FCM 1 BLOCK 2 MODULE 1 LESSON 3 WEST VISAYAS STATE UNIVERSITY COLLEGE OF MEDICINE

Water Resources, Sanitation, and Water-Related-Illness

By: Dr. Agnes Segunda F. Gerasmo | 12-09-19 | 9:00-10:00 AM LEGEND: þ Book µ Lecturer « Trans Comm

OUTLINE DISTRIBUTION OF THE WORLD’S WATER

I. Water and Man
A. Importance of Water
B. Water Cycle
C. Distribution of the World’s Water
D. Water Quantity ad Health
E. Main Sources of Water
F. Uses of Water
G. Factors influencing the Use of Water
II. Levels of Water Supply Services
A. Level I (Point Source)
B. Level II (Communal Faucet System or Standpost)
C. Level III (Water Works System with Individual
Household Connection)
III. Water Pollution
A. Sources of Pollutants
Figure 2. Distribution of the world’s water
IV. Effects of Excessive Withdrawal from Reservoir
V. Watersheds and Water Supply
• About 70% of the human body is made up of water, and more
VI. Drinking Water
than 70% of Earth is covered in water.
A. Basic Requirements
B. Water Purification Methods • Water creates an environment that sustains and nurtures
plants, animals and humans, making Earth a perfect match for
C. Sanitary Analysis of Water
life in general.
D. Instances When a Sanitary Survey is Conducted
VII. Microbial Hazards Associated with Drinking Water • Roughly 326 million cubic miles (1.332 billion cubic kilometers)
A. Quantitative Microbial Risk Assessment of the earth, according to a recent study from the U.S.
VIII. Diseases Related to Water Geological Survey, is water.
A. Categories • Some 72% of earth is covered in water, but 97% of that is salty
B. Basic Strategies on Prevention ocean water and not suitable for drinking.
IX. Government Programs
WATER QUANTITY AND HEALTH
I. WATER AND MAN • The human body’s absolute dependence on regular intake of
water is second only to its need for oxygen. (Nadakavukaren,
IMPORTANCE OF WATER Man and Environment).
• It is essential to life. • Without food, man can survive for several weeks; without water
• Basic and essential component of primary health care is the man will die in a few days at most.
provision of safe, adequate, and accessible supplies of water • Water is needed in digestion, transport of nutrients and
combined with proper sanitation. hormones, and removal of wastes.
• Water and sanitation are basic human rights. • 1-3 liters per day is necessary per person, and 7.5 liters for a
lactating mother.
WATER CYCLE
MAIN SOURCES OF WATER
• Surface water – derived from rivers, lakes, seas, and oceans
→ Almost always contaminated by surface run-off
• Groundwater/aquifer – the largest source of water
→ Can be obtained from wells and springs (over 96% of all
freshwater sources)
→ Contains more water than there is in surface water
→ Replenished by rain and rivers
→ May cause pollution when contaminants from water from
domestic waste water, agricultural run-offs, and industrial
effluents reach the aquifer or water table in the form of
leachate
• Rainwater – associated with seasonal occurrence

Figure 1. Water Cycle

USES OF WATER
• Water falls on earth as rain, and part goes directly into ground 1. Drinking
surfaces and finds its way into bodies of water. 2. Cooking
• A part is immediately returned to the atmosphere by 3. Bathing
evaporation. 4. Washing
5. Maintaining general cleanliness
• The rest goes into the ground, forming part of groundwater.
6. Industry
7. Agriculture
8. Heating and air conditioning of buildings
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 FACTORS INFLUENCING THE USE OF WATER
• Cultural habits
• Pattern and standard of living
• Cost of water
• Level of water service
• Quality of water
II. LEVELS OF WATER SUPPLY SERVICES
LEVEL 1 (POINT SOURCE)
Figure 3. Level I Water Supply
• Level I (Point source) – has a stand-alone water point
→ A system in which the source is a protected dug well, a
drilled or driven well, a rain water tank, or a developed
spring with outlet but without a distribution system
→ With water from a source put in a reservoir provided with
an outlet
→ Can serve about 15-25 households and within reach of not
more than 250 meters from the farthest user
→ Typical usage: 10 to 15 liters per person per day
LEVEL 2 (COMMUNAL FAUCET SYSTEM OR STANDPOST)
Figure 4. Level II Water Supply
• Level II (Communal Faucet System or Standpost) – pipes
water with communal water point
→ A system composed of a source, a reservoir, a borewell,
and piped distribution network and communal faucet on
standpost located not more than 25 meters from the
farthest house
→ Generally for rural areas where houses are clustered
densely
→ Serves 5-10 households per communal faucet in a
community usually with 100 households
→ Typical usage: 20 to 50 liters
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LEVEL 3 (WATER WORKS SYSTEM WITH INDIVIDUAL
HOUSEHOLD CONNECTION)
Figure 5. Level III Water Supply
• Level III (Water Works System with individual household
connection) – a system with a source, transmission pipes,
reservoir, and with piped distribution network for household
faucets
→ The most accessible
→ Suited for densely populated areas
→ Generally for urban areas
→ Has one or more faucet per household in a community of
600 households per system
→ Typical usage: 60 to 150 liters
III. WATER POLLUTION
• In the Philippines, the following are problems regarding
coverage of quality water supply and sanitation:
1. Low investment
2. Small supply systems
3. A fragmented sector structure
4. An increase in pollution of water resources
5. Too low tariffs resulting in poor utility performance
• The extension of coverage has not kept pace with the growing
population.
• In many areas of the country, sanitation is still regarded as a
private responsibility resulting in almost no connection to a
sewerage system.
• In 2008, 8.1 Filipino households had no toilets; in 2011, 9.6%.
(National Nutrition Survey, FNRI)
• 7% of Filipino households with facilities for sewage treatment.
(National Nutrition Survey, FNRI).
• As of 2010, 16% of Filipino households lacked access to clean
and potable water, the National Statistical Coordination Board
reported.
• Improper disposal of waste material leads to leaching into
ground water of toxic chemicals and heavy metals and pollution
of other waterways and bodies of water.
• According to the Water Environment Partnership in Asia, nearly
2.2 million metric tons of organic pollutants are produced
annually by domestic (48%), agricultural (37%), and industrial
(15%) sectors.
SOURCES OF POLLUTANTS
1. POINT SOURCES
• Point sources – pollutants which enter a waterway from a
specific point through a pipe, ditch, culvert, etc.
→ Generally from sewage treatment plants and industrial
factories
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 2. NON-POINT SOURCES VI. WATERSHEDS AND WATER SUPPLY
• Non-point sources – pollutants which run off or seep into
waterways from broad areas of land
→ The largest contributor to water pollution
• Examples of non-point sources are:
1. Soil erosion and sedimentation
2. Construction activities
3. Animal feed runoff
4. Pesticide and fertilizer runoff
5. Urban street runoff
6. Acid mine drainage
7. Fallout of airborne pollutants

IV. EFFECTS OF EXCESSIVE WITHDRAWAL

FROM RESERVOIR
• Ground water is limited in volume, and once depleted, is Figure 7. Water sheds
irreplaceable.
• Excessive withdrawal of ground water results in the lowering of • The watershed collects rain and snowmelt, and delivers it to
the ground water table and the possible contamination by that body of water.
nearby excreta disposal facilities. • Some of it is intercepted and used by trees and other
• If water table is too low, rivers and streams are depleted, salt vegetation.
intrusion may occur. • Some flows overland in streams and rivers.
• Some soaks into the soil, which filters the water as it travels
downward to be stored in under- ground aquifers.
• It may re-emerge at a spring or seep, or it can remain
underground for a period of time ranging from days to
thousands of years.
• The plants and soil, and the microbes that live in them, do much
of the work in a watershed.
• In forests and floodplains, farms and prairies, arroyos and
wetlands, they work behind the scenes to filter, store and
Figure 6. Impacts of Overpumping of Groundwater and produce clean water.
Groundwater Depletion • Taking care of the soil and vegetation enhances their ability to
do those jobs.
V. WATER SUPPLY AND SANITATION
VII. DRINKING WATER
• Securing the microbial safety of drinking-water supplies is
based on the use of multiple barriers, from catchment to • Before water is used, distributed, or sold for drinking, it should
consumer, to prevent the contamination of drinking water or to pass the criteria on standard parameters and values for
reduce contamination to levels not injurious to health. bacteriological, physical, chemical, biological, and radiological
quality set by the Philippine National Standards for Drinking
• Safety is increased if multiple barriers are in place, including
protection of water resources, proper selection and operation Water.
of a series of treatment steps and management of distribution
systems (piped or otherwise) to maintain and protect treated BASIC REQUIREMENTS
water quality. 1. Free from pathogenic organisms
• The preferred strategy is a management approach that places 2. Free from compounds that have an adverse effect on human
the primary emphasis on preventing or reducing the entry of health
pathogens into water sources and reducing reliance on 3. Fairly clear (little color, low turbidity)
treatment processes for removal of pathogens. 4. Not salty
• The greatest microbial risks are associated with ingestion of 5. Free from compounds that cause an offensive smell or taste
water that is contaminated with faeces from humans or animals 6. Not causing corrosion of the water supply
(including birds). Faeces can be a source of pathogenic 7. Not staining clothes washed on it
bacteria, viruses, protozoa and helminths.
• Faecally derived pathogens are the principal concerns in WATER PURIFICATION METHODS
setting health-based targets for microbial safety. Microbial
water quality often varies rapidly and over a wide range. Short-
term peaks in pathogen concentration may increase disease
risks considerably and may trigger outbreaks of waterborne
disease.
• By the time microbial contamination is detected, many people
may have been exposed. For these reasons, reliance cannot
be placed solely on end-product testing, even when frequent,
to determine the microbial safety of drinking water.
• The greatest risk to public health from microbes in water is
associated with consumption of drinking-water that is
contaminated with human and animal excreta, although other
sources and routes of exposure may also be significant.
• Waterborne outbreaks have been associated with inadequate
treatment of water supplies and unsatisfactory management of Figure 8. Common water treatment process
drinking water distribution.
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 DEIONIZATION/DEMINERALIZATION • Waterborne pathogens have several properties that distinguish
• Deionization/demineralization – removal of the ionized them from other drinking-water contaminants:
minerals and salts from a solution by a 2- phase ion exchange 1. Pathogens can cause acute and also chronic health
procedure effects.
2. Some pathogens can grow in the environment.
3. Pathogens are discrete.
DISTILLATION 4. Pathogens are often aggregated or adherent to
• Distillation – the process of separating organic and inorganic suspended solids in water, and pathogen concentrations
solids from water by evaporation followed by cooling and vary in time, so that the likelihood of acquiring an infective
condensation dose cannot be predicted from their average
concentration in water.
FILTRATION • Exposure to a pathogen resulting in disease depends upon the
• Filtration – the process by which solids are separated from dose, invasiveness and virulence of the pathogen, as well as
liquids by means of porous substances the immune status of the individual. If infection is established,
pathogens multiply in their host.
SANITARY ANALYSIS OF WATER • Certain waterborne pathogens are also able to multiply in food,
beverages or warm water systems, perpetuating or even
PHYSICAL increasing the likelihood of infection.
• Physical analysis – determines substances which affect the → Unlike many chemical agents, pathogens do not exhibit a
physical and aesthetic quality of water such as taste, odor, cumulative effect.
color, and turbidity
QUANTITATIVE MICROBIAL RISK ASSESSMENT (QMRA
CHEMICAL • Quantitative microbial risk assessment (QMRA) - is a
• Chemical analysis – detects pollution especially by industrial mathematical framework for evaluating infectious risks from
wastes human pathogens, can assist in understanding and managing
→ Provides data regarding the chemical quality of water, the waterborne microbial hazards, especially those associated with
effectiveness of purification processes, and the previous sporadic disease.
history of water
• Values for chemical analysis are: VIII. DISEASES RELATED TO WATER
1. 0.01 mg/L – arsenic CATEGORIES
2. 1 mg/L – fluoride
3. 0.01 mg/L – lead CATEGORY I (WATER-BORNE)
4. 0.001 mg/L – mercury • Water acts as the passive vehicle for the infecting agents, or
the drinking water contains the disease agent.
MICROSCOPIC
• Microscopic analysis – designed to detect and measure the Disease Etiologic Agent Control
quantities of algae, protozoa, and related organisms as Improved water
frequent sources of odors and tastes Diarrhea, Campylobacter
supply (quality,
gastroenteritis Salmonella
• 10 – permissible limit count/mL quantity)
Proper excreta
BACTERIOLOGIC Cholera Vibrio cholerae
disposal
• Bacteriologic analysis – deals with the numbers and kind of Typhoid fever Salmonella typhi
bacteria present.
Entamoeba
• 0/100 mL – normal E. coli or coliform count Amoebic dysentery
histolytica Improved personal,
domestic, food
RADIOLOGIC Bacillary dysentery Shigella hygiene
• A few natural waters contain significant amounts of radium and Hepatitis A Hepatitis A virus
its decay products.
• Some may be from radioisotopes from atmospheric fallout, or Poliomyelitis Polio Virus
to pollution with waters from the use or processing of Table 1. Microbial Water-borne Diseases
radioactive materials.
Disease Etiologic Agent Control
INSTANCES WHEN A SANITARY SURVEY IS CONDUCTED Mercury (from
1. When the source is positively found to be contaminated Minamata Disease
contaminated fish)
→ The survey results will indicate where corrective and
preventive measures will be instituted. Lead (from water
Lead poisoning
2. When an outbreak of water-borne diseases occurred in the pipes, milk, paint)
area served by the water system Pollution control of
Cadmium poisoning Cadmium
3. When significant change is noted that may affect the system water resources
Arsenic (usually from
VII. MICROBIAL HAZARDS ASSOCIATED WITH Arsenic poisoning springs and
DRINKING-WATER wells)
• Infectious diseases caused by pathogenic bacteria, viruses
Dental fluorosis Fluoride
and parasites (e.g. protozoa and helminths) are the most
common and widespread health risk associated with drinking- Table 2. Chemical Poisoning
water. The public health burden is determined by the severity
and incidence of the illnesses associated with pathogens, their
infectivity and the population exposed.

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 CATEGORY II (WATER WASHED) BASIC STRATEGIES ON PREVENTION
• Category II (water-washed) diseases – diseases due to lack • Improvement in water quality
of adequate quantity of water and poor personal hygiene which • Making water sources readily available and accessible to
favor the spread of diseases consumers
• Improvement in hygiene and sanitation practices
Disease Etiologic Agent Control
Scabies Sarcoptes scabei IX. GOVERNMENT PROGRAMS
Improved
Lymphogranuloma availability of • In 2010, DOH, together with the Department of the Interior and
Trachoma water Local Government and the National AntiPoverty Commission
venereum
(NAPC), began conducting the Sagana at Ligtas na Tubig Sa
Improved Lahat Program or SaLinTubig
Pediculus humanus
Pediculosis washing of body → The program provides capacity-building for local
Frequent government units and water service providers, as well as
laundering of water supply systems for waterless areas, be it
Louse-borne
clothes municipalities, barangays, health centers, resettlement
Hygiene sites.
Relapsing Fever Borrelia recurrentis
education → As of 2012, the program has covered 290 out of its 455
Table 3. Water-washed Diseases targeted beneficiaries.
→ It plans to cover the rest from 2013-2016, with an annual
CATEGORY III (WATER-BASED) budget of P1.5 billion, according to a NAPC statement
(Fritzie Rodriguez, September 1,2015).
• Category III (water-based) diseases – diseases caused by → In 2017, it evolved to iWASH (Integrated Water Sanitation
parasites found in intermediate organisms living in
and Hygiene program).
contaminated water
• By 2030, the UN expects global food and water demand to
→ Do not spread person to person
double. Water resources must be properly managed;
• An essential part of the life cycle of the infecting agents takes otherwise, supply may not meet the demand.
place in aquatic animals.
→ To address the issue, the Philippines has the “Water Code
• Basic mode of transmission is via skin contact with infecting of 1976” and the National Water Resources Board which
agent present in water. focus on water re- sources ownership and management.
• Preventive measures are as follows: → The country has the "Sanitation Code of 1975" which sets
1. Avoidance of contact with contaminated water standards on food, water, toilets, among other public
2. Provision of sanitary excreta disposal facilities goods, services, and establishments.
• Examples of water-based diseases are: → The DOH also prescribed standards on drinking water.
1. Dracunculiasis → Not all Filipinos, however, directly benefit from these
2. Schistosomiasis policies.
3. Other helminthiases • In 2011, then senator Eduardo Angara filed SB 2997 or the
"Water Sector Reform Act" which proposed to increase funds
and to improve the country's water supply and sanitation
management.
→ As of press time September 8, 2016, it is still pending in
the Committee.

TRANS COMM
Prepared by: SGD 6 Pelayo, Reyes, Tagamolila B., Sillote
Format Editor: Billena

Figure 10. Disease Transmission Cycle of Schistosomiasis ASP on Dec 24 and Dec 31:

CATEGORY IV (FROM WATER-RELATED VECTORS)

• Category IV (from water-related vectors) – diseases
transmitted by insects which live close to water
• Infections are spread by mosquitoes, flies, and other insects
that breed in water or bite near it.

Disease Etiologic Agent Control

Malaria Anopheles Protective clothing
Proper drainage of
waste and stagnant
Dengue Aedes aegypti water, use of insect
repellants
Draining of wastewater, REFERENCES
use of insecticides and 1. Gerasmo, A.S., 2019. Water Supply and Sanitation
Filariasis Culex pipiens 2. Lopez-Erum, M.C., Water Supply and Relation to Illness
insect repellants
3. WVSU-COM Batch 2022, 2018. Water Resources, Sanitation,
Table 4. Diseases from Water-related Vectors
and Water-Related Illnesses.

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