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Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning

Author

Listed:
  • Freya Mills

    (Institute for Sustainable Futures, University of Technology Sydney, Level 10, UTS Building 10, 235 Jones Street, Ultimo, NSW 2007, Australia)

  • Juliet Willetts

    (Institute for Sustainable Futures, University of Technology Sydney, Level 10, UTS Building 10, 235 Jones Street, Ultimo, NSW 2007, Australia)

  • Susan Petterson

    (Water & Health Pty Ltd., P.O. Box 648, Salamander Bay, NSW 2317, Australia
    School of Medicine, Griffith University, Parklands Drive, Southport, QLD 4222, Australia)

  • Cynthia Mitchell

    (Institute for Sustainable Futures, University of Technology Sydney, Level 10, UTS Building 10, 235 Jones Street, Ultimo, NSW 2007, Australia)

  • Guy Norman

    (Water and Sanitation for the Urban Poor, 10 Queen Street Place, London EC4R 1BE, UK)

Abstract

Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed, this research identified gaps in their ability to predict faecal pathogen flows, to relate exposure risks to the existing sanitation services, and to compare expected impacts of improvements. This paper outlines a conceptual approach that links faecal waste discharge patterns with potential pathogen exposure pathways to quantitatively compare urban sanitation improvement options. An illustrative application of the approach is presented, using a spreadsheet-based model to compare the relative effect on disability-adjusted life years of six sanitation improvement options for a hypothetical urban situation. The approach includes consideration of the persistence or removal of different pathogen classes in different environments; recognition of multiple interconnected sludge and effluent pathways, and of multiple potential sites for exposure; and use of quantitative microbial risk assessment to support prediction of relative health risks for each option. This research provides a step forward in applying current knowledge to better consider public health, alongside environmental and other objectives, in urban sanitation decision making. Further empirical research in specific locations is now required to refine the approach and address data gaps.

Suggested Citation

  • Freya Mills & Juliet Willetts & Susan Petterson & Cynthia Mitchell & Guy Norman, 2018. "Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning," IJERPH, MDPI, vol. 15(2), pages 1-26, January.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:2:p:181-:d:128278
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    References listed on IDEAS

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    1. Heitor de Oliveira Duarte & Enrique Lopez Droguett & Márcio das Chagas Moura & Elainne Christine de Souza Gomes & Constança Barbosa & Verônica Barbosa & Moacyr Araújo, 2014. "An Ecological Model for Quantitative Risk Assessment for Schistosomiasis: The Case of a Patchy Environment in the Coastal Tropical Area of Northeastern Brazil," Risk Analysis, John Wiley & Sons, vol. 34(5), pages 831-846, May.
    2. Mirko S. Winkler & Samuel Fuhrimann & Phuc Pham-Duc & Guéladio Cissé & Jürg Utzinger & Hung Nguyen-Viet, 2017. "Assessing potential health impacts of waste recovery and reuse business models in Hanoi, Vietnam," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(1), pages 7-16, February.
    3. Mara, D. & Bos, R., 2010. "Risk analysis and epidemiology: the 2006 WHO guidelines for the safe use of wastewater in agriculture," IWMI Books, Reports H042603, International Water Management Institute.
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    Cited by:

    1. Mitsunori Odagiri & Ann Thomas & Maraita Listyasari & Freya Mills & Robert E. S. Bain & Zainal Muhammad & Tom Slaymaker & Aldy Mardikanto & Anita Gultom & Asri Indiyani & Hasnani Rangkuti & Juliet Wil, 2021. "Safely Managed On-Site Sanitation: A National Assessment of Sanitation Services and Potential Fecal Exposure in Indonesia," IJERPH, MDPI, vol. 18(15), pages 1-16, August.
    2. Marie Anita Temgoua Zemo & Samuel Foto Menbohan & Bernard Tossou Atchrimi & Christiane Noel Wilfreid Betsi & Bertha Leslie Kussu Mouloungui & Jean Dzavi & Mathias Nwaha & Nathaniel Lactio, 2024. "Environmental Consequences of Unregulated Sanitation Practices in Urban Watercourse Neighborhoods in Sub-Saharan Africa: A Case Study of Yaoundé City Cameroon," Academic Journal of Interdisciplinary Studies, Richtmann Publishing Ltd, vol. 13, March.

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