Residual microbiological risk after simple chlorine treatment of drinking ground water in small community systems

Zmirou, Denis; Rey, Sonia Uceira; Courtois, X.; Jp, Ferley; Blatier, J-F.; Chevallier, Philippe; Boudot, Jean‐Pierre; Potelon, J-L.; Mounir, R.

doi:10.1093/eurpub/5.2.75

Cited by 15 publications

(9 citation statements)

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“…Part of the problem is that chlorination alone is not effective against Cryptosporidium and has reduced impact against Giardia (two particularly important waterborne pathogens). A study of small systems in France showed that chlorination alone did not remove risk of illness associated with contaminated supplies, even when indicator organisms were inactivated [79]. However, the main problem appears to be inconsistent use.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Public Health Interventions to Reduce the Health Impact of Climate Change: A Systematic Review of Systematic Reviews

2013

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BackgroundClimate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases.Methods and FindingsFor each disease, we performed a systematic search with no restriction on date or language of publication on Medline, Web of Knowledge, Cochrane CENTRAL and SCOPUS up to December 2010 to identify systematic reviews of public health interventions. We retrieved some 3176 records of which 85 full papers were assessed and 33 included in the review. The included papers investigated the effect of public health interventions on various outcome measures. All interventions were GRADE assessed to determine the strength of evidence. In addition we developed a systematic review quality score. The interventions included environmental interventions to control vectors, chemoprophylaxis, immunization, household and community water treatment, greening cities and community advice. For most reviews, GRADE showed low quality of evidence because of poor study design and high heterogeneity. Also for some key areas such as floods, droughts and other weather extremes, there are no adequate systematic reviews of potential public health interventions.ConclusionIn conclusion, we found the evidence base to be mostly weak for environmental interventions that could have the most value in a warmer world. Nevertheless, such interventions should not be dismissed. Future research on public health interventions for climate change adaptation needs to be concerned about quality in study design and should address the gap for floods, droughts and other extreme weather events that pose a risk to health.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of Public Health Interventions to Reduce the Health Impact of Climate Change: A Systematic Review of Systematic Reviews

2013

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“…The longitudinal design of the study, with health surveillance actively measured by telephone calls, provided a quasi‐exhaustive collection of data. Other prospective studies that allowed quantification of rates of acute gastrointestinal conditions provided similar figures—about 0.5–2.0 cases per person‐year, according to age and to case definition (Hellard et al, 2001; Payment et al, 1997a; Zmirou et al, 1995; Payment et al, 1991). The endemic rather than epidemic pattern of ADCs in water systems that comply with bacterial standards confirms previous studies carried out in the same region of France (Zmirou et al, 1995; Zmirou et al, 1987).…”

Section: Discussionmentioning

confidence: 73%

Health risks and parasitical quality of water

Gofti-Laroche¹,

Demanse²,

Joret³

et al. 2003

Journal AWWA

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This article assesses the risks of acute digestive conditions (ADC) in relation to protozoa Giardia and Cryptosporidium conveyed through drinking water within a French general population. It is a part of the Epidemiology and Microbial Risk Assessment study, which combined a daily epidemiological followup among a panel of volunteers whose water was supplied by vulnerable public water systems. These systems were monitored with a microbiological surveillance of the tap water. Parasitical quality of the water was assessed using cartridge and immunofluorescence assays. The relationship between incidence of ADC and waterborne protozoa was modeled using logistic regression and generalized estimating equations analysis. During the study period, 712 cases of ADC occurred. Thirty‐six tap water samples were collected for parasitical quality analysis. of these, 11 tested positive for at least one protozoan, among which 10 complied with bacterial criteria. The final model included concentrations of Giardia cysts and several confounding factors; unfortunately, Cryptosporidium data were too sparse for analysis. Biostatistical modeling showed that Giardia detection was associated with an increased risk of ADC: relative risk (RR) = 1.19 (95% confidence interval = [0.96–1.48]) for 10 to 20 cysts/100 L, and RR = 1.24 [1.06–1.45] for more than 20 cysts/100 L, compared with absence of detectable cysts. These results suggest the role of Giardia in the endemic level of waterborne infectious diseases and raise the question of protozoa surveillance in drinking water, while traditional bacterial surveillance indicators have been shown to be poor predictors of their presence.

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“…If both parents smoke the presence of wheezes and asthma increases by 20%. At the same time, infections of the lower respiratory tract and cough increases by 30% and by 13%, respectively (Zmirou et al , 1990). These circumstances are directly related to the consumption of tobacco by the mother.…”

Section: Infections Of the Lower Respiratory Tractmentioning

confidence: 99%