Do disinfection byproducts in drinking water have an effect on human cancer risk worldwide? A meta‐analysis

In the present study, a meta‐analysis was carried out to clarify the association between disinfection byproducts (DBPs) in drinking water and human cancer risk worldwide. Kidney, colorectal, esophagus, urinary bladder, brain, breast, leukemia, lung, and rectum cancers were selected to perform this analysis. According to preferred reporting items for systematic review and meta‐analysis protocol (PRISMA) guidelines, the relevant studies were identified and selection criteria (inclusion and exclusion criteria) were applied. Next, effective subgroups in these studies (gender, type of drinking water source, and type of DBPs) were analyzed. The quality of the studies was evaluated using the Newcastle‐Ottawa Scale. In addition, this overall study included analyses of 16 case–control and 3 cohort studies. The overall odds ratio (OR) with 95% confidence intervals (CI) between DBPs and cancer risk was 1.01 (95% CI, 0.94–1.09). The summary ORs of cancer risk were 1.04 (95% CI, 0.89–1.19) for kidney; 0.98 (95% CI, 0.87–1.09) for colorectal; 1.07 (95% CI, 0.84–1.29) for esophagus; 0.93 (95% CI, 0.80–1.06) for pancreatic; 1.00 (95% CI, 0.83–1.18) for brain; 1.13 (95% CI, 0.99–1.26) for breast; 0.93 (95% CI, 0.72–1.13) for leukemia; and 1.18 (95% CI, 1–1.36) for lung cancers. The results of this meta‐analysis suggested that there is not a significant association between DBPs in water and cancer risk. In addition, subgroup analysis shows a positive association with colorectal and kidney cancer risk in men, as well as colon and breast cancers in females. Studies of both genders have shown a significant association between lung and pancreatic cancers. Moreover, this study finds a significant relationship between cancer rate and consumers of city water and bottled water sources. In analyzing different types of DBPs in water, chlorine and trichloromethane show a significant association in increasing cancer risk.     

Spatial variations of human health risk associated with exposure to chlorination by-products occurring in drinking water

During disinfection, chlorine reacts with organic matter present in drinking water and forms various undesirable chlorinated by-products (CBPs). This paper describes a study of the spatial variability of human health risk (i.e., cancer effects) from CBP exposure through drinking water in a specific region. The region under study involves nine drinking water distribution systems divided into several zones based on their characteristics. The spatial distribution of cancer risk (CR) was estimated using two years of data (2006-2008) on various CBP species. In this analysis, trihalomethanes (THMs) and haloacetic acids (HAAs) served as surrogates for CBPs. Three possible routes of exposure (i.e., via ingestion, inhalation and dermal contact) were considered for each selected compound. The cancer risk assessment involved estimating a unit risk (R(T)) in each zone of the selected distribution systems. A probabilistic analysis based on Monte Carlo simulations was employed. Risk assessment results showed that cancer risk varied between systems, but also within individual systems. As a result, the population of the same region was not exposed to the same risk associated with CBPs in drinking water. Unacceptable levels (i.e., R(T) > 10(-4)) for the estimated CR were determined for several zones in the studied region. This study demonstrates that a spatial-based analysis performed to represent the spatial distribution of risk estimates can be helpful in identifying suitable risk management strategies. Suggestions for improving the risk analysis procedure are also presented.     

Fuzzy synthetic evaluation of disinfection by-products--a risk-based indexing system

Disinfection by-products (DBPs) are formed when disinfectants such as chlorine, chloramine, and ozone react with organic matter in water. Chlorine being the most common disinfectant used in the drinking water industry worldwide, significant attention has been focused on chlorinated DBPs. A new indexing method using fuzzy synthetic evaluation is proposed to determine the health risk associated with the two major groups of chlorinated DBPs--trihalomethanes (THMs) and haloacetic acids (HAAs). Initially, membership functions for cancer and non-cancer risks associated with THMs and HAAs are used to establish the fuzzy evaluation matrices. Subsequently, weighted evaluation matrices for both types of risks are established by performing cross products on the weighted vectors (founded on the analytic hierarchy process) and the fuzzy evaluation matrices. In the final stage, the weighted evaluation matrices of cancer and non-cancer risks are aggregated to determine the final risk rating. Two case studies are provided to demonstrate the application of this method.     

Pesticide Risk Indicators: Unidentified Inert Ingredients Compromise Their Integrity and Utility

Pesticide Risk Indicators (PRIs) are widely used to evaluate and compare the potential health and environmental risks of pesticide use and to guide pest control policies and practices. They are applied to agricultural, landscape and structural pest management by governmental agencies, private institutions and individuals. PRIs typically assess only the potential risks associated with the active ingredients because, with few exceptions, pesticide manufacturers disclose only the identity of the active ingredients which generally comprise only a minor portion of pesticide products. We show that when inert ingredients are identified and assessed by the same process as the active ingredient, the product specific risk can be much greater than that calculated for the active ingredient alone. To maintain transparency in risk assessment, all those who develop and apply PRIs or make decisions based on their output, should clearly disclose and discuss the limitations of the method.     

Risk and opportunity in upgrading the US drinking water infrastructure system

This paper presents a practical risk assessment methodology to provide drinking water infrastructure (DWI) decision-makers with an objective risk assessment tool. The purpose of this risk assessment tool is to maintain the desired level-of-service or systems reliability [r(f)], while managing the financial uncertainty of the expected budgetary impact within the capital improvement program (CIP). The goal of this paper is to demonstrate the value of an objective risk assessment tool for estimating the DWI decision-maker's sensitivity to the risk of systems failure (R). The objectives are to: (1) incorporate probability of systems failure [p(f)] into the CIP budgetary analysis process and (2) evaluate the affects of p(f) on the expected CIP budgetary outcome. The magnitude of the expected budgetary impact is managed through the DWI decision-maker's sensitivity to R, which is represented by the level of the rate of reinvestment (RR). The expected result of the proposed risk assessment tool demonstrates that by proactively managing R to maintain a desired r(f) will effectively manage the impact of uncertainty on the expected budgetary outcome within the CIP. The expected contribution of the practical risk assessment methodology is to provide DWI decision-makers with the ability to reduce budgetary uncertainty when allocating limited financial resources among competing operational, repair, maintenance, and expansion activities within the CIP. The conclusions of the paper reveal that if DWI decision-makers assume risk-avoidance positions through proactive asset management (AM) strategies, they will achieve positive affects on expected budgetary outcomes.     

Antibiotic Resistance Due to Modern Agricultural Practices: An Ethical Perspective

The use of subtherapeutic doses of antibiotics in food-producing animals has been linked to antibiotic resistant infections in humans. Although this practice has been banned in Europe, the U.S. regulatory authorities have been slow to act. This paper discusses the regulatory hurdles and ethical dilemmas of banning this practice within the context of the risk analysis model (risk assessment, risk management, and risk communication). Specific issues include unethical use of scientific uncertainty during the risk assessment phase, the rejection of the precautionary principle leading to ineffective risk management, and the criticality of risk communication to build consensus and force action. The underlying root cause is a conflict of values (Type I ethical problem) among key stakeholders, which is examined in depth along with an ethical analysis using public health ethical values.     

Stochastic Watershed Water Quality Simulation for TMDL Development – A Case Study in the Newport Bay Watershed1

Abstract: Systematic consideration of uncertainty in data, model structure, and other factors is generally unaddressed in most Total Maximum Daily Load (TMDL) calculations. Our previous studies developed the Management Objectives Constrained Analysis of Uncertainty (MOCAU) approach as an uncertainty analysis technique specifically for watershed water quality models, based on a synthetic case. In this study, we applied MOCAU to analyze diazinon loading in the Newport Bay watershed (Southern California). The study objectives included (1) demonstrating the value of performing stochastic simulation and uncertainty analysis for TMDL development, using MOCAU as the technique and (2) evaluating the existing diazinon TMDL and generating insights for the development of scientifically sound TMDLs, considering uncertainty. The Watershed Analysis Risk Management Framework model was used as an example of a complex watershed model. The study revealed the importance and feasibility of conducting stochastic watershed water quality simulation for TMDL development. The critical role of management objectives in a systematic uncertainty assessment was well demonstrated. The results of this study are intuitive to TMDL calculation, model structure improvement and sampling strategy design.     

A response surface methodology to address uncertainties in cap rock failure assessment for CO2 geological storage in deep aquifers

Cap rock failure assessment, either tensile fracturing or shear slip reactivation of pre-existing fault, is a key issue for preventing CO₂ leakage from deep aquifer reservoirs up to the surface. For an appropriate use in risk management, the uncertainties associated with such studies should be investigated. Nevertheless, uncertainty analysis requires multiple simulations and a direct use of conventional numerical approaches might be too computer time consuming. An alternative is to use conventional analytical models, but their assumptions appear to be too conservative. An intermediate approach is then proposed based on the response surface methodology, consisting in estimating the effective stress state after CO₂ injection as a linear combination of the most influential site properties based on a limited number of numerical simulations. The decision maker is provided with three levels of information: (1) the identification of the most important site properties; (2) an analytical model for a quick assessment of the maximal sustainable overpressure and (3) a simplified model to be used in a computationally intensive uncertainty analysis framework. This generic methodology is illustrated with the Paris Basin case using a large-scale hydromechanical model to assess cap rock failure in the injector zone.     

Integrated Risk Framework for Onsite Wastewater Treatment Systems

Onsite wastewater treatment systems (OWTS) are becoming increasingly important for the treatment and dispersal of effluent in new urbanised developments that are not serviced by centralised wastewater collection and treatment systems. However, the current standards and guidelines adopted by many local authorities for assessing suitable site and soil conditions for OWTS are increasingly coming under scrutiny due to the public health and environmental impacts caused by poorly performing systems, in particular septic tank-soil adsorption systems. In order to achieve sustainable onsite wastewater treatment with minimal impacts on the environment and public health, more appropriate means of assessment are required. This paper highlights an integrated risk based approach for assessing the inherent hazards associated with OWTS in order to manage and mitigate the environmental and public health risks inherent with onsite wastewater treatment. In developing a sound and cohesive integrated risk framework for OWTS, several key issues must be recognised. These include the inclusion of relevant stakeholders throughout framework development, the integration of scientific knowledge, data and analysis with risk assessment and management ideals, and identification of the appropriate performance goals for successful management and mitigation of associated risks. These issues were addressed in the development of the risk framework to provide a generic approach to assessing risk from OWTS. The utilisation of the developed risk framework for achieving more appropriate assessment and management techniques for OWTS is presented in a case study for the Gold Coast region, Queensland State, Australia.     

HEALTH RISKS ASSOCIATED WITH CONSUMPTION OF UNTREATED WATER FROM HOUSEHOLD ROOF CATCHMENT SYSTEMS1

ABSTRACT: Rainwater harvesting is receiving increased attention worldwide as an alternative source of drinking water. Although collected rainwater is typically consumed without any type of disinfection, the microbial quality of this type of water source can be poor. Around the world, consumers of collected and stored rainwater may be at considerable risk to a variety of infectious diseases. This review presents studies attributing specific risks of diseases to the consumption of contaminated rainwater. Diseases attributed to the consumption of untreated rainwater include bacterial diarrheas due to Salmonella and Campylobacter, bacterial pneumonia due to Legionella, botulism due to Clostridium, tissue helminths, and protozoal diarrheas from Giardia and Cryptosporidium. Simple indicator systems such as fecal coliform measurements may prove to be inadequate for determining microbial risks associated with consumption of water from rainwater catchment systems.     

Informing the development of decision support tools for risk management: the case of electrical and magnetic fields

This paper describes tools developed through a community consultative process to help decision makers manage electrical and magnetic fields (EMF) health risk. The process involved in‐depth interviews with experts (N=12) and focus group discussions with seven different stakeholder groups. The results reveal commonly held intense public concerns about the long‐term health effects of EMF. These concerns were further reinforced by the lack of public trust in both government and industry with regards to EMF risk management. Overall, the participants wanted tools that can be used to manage EMF information, scientific uncertainty about EMF and the complex environment in which EMF issues are embedded. The findings contributed to a mapping out of response formats to address public concerns related to risk, hazard, trust, accountability and fairness across a range of stakeholder groups. These tools and their roles in the management of complex and variable risks, involving new circumstances (e.g. privatization) and information (e.g. new scientific studies) are presented. The importance of recognizing and working with uncertainty through adaptive management strategies, using qualitative approaches, is also discussed.     

A Framework for Assessing Climate Change Impacts on Water and Watershed Systems

In this article we present a framework for assessing climate change impacts on water and watershed systems to support management decision-making. The framework addresses three issues complicating assessments of climate change impacts—linkages across spatial scales, linkages across temporal scales, and linkages across scientific and management disciplines. A major theme underlying the framework is that, due to current limitations in modeling capabilities, assessing and responding to climate change should be approached from the perspective of risk assessment and management rather than as a prediction problem. The framework is based generally on ecological risk assessment and similar approaches. A second theme underlying the framework is the need for close collaboration among climate scientists, scientists interested in assessing impacts, and resource managers and decision makers. A case study illustrating an application of the framework is also presented that provides a specific, practical example of how the framework was used to assess the impacts of climate change on water quality in a mid-Atlantic, U.S., watershed.     

Options for management of municipal solid waste in New York City: a preliminary comparison of health risks and policy implications

Landfill disposal and waste-to-energy (WTE) incineration remain the two principal options for managing municipal solid waste (MSW). One critical determinant of the acceptability of these options is the different health risks associated with each. In this analysis relying on published data and exposure modeling, we have performed health risk assessments for landfill disposal versus WTE treatment options for the management of New York City's MSW. These are based on the realistic scenario of using a waste transfer station (WTS) in Brooklyn and then transporting the untreated MSW by truck to a landfill in Pennsylvania or using a WTE facility in Brooklyn and then transporting the resultant ash by truck to a landfill in Pennsylvania. The overall results indicate that the individual cancer risks for both options would be considered generally acceptable, although the risk from landfilling is approximately 5 times greater than from WTE treatment; the individual non-cancer health risks for both options would be considered generally unacceptable, although once again the risk from landfilling is approximately 5 times greater than from WTE treatment. If one considers only the population in Brooklyn that would be directly affected by the siting of either a WTS or a WTE facility in their immediate neighborhood, individual cancer and non-cancer health risks for both options would be considered generally acceptable, but risks for the former remain considerably higher than for the latter. These results should be considered preliminary due to several limitations of this study such as: consideration of risks only from inhalation exposures; assumption that only volume and not composition of the waste stream is altered by WTE treatment; reliance on data from the literature rather than actual measurements of the sites considered, assuming comparability of the sites. However, the results of studies such as this, in conjunction with ecological, socioeconomic and equity considerations, should prove useful to environmental managers, regulators, policy makers, community representatives and other stakeholders in making sound and acceptable decisions regarding the optimal handling of MSW.     

Time‐Dependent Health Risk from Contaminated Groundwater Including Use of Reliability,Resilience, and Vulnerability as Measures

Traditionally, assessment of human health risk caused by contamination of a water supply focuses on the maximum risk to an individual. Here, we introduce a time‐dependent risk assessment method and adapt and explore the reliability, resilience, and vulnerability (RRV) criteria from the surface‐water literature as possible tools for assessing this risk. Time‐dependent risk assessment, including RRV, is applied to two synthetic examples where water quality at a well varies over time. We calculate time‐dependent health risks for discrete periods of exposure to the contaminated water for a variable population. The RRV criteria provide information about time‐dependent risk: probability of an acceptable risk, probability of system recovery, maximum risk, and average exceedance of a prescribed risk threshold. The results demonstrate that episodic contamination events produce fundamentally different time‐dependent risks than long‐term events: these differences, such as generally lower risks for the episodic contamination, can be captured via plots of the risk and the RRV criteria. Furthermore, the evaluation of time‐dependent health risk and the RRV criteria demonstrates significant sensitivity to the shape of the contaminant breakthrough curve, length of exposure, and variability within the population. Overall, analysis of time‐dependent health risks provides substantial insight into the structure of risk, with RRV providing a reasonable framework for the evaluation of these risks.     

Land Resources Allocation Strategies in an Urban Area Involving Uncertainty: A Case Study of Suzhou,in the Yangtze River Delta of China

A large number of mathematical models have been developed to support land resource allocation decisions and land management needs; however, few of them can address various uncertainties that exist in relation to many factors presented in such decisions (e.g., land resource availabilities, land demands, land-use patterns, and social demands, as well as ecological requirements). In this study, a multi-objective interval-stochastic land resource allocation model (MOISLAM) was developed for tackling uncertainty that presents as discrete intervals and/or probability distributions. The developed model improves upon the existing multi-objective programming and inexact optimization approaches. The MOISLAM not only considers economic factors, but also involves food security and eco-environmental constraints; it can, therefore, effectively reflect various interrelations among different aspects in a land resource management system. Moreover, the model can also help examine the reliability of satisfying (or the risk of violating) system constraints under uncertainty. In this study, the MOISLAM was applied to a real case of long-term urban land resource allocation planning in Suzhou, in the Yangtze River Delta of China. Interval solutions associated with different risk levels of constraint violation were obtained. The results are considered useful for generating a range of decision alternatives under various system conditions, and thus helping decision makers to identify a desirable land resource allocation strategy under uncertainty.     

Case studies in co-benefits approaches to climate change mitigation and adaptation

Attempts to mitigate greenhouse gas emissions or manage the effects of climate change traditionally focus on management or policy options that promote single outcomes (e.g., either benefiting ecosystems or human health and well-being). In contrast, co-benefits approaches to climate change mitigation and adaptation address climate change impacts on human and ecological health in tandem and on a variety of spatial and temporal scales. The article engages the concept of co-benefits through four case studies. The case studies emphasize co-benefits approaches that are accessible and tractable in countries with human populations that are particularly vulnerable to climate change impacts. They illustrate the potential of co-benefits approaches and provide a platform for further discussion of several interdependent principles relevant to the implementation of co-benefits strategies. These principles include providing incentives across multiple scales and time frames, promoting long-term integrated impact assessment, and fostering multidimensional communication networks.     

Australian local government action on climate change adaptation: some critical reflections to assist decision-making

The primary objective of this paper is to discuss the limitations of risk management as a strategy for Australian local government climate change adaptation and explore the advantages of complementary approaches, including a social-ecological resilience framework, adaptive and transition management, and vulnerability assessment. Some federal and local government initiatives addressing the limitations of risk-based approaches are introduced. We argue that conventional risk-based approaches to adaptation, largely focused on hazard identification and quantitative modelling, will be inadequate on their own for dealing with the challenges of climate change. We suggest that responses to climate change adaptation should move beyond conventional risk-based strategies to more realistically account for complex and dynamically evolving social-ecological systems.     

Modelling hydroenvironmental and health risk assessment parameters along the South Wales Coast

This paper highlights the increasing concerns relating to hydroenvironmetal issues and cites recent examples of the challenges now being regularly faced by hydroenvironmetal scientists and engineers. The limitations and restrictions of both physical (or laboratory) and numerical (or computer based) hydraulic models used in the planning and management of aquatic basins are discussed. General details are given of numerical models used for flow and water quality concentration predictions in estuarine waters, with particular application to the challenges occurring along the South Wales coast. A highly accurate and non-diffusive finite difference scheme that solves the transport equation for predicting water quality indicators and suspended sediment concentration distributions is also discussed. In particular, details are outlined of the extension of the water quality indicators of faecal coliforms, as required to comply with the EU Bathing Water Directive, to predict health risk assessment, in the form of predicting the risk of gastroenteritis. Three example research projects along the South Wales coast are described; the projects involve the application of two-dimensional and three-dimensional hydroenvironmetal models to predict flow patterns and water quality indicator organism distributions in the coastal receiving waters. These studies include: (i) a curvilinear finite difference approach to modelling flows in the Bristol Channel, (ii) coastal health risk predictions in Swansea Bay using combined water quality and epidemiological models, and (iii) combined sewer overflow discharges into Cardiff Bay.     

Approaches to Evaluating Climate Change Impacts on Species: A Guide to Initiating the Adaptation Planning Process

Assessing the impact of climate change on species and associated management objectives is a critical initial step for engaging in the adaptation planning process. Multiple approaches are available. While all possess limitations to their application associated with the uncertainties inherent in the data and models that inform their results, conducting and incorporating impact assessments into the adaptation planning process at least provides some basis for making resource management decisions that are becoming inevitable in the face of rapidly changing climate. Here we provide a non-exhaustive review of long-standing (e.g., species distribution models) and newly developed (e.g., vulnerability indices) methods used to anticipate the response to climate change of individual species as a guide for managers grappling with how to begin the climate change adaptation process. We address the limitations (e.g., uncertainties in climate change projections) associated with these methods, and other considerations for matching appropriate assessment approaches with the management questions and goals. Thorough consideration of the objectives, scope, scale, time frame and available resources for a climate impact assessment allows for informed method selection. With many data sets and tools available on-line, the capacity to undertake and/or benefit from existing species impact assessments is accessible to those engaged in resource management. With some understanding of potential impacts, even if limited, adaptation planning begins to move toward the development of management strategies and targeted actions that may help to sustain functioning ecosystems and their associated services into the future.