Hunter Paul R, Zmirou-Navier Denis, Hartemann Philippe
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.
Sci Total Environ. 2009 Apr 1;407(8):2621-4. doi: 10.1016/j.scitotenv.2009.01.018. Epub 2009 Feb 4.
Recent evidence suggests that many improved drinking water supplies suffer from poor reliability. This study investigates what impact poor reliability may have on achieving health improvement targets. A Quantitative Microbiological Risk Assessment was conducted of the impact of interruptions in water supplies that forced people to revert to drinking raw water. Data from the literature were used to construct models on three waterborne pathogens common in Africa: Rotavirus, Cryptosporidium and Enterotoxigenic E. coli. Risk of infection by the target pathogens is substantially greater on days that people revert to raw water consumption. Over the course of a few days raw water consumption, the annual health benefits attributed to consumption of water from an improved supply will be almost all lost. Furthermore, risk of illness on days drinking raw water will fall substantially on very young children who have the highest risk of death following infection. Agencies responsible for implementing improved drinking water provision will not make meaningful contributions to public health targets if those systems are subject to poor reliability. Funders of water quality interventions in developing countries should put more effort into auditing whether interventions are sustainable and whether the health benefits are being achieved.
最近的证据表明，许多改善后的饮用水供应可靠性较差。本研究调查了可靠性差可能对实现健康改善目标产生何种影响。针对迫使人们转而饮用生水的供水中断影响，进行了一项定量微生物风险评估。利用文献数据构建了关于非洲常见的三种水源性病原体的模型：轮状病毒、隐孢子虫和产肠毒素大肠杆菌。在人们转而饮用生水的日子里，目标病原体的感染风险大幅增加。在饮用生水的几天时间里，因饮用改善后的水源水而带来的年度健康益处几乎将全部丧失。此外，饮用生水当天的患病风险在感染后死亡风险最高的幼儿中会大幅下降。如果那些改善饮用水供应系统可靠性差，负责实施改善饮用水供应的机构将无法对公共卫生目标做出有意义的贡献。发展中国家水质干预措施的资助者应更加努力地审核干预措施是否可持续以及是否实现了健康益处。
