While DeKalb County, Georgia, offers free radon screening for all eligible residents, portions of the county remain relatively under-sampled. This pilot study focused on 10% of the census tracts in the county with the lowest proportion of radon testing; most were in southern DeKalb County. In total, 217 households were recruited and homes were tested for indoor radon concentrations on the lowest livable floor over an eight-week period from March–May 2015. Tract-level characteristics were examined to understand the differences in socio-demographic and economic factors between the pilot study area and the rest of the county. The pilot study tracts had a higher proportion of African Americans compared to the rest of DeKalb County (82% versus 47%). Radon was detected above 11.1 Bq/m³ (0.3 pCi/L) in 73% of the indoor samples and 4% of samples were above 148 Bq/m³ (4 pCi/L). Having a basement was the strongest predictive factor for detectable and hazardous levels of radon. Radon screening can identify problems and spur homeowners to remediate but more research should be done to identify why screening rates vary across the county and how that varies with radon levels in homes to reduce radon exposure. Full article

The biosand filter (BSF) is an intermittently operated, household-scale slow sand filter for which little data are available on the effect of sand composition on treatment performance. Therefore, bench-scale columns were prepared according to the then-current (2006–2007) guidance on BSF design and run in parallel to conduct two microbial challenge experiments of eight-week duration. Triplicate columns were loaded with Accusand silica or crushed granite to compare virus and E. coli reduction performance. Bench-scale experiments provided confirmation that increased schmutzdecke growth, as indicated by decline in filtration rate, is the primary factor causing increased E. coli reductions of up to 5-log10. However, reductions of challenge viruses improved only modestly with increased schmutzdecke growth. Filter media type (Accusand silica vs. crushed granite) did not influence reduction of E. coli bacteria. The granite media without backwashing yielded superior virus reductions when compared to Accusand. However, for columns in which the granite media was first backwashed (to yield a more consistent distribution of grains and remove the finest size fraction), virus reductions were not significantly greater than in columns with Accusand media. It was postulated that a decline in surface area with backwashing decreased the sites and surface area available for virus sorption and/or biofilm growth and thus decreased the extent of virus reduction. Additionally, backwashing caused preferential flow paths and deviation from plug flow; backwashing is not part of standard BSF field preparation and is not recommended for BSF column studies. Overall, virus reductions were modest and did not meet the 5- or 3-log10 World Health Organization performance targets. Full article

Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts. Full article

There is growing evidence that household water treatment interventions improve microbiological water quality and reduce diarrheal disease risk. Few studies have examined, however, the impact of water treatment interventions on household-level hygiene and sanitation. This study examined the association of four water and sanitation conditions (access to latrines, improved sanitation, improved water and the plastic biosand filter) on the levels of total coliforms and E. coli on existing and introduced toys during an on-going randomized controlled trial of the plastic biosand filter (plastic BSF). The following conditions were associated with decreased bacterial contamination on children’s toys: access to a latrine, access to improved sanitation and access to the plastic BSF. Overall, compared to existing toys, introduced toys had significantly lower levels of both E. coli and total coliforms. Results suggest that levels of fecal indicator bacteria contamination on children’s toys may be associated with access to improved water and sanitation conditions in the home. In addition, the fecal indicator bacteria levels on toys probably vary with duration in the household. Additional information on how these toys become contaminated is needed to determine the usefulness of toys as indicators or sentinels of water, sanitation and hygiene conditions, behaviors and risks. Full article

A randomized controlled trial of the plastic BioSand filter (BSF) was performed in rural communities in Tamale (Ghana) to assess reductions in diarrheal disease and improvements in household drinking water quality. Few studies of household water filters have been performed in this region, where high drinking water turbidity can be a challenge for other household water treatment technologies. During the study, the longitudinal prevalence ratio for diarrhea comparing households that received the plastic BSF to households that did not receive it was 0.40 (95% confidence interval: 0.05, 0.80), suggesting an overall diarrheal disease reduction of 60%. The plastic BSF achieved a geometric mean reduction of 97% and 67% for E. coli and turbidity, respectively. These results suggest the plastic BSF significantly improved drinking water quality and reduced diarrheal disease during the short trial in rural Tamale, Ghana. The results are similar to other trials of household drinking water treatment technologies. Full article