiology: a cohort study in Medawachchiya, Sri Lanka.

BACKGROUND: The alarming rise in the prevalence of chronic kidney disease of uncertain etiology (CKDu) among the low socioeconomic farming community in the North Central Province of Sri Lanka has been recognized as an emerging public health issue in the country. METHODS: This study sought to determine the possible factors associated with the progression and mortality of CKDu. The study utilized a single-center cohort registered in 2003 and followed up until 2009 in a regional clinic in the endemic region, and used a Cox proportional hazards model. RESULTS: We repeatedly found an association between disease progression and hypertension. Men were at higher risk of CKDu than women. A significant proportion of the patients in this cohort were underweight, which emphasized the need for future studies on the nutritional status of these patients. CONCLUSIONS: Compared with findings in western countries and other regions of Asia, we identified hypertension as a major risk factor for progression of CKDu in this cohort.