Quantitative microbial risk assessment of distributed drinking water using faecal indicator incidence and concentrations. 2007

J Hein M van Lieverloo, and E J Mirjam Blokker, and Gertjan Medema
Kiwa Water Research, Groningenhaven 7 PO Box 1072, 3430 BB, Nieuwegein, The Netherlands. Hein.van.Lieverloo@nizo.nl

Quantitative Microbial Risk Assessments (QMRA) have focused on drinking water system components upstream of distribution to customers, for nominal and event conditions. Yet some 15-33% of waterborne outbreaks are reported to be caused by contamination events in distribution systems. In the majority of these cases and probably in all non-outbreak contamination events, no pathogen concentration data was available. Faecal contamination events are usually detected or confirmed by the presence of E. coli or other faecal indicators, although the absence of this indicator is no guarantee of the absence of faecal pathogens. In this paper, the incidence and concentrations of various coliforms and sources of faecal contamination were used to estimate the possible concentrations of faecal pathogens and consequently the infection risks to consumers in event-affected areas. The results indicate that the infection risks may be very high, especially from Campylobacter and enteroviruses, but also that the uncertainties are very high. The high variability of pathogen to thermotolerant coliform ratios estimated in environmental samples severely limits the applicability of the approach described. Importantly, the highest ratios of enteroviruses to thermotolerant coliform were suggested from soil and shallow groundwaters, the most likely sources of faecal contamination that are detected in distribution systems. Epidemiological evaluations of non-outbreak faecal contamination of drinking water distribution systems and thorough tracking and characterisation of the contamination sources are necessary to assess the actual risks of these events.

UI MeSH Term Description Entries
D009426 Netherlands Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES. Holland,Kingdom of the Netherlands
D004196 Disease Outbreaks Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS. Outbreaks,Infectious Disease Outbreaks,Disease Outbreak,Disease Outbreak, Infectious,Disease Outbreaks, Infectious,Infectious Disease Outbreak,Outbreak, Disease,Outbreak, Infectious Disease,Outbreaks, Disease,Outbreaks, Infectious Disease
D004926 Escherichia coli A species of gram-negative, facultatively anaerobic, rod-shaped bacteria (GRAM-NEGATIVE FACULTATIVELY ANAEROBIC RODS) commonly found in the lower part of the intestine of warm-blooded animals. It is usually nonpathogenic, but some strains are known to produce DIARRHEA and pyogenic infections. Pathogenic strains (virotypes) are classified by their specific pathogenic mechanisms such as toxins (ENTEROTOXIGENIC ESCHERICHIA COLI), etc. Alkalescens-Dispar Group,Bacillus coli,Bacterium coli,Bacterium coli commune,Diffusely Adherent Escherichia coli,E coli,EAggEC,Enteroaggregative Escherichia coli,Enterococcus coli,Diffusely Adherent E. coli,Enteroaggregative E. coli,Enteroinvasive E. coli,Enteroinvasive Escherichia coli
D005243 Feces Excrement from the INTESTINES, containing unabsorbed solids, waste products, secretions, and BACTERIA of the DIGESTIVE SYSTEM.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014871 Water Microbiology The presence of bacteria, viruses, and fungi in water. This term is not restricted to pathogenic organisms. Microbiology, Water
D014881 Water Supply Means or process of supplying water (as for a community) usually including reservoirs, tunnels, and pipelines and often the watershed from which the water is ultimately drawn. (Webster, 3d ed) Supplies, Water,Supply, Water,Water Supplies
D015233 Models, Statistical Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc. Probabilistic Models,Statistical Models,Two-Parameter Models,Model, Statistical,Models, Binomial,Models, Polynomial,Statistical Model,Binomial Model,Binomial Models,Model, Binomial,Model, Polynomial,Model, Probabilistic,Model, Two-Parameter,Models, Probabilistic,Models, Two-Parameter,Polynomial Model,Polynomial Models,Probabilistic Model,Two Parameter Models,Two-Parameter Model
D018570 Risk Assessment The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988) Assessment, Risk,Benefit-Risk Assessment,Risk Analysis,Risk-Benefit Assessment,Health Risk Assessment,Risks and Benefits,Analysis, Risk,Assessment, Benefit-Risk,Assessment, Health Risk,Assessment, Risk-Benefit,Benefit Risk Assessment,Benefit-Risk Assessments,Benefits and Risks,Health Risk Assessments,Risk Analyses,Risk Assessment, Health,Risk Assessments,Risk Benefit Assessment,Risk-Benefit Assessments
D021821 Communicable Diseases, Emerging Infectious diseases that are novel in their outbreak ranges (geographic and host) or transmission mode. Infectious Diseases, Emerging,Communicable Diseases, Re-Emerging,Communicable Diseases, Reemerging,Infectious Diseases, Re-Emerging,Infectious Diseases, Reemerging,Communicable Disease, Emerging,Communicable Disease, Re-Emerging,Communicable Disease, Reemerging,Communicable Diseases, Re Emerging,Disease, Emerging Communicable,Disease, Emerging Infectious,Disease, Re-Emerging Communicable,Disease, Re-Emerging Infectious,Disease, Reemerging Communicable,Disease, Reemerging Infectious,Diseases, Emerging Communicable,Diseases, Emerging Infectious,Diseases, Re-Emerging Communicable,Diseases, Re-Emerging Infectious,Diseases, Reemerging Communicable,Diseases, Reemerging Infectious,Emerging Communicable Disease,Emerging Communicable Diseases,Emerging Infectious Disease,Emerging Infectious Diseases,Infectious Disease, Emerging,Infectious Disease, Re-Emerging,Infectious Disease, Reemerging,Infectious Diseases, Re Emerging,Re-Emerging Communicable Disease,Re-Emerging Communicable Diseases,Re-Emerging Infectious Disease,Re-Emerging Infectious Diseases,Reemerging Communicable Disease,Reemerging Communicable Diseases,Reemerging Infectious Disease,Reemerging Infectious Diseases

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