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Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 April 2015) | Viewed by 67014

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Dr. Samuel Dorevitch

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Guest Editor

Division of Environmental and Occupational Health Sciences, School of Public Health, and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, IL 60612, USA
Interests: environmental epidemiology; surface water; water recreation; gastrointestinal illness; microbial indicators and pathogens; climate change; sustainability

Special Issue Information

Dear Colleagues,

The past decade has seen an explosion of information concerning the presence and concentration of potentially hazardous substances in surface water, ground water, wastewater, drinking water, recycled water, bottled water, water distribution systems, and in-premise plumbing. Regulatory standards are lacking for the vast majority of these substances, which include new industrial chemicals, nanomaterials, pharmaceuticals, and personal care products. At the same time, new concerns have emerged about previously-recognized physical agents, chemicals hazards, and their metabolites, and about biological agents and the toxins they elaborate.

Information concerning the human health impacts of emerging waterborne hazards has lagged behind efforts to characterize concentrations of and exposures to such hazards. This Special Issue will showcase and summarize new information about the human health effects of waterborne hazards. Authors are encouraged to submit manuscripts that provide novel information about the diverse human health outcomes associated with exposure, through water, to physical, chemical, and biological agents.

Dr. Samuel Dorevitch
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

drinking water
ground water
bottled water
emerging contaminants
biofilm
algal bloom
disinfection byproducts
cancer
gastrointestinal illness
respiratory infection
epidemiology

Published Papers (11 papers)

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Editorial

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598 KiB

Open AccessEditorial

Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns

by Samuel Dorevitch

Int. J. Environ. Res. Public Health 2015, 12(10), 12886-12888; https://doi.org/10.3390/ijerph121012886 - 15 Oct 2015

Cited by 1 | Viewed by 3428

Abstract

One of the Millennium Development Goals of the United Nations has been “To ensure environmental sustainability”, which includes the target of a 50% reduction by 2015 of “…the proportion of the population without sustainable access to safe drinking water and basic sanitation”. [...] [...] Read more.

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

Research

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1276 KiB

Open AccessArticle

The Risk of Reported Cryptosporidiosis in Children Aged <5 Years in Australia is Highest in Very Remote Regions

by Aparna Lal, Emily Fearnley and Martyn Kirk

Int. J. Environ. Res. Public Health 2015, 12(9), 11815-11828; https://doi.org/10.3390/ijerph120911815 - 18 Sep 2015

Cited by 11 | Viewed by 5276

Abstract

The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2–1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2–2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3–6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9–9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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839 KiB

Open AccessArticle

Associations among Human-Associated Fecal Contamination, Microcystis aeruginosa, and Microcystin at Lake Erie Beaches

by Cheonghoon Lee, Jason W. Marion, Melissa Cheung, Chang Soo Lee and Jiyoung Lee

Int. J. Environ. Res. Public Health 2015, 12(9), 11466-11485; https://doi.org/10.3390/ijerph120911466 - 11 Sep 2015

Cited by 7 | Viewed by 5285

Abstract

Lake Erie beaches exhibit impaired water quality due to fecal contamination and cyanobacterial blooms, though few studies address potential relationships between these two public health hazards. Using quantitative polymerase chain reaction (qPCR), Microcystis aeruginosa was monitored in conjunction with a human-associated fecal marker (Bacteroides fragilis group; g-Bfra), microcystin, and water quality parameters at two beaches to evaluate their potential associations. During the summer of 2010, water samples were collected 32 times from both Euclid and Villa Angela beaches. The phycocyanin intergenic spacer (PC-IGS) and the microcystin-producing (mcyA) gene in M. aeruginosa were quantified with qPCR. PC-IGS and mcyA were detected in 50.0% and 39.1% of samples, respectively, and showed increased occurrences after mid-August. Correlation and regression analyses showed that water temperature was negatively correlated with M. aeruginosa markers and microcystin. The densities of mcyA and the g-Bfra were predicted by nitrate, implicating fecal contamination as contributing to the growth of M. aeruginosa by nitrate loading. Microcystin was correlated with mcyA (r = 0.413, p < 0.01), suggesting toxin-producing M. aeruginosa populations may significantly contribute to microcystin production. Additionally, microcystin was correlated with total phosphorus (r = 0.628, p < 0.001), which was higher at Euclid (p < 0.05), possibly contributing to higher microcystin concentrations at Euclid. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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673 KiB

Open AccessArticle

Application of Probabilistic Risk Assessment in Establishing Perchlorate and Goitrogen Risk Mitigation Strategies

by Douglas Crawford-Brown

Int. J. Environ. Res. Public Health 2015, 12(9), 10374-10390; https://doi.org/10.3390/ijerph120910374 - 26 Aug 2015

Cited by 3 | Viewed by 3581

Abstract

This paper applies probabilistic risk assessment in quantifying risks from cumulative and aggregate risk pathways for selected goitrogens in water and food. Results show that the percentages of individuals with a Hazard Index (HI) value above 1 ranges between 30% and 50% both with and without serum half-life correction when a traditional regulatory assessment approach based on establishment of a No Observed Effects Level (NOEL) is used. When an exposure-response curve is instead used and a threshold of 50% inhibition is assumed, 1.1% or less of the population exceeds an HI value of 1 with no serum half-life correction, rising to as high as 11% when serum half-life correction is applied. If 0% to 5% threshold for iodide uptake inhibition is assumed for production of adverse effects, the percentage of the population with an HI above 1 is 46.2% or less with no serum half-life correction, and 47.2% or less when serum half-life correction is applied. The probabilistic analysis shows that while there are exposed groups for whom perchlorate exposures are the primary cause of individuals having HI values above 1, these constitute significantly less than 1% of the population. Instead, the potential risk from exposure to goitrogens is dominated by nitrates without serum half-life correction and thiocyanates with serum half-life correction, suggesting public health protection is better accomplished by a focus on these and other goitrogens expect in highly limited cases where waterborne perchlorate is at unusually high concentrations. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

270 KiB

Open AccessArticle

Quantification of Protozoa and Viruses from Small Water Volumes

by J. Alfredo Bonilla, Tonya D. Bonilla, Amir M. Abdelzaher, Troy M. Scott, Jerzy Lukasik, Helena M. Solo-Gabriele and Carol J. Palmer

Int. J. Environ. Res. Public Health 2015, 12(7), 7118-7132; https://doi.org/10.3390/ijerph120707118 - 24 Jun 2015

Cited by 15 | Viewed by 5538

Abstract

Large sample volumes are traditionally required for the analysis of waterborne pathogens. The need for large volumes greatly limits the number of samples that can be processed. The aims of this study were to compare extraction and detection procedures for quantifying protozoan parasites and viruses from small volumes of marine water. The intent was to evaluate a logistically simpler method of sample collection and processing that would facilitate direct pathogen measures as part of routine monitoring programs. Samples were collected simultaneously using a bilayer device with protozoa capture by size (top filter) and viruses capture by charge (bottom filter). Protozoan detection technologies utilized for recovery of Cryptosporidium spp. and Giardia spp. were qPCR and the more traditional immunomagnetic separation—IFA-microscopy, while virus (poliovirus) detection was based upon qPCR versus plaque assay. Filters were eluted using reagents consistent with the downstream detection technologies. Results showed higher mean recoveries using traditional detection methods over qPCR for Cryptosporidium (91% vs. 45%) and poliovirus (67% vs. 55%) whereas for Giardia the qPCR-based methods were characterized by higher mean recoveries (41% vs. 28%). Overall mean recoveries are considered high for all detection technologies. Results suggest that simultaneous filtration may be suitable for isolating different classes of pathogens from small marine water volumes. More research is needed to evaluate the suitability of this method for detecting pathogens at low ambient concentration levels. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

937 KiB

Open AccessArticle

Flooding and Clostridium difficile Infection: A Case-Crossover Analysis

by Cynthia J. Lin, Timothy J. Wade and Elizabeth D. Hilborn

Int. J. Environ. Res. Public Health 2015, 12(6), 6948-6964; https://doi.org/10.3390/ijerph120606948 - 17 Jun 2015

Cited by 17 | Viewed by 6307

Abstract

Clostridium difficile is a bacterium that can spread by water. It often causes acute gastrointestinal illness in older adults who are hospitalized and/or receiving antibiotics; however, community-associated infections affecting otherwise healthy individuals have become more commonly reported. A case-crossover study was used to assess emergency room (ER) and outpatient visits for C. difficile infection following flood events in Massachusetts from 2003 through 2007. Exposure status was based on whether or not a flood occurred prior to the case/control date during the following risk periods: 0–6 days, 7–13 days, 14–20 days, and 21–27 days. Fixed-effects logistic regression was used to estimate the risk of diagnosis with C. difficile infection following a flood. There were 129 flood events and 1575 diagnoses of C. difficile infection. Among working age adults (19–64 years), ER and outpatient visits for C. difficile infection were elevated during the 7–13 days following a flood (Odds Ratio, OR = 1.69; 95% Confidence Interval, CI: 0.84, 3.37). This association was more substantial among males (OR = 3.21; 95% CI: 1.01–10.19). Associations during other risk periods were not observed (p < 0.05). Although we were unable to differentiate community-associated versus nosocomial infections, a potential increase in C. difficile infections should be considered as more flooding is projected due to climate change. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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2486 KiB

Open AccessArticle

Drinking Water from Dug Wells in Rural Ghana — Salmonella Contamination, Environmental Factors, and Genotypes

by Denise Myriam Dekker, Ralf Krumkamp, Nimako Sarpong, Hagen Frickmann, Kennedy Gyau Boahen, Michael Frimpong, Renate Asare, Richard Larbi, Ralf Matthias Hagen, Sven Poppert, Wolfgang Rabsch, Florian Marks, Yaw Adu-Sarkodie and Jürgen May

Int. J. Environ. Res. Public Health 2015, 12(4), 3535-3546; https://doi.org/10.3390/ijerph120403535 - 27 Mar 2015

Cited by 17 | Viewed by 8622

Abstract

Salmonellosis is an important but neglected disease in sub-Saharan Africa. Food or fecal-oral associated transmissions are the primary cause of infections, while the role of waterborne transmission is unclear. Samples were collected from different dug wells in a rural area of Ghana and analyzed for contamination with bacteria, and with Salmonella in particular. In addition, temporal dynamics and riks factors for contamination were investigated in 16 wells. For all Salmonella isolates antibiotic susceptibility testing was performed, serovars were determined and strains from the same well with the same serovar were genotyped. The frequency of well water contamination with Gram-negative rod-shaped bacteria was 99.2% (n = 395). Out of 398 samples, 26 (6.5%) tested positive for Salmonella spp. The serovar distribution was diverse including strains not commonly isolated from clinical samples. Resistance to locally applied antibiotics or resistance to fluoroquinolones was not seen in the Salmonella isolates. The risk of Salmonella contamination was lower in wells surrounded by a frame and higher during the rainy season. The study confirms the overall poor microbiological quality of well water in a resource-poor area of Ghana. Well contamination with Salmonella poses a potential threat of infection, thus highlighting the important role of drinking water safety in infectious disease control. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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706 KiB

Open AccessArticle

Impact of a Risk Management Plan on Legionella Contamination of Dental Unit Water

by Erica Leoni, Laura Dallolio, Francesca Stagni, Tiziana Sanna, Giovanni D'Alessandro and Gabriela Piana

Int. J. Environ. Res. Public Health 2015, 12(3), 2344-2358; https://doi.org/10.3390/ijerph120302344 - 23 Feb 2015

Cited by 28 | Viewed by 6678

Abstract

The study aimed to assess the prevalence of Legionella spp. in dental unit waterlines of a dental clinic and to verify whether the microbiological parameters used as indicators of water quality were correlated with Legionella contamination. A risk management plan was subsequently implemented in the dental health care setting, in order to verify whether the adopted disinfection protocols were effective in preventing Legionella colonization. The water delivered from syringes and turbines of 63 dental units operating in a dental clinic, was monitored for counts of the heterotrophic bacteria P. aeruginosa and Legionella spp. (22 °C and 37 °C). At baseline, output water from dental units continuously treated with disinfection products was more compliant with the recommended standards than untreated and periodically treated water. However, continuous disinfection was still not able to prevent contamination by Legionella and P. aeruginosa. Legionella was isolated from 36.4%, 24.3% and 53.3% of samples from untreated, periodically and continuously treated waterlines, respectively. The standard microbiological parameters used as indicators of water quality proved to be unreliable as predictors of the presence of Legionella, whose source was identified as the tap water used to supply the dental units. The adoption of control measures, including the use of deionized water in supplying the dental unit waterlines and the application of a combined protocol of continuous and periodic disinfection, with different active products for the different devices, resulted in good control of Legionella contamination. The efficacy of the measures adopted was mainly linked to the strict adherence to the planned protocols, which placed particular stress on staff training and ongoing environmental monitoring. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

Review

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Open AccessReview

Common Features of Opportunistic Premise Plumbing Pathogens

by Joseph O. Falkinham III

Int. J. Environ. Res. Public Health 2015, 12(5), 4533-4545; https://doi.org/10.3390/ijerph120504533 - 24 Apr 2015

Cited by 76 | Viewed by 6924

Abstract

Recently it has been estimated that the annual cost of diseases caused by the waterborne pathogens Legionella pneumonia, Mycobacterium avium, and Pseudomonas aeruginosa is $500 million. For the period 2001–2012, the estimated cost of hospital admissions for nontuberculous mycobacterial pulmonary disease, the majority caused by M. avium, was almost $1 billion. These three waterborne opportunistic pathogens are normal inhabitants of drinking water—not contaminants—that share a number of key characteristics that predispose them to survival, persistence, and growth in drinking water distribution systems and premise plumbing. Herein, I list and describe these shared characteristics that include: disinfectant-resistance, biofilm-formation, growth in amoebae, growth at low organic carbon concentrations (oligotrophic), and growth under conditions of stagnation. This review is intended to increase awareness of OPPPs, identify emerging OPPPs, and challenge the drinking water industry to develop novel approaches toward their control. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

Other

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717 KiB

Open AccessConference Report

U.S. Recreational Water Quality Criteria: A Vision for the Future

by Roger S. Fujioka, Helena M. Solo-Gabriele, Muruleedhara N. Byappanahalli and Marek Kirs

Int. J. Environ. Res. Public Health 2015, 12(7), 7752-7776; https://doi.org/10.3390/ijerph120707752 - 09 Jul 2015

Cited by 65 | Viewed by 8412

Abstract

This manuscript evaluates the U.S. Recreational Water Quality Criteria (RWQC) of 2012, based upon discussions during a conference held 11–13 March 2013, in Honolulu, Hawaii. The RWQC of 2012 did not meet expectations among the research community because key recommended studies were not completed, new data to assess risks to bathers exposed to non-point sources of fecal indicator bacteria (FIB) were not developed, and the 2012 RWQC did not show marked improvements in strategies for assessing health risks for bathers using all types of recreational waters. The development of the 2012 RWQC was limited in scope because the epidemiologic studies at beach sites were restricted to beaches with point sources of pollution and water samples were monitored for only enterococci. The vision for the future is development of effective RWQC guidelines based on epidemiologic and quantitative microbial risk assessment (QMRA) studies for sewage specific markers, as well as human enteric pathogens so that health risks for bathers at all recreational waters can be determined. The 2012 RWQC introduced a program for states and tribes to develop site-specific water quality criteria, and in theory this approach can be used to address the limitations associated with the measurements of the traditional FIB. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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2208 KiB

Open AccessShort Communication

Surveillance of Hepatitis E Virus Contamination in Shellfish in China

by Shenyang Gao, Dandan Li, Enhui Zha, Tiezhong Zhou, Shen Wang and Xiqing Yue

Int. J. Environ. Res. Public Health 2015, 12(2), 2026-2036; https://doi.org/10.3390/ijerph120202026 - 11 Feb 2015

Cited by 42 | Viewed by 6201

Abstract

Background: Hepatitis E virus (HEV) has been confirmed to be a zoonotic virus of worldwide distribution. HEV contamination in the water environment has not been well examined in China. The objective of this study was to evaluate HEV contamination in shellfish in a coastal area of China. Such contamination would be significant for evaluating public health risks. Methods: samples of three species shellfish were collected from thirteen points of estuarine tidal flats around the Bohai Gulf and screened for HEV RNA using an in-house nested RT-PCR assay. The detected HEV-positive samples were further verified by gene cloning and sequencing analysis. Results: the overall HEV-positive detection rate is approximately 17.5% per kilogram of shellfish. HEV was more common among S. subcrenata (28.2%), followed by A. granosa (14.3%) and R. philippinarum (11.5%). The phylogenetic analysis of the 13 HEV strains detected revealed that gene fragments fell into two known 4 sub-genotypes (4b/4d) groups and another unknown group. Conclusions: 13 different sub-genotype 4 HEVs were found in contaminated shellfish in the Bohai Gulf rim. The findings suggest that a health risk may exist for users of waters in the Bonhai area and to consumers of shellfish. Further research is needed to assess the sources and infectivity of HEV in these settings, and to evaluate additional shellfish harvesting areas. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

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