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OJHAS Vol. 10, Issue 2:
(Apr-Jun 2011) |
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| Drinking
Water Quality Deterioration in Households
of Students with High Illness Absenteeism |
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Tambekar DH, Shirsat SD, Post Graduate Department of
Microbiology, SGB Amravati University, Amravati 444602, India,
Bhadange DG, Department of Botany, Shri
Shivaji College, Akola - 444001, India |
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Address for Correspondence |
Professor and Head,
Department of Microbiology,
Amravati University, Amravati-444602,
Maharashtra, India.
E-mail:
diliptambekar@rediffmail.com |
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Tambekar DH, Shirsat SD, Bhadange DG. Drinking
Water Quality Deterioration in Households
of Students with High Illness Absenteeism. Online J Health Allied Scs.
2011;10(2):4 |
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Submitted: Jun 24,
2011; Accepted: Jul 16, 2011; Published: Jul 30, 2011 |
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| Abstract: |
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Objective:
School and household lacked safe drinking water and thus school absenteeism
rates were high among students with poor water quality. So we assessed
fecal contamination of drinking water in households of students with
high illness absenteeism and evaluate the factors for non-potability. Method:
Drinking water samples (100) were collected from household water container of
50 students for fecal contamination. Results: A
total of 40 (80%) family’s water was potable before use, out of which
40% became non-potable after use. Factors responsible for reduction
in potability were water withdrawal without handwashing up to (56%),
poor domestic hygiene (56%), dipping hands in water (55%), placing water
dipper on lid (52%) and no washing of container (0%). Socio-economic
condition also had impact on water potability. Conclusion:
Water quality deterioration occurs by multiple factors like improper
storage, unhygienic habits of water handling and circumstances. Results
focused on the need
for further protocols for safe and hygienic storage of water.
Key Words:
Household water quality; fecal contamination; Storage-handling; Hygiene;
Illness absenteeism
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The burden
of diarrhoeal diseases remains high in the developing world due to poor
sanitation, inadequate personal, and domestic, household and community
hygiene which are responsible for most waterborne infections.(1)
Most, diarrhoeal infections are transmitted through the faeco-oral route,
and over 70% of all diarrhoeal cases can be attributed to contaminated
food and water.(2) That
results in 2.5 million childhood deaths yearly.(3) Usually pollution in drinking water is man made and due
to improper handling, storage and serving practices which leads to the
serious water borne diseases.(4) The number of different types of
pathogens that can be present in water as a result of pollution with
human or animal faeces is very large and it is not possible to test
water samples for each specific pathogen. The coliform group has been
extensively used as an indicator of water pollution and public protection
concept.(5) Even,
a better water source does not lead to full health benefits in the absence
of improved water storage and sanitation. (6) Clearly, point-of-use
water quality is a critical public health indicator.(7) School-aged children (5-13 years) often
remain absent because of the common infectious diseases. Absenteeism
as a result of illness from transmissible infections is a major problem
in educational institutions which may interfere with class absenteeism
and affect academic performance.(8) Undoubtedly, adequate personal
and domestic hygiene practices are essential in reducing the risks of
water quality deterioration and thus illness rate in school children.
An improved hygiene-education programme appears to need to change deep-rooted
inherent behaviors such as hand washing prior to water handling, as
well as proper protection of container-stored water from personal, domestic
and environmental contamination. In
this project we determine the extent of and risk factors for fecal contamination
in drinking water, by examined drinking water quality during the cascade
from storage to consumption in households of students with high illness
absenteeism.
Criteria
for inclusion: The study was conducted during the session of 2010-2011
among houses of students from three primary schools of different places
talukas viz Chandur Rly, Dhamangaon Rly and Bhatkuli of Amravati district,
Maharashtra.
Selection
of schools: For the study, primary schools (below 12 years) were
selected based on baseline survey of student’s previous year data
with high rate of illness absenteeism among all elementary schools in
the particular talukas with prior permission of District education officer.
Selection
of students: From these schools, 50 students were selected based
upon the absenteeism mainly due to gastrointestinal illness based on
detailed discussion with their teacher and parents about health, illness
episodes and behavioral habits of students.
Collection
and processing of water samples:
On the selection of targeted students, a total of 100 drinking water
samples before use (unused water) and after use (residual/remnant water
in container) were collected from households of 50 students (two samples
from each family) from water storage container/vessel of the house for
presence of fecal contamination or thermo-tolerant Coliforms (TTC) by
Eijkman test and processed within 6 hours. Both before use and after
use samples were inoculated in selective Brilliant Green Bile Lactose
Broth (BGLB) as presumptive medium and tryptone broth and were
incubated at 370C and 45.5OC for 24-48 hours.
If growth (cloudiness) and gas occurred in BGLB with production of Indol
(detected by Kovacs reagent) confirmed the presence of thermo-tolerant
coliforms in drinking water.
Family Background
of students: The detailed information of the family background of
the students, hygienic conditions, and method of collection, storage
and practices were recorded by questioning the parents and household
members. The socio-economical condition, education of the parents, number
of children etc were also been recorded and correlate these information
in water hygiene practices and behaviors of the household members.
Statistical
methods: To find out the probable cause of the non-potability or
contamination in drinking water, a 125 questionnaire were filled, along
with information on the respondent’s personal and domestic hygiene
practices, water handling, storage container characteristics, usage,
socio-economical status and related data from respective house. The
collected data was statistically analyzed by using SPSS software (SPSS
version 15.0 for window) in relation to potability of drinking water
of households of students.
A total of
50 primary school students (with high absenteeism rate) were selected
from three different places/schools viz 15 from school of Bhatkuli,
17 from Chandur Rly and 18 from Dhamangaon Rly of Amravati district.
Two drinking water samples (Before use and after use) from each households
of student i.e. a total of 100 water samples were collected and analyzed
for potability.
To find out
the probable cause of the non-potability in drinking water, this survey
was conducted and quality of household drinking water (before and after
use) were analysed for TTC contamination. Out of 50 water samples collected
before use 40 (80%) were potable and 10 (20%) non-potable. Total of
10 families had non-potable water before use and these families water
were not further discussed. Out of 40 households water, 16 (40%) became
non-potable after use due to improper storage and handling practices
were studied further for water quality between source and point-of-use. Furthermore, the deterioration
in water quality between source and point-of-use has been shown to be
proportionately greater than source water.(9) The
quality of residual drinking water (potability after use) was correlated
with family background, personal and domestic hygiene and water hygiene
behavior of family members.
Domestic hygiene
of houses affects the drinking water quality, and showed that good domestic
hygiene kept water 62% potable, moderate up to 60% and poor hygiene
reduces the potability up to 56%. The results confirms the findings
that maintaining overall good domestic hygiene leads to high potability
of water whereas low hygienic conditions in the houses leads to poor
quality of water.(10,11)
Our data strongly
suggested that the major sources of contamination were resulted from
poor water storage and unhygienic practices in the home. Hygiene of
water container was the important aspect; the good hygiene of container
maintains (62%) water samples potable, the moderate (63%) and the poor
(50%) (Fig.1).
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Fig. 1: Effect
of domestic hygiene, container hygiene, hand washing, hand dipping,
adding unused water from dipper, adding fresh water to residual water,
placing dipper on lid and type of water withdrawal utensil
on quality of drinking water |
The unhygienic
habits of most of the people lead to the various infections through
contaminated hands and fingernails. (12) Those family members washed
their hands before water withdrawal maintained water potability 69%
whereas those didn’t washed hands reduced it to 56% (Fig.1). Hence
it proves that hand washing before drinking of water is the most effective
and least expensive major to prevent transmission of infection.(13)
Dirty hands
of children caused contamination in drinking water when they put their
hands or utensils into the household water container. Those students/
children are not allowed to take water by themselves leads 100% potability
even after use whereas children take water by their own hands reduces
the portability to 59% after use (Fig.1). These findings are consistence
with those obtained by Jensen et al., 2004 who stated that children
take water themselves after playing without handwashing or with dirty
hands, enhance the chances of water contaminations.(14)
Those students/
children withdrawn drinking water by dipping their hands contaminates
the water and reduces its potability to 55% whereas those collecting
water without dipping hands retains 100% potability (Fig.1) which
proves that dirty
hands and household utensils appeared to contribute to point-of-use
contamination, highlighting the need for improved personal and domestic
hygiene practices.(15) The
dirty hands carry the bacterial pathogens and cause most of the serious
intestinal infections.(12)
Tambekar
et al., 2008 showed that practicing additions of fresh water
in residual water or unused water from dipper to storage container
enhance the chances of contamination (10) which was consistence with
our finding resulted in reduction in water potability (40%) whereas
when families didn’t add fresh water in remnant water in container
maintained potability of water to 63%. When water was added from water
dipper (Jar water) to container, potability of water reduced to 50%
after use. Keeping the water dipper (jar) on lid of water storage container
lead to 52% water potability whereas the families, who never placed
water dipper on lid had 100% water potability after use (Fig.1).
Use of long
handle dipper for withdrawal of water prevents chances of contamination
during storage and kept the water 100% potable whereas it reduced
when glass (57%) or mug (43%) were used for water withdrawal (Fig.1).
These findings are consistence with the results of other authors.(10,16)
Hence people should use dipper with long handle and avoid the use of
glass or mug for withdrawal of water to prevent the transmission of
contamination in the stored water.
Nearby accumulation
of residual of spilled water enhances the chances of contamination in
drinking water. Container kept inside the house on stand or on height
reduces the potability to 72% whereas it was up to 57%, 50%, 40%, 0%
when containers were placed inside the house without stand, outside
without stand, outside on stand and on kitchen (owta) platform respectively
(Fig. 2). Frequent or daily washing of storage container increased
the potability whereas no washing or occasional washing reduced the
potability. (10) The types of storage water container affect the keeping
quality of household drinking water (17) and it was found that plastic
container reduces the potability to 0% whereas it was 61% and 62% in
earthenware or steel container respectively (Fig. 2).
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Fig.
2: Effect of nearby residual water accumulation, position of container,
washing interval of container, type of container and regularity of water
supply on quality of drinking water |
Longer storage
time leads to less potability as compare to regular (64 % potability)
or intermitted (58%) water supply, thus indicating longer storage time
implies more chances for contamination.(15)
Socioeconomic
condition has prominent effect on overall hygienic condition of family
and quality of food and drinking water.(18,19) In our study, socioeconomic
condition of family’s kept or maintains good quality water whereas
it reduced to 67- 33% low to very low economic group indicating
socio-economical status of families of students were inversely proportional
to quality of drinking water as well as over al hygiene of family (Fig.
3).
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Fig. 3: Effect
of socio-economical status of students family on drinking water quality |
The
study concluded that small families, keeping the water container at
height, use of dipper with long handle for water withdrawal, no addition
of fresh/used water in residual water, hand
washing before taking water, avoiding dipping of hands in water,
daily washing of storage container, proper domestic hygiene and personal
hygiene maintains potability of drinking water. Hence using these practices
improves the drinking water quality as well as the health of the user
or family members and decreases the absenteeism in the school which
indirectly enhances social and health status of the students and the
family members.
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