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69 KiB

Open AccessArticle

Microbiological Surveillance and State of the Art Technological Strategies for the Prevention of Dialysis Water Pollution

by Piergiorgio Bolasco, Antonio Contu, Patrizia Meloni, Dorio Vacca and Andrea Galfrè

Int. J. Environ. Res. Public Health 2012, 9(8), 2758-2771; https://doi.org/10.3390/ijerph9082758 - 2 Aug 2012

Cited by 7 | Viewed by 7455

Abstract

Methods: The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Results: [...] Read more.

Methods: The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Results: Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Conclusions: Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River

by Jyotsna S. Jagai, Jeffrey K. Griffiths, Paul K. Kirshen, Patrick Webb and Elena N. Naumova

Int. J. Environ. Res. Public Health 2012, 9(5), 1771-1790; https://doi.org/10.3390/ijerph9051771 - 7 May 2012

Cited by 15 | Viewed by 9859

Abstract

Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be [...] Read more.

Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older) along the Ohio River for a 14-year period (1991–2004) to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

A Summary Catalogue of Microbial Drinking Water Tests for Low and Medium Resource Settings

by Robert Bain, Jamie Bartram, Mark Elliott, Robert Matthews, Lanakila McMahan, Rosalind Tung, Patty Chuang and Stephen Gundry

Int. J. Environ. Res. Public Health 2012, 9(5), 1609-1625; https://doi.org/10.3390/ijerph9051609 - 4 May 2012

Cited by 78 | Viewed by 21173

Abstract

Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate [...] Read more.

Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate test(s) for a particular budget, application and setting. To assist the selection process we identified the characteristics associated with low and medium resource settings and we specified the basic information that is needed for different forms of water quality monitoring. We then searched for available faecal indicator bacteria tests and collated this information. In total 44 tests have been identified, 18 of which yield a presence/absence result and 26 of which provide enumeration of bacterial concentration. The suitability of each test is assessed for use in the three settings. The cost per test was found to vary from $0.60 to $5.00 for a presence/absence test and from $0.50 to $7.50 for a quantitative format, though it is likely to be only a small component of the overall costs of testing. This article presents the first comprehensive catalogue of the characteristics of available and emerging low-cost tests for faecal indicator bacteria. It will be of value to organizations responsible for monitoring national water quality, water service providers, researchers and policy makers in selecting water quality tests appropriate for a given setting and application. Full article

(This article belongs to the Special Issue Drinking Water and Health)

356 KiB

Open AccessArticle

Binational Arsenic Exposure Survey: Methodology and Estimated Arsenic Intake from Drinking Water and Urinary Arsenic Concentrations

by Jason Roberge, Mary Kay O’Rourke, Maria Mercedes Meza-Montenegro, Luis Enrique Gutiérrez-Millán, Jefferey L. Burgess and Robin B. Harris

Int. J. Environ. Res. Public Health 2012, 9(4), 1051-1067; https://doi.org/10.3390/ijerph9041051 - 26 Mar 2012

Cited by 18 | Viewed by 9889

Abstract

The Binational Arsenic Exposure Survey (BAsES) was designed to evaluate probable arsenic exposures in selected areas of southern Arizona and northern Mexico, two regions with known elevated levels of arsenic in groundwater reserves. This paper describes the methodology of BAsES and the relationship [...] Read more.

The Binational Arsenic Exposure Survey (BAsES) was designed to evaluate probable arsenic exposures in selected areas of southern Arizona and northern Mexico, two regions with known elevated levels of arsenic in groundwater reserves. This paper describes the methodology of BAsES and the relationship between estimated arsenic intake from beverages and arsenic output in urine. Households from eight communities were selected for their varying groundwater arsenic concentrations in Arizona, USA and Sonora, Mexico. Adults responded to questionnaires and provided dietary information. A first morning urine void and water from all household drinking sources were collected. Associations between urinary arsenic concentration (total, organic, inorganic) and estimated level of arsenic consumed from water and other beverages were evaluated through crude associations and by random effects models. Median estimated total arsenic intake from beverages among participants from Arizona communities ranged from 1.7 to 14.1 µg/day compared to 0.6 to 3.4 µg/day among those from Mexico communities. In contrast, median urinary inorganic arsenic concentrations were greatest among participants from Hermosillo, Mexico (6.2 µg/L) whereas a high of 2.0 µg/L was found among participants from Ajo, Arizona. Estimated arsenic intake from drinking water was associated with urinary total arsenic concentration (p < 0.001), urinary inorganic arsenic concentration (p < 0.001), and urinary sum of species (p < 0.001). Urinary arsenic concentrations increased between 7% and 12% for each one percent increase in arsenic consumed from drinking water. Variability in arsenic intake from beverages and urinary arsenic output yielded counter intuitive results. Estimated intake of arsenic from all beverages was greatest among Arizonans yet participants in Mexico had higher urinary total and inorganic arsenic concentrations. Other contributors to urinary arsenic concentrations should be evaluated. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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554 KiB

Open AccessArticle

Global Access to Safe Water: Accounting for Water Quality and the Resulting Impact on MDG Progress

by Kyle Onda, Joe LoBuglio and Jamie Bartram

Int. J. Environ. Res. Public Health 2012, 9(3), 880-894; https://doi.org/10.3390/ijerph9030880 - 14 Mar 2012

Cited by 324 | Viewed by 41735

Abstract

Monitoring of progress towards the Millennium Development Goal (MDG) drinking water target relies on classification of water sources as “improved” or “unimproved” as an indicator for water safety. We adjust the current Joint Monitoring Programme (JMP) estimate by accounting for microbial water quality [...] Read more.

Monitoring of progress towards the Millennium Development Goal (MDG) drinking water target relies on classification of water sources as “improved” or “unimproved” as an indicator for water safety. We adjust the current Joint Monitoring Programme (JMP) estimate by accounting for microbial water quality and sanitary risk using the only-nationally representative water quality data currently available, that from the WHO and UNICEF “Rapid Assessment of Drinking Water Quality”. A principal components analysis (PCA) of national environmental and development indicators was used to create models that predicted, for most countries, the proportions of piped and of other-improved water supplies that are faecally contaminated; and of these sources, the proportions that lack basic sanitary protection against contamination. We estimate that 1.8 billion people (28% of the global population) used unsafe water in 2010. The 2010 JMP estimate is that 783 million people (11%) use unimproved sources. Our estimates revise the 1990 baseline from 23% to 37%, and the target from 12% to 18%, resulting in a shortfall of 10% of the global population towards the MDG target in 2010. In contrast, using the indicator “use of an improved source” suggests that the MDG target for drinking-water has already been achieved. We estimate that an additional 1.2 billion (18%) use water from sources or systems with significant sanitary risks. While our estimate is imprecise, the magnitude of the estimate and the health and development implications suggest that greater attention is needed to better understand and manage drinking water safety. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Removal of Escherichia coli and Faecal Coliforms from Surface Water and Groundwater by Household Water Treatment Devices/Systems: A Sustainable Solution for Improving Water Quality in Rural Communities of the Southern African Development Community Region

by Jocelyne K. Mwabi, Bhekie B. Mamba and Maggy N. B. Momba

Int. J. Environ. Res. Public Health 2012, 9(1), 139-170; https://doi.org/10.3390/ijerph9010139 - 4 Jan 2012

Cited by 64 | Viewed by 19794

Abstract

There is significant evidence that household water treatment devices/systems (HWTS) are capable of dramatically improving microbially contaminated water quality. The purpose of this study was to examine five filters [(biosand filter-standard (BSF-S); biosand filter-zeolite (BSF-Z); bucket filter (BF); ceramic candle filter (CCF); and [...] Read more.

There is significant evidence that household water treatment devices/systems (HWTS) are capable of dramatically improving microbially contaminated water quality. The purpose of this study was to examine five filters [(biosand filter-standard (BSF-S); biosand filter-zeolite (BSF-Z); bucket filter (BF); ceramic candle filter (CCF); and silver-impregnated porous pot (SIPP)] and evaluate their ability to improve the quality of drinking water at the household level. These HWTS were manufactured in the workshop of the Tshwane University of Technology and evaluated for efficiency to remove turbidity, faecal coliforms and Escherichia coli from multiple water source samples, using standard methods. The flow rates ranged from 0.05 L/h to 2.49 L/h for SIPP, 1 L/h to 4 L/h for CCF, 0.81 L/h to 6.84 L/h for BSF-S, 1.74 L/h to 19.2 L/h and 106.5 L/h to 160.5 L/h for BF The turbidity of the raw water samples ranged between 2.17 and 40.4 NTU. The average turbidity obtained after filtration ranged from 0.6 to 8 NTU (BSF-S), 1 to 4 NTU (BSF-Z), 2 to 11 NTU (BF), and from 0.6 to 7 NTU (CCF) and 0.7 to 1 NTU for SIPP. The BSF-S, BSF-Z and CCF removed 2 to 4 log₁₀ (99% to 100%) of coliform bacteria, while the BF removed 1 to 3 log (90% to 99.9%) of these bacteria. The performance of the SIPP in removing turbidity and indicator bacteria (>5 log₁₀, 100%) was significantly higher compared to that of the other HWTS (p < 0.05). The findings of this study indicate that the SIPP can be an effective and sustainable HWTS for the Southern African Development Community (SADC) rural communities, as it removed the total concentration of bacteria from test water, can be manufactured using locally available materials, and is easy to operate and to maintain. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Microbiological Evaluation of Water Quality from Urban Watersheds for Domestic Water Supply Improvement

by A. Mark Ibekwe, Shelton E. Murinda and Alexandria K. Graves

Int. J. Environ. Res. Public Health 2011, 8(12), 4460-4476; https://doi.org/10.3390/ijerph8124460 - 30 Nov 2011

Cited by 14 | Viewed by 9563

Abstract

Agricultural and urban runoffs may be major sources of pollution of water bodies and major sources of bacteria affecting the quality of drinking water. Of the different pathways by which bacterial pathogens can enter drinking water, this one has received little attention to [...] Read more.

Agricultural and urban runoffs may be major sources of pollution of water bodies and major sources of bacteria affecting the quality of drinking water. Of the different pathways by which bacterial pathogens can enter drinking water, this one has received little attention to date; that is, because soils are often considered to be near perfect filters for the transport of bacterial pathogens through the subsoil to groundwater. The goals of this study were to determine the distribution, diversity, and antimicrobial resistance of pathogenic Escherichia coli isolates from low flowing river water and sediment with inputs from different sources before water is discharged into ground water and to compare microbial contamination in water and sediment at different sampling sites. Water and sediment samples were collected from 19 locations throughout the watershed for the isolation of pathogenic E. coli. Heterotrophic plate counts and E. coli were also determined after running tertiary treated water through two tanks containing aquifer sand material. Presumptive pathogenic E. coli isolates were obtained and characterized for virulent factors and antimicrobial resistance. None of the isolates was confirmed as Shiga toxin E. coli (STEC), but as others, such as enterotoxigenic E. coli (ETEC). Pulsed field gel electrophoresis (PFGE) was used to show the diversity E. coli populations from different sources throughout the watershed. Seventy six percent of the isolates from urban sources exhibited resistance to more than one antimicrobial agent. A subsequent filtration experiment after water has gone through filtration tanks containing aquifer sand material showed that there was a 1 to 2 log reduction in E. coli in aquifer sand tank. Our data showed multiple strains of E. coli without virulence attributes, but with high distribution of resistant phenotypes. Therefore, the occurrence of E. coli with multiple resistances in the environment is a matter of great concern due to possible transfer of resistant genes from nonpathogenic to pathogenic strains that may result in increased duration and severity of morbidity. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Three Potential Sources of Microfungi in a Treated Municipal Water Supply System in Sub-Tropical Australia

by Noel B. Sammon, Keith M. Harrower, Larelle D. Fabbro and Rob H. Reed

Int. J. Environ. Res. Public Health 2011, 8(3), 713-732; https://doi.org/10.3390/ijerph8030713 - 3 Mar 2011

Cited by 20 | Viewed by 12078

Abstract

Some microfungi are known to be opportunistic human pathogens, and there is a body of scientific opinion that one of their routes of infection may be water aerosols. Others have been implicated as causative agents of odours and off-tastes in drinking water. This [...] Read more.

Some microfungi are known to be opportunistic human pathogens, and there is a body of scientific opinion that one of their routes of infection may be water aerosols. Others have been implicated as causative agents of odours and off-tastes in drinking water. This study was undertaken to investigate three potential sources of microfungi in a treated, oligotrophic municipal water supply system in sub-tropical Australia. Formation of the microfungal component of developing biofilm on hard surfaces in water storage reservoirs was also assessed. Inside and outside air samples were collected from two reservoirs using two types of Burkard air samplers. Biofilm and soft sediment samples were collected from the inner surfaces of asbestos cement water pipes and from pipe dead ends respectively. These were analysed for microfungal growth and sporulation using Calcofluor White stain and epifluorescent microscopy. Artificial coupons of glass, PVC and concrete were immersed in two reservoirs to assess microfungal biofilm formation. This was analysed periodically using Calcofluor White stain and epifluorescent microscopy, cultures of coupon swabs and scanning electron microscopy. Fungal spores were recovered from all air samples. The number of colonies and the genera were similar for both inside and outside air. Microfungal filaments and sporulating structures were recovered from most of the pipe inner surface biofilm and dead end sediment samples, but were sparser in the biofilm than in the sediment samples. No recognisable, vegetative filamentous fungi were found in the slowly developing biofilm on coupons. This study indicates that airborne spores are an important potential source of microfungi found in water storage reservoirs. It has also demonstrated conclusively that filamentous microfungi grow and sporulate on water pipe inner surfaces and in soft sediments within the water distribution system. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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266 KiB

Open AccessArticle

Bottled Water: United States Consumers and Their Perceptions of Water Quality

by Zhihua Hu, Lois Wright Morton and Robert L. Mahler

Int. J. Environ. Res. Public Health 2011, 8(2), 565-578; https://doi.org/10.3390/ijerph8020565 - 21 Feb 2011

Cited by 173 | Viewed by 35782

Abstract

Consumption of bottled water is increasing worldwide. Prior research shows many consumers believe bottled water is convenient and has better taste than tap water, despite reports of a number of water quality incidents with bottled water. The authors explore the demographic and social [...] Read more.

Consumption of bottled water is increasing worldwide. Prior research shows many consumers believe bottled water is convenient and has better taste than tap water, despite reports of a number of water quality incidents with bottled water. The authors explore the demographic and social factors associated with bottled water users in the U.S. and the relationship between bottled water use and perceptions of the quality of local water supply. They find that U.S. consumers are more likely to report bottled water as their primary drinking water source when they perceive that drinking water is not safe. Furthermore, those who give lower ratings to the quality of their ground water are more likely to regularly purchase bottle water for drinking and use bottle water as their primary drinking water source. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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195 KiB

Open AccessArticle

The Effect of Handwashing with Water or Soap on Bacterial Contamination of Hands

by Maxine Burton, Emma Cobb, Peter Donachie, Gaby Judah, Val Curtis and Wolf-Peter Schmidt

Int. J. Environ. Res. Public Health 2011, 8(1), 97-104; https://doi.org/10.3390/ijerph8010097 - 6 Jan 2011

Cited by 170 | Viewed by 60232

Abstract

Handwashing is thought to be effective for the prevention of transmission of diarrhoea pathogens. However it is not conclusive that handwashing with soap is more effective at reducing contamination with bacteria associated with diarrhoea than using water only. In this study 20 volunteers [...] Read more.

Handwashing is thought to be effective for the prevention of transmission of diarrhoea pathogens. However it is not conclusive that handwashing with soap is more effective at reducing contamination with bacteria associated with diarrhoea than using water only. In this study 20 volunteers contaminated their hands deliberately by touching door handles and railings in public spaces. They were then allocated at random to (1) handwashing with water, (2) handwashing with non-antibacterial soap and (3) no handwashing. Each volunteer underwent this procedure 24 times, yielding 480 samples overall. Bacteria of potential faecal origin (mostly Enterococcus and Enterobacter spp.) were found after no handwashing in 44% of samples. Handwashing with water alone reduced the presence of bacteria to 23% (p < 0.001). Handwashing with plain soap and water reduced the presence of bacteria to 8% (comparison of both handwashing arms: p < 0.001). The effect did not appear to depend on the bacteria species. Handwashing with non-antibacterial soap and water is more effective for the removal of bacteria of potential faecal origin from hands than handwashing with water alone and should therefore be more useful for the prevention of transmission of diarrhoeal diseases. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

An Assessment of the Interindividual Variability of Internal Dosimetry during Multi-Route Exposure to Drinking Water Contaminants

by Mathieu Valcke and Kannan Krishnan

Int. J. Environ. Res. Public Health 2010, 7(11), 4002-4022; https://doi.org/10.3390/ijerph7114002 - 17 Nov 2010

Cited by 13 | Viewed by 9900

Abstract

The objective of this study was to evaluate inter-individual variability in absorbed and internal doses after multi-route exposure to drinking water contaminants (DWC) in addition to the corresponding variability in equivalent volumes of ingested water, expressed as liter-equivalents (LEQ). A multi-route PBPK model [...] Read more.

The objective of this study was to evaluate inter-individual variability in absorbed and internal doses after multi-route exposure to drinking water contaminants (DWC) in addition to the corresponding variability in equivalent volumes of ingested water, expressed as liter-equivalents (LEQ). A multi-route PBPK model described previously was used for computing the internal dose metrics in adults, neonates, children, the elderly and pregnant women following a multi-route exposure scenario to chloroform and to tri- and tetra-chloroethylene (TCE and PERC). This scenario included water ingestion as well as inhalation and dermal contact during a 30-min bathroom exposure. Monte Carlo simulations were performed and distributions of internal dose metrics were obtained. The ratio of each of the dose metrics for inhalation, dermal and multi-route exposures to the corresponding dose metrics for the ingestion of drinking water alone allowed computation of LEQ values. Mean BW-adjusted LEQ values based on absorbed doses were greater in neonates regardless of the contaminant considered (0.129–0.134 L/kg BW), but higher absolute LEQ values were obtained in average adults (3.6–4.1 L), elderly (3.7–4.2 L) and PW (4.1–5.6 L). LEQ values based on the parent compound’s AUC were much greater than based on the absorbed dose, while the opposite was true based on metabolite-based dose metrics for chloroform and TCE, but not PERC. The consideration of the 95th percentile values of BW-adjusted LEQ did not significantly change the results suggesting a generally low intra-subpopulation variability during multi-route exposure. Overall, this study pointed out the dependency of the LEQ on the dose metrics, with consideration of both the subpopulation and DWC. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Determinants of Use of Household-level Water Chlorination Products in Rural Kenya, 2003–2005

by Amy E. DuBois, John A. Crump, Bruce H. Keswick, Laurence Slutsker, Robert E. Quick, John M. Vulule and Stephen P. Luby

Int. J. Environ. Res. Public Health 2010, 7(10), 3842-3852; https://doi.org/10.3390/ijerph7103842 - 25 Oct 2010

Cited by 24 | Viewed by 10453

Abstract

Household-level water treatment products provide safe drinking water to at-risk populations, but relatively few people use them regularly; little is known about factors that influence uptake of this proven health intervention. We assessed uptake of these water treatments in Nyanza Province, Kenya, November [...] Read more.

Household-level water treatment products provide safe drinking water to at-risk populations, but relatively few people use them regularly; little is known about factors that influence uptake of this proven health intervention. We assessed uptake of these water treatments in Nyanza Province, Kenya, November 2003–February 2005. We interviewed users and non-user controls of a new household water treatment product regarding drinking water and socioeconomic factors. We calculated regional use-prevalence of these products based on 10 randomly selected villages in the Asembo region of Nyanza Province, Kenya. Thirty-eight percent of respondents reported ever using household-level treatment products. Initial use of a household-level product was associated with having turbid water as a source (adjusted odds ratio [AOR] = 16.6, p = 0.007), but consistent usage was more common for a less costly and more accessible product that did not address turbidity. A combination of social marketing, retail marketing, and donor subsidies may be necessary to extend the health benefits of household-level water treatment to populations most at risk. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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189 KiB

Open AccessArticle

Determinants of Arsenicosis Patients’ Perception and Social Implications of Arsenic Poisoning through Groundwater in Bangladesh

by M. Mizanur Rahman Sarker

Int. J. Environ. Res. Public Health 2010, 7(10), 3644-3656; https://doi.org/10.3390/ijerph7103644 - 14 Oct 2010

Cited by 18 | Viewed by 10863

Abstract

Adverse human health effects ranging from skin lesions to internal cancers as well as widespread social and psychological problems caused by arsenic contaminated drinking water in Bangladesh may be the biggest arsenic calamity in the world. From an arsenicosis patients survey, this paper [...] Read more.

Adverse human health effects ranging from skin lesions to internal cancers as well as widespread social and psychological problems caused by arsenic contaminated drinking water in Bangladesh may be the biggest arsenic calamity in the world. From an arsenicosis patients survey, this paper empirically analyzes the determinants of arsenicosis patients’ perception about chronic arsenic poisoning and social and psychological implications of arsenicosis. In this study, cross-sectional data were collected from the Matlab and Hajiganj Upzillas of Chandpur district which are known to be highly contaminated with arsenic in their underground water. Respondents informed that arsenic poisoning causes a wide range of social and psychological problems. Female respondents were less vulnerable in the case of social problems (p < 0.01) and more vulnerable for the psychological problems (p < 0.001) of arsenicosis than male respondents. The results based on logit analysis showed that education (p < 0.01) and household income (p < 0.05) were significantly correlated to respondents’ perception about arsenicosis. The arsenicosis related special program (s) needs a clear understanding of people’s perception about arsenic exposure for abating the health burden as well as social and psychological problems. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Different Length (DL) qPCR for Quantification of Cell Killing by UV-induced DNA Damage

by Knut Rudi, Irina Hagen, Bente Carina Johnsrud, Guro Skjefstad and Ingun Tryland

Int. J. Environ. Res. Public Health 2010, 7(9), 3376-3381; https://doi.org/10.3390/ijerph7093376 - 31 Aug 2010

Cited by 24 | Viewed by 9239

Abstract

We describe the different length (DL) qPCR method for quantification of UV induced DNA damage in cell killing. The principle of DL qPCR is that DNA damage inhibits PCR. Applications with different lengths can therefore be used to detect different levels of UV-induced [...] Read more.

We describe the different length (DL) qPCR method for quantification of UV induced DNA damage in cell killing. The principle of DL qPCR is that DNA damage inhibits PCR. Applications with different lengths can therefore be used to detect different levels of UV-induced DNA damage. The assay was evaluated on three strains of Escherichia coli exposed to varying levels of ultraviolet (UV) radiation. We show that DL qPCR sensitivity and reproducibility are within the range of practical application to detect the effect of UV cell killing. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Microfungi in Drinking Water: The Role of the Frog Litoria caerulea

by Noel B. Sammon, Keith M. Harrower, Larelle D. Fabbro and Rob H. Reed

Int. J. Environ. Res. Public Health 2010, 7(8), 3225-3234; https://doi.org/10.3390/ijerph7083225 - 19 Aug 2010

Cited by 7 | Viewed by 9799

Abstract

Microfungi were recovered from all parts of a municipal water distribution system in sub-tropical Australia even though virtually no colony-forming units were recovered from the treated water as it left the treatment plant. A study was then undertaken to determine the potential sources [...] Read more.

Microfungi were recovered from all parts of a municipal water distribution system in sub-tropical Australia even though virtually no colony-forming units were recovered from the treated water as it left the treatment plant. A study was then undertaken to determine the potential sources of the microfungal population in the distribution system. Observation of frogs (Litoria caerulea) using the internal infrastructure of a reservoir as diurnal sleeping places, together with observation of visible microfungal growth on their faecal pellets, led to an investigation of the possible involvement of this animal. Old faecal pellets were collected and sporulating fungal colonies growing on their surfaces were identified. Fresh faecal pellets were collected and analysed for microfungal content, and skin swabs were analysed for yeasts. It was found that the faeces and skin of L. caerulea carried large numbers of yeasts as well as spores of various filamentous fungal genera. While there are many possible sources of microfungal contamination of municipal drinking water supplies, this study has revealed that the Australian green tree frog L. caerulea is one of the important sources of filamentous microfungi and yeasts in water storage reservoirs in sub-tropical Australia where the animal is endemic. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Factors Associated to Endemic Dental Fluorosis in Brazilian Rural Communities

by Efigênia F. Ferreira, Andréa Maria D. Vargas, Lia S. Castilho, Leila Nunes M. Velásquez, Lucia M. Fantinel and Mauro Henrique N. G. Abreu

Int. J. Environ. Res. Public Health 2010, 7(8), 3115-3128; https://doi.org/10.3390/ijerph7083115 - 6 Aug 2010

Cited by 19 | Viewed by 12351

Abstract

The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The [...] Read more.

The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The Thystrup & Fejerskov index was employed by a single examiner for the diagnosis of dental fluorosis. A sampling campaign of deep groundwater in the rural communities of interest was carried out concomitantly to the epidemiological survey for the determination of physiochemical parameters. Multilevel modeling of 276 individuals from seven rural communities was achieved using the non-linear logit link function. Parameters were estimated using the restricted maximum likelihood method. Analysis was carried out considering two response variables: presence (TF 1 to 9) or absence (TF = 0) of any degree of dental fluorosis; and presence (TF ≥ 5—with loss of enamel structure) or absence of severe dental fluorosis (TF ≤ 4—with no loss of enamel structure). Hydrogeological analyses revealed that dental fluorosis is influenced by the concentration of fluoride (OR = 2.59 CI95% 1.07–6.27; p = 0.073) and bicarbonate (OR = 1.02 CI95% 1.01–1.03; p = 0.060) in the water of deep wells. No other variable was associated with this prevalence (p > 0.05). More severe dental fluorosis (TF ≥ 5) was only associated with age group (p < 0.05). No other variable was associated to the severe dental fluorosis (p > 0.05). Dental fluorosis was found to be highly prevalent and severe. A chemical element besides fluoride was found to be associated (p > 0.05) to the prevalence of dental fluorosis, although this last finding should be interpreted with caution due to its p value. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Open AccessArticle

Incidence and Distribution of Microfungi in a Treated Municipal Water Supply System in Sub-Tropical Australia

by Noel B. Sammon, Keith M. Harrower, Larelle D. Fabbro and Rob H. Reed

Int. J. Environ. Res. Public Health 2010, 7(4), 1597-1611; https://doi.org/10.3390/ijerph7041597 - 6 Apr 2010

Cited by 43 | Viewed by 10918

Abstract

Drinking water quality is usually determined by its pathogenic bacterial content. However, the potential of water-borne spores as a source of nosocomial fungal infection is increasingly being recognised. This study into the incidence of microfungal contaminants in a typical Australian municipal water supply [...] Read more.

Drinking water quality is usually determined by its pathogenic bacterial content. However, the potential of water-borne spores as a source of nosocomial fungal infection is increasingly being recognised. This study into the incidence of microfungal contaminants in a typical Australian municipal water supply was carried out over an 18 month period. Microfungal abundance was estimated by the membrane filtration method with filters incubated on malt extract agar at 25 °C for seven days. Colony forming units were recovered from all parts of the system and these were enumerated and identified to genus level. The most commonly recovered genera were Cladosporium, Penicillium, Aspergillus and Fusarium.Nonparametric multivariate statistical analyses of the data using MDS, PCA, BEST and bubble plots were carried out with PRIMER v6 software. Positive and significant correlations were found between filamentous fungi, yeasts and bacteria. This study has demonstrated that numerous microfungal genera, including those that contain species which are opportunistic human pathogens, populate a typical treated municipal water supply in sub-tropical Australia. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Microbial Monitoring of Surface Water in South Africa: An Overview

by Catherine D. Luyt, Roman Tandlich, Wilhelmine J. Muller and Brendan S. Wilhelmi

Int. J. Environ. Res. Public Health 2012, 9(8), 2669-2693; https://doi.org/10.3390/ijerph9082669 - 30 Jul 2012

Cited by 36 | Viewed by 10545

Abstract

Infrastructural problems force South African households to supplement their drinking water consumption from water resources of inadequate microbial quality. Microbial water quality monitoring is currently based on the Colilert^®18 system which leads to rapidly available results. Using Escherichia coli as the [...] Read more.

Infrastructural problems force South African households to supplement their drinking water consumption from water resources of inadequate microbial quality. Microbial water quality monitoring is currently based on the Colilert^®18 system which leads to rapidly available results. Using Escherichia coli as the indicator microorganism limits the influence of environmental sources on the reported results. The current system allows for understanding of long-term trends of microbial surface water quality and the related public health risks. However, rates of false positive for the Colilert^®18-derived concentrations have been reported to range from 7.4% to 36.4%. At the same time, rates of false negative results vary from 3.5% to 12.5%; and the Colilert medium has been reported to provide for cultivation of only 56.8% of relevant strains. Identification of unknown sources of faecal contamination is not currently feasible. Based on literature review, calibration of the antibiotic-resistance spectra of Escherichia coli or the bifidobacterial tracking ratio should be investigated locally for potential implementation into the existing monitoring system. The current system could be too costly to implement in certain areas of South Africa where the modified H₂S strip test might be used as a surrogate for the Colilert^®18. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Filamentous Fungi in Drinking Water, Particularly in Relation to Biofilm Formation

by Virgínia M. Siqueira, Helena M. B. Oliveira, Cledir Santos, R. Russell M. Paterson, Norma B. Gusmão and Nelson Lima

Int. J. Environ. Res. Public Health 2011, 8(2), 456-469; https://doi.org/10.3390/ijerph8020456 - 9 Feb 2011

Cited by 62 | Viewed by 19913

Abstract

The presence of filamentous fungi in drinking water has become an area worthy of investigation with various studies now being published. The problems associated with fungi include blockage of water pipes, organoleptic deterioration, pathogenic fungi and mycotoxins. Fungal biofilm formation is a less [...] Read more.

The presence of filamentous fungi in drinking water has become an area worthy of investigation with various studies now being published. The problems associated with fungi include blockage of water pipes, organoleptic deterioration, pathogenic fungi and mycotoxins. Fungal biofilm formation is a less developed field of study. This paper updates the topic and introduces novel methods on fungal biofilm analysis, particularly from work based in Brazil. Further recommendations for standard methodology are provided. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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New Perspectives in Monitoring Drinking Water Microbial Quality

by Mª José Figueras and Juan J. Borrego

Int. J. Environ. Res. Public Health 2010, 7(12), 4179-4202; https://doi.org/10.3390/ijerph7124179 - 10 Dec 2010

Cited by 165 | Viewed by 21453

Abstract

The safety of drinking water is evaluated by the results obtained from faecal indicators during the stipulated controls fixed by the legislation. However, drinking-water related illness outbreaks are still occurring worldwide. The failures that lead to these outbreaks are relatively common and typically [...] Read more.

The safety of drinking water is evaluated by the results obtained from faecal indicators during the stipulated controls fixed by the legislation. However, drinking-water related illness outbreaks are still occurring worldwide. The failures that lead to these outbreaks are relatively common and typically involve preceding heavy rain and inadequate disinfection processes. The role that classical faecal indicators have played in the protection of public health is reviewed and the turning points expected for the future explored. The legislation for protecting the quality of drinking water in Europe is under revision, and the planned modifications include an update of current indicators and methods as well as the introduction of Water Safety Plans (WSPs), in line with WHO recommendations. The principles of the WSP approach and the advances signified by the introduction of these preventive measures in the future improvement of dinking water quality are presented. The expected impact that climate change will have in the quality of drinking water is also critically evaluated. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Human Health Risk Assessment of Pharmaceuticals in Water: Issues and Challenges Ahead

by Arun Kumar, Biao Chang and Irene Xagoraraki

Int. J. Environ. Res. Public Health 2010, 7(11), 3929-3953; https://doi.org/10.3390/ijerph7113929 - 5 Nov 2010

Cited by 68 | Viewed by 15565

Abstract

This study identified existing issues related to quantitative pharmaceutical risk assessment (QPhRA, hereafter) for pharmaceuticals in water and proposed possible solutions by analyzing methodologies and findings of different published QPhRA studies. Retrospective site-specific QPhRA studies from different parts of the world (U.S.A., United [...] Read more.

This study identified existing issues related to quantitative pharmaceutical risk assessment (QPhRA, hereafter) for pharmaceuticals in water and proposed possible solutions by analyzing methodologies and findings of different published QPhRA studies. Retrospective site-specific QPhRA studies from different parts of the world (U.S.A., United Kingdom, Europe, India, etc.) were reviewed in a structured manner to understand different assumptions, outcomes obtained and issues, identified/addressed/raised by the different QPhRA studies. Till date, most of the published studies have concluded that there is no appreciable risk to human health during environmental exposures of pharmaceuticals; however, attention is still required to following identified issues: (1) Use of measured versus predicted pharmaceutical concentration, (2) Identification of pharmaceuticals-of-concern and compounds needing special considerations, (3) Use of source water versus finished drinking water-related exposure scenarios, (4) Selection of representative exposure routes, (5) Valuation of uncertainty factors, and (6) Risk assessment for mixture of chemicals. To close the existing data and methodology gaps, this study proposed possible ways to address and/or incorporation these considerations within the QPhRA framework; however, more research work is still required to address issues, such as incorporation of short-term to long-term extrapolation and mixture effects in the QPhRA framework. Specifically, this study proposed a development of a new “mixture effects-related uncertainty factor” for mixture of chemicals (i.e., mixUF_composite), similar to an uncertainty factor of a single chemical, within the QPhRA framework. In addition to all five traditionally used uncertainty factors, this uncertainty factor is also proposed to include concentration effects due to presence of different range of concentration levels of pharmaceuticals in a mixture. However, further work is required to determine values of all six uncertainty factors and incorporate them to use during estimation of point-of-departure values within the QPhRA framework. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Water Microbiology. Bacterial Pathogens and Water

by João P. S. Cabral

Int. J. Environ. Res. Public Health 2010, 7(10), 3657-3703; https://doi.org/10.3390/ijerph7103657 - 15 Oct 2010

Cited by 765 | Viewed by 64952

Abstract

Water is essential to life, but many people do not have access to clean and safe drinking water and many die of waterborne bacterial infections. In this review a general characterization of the most important bacterial diseases transmitted through water—cholera, typhoid fever and [...] Read more.

Water is essential to life, but many people do not have access to clean and safe drinking water and many die of waterborne bacterial infections. In this review a general characterization of the most important bacterial diseases transmitted through water—cholera, typhoid fever and bacillary dysentery—is presented, focusing on the biology and ecology of the causal agents and on the diseases’ characteristics and their life cycles in the environment. The importance of pathogenic Escherichia coli strains and emerging pathogens in drinking water-transmitted diseases is also briefly discussed. Microbiological water analysis is mainly based on the concept of fecal indicator bacteria. The main bacteria present in human and animal feces (focusing on their behavior in their hosts and in the environment) and the most important fecal indicator bacteria are presented and discussed (focusing on the advantages and limitations of their use as markers). Important sources of bacterial fecal pollution of environmental waters are also briefly indicated. In the last topic it is discussed which indicators of fecal pollution should be used in current drinking water microbiological analysis. It was concluded that safe drinking water for all is one of the major challenges of the 21st century and that microbiological control of drinking water should be the norm everywhere. Routine basic microbiological analysis of drinking water should be carried out by assaying the presence of Escherichia coli by culture methods. Whenever financial resources are available, fecal coliform determinations should be complemented with the quantification of enterococci. More studies are needed in order to check if ammonia is reliable for a preliminary screening for emergency fecal pollution outbreaks. Financial resources should be devoted to a better understanding of the ecology and behavior of human and animal fecal bacteria in environmental waters. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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Inadequately Treated Wastewater as a Source of Human Enteric Viruses in the Environment

by Anthony I. Okoh, Thulani Sibanda and Siyabulela S. Gusha

Int. J. Environ. Res. Public Health 2010, 7(6), 2620-2637; https://doi.org/10.3390/ijerph7062620 - 14 Jun 2010

Cited by 222 | Viewed by 17801

Abstract

Human enteric viruses are causative agents in both developed and developing countries of many non-bacterial gastrointestinal tract infections, respiratory tract infections, conjunctivitis, hepatitis and other more serious infections with high morbidity and mortality in immunocompromised individuals such as meningitis, encephalitis and paralysis. Human [...] Read more.

Human enteric viruses are causative agents in both developed and developing countries of many non-bacterial gastrointestinal tract infections, respiratory tract infections, conjunctivitis, hepatitis and other more serious infections with high morbidity and mortality in immunocompromised individuals such as meningitis, encephalitis and paralysis. Human enteric viruses infect and replicate in the gastrointestinal tract of their hosts and are released in large quantities in the stools of infected individuals. The discharge of inadequately treated sewage effluents is the most common source of enteric viral pathogens in aquatic environments. Due to the lack of correlation between the inactivation rates of bacterial indicators and viral pathogens, human adenoviruses have been proposed as a suitable index for the effective indication of viral contaminants in aquatic environments. This paper reviews the major genera of pathogenic human enteric viruses, their pathogenicity and epidemiology, as well as the role of wastewater effluents in their transmission. Full article

(This article belongs to the Special Issue Drinking Water and Health)

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