Disease burden due to gastrointestinal infections among people living along the major wastewater system in Hanoi, Vietnam

Samuel Fuhrimann, Maarten Nauta, Phuc Pham-Duc, Nguyen Thuy Tram, Hung Nguyen-Viet, Jürg Utzinger, Guéladio Cissé, Mirko S. Winkler

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Abstract

Background: Despite recent improvements of wastewater treatment capacities in urban areas of Hanoi, Vietnam, microbial pollution is still considerable. There is a paucity of burden estimates due to gastrointestinal infection in people living along the wastewater system, and among people who are in direct contact with the wastewater, such as farmers using wastewater in agriculture and aquaculture. Methods: A quantitative microbial risk assessment (QMRA) was pursued focussing on four population groups characterised by different levels of exposure to wastewater: (i) workers maintaining the wastewater conveyance and treatment systems; (ii) urban farmers using wastewater from To Lich River; (iii) community members in urban areas exposed to flooding events in the districts of Hoang Mai and Thanh Tri; and (iv) peri-urban farmers in Thanh Tri district, where Red River water is used for agriculture and aquaculture. The QMRA was developed on the basis of measured concentration of . Escherichia coli and . Salmonella spp. and . Ascaris spp. eggs in water samples. Published ratios between measured organisms and pathogenic strains of norovirus, rotavirus, . Campylobacter spp. ., pathogenic . E. . . coli, pathogenic . Salmonella spp., . Cryptosporidium spp. and . Ascaris lumbricoides were employed to estimate annual risk of gastrointestinal infection and disease burden. Results: The QMRA estimated a disease burden of 0.011 disability-adjusted life years (DALYs) per person per year in urban farmers, 0.006 DALYs for sanitation workers, 0.0005 DALYs for urban communities at risk of flooding events and 0.0004 DALYs for peri-urban farmers. Urban farmers had considerably higher incidence estimates for gastrointestinal disease episodes per year (2.0) compared to the other exposure groups (≤ 1.0). Conclusions: Urban farmers using wastewater from To Lich River have a high gastrointestinal disease burden, which is about 100 times larger than the health-based targets for wastewater use set by the World Health Organization. These findings are of direct public health relevance and call for upgrading Hanoi's wastewater system to reduce microbial contamination. Finally, this study presents a first example on how to link QMRA to a sanitation safety planning (SSP) approach in an Asian context and its findings are interesting in the frame of Sustainable Development Goal (SDGs) #6.
Original languageEnglish
JournalAdvances in Water Resources
Volume108
Pages (from-to)439-449
Number of pages11
ISSN0309-1708
DOIs
Publication statusPublished - 2017

Keywords

  • Water Science and Technology
  • Bacteria
  • Helminths
  • Quantitative microbial risk assessment
  • Sanitation safety planning
  • Sustainable development goals
  • Urban farming
  • Vietnam
  • Wastewater
  • Agriculture
  • Aquaculture
  • Escherichia coli
  • Floods
  • Health
  • Health risks
  • Occupational risks
  • Planning
  • Risk assessment
  • Risk perception
  • River pollution
  • Rivers
  • Safety engineering
  • Salmonella
  • Sanitation
  • Sustainable development
  • Urban planning
  • Safety planning
  • Viet Nam
  • Wastewater treatment

Cite this

Fuhrimann, Samuel ; Nauta, Maarten ; Pham-Duc, Phuc ; Tram, Nguyen Thuy ; Nguyen-Viet, Hung ; Utzinger, Jürg ; Cissé, Guéladio ; Winkler, Mirko S. / Disease burden due to gastrointestinal infections among people living along the major wastewater system in Hanoi, Vietnam. In: Advances in Water Resources. 2017 ; Vol. 108. pp. 439-449.
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title = "Disease burden due to gastrointestinal infections among people living along the major wastewater system in Hanoi, Vietnam",
abstract = "Background: Despite recent improvements of wastewater treatment capacities in urban areas of Hanoi, Vietnam, microbial pollution is still considerable. There is a paucity of burden estimates due to gastrointestinal infection in people living along the wastewater system, and among people who are in direct contact with the wastewater, such as farmers using wastewater in agriculture and aquaculture. Methods: A quantitative microbial risk assessment (QMRA) was pursued focussing on four population groups characterised by different levels of exposure to wastewater: (i) workers maintaining the wastewater conveyance and treatment systems; (ii) urban farmers using wastewater from To Lich River; (iii) community members in urban areas exposed to flooding events in the districts of Hoang Mai and Thanh Tri; and (iv) peri-urban farmers in Thanh Tri district, where Red River water is used for agriculture and aquaculture. The QMRA was developed on the basis of measured concentration of . Escherichia coli and . Salmonella spp. and . Ascaris spp. eggs in water samples. Published ratios between measured organisms and pathogenic strains of norovirus, rotavirus, . Campylobacter spp. ., pathogenic . E. . . coli, pathogenic . Salmonella spp., . Cryptosporidium spp. and . Ascaris lumbricoides were employed to estimate annual risk of gastrointestinal infection and disease burden. Results: The QMRA estimated a disease burden of 0.011 disability-adjusted life years (DALYs) per person per year in urban farmers, 0.006 DALYs for sanitation workers, 0.0005 DALYs for urban communities at risk of flooding events and 0.0004 DALYs for peri-urban farmers. Urban farmers had considerably higher incidence estimates for gastrointestinal disease episodes per year (2.0) compared to the other exposure groups (≤ 1.0). Conclusions: Urban farmers using wastewater from To Lich River have a high gastrointestinal disease burden, which is about 100 times larger than the health-based targets for wastewater use set by the World Health Organization. These findings are of direct public health relevance and call for upgrading Hanoi's wastewater system to reduce microbial contamination. Finally, this study presents a first example on how to link QMRA to a sanitation safety planning (SSP) approach in an Asian context and its findings are interesting in the frame of Sustainable Development Goal (SDGs) #6.",
keywords = "Water Science and Technology, Bacteria, Helminths, Quantitative microbial risk assessment, Sanitation safety planning, Sustainable development goals, Urban farming, Vietnam, Wastewater, Agriculture, Aquaculture, Escherichia coli, Floods, Health, Health risks, Occupational risks, Planning, Risk assessment, Risk perception, River pollution, Rivers, Safety engineering, Salmonella, Sanitation, Sustainable development, Urban planning, Safety planning, Viet Nam, Wastewater treatment",
author = "Samuel Fuhrimann and Maarten Nauta and Phuc Pham-Duc and Tram, {Nguyen Thuy} and Hung Nguyen-Viet and J{\"u}rg Utzinger and Gu{\'e}ladio Ciss{\'e} and Winkler, {Mirko S.}",
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language = "English",
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journal = "Advances in Water Resources",
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Disease burden due to gastrointestinal infections among people living along the major wastewater system in Hanoi, Vietnam. / Fuhrimann, Samuel; Nauta, Maarten; Pham-Duc, Phuc; Tram, Nguyen Thuy; Nguyen-Viet, Hung; Utzinger, Jürg; Cissé, Guéladio; Winkler, Mirko S.

In: Advances in Water Resources, Vol. 108, 2017, p. 439-449.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Disease burden due to gastrointestinal infections among people living along the major wastewater system in Hanoi, Vietnam

AU - Fuhrimann, Samuel

AU - Nauta, Maarten

AU - Pham-Duc, Phuc

AU - Tram, Nguyen Thuy

AU - Nguyen-Viet, Hung

AU - Utzinger, Jürg

AU - Cissé, Guéladio

AU - Winkler, Mirko S.

PY - 2017

Y1 - 2017

N2 - Background: Despite recent improvements of wastewater treatment capacities in urban areas of Hanoi, Vietnam, microbial pollution is still considerable. There is a paucity of burden estimates due to gastrointestinal infection in people living along the wastewater system, and among people who are in direct contact with the wastewater, such as farmers using wastewater in agriculture and aquaculture. Methods: A quantitative microbial risk assessment (QMRA) was pursued focussing on four population groups characterised by different levels of exposure to wastewater: (i) workers maintaining the wastewater conveyance and treatment systems; (ii) urban farmers using wastewater from To Lich River; (iii) community members in urban areas exposed to flooding events in the districts of Hoang Mai and Thanh Tri; and (iv) peri-urban farmers in Thanh Tri district, where Red River water is used for agriculture and aquaculture. The QMRA was developed on the basis of measured concentration of . Escherichia coli and . Salmonella spp. and . Ascaris spp. eggs in water samples. Published ratios between measured organisms and pathogenic strains of norovirus, rotavirus, . Campylobacter spp. ., pathogenic . E. . . coli, pathogenic . Salmonella spp., . Cryptosporidium spp. and . Ascaris lumbricoides were employed to estimate annual risk of gastrointestinal infection and disease burden. Results: The QMRA estimated a disease burden of 0.011 disability-adjusted life years (DALYs) per person per year in urban farmers, 0.006 DALYs for sanitation workers, 0.0005 DALYs for urban communities at risk of flooding events and 0.0004 DALYs for peri-urban farmers. Urban farmers had considerably higher incidence estimates for gastrointestinal disease episodes per year (2.0) compared to the other exposure groups (≤ 1.0). Conclusions: Urban farmers using wastewater from To Lich River have a high gastrointestinal disease burden, which is about 100 times larger than the health-based targets for wastewater use set by the World Health Organization. These findings are of direct public health relevance and call for upgrading Hanoi's wastewater system to reduce microbial contamination. Finally, this study presents a first example on how to link QMRA to a sanitation safety planning (SSP) approach in an Asian context and its findings are interesting in the frame of Sustainable Development Goal (SDGs) #6.

AB - Background: Despite recent improvements of wastewater treatment capacities in urban areas of Hanoi, Vietnam, microbial pollution is still considerable. There is a paucity of burden estimates due to gastrointestinal infection in people living along the wastewater system, and among people who are in direct contact with the wastewater, such as farmers using wastewater in agriculture and aquaculture. Methods: A quantitative microbial risk assessment (QMRA) was pursued focussing on four population groups characterised by different levels of exposure to wastewater: (i) workers maintaining the wastewater conveyance and treatment systems; (ii) urban farmers using wastewater from To Lich River; (iii) community members in urban areas exposed to flooding events in the districts of Hoang Mai and Thanh Tri; and (iv) peri-urban farmers in Thanh Tri district, where Red River water is used for agriculture and aquaculture. The QMRA was developed on the basis of measured concentration of . Escherichia coli and . Salmonella spp. and . Ascaris spp. eggs in water samples. Published ratios between measured organisms and pathogenic strains of norovirus, rotavirus, . Campylobacter spp. ., pathogenic . E. . . coli, pathogenic . Salmonella spp., . Cryptosporidium spp. and . Ascaris lumbricoides were employed to estimate annual risk of gastrointestinal infection and disease burden. Results: The QMRA estimated a disease burden of 0.011 disability-adjusted life years (DALYs) per person per year in urban farmers, 0.006 DALYs for sanitation workers, 0.0005 DALYs for urban communities at risk of flooding events and 0.0004 DALYs for peri-urban farmers. Urban farmers had considerably higher incidence estimates for gastrointestinal disease episodes per year (2.0) compared to the other exposure groups (≤ 1.0). Conclusions: Urban farmers using wastewater from To Lich River have a high gastrointestinal disease burden, which is about 100 times larger than the health-based targets for wastewater use set by the World Health Organization. These findings are of direct public health relevance and call for upgrading Hanoi's wastewater system to reduce microbial contamination. Finally, this study presents a first example on how to link QMRA to a sanitation safety planning (SSP) approach in an Asian context and its findings are interesting in the frame of Sustainable Development Goal (SDGs) #6.

KW - Water Science and Technology

KW - Bacteria

KW - Helminths

KW - Quantitative microbial risk assessment

KW - Sanitation safety planning

KW - Sustainable development goals

KW - Urban farming

KW - Vietnam

KW - Wastewater

KW - Agriculture

KW - Aquaculture

KW - Escherichia coli

KW - Floods

KW - Health

KW - Health risks

KW - Occupational risks

KW - Planning

KW - Risk assessment

KW - Risk perception

KW - River pollution

KW - Rivers

KW - Safety engineering

KW - Salmonella

KW - Sanitation

KW - Sustainable development

KW - Urban planning

KW - Safety planning

KW - Viet Nam

KW - Wastewater treatment

U2 - 10.1016/j.advwatres.2016.12.010

DO - 10.1016/j.advwatres.2016.12.010

M3 - Journal article

VL - 108

SP - 439

EP - 449

JO - Advances in Water Resources

JF - Advances in Water Resources

SN - 0309-1708

ER -