Green buildings are increasingly being plumbed with crosslinked polyethylene (PEX) potable water pipe. Tap water quality was investigated at a six month old plumbing system and chemical and odor ...quality impacts of six PEX pipe brands were examined. Eleven PEX related contaminants were found in the plumbing system; one regulated (toluene) and several unregulated: Antioxidant degradation products, resin solvents, initiator degradation products, or manufacturing aides. Water chemical and odor quality was monitored for new PEX-a, -b and -c pipes with (2 mg/L free chlorine) and without disinfectant over 30 days. Odor and total organic carbon (TOC) levels decreased for all pipes, but odor remained greater than the USA's Environmental Protection Agency's (USEPA) secondary maximum contaminant level. Odors were not attributed to known odorants ethyl-tert-butyl ether (ETBE) or methyl-tert-butyl ether (MTBE). Free chlorine caused odor levels for PEX-a1 pipe to increase from 26 to 75 threshold odor number (TON) on day 3 and affected the rate at which TOC changed for each brand over 30 days. As TOC decreased, the ultraviolet absorbance at 254 nm increased. Pipes consumed as much as 0.5 mg/L as Cl2 during each 3 day stagnation period. Sixteen organic chemicals were identified, including toluene, pyridine, methylene trichloroacetate and 2,4-di-tert-butylphenol. Some were also detected during the plumbing system field investigation. Six brands of PEX pipes sold in the USA and a PEX-a green building plumbing system impacted chemical and drinking water odor quality.
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•First US study detailing the impact of multiple PEX pipes on drinking water quality.•Eleven regulated and unregulated contaminants found in a PEX plumbing system.•For 30 days, odor and TOC levels decreased for six PEX brands sold in the USA.•PEX pipes caused odor that exceeded the USEPA SMCL even on day 30.•Disinfectant exposure sometimes caused greater odor levels for PEX pipes.
In an age of pandemics the relationship between the health of the city and good sanitation has never been more important. Waste and the City is a call to action on one of modern urban life 39 most ...neglected issues: sanitation infrastructure. The Covid-19 pandemic has laid bare the devastating consequences of unequal access to sanitation in cities across the globe. At this critical moment in global public health, Colin McFarlane makes the urgent case for Sanitation for All. The book outlines the worldwide sanitation crisis and offers a vision for a renewed, equitable investment in sanitation that democratises and socialises the modern city. Adopting Henri Lefebvre 39 concept of the right to the city 39, it uses the notion of 39 citylife 39 to reframe the discourse on sanitation from a narrowly-defined policy discussion to a question of democratic right to public life and health. In doing so, the book shows that sanitation is an urbanizing force whose importance extends beyond hygiene to the very foundation of urban social life.
The hospital environment is a potential reservoir of bacteria with plasmids conferring carbapenem resistance. Our Hospital Epidemiology Service routinely performs extensive sampling of high-touch ...surfaces, sinks, and other locations in the hospital. Over a 2-year period, additional sampling was conducted at a broader range of locations, including housekeeping closets, wastewater from hospital internal pipes, and external manholes. We compared these data with previously collected information from 5 years of patient clinical and surveillance isolates. Whole-genome sequencing and analysis of 108 isolates provided comprehensive characterization of
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-positive isolates, enabling an in-depth genetic comparison. Strikingly, despite a very low prevalence of patient infections with
-positive organisms, all samples from the intensive care unit pipe wastewater and external manholes contained carbapenemase-producing organisms (CPOs), suggesting a vast, resilient reservoir. We observed a diverse set of species and plasmids, and we noted species and susceptibility profile differences between environmental and patient populations of CPOs. However, there were plasmid backbones common to both populations, highlighting a potential environmental reservoir of mobile elements that may contribute to the spread of resistance genes. Clear associations between patient and environmental isolates were uncommon based on sequence analysis and epidemiology, suggesting reasonable infection control compliance at our institution. Nonetheless, a probable nosocomial transmission of
sp. from the housekeeping environment to a patient was detected by this extensive surveillance. These data and analyses further our understanding of CPOs in the hospital environment and are broadly relevant to the design of infection control strategies in many infrastructure settings.
Carbapenemase-producing organisms (CPOs) are a global concern because of the morbidity and mortality associated with these resistant Gram-negative bacteria. Horizontal plasmid transfer spreads the resistance mechanism to new bacteria, and understanding the plasmid ecology of the hospital environment can assist in the design of control strategies to prevent nosocomial infections. A 5-year genomic and epidemiological survey was undertaken to study the CPOs in the patient-accessible environment, as well as in the plumbing system removed from the patient. This comprehensive survey revealed a vast, unappreciated reservoir of CPOs in wastewater, which was in contrast to the low positivity rate in both the patient population and the patient-accessible environment. While there were few patient-environmental isolate associations, there were plasmid backbones common to both populations. These results are relevant to all hospitals for which CPO colonization may not yet be defined through extensive surveillance.
Social Medicine in Russia Reiling, Jennifer
JAMA : the journal of the American Medical Association,
02/2018, Volume:
319, Issue:
5
Journal Article
Peer reviewed
The development of social medicine in Russia is discussed. The nation has already developed the state care of the sick to a point of which we are just beginning to dream. Modern sanitary engineering ...evidently still remains to be developed in Russia. The development of public health activities along medical and bacteriologic lines, on the other hand, is modern and progressive.
Septic systems may contribute micropollutants to shallow groundwater and surface water. We constructed two in situ conventional drainfields (drip dispersal and gravel trench) and an advanced ...drainfield of septic systems to investigate the fate and transport of micropollutants to shallow groundwater. Unsaturated soil-water and groundwater samples were collected, over 32 sampling events (January 2013 to June 2014), from the drainfields (0.31–1.07 m deep) and piezometers (3.1–3.4 m deep). In addition to soil-water and groundwater, effluent samples collected from the septic tank were also analyzed for 20 selected micropollutants, including wastewater markers, hormones, pharmaceuticals and personal care products (PPCPs), a plasticizer, and their transformation products. The removal efficiencies of micropollutants from septic tank effluent to groundwater were similar among three septic systems and were 51–89% for sucralose and 53–>99% for other micropollutants. Even with high removal rates within the drainfields, six PPCPs and sucralose with concentrations ranging from <0.3 to 154 ng/L and 121 to 32,000 ng/L reached shallow groundwater, respectively. The human health risk assessment showed that the risk to human health due to consumption of groundwater is negligible for the micropollutants monitored in the study. A better understanding of ecotoxicological effects of micropollutant mixtures from septic systems to ecosystem and human health is warranted for the long-term sustainability of septic systems.
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•Transport, transformations, and risk assessment of micropollutants was studied in septic systems.•High removal of many micropollutants occurred within three types of septic systems.•Sucralose and six PPCPs were detected in shallow groundwater below the septic systems.•Micropollutants detected in groundwater do not appear to pose a risk to the human health.
Opportunistic premise (i.e., building) plumbing pathogens (OPPPs, e.g., Legionella pneumophila, Mycobacterium avium complex, Pseudomonas aeruginosa, Acanthamoeba, and Naegleria fowleri) are a ...significant and growing source of disease. Because OPPPs establish and grow as part of the native drinking water microbiota, they do not correspond to fecal indicators, presenting a major challenge to standard drinking water monitoring practices. Further, different OPPPs present distinct requirements for sampling, preservation, and analysis, creating an impediment to their parallel detection. The aim of this critical review is to evaluate the state of the science of monitoring OPPPs and identify a path forward for their parallel detection and quantification in a manner commensurate with the need for reliable data that is informative to risk assessment and mitigation. Water and biofilm sampling procedures, as well as factors influencing sample representativeness and detection sensitivity, are critically evaluated with respect to the five representative bacterial and amoebal OPPPs noted above. Available culturing and molecular approaches are discussed in terms of their advantages, limitations, and applicability. Knowledge gaps and research needs towards standardized approaches are identified.
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•Opportunistic pathogens in premise plumbing (OPPPs) are a growing source of disease.•Reliable detection and monitoring strategies are urgently needed for OPPPs.•Different OPPPs present distinct requirements for sampling, preservation, and analysis.•The state of the science of monitoring OPPPs is critically reviewed.
In the past decades, China has observed rapid urbanization, the nation's urban population reached 50% in 2000, and is still in steady increase. Rapid urbanization in China has an adverse impact on ...urban hydrological processes, particularly in increasing the urban flood risks and causing serious urban flooding losses. Urban flooding also increases health risks such as causing epidemic disease break out, polluting drinking water and damaging the living environment. In the highly urbanized area, non-engineering measurement is the main way for managing urban flood risk, such as flood risk warning. There is no mature method and pilot study for urban flood risk warning, the purpose of this study is to propose the urban flood risk warning method for the rapidly urbanized Chinese cities.
This paper first presented an urban flood forecasting model, which produces urban flood inundation index for urban flood risk warning. The model has 5 modules. The drainage system and grid dividing module divides the whole city terrain into drainage systems according to its first-order river system, and delineates the drainage system into grids based on the spatial structure with irregular gridding technique; the precipitation assimilation module assimilates precipitation for every grids which is used as the model input, which could either be the radar based precipitation estimation or interpolated one from rain gauges; runoff production module classifies the surface into pervious and impervious surface, and employs different methods to calculate the runoff respectively; surface runoff routing module routes the surface runoff and determines the inundation index. The routing on surface grid is calculated according to the two dimensional shallow water unsteady flow algorithm, the routing on land channel and special channel is calculated according to the one dimensional unsteady flow algorithm.
This paper then proposed the urban flood risk warning method that is called DPSIR model based multiple index fuzzy evaluation warning method, and referred to as DMFEW method. DMFEW first selects 5 evaluation indexes based on the DPSIR model for flood risk warning evaluation, including driving force index, pressure index, state index, impact index and response index. Based on the values of all evaluation indexes, one evaluation index for the whole system evaluation result is determined by using the fuzzy comprehensive evaluation method. The flood risk level is divided into 4 levels, having Level 1 the most serious. Every evaluation index is also categorized as 4 levels, and a linear fuzzy subjection function is proposed to do the fuzzy comprehensive evaluation.
Dongguan City is used as the study case to validate the proposed method. The urban flood forecasting model is set up with the topographic data, the city map, the underground pipelines and land cover types, and two flood events are simulated with observed precipitation, one is interpolated from the rain gauges data, and another is estimated by digital weather radar. The simulated results are compared with the investigated water depth, and the results show the model has very good performances. The results are further used for the flood risk warning simulation, and are very reasonable.
•An urban flood forecasting model that could produce inundation index is proposed.•The proposed urban flood forecasting model could couple radar estimated rainfall.•The proposed urban flood forecasting model simulated an observed flood event well.•An urban flood risk warning method based on DPSIR model is proposed and works well.•The urban flood forecasting and risk warning have very high spatial resolution.
Lead pipes for carrying drinking water were well recognized as a cause of lead poisoning by the late 1800s in the United States. By the 1920s, many cities and towns were prohibiting or restricting ...their use. To combat this trend, the lead industry carried out a prolonged and effective campaign to promote the use of lead pipes. Led by the Lead Industries Association (LIA), representatives were sent to speak with plumbers' organizations, local water authorities, architects, and federal officials. The LIA also published numerous articles and books that extolled the advantages of lead over other materials and gave practical advice on the installation and repair of lead pipes. The LIA's activities over several decades therefore contributed to the present-day public health and economic cost of lead water pipes.
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During January 2014, an industrial solvent contaminated West Virginia’s Elk River and 15% of the state population’s tap water. A rapid in-home survey and water testing was conducted 2 weeks following ...the spill to understand resident perceptions, tap water chemical levels, and premise plumbing flushing effectiveness. Water odors were detected in all 10 homes sampled before and after premise plumbing flushing. Survey and medical data indicated flushing caused adverse health impacts. Bench-scale experiments and physiochemical property predictions showed flushing promoted chemical volatilization, and contaminants did not appreciably sorb into cross-linked polyethylene (PEX) pipe. Flushing reduced tap water 4-methylcyclohexanemethanol (4-MCHM) concentrations within some but not all homes. 4-MCHM was detected at unflushed (<10 to 420 μg/L) and flushed plumbing systems (<10 to 96 μg/L) and sometimes concentrations differed among faucets within each home. All waters contained less 4-MCHM than the 1000 μg/L Centers for Disease Control drinking water limit, but one home exceeded the 120 μg/L drinking water limit established by independent toxicologists. Nearly all households refused to resume water use activities after flushing because of water safety concerns. Science based flushing protocols should be developed to expedite recovery, minimize health impacts, and reduce concentrations in homes when future events occur.
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