Journal of water and health最新文献

There is growing interest in the utility of wastewater and environmental surveillance (WES) in supporting disease outbreaks, including the monitoring of Vibrio cholerae. The objective of this scoping review was to describe the current evidence regarding the surveillance of V. cholerae in wastewater and wastewater-impacted environmental waters (including drinking water). We conducted a comprehensive electronic search, updated to January 2025. Following duplicate screening, we identified 114 eligible studies. The studies evaluated early WES warning systems, monitored trends in ongoing outbreaks, and described serogroups and virulent strains of toxigenic V. cholerae circulating in communities. Most studies were conducted in South-East Asia (44%), particularly India and Bangladesh, where cholera is endemic. A large proportion of studies detected V. cholerae subgroup O1 or O139, and numerous virulent strains such as ctxA/B. Studies were generally poorly reported, for example, inconsistent reporting on sample management, data reliability, and sampling frequency were common. WES has not been widely integrated into existing surveillance systems for real-time cholera monitoring. Our findings underscore the need for further clearly reported research to clarify the role of WES for early warning systems for cholera outbreaks, and to identify strategies that may optimise WES implementation for public health benefit.

It is important to efficiently recover (oo)cysts in water during the established detection process, as Cryptosporidium and Giardia are known to cause waterborne outbreaks. We investigated the recovery of these (oo)cysts based on the pH of HCl and NaOH used during the immunomagnetic separation (IMS) step. Additionally, we evaluated the efficiency of heat dissociation as a potential alternative to acid dissociation in IMS. The results showed that recovery rates decreased as the final pH deviated from neutral. The highest recovery rates, exceeding 60%, were observed when the pH of 0.1 N HCl and 1 N NaOH fell within the range of 0.9-1.0 and 13.0-13.1, respectively. The pH had a greater impact on cysts than on oocysts. Since the absolute zeta potential of cysts is lower than that of oocysts, cysts may be less stable in water and more sensitive to pH variations. The recovery rates of (oo)cysts were comparable when either acid and heat dissociation was applied. Therefore, to enhance the recovery of (oo)cysts in environmental water, it is essential to regularly monitor the pH of the reagent used in IMS step. Furthermore, the application of heat dissociation without HCl and NaOH may be considered as an alternative method.

This study analyzed a 22-year historical series of outbreaks of waterborne and foodborne diseases, aiming to provide a mapping of the main associated pathogens, regions with the highest incidence, foods involved, and places of infection. The results, in the scenario of Brazilian macro-regions, showed heterogeneity in the macro-regional microbiological profile, with the Southeast region being the one with the highest number of diseases caused by viruses, while in the others there was bacterial predominance. Of the 78 organisms reported, 10 caused more than 95% of illnesses. Among them, Escherichia coli was the bacteria that grew the most in the number of notifications from 2011 to 2021. Water was one of the main vehicles of transmission, in addition to foods that showed classic behavior in terms of microbiological transmission. Weaknesses were observed in the records that limit the carrying out of more specific analyses due to the large number of inconsistent, ignored, or inconclusive cases, which, in some parameters, exceeded 50% of notifications. This research highlights the need to strengthen the health system, so that there is a more specific and effective diagnosis of factors related to the spread of infectious diseases.

Disinfection is essential for protecting human health from microorganisms in drinking water. In addition to killing microorganisms, disinfection can introduce disinfection byproducts (DBPs), which impose detrimental effects on human health. In this study, a total of 15,280 water samples were monitored in 120 counties of Hunan Province, Central China, in periods ranging from 1 July 2023 to 31 December 2024. We evaluated the health risks of DBPs in drinking water through various exposure routes and conducted a comprehensive analysis of different factors that impact the health risks associated with these DBPs. The overall carcinogenic and noncarcinogenic risks resulting from exposure to DBPs through multiple pathways were 1.15 × 10^-5 and 2.59 × 10^-2, respectively. For different exposure routes, oral exposure to DBPs contributed the most to carcinogenic risk (1.13 × 10^-5) and noncarcinogenic risk (2.52 × 10^-2). The subgroup analysis revealed that the younger the child, the greater health risk they faced. The carcinogenic and noncarcinogenic risks for children aged 1-2 years were 2.56 × 10^-5 and 5.75 × 10^-2, respectively. Our study indicated that the potential carcinogenic risk of DBPs should be considered, and possible actions should be implemented to mitigate these health risks.

Access to safe drinking water, vital for public health, is critical in fragile Somalia, prone to water scarcity due to poor management. This study investigates spatial distribution and determinants of unimproved drinking water sources in Somali households. Using 2020 Somalia Health and Demographic Survey (SHDS) data, a mixed-methods approach included: descriptive statistics for prevalence; multilevel binary logistic regression identifying factors (individual, household, community) in unimproved water reliance; and spatial analysis (Moran's I, Gi*) for patterns, hotspots. Results reveal significant disparities: 54.7% of poorest households used unimproved sources versus 2.6% of wealthiest. Abandoned household headship showed 65% higher odds (AOR = 1.653) of using unimproved sources. Radio ownership reduced odds (AOR = 0.836). Banaadir region (AOR = 6.571 vs Awdal) and nomadic communities (AOR = 31.91) faced substantially higher odds. Higher community literacy surprisingly increased odds (AOR = 2.443). Significant spatial autocorrelation (Moran's I = 0.278, p<0.05) was identified, with northern hotspots and southwestern cold spots of unimproved water use. Individual, household, community, and spatial factors influence access to unimproved drinking water in Somalia, revealing profound socio-economic, geographic inequities. Targeted, context-specific interventions are crucial to address these disparities, improve safe water access, and help achieve SDG 6.

The occurrence of heavy metal contamination in groundwater poses significant health risks through ingestion and dermal exposure, with potential links to cancer and other diseases. This study evaluated groundwater samples for 10 heavy metals (Al, As, Cr, Cu, Cd, Fe, Mn, Ni, Pb, and Zn) using ICP-OES. While cadmium and chromium levels were within acceptable limits prescribed by the Bureau of Indian Standards, aluminum and iron exceeded these limits in 56 and 58% of samples, respectively. Other metals surpassed limits in 2-20% of cases. Health risk analysis revealed non-carcinogenic risks for 28% of adults and 44% of children, alongside carcinogenic risks from arsenic (36% of samples) and nickel (46% of samples), especially affecting children. Sensitivity analysis highlighted heavy metal concentration as the key variable influencing risk, and principal component analysis suggested geogenic sources, like rock weathering, as major contributors to contamination. Despite these risks, the heavy metal pollution index remained within acceptable limits for all samples. The study emphasizes the necessity for continuous monitoring and targeted mitigation strategies to address heavy metal contamination and protect public health.

The majority of people with enterically transmitted viruses excrete significant amounts of the virus in their feces for several days or weeks. Therefore, viruses causing diarrhea could be detected in the feces of infected persons and wastewater. In this study, the presence of human astrovirus (AstV), norovirus (NoV), rotavirus (RV), and enterovirus (EntV) was analyzed by real-time RT-PCR in raw sewage (n = 96), treated sewage (n = 96) and diarrheal stool samples (n = 200). Overall, 92.7% (89/96) of raw sewage samples and 48% (46/96) of treated sewage tested positive for at least one virus. The highest detection rates of the four viruses in raw sewage were observed in the winter season. Overall, the mean concentration of the four viruses was 7.3 log₁₀ in raw and 4.8 log₁₀ in treated wastewater, for a total removal of 34% of viral loads. In clinical samples, the most commonly detected virus was EntV followed by RV, NoV, and AstV. The mean concentrations of the four viruses in clinical samples ranged between 2.5 × 10¹ and 9.86 × 10⁷ GC/g. The results presented here demonstrated that the environmental surveillance of entric viruses in sewage is a useful tool for the study of their transmission dynamics in humans and their molecular epidemiology.

This PRISMA review investigated the extent to which epidemiological evidence supports the use of faecal indicator organisms (FIOs) to manage microbial health risks in recreational waters without point sources of sewage. The quality of papers meeting the inclusion criteria was appraised using the Office of Health Assessment and Translation (OHAT) Risk of Bias tool and low-bias studies were synthesised. Studies consistently reported elevated illness risks (particularly gastrointestinal) among bathers compared with non-bathers. However, no FIOs or pathogens were associated consistently with any health outcomes. While enterococci most frequently correlated with a variety of illnesses, the relatively even split of positive and negative associations suggests an overall lack of association. Consequently, applying FIO guidelines derived from epidemiological studies with point sources of sewage could result in type I and type II errors. Overall, results suggest that the sources and drivers of health risks are site-specific. Tools including sanitary surveys, microbial source tracking, epidemiology and quantitative microbial risk assessment provide avenues for characterising site-specific health risks, for those who can afford them. Meanwhile, characterising the site-specific sources/drivers of contamination seems pragmatic as the limited evidence so far suggests that FIO monitoring may not be sufficient to protect health in these waters.

In recent years, mental disorders have become serious health problems. Monitoring the usage of psychotropic drugs can reflect the prevalence of mental disorders in the population, and wastewater analysis is an effective method for monitoring the use of psychoactive pharmaceuticals. In our study, we collected 58 samples from 12 wastewater treatment plants (WWTPs) in a southern city in China. We then analyzed the concentrations and loads of 18 frequently used psychoactive drugs and corresponding metabolites. The most abundant compounds in wastewater were diazepam, sulpiride, clozapine, venlafaxine, and quetiapine, with a detection frequency close to 100%. Sulpiride had the highest average load, followed by venlafaxine, clozapine, quetiapine, and diazepam. The higher load of diazepam in suburban WWTPs than in urban WWTPs reflects the large numbers of older people living in suburban areas in most of China. The lower loads of most target compounds in suburban WWTPs than in urban WWTPs indicate a greater likelihood of mental disorders in urban people than in suburban people. A correlation analysis of the target compounds revealed a correlation between the occurrence of venlafaxine, sulpiride, and clozapine. Overall, wastewater analysis is expected to be a significant tool for monitoring the consumption of psychoactive pharmaceuticals.

Groundwater contamination by lead (Pb) occurs commonly in historically mined regions and presents health risks to exposed residents. Poor documentation of elevated Pb levels in underserved regions prevents the development of environmental contamination policies and interventions. This study investigates Pb contamination and associated carcinogenic and non-carcinogenic health risks in Makululu, a large compound near the former Pb mine in Kabwe City, Zambia. We analyzed 34 drinking groundwater samples from hand pump boreholes (n = 21) and shallow wells (n = 13). Pb concentrations exceeded WHO and USEPA standards for safe drinking in 100% of boreholes (median = 0.15 mg/L) and 77% of shallow wells (median = 0.06 mg/L). Linear regression analysis identified temperature and depth as key predictors of Pb concentrations, with higher temperatures correlating with increased Pb levels (p = 0.008), and deeper boreholes (50-100 m) exhibiting significantly higher Pb concentrations (p = 0.007) than shallow wells (10 m). Health risk assessments revealed that adults consuming borehole water had an average daily dose of 0.005 mg/kg/day of Pb exceeding WHO thresholds, with hazard quotients (HQ > 1) indicating non-carcinogenic risks. The findings highlight the urgent need for policies to mitigate environmental pollution, enforce water quality standards to reduce Pb levels and protect public health in Makululu.