Water hygiene

Water consumption and availability, sources of potable water, water

treatment, water contaminants, mineral water, recreational water use,
sewage treatment
Definition of water hygiene
• Water hygiene focuses on
natural and anthropogenic
pollutants (from soil and
through air precipitation,
chemicals, waste, sewage)
present in water, affecting
human health.
Importance of safe water
• Annually, safer water could prevent:
• 1.4 million child deaths from diarrhea;
• 500 000 deaths from malaria;
• 860 000 child deaths from malnutrition; and
• 280 000 deaths from drowning.
• In addition, 5 million people can be protected from being seriously
incapacitated from lymphatic filariasis and another 5 million from
trachoma.
Mortality and burden of disease from water
and sanitation
• http://www.who.int/gho/phe/water_sanitation/burden/en/
How to decrease the burden?
• Providing leadership in Water, Sanitation, and Hygiene related issues (by making
authoritative statements, influencing policy and coordinating networks of
partners and collaborating centers)
• Normative work (mainly on water quality, but also on monitoring approaches and
interventions, usually resulting in guidelines and best practice texts)
• Providing evidence (through various monitoring activities, but also through
commissioned research)
• Supporting Member States (through technical cooperation and capacity building)
• Responding to emergencies (the role in the Health Cluster - WASH in healthcare -
and in the WASH cluster - restoring safe water supplies and adequate sanitation)
• Knowledge management (through analysis, synthesis and dissemination of
reliable and credible information)
Water consumption and
availability
Available water, industrial and domestic water consumption
Distribution of Earth’s water
Fresh water
• Only 2.5% of the Earth's water
is fresh water.
• Water is not an innate matter,
through the water cycle, it is
present not only on the Earth’s
surface but in the air as well.
This explains the many effects
of water pollution on human
health and environment.
Water consumption worldwide
• Worldwide, 70% of all
water consumption is
used in agriculture,
20% for the industry
and only 10% for
domestic use.
• In the developed,
industrialized
countries, almost half
of water consumption
is used for industrial
purposes.
• Belgium, for example,
uses 80% of the water
available for industry.
Increasing water demand
• Demand for freshwater is Food industry
Other
5%

increasing by 64 billion cubic 7%

meters a year Petroleum and coal

industry
Paper industry
8%
38%

• Almost 80% of diseases in so Chemical industry

called "developing" countries are 9%

associated with water, causing

around three million early deaths.
For example, 5,000 children die Metal industry

every day from diarrhea. 33%

Water consumption in industry

Water consumption of an individual
• Physiological water demand:
• 2-3 liter/capita/day (depending on
temperature, wind, relative moisture,
work intensity, physical activity)
• Domestic daily consumption
(direct):
• Drinking 2-3 l/capita/day,
• Cooking 4-5 l/capita/day,
• Cleaning 8-15 l/capita/day,
• Washing (dishes, clothes) 30-40
l/day/capita,
• Personal hygiene (including the use of
toilette) 50-180 l/capita/day.
Fun fact
• Water is used to produce
very different products. For
instance, if we take in
consideration the total
indirect water consumption
for the production of a
single hamburger (salad,
meat, bun), we would need
2400 l of water in all to
produce it.
Availability of water
• More than 1.5
billion people lack
access to clean,
healthy water
already.
• More than 1 billion
people have to
travel at least 3
hours to reach a
clean water
source.
Alarming
trends
Sources of potable water
Bank filtration and ground water
Source of water
Source of potable water
• Drinking water may come from
surface water and ground water.
• Large-scale water supply systems
tend to rely on surface water
resources, and smaller water
systems tend to use ground water.
• Slightly more than half of the US
population receives its drinking
water from ground water sources.
This figure may vary greatly
depending on the country’s
characteristic.
Surface water
• Surface water includes
rivers, lakes, and reservoirs.
• In Hungary 44% of drinking
water is extracted from
surface water.
• In this case the river bed
acts as a filterer itself, so it
is considered safe. Of
course, water must be
treated afterwards.
Ground water
• Ground water is pumped from wells
that are drilled into aquifers.
Aquifers are geologic formations that
contain water.
• Depending on the components of
the soil, confined aquifers can be
contaminated with certain naturally
present substances (e.g. Arsenic, see
below) that are harmful to human
health.
• 35% of Hungary’s water supply
comes from confined aquifers.
Unconfined aquafiers
• Unconfined (meaning above a
confining bed, near the surface)
aquifers are potentially
dangerous because of the high
risk of industrial, domestic and
agricultural contamination.
Water treatment
Quality requirements, water treatment plant, microbiological examination
Quality requirements of drinking water
• Free of harmful chemical and biological
agents
• Contains minerals
• Cool, refreshing, temperature around 12°C
• Clean, odorless, tasteless
• Cheap, accessible in large amounts
How a water treatment plant works
Steps of water treatment may include:
• Pre-chlorination: for algae control and arresting any biological growth
• Aeration: along with pre-chlorination for removal of dissolved iron and
manganese
• Coagulation: for flocculation (floc)
• Coagulant aids to improve coagulation and for thicker floc formation
• Sedimentation: for solids separation, that is removal of suspended solids
trapped in the floc
• Filtration: removing particles from water
• Desalination: Process of removing salt from the water
• Disinfection
Safety measures
• A very important aspect is to preserve the quality of water during
extraction, within the pipes, and until it reaches the homes.
• Water samples are taken regularly at water extraction facilities. The
frequency depends on the water extraction rate. The more drinking water
is produced, the more samples are taken. In larger facilities this may mean
several times during the day.
• The area of these facilities is protected as well, as a precaution. For
example, the immediate surroundings of these facilities cannot be used for
agriculture or waste disposal.
• Within the pipes, quality can be maintained by the upkeep of high pressure
all along the way.
Microbiological examination of water
• Total bacterial count to measure quality of water: it means total
number of bacteria in 1 ml water (incubated at 22 oC and 37 oC for 24
hours).
• Typically three indicator bacteria are chosen:
• Coliforms,
• Escherichia coli (E. coli) and
• Pseudomonas aeruginosa.
Coliform bacteria
• Coliform bacteria are common in the
environment and are generally not harmful.
However, the presence of these bacteria in
drinking water is usually a result of a problem
with the treatment system or the pipes which
distribute water, and indicates that the water
may be contaminated with germs that can
cause disease.
• Fecal Coliform and E. coli are bacteria the
presence of which indicates that the water
may be contaminated with human or animal
wastes.
Water contaminants
Chemical, biological, physical contaminants
Most important water contaminants
• Chemical
1. Mercury
2. Cadmium
3. Lead
4. Arsenic
5. Fluoride
6. Artificial fertilizer
• Physical
7. Thermal pollution
8. Radioactive pollution
• Biological
9. Infectious diseases linked to water
1. Mercury (Minamata disease)
• Minamata disease is a neurological
syndrome caused by severe mercury
poisoning.
• Symptoms include ataxia, numbness in the
hands and feet, general muscle weakness,
narrowing of the field of vision, and
damage to hearing and speech. In
extreme cases, insanity, paralysis, coma,
and death follow within weeks of the
onset of symptoms.
• A congenital form of the disease can also
affect fetuses in the womb.
Minamata disease
• The disease was first discovered in Minamata city in Kumamoto prefecture,
Japan, in 1956.
• It was caused by the release of methylmercury in the industrial wastewater
from the Chisso Corporation's chemical factory, which continued from 1932
to 1968.
• This highly toxic chemical bioaccumulated in shellfish and fish in Minamata
Bay and the Shiranui Sea, which, when eaten by the local population,
resulted in mercury poisoning.
• As of March 2001, 2,265 victims had been officially recognized (1,784 had
died) and over 10,000 had received financial compensation from Chisso. By
2004, Chisso Corporation had paid $86 million in compensation, and in the
same year was ordered to clean up its contamination.
Transformation of mercury
2. Cadmium (Itai-itai disease)
• Itai-itai disease was the documented
case of mass cadmium poisoning in
Toyama Prefecture, Japan, starting
around 1912.
• The cadmium poisoning caused
softening of the bones and kidney
failure.
• The disease is named for the severe
pains (itai=pain) caused in the joints and
spine.
Itai-Itai disease
• The disease was caused by cadmium poisoning due to mining in
Toyama Prefecture that continuously polluted the rivers of the region.
• The river was used mainly for irrigation of rice fields, but also for
drinking water, washing, fishing, and other uses by downstream
populations.
• The cadmium and other heavy metals accumulated at the bottom of
the river and in the water of the river. This water was then used to
irrigate the rice fields.
• The rice absorbed heavy metals, especially the cadmium. The
cadmium accumulated in the people eating contaminated rice.
3. Lead
• Lead, a metal found in natural deposits, is commonly used in
household plumbing materials and water service lines.
• Homes built before 1986 are more likely to have lead pipes, fixtures
and solder.
• At a young age exposure to lead in drinking water above the action
level can result in delays in physical and mental development, along
with slight deficits in attention span and learning abilities.
• In adults, it can cause increases in blood pressure. Adults who drink
this water over many years could develop kidney problems or high
blood pressure.
4. Arsenic (Black foot disease)
• Arsenic is a semi-metal element in the periodic table. It enters drinking
water supplies from natural deposits in the earth OR from agricultural and
industrial practices.
• Natural arsenic contamination is a cause for concern in many countries of
the world including Argentina, Bangladesh, Chile, China, India, Mexico,
Thailand, Hungary and the United States of America.
• A 2007 study found that over 137 million people in more than 70 countries
are probably affected by arsenic poisoning of drinking water.
• Consuming water contaminated by arsenic can cause skin and bladder
cancer, as well as cardiovascular disease.
• WHO's Guideline Value for arsenic in drinking water is 0.01 mg /liter.
Arsenic
contami-
nation
Black foot disease
• Arsenicosis is the effect of arsenic
poisoning, usually over a long period such
as from 5 to 20 years.
• Drinking arsenic-rich water over a long
period results in various health effects
including skin problems (such as color
changes on the skin, and hard patches on
the palms and soles of the feet), skin
cancer, cancers of the bladder, kidney and
lung, and diseases of the blood vessels of
the legs and feet, and possibly also
diabetes, high blood pressure and
reproductive disorders.
5. Fluoride
• The amount of fluoride in drinking water is regulated. Fluoride may
cause health problems if present in public or private water supplies in
amounts greater than the drinking water standard set.
• Exposure to excessive consumption of fluoride over a lifetime may
lead to increased likelihood of
• Bone fractures in adults, and may result in effects on bone leading to pain and
tenderness.
• Children aged 8 years and younger exposed to excessive amounts of fluoride
have an increased chance of developing pits in the tooth enamel, along with a
range of cosmetic effects to teeth.
Fluoride supplementation in water
• In certain countries, communities choose to adjust the fluoride
concentration in the water supply to a level beneficial to reduce tooth
decay and promote good oral health.
• Water is just one of several sources of fluoride. Other sources include
dental products such as toothpaste and mouth rinses, prescription
fluoride supplements, and professionally applied fluoride products
such as varnish and gels.
• Recognizing that it is now possible to receive enough fluoride with
slightly lower or zero levels of fluoride in water, new
recommendations for community water fluoridation are being
developed.
6. Artificial fertilizers
• Fertilizer is any material of
natural or synthetic origin
(other than liming materials)
that is applied to soils or to
plant tissues (usually leaves)
to supply one or more plant
nutrients essential to the
growth of plants.
• They contain three main
macronutrients: nitrogen (N),
phosphorus (P), potassium (K).
Blue Baby syndrome (methaemoglobinemia)
• In the body nitrates are converted to nitrites. The nitrites react with
haemoglobin in the red blood cells to form methaemoglobin,
affecting the blood's ability to carry enough oxygen to the cells of the
body.
• The most common cause of methaemoglobinemia is high levels of
nitrates in drinking water and certain vegetables.
• Intense farming practice may increase this to more than 50 mg/liter.
Levels greater than 50mg/liter are known to have been associated
with methaemoglobinemia in bottle fed infants (Blue Baby
syndrome).
Blue Baby syndrome
• Bottle-fed infants less than three
months of age are particularly at risk,
adults are not.
• This is due to the following reasons:
• Fetal hemoglobin shows higher affinity to
with nitrites than adult Hg.
• Due to the different bacterial composition
of the infant GI tract, the transformation
of nitrates to nitrites is much higher at
early age.
• The immature kidney of a newborn shows
decreased clearance of these substances.
7. Thermal pollution of water
• Thermal pollution is the rise or fall in the temperature of a natural
body of water caused by human influence. Thermal pollution, unlike
chemical pollution, results in a change in the physical properties of
water.
• A common cause of thermal pollution is the use of water as a coolant
by power plants and industrial manufacturers.
• Elevated water temperatures decreases oxygen levels, which can kill
fish, and can alter food chain composition, reduce species
biodiversity, and promote invasion by new thermophilic species.
8. Radioactive pollution in water
• Deposition of nuclear wastes
• Scientists studying the
movement of groundwater have
found that radioactive
contaminants can migrate over
long distances faster than
originally thought.
• Mining
• Nuclear power plants
• Health care
9. Infectious diseases linked to water
• Water-borne: oral-fecal diseases transmitted through ingestion of contaminated
water (cholera, typhoid fever, amoebiasis)
• Water-washed: usually oral-fecal or contact diseases resulting from inadequate
personal hygiene due to lack of water (salmonellosis, typhoid fever, trachoma,
amoebiasis, hepatitis A and E… etc.)
• Water-based: the pathogen spends a part of its life-cycle in water and infection
occurs through ingestion or contact (schistosomiasis, dracunculiasis)
• Water-related vector-borne: the life-cycle of a primary arthropod vector of the
pathogen is connected to water (malaria, dengue, filariasis, yellow fever)
• Water-dispersed: pathogen lives and reproduces in water and transmission
occurs by dispersion of contaminated water droplets into the air and subsequent
inhalation (legionellosis).
Patterns of water based epidemics
• The area of the epidemic
coincide with the area of a
given water supply.
• Suddenly, large number of
cases.
• The causative agent can be
detected in water.
• Sudden drop of the number
of cases after the polluted
source is shut off.
Epidemic in Miskolc 2006
• Source of water was karst
water.
• Due to episodes of heavy
raining the amount of karst
water increased.
• Self-cleansing potential was
not enough
• Contaminated water entered
the system causing an
epidemic
Mineral water
Legislation and consumption
Legislation
• In the European Union, bottled water may be called mineral water
when it is bottled at the source and has undergone no or minimal
treatment.
• Permitted is the removal of iron, manganese, sulfur and arsenic through
decantation, filtration or treatment with ozone-enriched air, in so far as this
treatment does not alter the composition of the water as regards the
essential constituents which give it its properties.
• No additions are permitted except for carbon dioxide, which may be added,
removed or re-introduced by exclusively physical methods.
• No disinfection treatment is permitted, nor is the addition of any
bacteriostatic agents.
Bottled water
consumption
Recreational water use
Linked activities, adverse health outcomes, prevention
Recreational activities linked to water
• Swimming
• Rafting, canoeing
• Waterskiing, jet skiing,
windsurfing
• Use of inland waterways for
boating
• Recreational use of drinking-
water reservoirs
• Dog-walking and horse-riding
Adverse heath outcomes linked to
recreational water use
• Drowning and injury prevention
• Sun, heat and cold
• Fecal pollution
• Microbial aspects of beach sand
quality
• Algae and cyanobacteria in water
• Chemical and physical agent
• Dangerous aquatic organisms
Relative
severity
Prevention of
principal hazards
Balneotherapy
Indications and contraindications
Balneotherapy
• The term "balneotherapy" is generally applied to everything relating to spa
treatment, including the drinking of waters and the use of hot baths and
natural vapor baths, as well as of the various kinds of mud and sand used
for hot applications.
• Balneotherapy refers to the medical use of these spas, as opposed to
recreational use.
• Common minerals found in spa waters are sodium, magnesium, calcium,
and iron, as well as arsenic, lithium, potassium, manganese, bromine, and
iodine.
• All these may be contained in the peat that is commonly used in
preparation of spa waters.
• Resorts may also add minerals or essential oils to naturally-occurring hot
springs.
Balneotherapy indication
• The major dermatologic and
musculoskeletal diseases that are
frequently treated by balneotherapy with
a remarkable rate of success are:
• atopic dermatitis,
• psoriasis,
• rheumatoid arthritis (RA),
• ankylosing spondylitis,
• osteoarthritis,
• low back pain.
Contraindications of balneotherapy
• Fever
• Active tuberculosis
• Active infectious disease
• Active/acute inflammation
• Hemodynamic instability
• Pregnancy and lactation
• Patients without rehabilitation potential, suffering from
• Internal organs diseases in the stage of decompensation
• Cancers and cancer conditions after operations
• Epilepsy
• Mental disorders
• Vascular diseases – phlebothrombosis, active thrombophlebitis, etc.
• Pacemaker implants
• Unstable hypertension
Evidence-based hydro- and balneotherapy in
Hungary: a systematic review and meta-analysis
• http://www.ncbi.nlm.nih.gov/pubmed/23677421
Sewage treatment
Primary, secondary, tertiary treatment, sludge disposal
Sewage
treatment
schematically
Sewage treatment
• Sewage treatment is the process of removing contaminants from
wastewater and household sewage, both run-off (effluents),
domestic, commercial and institutional. Sewage is generated by
• residential (household waste liquid from toilets, baths, showers, kitchens,
sinks and so forth that is disposed of via sewers)
• institutional, commercial and industrial establishments (includes liquid waste
from industry and commerce)
• Sewage treatment generally involves three stages called primary,
secondary and tertiary treatment.
The
distribution
of
wastewater
treatment
methods in
Europe
Primary and secondary treatment
• Primary treatment consists of temporarily holding the sewage in a
basin where heavy solids can settle to the bottom while oil, grease
and lighter solids float to the surface. The settled and floating
materials are removed and the remaining liquid may be discharged or
subjected to secondary treatment.
• Secondary treatment removes dissolved and suspended biological
matter. Secondary treatment is typically performed by indigenous,
water-borne microorganisms in a managed habitat. Secondary
treatment may require a separation process to remove the
microorganisms from the treated water prior to discharge or tertiary
treatment.
Tertiary treatment
• Tertiary treatment is sometimes defined as anything more than
primary and secondary treatment in order to allow rejection into a
highly sensitive or fragile ecosystem (estuaries, low-flow rivers, and
coral reefs).
• Treated water is sometimes disinfected chemically or physically (for
example, by lagoons and microfiltration) prior to discharge into a
stream, river, bay, lagoon or wetland, or it can be used for the
irrigation of a golf course, green way or park.
• If it is sufficiently clean, it can also be used for groundwater recharge
or agricultural purposes.
Sludge disposal
• Sludge refers to the residual, semi-solid material left from industrial
wastewater or sewage treatment processes. Sludge can be
incinerated, used for landfill, compost or other agricultural use later
on.
• The most important disposal methods are:
• incineration
• landfilling
• composting
• agricultural use
The disposal
methods
used in the
Europe
Thank you for your
attention!