Jamie Bartram

Toxic Cyanobacteria in Water: A guide to their public health consequences,monitoring and management

This book describes the present state of knowledge regarding the impact of cyanobacteria on health through the use of water. It considers aspects of risk management and details the information needed for protecting drinking water sources and recreational water bodies from the health hazards caused by cyanobacteria and their toxins. It also outlines the state of knowledge regarding the principal considerations in the design of programmes and studies for monitoring water resources and supplies and describes the approaches and procedures used. The development of this publication was guided by the recommendations of several expert meetings concerning drinking water (Geneva, December 1995; Bad Elster, June 1996) and recreational water (Bad Elster, June 1996; St Helier, May 1997). An expert meeting in Bad Elster, April 1997, critically reviewed the literature concerning the toxicity of cyanotoxins and developed the scope and content of this book. A draft manuscript was reviewed at an editorial meeting in November 1997, and a further draft was reviewed by the working group responsible for updating the Guidelines for Drinkingwater Quality in March 1998.

Estimating the Burden of Disease from Water, Sanitation, and Hygiene at a Global Level

We estimated the disease burden from water, sanitation, and hygiene at the global level taking into account various disease outcomes, principally diarrheal diseases. The disability-adjusted life year (DALY) combines the burden from death and disability in a single index and permits the comparison of the burden from water, sanitation, and hygiene with the burden from other risk factors or diseases. We divided the worlds population into typical exposure scenarios for 14 geographical regions. We then matched these scenarios with relative risk information obtained mainly from intervention studies. We estimated the disease burden from water, sanitation, and hygiene to be 4.0% of all deaths and 5.7% of the total disease burden (in DALYs) occurring worldwide, taking into account diarrheal diseases, schistosomiasis, trachoma, ascariasis, trichuriasis, and hookworm disease. Because we based these estimates mainly on intervention studies, this burden is largely preventable. Other water- and sanitation-related diseases remain to be evaluated. This preliminary estimation of the global disease burden caused by water, sanitation, and hygiene provides a basic model that could be further refined for national or regional assessments. This significant and avoidable burden suggests that it should be a priority for public health policy.

Water quality monitoring : a practical guide to the design and implementation of freshwater quality studies and monitoring programmes

Introduction. Water Quality. Designing a Monitoring Programme. Resources for a Monitoring Programme. Field Work and Sampling. Field Testing Methods. Physical and Chemical Analyses. Advanced Instrumental Analysis. Analytical Quality Assurance. Microbiological Analyses. Biological Monitoring. Hydrological Measurements. Sediment Measurements. Use and Reporting Of Monitoring Data. Index.

Hygiene, Sanitation, and Water: Forgotten Foundations of Health

As the first article in a four-part PLoS Medicine series on water and sanitation, Jamie Bartram and Sandy Cairncross argue that the massive burden of ill health associated with poor hygiene, sanitation, and water supply demands more attention from health professionals and policymakers.

HEALTH RISKS CAUSED BY FRESHWATER CYANOBACTERIA IN RECREATIONAL WATERS

Toxic cyanobacteria are increasingly being perceived as a potential health hazard, particularly in waters used for recreation. A few countries are developing regulations to protect human health from these toxins, and the World Health Organization (WHO) has published both a guideline value for one cyanotoxin in drinking water and a procedural guideline for recreational waters. This article presents an overview of the currently known cyanotoxins and of documented cases of human illnesses attributed to them. It further discusses exposure pathways and approaches to risk management. In this context, the WHO guideline for recreational waters is presented, and monitoring approaches are outlined.Toxic cyanobacteria are increasingly being perceived as a potential health hazard, particularly in waters used for recreation. A few countries are developing regulations to protect human health from these toxins, and the World Health Organization (WHO) has published both a guideline value for one cyanotoxin in drinking water and a procedural guideline for recreational waters. This article presents an overview of the currently known cyanotoxins and of documented cases of human illnesses attributed to them. It further discusses exposure pathways and approaches to risk management. In this context, the WHO guideline for recreational waters is presented, and monitoring approaches are outlined.

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low‐ and middle‐income settings and provide an overview of the impact on other diseases.

Not Just a Drop in the Bucket: Expanding Access to Point-of-Use Water Treatment Systems

Since 1990, the number of people without access to safe water sources has remained constant at approximately 1.1 billion, of whom approximately 2.2 million die of waterborne disease each year. In developing countries, population growth and migrations strain existing water and sanitary infrastructure and complicate planning and construction of new infrastructure. Providing safe water for all is a long-term goal; however, relying only on time- and resource-intensive centralized solutions such as piped, treated water will leave hundreds of millions of people without safe water far into the future. Self-sustaining, decentralized approaches to making drinking water safe, including point-of-use chemical and solar disinfection, safe water storage, and behavioral change, have been widely field-tested. These options target the most affected, enhance health, contribute to development and productivity, and merit far greater priority for rapid implementation.

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

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.

Water Quality: Guidelines, Standards and Health: Assessment of Risk and Risk Management for Water-Related Infectious Disease

The quality of water, whether it is used for drinking, irrigation or recreational purposes, is significant for health in both developing and developed countries worldwide. In responding to this challenge, countries develop standards intended to protect public health. Recognising this, the World Health Organization (WHO) develops ‘guidelines’ that present an authoritative assessment of the health risks associated with hazards through water and of the effectiveness of approaches to their control. To date, the various WHO guidelines concerned with water ( Guidelines for drinking-water quality; Guidelines for the safe use of wastewater and excreta in agriculture and aquaculture; Guidelines for safe recreational water environments ) have been developed in isolation from one another. However, their common primary concern is for health hazards derived from excreta. Addressing their specific areas of concern together will tend to support better health protection and highlight the value of interventions closer to sources of pollution, which may otherwise be under-valued. The potential to increase consistency in approaches to assessment and management of water-related microbial hazards was discussed by an international group of experts between 1999 and 2001. These discussions led to the development of a harmonised framework, which was intended to inform the process of development of guidelines and standards. Subsequently, a series of reviews was developed and refined, which addressed the principle issues of concern linking water and health to the establishment and implementation of effective, affordable and efficient guidelines and standards. The book is based on these reviews and the harmonised framework. This book will prove invaluable to all those concerned with issues relating to microbial water quality and health, including environmental and public health scientists, water scientists, policy makers and those responsible for developing standards and regulations. This title belongs to WHO Water Series . ISBN: 9781780405889 (eBook) ISBN: 9781900222280 (Print)

Assessing Microbial Safety of Drinking Water: Improving Approaches and Methods

Inadequate drinking water quality and poor sanitation have remained the worlds major causes of preventable morbidity and mortality. In 1996 the OECD called for concerted action to improve the assessment and management of the worlds sources of drinking water. This guidance document seeks to respond to this call. It is the product of a shared initiative between the OECD and the World Health Organization. It is a state-of-the-art review that will contribute to the revisions of the WHOs Guidelines for Drinking Water Quality. Assessing Microbial Safety Of Drinking-water has elements of both revolution and evolution. It is revolutionary in that it supports a rapidly emerging approach for a broader, system-wide management perspective. This is based on a risk management framework that has evolved from the traditional indicator concept to include multiple parameters and where consideration is also given to tolerable risk, water quality targets and public health status. This title belongs to WHO Drinking-water Quality Series. . ISBN: 9781780405872 (eBook) ISBN: 9781843390367 (Print)