Abstract
The reliance on chlorination in humanitarian operations has raised concerns among practitioners about possible health risks associated with disinfection by-products; however, to date, there has not been an evaluation of disinfection by-product (DBP) levels in an emergency water supply intervention. This study aimed to investigate DBP levels at a surface-water treatment plant serving a refugee settlement in northern Uganda using the colorimetric Hach THM Plus Method. The plant had two treatment processes: (1) Simultaneous clarification–chlorination (“rapid treatment”); and (2) pre-clarification and chlorination in separate tanks (“standard treatment”). For both standard (n = 17) and rapid (n = 3) treatment processes, DBP levels in unique parcels of water were tested at 30 min post-chlorination and after 24 h of storage (to simulate what refugees actually consume). DBP levels after 24 h did not exceed the World Health Organization (WHO) guideline limit of 300 ppb equivalent chloroform, either for standard treatment (mean: 85.1 ppb; 95% confidence interval (C.I.): 71.0–99.1 ppb; maximum: 133.7 ppb) or for rapid treatment (mean: 218.0 ppb; 95% C.I.: 151.2–284.8; maximum: 249.0 ppb). Observed DBPs levels do not appear to be problematic with respect to the general population, but may pose sub-chronic exposure risks to specifically vulnerable populations that warrant further investigation.
Highlights
Chlorination is the most widely used method for water treatment in humanitarian emergencies because of its simplicity, low cost, and importantly, the residual protection it provides
In refugee and internally displaced persons (IDP) camps in humanitarian crisis zones, centralized batch chlorination remains the primary approach to treating large quantities of water, while point-of-use and point-of-distribution approaches are utilized in specific niche roles [1,2,3,4,5]
A number of chlorine products are commonly utilized in humanitarian response including calcium hypochlorite powders, sodium hypochlorite solutions, as well as tablets composed of various chlorine compounds such as sodium dichloroisocyanurate (NaDCC) or chlorine dioxide
Summary
Chlorination is the most widely used method for water treatment in humanitarian emergencies because of its simplicity, low cost, and importantly, the residual protection it provides. A number of chlorine products are commonly utilized in humanitarian response including calcium hypochlorite powders (e.g., high-test hypochlorite, HTH), sodium hypochlorite solutions (e.g., bleach), as well as tablets composed of various chlorine compounds such as sodium dichloroisocyanurate (NaDCC) or chlorine dioxide. When these products react with water, hypochlorous acid and hypochlorite ions are formed, which provide the disinfectant effect. Similar concerns have been raised about the use of various chlorine products in household water treatment programs in developing country settings [7,8]
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