Cooling off health security hot spots: Getting on top of it down under

Australia is free of many diseases, pests and weeds found elsewhere in the world due to its geographical isolation and relatively good health security practices. However, its health security is under increasing pressure due to a number of ecological, climatic, demographic and behavioural changes occurring globally. North Queensland is a high risk area (a health security hot spot) for Australia, due in part to its connection to neighbouring countries via the Torres Strait and the Indo‐Papuan conduit, its high diversity of wildlife reservoirs and its environmental characteristics. Major outbreaks of exotic diseases, pests and weeds in Australia can cost in excess of $1 billion; however, most expenditure on health security is reactive apart from preventive measures undertaken for a few high profile diseases, pests and weeds. Large gains in health security could therefore be made by spending more on pre-emptive approaches to reduce the risk of outbreaks, invasion/spread and establishment, despite these gains being difficult to quantify. Although biosecurity threats may initially have regional impacts (e.g. Hendra virus), a break down in security in health security hot spots can have national and international consequences, as has been seen recently in other regions with the emergence of SARS and pandemic avian influenza. Novel approaches should be driven by building research and management capacity, particularly in the regions where threats arise, a model that is applicable both in Australia and in other regions of the world that value and therefore aim to improve their strategies for maintaining health security.     

Relationship between fluorine in drinking water and dental health of residents in some large cities in China

In this project, the relationship between fluorine content in drinking water and dental health of residents in some large cities in China was evaluated. The concentration of fluorine in tap water and in urine of local subjects of 28 cities and 4 high fluorine villages in China shows a strong positive correlation (r(2)=0.96, S.E.=0.9881). Our studies indicate that drinking water is the most important source of fluorine intake for Chinese people, and in more than 90% of urban cities, fluorine concentrations in drinking water are below levels recommended by the WHO (approximately 0.5-1.0 mg/l). A 1995 investigation by The National Committee on Oral Health of China (NCOH) shows the relationship between average number of decayed, missing and filled teeth (DMFT) of urban residents and fluorine concentration in drinking water to be negatively correlated but not forming a good linear relationship. Our results, together with the previous study, suggest that: (1) dental caries of the study population can be reduced by drinking water fluoridation and that (2) other factors such as economic level, weather, lifestyle, food habits, living condition, etc., of a city can also affect the incidence of dental caries that cannot be predicted by fluoridation alone. Research on the relation between index of fluorosis (IF) and the fluorine concentration in drinking water for the four high fluorine villages showed that the recommended concentration of fluorine in drinking water can protect from dental fluorosis.     

Policy,practice and decision making for zoonotic disease management: Water and Cryptosporidium

Decision making for zoonotic disease management should be based on many forms of appropriate data and sources of evidence. However, the criteria and timing for policy response and the resulting management decisions are often altered when a disease outbreak occurs and captures full media attention. In the case of waterborne disease, such as the robust protozoa, Cryptosporidium spp, exposure can cause significant human health risks and preventing exposure by maintaining high standards of biological and chemical water quality remains a priority for water companies in the UK. Little has been documented on how knowledge and information is translated between the many stakeholders involved in the management of Cryptosporidium, which is surprising given the different drivers that have shaped management decisions. Such information, coupled with the uncertainties that surround these data is essential for improving future management strategies that minimise disease outbreaks. Here, we examine the interplay between scientific information, the media, and emergent government and company policies to examine these issues using qualitative and quantitative data relating to Cryptosporidium management decisions by a water company in the North West of England. Our results show that political and media influences are powerful drivers of management decisions if fuelled by high profile outbreaks. Furthermore, the strength of the scientific evidence is often constrained by uncertainties in the data, and in the way knowledge is translated between policy levels during established risk management procedures. In particular, under or over-estimating risk during risk assessment procedures together with uncertainty regarding risk factors within the wider environment, was found to restrict the knowledge-base for decision-making in Cryptosporidium management. Our findings highlight some key current and future challenges facing the management of such diseases that are widely applicable to other risk management situations.     

Occurrence and fate of pharmaceutical products and by-products,from resource to drinking water

Among all emerging substances in water, pharmaceutical products (PPs) and residues are a lot of concern. These last two years, the number of studies has increased drastically, however much less for water resources and drinking water than for wastewater. This literature review based on recent works, deals with water resources (surface or groundwater), focusing on characteristics, occurrence and fate of numerous PPs studied, and drinking water including water quality. Through this review, it appears that the pharmaceutical risk must be considered even in drinking water where concentrations are very low. Moreover, there is a lack of research for by-products (metabolites and transformation products) characterization, occurrence and fate in all water types and especially in drinking water.     

Basic Environmental Requirements for EU Accession: An Impact Study on Hungary

It can be stated in general that (with the exception of agriculture) the Hungarian economy, because of its outdated technologies, is a bigger threat to the environment than countries of Western Europe. However, as the volume of economic output, per capita consumption and the number of motor vehicles is considerably lower than those in more advanced industrial nations, by most indicators low per capita figures put Hungary in a better position. Still, we must remember that the EU's environmental policy puts heavy emphasis on the efficient utilization of resources and environmental efficiency, calculated against pollution generated in the course of creating units of national wealth and the amount of energy and natural resources required to it. By these standards, Hungary lags far behind the West European model.The problem is compounded by the fact that, while nations of Western Europe had created environmental infrastructure (i.e., wastewater disposal and treatment, waste management) in an earlier phase of their economic development, Hungary is only now embarking on a similar project. Indeed, the existing gap between utility services of drinking water and sewage disposal and treatment, and large amounts of untreated and illegally dumped waste lead to serious environmental damage. Although the state of the country's natural environment is considered satisfactory, factors outlined above indicate there are many responsibilities ahead of us if we are to meet western environmental standards.     

水电工程干扰下饮用水水源地的水质风险评估

采用数值模拟方式预测和评估水电工程对其影响区内饮用水水源地的水质风险,其目的在于辨析工程对取水水质安全的影响。以汉江上游待建旬阳水电站库区内水源地为例,建立二维水流和水质数学模型,分析了水域水动力学和水质变化特征,选取最不利方案进行水质风险评估,并从水体水动力特征和营养状态判别了富营养化风险程度。研究表明：工程兴建后水源地水域水流变化和取水口临近支流潜在污染源的威胁,水质遭受污染的风险增大,在月河水质超标及特定水库运行条件下许家台取水口水质无法保障。同时,水域富营养化水平相比建库前并没有显著的提高。研究可为水电开发涉及水源地项目的水环境影响分析提供理论依据     

公众太湖蓝藻水华生态风险感知特征研究——以无锡市区为例

蓝藻水华暴发已成为全球性生态环境问题。太湖作为流域重要的水源地,2007年蓝藻水华事件的暴发引起公众的高度关注。运用问卷调查法,研究无锡市区489名公众的太湖蓝藻水华生态风险感知特征及其主要影响因素。研究结果表明：蓝藻水华生态风险被公众知觉为总体风险是陌生和完全可控的;蓝藻水华暴发原因是陌生和不可控的,这是引起公众风险意识的主要因素。影响公众蓝藻水华生态风险感知水平的主要因素有媒体、信息和个体因素。报纸广播电视是主要的媒体因素。信息因素有灾害信息、灾害治理信息、政府防范措施信息。灾害治理信息的影响作用最大,其次是灾害信息和政府防范措施信息。不同性别、年龄段、教育程度、收入水平及职业的人群,对不同类别的风险信息关注程度不同,影响到个体风险偏好的不同。研究结果有助于决策者更全面地理解蓝藻水华风险的本质,开展风险沟通,针对不同特征的人群选择有效的风险管理方案。〖     

A commentary on recent water safety initiatives in the context of water utility risk management

Over the last decade, suppliers of drinking water have recognised the limitations of relying solely on end-product monitoring to ensure safe water quality and have sought to reinforce their approach by adopting preventative strategies where risks are proactively identified, assessed and managed. This is leading to the development of water safety plans; structured 'route maps' for managing risks to water supply, from catchment to consumer taps. This paper reviews the Hazard Analysis and Critical Control Point (HACCP) procedure on which many water safety plans are based and considers its appropriateness in the context of drinking water risk management. We examine water safety plans in a broad context, looking at a variety of monitoring, optimisation and risk management initiatives that can be taken to improve drinking water safety. These are cross-compared using a simple framework that facilitates an integrated approach to water safety. Finally, we look at how risk management practices are being integrated across water companies and how this is likely to affect the future development of water safety plans.     

Floods and human health: A systematic review

Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004–2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs.     

Assessing the human health impacts of exposure to disinfection by-products — A critical review of concepts and methods

Understanding the public health implications of chemical contamination of drinking water is important for societies and their decision-makers. The possible population health impacts associated with exposure to disinfection by-products (DBPs) are of particular interest due to their potential carcinogenicity and their widespread occurrence as a result of treatments employed to control waterborne infectious disease.We searched the literature for studies that have attempted quantitatively to assess population health impacts and health risks associated with exposure to DBPs in drinking water. We summarised and evaluated these assessments in terms of their objectives, methods, treatment of uncertainties, and interpretation and communication of results.In total we identified 40 studies matching our search criteria. The vast majority of studies presented estimates of generic cancer and non-cancer risks based on toxicological data and methods that were designed with regulatory, health-protective purposes in mind, and therefore presented imprecise and biased estimates of health impacts. Many studies insufficiently addressed the numerous challenges to DBP risk assessment, failing to evaluate the evidence for a causal relationship, not appropriately addressing the complex nature of DBP occurrence as a mixture of chemicals, not adequately characterising exposure in space and time, not defining specific health outcomes, not accounting for characteristics of target populations, and not balancing potential risks of DBPs against the health benefits related with drinking water disinfection. Uncertainties were often poorly explained or insufficiently accounted for, and important limitations of data and methods frequently not discussed. Grave conceptual and methodological limitations in study design, as well as erroneous use of available dose–response data, seriously impede the extent to which many of these assessments contribute to understanding the public health implications of exposure to DBPs. In some cases, assessment results may cause unwarranted alarm among the public and potentially lead to poor decisions being made in sourcing, treatment, and provision of drinking water. We recommend that the assessment of public health impacts of DBPs should be viewed as a means of answering real world policy questions relating to drinking water quality, including microbial contaminants; that they should be conducted using the most appropriate and up-to-date data and methods, and that associated uncertainties and limitations should be accounted for using quantitative methods where appropriate.     

Water pollution in Pakistan and its impact on public health--a review

Water pollution is one of the major threats to public health in Pakistan. Drinking water quality is poorly managed and monitored. Pakistan ranks at number 80 among 122 nations regarding drinking water quality. Drinking water sources, both surface and groundwater are contaminated with coliforms, toxic metals and pesticides throughout the country. Various drinking water quality parameters set by WHO are frequently violated. Human activities like improper disposal of municipal and industrial effluents and indiscriminate applications of agrochemicals in agriculture are the main factors contributing to the deterioration of water quality. Microbial and chemical pollutants are the main factors responsible exclusively or in combination for various public health problems. This review discusses a detailed layout of drinking water quality in Pakistan with special emphasis on major pollutants, sources of pollution and the consequent health problems. The data presented in this review are extracted from various studies published in national and international journals. Also reports released by the government and non-governmental organizations are included.     

Assessing the risk of an excess fluoride intake among Swedish children in households with private wells — Expanding static single-source methods to a probabilistic multi-exposure-pathway approach

It is often assumed that water consumption is the major route of exposure for fluoride and analysis of water fluoride content is the most common approach for ensuring that the daily intake is not too high. In the present study, the risk of excess intake was characterized for children in households with private wells in Kalmar County, Sweden, where the natural geology shows local enrichments in fluorine. By comparing water concentrations with the WHO drinking water guideline (1.5 mg/L), it was found that 24% of the ca. 4800 sampled wells had a concentration above this limit, hence providing a figure for the number of children in the households concerned assessed to be at risk using this straightforward approach. The risk of an excess intake could, alternatively, also be characterized based on a tolerable daily intake (in this case the US EPA RfD of 0.06 mg/kg-day). The exposure to be evaluated was calculated using a probabilistic approach, where the variability in all exposure factors was considered, again for the same study population. The proportion of children assessed to be at risk after exposure from drinking water now increased to 48%, and when the probabilistic model was adjusted to also include other possible exposure pathways; beverages and food, ingestion of toothpaste, oral soil intake and dust inhalation, the number increased to 77%. Firstly, these results show how the risk characterization is affected by the basis of comparison. In this example, both of the reference values used are widely acknowledged. Secondly, it illustrates how much of the total exposure may be overlooked when only focusing on one exposure pathway, and thirdly, it shows the importance of considering the variability in all relevant pathways.     

Duty and Standards of Care for Drinking Water Regulation in Australia

The application of mandatory drinking water standards in Australia should ensure a basic water quality for all communities, with some standards written as a function of population. The main tenet of feasibility would be the capture of public benefits which foreseeably outweighed costs. Benefit-cost analysis can be a very valuable tool which aids in the decision process, however care must be taken to avoid institutional abuse or an over-positioned stature because of its applicative constraints.Many of the benefits associated with drinking water standards will often defy accurate itemization or monetization, and hence feasibility will frequently rely on approximations and a close analysis of case merits. Risk assessment is often used to estimate benefits accrued. Two common methods for valuing water quality are (a) cost of illness approaches, and (b) willingness to pay to avoid risk. The advantage of willingness to pay is that it engenders a larger interpretation of cost and quality value, and allows the community to rank preferences based on their willingness to avoid unnecessary risks.Given the technicalities and details in 'smart' water quality regulation which avoids unnecessary intrusion caused by ill-founded and unresolved clarity, lengthy drafting deliberations may often be necessary. The statutory and administrative structure of a future regulator is therefore a fundamental facet under-pinning the success of a comprehensive and responsive mandatory program. The process and rationale for regulatory development should be transparent and open, and this should include mandatory opportunities for public input during regulation drafting. Post inauguration mechanisms for suggestions on possible improvements and review of real world application should be considered important aspects of this process. Good models for comparison currently exist in the United States and Europe.     

Exporting natural capital: the foreign eco-footprint on Costa Rica and implications for sustainability

As the world economy ‘globalizes’, trade has become a major mechanism by which much of the human population supports its needs. While trade in resource commodities (natural income) can increase the well-being of people in both exporting and importing countries, it can also lead to depletion of natural capital and the loss of ecosystems integrity. In recent years, various researchers have attempted to address this problem using a consumption-based perspective on ecological change. Their work shows that the loss of ecosystem integrity in almost any region of the world can be attributed to both local and international consumer demand. This paper illustrates the utility of modified eco-footprint analysis in assessing export-related ecological change in Costa Rica. We quantify ecological footprint of consumers around the world on the productive ecosystems of Costa Rica, document the changing character of this footprint and highlight some of the linkages between production for export in Costa Rica and ecological degradation. We then discuss the implications of the increasing trade-based entanglement of nations for ecosystems and global sustainability.     

Plants against the global epidemic of arsenic poisoning

Due to the growing current trend around the world of drinking water from underground sources, in an attempt to replace heavily polluted surface water supplies, arsenic is causing a global epidemic of poisoning with hundreds of millions of people now being thought at serious risk in many countries. Phytoremediation (bioremediation mediated by plants) has been proposed as an effective tool in arsenic cleanup. Actually, some plants (most notably, the Chinese brake fern Pteris vittata) have been reported to be suitable for arsenic phytoremediation. In this respect, transgenic plants are being developed to improve their capacity to accumulate arsenic. Most interestingly, rhizofiltration (use of plants to absorb or adsorb pollutants from water) is being considered for the ex situ and in situ remediation of arsenic-contaminated water. Similarly, some plants show great potential to remove arsenic from polluted soil.     

Sustainable nations: what do aggregate indexes tell us?

What is a ‘sustainable nation’ and how can we identify and rank ‘sustainable nations?’ Are nations producing and consuming in a sustainable way? Although several aggregate indexes have been proposed to answer such questions, comprehensive and internationally comparable data are not available for most of these. This paper quantitatively compares three aggregate indexes of sustainability: the World Bank’s ‘Genuine Savings’ measure, the ‘Ecological Footprint,’ and the ‘Environmental Sustainability Index.’ These three indexes are available for a large number of countries and also seem to be the most influential among the aggregate indexes. This paper first discusses the main limitations and weaknesses of each of these indexes. Subsequently, it shows that rankings of sustainable nations and aggregate assessments of unsustainable world population and world GDP shares vary considerably among these indexes. This disagreement leads to suggestions for analysis and policy. One important insight is that climate change, arguable the most serious threat currently faced by humanity, is not or arbitrarily captured by the indexes.     

Anishnaabe Aki: an indigenous perspective on the global threat of invasive species

Conservation discourses tend to portray invasive species as biological entities temporally connected to colonial timelines, using terms such as “alien”, “colonizing”, “colonial”, and “native”. This focus on a colonial timeline emerges from scientific publications within conservation biology and invasion ecology and is enacted through invasive species management by state and NGO actors. Colonialism is influential for indigenous nations in myriad ways, but in what ways do indigenous understandings of invasive species engage with colonialism? We conducted ethnographic research with indigenous Anishnaabe communities to learn about the ways Anishnaabe people conceptualize invasive species as a phenomenon in the world and were gifted with three primary insights. First, Anishnaabe regard plants, like all beings, as persons that assemble into nations more so than “species”. The arrival of new plant nations is viewed by some Anishnaabe as a natural form of migration. The second insight highlights the importance of actively discovering the purpose of new species, sometimes with the assistance of animal teachers. Lastly, while Anishnaabe describe invasive species as phenomenologically entangled with colonialism, the multiple ways Anishnaabe people think about invasive species provide alternatives to native–non-native binaries that dominate much of the scientific discourse.     

Chemical and microbiological examination of well and Nile water

The chemical composition and microbiological contamination of well water and Nile River water used for drinking were investigated in localities around Khartoum, Sudan, to present baseline data. The chemical analyses results obtained indicated that public health hazards due to pH, Ca⁺⁺, CO₃^??, HCO₃^?, and NO₃^? are unlikely in all the samples studied, while Na⁺ and Cl^? ions concentrations in well water warrant some attention. Contamination from organic matter and suspended material is also negligible. Microbial contamination with coliform and fecal coliform is high in surface wells and in the Nile River, but negligible in deep bores, tap water, and mineral water. The logarithm of the colony count ranges from zero for mineral water to 6.8 for water from the White Nile. In addition to drawing further attention to the well water and Nile water used for drinking by a wide sector of the population, the microbial count data for water from the Nile disagreed with the generally held belief that the Nile, being one of the largest rivers of the world, carries no detectable fecal contamination. Our data also did not support the belief that the White Nile is more contaminated than the Blue Nile.     

Discovering and characterizing farm households’ resilience under water scarcity

Water scarcity at an alarming rate has been a limiting factor for sustainable agriculture in arid and semi-arid environments of the world. It has resulted in a number of problems such as poverty and food insecurity among farm households. Therefore, building and improving resilience, as a way to mitigate the impacts of water scarcity, is important for farm households. But one of the significant steps for planning to improve farm households’ resilience under water scarcity is investigation of the current level of resilience of these households and understanding their variances. Therefore, this study offers a classification of farm households’ diversity based on resilience. Primary data were collected from 260 randomly selected farm households in 21 villages around Parishan wetland, Iran. Farm Household Resilience Scale was used to measure resilience. Cluster analysis suggested three groups: highly, medium-, and low-resilient farm households. The results of comparing three groups revealed that highly resilient farm households characterize with higher risk management, more agricultural water security, more positive psychological traits, and better knowledge management. Also, they had better water quality, attended more agricultural extension activities, and used modern irrigation systems. Farm households’ resilience map using GIS software illustrated that there is a relationship between resilience and farm location from the wetland. The findings of this study could be used by planner and policy-makers to improve farm households’ resilience in arid and semi-arid environments. Improvement in knowledge management system is recommended as one of the most effective policy instruments in building resilience.     

Arsenic poisoning in groundwater: health risk and geochemical sources in Bangladesh

Of the 2508 water samples analyzed in 10 districts of Bangladesh, 51%, on an average, contained arsenic levels of 0.05 to 2.50 mg/l. 95% of nail, 96% of hair, and 94% of urine samples contained arsenic above the normal level. Approximately 3.58 million people out of a total of 17.92 million who are drinking water containing arsenic levels >0.20 mg/l are potentially exposed to high risk of health hazard. Eight thousand and five hundred arsenic patients are identified; they are suffering from various skin lesions, gangrene in leg, skin, lung, bladder, liver, and renal cancer. A big portion of the total population is highly vulnerable to various internal cancers. Lowest arsenic concentration in drinking water producing dermatological disease is found to be 0.103 mg/l. However, the exposure time to develop arsenicosis varies from case to case reflecting its dependence on arsenic level in drinking water and food, nutritional status, genetic variant of human being, and compounding factors. This study has determined the high intensity of fluorescent humic substances in drinking water containing elevated concentrations of arsenic and very low concentrations of heavy metals. The synergistic/antagonistic effect of fluorescent compounds present in drinking water may aggravate the toxicity of arsenic. Geochemical study suggests that arsenic may be released from both reductive dissolution of Fe and Mn (oxy)hydroxide and microbial oxidation of organic matter.