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Int. J. Environ. Res. Public Health 2018, 15(2), 181; https://doi.org/10.3390/ijerph15020181

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

1
Institute for Sustainable Futures, University of Technology Sydney, Level 10, UTS Building 10, 235 Jones Street, Ultimo, NSW 2007, Australia
2
Water & Health Pty Ltd., P.O. Box 648, Salamander Bay, NSW 2317, Australia
3
School of Medicine, Griffith University, Parklands Drive, Southport, QLD 4222, Australia
4
Water and Sanitation for the Urban Poor, 10 Queen Street Place, London EC4R 1BE, UK
*
Author to whom correspondence should be addressed.
Received: 8 December 2017 / Revised: 11 January 2018 / Accepted: 16 January 2018 / Published: 23 January 2018
(This article belongs to the Section Environmental Science and Engineering)
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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. View Full-Text
Keywords: pathogens; urban sanitation; wastewater; public health; risk assessment; decision making; faecal waste; options assessment pathogens; urban sanitation; wastewater; public health; risk assessment; decision making; faecal waste; options assessment
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Mills, F.; Willetts, J.; Petterson, S.; Mitchell, C.; Norman, G. Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning. Int. J. Environ. Res. Public Health 2018, 15, 181.

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