Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable in low-resource communities. A pilot study was conducted of potential field use indicators, including the Colilert coliform Presence/ Absence test, hydrogen sulfide, alkalinity, hardness, pH, and fluorescently-labeled latex microspheres. The study included both laboratory and field testing. The Colilert Presence/ Absence test had the highest correlation to the United States Environmental Protection Agency standard method (IDEXX Quantitrays), but more data is needed before making a recommendation. This study adds to understanding about evaluation of biosand water filters and provides preliminary data to address the need for a field use indicator for biosand water filters.

Since the passage of the Clean Water Act, concern about surface water quality has increased. Reducing exposure to pathogens and adverse impacts on human health because of contact with surface waters has become the focus of many regulatory agencies. Fecal pollution is often a cause of surface water impairment. Fecal indicators, such as fecal coliforms and Escherichia coli, are used as surrogates to evaluate the presence or absence of fecal pollution. However, a growing body of research has shown that these species lack key characteristics necessary to be adequate indicators. As such, explorations into the efficacy of indicator species in predicting fecal pollution in water are necessary. Sinking Creek is a tributary of the Watauga River Watershed, located in Northeast Tennessee. Approximately ten miles of Sinking Creek have been placed on the national 303(d) list for fecal pollution, denoting the presence of fecal contamination exceeding the regulatory limit. Salmonella and Aeromonas are two enteric pathogens that would be expected to be detected in fecally contaminated waters. The primary objective of this study was to detect the presence of Salmonella and Aeromonas in Sinking Creek. The secondary objective was to evaluate their relationship with fecal coliforms, E. coli, and water quality parameters. Six study sites along Sinking Creek were sampled and standard methods were used to enumerate Salmonella and Aeromonas. Samples for Salmonella were collected for 8 months, while samples for Aeromonas were collected for seven. Salmonella and Aeromonas were present in Sinking Creek. Salmonella had the highest concentration at site 2 (the most downstream site), and was detected during all months of the study except for November. Salmonella concentrations varied by site. Aeromonas was present only during colder months, and had the highest concentration at site 2. Both Salmonella and Aeromonas show qualitative relationships with water quality parameters, such as dissolved oxygen and conductivity. However, statistically significant correlations of Salmonella and Aeromonas with water quality parameters were not observed. The lack of statistical significance is partially due to large variability and a small data set. Neither Salmonella or Aeromonas exhibited a relationship with fecal coliforms or E. coli. Therefore, fecal coliforms and E. coli may not be adequate indicator species for the presence of Salmonella, Aeromonas and possibly other waterborne pathogens. Traditional indicator species may inflate risk of pathogen exposure. Thus, many water bodies may be unnecessarily deemed as impaired. The results from this study can be used to guide further research regarding covariates influencing pathogen densities at fecally contaminated sites, as well as to guide decisions regarding impaired surface waters and management techniques.

Heavy metals are highly persistent in water and have a particular significance in ecotoxicology. Heavy metals loading from the Pearl River are likely to cause significant impacts on the environment in the South China Sea and the West Pacific. In this study, using monthly monitoring data from a water quality monitoring campaign during 2006–2012, the temporal variation and spatial transfer of six heavy metals (lead (Pb), copper (Cu), cadmium (Cd), zinc (Zn), arsenic (As), and mercury (Hg)) in the Pearl River were analyzed, and the heavy metal fluxes into the sea were calculated. During this period, the annual heavy metal loads discharged from the Pearl River into the South China Sea were 5.8 (Hg), 471.7 (Pb), 1524.6 (Cu), 3819.6 (Zn), 43.9 (Cd), and 621.9 (As) tons, respectively. The metal fluxes showed a seasonal variation with the maximum fluxes occurring from June to July. There is a close association between metal fluxes and runoff. The analysis of the heavy metal transfer from the upstream to the downstream revealed that the transfer from the upstream accounted for a major portion of the heavy metals in the Pearl River Delta. Therefore, earlier industry relocation efforts in the Pearl River watershed may have limited effect on the water quality improvement in surrounding areas. It is suggested that watershed-based pollution control measures focusing on wastewater discharge in both upstream and downstream areas should be developed and implemented in the future.

No description available.

Background: Evidence from experimental studies suggests that atrazine and its analytes alter the timing of puberty in laboratory animals. Such associations have not been investigated in humans. Objective: To determine the association between in utero exposure to atrazine analytes and earlier menarche attainment in a nested case-control study of the population-based Avon Longitudinal Study of Parents and Children. Methods: Cases were girls who reported menarche before 11.5 years while controls were girls who reported menarche at or after 11.5 years. Seven atrazine analyte concentrations were measured in maternal gestational urine samples (sample gestation week median (IQR): 12 (8–17)) during the period 1991–1992, for 174 cases and 195 controls using high performance liquid chromatography-tandem mass spectrometry. We evaluated the study association using multivariate logistic regression, adjusting for potential confounders. We used multiple imputation to impute missing confounder data for 29% of the study participants. Results: Diaminochlorotriazine (DACT) was the most frequently detected analyte (58%>limit of detection [LOD]) followed by desethyl atrazine (6%), desethyl atrazine mercapturate (3%), atrazine mercapturate (1%), hydroxyl atrazine (1%), atrazine (1%) and desisopropyl atrazine (0.5%). Because of low detection of other analytes, only DACT was included in the exposure–outcome analyses. The adjusted odds of early menarche for girls with DACT exposures≥median was 1.13 (95% Confidence Interval [95% CI]:0.82, 1.55) and exposure Conclusions: This study is the first to examine the association between timing of menarche and atrazine analytes. We found a weak, non-significant association between in-utero exposure to atrazine metabolite DACT and early menarche, though the association was significant in the subset of girls with complete confounder information. Further exploration of the role of these exposures in female reproduction in other cohorts is needed.

Motor vehicle inspection and maintenance (I/M) programs are designed to identify high-emitting vehicles and mitigate their impacts on air quality and climate. I/M programs have been traditionally ranked superior among various vehicle emission control measures by the results of cost-benefit analysis, based on the assumption that these programs will achieve the targeted emission reduction outcomes. However, the actual effects of I/M programs may be greatly uncertain and when this uncertainty is taken into account, these programs may become suboptimal. This study develops a new a cost-benefit analysis framework that links various program design consideration, such as program participation rate, identification rate and effective repair rate, to the public health benefits as well as costs of the programs. This framework helps decision makers to investigate minimum implementation requirements that at least ensure the benefits are greater than the costs of implementing the programs in order to improve the overall effectiveness of the I/M programs. To illustrate the applications of the framework, it was applied to a particulate matter oriented I/M program targeting all diesel-fueled vehicles in the city of Bangkok, Thailand, a large metropolitan area that has been suffering from severe ambient PM pollution mainly attributable to its wide use of diesel-fueled vehicles and motorcycles. It was found that the health benefits achieved from the program are sensitive to several key program design elements, including participation rate and problem vehicle identification rate, fraction of effective repairs and illegal operation rate. Other variables, such as the testing cut-points and vehicle population growth rate, only have modest effects on the overall emission reduction and consequent health benefits. Overall, the performance of multiple variables associated with I/M program design needs to be improved simultaneous in order to achieve the targeted benefits of the program.

Global climate change is anticipated to raise overall temperatures and has the potential to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world's largest developing country, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging and underexplored, particularly in developing countries. This is an exploratory study aimed at projecting future heat-related mortality risk in major urban areas in China. We focus on the 51 largest Chinese cities that include about one third of the total population in China, and project the potential changes in heat-related mortality based on 19 different global-scale climate models and three Representative Concentration Pathways (RCPs). City-specific risk estimates for high temperature and all-cause mortality were used to estimate annual heat-related mortality over two future twenty-year time periods. We estimated that for the 20-year period in Mid-21st century (2041-2060) relative to 1970-2000, incidence of excess heat-related mortality in the 51 cities to be approximately 37,800 (95% CI: 31,300-43,500), 31,700 (95% CI: 26,200-36,600) and 25,800 (95% CI: 21,300-29,800) deaths per year under RCP8.5, RCP4.5 and RCP2.6, respectively. Slowing climate change through the most stringent emission control scenario RCP2.6, relative to RCP8.5, was estimated to avoid 12,900 (95% CI: 10,800-14,800) deaths per year in the 51 cities in the 2050s, and 35,100 (95% CI: 29,200-40,100) deaths per year in the 2070s. The highest mortality risk is primarily in cities located in the North, East and Central regions of China. Population adaptation to heat is likely to reduce excess heat mortality, but the extent of adaptation is still unclear. Future heat mortality risk attributable to exposure to elevated warm season temperature is likely to be considerable in China's urban centers, with substantial geographic variations. Climate mitigation and heat risk management are needed to reduce such risk and produce substantial public health benefits.

Contamination of methylmercury (MeHg) in aquatic products has been a wide spread health concern. The objective of this study is to determine total mercury (THg) and MeHg concentrations in different species of aquatic products from major offshore farms in China, and to assess health impacts from consumption. Results showed that the concentrations of THg and MeHg ranged 5.6–328.4 ng/g (wet weight) and 4.3–303.6 ng/g (wet weight) in aquatic products, respectively, and were very variable among species and origin sources. Target hazard quotient (THQ) suggested that MeHg exposure via consumption posed high health risks to children aged 2–7 and higher income families. Residents above the age of 13 and with low income have relatively lower health risk of MeHg exposure. Health impacts on heart attacks and newborns’ IQ from MeHg exposure were evaluated using dose-response relationships. Results showed that mother’s consumption of aquatic products (at 6 ounce per day) may cause a loss of 0.38 IQ points for newborns. For non-pregnant, consumption of aquatic products may cause an increase rate of mortality and morbidity of heart attacks at 10.59 and 78.45 per 100,000 persons, respectively. The negative health impact of consuming seawater fish was higher than freshwater fish.

Abstract available in the Lancet.

Global climate change is anticipated to raise overall temperatures and is likely to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world’s largest developing country and the largest carbon emitter, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging, with the related health impacts in developing countries largely unexplored. This is an exploratory study aimed at projecting future heat-related mortality risk in major metropolitan areas in China. We focus on 50 large Chinese cities that cover about 1/3 of the total population in China, and propose to assess the potential changes in heat-related mortality under 19 different global-scale climate models and three Representative Concentration Pathways (RCPs) used in the latest Intergovernmental Panel on Climate Change Fifth Assessment Report (IPCC AR5). We project future changes in heat-related mortality in the 2050s and 2070s relative to the base period of 1950-2000. The projections are based on an integrated assessment framework that combines high-resolution climate model outputs, city-specific temperature-mortality relationships, population projections and baseline mortality rates. Future temperature changes in the study areas are estimated based on downscaled climate model outputs at a spatial resolution of about 1 square kilometer. City-specific historical temperature-mortality associations are obtained from the epidemiological literature. Population projections are based on the China census 2010 survey and projected population growth rates from the 2015 Revision of World Population Prospects by the United Nations. Baseline mortality rates are obtained from China’s national and local health statistics publications. Our findings suggest that future heat mortality risk attributable to elevated warm season temperature is likely to be significant in China’s urban areas, with substantial geographic variations, highlighting the significance of climate mitigation and local-level heat risk management.