Maria J. Gunnarsdottir

Benefits of Water Safety Plans: Microbiology, Compliance, and Public Health

The Water Safety Plan (WSP) methodology, which aims to enhance safety of drinking water supplies, has been recommended by the World Health Organization since 2004. WSPs are now used worldwide and are legally required in several countries. However, there is limited systematic evidence available demonstrating the effectiveness of WSPs on water quality and health. Iceland was one of the first countries to legislate the use of WSPs, enabling the analysis of more than a decade of data on impact of WSP. The objective was to determine the impact of WSP implementation on regulatory compliance, microbiological water quality, and incidence of clinical cases of diarrhea. Surveillance data on water quality and diarrhea were collected and analyzed. The results show that HPC (heterotrophic plate counts), representing microbiological growth in the water supply system, decreased statistically significant with fewer incidents of HPC exceeding 10 cfu per mL in samples following WSP implementation and noncompliance was also significantly reduced (p < 0.001 in both cases). A significant decrease in incidence of diarrhea was detected where a WSP was implemented, and, furthermore, the results indicate that population where WSP has been implemented is 14% less likely to develop clinical cases of diarrhea.

Icelandic experience with water safety plans.

The aim of this study was to investigate accumulated experience with water safety plans in one of the first countries to adopt systematic preventive management for drinking-water safety. Water utilities in Iceland have had a legal obligation since 1995 to implement a systematic preventive approach to secure safety of drinking water and protect public health. The water utilities responded by implementing either an adapted HACCP (Hazard Analysis Critical Control Points) model for larger water utilities or a simpler five step model for smaller water utilities. The research was carried out at 16 water utilities that serve about two-thirds of the population of Iceland. Both qualitative and quantitative methods were used with the aim of analysing if and what benefits water safety plans bring for water utilities and what is needed for successful implementation and operation of such systems. The results of the study show that numerous benefits and even the process of going through the implementing process were considered to be of advantage and change the attitude of the staff and the utility culture. Some obstacles and shortcomings came to light, such as lack of documentation and lack of regular internal and external audit. There was little communication with the public, although some mentioned that good public relations are important to succeed with water safety plans. Many important elements of success were revealed of which intensive training of staff and participation of staff in the whole process are deemed the most important. It is also important to have simple and well-structured guidelines, and good cooperation with the health authorities.

A diary study of action slips in healthy individuals

Memory complaints following minor head injury or whiplash are common and often bear similarity to absentmindedness or action slips (Reason, 1979). We replicated Reasons study by asking 189 healthy volunteers to keep diaries of their action slips for a week. The mean number of slips was 6.4 (SD = 4.9). Perceived stress did not correlate with number of slips but there was a weak positive correlation between action slips and scores on a memory failures questionnaire. Memory diaries may be clinically useful when assessing individuals who worry about cognitive sequelae of minor injuries. Diaries clarify the nature of the complaints and may have therapeutic value by demonstrating that the memory slips are less frequent than estimated by the patients.

Developing a national framework for safe drinking water—Case study from Iceland

Safe drinking water is one of the fundaments of society and experience has shown that a holistic national framework is needed for its effective provision. A national framework should include legal requirements on water protection, surveillance on drinking water quality and performance of the water supply system, and systematic preventive management. Iceland has implemented these requirements into legislation. This case study analyzes the success and challenges encountered in implementing the legislation and provide recommendations on the main shortcomings identified through the Icelandic experience. The results of the analysis show that the national framework for safe drinking water is mostly in place in Iceland. The shortcomings include the need for both improved guidance and control by the central government; and for improved surveillance of the water supply system and implementation of the water safety plan by the Local Competent Authorities. Communication to the public and between stakeholders is also insufficient. There is also a deficiency in the national framework regarding small water supply systems that needs to be addressed. Other elements are largely in place or on track. Most of the lessons learned are transferable to other European countries where the legal system around water safety is built on a common foundation from EU directives. The lessons can also provide valuable insights into how to develop a national framework elsewhere.

Overview of groundwater sources and water-supply systems, and associated microbial pollution, in Finland, Norway and Iceland

The characteristics of groundwater systems and groundwater contamination in Finland, Norway and Iceland are presented, as they relate to outbreaks of disease. Disparities among the Nordic countries in the approach to providing safe drinking water from groundwater are discussed, and recommendations are given for the future. Groundwater recharge is typically high in autumn or winter months or after snowmelt in the coldest regions. Most inland aquifers are unconfined and therefore vulnerable to pollution, but they are often without much anthropogenic influence and the water quality is good. In coastal zones, previously emplaced marine sediments may confine and protect aquifers to some extent. However, the water quality in these aquifers is highly variable, as the coastal regions are also most influenced by agriculture, sea-water intrusion and urban settlements resulting in challenging conditions for water abstraction and supply. Groundwater is typically extracted from Quaternary deposits for small and medium municipalities, from bedrock for single households, and from surface water for the largest cities, except for Iceland, which relies almost entirely on groundwater for public supply. Managed aquifer recharge, with or without prior water treatment, is widely used in Finland to extend present groundwater resources. Especially at small utilities, groundwater is often supplied without treatment. Despite generally good water quality, microbial contamination has occurred, principally by norovirus and Campylobacter, with larger outbreaks resulting from sewage contamination, cross-connections into drinking water supplies, heavy rainfall events, and ingress of polluted surface water to groundwater.RésuméLes caractéristiques des systèmes aquifères et la contamination des eaux souterraines en Finlande, Norvège et Islande, sont présentées, en lien avec des épidémies de maladies. Les disparités entre ces pays nordiques quant à l’approche utilisée en matière d’approvisionnement en eau potable à partir des eaux souterraines sont discutées, et des recommandations sont formulées pour le futur. La recharge des aquifères est habituellement élevée durant les mois d’automne ou d’hiver ou encore après la fonte des neiges dans les régions les plus froides. La plupart des aquifères continentaux sont libres et donc vulnérables aux pollutions, mais cependant ils sont souvent dépourvus de pressions anthropiques et la qualité de l’eau est bonne. Dans les zones côtières, les sédiments marins déposés précédemment peuvent rendre les aquifères captifs et les protéger dans une certaine mesure. Toutefois, la qualité d’eau de ces aquifères est très variable, du fait que les régions côtières sont également les plus influencées par l’agriculture, les intrusions d’eau de mer et les agglomérations urbaines, ce qui entraîne des conditions difficiles d’exploitation et d’approvisionnement en eau. Les eaux souterraines sont classiquement prélevées dans les dépôts sédimentaires du Quaternaire pour les municipalités de petite et moyenne dimension, dans le socle pour les habitations isolées, et dans les eaux de surface pour les plus grandes villes, à l’exception de l’Islande, où l’alimentation en eau potable repose presque entièrement sur les eaux souterraines. La gestion des aquifères par recharge artificielle, avec ou sans traitement préalable de l’eau, est largement répandue en Finlande afin d’accroître les ressources actuelles d’eau souterraine. En particulier pour les petits services d’adduction, l’eau souterraine est souvent distribuée sans traitement. Malgré la bonne qualité de l’eau en général, des contaminations microbiennes sont principalement causées par des norovirus et la bactérie Campylobacter, avec des épidémies plus importantes résultant d’une contamination par des eaux usées, des interactions avec les réseaux de distribution de l’eau potable, des événements pluvieux intenses, et des infiltrations d’eaux de surface contaminées vers les eaux souterraines.ResumenSe presentan las características de los sistemas de agua subterránea y de su contaminación en Finlandia, Noruega e Islandia, así como su relación con brotes de enfermedades. Se discuten las disparidades entre los países nórdicos en cuanto al enfoque para proveer agua potable segura a partir del agua subterránea y se dan recomendaciones para el futuro. La recarga de agua subterránea suele ser alta en los meses de otoño o invierno o después de la deshielo en las regiones más frías. La mayoría de los acuíferos continentales no están confinados y por lo tanto son vulnerables a la contaminación, pero a menudo carecen de mucha influencia antropogénica y la calidad del agua es buena. En las zonas costeras, los sedimentos marinos previamente emplazados pueden estar confinados y proteger hasta cierto punto a los acuíferos. Sin embargo, la calidad del agua en estos acuíferos es muy variable, ya que las regiones costeras también están más influenciadas por la agricultura, la intrusión de agua de mar y los asentamientos urbanos, resultando condiciones desafiantes para la captación y suministro de agua. El agua subterránea se extrae típicamente a partir de los depósitos del Cuaternario en los municipios pequeños y medianos, a partir de la roca de base en los hogares unifamiliares, y a partir del agua superficial en las ciudades más grandes, a excepción de Islandia, que depende casi enteramente de agua subterránea para el suministro público. La gestión de la recarga de acuíferos, con o sin tratamiento previo de agua, es ampliamente utilizada en Finlandia para extender los recursos actuales del agua subterránea. Especialmente en pequeñas empresas de servicios públicos, a menudo se suministra agua subterránea sin tratamiento. A pesar de la buena calidad del agua en general, la contaminación microbiana ha ocurrido, principalmente por norovirus y Campylobacter, con los brotes más grandes como resultado de la contaminación a partir de las aguas residuales, conexiones cruzadas en el suministro de agua potable, fuertes lluvias y el ingreso de agua superficial contaminada al agua subterránea.摘要本文展示了芬兰、挪威和冰岛地下水系统和地下水污染的特征,因为这些特征与疾病的爆发密切相关。论述了北欧国家在从地下水中提供安全饮用水方法中各国之间的差异,并为将来提供了建议。地下水补给在秋天和冬季或者最寒冷地区雪融之后通常很高。最内陆含水层为非承压含水层,因此,容易受到污染,但一般没有很大的人为影响,水质很好。在沿海地区,先前沉积的海相沉积物可能承压,在一定程度上保护含水层。然而,这些含水层的水质变化很大,因为沿海地区也受到农业、海水入侵和城市定居点极大影响,导致抽水和供水面临挑战。通常从第四纪沉积层中抽取地下水用于中小城市,从基岩层抽水用于家庭以及从地表水抽取用于最大的城市,冰岛是个例外,冰岛几乎完全依赖地下水用于公共供水。管理的含水层补给,无论是否经过水处理,在芬兰得到广泛应用,目的就是扩大目前的地下水资源。特别是在小的公共事业上,通常提供的地下水没有经过处理。尽管总的来说水质良好,但已经发生过微生物污染,主要是由诺洛病毒和弯曲杆菌导致的,还由于下水道污染、连通到饮用水供水、暴雨事件及污染的地表水进入地下水引起过较大的爆发。ResumoAs características dos sistemas de águas subterrâneas e contaminações subterrâneas na Finlândia, Noruega e Islândia são apresentadas, uma vez que estão relacionados com surtos de doenças. Disparidades entre os países Nórdicos na abordagem de fornecimento de água potável segura dos aquíferos são discutidas e fornecidas recomendações futuras. A recarga das águas subterrâneas é tipicamente mais elevada nos meses de outono ou inverno, ou após o desgelo das regiões mais frias. A maior parte dos aquíferos do interior são confinados e, portanto, vulneráveis à poluição, mas existe pouca interferência antrópica e qualidade da água é considerada boa. Na zona costeira, os sedimentos marinhos previamente depositados podem confinar e proteger os aquíferos até certo ponto. Entretanto, a qualidade da água nesses aquíferos é altamente variável, uma vez que as regiões costeiras também são mais influenciadas pela agricultura, intrusão de água salina e assentamentos urbanos, resultando em condições desafiadoras para a captação e abastecimento de água. As águas subterrâneas são comumente extraídas de depósitos Quaternários para pequenas e médias cidades, do maciço rochoso para residências individuais, e das águas superficiais para grandes cidades, com exceção da Islândia, que depende quase inteiramente das águas subterrâneas para abastecimento público. O gerenciamento da recarga de aquíferos, com ou sem tratamento prévio da água, é amplamente utilizado na Finlândia para preservar os recursos hídricos. Especialmente em pequenas cidades, a água subterrânea é fornecida sem tratamento. Apesar da boa qualidade da água de um modo geral, a contaminação microbiana tem ocorrido principalmente por norovírus e Campylobacter, com surtos maiores resultantes da contaminação de esgotos, ligações cruzadas no abastecimento de água potável, eventos de chuvas intensas e intrusão de águas superficiais poluídas nas águas subterrâneas.

Chemical quality and regulatory compliance of drinking water in Iceland

Assuring sufficient quality of drinking water is of great importance for public wellbeing and prosperity. Nations have developed regulatory system with the aim of providing drinking water of sufficient quality and to minimize the risk of contamination of the water supply in the first place. In this study the chemical quality of Icelandic drinking water was evaluated by systematically analyzing results from audit monitoring where 53 parameters were assessed for 345 samples from 79 aquifers, serving 74 water supply systems. Compliance to the Icelandic Drinking Water Regulation (IDWR) was evaluated with regard to parametric values, minimum requirement of sampling, and limit of detection. Water quality compliance was divided according to health-related chemicals and indicators, and analyzed according to size. Samples from few individual locations were benchmarked against natural background levels (NBLs) in order to identify potential pollution sources. The results show that drinking compliance was 99.97% in health-related chemicals and 99.44% in indicator parameters indicating that Icelandic groundwater abstracted for drinking water supply is generally of high quality with no expected health risks. In 10 water supply systems, of the 74 tested, there was an indication of anthropogenic chemical pollution, either at the source or in the network, and in another 6 water supplies there was a need to improve the water intake to prevent surface water intrusion. Benchmarking against the NBLs proved to be useful in tracing potential pollution sources, providing a useful tool for identifying pollution at an early stage.

Status of small water supplies in the Nordic countries: Characteristics, water quality and challenges

Access to safe water is essential for public health and is one of the most important prerequisites for good living and safe food production. Many studies have shown that non-compliance with drinking water quality standards in small water supply systems is much higher than in large systems. Nevertheless, people served by small water supply systems have the right to the same level of health protection. Actions are therefore needed to improve the situation. The objective of the present study was to carry out a baseline analysis of the situation in the Nordic region and provide recommendations for governmental policy and actions. Data were gathered on number of water supplies, population served, compliance with regulations and waterborne disease outbreaks from various sources in the Nordic countries. The collected data showed that there are about 12500 regulated water supplies, 9400 of which serve fewer than 500 persons. The number of unregulated and poorly regulated supplies is unknown, but it can be roughly estimated that these serve 10% of the Nordic population on a permanent basis or 2.6 million people. However, this does not tell the whole story as many of the very small water supplies serve transient populations, summerhouse dwellers and tourist sites, with many more users. Non-compliance regarding microbes is much higher in the small supplies. The population weighted average fecal contamination incidence rate in the Nordic region is eleven times higher in the smaller supplies than in the large ones, 0.76% and 0.07%, respectively. Registered waterborne disease outbreaks were also more frequent in the small supplies than in the large ones.