Abstract

Understanding how climate change will affect water quality and therefore, health, is critical for building resilient water services in low- and middle-income countries (LMICs) where the effect of climate change will be felt most acutely. Evidence of the effect of climate variables such as temperate and rainfall on water quality can generate insights into the likely impact of future climate change. While the seasonal effects on water quality are known, and there is strong qualitative evidence that climate change will impact water quality, there are no reviews that synthesise quantitative evidence from LMICs on links between climate variables and water quality. We mapped the available evidence on a range of climate exposures and water quality outcomes and identified 98 peer-reviewed studies. This included observational studies on the impact of temperature and rainfall events (which may cause short-term changes in contaminant concentrations), and modelling studies on the long-term impacts of sea level rise. Evidence on links between antecedent rainfall and microbiological contamination of water supplies is strong and relatively evenly distributed geographically, but largely focused on faecal indicator bacteria and on untreated shallow groundwater sources of drinking water. The literature on climate effects on geogenic contaminants was sparse. There is substantial research on the links between water temperature and cyanobacteria blooms in surface waters, although most studies were from two countries and did not examine potential effects on water treatment. Similarly, studies modelling the impact of sea level rise on groundwater salinity, mostly from south-Asia and the Middle East, did not discuss challenges for drinking water supplies. We identified key future research priorities based on this review. These include: more studies on specific pathogens (including opportunistic pathogens) in water supplies and their relationships with climate variables; more studies that assess likely relationships between climate variables and water treatment processes; studies into the relationships between climate variables and geogenic contaminants, including risks from heavy metals released as glacier retreat; and, research into the impacts of wildfires on water quality in LMICs given the current dearth of studies but recognised importance.

Highlights

  • Climate change poses serious threats to drinking water and health (McMichael et al 2006; Howard et al 2010)

  • The World Health Organization (WHO) estimates an additional 48,000 deaths from diarrhoea will be caused by climate effects between 2030 and 2050 (WHO, 2014), with 60% of diarrhoea deaths in low- and middle-income countries currently attributed to inadequate water, sanitation and hygiene (WASH) (Prüss-Ustün et al 2019)

  • Nineteen studies examined the links between microbiological quality, evi­ dence of faecal contamination, in source waters and rainfall

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Summary

Introduction

Climate change poses serious threats to drinking water and health (McMichael et al 2006; Howard et al 2010). Droughts, and windstorms pose short-term threats in the form of infrastructure damage and loss of services (Howard et al 2016). Outbreaks of infec­ tious diseases following an extreme weather event have been commonly attributed to contaminated drinking water supplies and other deficits in water supply and sanitation (Alderman et al 2012; Cann et al 2013). The World Health Organization (WHO) estimates an additional 48,000 deaths from diarrhoea will be caused by climate effects between 2030 and 2050 (WHO, 2014), with 60% of diarrhoea deaths in low- and middle-income countries currently attributed to inadequate water, sanitation and hygiene (WASH) (Prüss-Ustün et al 2019). Understand­ ing how slow- and rapid-onset climate events, coupled with land use change and population growth, affect drinking water is critical towards building resilience in the water sector and mitigating health impacts of climate change (Howard and Bartram, 2010; WHO, 2017a)

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