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"Sanitary Engineering methods."
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Stepped-wedge cluster-randomised controlled trial to assess the cardiovascular health effects of a managed aquifer recharge initiative to reduce drinking water salinity in southwest coastal Bangladesh: study design and rationale
IntroductionSaltwater intrusion and salinisation have contributed to drinking water scarcity in many coastal regions globally, leading to dependence on alternative sources for water supply. In southwest coastal Bangladesh, communities have few options but to drink brackish groundwater which has been associated with high blood pressure among the adult population, and pre-eclampsia and gestational hypertension among pregnant women. Managed aquifer recharge (MAR), the purposeful recharge of surface water or rainwater to aquifers to bring hydrological equilibrium, is a potential solution for salinity problem in southwest coastal Bangladesh by creating a freshwater lens within the brackish aquifer. Our study aims to evaluate whether consumption of MAR water improves human health, particularly by reducing blood pressure among communities in coastal Bangladesh.Methods and analysisThe study employs a stepped-wedge cluster-randomised controlled community trial design in 16 communities over five monthly visits. During each visit, we will collect data on participants’ source of drinking and cooking water and measure the salinity level and electrical conductivity of household stored water. At each visit, we will also measure the blood pressure of participants ≥20 years of age and pregnant women and collect urine samples for urinary sodium and protein measurements. We will use generalised linear mixed models to determine the association of access to MAR water on blood pressure of the participants.Ethics and disseminationThe study protocol has been reviewed and approved by the Institutional Review Boards of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b). Informed written consent will be taken from all the participants. This study is funded by Wellcome Trust, UK. The study findings will be disseminated to the government partners, at research conferences and in peer-reviewed journals.Trial registration numberNCT02746003; Pre-results.
Journal Article
Pathogen cross-transmission via building sanitary plumbing systems in a full scale pilot test-rig
The WHO Consensus Document on the epidemiology of the SARS epidemic in 2003, included a report on a concentrated outbreak in one Hong Kong housing block which was considered a 'super-spreading event'. The WHO report conjectured that the sanitary plumbing system was one transmission route for the virus. Empty U-traps allowed the aerosolised virus to enter households from the sewerage system. No biological evidence was presented. This research reports evidence that pathogens can be aerosolised and transported on airstreams within sanitary plumbing systems and enter buildings via empty U-traps. A sanitary plumbing system was built, representing two floors of a building, with simulated toilet flushes on the lower floor and a sterile chamber with extractor fan on the floor above. Cultures of a model organism, Pseudomonas putida at 106-109 cfu ml-1 in 0·85% NaCl were flushed into the system in volumes of 6 to 20 litres to represent single or multiple toilet flushes. Air and surface samples were cultured on agar plates and assessed qualitatively and semi-quantitatively. Flushing from a toilet into a sanitary plumbing system generated enough turbulence to aerosolise pathogens. Typical sanitary plumbing system airflows (between 20-30 ls-1) were sufficient to carry aerosolised pathogens between different floors of a building. Empty U-traps allowed aerosolised pathogens to enter the chamber, encouraging cross-transmission. All parts of the system were found to be contaminated post-flush. Empty U-traps have been observed in many buildings and a risk assessment indicates the potential for high risk cross-transmission under defect conditions in buildings with high pathogen loading such as hospitals. Under defective conditions (which are not uncommon) aerosolised pathogens can be carried on the airflows within sanitary plumbing systems. Our findings show that greater consideration should be given to this mode of pathogen transmission.
Journal Article
Mental health status of informal waste workers during the COVID-19 pandemic in Bangladesh
The deadliest coronavirus disease 2019 (COVID-19) is taking thousands of lives worldwide and presents an extraordinary challenge to mental resilience. This study assesses mental health status during the COVID-19 pandemic and its associated factors among informal waste workers in Bangladesh. A cross-sectional survey was conducted in June 2020 among 176 informal waste workers selected from nine municipalities and one city corporation in Bangladesh. General Health Questionnaire (GHQ-12) was used to assess respondents’ mental health. The study found that 80.6% of the individuals were suffering from psychological distress; 67.6% reported anxiety and depression, 92.6% reported social dysfunction, and 19.9% reported loss of confidence. The likelihood of psychological distress (Risk ratio [RR]: 1.23, 95% confidence interval [CI]: 1.02–1.48) was significantly higher for female than male. Multiple COVID-19 symptoms of the family members (RR: 1.20, 95% CI: 1.03–1.41), unawareness about COVID-19 infected neighbor (RR: 1.21, 95% CI: 1.04–1.41), income reduction (RR: 1.60, 95% CI: 1.06–2.41) and daily household meal reduction (RR: 1.34; 95% CI: 1.03–1.73) were also found to be associated with psychological distress. These identified factors should be considered in policy-making and support programs for the informal waste workers to manage the pandemic situation as well as combating COVID-19 related psychological challenges.
Journal Article
Upgrading of sewage treatment plant by sustainable and cost-effective separate treatment of industrial wastewater
The Olburgen sewage treatment plant has been upgraded to improve the effluent quality by implementing a separate and dedicated treatment for industrial (potato) wastewater and reject water. The separate industrial treatment has been realized within a beneficial public-private partnership. The separate treatment of the concentrated flows of industrial wastewater and sludge treatment effluent proved to be more cost-efficient and area and energy efficient than a combined traditional treatment process. The industrial wastewater was first treated in a UASB reactor for biogas production. The UASB reactor effluent was combined with the reject water and treated in a struvite reactor (Phospaq process) followed by a one stage granular sludge nitritation/anammox process. For the first time both reactors where demonstrated on full scale and have been operated stable over a period of 3 years. The recovered struvite has been tested as a suitable substitute for commercial fertilizers. Prolonged exposure of granular anammox biomass to nitrite levels up to 30 mg/l did not result in inhibition of the anammox bacteria in this reactor configuration. The chosen option required a 17 times smaller reactorvolume (20,000 m3 less volume) and saves electric power by approximately 1.5 GWh per year.
Journal Article
Investigation on the microbial community of an accelerating stabilization landfill by aeration engineering
The microbial community of the landfill undergoing aerobic stabilization process by aeration engineering was investigated. The municipal solid wastes (MSWs) were sampled from two aeration well sites with different landfill temperatures (65.5°C and 41.7°C) under higher and lower stabilization level. The physical component, chemical property, and microbial population of MSWs were analyzed and compared. The result showed that the phylum
Firmicutes
was dominant in the aerobic landfill; and the genus
Weissella
and
Syntrophaceticus
were more abundant in high, and low temperature site, respectively. The bacterial distribution showed difference on two temperature sites and four landfill depths, mainly affected by the ammonia-nitrogen and moisture content of MSWs. The ecological profiles of the microorganisms responded the aeration engineering were predicted. The anaerobic hydrolytic and acetogenic microorganisms were decreased in abundance, while the facultative
Lactobacillus
increased when the landfill under a higher stabilization level. The function abundances of methane oxidation, sulfide oxidation, and aerobic chemoheterotrophy were enriched by aeration engineering, which was the microbial mechanism for accelerating the stabilization process of landfill.
Journal Article
Combined sewer overflow control with LID based on SWMM: an example in Shanghai, China
Although low impact development (LID) has been commonly applied across the developed countries for mitigating the negative impacts of combined sewer overflows (CSOs) on urban hydrological environment, it has not been widely used in developing countries yet. In this paper, a typical combined sewer system in an urbanized area of Shanghai, China was used to demonstrate how to design and choose CSO control solutions with LID using stormwater management model. We constructed and simulated three types of CSO control scenarios. Our findings support the notion that LID measures possess favorable capability on CSO reduction. Nevertheless, the green scenarios which are completely comprised by LID measures fail to achieve the maximal effectiveness on CSO reduction, while the gray-green scenarios (LID measure combined with gray measures) achieve it. The unit cost-effectiveness of each type of scenario sorts as: green scenario > gray-green scenario > gray scenario. Actually, as the storage tank is built in the case catchment, a complete application of green scenario is inaccessible here. Through comprehensive evaluation and comparison, the gray-green scenario F which used the combination of storage tank, bio-retention and rain barrels is considered as the most feasible one in this case.
Journal Article
How to transform the practice of engineering to meet global health needs
More of the world’s population has access to cell phones than to basic sanitation facilities, a gap that can only be closed if the engineering and international aid communities adopt new approaches to design for scarcity and scalability.
Journal Article