Pharmaceutical Contaminants in Shallow Groundwater and Their Implication for Poor Sanitation Facilities in Low-Income Countries

Effluents from septic systems and impact on groundwater contamination: a systematic review

Globally, 2.2 billion people rely on groundwater for their water supply, and 2.8 billion use onsite sanitation systems for their sanitation needs. Groundwater contamination from septic systems is a critical public health concern, linked with diseases related to water sanitation and hygiene. Despite the severe impacts of septic systems on groundwater quality, comprehensive global studies remain limited. This study conducted a systematic review of articles published between 2012 and 2023 on topics related to septic systems and groundwater contamination, and 82 peer-reviewed articles met the inclusion criteria. The review identified key contaminants, including E.coli, nitrate, Enterococcus spp., total coliform, ammonium, phosphate, chlorides, and pharmaceuticals. Research on microbial indicators is more prevalent in Africa, while research on nutrients is common in North America. Research on organic contaminants including polyfluoroalkyl substances (PFAS), pharmaceuticals, and personal care products (PCPPs) is limited, particularly in low-and middle-income countries. Critical factors contributing to groundwater contamination include soil, hydrogeological conditions, climate, septic system maintenance and functioning, and septic density. The goal of this study was to comprehensively assess the extent of groundwater contamination resulting from septic system effluents by identifying the major contaminants typically found in affected groundwater sources and exploring the factors contributing to contamination. Identifying the major contaminants and factors related to groundwater contamination from septic systems is crucial for developing effective management strategies to protect groundwater sources.

Emerging organic compounds as markers of the degradation of groundwater qualitative and quantitative equilibrium in a context of rapid urban expansion

With the neo-metamorphosis of the residential landscape worldwide and sluggish sanitation strategies in urban environments, rudimentary on-site sanitation systems remain commonly used, especially in developing countries, despite the risks of groundwater contamination. The effective management of such water resources relies on assessment of the sensitivity of anthropized aquifers to man-made impact, including groundwater behavioural alteration, in terms of both quality and quantity. Associated with tracking of changes in land use, this study proposes an approach involving emerging organic contaminants (EOCs) as indicators of the alteration of groundwater balance due the exposure of shallow aquifers to the risks of infiltration of untreated wastewater from soak pits. This methodology was applied to the shallow aquifer beneath the urban agglomeration of Grand-Sfax (Tunisia). Combined with an updated follow-up of groundwater piezometric fluctuations in relation with inputs from surface contamination sources, the spatialisation of contamination levels by EOCs provided a clear delineation of the most impacted aquifer zones. This approach revealed a significant link between the continuous rise in piezometric levels by contributions from untreated inputs and the accumulation of high levels of contamination in groundwater. The understanding of EOC underground pathways allowed the determination of the fates and processes responsible for the diffusion of contamination throughout the studied aquifer. The ability of groundwater to reflect population life style and the use patterns of such organic molecules was also assessed. Besides revealing the legacy of persistent contamination, this approach involving EOCs as tracers with different levels of persistence provided a spatial observation of the aquifer exposure to continuous contamination processes. This approach made it possible to develop a conceptual presentation of aquifer vulnerability to urban pressures and to predict the effects of subsequent expansion of unplanned urbanisation on groundwater quality.

The pit latrine paradox in low-income settings: A sanitation technology of choice or a pollution hotspot?

Pit latrines are widely promoted to improve sanitation in low-income settings, but their pollution and health risks receive cursory attention. The present narrative review presents the pit latrine paradox; (1) the pit latrine is considered a sanitation technology of choice to safeguard human health, and (2) conversely, pit latrines are pollution and health risk hotspots. Evidence shows that the pit latrine is a 'catch-all' receptacle for household disposal of hazardous waste, including; (1) medical wastes (COVID-19 PPE, pharmaceuticals, placenta, used condoms), (2) pesticides and pesticide containers, (3) menstrual hygiene wastes (e.g., sanitary pads), and (4) electronic wastes (batteries). Pit latrines serve as hotspot reservoirs that receive, harbour, and then transmit the following into the environment; (1) conventional contaminants (nitrates, phosphates, pesticides), (2) emerging contaminants (pharmaceuticals and personal care products, antibiotic resistance), and (3) indicator organisms, and human bacterial and viral pathogens, and disease vectors (rodents, houseflies, bats). As greenhouse gas emission hotspots, pit latrines contribute 3.3 to 9.4 Tg/year of methane, but this could be an under-estimation. Contaminants in pit latrines may migrate into surface water, and groundwater systems serving as drinking water sources and pose human health risks. In turn, this culminates into the pit latrine-groundwater-human continuum or connectivity, mediated via water and contaminant migration. Human health risks of pit latrines, a critique of current evidence, and current and emerging mitigation measures are presented, including isolation distance, hydraulic liners/ barriers, ecological sanitation, and the concept of a circular bioeconomy. Finally, future research directions on the epidemiology and fate of contaminants in pit latrines are presented. The pit latrine paradox is not meant to downplay pit latrines' role or promote open defaecation. Rather, it seeks to stimulate discussion and research to refine the technology to enhance its functionality while mitigating pollution and health risks.

Global groundwater vulnerability for Pharmaceutical and Personal care products (PPCPs): The scenario of second decade of 21st century

The global production of PPCPs have increased by multiple folds promoting excessive exposure of its metabolites to humans via different aquatic systems. The higher residence time of toxic precursors of these metabolites pose direct human health risk. Among the different aquatic systems, the contamination of groundwater by PPCPs is the most concerning threat. This threat is especially critical considering the lesser oxidizing potential of the groundwater as compared to freshwater/river water. A major challenge also arises due to excessive dependency of the world's population on groundwater, which is exponentially increasing with time. This makes the identification and characterization of spatial contamination hotspots highly probabilistic as compared to other freshwater systems. The situation is more vulnerable in developing countries where there is a reported inadequacy of wastewater treatment facilities, thereby forcing the groundwater to behave as the only available sequestrating sink for all these contaminants. With increased consumption of antibiotics and other pharmaceuticals compounds, these wastes have proven capability in terms of enhancing the resistance among the biotic community of the soil systems, which ultimately can become catastrophic and carcinogenic in near future. Recent studies are supporting the aforementioned concern where compounds like diclofenac (analgesic) have attained a concentration of 1.3 mgL^-1 in the aquifer systems of Delhi, India. The situation is far worse for developed nations where prolonged and indiscriminate usage of antidepressants and antibiotics have life threating consequences. It has been confirmed that certain compounds like ofloxacin (antibiotics) and bis-(2-ethylhexyl)phthalate are present in some of the most sensitive wells/springs of the United States and Mexico. The current trend of the situation has been demonstrated by integrating a comparative approach of the published literatures in last three years. This review provides first-hand information report for formulating a directive policy framework for tackling PPCPs issues in the groundwater system.