The Water Safety Plan (WSP) methodology, which aims to enhance safety of drinking water supplies, has been recommended by the World Health Organization since 2004. WSPs are now used worldwide and are legally required in several countries. However, there is limited systematic evidence available demonstrating the effectiveness of WSPs on water quality and health. Iceland was one of the first countries to legislate the use of WSPs, enabling the analysis of more than a decade of data on impact of WSP. The objective was to determine the impact of WSP implementation on regulatory compliance, microbiological water quality, and incidence of clinical cases of diarrhea. Surveillance data on water quality and diarrhea were collected and analyzed. The results show that HPC (heterotrophic plate counts), representing microbiological growth in the water supply system, decreased statistically significant with fewer incidents of HPC exceeding 10 cfu per mL in samples following WSP implementation and noncompliance was also significantly reduced (p < 0.001 in both cases). A significant decrease in incidence of diarrhea was detected where a WSP was implemented, and, furthermore, the results indicate that population where WSP has been implemented is 14% less likely to develop clinical cases of diarrhea.
The aim of this study was to investigate accumulated experience with water safety plans in one of the first countries to adopt systematic preventive management for drinking-water safety. Water utilities in Iceland have had a legal obligation since 1995 to implement a systematic preventive approach to secure safety of drinking water and protect public health. The water utilities responded by implementing either an adapted HACCP (Hazard Analysis Critical Control Points) model for larger water utilities or a simpler five step model for smaller water utilities. The research was carried out at 16 water utilities that serve about two-thirds of the population of Iceland. Both qualitative and quantitative methods were used with the aim of analysing if and what benefits water safety plans bring for water utilities and what is needed for successful implementation and operation of such systems. The results of the study show that numerous benefits and even the process of going through the implementing process were considered to be of advantage and change the attitude of the staff and the utility culture. Some obstacles and shortcomings came to light, such as lack of documentation and lack of regular internal and external audit. There was little communication with the public, although some mentioned that good public relations are important to succeed with water safety plans. Many important elements of success were revealed of which intensive training of staff and participation of staff in the whole process are deemed the most important. It is also important to have simple and well-structured guidelines, and good cooperation with the health authorities.
Icelandic waterworks first began implementing hazard analysis and critical control points (HACCP) as a preventive approach for water safety management in 1997. Since then implementation has been ongoing and currently about 68% of the Icelandic population enjoy drinking water from waterworks with a water safety plan based on HACCP. Preliminary evaluation of the success of HACCP implementation was undertaken in association with some of the waterworks that had implemented HACCP. The evaluation revealed that compliance with drinking water quality standards improved considerably following the implementation of HACCP. In response to their findings, waterworks implemented a large number of corrective actions to improve water safety.The study revealed some limitations for some, but not all, waterworks in relation to inadequate external and internal auditing and a lack of oversight by health authorities. Future studies should entail a more comprehensive study of the experience with the use of HACCP with the purpose of developing tools to promote continuing success.
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