Paul Van Buynder

Indirect Potable Reuse: A Sustainable Water Supply Alternative

The growing scarcity of potable water supplies is among the most important issues facing many cities, in particular those using single sources of water that are climate dependent. Consequently, urban centers are looking to alternative sources of water supply that can supplement variable rainfall and meet the demands of population growth. A diversified portfolio of water sources is required to ensure public health, as well as social, economical and environmental sustainability. One of the options considered is the augmentation of drinking water supplies with advanced treated recycled water. This paper aims to provide a state of the art review of water recycling for drinking purposes with emphasis on membrane treatment processes. An overview of significant indirect potable reuse projects is presented followed by a description of the epidemiological and toxicological studies evaluating any potential human health impacts. Finally, a summary of key operational measures to protect human health and the areas that require further research are discussed.

Vaccine Effectiveness Against Laboratory-confirmed Influenza in Healthy Young Children: A Case-Control Study.

Background: The Western Australian Influenza Vaccine Effectiveness study commenced in 2008 to evaluate a new program to provide free influenza vaccine to all children aged 6 to 59 months. We aimed to assess the protective effect of inactivated influenza vaccination in these children. Methods: We conducted a prospective case–control study in general practices and a hospital emergency department, testing all eligible patients for influenza and a range of other common respiratory viruses. Influenza vaccine effectiveness (VE) against laboratory-confirmed influenza was estimated with cases defined as children with an influenza-like illness who tested positive and controls as those with an influenza-like illness who tested negative for influenza virus. We calculated VE using the adjusted odds ratio from multivariate logistic regression. As a surrogate marker for adequate specimen collection, we explored the difference in VE point estimates defining controls as children in whom another respiratory virus was detected. Results: A total of 75 children were enrolled from general practices and 214 through the emergency department, with 12 (27%) and 36 (17%), respectively, having laboratory-confirmed influenza. Using all the influenza-negative controls, the adjusted VE was 58% (95% confidence interval, 9–81). When controls were limited to those with another virus present, the adjusted VE was 68% (95% confidence interval, 26–86). Conclusions: VE estimates were higher when controls included only those children with another respiratory virus detected. Testing for other common respiratory viruses enables the control group to be restricted to those for whom an adequate sample is likely.

Lessons from the first year of the WAIVE study investigating the protective effect of influenza vaccine against laboratory-confirmed influenza in hospitalised children aged 6–59 months

Please cite this paper as: Dixon et al. (2010) Lessons from the first year of the WAIVE study investigating the protective effect of influenza vaccine against laboratory‐confirmed influenza in hospitalised children aged 6–59 months. Influenza and Other Respiratory Viruses 4(4), 231–234.

Recycled water: potential health risks from volatile organic compounds and use of 1,4-dichlorobenzene as treatment performance indicator.

Characterisation of the concentrations and potential health risks of chemicals in recycled water is important if this source of water is to be safely used to supplement drinking water sources. This research was conducted to: (i) determine the concentration of volatile organic compounds (VOCs) in secondary treated effluent (STE) and, post-reverse osmosis (RO) treatment and to; (ii) assess the health risk associated with VOCs for indirect potable reuse (IPR). Samples were examined pre and post-RO in one full-scale and one pilot plant in Perth, Western Australia. Risk quotients (RQ) were estimated by expressing the maximum and median concentration as a function of the health value. Of 61 VOCs analysed over a period of three years, twenty one (21) were detected in STE, with 1,4-dichlorobenzene (94%); tetrachloroethene (88%); carbon disulfide (81%) and; chloromethane (58%) most commonly detected. Median concentrations for these compounds in STE ranged from 0.81 μg/L for 1,4-dichlorobenzene to 0.02 μg/L for carbon disulphide. After RO, twenty six (26) VOCs were detected, of which 1,4-dichlorobenzene (89%); acrylonitrile (83%) chloromethane (63%) and carbon disulfide (40%) were the more frequently detected. RQ(max) were all below health values in the STE and after RO. Median removal efficiency for RO was variable, ranging from -77% (dichlorodifluoromethane) to 91.2% (tetrachloroethene). The results indicate that despite the detection of VOCs in STE and after RO, their human health impact in IPR is negligible due to the low concentrations detected. The results indicate that 1,4-dichlorobenzene is a potential treatment chemical indicator for assessment of VOCs in IPR using RO treatment.

A Proposed Approach for the Assessment of Chemicals in Indirect Potable Reuse Schemes

The city of Perth in Western Australia is facing a future of compromized water supplies. In recent years, this urban region has been experiencing rapid population growth, coupled with drying climate, which has exacerbated water shortages. As part of the government strategy to secure water sustainability and to address an agenda focused on all elements of the water cycle, a target of 20% reuse of treated wastewater by 2012 was established. This includes a feasibility review of managed aquifer recharge for indirect potable reuse. A characterization of contaminants in wastewater after treatment and an assessment of the health implications are necessary to reassure both regulators and the public. To date, the commonly used approach involves a comparison of measured contaminant concentrations with the established drinking-water standards or other toxicological guidelines for the protection of human health. However, guidelines and standards have not been established for many contaminants in recycled water (unregulated chemicals). This article presents a three-tiered approach for the preliminary health risk assessment of chemicals in order to determine key contaminants that need to be monitored and managed. The proposed benchmark values for the calculation of risk quotients are health based, systematically defined, scientifically defensible, easy to apply, and clear to interpret. The proposed methodology is based on the derivation of health-based levels for unregulated contaminants with toxicity information and a “threshold of toxicological concern” for unregulated contaminants without toxicity data. The application of this approach will help policymakers set guidelines regarding unregulated chemicals in recycled water.

Marketing paediatric influenza vaccination: results of a major metropolitan trial

Please cite this paper as: Van Buynder et al. (2010) Marketing paediatric influenza vaccination: results of a major metropolitan trial. Influenza and Other Respiratory Viruses 5(1), 33–38.

Pet birds and risks of respiratory disease in Australia: a review

Objective: Exposure to birds has long been associated with disease in humans. Three respiratory diseases (psittacosis, allergic alveolitis and asthma) were reviewed in association with pet bird ownership with the aim to clarify the spectrum of avian‐related respiratory illnesses.

Assessing Health Risks from Pesticides in Recycled Water: A Case Study of Augmentation of Drinking Water Supplies in Perth, Western Australia

ABSTRACT A characterization of pesticides in secondary treated effluent (STE) and a screening health risk assessment were conducted to evaluate potential health impacts of recycled water for potable reuse. Samples of STE were examined pre- and post-reverse osmosis (RO) treatment in two plants. Risk quotients (RQ) were estimated by expressing the maximum and median concentration as a function of the health value. Of 128 pesticides analyzed, 11 were detected in STE. Trifluralin was detected in 86.5% of the STE samples followed by metolachlor (67.6%), 2,4-D (50%), and propiconazole (42.5%). Metolachlor was the only pesticide detected post-RO in one sample (0.08 μg/L, limit of reporting = 0.05 μg/L). RQ(max) were all below health values in the STE with the exception of thiophanate methyl (RQ max = 2.4). RO was able to reduce the concentration of all pesticides below LOR. Median removal efficiency for RO ranged from 67.1% (atrazine) to 98.8% (2,4-D). The results indicate that, despite the detection of pesticides in STE, the impact on indirect potable reuse is negligible due to the low concentrations in STE and their subsequent removal during RO treatment. Implementation of risk management strategies to optimize safety and recommendations for a monitoring program are also discussed.

Validation of surgical site infection surveillance in Perth, Western Australia.

Abstract There is marked variation in the rate of surgical site infections (SSIs) following total hip and knee replacements reported by hospitals submitting data to the Healthcare Infection Surveillance Western Australia. Ablinded retrospective case review was performed in order to determine if the differences were due to varying surveillance and reporting effectiveness. To further assess the quality of surveillance methodology the infection control professional at each site completed a paper-based, structured interview. A total of 444 patient charts were reviewed. Overall, the sensitivity of routine surveillance was 83%, the specificity 99%, the positive predictive value 94% and the negative predictive value 97%. The sensitivity varied between hospitals, ranging from 20 to 100%. The results of the methodology survey revealed fairly comparable surveillance practices at nine of the 10 hospitals. The hospitals with the lowest SSI rates were also those with the highest sensitivity to detect an SSI, suggesting that the difference in the quality of surveillance and reporting by each hospital is not responsible for the variation in SSI rates. The results of this study support the notion that those hospitals reporting the lowest SSI rates demonstrate high performance in both detection and prevention of SSI following hip and knee replacement surgery.