WWETT Preview: Q&A With WHO’s Dr. Adrianus Vlugman, Part II

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In the second part of our Q&A with Dr. Adrianus Vlugman, a senior advisor on water, sanitation and environmental health at the World Health Organization, Vlugman discusses the scope of communicable disease spread by water or wastewater.

Dr. Vlugman will be a featured speaker at this year’s Water & Wastewater Equipment, Treatment & Transport (WWETT) Show, which will be held Feb. 23-26 at the Indiana Convention Center in Indianapolis. His presentation on the transfer of communicable disease in water and wastewater will be Feb. 26 at 1 p.m.

We’ll be posting more from our conversation with Dr. Vlugman this week, so check back often.

Plumber: Looking at the developed world — and specifically North America — how would you describe the scope of communicable disease spread by water or wastewater?

Dr. Vlugman:  The introduction of piped water supplies and flushing toilets in the 19th and 20th centuries along with regular hand washing resulted in huge improvements in public health, life expectancy and reduction in child mortality.

Improvements in water supply, sanitation and hygiene behavior have now also been achieved in developing countries, where 2.3 billion people gained access to improved drinking water between 1990 and 2012. Also, here we now see a steep reduction in communicable diseases and improvements in public health.

Thanks to achievements of the UN’s Millennium Development Goals, which include water supply and sanitation, diarrhea as a cause of childhood death decreased by 50 percent from 2000 to 2012. In 1990, 1.5 million children died of diarrhea, while in 2012 that number was 600,000.

Also, vaccination programs have reduced the incidence of diseases that could be transmitted through water, like polio, which is on the brink of being eradicated from this planet. The last indigenous polio case reported in the United States was in 1980, while the last case in the Americas was reported in Peru in 1991, 24 years ago.

Water is a very effective and efficient medium to transport waste from our homes, skin and industries. And therefore good and safe water supplies, sanitation and wastewater management have become an integral part of public health and primary, or preventive, health care. The word sanitation is derived from the Latin word "sanitas," which means health. All professionals in the water and wastewater industry are therefore primary health care workers in preventing communicable diseases.

Plumber: Looking at the developing world, how would you characterize the threat of drinking water source contamination by pathogens? What additional safeguards should be used?

Dr. Vlugman: Since the 1980s, a lot of money has gone into improved and extended piped drinking water systems in developing countries. This effort received increased attention since 2000 with the implementation of the MDGs to half the population without access to safe drinking water and without access to adequate sanitation.

The Americas have achieved this goal, but when there is more piped water, more wastewater is generated. In the Caribbean, only about 20 percent of wastewater is treated before discharge. In 1992, I reviewed the operational status of wastewater treatment plants in this subregion, and found that only 20 percent operate satisfactorily. The situation has not improved significantly in the past two decades.

A main concern is that the discharge of untreated wastewater is affecting drinking water sources, so there is an urgent need to treat wastewater before discharge, to protect drinking water catchment areas and to improve treatment and disinfection of drinking water before distribution and consumption.

PAHO/WHO has promoted and supported the implementation of the Water Safety Planning concept and tools to improve drinking water quality for the consumer. WSP looks at the complete water catchment area and includes a comprehensive risk assessment and risk management approach that encompasses all steps in water recharge and impact of climate change, pollution risks of water sources, treatment and distribution, and handling of water in the home — it’s a from “raindrop to tap” approach.


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