Prenatal screening and diagnosis of neural tube defects in England and Wales in 1985

A survey was carried out to determine the effect of prenatal screening and therapeutic abortion on births in 1985 with anencephaly and spina bifida in England and Wales. Maternal serum alpha-fetoprotein tests were done on 399 288 women (60 per cent of pregnant women): 4 per cent were reported as being screen-positive and 1 per cent had an amniocentesis. An estimated 534 pregnancies associated with anencephaly were terminated and an estimated 445 pregnancies associated with spina bifida (but without anencephaly) were terminated. Most (63 per cent) of the anencephalic pregnancies were first suspected from an ultrasound examination; 57 per cent of the spina bifida pregnancies were first suspected from a positive maternal serum alpha-fetoprotein test, 35 per cent by ultrasound, and the remaining 8 per cent by other means. The birth prevalence of anencephaly declined by 94 per cent between 1964–1972 and 1985, but when the terminations of pregnancy on account of having a fetus with anencephaly are added to the births the decline in prevalence was only 50 per cent. The birth prevalence of spina bifida declined by 68 per cent over the same period but when the terminations were added to the births the decline in prevalence was only 32 per cent. Among births with anencephaly 66 per cent had had no screening or diagnostic tests in early pregnancy, but in those that did nearly all were positive–usually in twin pregnancies where one fetus was affected but not the other. Among births with spina bifida, 48 per cent had no tests and in those that did the results were mainly negative. We conclude that in order to monitor adequately the national screening programme for anencephaly and spina bifida a special neural tube defects register should be formed.     

Water supply development and tariffs in Tanzania: From free water policy towards cost recovery

The article describes the historical development of water tariff policy in Tanzania from the colonial times to present. After gaining independence, the country introduced “free” water policy in its rural areas. Criticism against this policy was expressed already in the 1970s, but it was not until the late 1980s that change became unavoidable. All the while urban water tariffs continued to decline in real terms. In rural and periurban areas of Tanzania consumers often have to pay substantial amounts of money for water to resellers and vendors since the public utilities are unable to provide operative service. Besides, only a part of the water bills are actually collected. Now that the free water supply policy has been officially abandoned, the development of water tariffs and the institutions in general are a great challenge for the country.     

The real water consumption behind drinking water: the case of Italy

The real amount of drinking water available per capita is a topic of great interest for human health and the economic and political management of resources. The global market of bottled drinking water, for instance, has shown exponential growth in the last twenty years, mainly due to reductions in production costs and investment in promotion. This paper aims to evaluate how much freshwater is actually consumed when water is drunk in Italy, which can be considered a mature bottled-water market. A Water Footprint (WF) calculation was used to compare the alternatives: bottled and tap water. Six Italian brands of water sold in PET bottles were inventoried, analysed and compared with the public tap water of the city of Siena, as representative of the Italian context. Results showed that more than 3 L of water were needed to provide consumers with 1.50 L of drinking water. In particular, a volume of 1.50 L of PET-bottled water required an extra virtual volume of 1.93 L of water while an extra 2.13 L was necessary to supply the same volume of tap water. These values had very different composition and origin. The WF of tap water was mainly due to losses of water during pipeline distribution and usage, while WF of bottled water was greatly influenced by the production of plastic materials. When the contribution of cooling water was added to the calculation, the WF of bottled water rose from 3.43 to 6.92 L. Different strategies to reduce total water footprint are discussed.