Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water.
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ABSTRACT:
SUBMITTER: Chan EYY
PROVIDER: S-EPMC8656607 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background:Diarrheal and intestinal infectious disease caused by inadequate drinking water, sanitation, and hygiene (WASH) is not only a great concern in developing countries but also a problem in low-income populations and rural areas in developed countries. In this study, we assessed the exposure to inadequate WASH in Korea and estimated the burden of disease attributable to inadequate WASH. Methods:We used observational data on water supply, drinking water, sewage treatment rate, and hand washing to assess inadequate WASH conditions in Korea, and estimated the level of exposure in the entire population. The disease burden was estimated by applying the cause of death data from death registry and the morbidity data from the national health insurance to the population attributable fraction (PAF) for the disease caused by inappropriate WASH. Results:In 2013, 1.4% of the population were exposed to inadequate drinking water, and 1.0% were living in areas where sewerage was not connected. The frequency of handwashing with soap after contact with excreta was 23.5%. The PAF due to inadequate WASH as a cluster of risk factors was 0.353 (95% confidence interval [CI], 0.275-0.417), among which over 90% were attributable to hand hygiene factors that were significantly worse than those in American and European high-income countries. Conclusion:The level of hand hygiene in Korea has yet to be improved to the extent that it shows a significant difference compared to other high-income countries. Therefore, improving the current situation in Korea requires a continuous hand washing campaign and a program aimed at all people. In addition, continuous policy intervention for improvement of sewage treatment facilities in rural areas is required, and water quality control monitoring should be continuously carried out.
| S-EPMC6221858 | biostudies-other
Project description:Biofiltration is a water purification technology playing a pivotal role in producing safe drinking water. This technology attracts many interests worldwide due to its advantages, such as no addition of chemicals, a low energy input, and a high removal efficiency of organic compounds, undesirable taste and odours, and pathogens. The current review describes the microbial ecology of three biofiltration processes that are routinely used in drinking water treatment plants, i.e. (i) rapid sand filtration (RSF), (ii) granular activated carbon filtration (GACF), and (iii) slow sand filtration (SSF). We summarised and compared the characteristics, removal performance, and corresponding (newly revealed) mechanisms of the three biofiltration processes. Specifically, the microbial ecology of the different biofilter processes and the role of microbial communities in removing nutrients, organic compounds, and pathogens were reviewed. Finally, we highlight the limitations and challenges in the study of biofiltration in drinking water production, and propose future perspectives for obtaining a comprehensive understanding of the microbial ecology of biofiltration, which is needed to promote and optimise its further application. KEY POINTS: • Biofilters are composed of complex microbiomes, primarily shaped by water quality. • Conventional biofilters contribute to address safety challenges in drinking water. • Studies may underestimate the active/functional role of microbiomes in biofilters.
| S-EPMC9329406 | biostudies-literature
Project description:American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health.
| S-EPMC6311146 | biostudies-literature
Project description:Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option.
| S-EPMC3542352 | biostudies-other
Project description:Herd immunity arises when a communicable disease is less able to propagate because a substantial portion of the population is immune. Nonimmunizing interventions, such as insecticide-treated bednets and deworming drugs, have shown similar herd-protective effects. Less is known about the herd protection from drinking water, sanitation, and hand hygiene (WASH) interventions. We first constructed a transmission model to illustrate mechanisms through which different WASH interventions may provide herd protection. We then conducted an extensive review of the literature to assess the validity of the model results and identify current gaps in research. The model suggests that herd protection accounts for a substantial portion of the total protection provided by WASH interventions. However, both the literature and the model suggest that sanitation interventions in particular are the most likely to provide herd protection, since they reduce environmental contamination. Many studies fail to account for these indirect effects and thus underestimate the total impact an intervention may have. Although cluster-randomized trials of WASH interventions have reported the total or overall efficacy of WASH interventions, they have not quantified the role of herd protection. Just as it does in immunization policy, understanding the role of herd protection from WASH interventions can help inform coverage targets and strategies that indirectly protect those that are unable to be reached by WASH campaigns. Toward this end, studies are needed to confirm the differential role that herd protection plays across the WASH interventions suggested by our transmission model.
| S-EPMC5094239 | biostudies-literature
Project description:IntroductionSustainable Development Goal (SDG) 6 aims to coordinate international efforts toward "clean water and sanitation." However, water contaminated with pathogenic bacteria or thermotolerant coliforms (TTC) will not achieve the SDG target of clean water in the lives of people around the world. The aim of this study is to assess the water quality parameters of basic water services in Amhara and Afar regions of Ethiopia as well as the role and importance of local managerial committees in ensuring basic water functionality.MethodsThis mixed methods research, conducted in January-June 2019, sampled 22 districts from food-insecure areas in the Amhara and Afar regions of Ethiopia. From the 22 districts, which represent nearly one third of all districts in each region, 111 water services classified as "basic" were randomly selected. For each selected water service, research included: water quality sample testing, visual observation of water services, interviews and focus group discussions with the associated water managerial committee members. Descriptive statistics frequency, percent, mean, median, standard deviations, normal tables, cross-tables and graphs are used to present the data.ResultsAlthough the international water standard for thermotolerant coliform (TTC) levels is 0 CFU/100ml, in our sample of 111 water services, the maximum TTC counts were 71 CFU/100 ml and the mean was 4 CFU/100 ml. Thermotolerant coliform counts were above the permissible standard values for nearly 40% (n = 111) of the basic water services. TTC was detected in 44 (39.64%) (n = 111) basic water services. Of these, 38 (34.23%) were operationally functional while 6 (5.41%) were not functional. Approximately one third of the basic water services sampled, deemed "functional" by international standards, do not provide potable water due to thermotolerant coliform (TTC) levels.ConclusionOur findings from the Amhara and Afar regions of Ethiopia demonstrate that water quality parameters are not currently considered in classifying basic water services. This suggests that international efforts to address SDG 6 should incorporate water quality as a key parameter to better track international progress toward "clean water and sanitation" efforts. We discuss two potential pathways for stronger inclusion of water quality parameters in international definitions: (1) to mandate water quality within "functional" and "non-functional" definitions or (2) to add a ladder rung titled "safe basic water services" to the international drinking water ladder. Our findings from Ethiopia suggest that additional research should be undertaken in development contexts to assess whether or not "functional" basic water services provide safe drinking water to users.
| S-EPMC8341575 | biostudies-literature
Project description:Concentration- and time-dependent genomic changes in the mouse urinary bladder following exposure to arsenate in drinking water for up to twelve weeks. Inorganic arsenic (Asi) is a known human bladder carcinogen. The objective of this study was to examine the concentration dependence of the genomic response to Asi in the urinary bladders of mice. C57BL/6J mice were exposed for 1 or 12 weeks to arsenate in drinking water at concentrations of 0.5, 2, 10, and 50 mg As/L. Urinary bladders were analyzed using gene expression microarrays. A consistent reversal was observed in the direction of gene expression change: from predominantly decreased expression at 1 week to predominantly increased expression at 12 weeks. These results are consistent with evidence from in vitro studies of an acute adaptive response that is suppressed on longer exposure due to down-regulation of Fos. Pathways with the highest enrichment in gene expression changes were associated with epithelial-to-mesenchymal transition, inflammation, and proliferation. Benchmark dose (BMD) analysis determined that the lowest median BMD values for pathways were above 5 mg As/L, despite the fact that pathway enrichment was observed at the 0.5 mg As/L exposure concentration. This disparity may result from the non-monotonic nature of the concentration-responses for the expression changes of a number of genes, as evidenced by the much fewer gene expression changes at 2 mg As/L compared to lower or higher concentrations. Pathway categories with concentration-related gene expression changes included cellular morphogenesis, inflammation, apoptosis/survival, cell cycle control, and DNA damage response. The results of this study provide evidence of a concentration-dependent transition in the mode of action for the subchronic effects of Asi in mouse bladder cells in the vicinity of 2 mg Asi/L.
2011-09-15 | GSE32102 | GEO
Project description:In 1974, the United States established the Safe Drinking Water Act (SDWA) to protect consumers from potential exposure to drinking water contaminants associated with health risks. Each contaminant is assigned a health-based standard meant to reflect the maximum level at which an adverse human health outcome is unlikely; measurements beyond that level have greater potential to result in adverse health outcomes. Although there is extensive research on human health implications following water contaminant exposure, few studies have specifically examined associations between fetal health and municipal drinking water violations. Therefore, the objective of this study is to assess whether SDWA drinking water violations are associated with fetal health outcomes, including preterm birth (PTB), low birth weight (LBW), and term-low birth weight (tLBW), in the Commonwealth of Virginia. Singleton births (n = 665,984) occurring between 2007 and 2015 in Virginia were geocoded and assigned to a corresponding estimated water service area. Health-based (HB) and monitoring and reporting (MR) violations for 12 contaminants were acquired from the US EPA Safe Drinking Water Information System, with exposure defined at the approximate service area level to limit exposure misclassification. A logistic regression model for each birth outcome assessed potential relationships with SDWA violations. When examining the association between individual MR violations and birth outcomes, Nitrate-Nitrite (OR = 1.10; 95% CI = 1.02, 1.18, P = 0.01) was positively associated with PTB and the total coliform rule was negatively associated with tLBW (OR = 0.93; 95% CI = 0.87, 1.00, P = 0.04). These findings indicate that a lack of regular monitoring and reporting by water providers (resulting in monitoring and reporting violations) may be concealing health-based violations as these health concerns cannot be revealed without testing, suggesting a need for additional technical, managerial, and financial support to enable often-underfunded water systems to adhere to monitoring and reporting requirements meant to protect public health.
| S-EPMC9901941 | biostudies-literature
Project description:Small-size microbial metagenome of drinking water
| PRJNA449471 | ENA
Project description:Throughout the developing world, over 200 million people drink groundwater containing fluoride concentrations surpassing the World Health Organization's maximum recommended contaminant level (WHO-MCL) of 1.5?mg F-/L, resulting in adverse health effects ranging from mottled tooth enamel to debilitating skeletal fluorosis. Existing technologies to remove fluoride from water, such as reverse osmosis and filtration with activated alumina, are expensive and are not accessible for low-income communities. Our group and others have demonstrated that minimally-processed bauxite ores can remove fluoride to safe levels at a fraction of the cost of activated alumina. We report results from testing for some technical challenges that may arise in field deployment of this technology at large scale, particularly in a sufficiently robust manner for application in development contexts. Anticipating possible modes of failure and addressing these challenges in advance in the laboratory is particularly important for technologies for vulnerable communities where the opportunity to re-launch pilot projects is limited and small failures can keep solutions from the people that need them most. This work addresses three potential technical barriers to reliable removal of fluoride from drinking water with bauxite ore from Visakhapatnam, Andhra Pradesh, India. We evaluate competition from co-occurring ions, adsorption reversibility, and potability of the product water with regards to leaching of undesirable ions during treatment with various adsorbent materials including raw and thermally activated bauxite, and synthetic gibbsite (a simple model system). Under the conditions tested, the presence of phosphate significantly impacts fluoride adsorption capacity on all adsorbents. Sulfate impacts fluoride adsorption on gibbsite, but not on either bauxite adsorbent. Nitrate and silicate (as silicic acid), tested only with gibbsite, do not affect fluoride adsorption capacity. Both thermally activated bauxite and gibbsite show non-reversible adsorption of fluoride at a pH of 6. Raw bauxite leached arsenic and manganese in a TCLP leaching test at levels indicating the need for ongoing monitoring of treated water, but not precluding safe deployment of bauxite as a fluoride remediation technology. Understanding these phenomena is crucial to ensure field deployment over large diverse geographical areas with aquifers varying in groundwater composition, and for ensuring that the appropriate engineering processes are designed for field implementation of this innovation.
| S-EPMC6277820 | biostudies-other