Natural Contamination Research Articles

Assessment of natural fluoride contamination in water intended for human consumption from various regions in Tunisia

ABSTRACT Fluoride is a naturally occurring element present in the Earth's crust, which is released from rocks into the soil and water. Elevated levels of fluoride have been reported in phreatic groundwater worldwide, posing significant health risks to animals, plants, and humans. This study aims to assess the fluoride content in water intended for human consumption from both public networks and groundwater sources in various regions of Tunisia. A total of 46 water samples were collected between 2020 and 2021. The fluoride levels were determined using potentiometry with a combined Fluoride perfectION™ ISE selective electrode. The analysis revealed that fluoride content ranged from 0.351 to 6.016 mg/L. Samples exceeding the regulated limit of 1.5 mg/L were predominantly found in the southern areas of the country (64.3%, averaging 1.755 mg/L), regions known by hydrogeological fluoride deposits (54.8%, averaging 1.715 mg/L), and groundwater sources (75%, averaging 2.103 mg/L). Exposure of animals and humans to such high levels of fluoride poses a serious public health concern. Consequently, the implementation of a national strategy for the monitoring and control of public water resources intended for consumption is essential in mitigating the risks associated with fluoride contamination.

Development of sensitive and rapid immunoassays for Moniliformin (MON) detection based on nanomaterials labeled monoclonal antibodies.

Moniliformin (MON) is a toxic secondary metabolite from Fusarium species. The natural contamination of MON in cereals and cereal by-products, poses a risk of exposure to MON. However, so far, no immunoassay method has been reported to detect MON in field samples. In this study, anti-MON monoclonal antibody (mAb) with high affinity (1×108) and isotype of IgG1 was subjected to establish indirect competitive ELISA (ic-ELISA) and immunochromatographic test strips (ICTS). The optimized ic-ELISA resulted in the lowest detection limit (LOD) of 1.55μg/mL. The LOD value for gold nanoparticles (AuNP) -based test strip was 0.83μg/mL. The multi branched gold nano-flower particles (AuNFs) reported higher sensitivity with LOD of 0.38μg/mL. Moreover, the developed test strips exhibited a high specificity without cross-reactivity to related competitive toxins. In conclusion, immunoassay methods were successfully developed to detect MON in field samples with a short detection time to ensure food security.

Natural Environmental Contaminants and the Impact of Green Technologies on Climate Change

Environment has been defined as the natural world in which living things dwell and grow. There are certain factors which often pose challenges to the environment and are capable of interrupting capacity building as well as sustainability. This research evaluates such factors as environmental contaminants which include any chemical, biological, or radiological substance or matter that hurts air, water, soil or living organisms. However, with the advancement of green technologies on the environment, there is a revolutionary change with regards to clean energy production, solar power, reduction of emissions of carbon dioxide, use of alternative fuels and other technologies that are less harmful to the environment than fossil fuels. This research focuses on clean energy production such as solar energy and other technologies that serve the best purpose of reducing emissions of carbon dioxide usually generated by vehicles, motorcycles and fuel power generators majorly in the cities, particularly in the industrial environments. These emissions from vehicle engines, power generators, gas flaring and other environmental contaminants are very dangerous to human health. Many, who have ingested these emissions, have serious interference with their bodies’ internal functioning, causing diseases like cancer, itching in the eyes and respiratory disorders like asthma. The pressing need to explore green technologies for sustainability becomes imperative and this gave rise to this research. To achieve this aim, this research adopts the doctrinal research methodology in examining the natural environmental contaminants and the impact of green technologies on climate change. On this premise, this research recommends tremendous exploration of green technologies as a recipe for a sustainable environment.

Development of an Easy-To-Use Microfluidic System to Assess Dynamic Exposure to Mycotoxins in 3D Culture Models: Evaluation of Ochratoxin A and Patulin Cytotoxicity.

Mycotoxins are among the most concerning natural toxic food contaminants. Over the years, significant efforts have been made to characterize the risk associated with their exposure. However, assessing their toxicity has so far been elusive due to the lack of adequate models that closely mimic the physiological conditions of human cells in vivo. Here, we present the SpheroFlow Device (SFD), an efficient microfluidic platform designed, manufactured, and validated to evaluate mycotoxin-induced cytotoxicity under dynamic and continuous exposure in 3D culture settings. In the present study, we integrated human neuroblastoma SH-SY5Y spheroids into the SFD to assess the acute toxicity induced by the mycotoxins ochratoxin A (OTA) and patulin (PAT). The developed system enabled qualitative and quantitative measurements of concentration-response relationships and provided accurate control over the culture microenvironment. Our findings show that by enhancing 3D culture model by applying dynamic flow, SH-SY5Y spheroids exhibited different sensitivities to OTA and PAT compared to conventional static SH-SY5Y spheroids, confirming the critical role of culture models in mycotoxin toxicity assessment. This is the first study assessing the neurotoxicity of OTA and PAT on 3D neuroblastoma spheroids considering the contribution of fluid flow.

Preharvest Natural Multitoxin Contamination of Winter Wheat Genotypes in Hungary with Special Attention to Aflatoxins and HT-2 Toxin

Toxigenic fungi are among the most significant disease-causing agents in wheat. DON is the most common Fusarium mycotoxin, and for a long time, it was the only toxin researched. However, multitoxin data from wheat samples have drawn attention to the fact that much more toxins can be involved in the wheat toxin story than we supposed earlier. For resistance breeding, we need a more detailed approach to identify toxins that occur above the limit and identify the source of the fungal species that produces them. This study analyzed local wheat varieties for fungal infections and natural multitoxin contamination. Eighteen winter wheat genotypes were tested for fungal contaminations across three different locations in 2021 and 2022. Fourteen different mycotoxins—deoxynivalenol, aflatoxins (B1, B2, G1, and G2), fumonisins (B1 and B2), sterigmatocystin, ochratoxin A, zearalenone, T-2, HT-2, and diacetoxyscirpenol—were analyzed using HPLC/triple-quad MS. Toxigenic species such as Fusarium, Aspergillus, and Penicillium had low rates of occurrence, but the toxin contamination was often surprisingly high. Many samples without corresponding fungal infections were also identified as containing mycotoxins. Therefore, the identified fungal infection is less useful for forecasting toxin level. In conclusion, mycotoxin contamination is decisive. Most samples were contaminated by one or more mycotoxins. Although the mycotoxin concentrations typically remained below EU limits, some samples exhibited higher levels, particularly aflatoxins and Ht-2 toxin. Significant variations were observed across year, location, and genotype. For several toxins, significant genotype differences were identified, supporting the hypothesis that resistance may be a useful and suitable control measure. Stability of toxin contamination across years and locations is a very valuable trait; genotypes were identified with low toxin levels and stability (low variance) to all mycotoxins tested. It seems that, in addition to DON, more attention should be given to aflatoxin B1, B2, and G1, which provided similar concentrations. The HT-2 toxin was present in many samples surpassing EU limits. This is the first report on the dangerous occurrence of preharvest-origin aflatoxins and the HT-2 toxin of wheat in Hungary.

Depuration of Aliarcobacter butzleri and Malaciobacter molluscorum in Comparison with Escherichia coli in Mussels (Mytilus galloprovincialis) and Oysters (Crassostrea gigas).

Arcobacter-related species are considered emerging food-borne and waterborne pathogens, with shellfish being a suggested reservoir. In a published study that investigated 204 shellfish samples and 476 isolates, the species Arcobacter butzleri (now known as Aliarcobacter butzleri) and Arcobacter molluscorum (now known as Malaciobacter molluscorum) have been isolated as the most dominant species. However, the efficiency of depuration for eliminating A. butzleri and M. molluscorum in comparison with Escherichia coli from mussels and oysters is unknown and is therefore the objective of this investigation. The shellfish depuration process was evaluated in the laboratory, in summer and winter, using mussels and oysters collected from the Ebro Delta harvesting areas after performing a natural contamination and an artificial contamination using the same conditions for both mollusk and seasons. The natural contamination was performed by exposing the shellfish to a freshwater channel that receives untreated sewage from the village of Poble Nou (PNC) and that had a salinity of 10.7-16.8‱. The artificial contamination exposed the shellfish to A. butzleri and E. coli (in one tank) and to M. molluscorum and E. coli in another tank under controlled conditions of salinity (34.5‱) and temperature (20 °C summer and 14 °C winter). When evaluating the reduction in the bacteria load (every 24 h) throughout 120 h, the naturally contaminated shellfish at the PNC showed a higher reduction than the shellfish contaminated at the laboratory, with the exception of M. molluscorum, that at 24 h could not be detected in summer, neither in mussels nor in oysters. This may be attributed to the fact that the bacteria from the PNC were less adapted to the conditions of high salinity (34.5‱) in which the depuration process was performed. Although temperature did not statistically make a difference in depuration, at 20 °C a higher elimination of all bacteria was recorded relative to 14 °C. In general, E. coli survived more in mussels than in oysters, and M. molluscorum suffered in both mollusks a higher reduction than A. butzleri. New studies are required to determine further the safety of bivalves regarding the presence of Arcobacter-related species.

Assessment of groundwater mineralization in the arid steppe region of the Messaad plateau aquifer, Southern Algeria

Water scarcity is severely high in the North Africa and the Middle East (MENA) regions. The deterioration of water quality has an impact on the human health as well as on the development of agricultural activities, especially in arid regions, where precipitations are less frequent. The aim of this work is to identify and evaluate the chemistry of the groundwater aquifer in the region of Messaad plateau. This region is located 370 km south of Algiers in southern Algeria. A dozen of samples were collected from wells and analyzed using physic-chemical technics, and the results were processed statistically. The distribution of the conductivity values and the various chemical parameters suggest that the groundwater in the Messad wadi area is overall highly mineralized, with the EC ranging from 550 µS . cm–1 to 8790.13 µS . cm–1, with a predominance of calcium sulphate facies and calcium chloride facies. The level of mineralization noted in the southern and southeastern portions of the research area sheds light on the source of natural contamination. The SO42–, Cl– , Ca2+ , Na+ ions are the most important factors influencing the electrical conductivity of water and the groundwater chemistry. These ions are the result of the continuous dissolution of gypsum and halite in the clays and marls of the Barremian formations.

Impact of Natural Contamination on the Harmonic Distortion of Leakage Current in 150 kV Ceramic Insulators

Impact of Natural Contamination on the Harmonic Distortion of Leakage Current in 150 kV Ceramic Insulators

From flames to lab: A robust non-destructive sampling method for evaluating PAH exposure in firefighters’ personal protection equipment

Polycyclic aromatic hydrocarbons (PAHs) are compounds with high carcinogenic potential, produced during incomplete combustion. Certain professions, such as firefighting, expose workers to significant levels of PAHs during their operations, making it essential to investigate sampling protocols to evaluate their exposure in the work environment.This study presents a non-destructive and cost-effective sampling method for monitoring PAHs in firefighters’ personal protective equipment (PPE) and intervention vehicles. Sampling was conducted using three isopropanol wipes per collection zone, with comprehensive validation trials ensuring the method’s effectivenes. The method was tested under both natural contamination and spiking scenarios, showing similar results in both protocols.Analysis of contaminated PPE revealed significant PAH contamination in specific zones, such as gloves, lower back sleeves, and knees, due to direct exposure to flames and smoke during firefighting, with the highest concentrations in the outer and moisture layers. The cleaning efficacy of PPE was also evaluated employing specific washing machines, showing substantial reductions in PAH levels of approximately 76%. Additionally, non-targeted analysis detected organophosphate flame retardants (OPFRs) and furans, suggesting broader utility for environmental monitoring. This comprehensive approach improves the accessibility of chemical exposure studies in high-risk professions, contributing to better protective measures and occupational health and safety.

Metal variability of the shrimp Palaemon elegans across coastal zones: anthropogenic and geological impacts.

This study focused on 120 specimens of the shrimp Palaemon elegans collected in intertidal zones in eight selected areas. This study aimed to assess the suitability of P. elegans as a bioindicator of natural and anthropogenic marine pollution. Metal concentrations of aluminum (Al), cadmium (Cd), copper (Cu), iron (Fe), lead (Pb), and zinc (Zn) were measured in shrimp collected from various sites in the Canary Islands, including areas affected by volcanic activity, industrial activity, and control zones. The determination of metal concentrations was conducted using inductively coupled plasma optical emission spectrophotometry (ICP-OES). The results showed significant differences in metal concentrations across the studied sites, with the highest levels of Al, Cu, Fe, Pb, and Zn observed in areas impacted by the Tajogaite volcanic eruption and harbor activity. Sites near old landfills and sewage pipes also exhibited elevated levels of Cd, Cu, and Pb, indicating strong anthropogenic influence. Al was found in the highest concentration in Harbour, reaching 25.7 ± 6.2mg/kg, while the lowest concentration was observed in Control Lp at 11.5 ± 0.69mg/kg. Conversely, lower metal concentrations were detected in control zones and areas with high dinoflagellate presence, suggesting a potential role of bioremediation by marine phytoplankton. The ability of P. elegans to accumulate metals in its tissues, particularly in areas of high pollution, highlights its potential as a bioindicator species. This study underscores the importance of P. elegans in monitoring marine pollution and provides insights into the environmental impact of both natural and human-induced contamination on coastal ecosystems.

Utilizing a multi-tracer method to investigate sulphate contamination: Novel insights on hydrogeochemical characteristics of groundwater in intricate karst systems

Karst environments, especially in Mediterranean area, are highly vulnerable to natural and anthropogenic contamination. This study presents a comprehensive hydrogeochemical assesment of surface water and groundwater across a 2300 km2 catchment area spanning Southern Dalmatia (Croatia) and Western Herzegovina (Bosnia and Herzegovina).For the first time in the study area, data were collected over six years integrating ion analysis, sulphur isotope (δ34S) composition, and physical-chemical analysis of water from 30 locations. The research identified four hydrogeochemical facies (carbonate, sulphate, mixed carbonate/sulphate and chloride), influenced by seawater intrusion, carbonate dissolution, evaporite presence, and human activities.Elevated sulphate levels, often exceeding 250 mg/L, were a main focus of the study due to their potential risks to drinking water quality. The study developed a conceptual model to explain the distribution of sulphates, underscoring the importance of evaporite diapirism and δ34S analysis in tracing sulphate origins. These findings contribute to an improved understanding of karst systems and offer essential data for groundwater protection and legislative measures in the Mediterranean region.

Study on reference material of heavy metals (lead, cadmium, arsenicic, and mercury) in mustard greens by natural infection method

Vegetables are an essential part of daily meals. Each type contains different nutrients and serves various functions, but all provide essential nutrients for human health. Many metal elements are known to play important roles in living organisms and humans. However, heavy metal contamination can be toxic to the body and impact the health of consumers. To ensure the quality of vegetable products, determining the levels of heavy metals (Pb, Cd, As, Hg) is crucial for food safety control in vegetables. Therefore, using heavy metal standard samples (Pb, Cd, As, and Hg) in vegetables provides reference values and accuracy benchmarks for testing results, aiding in precise and objective evaluation during sample testing. This study aims to develop a process for creating standard samples for analyzing heavy metals Pb, Cd, As, and Hg in vegetables using a natural contamination method. The produced samples demonstrated consistency and stability, with an estimated duration of 627 days from the production date. The measurement uncertainty ranges from 7,94% to 15,7%. The values of the standard samples align with the low contamination levels required for analysis, making them suitable for quality control in laboratories. Additionally, the results of this study lay the groundwork for further research into developing other standard samples with diverse matrices and analytical criteria using natural contamination methods.

Microextraction isolation and concentration of mycotoxins for their determination in food products

Mycotoxins are among the most dangerous natural contaminants of food products. The review discusses the principles of microextraction methods (liquid-liquid and solid-phase microextraction) used for the isolation and concentration of mycotoxins from food products for their subsequent determination by various physico-chemical methods of analysis. The capabilities and limitations of the discussed methods, as well as examples of their practical application, are described.

Performance evaluation of a community-based water management organisation using integrated water quality monitoring

ABSTRACT Community-based water management organisations (CBWMOs) play an important role in providing water services worldwide. However, there is some debate as to their capacity to sustain a safe drinking water supply considering the current socioeconomic and climate scenarios. Here, we present an integrated water quality assessment of the supply system of a CBWMO in Concepción of San Ramon, Costa Rica. Major ions, trace metals, and coliforms were analysed in the households and water sources over a 1-year period. The spring risk assessments and the water quality of the main river in the catchment were also carried out. We found that although the supplied water meets adequate standards, spatial and temporal changes in the water quality of the sources exist. Springwater composition is mainly driven by rock–water interaction processes, but early signs of potential anthropogenic pollution were found. The springs showed concentrations of NO3- above natural levels and microbial contamination in 37 and 18% of the cases, respectively. River water quality showed a distinct composition, which is consistent with the anthropogenic pressures in the catchment. This study provides useful information on how water quality assessments can be used beyond regulatory processes to improve planning by CBWMOs to ensure water security.

Heavy Metal Contamination in Birds from Protected Regions in the Amazon.

The extraction of crude oil and gold has substantially increased heavy metal contamination in the environment, yet the study of wildlife exposure and biological response to this pollution remains nascent even in the most biodiverse places in the world. We present a survey of heavy metal exposure in the feathers of wedge-billed woodcreepers (Glyphorynchus spirurus), a resident neotropical bird found within protected regions of the Amazon near oil and gold extraction sites. Our results show elevated heavy metal contamination in samples collected from protected areas proximate to known oil and gold extraction. Surprisingly, several samples from remote reference sites also displayed elevated levels of various heavy metals, suggesting a background of natural deposition or complex heavy metal contamination in the environment from anthropogenic sources. These results highlight the need to understand the ecological and biological impacts of increased heavy metal exposure on wildlife across space and time, including remote regions of the world purportedly untouched by these human-mediated stressors. Toward this goal, historical and contemporary data from native bird populations may provide crucial indicators for heavy metal contamination and exposure in wildlife and human communities. Environ Toxicol Chem 2024;43:2601-2607. © 2024 The Author(s). Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Multi-contamination groundwater risk assessment based on integrated OSPRC framework considering receptor and consequence components

This study evaluates the risks associated with geogenic and anthropogenic contaminants in the Azarshahr aquifer situated in the Lake Urmia watershed in NW Iran, an area critically affected by both natural mineral deposits and intensive agricultural activities. This region, characterized by its significant geological diversity and extensive use of pesticides and fertilizers, presents a unique opportunity to study the interaction between natural and human-induced groundwater contamination. Employing the Origin-Source-Pathway-Receptors-Consequence (OSPRC) framework, the research focuses on the linkage between these contaminants and waterborne diseases, particularly examining the less-studied “Receptor” and “Consequence” components using the Groundwater Quality Index (GQI) and health risk indices. Our approach integrates vulnerability assessments through the DRASTIC and SPECTR methods, enhanced by Sugeno fuzzy logic, to produce a detailed risk map highlighting two critical zones: Risk Cell 1, impacted predominantly by agricultural contaminants including nitrate and chlorpyrifos, and Risk Cell 2, affected by geogenic contaminants such as arsenic, lead, nickel, and chromium. This comprehensive analysis not only maps out the source and migration pathways of these contaminants but also evaluates their impact on human health. The findings underscore a strong correlation between identified risks and health impacts, emphasizing the pressing need for targeted health interventions and improved management of water resources in the region. By advancing the application of the OSPRC framework, this research fills a vital gap in our understanding of aquifer contamination dynamics and sets a new standard for future groundwater risk assessments.

From drops to drums: Assessing rainwater storage’s quality and quantity for addressing water demands in dry periods – A case study from Arusha Tanzania

Sustainable Development Goal 6 highlight the importance of providing reliable, affordable, and safe source of clean drinking water and sanitation for all by 2030. In Tanzania there is a dire need of a water supply strategy due to high levels of natural fluoride contamination in ground water (upto 74 mg/L) and the challenge of meeting water demand during 5 months long dry period. This study assesses social and technical feasibility of implementing rainwater harvesting (RWH) along with treatment technologies that includes Denutritor® to remove ammonia/pesticides and ultrafiltration to eliminate carbon. This integrated technology known as “Mbinguni Maji” is aimed for the long-term water storage to supply drinking water throughout the dry season. The methodology involves i) Assessing the technical feasibility of RWH using database from QGIS and Water Productivity Open-access portal (WaPOR) from the Food and Agricultural Organization of the United Nations; ii) conducting pilot demonstration in 5 different locations in Tanzania; and iii) conducting socio-economic survey for social acceptance of the technology through detailed questionnaires administered to residential homes, medical facilities, schools, hotels, and water kiosk owner. The result indicates that, from technical perspective, there is ample rainfall (average of 1036 mm/year) to supply water throughout the dry season, primarily for drinking and cooking purpose only (upto a maximum of 10 lpcd). The pilot demonstration confirms that the Mbinguni Maji RWH technology produce water that meets WHO water quality standards. The produced water is free from nutrients like carbon and ammonia, ensuring the possibility of long-term storage without bacterial and algal growth. Furthermore, Lab scale demonstration of Denutritor® show promising result of removing nitrite, ammonia even at high elevated temperature (30 °C), which can be effectively applied in Tanzania. In terms of social acceptance, RWH technology is already widely practised in Tanzania during the rainy season. However, the initial investment costs and operation & maintenance (O&M) concerns hinder the usage of RWH technology. Therefore, to ensure the long-term sustainability of RWH technologies, there is a need of development of comprehensive business plan and community awareness campaign.

Assessment of the Radioactivity, Metals Content and Mineralogy of Granodiorite from Calabria, Southern Italy: A Case Study.

In this paper, an assessment of the natural radioactivity level, radon exhalation, metal contamination, and mineralogy of a granodiorite rock sample from Stilo, in the Calabria region, Southern Italy is presented as a case study. This rock was employed as a building material in the area under study. The specific activity of 226Ra, 232Th and 40K natural radioisotopes was assessed through high-purity germanium (HPGe) gamma-ray spectrometry. Then, several indices such as the absorbed gamma dose rate (D), the annual effective dose equivalent (AEDE), the activity concentration index (ACI) and the alpha index (Iα), were quantified to determine any potential radiological health risk related to radiation exposure from the analyzed rock. Furthermore, E-PERM electret ion chambers and inductively coupled plasma mass spectrometry (ICP-MS) measurements were carried out to properly quantify the radon exhalation rate and any possible metal pollution, respectively. In particular, to further address metal pollution factors, the geo-accumulation index (Igeo) was calculated to properly address the toxicity levels of the ecosystem originating from the detected metals. Finally, with the aim of successfully discriminating the provenance of such naturally occurring radionuclides, a combined approach involving X-ray diffraction (XRD) and µ-Raman spectroscopy was employed for the identification of the main radioisotope-bearing minerals characterizing the investigated granodiorite. The results achieved in this case study can be taken as the basis for further inquiries into background levels of radioactivity and chemical contamination in natural stone employed as building materials.

Current Status and Recent Development in Biopesticides

Biopesticides are viewed as the best option in contrast to synthetic pesticides that are profoundly viable, target explicit and diminish natural dangers. These components prompted its application in bother the executive’s program rather than synthetic pesticides all through the world. Biopesticides are derived from plants and other natural materials like fungi, bacteria, viruses, nematodes and protozoa. The development innovative work in the field of biopesticide applications incredibly diminish the natural contamination brought about by the compound manufactured by synthetic insecticides residues and it advances the economic improvement of farming . Since the appearance of biopesticides, countless items have been enrolled and delivered, some of which have assumed a main part in the agro- market. The improvement of biopesticide has incited to supplant the synthetic pesticide in pest management. The current status and progression of biopesticides is zeroing in predominantly on improving activity spectra, supplanting of synthetic pesticides, its job in integrated pest management and in the proper application of botanical and semiochemical in the pest management

Quantification of Nitrate Level in Shallow and Deep Groundwater Wells for Drinking, Domestic and Agricultural Uses in Northeastern Arid Regions of Saudi Arabia

Nitrate (NO3−) is a vulnerable natural contaminant that can be found in groundwater. The estimated nitrate concentrations for four categories of wells in the northeastern arid regions of Saudi Arabia—commercial treated water stations for drinking, commercial stations of untreated water for domestic uses, private wells of residences for households, and private wells for agricultural uses—were found to be in the 16–380 mg/L range. Drinking water from all commercial treated water stations has lower nitrate levels, based on the WHO standard of 50 mg/L. In contrast, almost 33% of commercial stations with untreated water (used only for domestic purposes) in the studied areas had higher nitrate levels that were unsuitable for drinking. Approximately half of the private wells of residences and wells for agricultural uses had very high nitrate levels. They can be considered unsuitable for drinking due to excessive levels of nitrates but can be used for domestic and agricultural purposes. Thus, adopting specific strategies to reduce nitrate levels in public wells in the studied areas is crucial. The data obtained in the present study are essential for equipping decision-makers with valuable insights, allowing them to enact appropriate measures, as needed, and uphold community health in the studied regions.