Multi-objective ecological restoration priority in China: Cost-benefit optimization in different ecological performance regimes based on planetary boundaries.

In the context of the "United Nations Decade on Ecosystem Restoration", optimizing spatiotemporal arrangements for ecological restoration is an important approach to enhancing overall socioecological benefits for sustainable development. However, against the background of ecological degradation caused by the human use of most natural resources at levels that have approached or exceeded the safe and sustainable boundaries of ecosystems, it is key to explain how to optimize ecological restoration by classified management and optimal total benefits. In response to these issues, we combined spatial heterogeneity and temporal dynamics at the national scale in China to construct five ecological performance regimes defined by indicators that use planetary boundaries and ecological pressures which served as the basis for prioritizing ecological restoration areas and implementing zoning control. By integrating habitat conservation, biodiversity, water supply, and restoration cost constraints, seven ecological restoration scenarios were simulated to optimize the spatial layout of ecological restoration projects (ERPs). The results indicated that the provinces with unsustainable freshwater use, climate change, and land use accounted for more than 25%, 66.7%, and 25%, respectively, of the total area. Only 30% of the provinces experienced a decrease in environmental pressure. Based on the ecological performance regimes, ERP sites spanning the past 20 years were identified, and more than 50% of the priority areas were clustered in regime areas with increased ecological stress. As the restoration area targets doubled (40%) from the baseline (20%), a multi-objective scenario presents a trade-off between expanded ERPs in areas with highly beneficial effects and minimal restoration costs. In conclusion, a reasonable classification and management regime is the basis for targeted restoration. Coordinating multiple objectives and costs in ecological restoration is the key to maximizing socio-ecological benefits. Our study offered new perspectives on systematic and sustainable planning for ecological restoration.

Preparing schools for future pandemics: Insights on water, sanitation and hygiene solutions from the Brazilian school reopening policies.

Post-COVID-19, schools urgently need to enhance infection control and prevention (IPC) measures, including water, sanitation, and hygiene (WASH), to prepare for future outbreaks and pandemics. Particularly in Brazil, that is of particular concern, as students are still recovering from the 20th longest school closure in the world. Hence, the current study had two goals: (i) to describe WASH solutions outlined in policies released at the federal, state, and capital city levels in Brazil during the COVID-19 pandemic for the safe reopening of schools and (ii) to discuss their potential to enhance school's capacity to remain operational during a new pandemic or outbreak. With a qualitative exploratory approach, we performed content analysis to discuss the direction (what, where, how and for whom?) of 66 public policies by integrating four frameworks. Solutions were discussed in the light of the principles of human rights and the human rights to water and sanitation, international guidelines for WASH and IPC in schools and the Sphere minimum standards for humanitarian aid. One hundred and fifty-nine solutions, spanning five thematic areas and five population groups, including software and hardware interventions, were compiled for potential use in Brazil and beyond. While suggested solutions have the potential to provide a cleaner and safer learning environment, it is essential to exercise caution when implementing these measures and adapt them to the specific circumstances of each school.

Bacterial communities of planktonic bacteria and mature biofilm in service lines and premise plumbing of a Megacity: Composition, Diversity, and influencing factors.

Although simulated studies have provided valuable knowledge regarding the communities of planktonic bacteria and biofilms, the lack of systematic field studies have hampered the understanding of microbiology in real-world service lines and premise plumbing. In this study, the bacterial communities of water and biofilm were explored, with a special focus on the lifetime development of biofilm communities and their key influencing factors. The 16S rRNA gene sequencing results showed that both the planktonic bacteria and biofilm were dominated by Proteobacteria. Among the 15,084 observed amplicon sequence variants (ASVs), the 33 core ASVs covered 72.8 %, while the 12 shared core ASVs accounted for 62.2 % of the total sequences. Remarkably, it was found that the species richness and diversity of biofilm communities correlated with pipe age. The relative abundance of ASV2 (f_Sphingomonadaceae) was lower for pipe ages 40-50 years (7.9 %) than for pipe ages 10-20 years (59.3 %), while the relative abundance of ASV10 (f_Hyphomonadaceae) was higher for pipe ages 40-50 years (19.5 %) than its presence at pipe ages 20-30 years (1.9 %). The community of the premise plumbing biofilm had significantly higher species richness and diversity than that of the service line, while the steel-plastics composite pipe interior lined with polyethylene (S-PE) harbored significantly more diverse biofilm than the galvanized steel pipes (S-Zn). Interestingly, S-PE was enriched with ASV27 (g_Mycobacterium), while S-Zn pipes were enriched with ASV13 (g_Pseudomonas). Moreover, the network analysis showed that five rare ASVs, not core ASVs, were keystone members in biofilm communities, indicating the importance of rare members in the function and stability of biofilm communities. This manuscript provides novel insights into real-world service lines and premise plumbing microbiology, regarding lifetime dynamics (pipe age 10-50 years), and the influences of pipe types (premise plumbing vs. service line) and pipe materials (S-Zn vs. S-PE).

Economic risks hidden in local water pollution and global markets: A retrospective analysis (1995-2010) and future perspectives on sustainable development goal 6.

Pollution from untreated wastewater discharges depletes clean water supply for humans and the environment. It poses adverse economic impacts by determining agricultural yields, manufacturing productivity, and ecosystem functionality. Current studies mainly focus on quantity-related water scarcity assessment. It is unknown how low water quality amplifies local water stress and induces cascading economic risks globally. In this study, we estimated both quality and quantity-related water scarcity index (WSI), local economic water scarcity risk (WSR), and cascading virtual WSR evident in global trade markets across 40 major economies from 1995 to 2010. We find developing countries, e.g., India and China, witnessed fast growth in both quantity and quality-related WSI. Major developed economies, e.g., the US and Germany, experienced a modest increase in water stress but alleviated quality-related risks. Local economic risk (WSR) grew from $116B to $380B, with quality-related risks rising from 20 % to 30 %. Virtual economic WSR in global supply chains increased from $39B to $160B, with quality-related risks increasing from 19 % to 27 %. China became the top exporter of economic WSR, ranked above the US, France, and Japan, and the second-largest position as an importer, trailing only the US. We finally conducted scenario modeling by 2030, assuming different progresses on SDG 6 targets. The findings suggest that only the most ambitious progress in both water quality enhancement and efficiency improvement helps to alleviate ∼20 % economic WSR globally. Our findings underscore the necessity for strategies that integrate management of untreated wastewater flows, improved water use efficiency, and diversification of supply chain networks to enhance global economic resilience to water challenges in the future.

HIV Vulnerabilities Associated with Water Insecurity, Food Insecurity, and Other COVID-19 Impacts Among Urban Refugee Youth in Kampala, Uganda: Multi-method Findings.

Food insecurity (FI) and water insecurity (WI) are linked with HIV vulnerabilities, yet how these resource insecurities shape HIV prevention needs is understudied. We assessed associations between FI and WI and HIV vulnerabilities among urban refugee youth aged 16-24 in Kampala, Uganda through individual in-depth interviews (IDI) (n = 24), focus groups (n = 4), and a cross-sectional survey (n = 340) with refugee youth, and IDI with key informants (n = 15). Quantitative data was analysed via multivariable logistic and linear regression to assess associations between FI and WI with: reduced pandemic sexual and reproductive health (SRH) access; past 3-month transactional sex (TS); unplanned pandemic pregnancy; condom self-efficacy; and sexual relationship power (SRP). We applied thematic analytic approaches to qualitative data. Among survey participants, FI and WI were commonplace (65% and 47%, respectively) and significantly associated with: reduced SRH access (WI: adjusted odds ratio [aOR]: 1.92, 95% confidence interval [CI]: 1.19-3.08; FI: aOR: 2.31. 95%CI: 1.36-3.93), unplanned pregnancy (WI: aOR: 2.77, 95%CI: 1.24-6.17; FI: aOR: 2.62, 95%CI: 1.03-6.66), and TS (WI: aOR: 3.09, 95%CI: 1.22-7.89; FI: aOR: 3.51, 95%CI: 1.15-10.73). WI participants reported lower condom self-efficacy (adjusted ß= -3.98, 95%CI: -5.41, -2.55) and lower SRP (adjusted ß= -2.58, 95%CI= -4.79, -0.37). Thematic analyses revealed: (1) contexts of TS, including survival needs and pandemic impacts; (2) intersectional HIV vulnerabilities; (3) reduced HIV prevention/care access; and (4) water insecurity as a co-occurring socio-economic stressor. Multi-method findings reveal FI and WI are linked with HIV vulnerabilities, underscoring the need for HIV prevention to address co-occurring resource insecurities with refugee youth.

Evidence of waste management impacting severe diarrhea prevalence more than WASH: An exhaustive analysis with Brazilian municipal-level data.

Adequate housing protects from diarrhea, which is a substantial health concern in low- and middle-income countries. The purpose of this study was to quantify the relationship between severe diarrhea and housing features at the municipal level to help in public health planning. Regression analyses were performed on annual (2000-2012) datasets on Brazilian municipalities (5570) in six household feature categories (e.g., waste management) and four severe diarrhea outcomes (e.g., diarrhea deaths of under-5 children). Household data were not available elsewhere of this magnitude and granularity, highlighting the scientific value-add of this study. Municipalities were clustered prior to regression analysis because of data heterogeneity. The compositional household feature data were also subjected to principal component analysis to diminish feature variable multicollinearity. The highest explanatory power was found for diarrhea deaths of under-5 children (R2 = 10-22 %), while those in the over-5 population were the least best explained (R2 = 0.3-7 %). Household features predicted diarrhea outcomes more accurately in the "advanced" housing municipality cluster (R2 = 16-22 %) than in the "mid-level" (R2 = 7-20 %) and "basic" (R2 = 6-12 %) ones (over-5 diarrhea deaths excluded). Under-5 children's diarrhea death prevalence was three times higher in the "basic" cluster than in the "advanced" cluster. Importantly, the impact of waste management was overall the largest of all household features, even larger than those of WASH, i.e., water supply, sanitation, and household drinking water treatment. This is surprising in the context of existing literature because WASH is generally regarded as the most important household factor affecting gastrointestinal health. In conclusion, public health interventions could benefit from customizing interventions for diarrhea outcomes, municipality types, and household features. Waste management's identified stronger association with diarrhea compared to WASH may have important implications beyond the water field and Brazil.

Assessment of Water, Sanitation, and Hygiene Conditions in Public Elementary Schools in Quetzaltenango, Guatemala, in the Context of the COVID-19 Pandemic.

Water, sanitation, and hygiene (WASH) services in schools are essential to reduce infectious disease transmission, including that of COVID-19. This study aimed to establish a baseline of WASH services in six public elementary schools in Guatemala, with a focus on hand hygiene. We used the WHO/UNICEF Joint Monitoring Programme (JMP) report indicators to assess the WASH infrastructure at each school. We collected water samples from easily accessible water points (pilas, or bathroom sinks) at each school to test for the presence of total coliforms and E. coli. In-depth interviews were carried out with teachers to understand hand hygiene practices and systems at school. Results indicate that all schools had water available at the time of the survey. All water samples at four schools tested positive for total coliforms and at one school, positive for E. coli. All schools had sanitation facilities, but services were limited. Only 43% of handwashing stations at schools had soap available. No school had disability-inclusive WASH services. Financial constraints and a lack of appropriate WASH infrastructure were the main barriers reported by teachers to meet hand hygiene needs at school. Appropriate access to WASH infrastructure and supplies could increase hand hygiene practices and improve learning conditions for students.

Sand dam contributions to year-round water security monitored through telemetered handpump data.

Sand dams are a form of rainwater harvesting, prolific in arid and semi-arid lands. Water is provided partly via handpumps, which, as the only improved method of abstraction from sand dams, are important for drinking water security. Accelerometers and cellular transmitters were fitted to 30 handpumps by the Africa Sand Dam Foundation (ASDF) in 2019 to monitor the use and reliability of the handpumps by recording hourly water volume abstracted. Data from April 2019 to October 2021 for 26 of these sites, alongside qualitative data, were analysed and each handpump's contribution to year-round water security was explored, focusing on the long dry season when water supply from other sources is compromised. Abstraction was over 20 times higher in the long dry season than in any other season, and at sites with higher salinity, higher livestock use, and larger dam wall area. At 21 wells, abstraction was still being recorded at the end of at least one long dry season; however, high spatial and temporal heterogeneity between pumps and seasons means that not all sand dams deliver reliable water supply year-round. Quantifying the contribution that sand dams make to water security is crucial for understanding their resilience against a changing climate and can aid decision makers when choosing the most appropriate water management technique. Knowledge of temporal and site heterogeneity in abstraction can inform when other water sources need increasing and can help with sand dam design optimisation. Overall, our results indicate the positive contribution that sand dams make to year-round water security through the water that is abstracted through handpumps.

Effects of the COVID-19 Pandemic on Legionella Water Management Program Performance across a United States Lodging Organization.

Legionella, the bacterium that causes Legionnaires' disease, can grow and spread in building water systems and devices. The COVID-19 pandemic impacted building water systems through reductions in water usage. Legionella growth risk factors can be mitigated through control measures, such as flushing, to address stagnation, as part of a water management program (WMP). A national lodging organization (NLO) provided WMP data, including Legionella environmental testing results for periods before and during the pandemic. The statistical analysis revealed an increased risk of water samples testing positive for Legionella during the pandemic, with the greatest increase in risk observed at the building's cold-water entry test point. Sample positivity did not vary by season, highlighting the importance of year-round Legionella control activities. The NLO's flushing requirements may have prevented an increased risk of Legionella growth during the pandemic. However, additional control measures may be needed for some facilities that experience Legionella detections. This analysis provides needed evidence for the use of flushing to mitigate the impacts of building water stagnation, as well as the value of routine Legionella testing for WMP validation. Furthermore, this report reinforces the idea that WMPs remain the optimal tool to reduce the risk of Legionella growth and spread in building water systems.

COVID-19 brought the water struggles in Ghana into our homes in Canada: Collective emotions and WASH struggles in distant locations during health emergencies.

The COVID-19 pandemic has heightened and made visible the embodied consequences of water, sanitation and hygiene (WASH) inequalities and the relationalities of health in place. This paper combines insights from relational geographies and embodied epidemiology to explore psychosocial concerns among Ghanaian migrants in Canada due to their multiple and simultaneous roles in the WASH space in Ghana, particularly during the COVID-19 pandemic. We explored this using narratives from in-depth interviews with 27 participants (16 women and 11 men) residing in Ontario, Canada. The case of Ghana offers insight into how social ties with home communities could provide a safety net during emergencies but could also affect the psychosocial wellbeing of migrants. Results revealed four interrelated psychosocial stressors, including social stressors, financial stressors, stressors related to perceived inequality and stressors related to the fear of infection during WASH access. The paper underscores the urgent need for research to move beyond local health implications of WASH inequalities and begin to prioritize how these social inequalities are embodied at distant locations.

Drink Tap: A Multisector Program to Promote Water Access and Intake in San Francisco Parks.

Taxes on sugar-sweetened beverages (SSBs), or drinks with added sugars, show promise in decreasing purchases and consumption of SSBs. Some have called for coupling such taxes with improvements in access to safe drinking water as a strategy for reducing inequities in SSB intake, yet no studies have examined such an approach. Drink Tap is a San Francisco-based program in which public tap water stations were installed in parks and public spaces (winter 2017) and promotional efforts (fall and winter 2018) encouraged water intake. At the same time, San Francisco and surrounding communities were also implementing SSB taxes. We conducted a quasi-experimental study to examine whether water access and promotion combined with SSB taxes affected beverage intake habits more than SSB taxes alone. We conducted 1-hour observations (N = 960) at 10 intervention parks (Drink Tap plus SSB taxes) and 20 comparison parks (SSB taxes only) in San Francisco Bay Area cities before (July-September 2016) and after (June-August 2019) implementation of Drink Tap. We found significant adjusted percentage increases in drinking water among visitors to intervention parks, compared with comparison parks: water from park water sources (+80%, P < .001) and water from reusable bottles (+40%, P = .02). We found no significant reductions in visitors observed drinking bottled water, juices, or SSBs. The Drink Tap intervention led to increases in water intake from park sources and reusable bottles across parks that surpassed increases achieved through SSB taxes alone. Jurisdictions should consider coupling tap water access and promotion with policies for reducing intake of SSBs.

Evaluate the compliance of ballast water management system on various types of operational vessels based on the D-2 standard.

The transfer of ship ballast water poses significant risks to the aquatic ecosystem and human health. To mitigate the influences of non-native species, ballast water management systems (BWMS) have been installed on international ships to ensure proper treatment of ballast water before discharge. This study investigates whether ballast water discharges managed by BWMS meet the requirements of the D-2 standard for organisms in different size classes. Representative ballast water samples were collected from 28 ships (a total of 20 different BWMS) arriving in Shanghai during the period 2020-2022. Results have shown that two samples (7.1 %) exceeded the D-2 Standard. The compliance rates varied among different vessel types, with cargo vessels achieving a compliance rate of 81.8 %, while LNG vessels and container vessels achieved 100 % compliance. The potential to achieve higher levels of ballast water management will increase as crews improve their skills in operating BWMS and BWMS is further developed.

Predictors of Food and Water Stockpiling During the COVID-19 Pandemic Among Latinos and Non-Latino Black People.

OBJECTIVE: The study examined factors associated with food and water stockpiling (FWS) during the COVID-19 pandemic. METHODS: A secondary analysis of online survey data collected in two waves: April 2020 (wave 1) and June/July 2020 (wave 2), was conducted through REDCap web application. A total of 2,271 Non-Latino Black and Latino adults (mean age: 36.8 years (SD = 16.0); 64.3% female) living in Illinois were recruited. Participants self-reported if they stockpiled food and/or water (FWS) seven days prior to survey completion because of the pandemic. Logistic regression was used to determine if each variable was associated with the odds of reporting FWS. RESULTS: Nearly a quarter (23.3%) of participants reported FWS. The adjusted model revealed that odds of FWS increase as the number of household members increased (OR: 1.21; 95% CI: 1.05-1.41). Odds of FWS were lower among participants who were not self-quarantining compared to those self-quarantining all the time (OR: 0.32; 95% CI: 0.17 - 0.62). Furthermore, individuals with lower levels of concern about COVID-19 had lower odds of FWS than those extremely concerned. CONCLUSIONS: Household size, self-quarantine status, and concern about COVID-19 were significantly associated with FWS. These findings highlight the need to address the concerns of marginalized individuals to promote healthy behaviors.

Lead levels in drinking water from point-of-use dispensers: a case study of elementary schools in Taichung, Taiwan.

Drinking water contaminated with lead has adverse health consequences, particularly in young children. Water dispensed from point-of-use dispensers is generally regarded as drinking water instead of conventional tap water in Taiwan, and such dispensers are installed in all public facilities, including elementary schools. However, studies on drinking water quality are mainly focused on tap water, while dispenser water quality is less known. Hence, this study investigated lead concentrations in drinking water from point-of-use dispensers in elementary schools of Taichung, Taiwan. Water samples were collected between September 2019 and February 2021 from 86 schools across 24 districts utilizing a modified first draw sampling protocol to collect ten 100-mL sequential samples. Approximately 26% of the schools had at least one sample exceeding 10 µg/L (Taiwan EPA standard), with the highest level reaching 99.2 µg/L. Exceedance tendency varied with water use, seasons, and age of the schools. Samples collected over the weekends and during summer showed higher levels and frequencies of contamination. Lead levels surpassing the standard were observed in 14% of weekend and 17% of summer samples, compared to only 4% of weekday and 4% of winter samples. Similarly, while older schools (age > 40 years) exhibited higher contamination, young schools (age < 20 years) were also not entirely safe. This study reveals that point-of-use dispensers do not always provide safe drinking water. Findings also indicate the susceptibility of children in elementary schools to lead exposure through their drinking water. Therefore, a routine monitoring program for heavy metals, including lead, in drinking water is urgently needed.

A fuzzy inference-based index for piped water supply service quality in a complex, low-income urban setting.

Sustainable Development Goal (SDG) 6 calls for universal access to safely managed drinking water services. We studied the evolution of the water supply service between January 2017 and December 2021 in the town of Uvira (South Kivu, Democratic Republic of the Congo) where large investments were made to improve the water supply infrastructure during this period, including a new 2,000-m3 tank, 56 community taps and 1,191 private taps. Across 16 geographic clusters in the town, we assessed water service accessibility, water quantity, continuity, and affordability, based on data provided by the construction team and the utility. We combined these dimensions into a single index ranging 0-100% according to rules defined using the fuzzy inference Mamdani method. Our results show that despite substantial increases in accessibility (i.e. proportion of households with a private tap or within 200 m of a community tap), overall service quality remained unsatisfactory, with a maximum index value of 38.1%, and worsened in many parts of the town due to limitations of the water production capacity after major flooding events and persistent electricity supply issues. The estimated amount of water supplied per user per day remained under 20 L during >95% of the observation period, with a decreasing trend. Pumps operated 58% of the time on average and the frequency of days without electricity supply increased over time. Our study highlights the important gap between upgrades in water supply infrastructure and improvements in the quality of service. The analysis of potential future scenarios for Uvira indicates that increasing production capacity is priority to improve overall service quality. Our results demonstrate that meeting SDG6 will be challenging in complex urban settings and will not only require sustained investments in water supply infrastructure but also in systems management and in energy supply.

Assessing the efficacy of river bank filtration around a check dam in a non-perennial river for rural water supply in southern India.

Ideal locations for bank filtration wells were identified by assessing the efficiency of river bank filtration around a check dam in a non-perennial river located in southern India. The methodology of this study includes water sampling and water level measurements from existing wells, analysis of geochemical and biological parameters, pumping tests and borehole drilling. The conservative chloride and water level measurements indicate that production wells can be positioned up to 300 m from the check dam along the groundwater flow direction. It is recommended that if wells are not receiving 50% surface water contribution, then the production wells must be chosen within 110 m. In addition, the effectiveness of a river bank in improving water quality is evaluated by examining its hydraulic conductivity of 20 to 50 m/day (estimated using borehole data and pumping tests) and travel time and analysed water quality parameters. A significant reduction in microbiological load from surface water is evident even with a short travel time of 46 days. Substantial reduction in turbidity and improved geochemical characteristics were observed in wells located within the production zones which are supported by the Schoeller plot. The above results reveal that for the non-perennial river, in order to achieve maximum benefit through bank filtration, the same well cannot be used as a production well. Based on the water level in the check dam, the direction of groundwater flow and the percentage contribution of the river, it is necessary to shift the production well.

Analysis and comparison of wellhead protection areas delimitation methods applying a stochastic MODFLOW model as a reference.

Sustainable use of groundwater while maintaining economic and social development is a major challenge, and the implementation of wellhead protection areas (WHPA) for public supply wells has been applied as an instrument to overcome it. This study analyzes the WHPA delineation methods: calculated fixed radius (CFR) and two solutions of the WhAEM software (USEPA, 2018), one analytical and one semi-analytical. We compare their results with WHPAs generated by a stochastic three-dimensional MODFLOW-MODPATH model in two scenarios: eight pumping wells operating simultaneously and a single well pumping, both at the same public drinking water supply wellfield located on a coastal plain in Jaguaruna County, south Brazil. For the specific hydrogeological settings, all methods produced satisfactory results when delineating a 50-day time-of-travel (TOT) WHPA for a single well. However, as TOT increases, uncertainties are introduced, and the precision of the results is reduced. Multiple well pumping simultaneously presented similar issues regarding uncertainties caused by three-dimensional flow complexities resulting from well interferences. Despite being the simplest method applied in terms of hydrogeological data needs, the CFR method demonstrated reliability in its results. Additionally, we present an analysis comparing the dimensions of the capture zone with the 10- and 20-year TOT WHPAs, indicating that managing the entire capture zone is the best way to protect groundwater against conservative contaminants. Finally, we compare WHPA generated by a stochastic and a deterministic model to understand how uncertainties can affect model results.

Unimproved water and sanitation contributes to childhood diarrhoea during the war in Tigray, Ethiopia: a community based assessment.

Access to water, sanitation, and hygiene (WASH) is a global public health problem. The situation is worst in conflict areas, where people are displaced from their usual homes. Household supply of WASH and the incidence of diarrhoeal disease among children during the war in Tigray are not known or documented. The objective of this study was to investigate the sources of drinking water, sanitation and hygiene practices, and the incidence of diarrhoeal diseases among children during the war in Tigray, Ethiopia. A cross-sectional study was conducted to collect data on selected WASH indicators in six zones of Tigray from August 4-20, 2021. Data were collected from a total of 4381 sample households selected by lottery. Descriptive analysis was performed and the analysed data are presented in tables, figures and explanatory notes. Binary logistic regression was performed to examine the relationship between independent and dependent variables. A total of 4381 households from 52 woredas participated in the study. Approximately 67.7% of the study participants reported that they relied on an improved source of drinking water during the war. Coverage of sanitation, hand washing, and menstrual hygiene during the war was reported as 43.9%, 14.5%, and 22.1%, respectively. The prevalence of diarrhoeal diseases among children was 25.5% during the war. Water source, latrine type, solid waste disposal and health extension worker visits were the significant predictors of the likelihood of diarrhoea in children (p < 0.05). The results of the study show that a decrease in services from WASH is associated with a higher prevalence of diarrhoeal disease among children during the war in Tigray. To prevent the high prevalence of diarrhoeal disease among children in war-torn Tigray, Ethiopia, improved access to water and sanitation is recommended. In addition, collaborative efforts are needed to engage health extension workers to provide appropriate promotion and prevention services to war-affected communities in Tigray, Ethiopia. Further comprehensive surveys of households with children over one year of age are recommended to assess access to WASH and the burden of WASH associated diseases.

Sanitary and environmental conditions related to food poisoning among informal street vendors in downtown Medellín, Colombia, 2016.

Introduction: Although studies with informal workers have been conducted in Latin America and the Caribbean, there is still scarce evidence on the prevalence of food poisoning among workers with subsistence jobs on the streets and sidewalks of cities and on the factors that influence its presentation. Objectives: To determine sociodemographic, labor, sanitary, and environmental conditions that influence the prevalence of food poisoning in informal workers in downtown Medellín, Colombia. Methods: This is a cross-sectional study using a workers' survey as the primary source. A total of 686 workers aged ≥18 years who had been working for ≥ 5 years were surveyed. An assisted survey was initially applied as a pilot test for training purposes and to obtain informed consent. Results: We identified several associations and explanatory factors of food poisoning using chi-square tests and prevalence ratios, with unadjusted and adjusted 95% confidence intervals (95%CI). A higher prevalence of food poisoning (p < 0.05) was observed in workers with lower frequency of waste collection (PR = 2.09; 95%CI = 1.04-4.19), who left cooked food (PR = 6.40; 95%CI = 2.34-17.8), beverages or chopped fruits uncovered at their workplace (PR = 3.92; 95%CI = 1.40-10.48), with inadequate waste management (PR = 4.84; 95%CI = 2.12-11.06), exposure to polluted water (PR = 3.00; 95%CI = 1.20-7.50) and acceptable water supply (PR = 5.40; 95%CI = 1.60-17.8). The factors that explained higher rates of food poisoning were not having a waste collection service (PRadjusted = 5.58; 95%CI = 3.38-13.10), inadequate waste management (PRadjusted = 6.61; 95%CI = 1.25-34.84), and having sanitary services next to worker's stall (PRadjusted = 14.44; 95%CI = 1.26-165.11). Conclusions: The conditions that are associated with and explain the higher prevalence of food poisoning in this working population can be addressed with health promotion and disease prevention interventions.

Introducción: Aunque se han realizado estudios con trabajadores informales en América Latina y el Caribe, aun es escasa la evidencia con respecto a la prevalencia de intoxicaciones alimentarias en trabajadores con empleos de subsistencia en las calles y aceras de las ciudades y a los factores que influyen en su presentación. Objetivos: Determinar las condiciones sociodemográficas, laborales, sanitarias y ambientales que influyen en la prevalencia de intoxicación alimentaria en trabajadores informales del centro de Medellín. Métodos: Estudio transversal con fuente primaria de información en un censo de 686 trabajadores, ≥18 años y con ≥5 años en su oficio. Se aplicó encuesta asistida previa realización de prueba piloto, estandarización de encuestadores y toma de consentimiento. Resultados: Se identificaron asociaciones y factores explicativos de intoxicación alimentaria, con pruebas del chi-cuadrado y razones de prevalencia (RP), con intervalos de confianza del 95% (IC95%) crudos y ajustados. Mayor prevalencia de intoxicación alimentaria (p < 0,05) en trabajadores con menor frecuencia de recolección de residuos (RP = 2,09; IC95% = 1,04-4,19), en quienes dejaban alimentos preparados (RP = 6,40; IC95% = 2,34-17,8), bebidas o fruta picada descubiertos en el puesto de trabajo (RP = 3,92; IC95% = 1,40-10,48), con inadecuado manejo de residuos (RP = 4,84; IC95% = 2,12-11,06), exposición a agua contaminada (RP = 3,00; IC95% = 1,20-7,50) y de aceptable calidad (RP = 5,40; IC95% = 1,60-17,8). Explicaron mayor intoxicación alimentaria no tener servicio de recolección de residuos (RPajustada = 5,58; IC95% = 3,38-13,10), inadecuado manejo de residuos (RPajustada = 6,61; IC95% = 1,25-34,84), y tener servicios sanitarios al lado del puesto de trabajo (RPajustada = 14,44; IC95% = 1,26-165,11). Conclusiones: Las condiciones que se asocian y explican mayor prevalencia de intoxicación alimentaria en esta población trabajadora, pueden ser revertidas con acciones de promoción de la salud y prevención de la enfermedad.

Derivation of subacute guidance values for chemical contaminants of drinking water quality standard in Japan.

The concentration of chemicals in drinking water may transiently and accidently exceed the Drinking Water Quality Standard (DWQS). If the level of a contaminant is not expected to cause adverse effects for a limited period of exposure, immediate suspension of the water supply may not be necessary. Assessments should be conducted using subacute guidance values (SGVs). In this study, we assessed 26 chemicals for the DWQS to establish the SGVs. Principally, a key study was selected from subacute studies to derive a Subacute Reference Dose (saRfD). The SGV was calculated from the saRfD for adults (drinking water intakes: 40 mL/kg/day) and children (drinking water intakes: 150 mL/kg/day). No allocation factor was applied to derive the SGV. We established the SGV for 20 chemicals, which were 2-38 times higher than the corresponding DWQS. However, SGVs for six chemicals were the same as the corresponding DWQS. Therefore, immediate action will be required for these six accidental contaminants. Our established SGVs are useful for assessing accidental contamination.