Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 205 North Mathews Avenue, 3221 Newmark Civil Engineering Laboratory, Urbana, Illinois 61801, United States.
The School with Sustainable Engineering and the Built Environment and The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona 85287, United States.
Environ Sci Technol. 2021 Apr 20;55(8):5463-5474. doi: 10.1021/acs.est.0c05693. Epub 2021 Mar 22.
Decision-makers in developing communities often lack credible data to inform decisions related to water, sanitation, and hygiene. Quantitative microbial risk assessment (QMRA), which quantifies pathogen-related health risks across exposure routes, can be informative; however, the utility of QMRA for decision-making is often undermined by data gaps. This work integrates QMRA, uncertainty and sensitivity analyses, and household surveys in Bwaise, Kampala (Uganda) to characterize the implications of censored data management, identify sources of uncertainty, and incorporate risk perceptions to improve the suitability of QMRA for informal settlements or similar settings. In Bwaise, drinking water, hand rinse, and soil samples were collected from 45 households and supplemented with data from 844 surveys. Quantified pathogen (adenovirus, , and spp./EIEC) concentrations were used with QMRA to model infection risks from exposure through drinking water, hand-to-mouth contact, and soil ingestion. Health risks were most sensitive to pathogen data, hand-to-mouth contact frequency, and dose-response models (particularly ). When managing censored data, results from upper limits of detection, half of limits of detection, and uniform distributions returned similar results, which deviated from lower limits of detection and maximum likelihood estimation imputation approaches. Finally, risk perceptions (e.g., it is unsafe to drink directly from a water source) were identified to inform risk management.
发展中社区的决策者在做出与水、环境卫生和个人卫生相关的决策时，往往缺乏可靠的数据。定量微生物风险评估（QMRA）可以量化与病原体相关的健康风险，但由于数据缺口，QMRA 对决策的实用性往往受到影响。本研究将 QMRA、不确定性和敏感性分析以及家庭调查相结合，对坎帕拉博瓦塞（乌干达）的情况进行了分析，以了解数据删失管理的影响，确定不确定性的来源，并结合风险认知，从而提高 QMRA 对非正规住区或类似环境的适用性。在博瓦塞，从 45 户家庭中采集饮用水、手部冲洗和土壤样本，并辅以 844 项调查数据。使用定量病原体（腺病毒、 和 spp./EIEC）浓度，结合 QMRA 对通过饮用水、经手到口接触和土壤摄入暴露的感染风险进行建模。健康风险对病原体数据、经手到口接触频率和剂量反应模型（特别是 ）最为敏感。在管理数据删失时，检测上限、检测下限的一半和均匀分布的结果相似，而低于检测下限和最大似然估计插补方法的结果则不同。最后，确定风险认知（例如，直接从水源饮水不安全），以进行风险管理。
