Primary Source Of Drinking Water Research Articles

Piped water flows but sachet consumption grows: The paradoxical drinking water landscape of an urban slum in Ashaiman, Ghana

Packaged “sachet” water has become the primary drinking water source for millions of West Africans despite ongoing controversy over inadequate management of the new waste streams created by all the plastic wrappers. While recent literature from Ghana has shown that municipal water rationing and lower socioeconomic status tend to drive sachet consumption at the metropolitan scale, some low-income communities with a reliable piped water supply still exhibit diverse drinking water-seeking behaviours. This paper explores the drinking water landscape of one poor, informal community in Ashaiman, Ghana, as a case study of the individual- and community-level factors that shape household drinking water decisions. Using the results of a water questionnaire completed by 95 households and the transcripts of four focus groups, our findings suggest that, after controlling for demographics, sachet water consumption is associated with proxies for higher disposable income and lack of knowledge about household water treatment methods, while social processes and attitudes toward water quality do not seem to drive drinking water decisions. This community presents a paradoxical drinking water landscape, as poverty abounds despite excellent piped water access, and low-income households with slightly greater means tend to opt for packaged water as opposed to being driven to it by piped water shortages. These nuances in drinking water purchasing behaviour can inform policy and planning for drinking water provision in urban slums across the region.

Arsenic exposure to drinking water in the Mekong Delta

Arsenic (As) contamination of groundwater drinking sources was investigated in the Mekong Delta, Vietnam in order to assess the occurrence of As in the groundwater, and the magnitude of As exposure of local residents through measurements of As in toenails of residents consuming groundwater as their major drinking water source. Groundwater (n=68) and toenail (n=62) samples were collected in Dong Thap Province, adjacent to the Mekong River, in southern Vietnam. Fifty-three percent (n=36) of the wells tested had As content above the World Health Organization's (WHO) recommended limit of 10ppb. Samples were divided into Northern (mean As=4.0ppb) and Southern (329.0ppb) groups; wells from the Southern group were located closer to the Mekong River. Elevated As contents were associated with depth (<200m), salinity (low salinity), and redox state (reducing conditions) of the study groundwater. In 79% of the wells, As was primarily composed of the reduced As(III) species. Arsenic content in nails collected from local residents was significantly correlated to As in drinking water (r=0.49, p<0.001), and the relationship improved for pairs in which As in drinking water was higher than 1ppb (r=0.56, p<0.001). Survey data show that the ratio of As in nail to As in water varied among residents, reflecting differential As bioaccumulation in specific exposed sub-populations. The data show that water filtration and diet, particularly increased consumption of animal protein and dairy, and reduced consumption of seafood, were associated with lower ratios of As in nail to As in water and thus could play important roles in mitigating As exposure in areas where As-rich groundwater is the primary drinking water source.

Drinking water infrastructure in the Ashanti Region of Ghana: developing a model for sustainable interventions by non-governmental organizations

Access to clean water plays a critical role in advancing health in low- and middle-income countries. Over the past decade, Ghana has met United Nations targets for expanding access to clean water. Non-governmental organizations (NGOs) have taken part in this achievement; however, they have done so with varying success. In 2013, researchers from the University of Chicago, accompanied by local partners, visited seven villages in the Ashanti Region in which a Ghanaian NGO had installed boreholes for drinking water access. Household and leader questionnaires were administered to examine the impact of the project on each community. Four additional villages, which utilize surface water, were visited to establish baseline health and sanitation characteristics. Water samples were collected from primary drinking water sources and tested for coliforms. Two out of seven NGO wells were non-functional and over 35% of respondents cited broken pipes as common problems. Nonetheless, over 60% of respondents reported that a borehole had reduced their water collection time by a median of 30 minutes daily. Coliform counts were lower in samples taken from boreholes relative to samples taken from communities using surface water. Finally, we found redundant water services in many communities and no formalized approach to borehole maintenance.

Primary Drinking Water Source and Acute Gastrointestinal Illness: New Mexico, 2007

The objectives of this study are to characterize New Mexico residents’ primary drinking water sources, consumption, and filter use by demographic characteristics, and to compare the 30-day prevalence of self-reported acute gastrointestinal illness (AGI) by water sources. We analyzed data on 6,600 adults surveyed in the 2007 New Mexico Behavioral Risk Factor Surveillance System. We estimated population frequencies and evaluated associations using chi-square tests and weighted multivariable logistic regression modeling. Over half (55 %) of individuals used public water as their primary drinking water source, 18 % used private wells, and 27 % used bottled water. Overall, 43 % of residents said they filtered their home tap water, which did not differ significantly by source. Compared to public water users, private well users had key demographic differences, including age, marital status, race, and education. The overall 30-day prevalence of AGI was 15 %. In models adjusted for demographic characteristics and health status indicators, individuals using well water had a non-significantly decreased odds of reporting AGI and seeking medical attention for AGI (odds ratio (OR) 0.83, 95 % CI 0.65–1.06 and OR 0.85, 95 % CI 0.41–1.80). This baseline measure suggests private well users are not uniformly distributed throughout the New Mexico population. This information is useful when planning educational outreach to targeted populations. Our cross-sectional analyses did not reveal significant associations between primary drinking water source and AGI. Future epidemiologic studies including children and measuring the duration of exposure and water quality are needed to fully understand the health impacts of drinking untreated or undertreated water.

Randomized Controlled Trials of Community Based Arsenic Interventions to Reduce Arsenic Exposure in Bangladesh

Background: Millions of villagers in Bangladesh drink water which exceeds the Bangladesh Arsenic (As) standard of 50 micrograms per liter. Exposure to elevated levels of inorganic As is associated with cancers of the skin, bladder, and lung, developmental effects, cardiovascular disease, and skin lesions. As mitigation typically involves testing the well water without providing resources to address health concerns or give advice on mitigation options. We sought to evaluate community level intervention strategies for As mitigation in Bangladesh. Method: We conducted two randomized controlled trials (RCT) in Singair and Shibalaya, Bangladesh. In the first cluster of 1000 households, we evaluated the effectiveness of having community members versus outside representatives disseminate As education and conduct water As testing using urinary As at baseline and follow-up. In the second cluster RCT of 450 households, we evaluated the effectiveness of community and household level As educational interventions on increasing the adoption of a fee-based As testing program. Our primary outcome in this RCT was a household purchasing As test for their primary drinking water source. Results: In the first RCT, we found that overall 53% of respondent using As contaminated wells (&gt;50?g/L), at baseline switched after receiving the intervention. When we stratified by those residing in a village where less than 60% of wells in use were As unsafe, UNICEF cutoff for well switching as a mitigation option, 74% of study households in the community tester villages, and 72% of households in the outside tester villages reported switching to an As safe drinking water source. These results were confirmed by a 30% reduction in urinary As between baseline and follow-up for those who reported switching to safe wells (p&lt;0.0001). In the RCT of the fee-based As testing program, we found that 93% of households that received the community and household level As interventions purchased an As test, in comparison to only 53% in the control group. Finding: These low cost easily to implement community based arsenic educational interventions were effective in reducing arsenic exposure and promoting the use of a fee-based arsenic testing program in communities in rural Bangladesh.

Groundwater arsenic in Chimaltenango, Guatemala.

In the Municipality of Chimaltenango, Guatemala, we sampled groundwater for total inorganic arsenic. In total, 42 samples were collected from 27 (43.5%) of the 62 wells in the municipality, with sites chosen to achieve spatial representation throughout the municipality. Samples were collected from household faucets used for drinking water, and sent to the USA for analysis. The only site found to have a concentration above the 10 μg/L World Health Organization provisional guideline for arsenic in drinking water was Cerro Alto, where the average concentration was 47.5 μg/L. A health risk assessment based on the arsenic levels found in Cerro Alto showed an increase in noncarcinogenic and carcinogenic risks for residents as a result of consuming groundwater as their primary drinking water source. Using data from the US Geological Survey and our global positioning system data of the sample locations, we found Cerro Alto to be the only site sampled within the tertiary volcanic rock layer, a known source of naturally occurring arsenic. Recommendations were made to reduce the levels of arsenic found in the community's drinking water so that the health risks can be managed.

Drinking Water in Transition: A Multilevel Cross-sectional Analysis of Sachet Water Consumption in Accra

Rapid population growth in developing cities often outpaces improvements to drinking water supplies, and sub-Saharan Africa as a region has the highest percentage of urban population without piped water access, a figure that continues to grow. Accra, Ghana, implements a rationing system to distribute limited piped water resources within the city, and privately-vended sachet water–sealed single-use plastic sleeves–has filled an important gap in urban drinking water security. This study utilizes household survey data from 2,814 Ghanaian women to analyze the sociodemographic characteristics of those who resort to sachet water as their primary drinking water source. In multilevel analysis, sachet use is statistically significantly associated with lower overall self-reported health, younger age, and living in a lower-class enumeration area. Sachet use is marginally associated with more days of neighborhood water rationing, and significantly associated with the proportion of vegetated land cover. Cross-level interactions between rationing and proxies for poverty are not associated with sachet consumption after adjusting for individual-level sociodemographic, socioeconomic, health, and environmental factors. These findings are generally consistent with two other recent analyses of sachet water in Accra and may indicate a recent transition of sachet consumption from higher to lower socioeconomic classes. Overall, the allure of sachet water displays substantial heterogeneity in Accra and will be an important consideration in planning for future drinking water demand throughout West Africa.

Biological and behavioral factors modify biomarkers of arsenic exposure in a U.S. population

Although consumption of drinking water contaminated with inorganic arsenic is usually considered the primary exposure route, aggregate exposure to arsenic depends on direct consumption of water, use of water in food preparation, and the presence in arsenicals in foods. To gain insight into the effects of biological and behavioral factors on arsenic exposure, we determined arsenic concentrations in urine and toenails in a U.S. population that uses public or private water supplies containing inorganic arsenic. Study participants were 904 adult residents of Churchill County, Nevada, whose home tap water supplies contained <3 to about 1200µg of arsenic per liter. Biomarkers of exposure for this study were summed urinary concentrations of inorganic arsenic and its methylated metabolites (speciated arsenical), of all urinary arsenicals (total arsenical), and of all toenail arsenicals (total arsenical). Increased tap water arsenic concentration and consumption were associated with significant upward trends for urinary speciated and total and toenail total arsenical concentrations. Significant gender differences in concentrations of speciated and total arsenicals in urine and toenails reflected male-female difference in water intake. Both recent and higher habitual seafood consumption significantly increased urinary total but not speciated arsenical concentration. In a stepwise general linear model, seafood consumption significantly predicted urinary total arsenical but not urinary speciated or toenail total arsenical concentrations. Smoking behavior significantly predicted urinary speciated or total arsenical concentration. Gender, tap water arsenic concentration, and primary drinking water source significantly predicted urinary speciated and total concentrations and toenail total arsenical concentrations. These findings confirm the primacy of home tap water as a determinant of arsenic concentration in urine and toenails. However, biological and behavioral factors can modify exposure–response relations for these biomarkers. Refining estimates of the influence of these factors will permit better models of dose–response relations for this important environmental contaminant.

Polycyclic aromatic hydrocarbons in water, sediment and soil of the Songhua River Basin, China

The Songhua River is the third largest river in China and the primary source of drinking and irrigation water for northeastern China. The distribution of 16 priority polycyclic aromatic hydrocarbons (PAHs) in water [dissolved water (DW) and suspended particulate matter (SPM)], sediment, and soil in the river basin was investigated, and the associated risk of cancer from these PAHs was also assessed. The total concentration of PAHs ranged from 13.9 to 161ngL(-1) in DW, 9.21 to 83.1ngL(-1) in SPM, 20.5 to 632ngg(-1) dw (dry weight) in sediment, and from 30.1 to 870ngg(-1) dw in soil. The compositional pattern of PAHs indicated that three-ring PAHs were predominant in DW and SPM samples, while four-ring PAHs dominated in sediment and soil samples. The spatial distribution of PAHs revealed some site-specific sources along the river, with principal component analysis indicating that these were from pyrogenic sources (such as coal and biomass combustion, and vehicle emissions) and coke oven emission distinguished as the main source of PAHs in the Songhua River Basin. Based on the ingestion of PAH-contaminated drinking water from the Songhua River, cancer risk was quantitatively estimated by combining the Incremental Lifetime Cancer Risk assessment model and BaP-equivalent concentration for five age groups of people (adults, teenagers, children, toddlers, and infants). Overall, the results suggest that the estimated integrated lifetime cancer risk for all groups was in acceptable levels. This study is the first attempt to provide information on the cancer risk of PAHs in drinking water from the Songhua River.

Improved but unsustainable: accounting for sachet water in post‐2015 goals for global safe water

The advent and rapid spread of sachet drinking water in West Africa presents a new challenge for providing sustainable access to global safe water. Sachet water has expanded drinking water access and is often of sufficient quality to serve as an improved water source for Millennium Development Goals (MDG) monitoring purposes, yet sachets are an unsustainable water delivery vehicle due to their overwhelming plastic waste burden. Monitoring of primary drinking water sources in West Africa generally ignores sachet water, despite its growing ubiquity. Sub-Saharan Africa as a region is unlikely to meet the MDG Target for drinking water provision, and post-2015 monitoring activities may depend upon rapid adaptability to local drinking water trends.

When urban taps run dry: Sachet water consumption and health effects in low income neighborhoods of Accra, Ghana

Intraurban differentials in safe drinking water in developing cities have been exacerbated by rapid population growth that exceeds expansion of local water infrastructure. In Accra, Ghana, municipal water is rationed to meet demand, and the gap in water services is increasingly being filled by private water vendors selling packaged “sachet” water. Sachets extend drinking water coverage deeper into low-income areas and alleviate the need for safe water storage, potentially introducing a health benefit over stored tap water. We explore correlates of using sachets as the primary drinking water source for 2093 women in 37 census areas classified as slums by UN-Habitat, and links between sachet water and reported diarrhea episodes in a subset of 810 children under five. We find that neighborhood rationing exerts a strong effect on a household's likelihood of buying sachet water, and that sachet customers tend to be the poorest of the poor. Sachet use is also associated with higher levels of self-reported overall health in women, and lower likelihood of diarrhea in children. We conclude with implications for sachet regulation in Accra and other sub-Saharan cities facing drinking water shortages.

Arsenic-contaminated cold-spring water in mountainous areas of Hui County, Northwest China: A new source of arsenic exposure

Although pump-well is the primary drinking water source in rural areas of China, there are still 8.4% of villages reliant on cold-spring. In this study, a survey of arsenic concentration in cold-springs and pump-wells was carried out in Hui County, Northwest China. A total of 352 drinking water samples, including 177 cold-springs and 175 pump-wells, were collected. The maximum arsenic concentrations in cold-springs and pump-wells were 0.482mg/L and 0.067mg/L, respectively. We found that 15.8% (28) of total cold-springs and 1.1% (2) of total pump-wells had arsenic concentrations exceeding the maximum allowable concentration of arsenic in drinking water of rural China (0.05mg/L). Our findings show that 5 cold spring-contaminated villages are located in the mountainous areas of Hui County and 2224 inhabitants may be at risk of high arsenic exposure. This paper indicates that arsenic contamination of cold-springs may be more serious than expected in mountainous areas of Northwest China and extensive surveys and epidemiological studies should be carried out to investigate the potential contaminated areas and affected population.

Bottled Water: United States Consumers and Their Perceptions of Water Quality

Consumption of bottled water is increasing worldwide. Prior research shows many consumers believe bottled water is convenient and has better taste than tap water, despite reports of a number of water quality incidents with bottled water. The authors explore the demographic and social factors associated with bottled water users in the U.S. and the relationship between bottled water use and perceptions of the quality of local water supply. They find that U.S. consumers are more likely to report bottled water as their primary drinking water source when they perceive that drinking water is not safe. Furthermore, those who give lower ratings to the quality of their ground water are more likely to regularly purchase bottle water for drinking and use bottle water as their primary drinking water source.

Arsenic in South Asia Groundwater

AbstractWithin the deltas of South Asia, widespread consumption of groundwater containing dangerous levels of arsenic adversely impacts tens of millions of people in Bangladesh, West Bengal, India, Cambodia, Vietnam, and Myanmar. This massive health crisis is the product of a confluence of processes initiated by the erosion of arsenic‐bearing minerals in the Himalaya, transport of sediments containing arsenic‐bearing iron oxides down the Brahmaputra–Ganges, Mekong, Irrawaddy and Red river systems, and deposition as deltaic sediments. Upon burial, dissolution of these arsenic‐bearing iron‐oxide minerals is triggered by reaction with organic carbon, releasing arsenic to the aquifer and producing aqueous concentrations that can exceed 1000 μg/L, 100 times the World Health Organization drinking water standard. These waters are the primary drinking water source for the majority of the people living in these low‐lying regions of Asia. Although groundwater contamination has likely persisted for millennia on the Asian deltas, consumption of these waters became widespread in the 1970s as groundwater was tapped to avoid water‐borne diseases in surface water bodies. Groundwater pumping for irrigation and other land use changes, including widespread rice cultivation, are now impacting the distribution of arsenic in (presently) unpredictable ways. Further, irrigation with arsenic‐rich waters is decreasing rice yields and providing an additional pathway of human exposure. In general, deeper groundwater contains low levels of arsenic. Efforts must continue to focus on protecting this resource for human consumption.

Pollution implications of Save River water from weathering and dissolution of metal hosting minerals at Dorowa phosphate mine, Zimbabwe

The study set out to determine the weathering and dissolution of metal hosting minerals at Dorowa for purposes of deducing pollution potential to the nearby Save River. Phosphate rock is mined at Dorowa for the production of phosphate fertilizer. The major minerals found in the ring complex are feldspars, pyroxenes, apatite, magnetite and calcite. Chemical analysis established that the rocks are associated with metals that include copper, lead, zinc, cobalt, nickel, tin and cadmium. Among the many minerals present apatite and calcite host metals more than the other minerals due to their crystal structure. This study investigated the weathering and dissolution of these two minerals. Both apatite and calcite dissolve in natural environmental conditions prevalent at Dorowa. From the analysis the study concludes that the potential availability of metals trapped in the calcite and apatite structures is high. The understanding of weathering and dissolution of metal hosting minerals is important in predicting quality of water around the study area, because most villagers use the Save River as their primary drinking water source.

Microbial and metal water quality in rain catchments compared with traditional drinking water sources in the East Sepik Province, Papua New Guinea

In Papua New Guinea, a significant portion of morbidity and mortality is attributed to water-borne diseases. To reduce incidence of disease, communities and non-governmental organizations have installed rain catchments to provide drinking water of improved quality. However, little work has been done to determine whether these rain catchments provide drinking water of better quality than traditional drinking water sources, and if morbidity is decreased in villages with rain catchments. The specific aim of this study was to evaluate the quality of water produced by rain catchments in comparison with traditional drinking water sources in rural villages in the East Sepik Province. Fifty-four water sources in 22 villages were evaluated for enterococci and Escherichia coli densities as well as 14 health-relevant metals. In addition, we examined how the prevalence of diarrhoeal illness in villages relates to the type of primary drinking water source. The majority of tested metals were below World Health Organization safety limits. Catchment water sources had lower enterococci and E. coli than other water sources. Individuals in villages using Sepik River water as their primary water source had significantly higher incidence of diarrhoea than those primarily using other water sources (streams, dug wells and catchments).

Arsenic in groundwater in New England — point-of-entry and point-of-use treatment of private wells

Arsenic in drinking water is a factor that has recently been shown to be a possible cause for an elevated bladder cancer risk in northern New England. More than 40% of the population in this region uses private wells as the primary drinking water source. Point-of-entry (POE) and point-of-use (POU) arsenic removal systems can be an attractive and effective way for a well owner to treat the water to reduce the arsenic level to below the US EPA maximum contaminant level (MCL) of 10 μg/L (10 ppb). A study based on data collected from customers in eastern New England and New Jersey has been conducted to identify areas with elevated arsenic concentrations and to assess the performance of installed POE and POU devices based on arsenic adsorption on hybrid hydrous iron oxide/polymer media. The first of these arsenic treatment systems became operational in November 2005 and as of August 26, 2007, a total of 275 systems has been installed. The raw water from all the systems was sampled at startup and 62 have since been re-sampled. Of the tested waters, 77% had arsenic concentrations less than 50 ppb which was the US EPA MCL for arsenic until January 2006. At this level, the lead column of the POE system would be expected to last for a minimum of 1.5 years in most waters before replacement is required. However, the actual life of the media column will depend upon the volume of processed water and the water chemistry (arsenic speciation, silica, phosphate and pH). To date, the collected data seem to fall into areas that have been identified by the US Geological Survey for the New England region and the New Jersey Geological Survey in New Jersey as having high arsenic concentrations in the groundwater. Periodic arsenic analyses of the customer waters have shown that the POE and POU systems operate as predicted and meet the needs of the customers in terms of arsenic removal and ease of operation. Only 10 systems have required replacement of the exhausted lead column since becoming operational, which is 4.2% of all installed devices. This means that even in challenging conditions the lead column effectively operates for an average of 10–12 months.

Sustained use of a household-scale water filtration device in rural Cambodia

The effectiveness of point-of-use water treatment may be limited by declining use over time, particularly when water treatment is introduced via targeted intervention programmes. In order to evaluate the long-term uptake and use of locally produced ceramic water filters in rural Cambodia, we visited households that had received filters as part of NGO-subsidized distribution programmes over a 4 year period from 2002 to 2006. Of the more than 2,000 filters distributed, we visited 506 randomly selected households in 13 villages spanning three provinces to assess filter time in use and to collect data on factors potentially correlated with long-term use. Results indicate that filter use declined at the rate of approximately 2% per month after implementation, largely owing to breakages, and that, controlling for time since implementation, continued filter use over time was most closely positively associated with: related water, sanitation and hygiene practices in the home; cash investment in the technology by the household; and use of surface water as a primary drinking water source.

Review of submarine groundwater discharge (SGD) in coastal zones of the Southeast and Gulf Coast regions of the United States with management implications

Groundwater serves as the primary drinking water source for over half of the coastal populations of the Southeast and Gulf Coast regions, two of the fastest growing regions in the United States. Increased demand for this resource has exceeded sustainable yields in many areas and induced saltwater intrusion of coastal aquifers. A process associated with coastal groundwater, submarine groundwater discharge (SGD), has been documented as a source of subsurface fluids to coastal ocean environments throughout the Southeast and Gulf Coast regions and is potentially a significant contributor to nearshore water and geochemical budgets (i.e., nutrients, carbon, trace metals) in many coastal regions. The importance of groundwater as a drinking water source for coastal populations and the influences of submarine groundwater discharge to the coastal ocean warrant increased research and management of this resource. This paper highlights findings from recent SGD studies on three hydrogeologically different continental margins (Onslow Bay, NC, southern Florida, and the Louisiana margin), provides background on the common methods of assessing SGD, and suggests a regional management plan for coastal groundwater resources. Suggested strategies call for assessments of SGD in areas of potentially significant discharge, development of new monitoring networks, and the incorporation of a regional coastal groundwater resources council.

Epidemiology and risk factors for endemic typhoid fever in Uzbekistan

To investigate the risk factors for infection with endemic typhoid fever in the Samarkand region of Uzbekistan. Case-control study of culture-confirmed bloodstream infection with Salmonella Typhi. Patients were compared to age-matched community controls. Salmonella Typhi isolates were tested for antimicrobial susceptibility. We enrolled 97 patients and 192 controls. The median age of patients was 19 years. In a conditional regression model, consumption of unboiled surface water outside the home [adjusted odds ratio (aOR)=3.0, 95% confidence interval (CI)=1.1-8.2], use of antimicrobials in the 2 weeks preceding onset of symptoms (aOR=12.2, 95% CI 4.0-37.0), and being a student (aOR=4.0, 95% CI 1.4-11.3) were independently associated with typhoid fever. Routinely washing vegetables (aOR 0.06, 95% CI 0.02-0.2) and dining at a tea-house (aOR 0.4, 95% CI 0.2-1.0) were associated with protection against illness. Salmonella Typhi resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole was identified in 6 (15%) of 41 isolates tested. Endemic typhoid fever in Uzbekistan is transmitted by contaminated water. Recent use of antimicrobials also increased risk of infection. Targeted efforts at improving drinking water quality, especially for students and young adults, are likely to decrease transmission of typhoid fever. Measures to decrease the unnecessary use of antimicrobials would be expected to reduce the risk of typhoid fever and decrease the spread of multiple drug-resistant Salmonella Typhi.