Abstract

Sanitary risk inspection, the systematic observation of contamination hazards, is often used to manage safety of water sources such as wells and boreholes. However, the replicability of sanitary risk inspections undertaken by different observers has not been studied. This study aimed to assess the replicability of sanitary risk inspections by two different observers in urban and peri-urban neighbourhoods of Greater Accra, Ghana. Two observers independently used a standard protocol to record contamination hazards around 62 groundwater sources, additionally recording urban-specific hazards such as damaged sewage pipes via a modified protocol. We calculated risk scores as the proportion of hazards observed at each source, separately for each observer. Linn’s concordance correlation coefficient indicated very high agreement between the two observers’ risk scores (n = 62; c = 0.949, 95% confidence limits 0.917–0.968). However, risk scores from urban-specific observations were uncorrelated with those from the standard protocol (r = 0.11, p = 0.41 for observer 1; r = 0.16, p = 0.22 for observer 2). Ours is the first study of replicability of sanitary risk observations and suggests high inter-observer agreement. However, urban contamination hazards were not captured using the standard protocol. In the future, assessment of inter-observer agreement and observations of urban-specific hazards could be incorporated into nationwide or regional sanitary risk surveys.

Highlights

  • A sanitary risk inspection is a structured observation checklist used to identify potential sources and pathways for faecal contamination in and around water sources (World Health Organization 1997)

  • The sample size was determined based on a least squares regression of overall sanitary risk score versus Escherichia coli counts in samples taken from water points

  • Our study is the first to examine this issue, finding high agreement between hazards recorded by two different observers for groundwater sources in urban and peri-urban Accra

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Summary

Introduction

A sanitary risk inspection is a structured observation checklist used to identify potential sources and pathways for faecal contamination in and around water sources (World Health Organization 1997). Sanitary risk inspection is typically used with community water sources such as hand-dug wells, springs, rainwater systems, and boreholes, rather than a piped supply system. The number of individual hazards observed at a given source is summed to provide a measure of the overall risk of contamination at that source. Despite the use of sanitary risk inspection protocols for almost 30 years, several issues affect their use. It is unclear whether sanitary risk observations

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