water quality health

8/13/2019 Water Quality Health

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Diseases related to contamination ofdrinking water constitute a major

burden on human health.Interventions to improve the qualityof drinking water provide significant

benefits to health.
http://www.whoindia.org/


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P e r c e n

t o

f t o t a l b

u r d e n

( w i t h i n r e g

i o n

)

1% -

5% -

Water, sanitation and hygiene

(5.5%)

Lead

Underweight

Indoor air (3.7 %)

Ambient air Occupational injuries

Developing countries(high mortality)

Developed countries

Occupational risks

AlcoholTobacco

Overweight

Lead

Unsafe sex

Tobacco

Climate change

AlcoholAmbient air

Water, sanitation and hygieneOverweight

Unsafe sex

Physical inactivityZinc deficiency

Global Burden of Disease attributableto selected major risk factors


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Deaths caused by selected infectiousdiseases in the SEA Region, 2002

(Figures in 000)

DiseaseMortality stratum

Total Low child,low adult

High child,high adult

Respiratory infections 1377 121 1256

Diarrhoeal diseases 802 44 758

Tuberculosis 701 160 541

HIV/AIDS 445 60 385

Measles 193 32 161

Malaria 95 9 86

Source: World Health Report 2002


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Emerging diseasesEmerging pathogens are those that have appeared in ahuman population for the first time or have occurredpreviously but are increasing in incidence orexpanding into areas where they have not previouslybeen reported, usually over last 20 years

Water borne emerging diseases:CryptosporidiumLegionellaEscherichia coli O157 (E. coli O157)Rotavirus, Hepatitis E virus, NorovirusHelicobacter pylori (H. pylori)


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Water Quality Problems due toChemicals in India

Quality Problem Remarks

Fluoride The population at risk is estimated to be around 66million in 20 states

Arsenic The population at risk is estimated to be more than 10million in 4 states.

Iron Around 1.5 lacks habitations spread over 16 states inthe country are found to be affected.

Nitrate Nitrate is emerging as a major problem in the States ofTamil Nadu, Rajasthan, Gujarat, Karnataka,Maharashtra, and Uttar Pradesh

Brackishness A major problem in parts of the States of Gujarat, Andhra Pradesh, Karnataka, Kerala, Orissa, Punjab,Rajasthan, Tamil Nadu, Haryana and Madhya Pradesh

Pesticides Ground water pollution due to pesticides includingcertain POPs has been reported in many areas.


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History of the WHO Guidelinesfor Drinking Water

1958, 1963, 1971: International Standards1984: First edition of Guidelines: basis forformulating standards, but standard setting is anational prerogative.1993: Second edition with increase in number ofchemicals covered.2004: Third edition introducing systematic watersafety approach


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WHO Water Quality GuidelinesAIM

Protection of human health Advisory in Nature Facilitate national standard-setting

Features Socio-Economic and environmental context Risk benefit philosophy local adaptation for health

gains Best available evidence- science and practice Scientific expert consensus

Approach Exploit global information and experience


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Why we need to review our approach

In all countries waterborne illnessstill occurs

Outbreaks show us that we cannotsolely rely on water treatmentindicators

End-point testing is too-little-too-late


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Interrelation of the chapters of the Guidelines for Drinkingwater Quality in ensuring drinking water safety

Introduction (Chapter 1)

The guidelinerequirements (Chapter 2)

Health-based targets (Chapter 3)

Public health context

and health outcome

Water Safety Plans(Chapter 4)

Systemassessment

Monitoring Management andcommunication

Surveillance(Chapter 5)

FRAMEWORK FOR SAFE DRINKING WATER SUPPORTINGINFORMATION

Microbial aspects(Chapters 7 and 11)

Chemical aspects (Chapters 8 and 12)

Radiologicalaspects

(Chapter 9)

Acceptabilityaspects

(Chapter 10)

Application of the Guidelines in specific circumstances(Chapter 6)

Large buildings, Emergencies and disasters, Travellers, Desalination systems,

Packaged drinking water, Food production, Planes and ships


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Framework for Water Safety in 3rd

Edition WHO GDWQ

Health Based Targets

Water Safety Plans1. System Assessment2. Monitoring of control measures

3. Management Plans Independent Surveillance


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Nature, application and assessment ofhealth-based targets

Type of target Nature of target Typicalapplications

Assessment

Health Outcomeepidemiologybased

Reduction indetected diseaseincidence or

prevalence

Microbial orchemical hazardswith high

measurabledisease burdenlargely waterassociated

Public healthsurveillance andanalytical

epidemiology

risk assessmentbased

Tolerable level ofrisk from

contaminants indrinking water,absolute or as afraction of the totalburden by allexposures

Microbial orchemical hazards

in situations wheredisease burden islow or cannot bemeasured directly

Quantitative riskassessment


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Nature, application and assessment ofhealth-based targets

Type of target Nature of target Typicalapplications

Assessment

Water Quality Guideline valuesapplied to water

quality

Chemicalconstituents

found in sourcewaters

Periodic measurementof key chemical

constituents to assesscompliance withrelevant guidelinevalues

Guideline valuesapplied in testingprocedures formaterials andchemicals

Chemicaladditives and by-products

Testing proceduresapplied to the materialsand chemicals toassess theircontribution to drinkingwater exposure takingaccount of variationsover time.


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Water Safety Plan

A WSP comprises, as a minimum, the threeessential actions that are the responsibilityof the drinking water supplier in order toensure that drinking water is safe. Theseare:

a system assessment; effective operational monitoring; and management


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Water Safety Plan Assemble the team Document and describe the system

Undertake a hazard assessmentand risk characterization

Identify control measures Define monitoring to controlmeasures

Develop supporting programmes Establish procedures to verify thewater safety plan

Prepare management procedures Establish documentation andcommunication procedures

Assess the existing proposedsystem


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WHO s ResponseMoving away from reliance on output

monitoring- i.e. measuring para-metres infinal waterMore input monitoring- i.e. measuring para-metres showing that the system is workingPriority focus on microbial hazardsShort- term chemical changes andexposures

Catchment-to- consumer (farm -to- fork) Multiple barrier approach HACCP Reality check on today s water supplysituations


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Independent Surveillance

Systematic independent surveillance thatverifies that the WSPs are operating properly

Audit of Water supply planShows WSP is being adhered to

VerificationEnd-product final check


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Updating the WHO Guidelines

Keeping the guidelines up-to-date is aformidable challenge

WHO installed a rolling revision processSubstantiating the positions and guidanceon good practice are the two key areasPeer and public domain review are built - in


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Rolling Revision of WHO Guidelines

for Drinking-water quality Application in specific settingsWater and sanitation on ships and in aviation(International Health Regulations)

Desalination plantsTemporary water suppliesWater supply in emergenciesSmall community water supplyWater supply in large buildingsWater supply in health care facilities


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The WHO Guidelines for DrinkingWater Quality 3 rd Edition

Available at WHO s website at:

http://www/who.int/water_sanitation-health/dwq/en/
http://www/who.int/water_sanitation-health/dwq/en/http://www/who.int/water_sanitation-health/dwq/en/http://www/who.int/water_sanitation-health/dwq/en/http://www/who.int/water_sanitation-health/dwq/en/http://www.whoindia.org/


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Rolling Publication Schedule

First Addendum in early 2005 Second Addendum by end 2006

Final Task Force Meeting to adopt FourthEdition in Late 2007 Fourth Edition to be published in 2008, the

50th

anniversary of the first WHOpublication on drinking water quality


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Environmental Health

Assisted the district authorities in strengtheningenvironmental sanitation programme, includinghygiene education, waste management and sanitarytoilets in the disaster hit areas/camps and providingtechnical support during rehabilitation period in:

Nagapattinam , Cuddalore and Karaikal districts: Gandhi GramRural University, Gandhigram

Monitoring drinking water quality in the coastal areas ofTamil Nadu TWAD Board

Health Care Waste management in 17 selected Govt.Hospitals initiated


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Maintaining Basic Sanitation andWater Supply is still a Challenge


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Environmental sanitation projects were set up


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Environmental sanitation projects were set upthrough Gandhigram Institute with WHO

support

strengtheningmonitoring ofdrinking-waterquality inNagapattinam,Cuddalore and

Karaikal


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Monitoring quality of Ground Water

The work is in progress on a projectbeing implemented by the Tamil NaduWater and Drainage Board withassistance from WHO, to assess thechanges of drinking-water quality in thecoast after the tsunami.


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THANK YOU

water quality health

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