Designing sustainable sanitation in urban planning proposed for Changzhou, China

Short-term effects of ambient air pollutants and myocardial infarction in Changzhou, China

Ambient air pollution had been shown strongly associated with cardiovascular diseases. However, the association between air pollution and myocardial infarction (MI) is inconsistent. In the present study, we conducted a time-series study to investigate the association between air pollution and MI. Daily air pollutants, weather data, and MI data were collected from January 2015 to December 2016 in Changzhou, China. Generalized linear model (GLM) was used to assess the immediate effects of air pollutants (PM_2.5, PM₁₀, NO₂, SO₂, and O₃) on MI. We identified a total of 5545 cases for MI, and a 10-μg/m³ increment in concentrations of PM_2.5 and PM₁₀ was associated with respective increases of 1.636% (95% confidence interval [CI] 0.537-2.740%) and 0.805% (95% CI 0.037-1.574%) for daily MI with 2-day cumulative effects. The associations were more robust among males and in the warm season versus the cold one. No significant effect was found in SO₂, NO₂, or O₃. This study suggested that short-term exposure to PM_2.5 and PM₁₀ was associated with the increased MI risks. Our results might be useful for the primary prevention of MI exacerbated by air pollutants.

Acute effects of air pollution on ischaemic stroke onset and deaths: a time-series study in Changzhou, China

OBJECTIVE

To investigate the acute effect of air pollutants on ischaemic stroke (IS) and IS-related death.

SETTING

Five urban districts in Changzhou, China, between 9 January 2015 and 31 December 2016.

PARTICIPANTS

A total of 32 840 IS cases and 4028 IS deaths were enrolled.

MAIN OUTCOME MEASURES

A time-series design, generalised additive model and multivariable regression model were used to examine the percentage change (95% CI) in daily IS counts and deaths with an IQR increase in air pollutant levels for different single or multiple lag days in single-pollutant and two-pollutant models.

RESULTS

Daily IS counts increased 0.208% (95% CI 0.036% to 0.381%) with an IQR increment in the levels of nitrogen dioxide (NO2). The estimated risk of NO2 was more robust in males and in the cold season. For daily IS counts, the estimated effects of NO2 and sulfur dioxide (SO2) were more significant when adjusted for particulate matter with aerodynamic diameters <2.5 µm (PM2.5) and PM10. An IQR increment in the concentration of PM10, SO2 and NO2 significantly increased IS deaths with 6 days of cumulative effects (0.268%, 95% CI 0.007% to 1.528%; 0.34%, 0.088% to 0.592%; and 0.263%, 0.004% to 0.522%, respectively). Young individuals (<65 years old) had a higher IS mortality risk for PM2.5, PM10, NO2 and CO. For IS death, the effect estimates of SO2 in the elderly, females and the cold season were more pronounced; statistical significance was also identified for SO2 when adjusted for carbon monoxide (CO).

CONCLUSIONS

This study suggested that short-term exposure to ambient NO2 was associated with increased IS risk. In addition, SO2 was associated with increased IS onset and death.

Wastewater discharge impact on drinking water sources along the Yangtze River (China)

Unplanned indirect (de facto) wastewater reuse occurs when wastewater is discharged into surface waters upstream of potable drinking water treatment plant intakes. This paper aims to predict percentages and trends of de facto reuse throughout the Yangtze River watershed in order to understand the relative contribution of wastewater discharges into the river and its tributaries towards averting water scarcity concerns. The Yangtze River is the third longest in the world and supports more than 1/15 of the world's population, yet the importance of wastewater on the river remains ill-defined. Municipal wastewater produced in the Yangtze River Basin increased by 41% between 1998 and 2014, from 2580m³/s to 3646m³/s. Under low flow conditions in the Yangtze River near Shanghai, treated wastewater contributions to river flows increased from 8% in 1998 to 14% in 2014. The highest levels of de facto reuse appeared along a major tributary (Han River) of the Yangtze River, where de facto reuse can exceed 20%. While this initial analysis of de facto reuse used water supply and wastewater data from 110 cities in the basin and 11 gauging stations with >50years of historic streamflow data, the outcome was limited by the lack of gauging stations at more locations (i.e., data had to be predicted using digital elevation mapping) and lack of precise geospatial location of drinking water intakes or wastewater discharges. This limited the predictive capability of the model relative to larger datasets available in other countries (e.g., USA). This assessment is the first analysis of de facto wastewater reuse in the Yangtze River Basin. It will help identify sections of the river at higher risk for wastewater-related pollutants due to presence of-and reliance on-wastewater discharge that could be the focus of field studies and model predictions of higher spatial and temporal resolution.

A new approach to nationwide sanitation planning for developing countries: Case study of Indonesia

Many developing countries struggle to provide wastewater and solid waste services. The backlog in access has been partly attributed to the absence of a functional sanitation planning framework. Various planning tools are available; however a comprehensive framework that directly links a government policy to nationwide planning is missing. Therefore, we propose a framework to facilitate the nationwide planning process for the implementation of wastewater and solid waste services. The framework requires inputs from government planners and experts in the formulation of starting points and targets. Based on a limited number of indicators (population density, urban functions) three outputs are generated. The first output is a visualization of the spatial distribution of wastewater and solid waste systems to support regional priority setting in planning and create awareness. Secondly, the total number of people served, budget requirements and distribution of systems is determined. Thirdly, the required budget is allocated to the responsible institution to assure effective implementation. The determined budgets are specified by their beneficiaries, distinguishing urban, rural, poor and non-poor households. The framework was applied for Indonesia and outputs were adopted in the National Development Plan. The required budget to reach the Indonesian government's 2019 target was determined to be 25 billion US$ over 5years. The contribution from the national budget required a more than fivefold increase compared to the current budget allocation in Indonesia, corresponding to an increase from 0.5 to 2.7 billion US$ per year. The budget for campaigning, advocacy and institutional strengthening to enable implementation was determined to be 10% of the total budget. The proposed framework is not only suitable for Indonesia, but could also be applied to any developing country that aims to increase access to wastewater and solid waste facilities.

Feasibility analysis of wastewater and solid waste systems for application in Indonesia

Indonesia is one of many developing countries with a backlog in achieving targets for the implementation of wastewater and solid waste collection, treatment and recovery systems. Therefore a technical and financial feasibility analysis of these systems was performed using Indonesia as an example. COD, BOD, nitrogen, phosphorus and pathogen removal efficiencies, energy requirements, sludge production, land use and resource recovery potential (phosphorus, energy, duckweed, compost, water) for on-site, community based and off-site wastewater systems were determined. Solid waste systems (conventional, centralized and decentralized resource recovery) were analyzed according to land requirement, compost and energy production and recovery of plastic and paper. In the financial analysis, investments, operational costs & benefits and Total Lifecycle Costs (TLC) of all investigated options were compared. Technical performance and TLC were used to guide system selection for implementation in different residential settings. An analysis was undertaken to determine the effect of price variations of recoverable resources and land prices on TLC. A 10-fold increase in land prices for land intensive wastewater systems resulted in a 5 times higher TLC, whereas a 4-fold increase in the recovered resource selling price resulted in maximum 1.3 times higher TLC. For solid waste, these impacts were reversed - land price and resource selling price variations resulted in a maximum difference in TLC of 1.8 and 4 respectively. Technical and financial performance analysis can support decision makers in system selection and anticipate the impact of price variations on long-term operation. The technical analysis was based on published results of international research and the approach can be applied for other tropical, developing countries. All costs were converted to per capita unit costs and can be updated to assess other countries' estimated costs and benefits. Consequently, the approach can be used to guide wastewater and solid waste system planning in developing countries.