Drinking water consumption patterns in British Columbia: an investigation of associations with demographic factors and acute gastrointestinal illness

The complex association between drinking water consumption and endemic gastrointestinal illness as shown by Swedish cohort studies

It is well known that municipal drinking water may be the cause of gastrointestinal illness (GII) outbreaks, but it is still unclear to what extent drinking water contributes to endemic GII. To explore this, we conducted a prospective cohort study among 6,955 adults in five municipalities in Sweden, collecting monthly GII episodes and mean daily cold drinking water consumption through SMS (Short Message Service). When the association between drinking water consumption and GII (all symptoms) and acute gastrointestinal illness (AGI, vomiting and/or three loose stools during a 24-h period) were assessed, there were indications that the association departed from linearity, following a unimodal shape. Among consumers in surface water areas, the highest risk of GII and AGI was generally seen among the average consumers, while the opposite was seen among groundwater consumers. The association however also seemed to be affected by neighbouring communities. The results of the study indicate that there is indeed an association between drinking water consumption and endemic GII, but the nature of this association is complex and likely affected by multiple factors, for example, water source type in the home and degree of exposure to drinking water from additional sources.

Mapping domestic water use to quantify water-demand and water-related contaminant exposure in a peri-urban community, Indonesia

Water use of domestic activities was quantified by interviewing 217 people in a peri-urban community near Bandung, Indonesia. Resulting in data on domestic water demand and data needed for exposure modelling of domestic activities: drinking, cooking, brushing teeth, swimming, bathing, laundry, dishwashing, religious cleansing, washing hands and cleaning food. Average total domestic water usage was 117 l/person/day, topping the WHO guidelines for basic needs (50-100 l/person/day). This water use level is comparable with higher income countries for the same set of activities but 100% higher than water use in an Indonesian traditional rural community. The final dataset provides insight in quantity of water used for domestic activities, as well as the use-frequency, duration and water sources used. These data are scarce for Indonesia and other low-middle income countries but necessary for water demand studies and estimating risks through exposure to pathogens and emerging contaminants in human exposure modelling.

Evaluation of Drinking Water Quality From Water Coolers in Makkah, Saudi Arabia

The quality of drinking water is an important health issue in crowded cities, so that an adequate drinking water with good quality must be provided, hence over hundreds of water coolers are distributed in Makkah city to cope with the increasing demand for drinking water. The present study aimed to determine the chemical and microbial quality of drinking water from coolers in Makkah city. Sixty-three samples from randomly selected water coolers were tested for chemical and bacteriological quality. For all samples, the mean value of physiochemical tests of pH (7.12), TDS (152.7 ppm), turbidity (2.56 NTU), free chlorine (0.312 ppm), fluoride (0.112 ppm), chloride (25.7 ppm), bromide (0.123 ppm), nitrate (0.616 ppm), sulfate (8.36 ppm), lithium (0.134 ppm), sodium (17.6 ppm), potassium (1.42 ppm), magnesium (1.95 ppm), calcium (19.2 ppm), chromium (0.025 ppm), cadmium (0.0026 ppm), and lead (0.0244 ppm) did not exceed the reference values of the drinking water regulations. The total coliform count was detected in 3.2% of the water samples. For total coliform count, the MPN in the majority of water samples (96.8%) was excellent while for E. coli count, the MPN in all water samples (100%) was excellent. Bacteriological quality has shown that no Pseudomonas, Salmonellae, or Legionellae species contamination detected. It was concluded that, the drinking waters in coolers in Makkah city were complied with international standards and within the acceptable limit. It is worth to continue periodic inspection and maintenance for the drinking water coolers during mass gatherings.

Drinking Water Consumption Patterns among Private Well Users in Ontario: Implications for Exposure Assessment of Waterborne Infection

Understanding the water consumption patterns within a specific population informs development of increasingly accurate, spatially specific exposure and/or risk assessment of waterborne infection. The current study examined the consumption patterns of private well users in Ontario while considering potentially influential underlying sociodemographics, household characteristics, and experiential factors. A province-wide online survey was circulated between May and August 2018 (n = 1,162). Overall, 81.5% of respondents reported daily well water consumption (i.e., tap water). Results indicate a mean daily well water consumption rate of 1,132 mL/day (SD = 649 mL/day) among well water consumers. Gender was significantly associated with well water consumption, with higher consumption rates found among female respondents. The experience of acute gastrointestinal illness (AGI) symptoms or diagnosis in the past 12 months did not impact the volume of water consumed, suggesting that experiencing previous AGI does not decrease consumption volumes, and therefore exposure over time. Significantly higher rates of well water consumption were found among respondents who reported previous testing or ongoing water treatment. Approximately 45.5% of survey respondents who stated that they do not consume well water selected bottled water as their primary household drinking water supply. Bottled water consumption was also not associated with previous AGI experiences. Findings will inform future quantitative microbial risk assessments associated with private well water use by providing spatially and demographically specific estimates of well water consumption.

Effect of Filter Types on Physicochemical Properties, Volatile Compounds, and Sensory Evaluations of Purified Water by Point-of-Use Water Treatment

This study investigated purified water from four different filter types for removing minerals, anions, and volatile organic compounds (VOCs), and affecting sensory perception and consumer acceptability. Ultrafiltration (UF), CSM-ultrafiltration (CU), alumina nanofiber (AN), and reverse osmosis (RO) filters were used for a point-of-use water treatment system with a pre-carbon filter (PR) and post-carbon filter (PO). Filters efficiently removed VOCs, which could negatively affect the sensory perception of water. The total VOC concentration of tap water (TW) (14.97 µg/Kg) was reduced by 70% by the PR, 75.3-88.7% by the PR-main filter, and >97% by the PR-RO-PR. Using the polarized sensory position test, the subjects clearly discriminated TW from the samples; however, most of the purified water was not. The difference in the mean ratings of consumer acceptability among the purified samples was <1 except for PR-RO-PO in consumer testing. These results suggested that although there are differences in the capability of different filter types to eliminate minerals, anions, and VOCs, overall consumers did not identify sensory differences among them, and demonstrated similar consumer acceptability of the purified water produced. Simply applying a pre-carbon filter for TW treatment is enough to minimize VOCs, which negatively influence consumer acceptability.

Tap Water, Bottled Water or In-Home Water Treatment Systems: Insights on Household Perceptions and Choices

This article addresses household strategies for coping with perceived tap water quality issues. By using a household survey (n = 581) in Catalonia (Spain) and three models, this article analyses the drivers and motivations behind the installation of in-home water treatment systems, and the use of bottled water for drinking and cooking. The main explanatory factors of the higher consumption of bottled water were the perception of poor tap water quality, the lack of in-home treatment systems, and the presence of children at home. Income did not appear as a significant variable explaining the use of bottled water, unlike in other studies. The presence of in-home treatment systems is related to factors, such as perceived bad water quality, larger households, and single-family housing. Income and housing tenure appeared as explanatory variables only when considering systems requiring some kind of installation: lower incomes or renting a multi-family house reduce the probability of having an in-home water treatment that required installation because of important investments and operating costs, and the space needed in the housing units. In-house water treatment systems may become a solid alternative to bottled water when tap water raises problematic perceptions related to bad taste, odor, or lime presence.

Urban Water Consumption Patterns in an Adult Population in Wuxi, China: A Regression Tree Analysis

Understanding water intake variation is crucial for assessing human exposure to water pollutants. The correlation between water intake and demographic factors warrants further exploration. A cross-sectional study was conducted to estimate urban water consumption and its associated factors among adults in Wuxi, China, in 2015. The water consumption information was obtained by a 24-h self-report diary over seven consecutive days. A classification and regression tree (CART) analysis was applied to detect how water consumption varied with the demographic variables. Finally, a total of 1188 adults (18–87 years old) were included. The results demonstrated that the median water consumption of the adults was 1525 mL/day in summer and 1217 mL/day in winter. The results of the CART analysis demonstrated that body mass index (BMI) and age were the leading factors that were associated with water consumption in summer and winter, respectively. The water consumption threshold of BMI for men differed from women (23 kg/m² vs. 18 kg/m²) in summer, and the threshold of age for men was also different from women (43 years vs. 21 years) in winter. In conclusion, the findings are useful for accurately assessing human exposure to water pollutants and identifying the high-risk subgroups.

Risk factor analysis of insufficient fluid intake among urban adults in Wuxi, China: a classification and regression tree analysis

Background

Dehydration due to insufficient fluid intake (IFI) is detrimental to health. This cross-sectional study aimed to assess the fluid intake of urban adults in Wuxi, China, and to identify potential risk factors contributing to IFI.

Methods

Adults were selected from the urban area of Wuxi, China, using a multiple-stage random sampling method. The fluid intake information was obtained with a 24-h self-reported diary over seven consecutive days in both summer and winter of 2015. A classification and regression tree (CART) analysis was conducted to detect the potential risk factors associated with IFI. CART is a machine-learning algorithm that portions the data into subsets by threshold.

Results

A total of 584 adults aged 18–87 years were included. The results showed that the median (P25–P75) values of daily fluid intake of the participants were 1100 (800–1550) mL in summer and 1000 (750–1300) mL in winter. Women had a higher prevalence of IFI than men in both summer (odds ratio (OR) = 2.683, 95% confidence interval (CI): 1.830–3.934) and winter (OR = 2.636, 95% CI: 1.677–4.142). The results of CART analysis showed that, in summer, BMI < 25 kg/m² (probability: 64.2%) and age < 64 years (probability: 67.4%) were main risk factors of IFI for men, and BMI < 29 kg/m² (probability: 81.6%) and living in C Community (probability: 86.7%) were main risk factors for women. In winter, age < 40 years (probability: 81.8%) and BMI < 20 kg/m² (probability: 94.5%) were identified as main risk factors of IFI for men and women, respectively.

Conclusions

Most of the participants living in the study site had IFI. The fluid consumption varied by gender, age, location, and BMI. The findings could be useful for the implementation and optimization of intervention programs by identifying the individuals who may at greater risk of dehydration.

Exploring the Role of Advertising Types on Improving the Water Consumption Behavior: An Application of Integrated Fuzzy AHP and Fuzzy VIKOR Method

In recent years, many cities have suffered from a shortage of drinking water, mainly due to population growth. Hence, the desire to curb undue water consumption through the identification of the main factors affecting consumer behavior has become very important in managing drinking water supplies. Modifying the consumption pattern means institutionalizing of a sustainable culture in water consumption among consumers and the identification of the main criteria affecting their behavior. In 2018, a survey was applied to examine the role of mass media advertising in modifying the water consumption pattern in Iran. An integration of fuzzy AHP and fuzzy VIKOR was proposed based on group decision making, and fuzzy trapezoidal sets used to model linguistic variables and to deal with uncertainty in opinions. We devised and conducted a questionnaire with 24 main criteria and 8 sub-criteria to measure the impact of advertising on water consumption. The case study population in this study included all urban households over 15 cities of Iran. A total of 5630 questionnaires were distributed among the various populations with cluster method. Then, by analyzing the results, advertisements using animation had the highest impact on consumer behavior, among the available alternatives, and could play a significant role in modifying the water consumption pattern. Additionally, a fuzzy evaluation technique is performed to validate the result of the applied method. Subsequently, a sensitivity analysis was conducted to validate the stability of the final ranking. Finally, the prioritization results of the types of advertising by the proposed method were compared with the results of the fuzzy AHP method.

Risk Perception and Human Health Risk in Rural Communities Consuming Unregulated Well Water in Saskatchewan, Canada

Rural communities dependent on unregulated drinking water are potentially at increased health risk from exposure to contaminants. Perception of drinking water safety influences water consumption, exposure, and health risk. A community-based participatory approach and probabilistic Bayesian methods were applied to integrate risk perception in a holistic human health risk assessment. Tap water arsenic concentrations and risk perception data were collected from two Saskatchewan communities. Drinking water health standards were exceeded in 67% (51/76) of households in Rural Municipality #184 (RM184) and 56% (25/45) in Beardy's and Okemasis First Nation (BOFN). There was no association between the presence of a health exceedance and risk perception. Households in RM184 or with an annual income >$50,000 were most likely to have in-house water treatment. The probability of consuming tap water perceived as safe (92%) or not safe (0%) suggested that households in RM184 were unlikely to drink water perceived as not safe. The probability of drinking tap water perceived as safe (77%) or as not safe (11%) suggested households in BOFN contradicted their perception and consumed water perceived as unsafe. Integration of risk perception lowered the adult incremental lifetime cancer risk by 3% to 1.3 × 10^-5 (95% CI 8.4 × 10^-8 to 9.0 × 10^-5 ) for RM184 and by 8.9 × 10^-6 (95% CI 2.2 × 10^-7 to 5.9 × 10^-5 ) for BOFN. Probability of exposure to arsenic concentrations >1:100,000, negligible cancer risk, was 23% for RM184 and 22% for BOFN.

Factors influencing perceptions of private water quality in North America: a systematic review

BACKGROUND

An estimated four million and 43 million people in Canada and the USA use private water supplies. Private water supplies are vulnerable to waterborne disease outbreaks. Private water supplies in Canada and the USA are often unregulated and private water management is often a choice left to the owner. Perceptions of water quality become important in influencing the adoption of private water stewardship practices, therefore safeguarding public health.

METHODS

We conducted a systematic literature review to understand factors that shape perceptions of water quality among private water users. We searched six computer databases (Web of science, Medline, Scopus, EBSCO, PubMed and Agricola). The search was limited to primary peer-reviewed publications, grey literature and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and to articles which published data on surveys of private water users within Canada and the USA. The search was also restricted to publications from 1986 to 2017. The literature search generated 36,478 records. Two hundred and four full text were reviewed.

RESULTS

Fifty-two articles were included in the final review. Several factors were found to influence perceptions of water quality including organoleptic preferences, chemical and microbiological contaminants, perceived risks, water well infrastructure, past experience with water quality, external information, demographics, in addition to the values, attitudes, and beliefs held by well owners.

CONCLUSIONS

Understanding the factors that shape perceptions of water quality among private water users is an important step in developing private water management policies to increase compliance towards water testing and treatment in Canada and the USA. As many jurisdictions in Canada and the USA do not have mandatory private water testing or treatment guidelines, delineating these factors is an important step in informing future research and guiding policy on the public health of private water systems.

How are perceptions associated with water consumption in Canadian Inuit? A cross-sectional survey in Rigolet, Labrador

Concerns regarding the safety and aesthetic qualities of one's municipal drinking water supply are important factors influencing drinking water perceptions and consumption patterns (i.e. sources used and daily volume of consumption). In northern Canada, Inuit communities face challenges with drinking water quality, and many Inuit have reported concerns regarding the safety of their drinking water. The objectives of this research were to describe perceptions of municipal tap water, examine use of water sources and changes following the installation of a potable water dispensing unit (PWDU) in 2014, and identify factors associated with water consumption in the Inuit community of Rigolet. This study used data from three cross-sectional census surveys conducted between 2012 and 2014. Principal component analysis (PCA) was used to aggregate data from multiple variables related to perceptions of water, and logistic regressions were used to identify variables associated with water consumption patterns. Three quarters of residents reported using the PWDU after its installation, with concomitant declines reported in consumption of bottled, tap, and brook water. Negative perceptions of tap water were associated with lower odds of consuming tap water (OR_{PCAcomponent1}=0.73, 95% CI 0.56-0.94; OR_{PCAcomponent2}=0.67, 95% CI 0.49-0.93); women had higher odds of drinking purchased water compared to men (OR=1.90, 95% CI 1.11-3.26). The median amount of water consumed per day was 1L. Using brook water (OR=2.60, 95% CI 1.22-5.56) and living in a household where no one had full-time employment (OR=2.94, 95% CI 1.35-6.39) were associated with consuming >2L of water per day. Results of this study may inform drinking water interventions, risk assessments, and public health messaging in Rigolet and other Indigenous communities.

Measuring sporadic gastrointestinal illness associated with drinking water - an overview of methodologies

There is an increasing awareness that drinking water contributes to sporadic gastrointestinal illness (GI) in high income countries of the northern hemisphere. A literature search was conducted in order to review: (1) methods used for investigating the effects of public drinking water on GI; (2) evidence of possible dose-response relationship between sporadic GI and drinking water consumption; and (3) association between sporadic GI and factors affecting drinking water quality. Seventy-four articles were selected, key findings and information gaps were identified. In-home intervention studies have only been conducted in areas using surface water sources and intervention studies in communities supplied by ground water are therefore needed. Community-wide intervention studies may constitute a cost-effective alternative to in-home intervention studies. Proxy data that correlate with GI in the community can be used for detecting changes in the incidence of GI. Proxy data can, however, not be used for measuring the prevalence of illness. Local conditions affecting water safety may vary greatly, making direct comparisons between studies difficult unless sufficient knowledge about these conditions is acquired. Drinking water in high-income countries contributes to endemic levels of GI and there are public health benefits for further improvements of drinking water safety.

Household water quantity and health: a systematic review

While the quantity of water used in the home is thought to be an important determinant of health, much of the evidence relies on using water access as a proxy for quantity. This review examines the health effects of household water quantity using studies that directly measured water quantity. We searched MEDLINE, EMBASE, the Cochrane Library, Web of Science, and article reference lists. Eligible studies included experimental and observational studies that measured a difference in water quantity and quantified an association between water quantity and health outcomes. 21 studies, divided into six of the many possible water-quantity associated outcomes, met the eligibility criteria. Due to heterogeneity in designs, settings, methods, and outcomes, a meta-analysis was inappropriate. Overall results showed a positive association between water quantity and health outcomes, but the effect depended on how the water was used. Increased water usage for personal hygiene was generally associated with improved trachoma outcomes, while increased water consumption was generally associated with reduced gastrointestinal infection and diarrheal disease and improved growth outcomes. In high-income countries, increased water consumption was associated with higher rates of renal cell carcinoma and bladder cancer but not associated with type II diabetes, cardiac-related mortality, or all-cause mortality.

Drinking water quality and public health in Southwestern Saudi Arabia: The need for a national monitoring program

Aim of the Study:

The aim was to investigate the bacteriological quality of drinking water, and explore the factors involved in the knowledge of the public about the quality of drinking water in Najran region, Saudi Arabia.

Study Design:

A cross-sectional descriptive study.

Materials and Methods:

A total of 160 water samples were collected. Total coliforms, fecal coliform, and fecal streptococci were counted using Most Probable Number method. The bacterial genes lacZ and uidA specific to total coliforms and Escherichia coli, respectively, were detected using multiplex polymerase chain reaction. An interview was conducted with 1200 residents using a questionnaire.

Results:

Total coliforms were detected in 8 (20%) of 40 samples from wells, 13 (32.5%) of 40 samples from tankers, and 55 (68.8%) of 80 samples from roof tanks. Twenty (25%) and 8 (10%) samples from roof tanks were positive for E. coli and Streptococcus faecalis, respectively. Of the 1200 residents participating in the study, 10%, 45.5%, and 44.5% claimed that they depended on municipal water, bottled water, and well water, respectively. The majority (95.5%) reported the use of roof water tanks as a source of water supply in their homes. Most people (80%) believed that drinking water transmitted diseases. However, only 25% of them participated in educational programs on the effect of polluted water on health.

Conclusions:

Our results could help health authorities consider a proper regular monitoring program and a sustainable continuous assessment of the quality of well water. In addition, this study highlights the importance of the awareness and educational programs for residents on the effect of polluted water on public health.

Socio-ecological risk factors for prime-age adult death in two coastal areas of Vietnam

BACKGROUND

Hierarchical spatial models enable the geographic and ecological analysis of health data thereby providing useful information for designing effective health interventions. In this study, we used a Bayesian hierarchical spatial model to evaluate mortality data in Vietnam. The model enabled identification of socio-ecological risk factors and generation of risk maps to better understand the causes and geographic implications of prime-age (15 to less than 45 years) adult death.

METHODS AND FINDINGS

The study was conducted in two sites: Nha Trang and Hue in Vietnam. The study areas were split into 500×500 meter cells to define neighborhoods. We first extracted socio-demographic data from population databases of the two sites, and then aggregated the data by neighborhood. We used spatial hierarchical model that borrows strength from neighbors for evaluating risk factors and for creating spatially smoothed risk map after adjusting for neighborhood level covariates. The Markov chain Monte Carlo procedure was used to estimate the parameters. Male mortality was more than twice the female mortality. The rates also varied by age and sex. The most frequent cause of mortality was traffic accidents and drowning for men and traffic accidents and suicide for women. Lower education of household heads in the neighborhood was an important risk factor for increased mortality. The mortality was highly variable in space and the socio-ecological risk factors are sensitive to study site and sex.

CONCLUSION

Our study suggests that lower education of the household head is an important predictor for prime age adult mortality. Variability in socio-ecological risk factors and in risk areas by sex make it challenging to design appropriate intervention strategies aimed at decreasing prime-age adult deaths in Vietnam.

Risk factors associated with the choice to drink bottled water and tap water in rural Saskatchewan

A cross-sectional study investigated risk factors associated with choices to drink bottled water and tap water in rural Saskatchewan. Of 7,500 anonymous postal questionnaires mailed out, 2,065 responses were analyzed using generalized linear mixed models. Those who reported a water advisory (p < 0.001) or living in the area for ≤10 years (p = 0.01) were more likely to choose bottled water. Those who reported tap water was not safe to drink were more likely to choose bottled water, an effect greater for those who had no aesthetic complaints (p ≤ 0.001), while those with aesthetic complaints were more likely to choose bottled water if they believed the water was safe (p < 0.001). Respondents who treated their water and did not use a community supply were more likely to choose bottled water (p < 0.001), while those who did not treat their water were more likely to choose bottled water regardless of whether a community supply was used (p < 0.001). A similar pattern of risk factors was associated with a decreased likelihood of consuming tap water daily; however, the use of a community water supply was not significant. Understanding the factors involved in drinking water choices could inform public health education efforts regarding water management in rural areas.

Investigating public perceptions and knowledge translation priorities to improve water safety for residents with private water supplies: a cross-sectional study in Newfoundland and Labrador

Background

The first objective of this study was to investigate the public perceptions of private water and alternative sources with respect to safety, quality, testing and treatment in Newfoundland and Labrador (NL), Canada. The second objective was to provide public health practitioners with recommendations for improving knowledge translation (KT) efforts in NL, based on assessments of respondents’ perceived information needs and preferred KT methods.

Methods

A cross-sectional telephone survey of 618 households with private water supplies was conducted in March-April, 2007. Questions pertained to respondents’ perceptions of their tap water, water concerns, alternative water use, well characteristics, and water testing behaviours.

Results

Approximately 94% of households were supplied by private wells (50% drilled and 50% dug wells), while 6% obtained water from roadside ponds, rivers or springs (RPRS). While 85% rated their water quality highly, 55% nevertheless had concerns about its overall safety. Approximately 11% of respondents never tested their water, and of the 89% that had, 80% tested at frequencies below provincial recommendations for bacterial testing. More than one-third of respondents reported treating their water in the home, and 78% employed active carbon filtration methods. Respondents wanted more information on testing options and advice on effective treatment methods. Targeted advertising through television, flyers/brochures and/or radio is recommended as a first step to increase awareness. More active KT methods involving key stakeholders may be most effective in improving testing and treatment behaviour.

Conclusions

The results presented here can assist public health practitioners in tailoring current KT initiatives to influence well owner stewardship behaviour.

Domestic water uses: characterization of daily cycles in the north region of Portugal

Nowadays, there is an increasing discussion among specialists about water use efficiency and the best measures to improve it. In Portugal, there have been a few attempts to expand the implementation of in situ water reuse projects. However, there is a lack of information about indoor water uses and how they are influenced by sociodemographic characteristics. There are several studies that investigate per capita global water usage, but the partitioning of this volume per domestic device and daily cycles is yet unknown. Identified as one of the key questions in sustainable building design, the water end-use is of primary importance to the design of hydraulic networks in buildings. In order to overcome this lack, a quantitative characterization of daily water uses for each domestic device was performed, based on a weekly monitoring program in fifty-two different dwellings in the northern region of Portugal (Vila Real, Valpaços and Oporto). For forty of them, each water usage of different domestic devices of each dwelling was recorded. At the same time, the remaining twelve dwellings were also monitored in order to register the volume of water consumed in each utilization of each domestic device. This paper presents the results of this complete monitoring program, using collected data to establish indoor water use patterns for each domestic device, aiming to support a more realistic approach to residential water use. The daily cycles in the different cities, where the monitoring program was performed, are also presented, in order to evaluate possible influences of sociodemographic characteristics.

Total daily water intake in Guatemalan children

BACKGROUND

Water is an essential nutrient, but recommendations for total water requirements only emerged in 2005, in the context of estimated average population targets in the Dietary Reference Intakes (DRIs) for US and Canadian societies.

OBJECTIVE

To assess total daily water acquisition, and the contribution of water acquired from all possible sources, among Guatemalan children.

METHODS

A total of 449 urban Guatemalan schoolchildren, aged 8 to 11 years, evenly divided between two socioeconomic strata, completed a 1-day pictorial registry of all foods and beverages consumed. Estimated energy intake, total water intake, and the contributions of water from drinking water, beverages, intrinsic and extrinsic water in foods, and the oxidation of macronutrients were assessed.

RESULTS

The contribution of water from the examined water sources was 8% for drinking water, 49% for beverages, 29% for all foods, and 14% for metabolism of macronutrients, with only slight variance across sexes and social class. The average total daily water acquisition was 1,841 +/- 572 mL for boys and 1,834 +/- 484 mL for girls, which fall short of the North American DRI recommendations of 2.4 and 2.1 L, respectively There was correspondingly lower average consumption of dietary liquids.

CONCLUSIONS

Foods play an important role in the acquisition of water from their hydration and metabolic oxidation, contributing 43.8% of the daily supply to these children. There is still a calculated shortfall of daily water acquisition, as compared with the DRI recommendations, which could be overcome by greater intake of plain water and low-energy fresh produce.

Microbiological quality of drinking water from dispensers in Italy

BACKGROUND

Water coolers are popular in office buildings and commercial stores and the quality of this source of drinking water has the potential to cause waterborne outbreaks, especially in sensitive and immunocompromised subjects. The aim of this study was to determine the quality of water plumbed in coolers from commercial stores in comparison with tap water in Italy.

METHODS

For each sample, microbial parameters and chemical indicators of contamination were evaluated and information about the date of installation, time since last ordinary and extraordinary maintenance of water coolers was collected.

RESULTS

In all samples the chemical parameters (nitrite, ammonium, free active chlorine residual) did not exceed the reference values of the drinking water regulation; the pH value in 86.8% samples of the carbonated waters was lower than the reference limit. The microbiological results indicated that the bacteria count at 22 degrees C and 37 degrees C was higher than the required values in 71% and 81% for the non-carbonated water and in 86% and 88% for the carbonated one, respectively. Enterococcus spp. and Escherichia coli were not detected in any of the water samples. Pseudomonas aeruginosa was found in only one sample of the tap water and in 28.9% and 23.7% of the non-carbonated and carbonated water samples, respectively. No statistically significant differences in bacterial counts at 22 degrees C and 37 degrees C have been found between the non-carbonated and carbonated water from the sampled coolers in relation with the time since the last filter was substituted. The bacteriological quality of tap water was superior to that of non-carbonated and carbonated water from coolers.

CONCLUSION

The results emphasize the importance of adopting appropriate routinely monitoring system in order to prevent or to diminish the chances of contamination of this water source.