7.

Water Quality
to protect the health of the public - introduction of chlorination of drinking water
- results in drastic reductions in waterborne infections
Vulnerable groups diseases caused by water contamination - children, elderly,
immunocompromised patients
In the US, water quality regulations are designed to protect the public from contaminated
drinking water and from other forms of water pollution
2 major water quality regulations are
1. Safe Drinking Act
2. Clean Water Act
Although it is possible for a human to live up to a month without food, that same individual can
survive for only about a week without water
The average requirement for human consumption of water per day is approx. 2.5 liters
includes water from food sources
- Approx. 2/3 of the human body is water
- 3/4 of the brain is water
- In the US, the average persons used about 100 gallons of water per day
- Average resident uses over 100,000 gallons of water during a year
- 50 to 70% of household water is used for outdoor purposes
- About 20% of the world’s population lacks safe drinking water
the problem of lack of access to safe drinking water is likely to worsen
Public water supplies may carry organic chemicals, lead, arsenic, bacteria, viruses, parasites.
The Water Supply
2 main sources of drinking water - surface water and ground water
- Surface waters - rivers, lakes, etc.
- Ground water - stored naturally in underground aquifers
Communities near the sea run the risk of salt water intrusion into the aquifer when excessive
amounts of water are withdrawn
Hydrology - The field of water science
The Hydrological Cycle - the process by which freshwater supply is continuously replenished
A pumping system driven by the sun that moves freshwater from the oceans to landmasses and
then returns it to the ocean
- The total volume in the terrestrial Hydrological Cycle is about 119,000 km^3
- Annually The Hydrological Cycle circulates nearly 577,000 km^3 of water
Freshwater Resources
- The same amount of water exists today that existed 2,000 years ago
- 70% of the earth’s surface is covered with water
- 3% of all water is freshwater, which majority is unavailable for use
- 75% of freshwater supplies are frozen in the polar ice caps and in glaciers
- readily available sources constitute water supply that is renewed by hydrological cycle
- Unequal distribution of water is exacerbated by annual cycles of drought and flooding
- The continent of North America has the largest amount of freshwater available to the
population
Water Scarcity and Water Stress
The demand for water presently exceeds the available water supply as a result of water scarcity
and water stress
- About 200 million people live in water-stressed countries
Treatment of Water for Residential Consumption
EPA sets water quality standards for safe levels of chemical contaminants and waterborne
microorganisms
4 stages of water treatment
1. Coagulation - Aluminum sulfate is used to remove suspended material
2. Sedimentation - Heavy particles settle to the bottom
3. Filtration
4. Disinfection - Chlorine to destroy pathogens
Fluoridation of Water
- Fluoride is added to public water to prevent tooth decay (dental caries)
- Fluorosis - The dental condition in which teeth have been discolored by fluoride
- Fluoride in water causes staining and prevents tooth decay
- Optimal fluoride level was set at .7 to 1.2 ppm
Treatment of Water from Aquifers
Aquifers are a common source of potable water in many communities
- aquifers, minimal aeration, filtration and disinfection are necessary
- Filtration - Use of ultra fine filters to draw out impurities
Drinking Water Contamination
- The public water supply generally is monitored carefully and must adhere to EPA safety
standards
- Potable water (drinking water) - from wells and runoff from the land’s surface
- Almost all water in its natural state is impure, because of common naturally occurring
and anthropogenic sources of pollution
- Naturally occurring sources of pollution arise from the diversity of aquatic animals and
plants that inhabit the bodies of water used for human consumption
- In addition to microbial organisms that live in water, waste contaminates water
- Runoff from urban streets is a growing contributor of water pollution, especially after
heavy rainfall
4 major groups of disease-causing agents that may be present in the water supply
1. Parasites - e.g., giardia
2. Bacteria - e.g., E. coli and Shigella
3. Viruses - e.g., Norwalk and hepatitis viruses
4. Chemicals - e.g., pesticides and heavy metals

Waterborne Diseases and Fecal Contamination

Conditions that are transmitted through the ingestion of contaminated water and water acts as
the passive carrier of the infectious agent
- Waterborne diarrheal conditions - morbidity and mortality of developing nations
Gastroenteritis - A condition transmitted by water inflammation of the stomach and small and
large intestines
- transmission via the public water supply is a consequence of the malfunctioning of a
water processing system
- Bacterial, viral and protozoan pathogens are responsible for Waterborne infections
Waterborne Disease by protozoan - Cryptosporidiosis and Giardiasis
Enteric Protozoal Parasites
Cryptosporidiosis
- infectious agent Cryptosporidium pavrum, a protozoal organism
- transmitted through ingestion of feces
- Contaminated water has been linked to most known outbreaks
- Travel to another country is a strong and significant risk factor
- low doses of Cryptosporidium pavrum are required for infection
Amebiasis
- caused by the protozoal parasite Entamoeba histolytica
- transmitted through ingestion of feces
- Oocysts of Cryptosporidium pavrum are resistant to chlorine treatment
Giardiasis
- Giardia intestinalis, a protozoal organism
- Cysts of Giardia intestinalis can survive a long time in cold water
- Transmitted through contaminated food and water
Cyclosporiasis
- Causative organism Cyclospora Cayetanensis
- transmitted via ingestion of contaminated food and water

Bacterial Enteropathogens
Salmonella
- Salmonella Typhi causes Typhoid fever
- transmitted by fecal contaminated food and water
E. Coli
- transmitted through contact with contaminated bodies of water and through ingestion
of contaminated food and water
Vibrio Cholerae
- that causes cholera
- Developed countries have very low risk of contracting cholera
- underlying factors - inadequate infrastructure for processing water
- Migrations of large numbers of people to urban areas
-
Viral Pathogens
- Over 100 viruses are found in human stool and pose a potential for transmission by
water
- Viruses found in human stool are more resistant to environmental conditions and
sewage treatment process than many of the sewage-associated bacteria
- Virus-associated conditions that may be spread through water are viral gastroenteritis
human enteric virus group - Norwalk virus, rotavirus, hepatitis A virus, adenovirus, enterovirus
- The human enteric virus group is one of the leading causes of human illness
- Enteric - Relating to the intestines
- Disease outbreaks caused by enteric viruses have been associated with water and food
contamination by virus-laden human stools
- 2 causes of viral gastroenteritis - norovirus and adenoviruses
Noroviruses can be carried in contaminated food and drink
adenovirus is direct person-to-person contact but also through water which is less common
Viral hepatitis A and hepatitis E - spread via fecal-oral route by contaminated food and water
- Hepatitis A - consumption of raw or uncooked claims taken from contaminated bodies
of water
- Hepatitis E - drinking-water contamination
Workers who come into contact with sewage are at an increased risk

Other Agents
Guinea Worm
- Caused by nematode Dracunculus Medinensis,
- forms larvae that enter the water supply
- associated with feet blisters the worm escapes from
Legionnaires’ Disease
- by the bacterium Legionella pneumophila
- Disease produces lung infections in the form of pneumonia
- milder form - pneumonia absent - Pontiac fever
- Transmission - water that is contaminated becomes aerosolized and is inhaled or
ingested in such way that it enters the respiratory system
Chemicals in the Water Supply
from natural and anthropogenic sources
- Chemical contaminants - aluminum, arsenic, fluoride, lead, pesticides, radon,
disinfection by-products
- Pharmaceutical and Personal Care Products (PPCPs) represent another source of
contamination by either being washed off or excreted from the body
- Sewage Epidemiology - A new field of monitoring excreted drugs in the sewer system to
assess the level of illicit drug use in the community
Water Disinfection By-products (DBPs)
- Chemicals used to disinfect water include - chlorine, choramines, chlorine dioxide,
ozone
- these chemicals are associated with by-products of chlorination called DBPs
- Chlorine is associated with trihalomethane (THMs) - which are among the most common
and widely measured DBPs
- Chlorinated drinking water is associated with late adverse pregnancy outcomes
Solvent-Contaminated Drinking Water
Industrial chemicals may infiltrate the underground aquifers used for public water supplies
Beach and Coastal Pollution
- Pollution, ocean dumping of dredged material, sand and gravel mining, oil and gas
development, shipping, habitat destruction and overfishing
- Caused by - draining of coastal ecosystems, dreading, solid waste disposal, construction
of damns for flood control, discharge of wastes from farms and industries, logging
activities
- As the population increases, coastal areas are threatened by overdevelopment, poor
planning, and economic expansion
- During heavy rains, urban runoff into the oceans degrades the quality of ocean water by
adding microbial agents, nutrients, and chemical toxins
The problem of urban runoff result in the loss of wetlands (natural water-filtering mechanism)
Petroleum Spills
- One of the worst oil spills in US by the tanker Exxon Valdez
- Pollutions associated with tankers and offshore drilling platforms - crude oil and heavy
fuel oil
- An explosion at the Deepwater Horizon oil platform caused the largest marine oil spill
in history up to that time
- 5 million barrels of oil into the Gulf of Mexico