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Health risks from water

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Infectious Bacterial Gastro-Enteritis. Source: NRH Burgess 1990. Public ... Campylobacter jejuni (incubation period: 24 - 72 Hrs) Duration of illness: 1 - 4 ... – PowerPoint PPT presentation

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Title: Health risks from water


1
Health risks from water
  • Opportunities Problems

2
Water is Life
  • Human 65 H2O
  • Minimal Daily loss 1 kg H20 / person
  • Maximal Hourly loss 10 kg H2O / person
  • Loss to be replenished by eating drinking
  • Human lt60 H20 in danger zone

3
Potable Water
  • Perishable Commodity (lt 24 Hours)
  • Keep cool or add Chlorine or active
    oxygen-derivate
  • Keep Running
  • Bio-film development on Surfaces

4
Healthy and Sustainable BuildingPotable Water
  • Disease Risks
  • Veterans Disease caused by Legionella
  • - Infections / Intoxications of Household Water
    ( 2nd quality water)
  • Prevention
  • Keep potable water supply below 18C at all
    times
  • Mark each Household Water outlet individually
    and clearly
  • Stimulate distinguishable odour and taste of 1st
    2nd quality water
  • Make disconnecting of 2nd quality water-systems
    easy
  • Inform consumer

5
Healthy and Sustainable BuildingHot Water
  • Disease Risks
  • Scalding
  • Veterans Disease caused by Legionella
  • Pontiac Fever caused by Legionella
  • Atopic Disease through lack off mite
    extermination at laundering
  • Humidifier Disease through antigens of
    micro-organisms
  • Prevention
  • Install thermostatic mixing faucet
  • Replace boiler by geyser with a short hot water
    conduct
  • Install facility for washing machine with extra
    water heating (gt60oC)
  • Inform consumer

6
Legionella Risk
  • Veterans Disease Pontiac Fever
  • Lung infection (Shower, Air-Conditioning,
    Cooling Towers)
  • 18oC lt Bacterial Growth lt 60oC
  • Bacterial Survival up to 65oC
  • Viable Legionella present in surface coastal
    waters

7
1000 Legionella-infections
  • 950-990x cases of Pontiac Fever
  • 9-30x surviving Veteran-Disease patients, but
    with persisting chronic symptoms
  • 1-20x fatal cases

Source JEMH van Bronswijk e.a. 1999. Gezond en
Duurzaam Bouwen (GeDuBo). Research Report for the
Netherlands Ministry of Housing
8
Legionellosis Risk Classes
Source CJPA Hoebe, JJM Cluitmans, JHT
Wagenvoort, WJ van Leeuwen, MAJ Bilkert-Mooiman
1999. Koud leidingwater als bron van fatale
nosocomiale pneumonieën door Legionella
pneumophila in een revalidatiekliniek. Nederl.
Tijdschr. Geneesk. 143(20)1041-1045
JEMH van Bronswijk, October 9, 1999
9
Legionellosis
  • Since the 1986 report of the Health
    Administration 5,000 preventable deaths occurred
    in NL
  • For each Legionella death 50 to 1,000 persons are
    diseased
  • Risk in modern dwellings and in hospitals is
    comparable
  • Preventive technology is available

10
Legionella extermination
  • At temperatures gt64C no breathing of Legionella
    occurs
  • No growth lt18C Legionella remains vital
  • 0.5 mg free chlorine / l water kills bacteria
  • Copper or silver-ions in the water decrease growth


Use a thermostatic mixing tap with automatic
emptying, to prevent both burns and a Legionella
infection! Source Report Gezondheidsraad 1986
Pubmed 1995-1999
11
Waste Water
  • Bathroom, Toilet, Kitchen Human pathogens from
    man pets (also SARS)
  • (Run-off) Rainwater Human pathogens from birds
    rodents
  • Waste water is a breeding ground for biting
    insects a domain of rodents keep is covered

12
Outdoor Waterrisks opportunities
  • Visual Comfort
  • Water Management
  • Recreation
  • Diarrhoea (e.g. Escherichia coli, Salmonella)
  • Weils Disease
  • Temperate-region Malaria (brackish water)
  • SARS ?

13
Causes of Summer FluInfectious Bacterial
Gastro-Enteritis
  • Campylobacter jejuni (incubation period 24 - 72
    Hrs) Duration of illness 1 - 4 Days Infected
    food chicken, milk, water
  • Vectors fly, rat, mouse, cockroach, rain water,
    2nd quality water
  • 2. Clostridium perfringens (incubation period 8
    - 24 Hrs) Duration of illness lt 7 Days Infected
    food too slowly chilled dishes
  • Vectors fly, rat, mouse, cockroach, human hands
  • 3. Salmonella (incubation period 8-48 Hrs)
  • Duration of illness 5 - 7 Days Infected food
    meat dishes, water
  • Vectors fly, rat, mouse, cockroach, rain water,
    2nd quality water
  • 4. Staphylococcus aureus (incubation period lt 6
    Hrs)
  • Duration of illness lt 24 Hrs Infected food
    milk products, meat dishes
  • Vectors fly, rat, mouse, cockroach, human hands

Source NRH Burgess 1990. Public Health Pests.
Chapman Hall, London E Eyskens, L Feenstra, AE
Meinders, JP Vandenbroucke 1991. Codex Medicus.
9e druk. Elsevier, Amsterdam
14
Weils Disease
  • First described by Adolf Weil (1848-1916) in
    Wiesbaden (Germany)
  • Infection with Leptispira ictero-haemorrhagiae
  • Human disease after contact with urine of
    infected rodents such as the Norway Rat (Rattus
    norvegicus) most common in Zuid-Holland
  • Symptoms and Course incubation period of 2-20
    days followed by 4-9 days with severe flu-like
    symptoms may develop from 6th-12th day of
    illness into meningitis, as well as damage to
    liver, kidneys and heart

15
Preventing Weils Disease
  • Minimize open water in residential areas
  • Open city water should have steep banks
  • Mow banks of city water 2x yearly
  • Keep city water deep (gt 3 m)
  • Exterminate Rattus sp in residential areas
  • Inform consumers

Number of drowned children will decrease
increase
16
Healthy and Sustainable BuildingOpen Water in
Cities Towns
  • Disease Risks
  • Weils Disease
  • Papular Urticaria due to mosquitoes and biting
    flies
  • Re-introduction of temperate-region malaria
    (only in brackish areas)
  • Prevention
  • Fill up marshy fields and stagnant waters in
    living areas
  • Refrain from introducing water-purifying marshes
    in living areas
  • Can marshes or ponds not be avoided install rat
    mosquito extermination program
  • Prevent mosquitoes black flies from entering
    the house (fixed insect screens in windows
    doors)
  • Inform consumer

17
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18
Dutch Anti-malaria Poster from the 1st half of
the 20th century
Ziet gij muggen lang van poot Aarzelt niet, maar
slaat ze dood
Translation Do you see mosquitoes long of legs
? Dont wait, squeeze them to death
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