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Health Impact Assessment for Sustainable Water Management

BOOK

Health Impact Assessment for Sustainable Water Management

Lorna Fewtrell | David Kay | M. Benjamin

(2008)

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Additional Information

Book Details

ISBN
978-1-78040-187-4
Edition
1
Language
English
Pages
286
Subjects
The environment
Environmental science, engineering & technology
Water supply & treatment

Abstract

Health Impact Assessment for Sustainable Water Management is a pioneering international text, exploring and developing this emerging discipline. It is the first to take an international perspective seeking to draw generic lessons from both the developed and developing nations’ experience in this new area of activity. The approach is being applied in policy development to strengthen the ‘evidence-base’ and across a wide spectrum of resource developments, industrial and urban infrastructure projects and in ‘aid’ projects in developing countries. 
This book illustrates the importance of considering health in water management developments and demonstrates the role of health impact assessment (HIA) in this process. Case-studies illustrate a range of management approaches to different system implementation issues and scale factors, ranging from domestic rainwater harvesting for the supply of non-potable water to a large-scale hydroelectric project. The concept, objectives, terminology and challenges of HIA are introduced and illustrated by case studies including rainwater harvesting, greywater reuse, sustainable drainage and evaluations of the health impacts of flooding. Developing country case studies include a small-scale irrigation project in Zimbabwe, a large hydro-electric scheme in Lao (Peoples Democratic Republic) and the implementation issues surrounding the use of domestic wastewater as a resource in demand by agricultural enterprises in Pakistan. 
The case studies illustrate different HIA approaches, including the use of quantitative and qualitative information and provide benchmarks of current practice for practitioners seeking to apply HIA in the emerging agendas in both developed and developing nations. The critical appraisals within each chapter offer both best practice exemplars as well as explanations of problems and mistakes of past project implementation, and define the requirements for the policy communities who will be increasingly required to accommodate HIA information in resource allocation decisions. As a result, this book will be of interest to planners, developers, policy makers, public health, environmental and water utility scientists and practitioners.

Table of Contents

Section Title Page Action Price
Title 2
Half-Title 4
Copyright 5
Contents 6
Preface 10
Foreward 12
List of Contributors 14
Abbreviations 18
Chapter 1: Health impact assessment for sustainable water management: the lay of the land 22
1.1 BACKGROUND 22
1.2 ORIGINS OF HIA 28
1.3 DEVELOPING RATIONALE 29
1.3.1 Economics 29
1.3.2 Equity 32
1.3.3 Public health 34
1.3.4 Good governance 34
1.4 SUSTAINABLE WATER MANAGEMENT 35
1.5 DEFINITIONS OF HEALTH AND HIA 35
1.5.1 Health 35
1.5.2 Determinants of health 36
1.5.3 HIA 37
1.6 THE HIA PROCESS 40
1.6.1 Levels of HIA 41
1.7 CHALLENGES 42
1.7.1 Stakeholder participation 42
1.7.2 Quantification 43
1.7.3 Data needs and availability 43
1.7.4 Possible biases 44
1.7.5 Evaluation 44
1.7.6 Multi-disciplinary nature 45
1.8 STRUCTURE OF THE BOOK 45
1.9 REFERENCES 45
Chapter 2: An overview of UK-based HIA research on water management and flooding 50
2.1 INTRODUCTION 50
2.1.1 Water Cycle Management for New Developments (WaND) 51
2.1.2 Adaptable Urban Drainage – Addressing Change in Intensity, Occurrence and Uncertainty of Stormwater (AUDACIOUS) 51
2.1.3 Flood Risk Management Research Consortium (FRMRC) 52
2.1.4 Health impact assessment 52
2.2 QUANTIFICATION 52
2.2.1 DALYs 53
2.2.2 Qualitative data 54
2.3 SCREENING 54
2.3.1 Water management options 54
2.3.2 Flood risk 55
2.4 SCOPING 55
2.5 PROFILING (CASE STUDY) 56
2.5.1 Vulnerable groups 56
2.6 RISK ASSESSMENT 57
2.6.1 Hazard identification 58
2.6.2 Exposure assessment 58
2.6.3 Dose-response assessment 58
2.6.4 Risk characterization 59
2.7 HEALTH IMPACT STATEMENT AND REFERENCE LEVELS OF RISK 60
2.8 DISCUSSION 62
2.9 REFERENCES 62
Chapter 3: Rainwater harvesting – an HIA of rainwater harvesting in the UK 66
3.1 INTRODUCTION 66
3.2 RISK ASSESSMENT 67
3.2.1 Possible hazards associated with rainwater harvesting 67
3.2.2 Exposure assessment 67
3.2.2.1 Drowning and near-drowning 68
3.2.2.2 Injury 68
3.2.2.3 Infection 71
3.2.2.3.1 Campylobacter spp. 72
3.2.2.3.2 Cryptosporidium spp. 74
3.2.2.3.3 Other infections and qualitative estimates 77
3.2.3 Risk characterization 78
3.2.3.1 Injury 79
3.2.3.2 Infection 79
3.2.3.3 Summary of risk characterization 79
3.3 HEALTH IMPACT STATEMENT 81
3.4 DISCUSSION 81
3.5 REFERENCES 82
APPENDIX 3.1 SUMMARY OF INFECTION PARAMETERS 86
Campylobacter spp. through toilet flushing 86
Campylobacter spp. through direct ingestion (external tap use) 87
Campylobacter spp. through cross connections (contaminated potable supplies 87
Cryptosporidium spp. through direct ingestion (external tap use) 88
Cryptosporidium spp. through cross connections (contaminated potable supplies) 88
Cryptosporidium spp. through contaminated garden produce 89
REFERENCES 89
Chapter 4: HIA of sustainable drainage options in the UK 90
4.1 INTRODUCTION 90
4.2 RISK ASSESSMENT 92
4.2.1 Possible hazards associated with SUDS 92
4.2.2 Exposure assessment 93
4.2.2.1 Drowning and near-drowning 93
4.2.2.2 Injury 94
4.2.2.3 Infection 94
4.2.2.3.1 Dog faeces 95
4.2.2.3.2 Rat urine 97
4.2.2.3.3 Insect vectors 97
4.2.2.3.4 Waterfowl faeces 98
4.2.2.4 Anxiety 100
4.2.2.4.1 Drowning and safety 100
4.2.2.4.2 Mosquitoes and insect vectors 101
4.2.3 Health benefits 101
4.2.4 Risk characterization 102
4.2.4.1 Drowning and near-drowning 102
4.2.4.2 Infection 102
4.2.4.3 Summary of risk characterization 102
4.2.5 Risk management 103
4.3 HEALTH IMPACT STATEMENT 104
4.4 DISCUSSION 104
4.5 REFERENCES 105
Chapter 5: HIA of greywater reuse in the UK 110
5.1 INTRODUCTION 110
5.1.1 Greywater quality 111
5.1.1.1 Quality prior to treatment 111
5.1.1.2 Potential for the survival of pathogens in untreated greywater 113
5.1.1.3 Treatment options 113
5.1.1.4 Microbial quality post treatment 114
5.2 RISK ASSESSMENT 115
5.2.1 Possible hazards associated with greywater reuse 115
5.2.2 Exposure assessment 116
5.2.2.1 Drowning and near-drowning 116
5.2.2.2 Injury 117
5.2.2.3 Chemical intoxication 117
5.2.2.4 Anxiety 119
5.2.2.5 Infection 119
5.2.2.5.1 Salmonella spp. 122
5.2.2.5.2 Cryptosporidium spp. 123
5.2.2.5.3 Legionella spp. 129
5.2.2.5.4 Skin infection 130
5.2.3 Risk characterization 131
5.2.3.1 Drowning and near-drowning 131
5.2.3.2 Injury and chemical intoxication 131
5.2.3.3 Infection 133
5.2.3.4 Risk characterization summary 133
5.2.4 Risk management 133
5.3 HEALTH IMPACT STATEMENT 134
5.4 DISCUSSION 134
5.5 REFERENCES 135
APPENDIX 5.1 SUMMARY OF INFECTION PARAMETERS 140
REFERENCES 141
Chapter 6: Flooding and health – an evaluation of the health impacts of urban pluvial flooding in the UK 142
6.1 INTRODUCTION 142
6.1.1 Health effects 143
6.2 MORTALITY AND INJURIES 144
6.2.1 Mortality 144
6.2.2 Injuries 146
6.2.3 Mortality and injury quantification 147
6.3 INFECTION 147
6.3.1 Bacterial 147
6.3.1.1 Legionella 147
6.3.1.2 Leptospirosis 148
6.3.1.3 Quantification of bacterial infection 148
6.3.2 Fungal 149
6.3.3 Respiratory disease 150
6.3.3.1 Quantification of respiratory illness 150
6.3.4 Gastrointestinal infection 151
6.3.4.1 Gastrointestinal illness quantification 152
6.3.5 Earache and skin rash 153
6.3.5.1 Quantification 153
6.3.6 Vector-borne illness 153
6.3.6.1 Vector-borne illness quantification 154
6.4 MENTAL HEALTH EFFECTS 155
6.4.1 Single event studies 155
6.4.1.1 Post-traumatic stress disorder 155
6.4.1.2 General symptoms 157
6.4.2 Multiple event studies 158
6.4.3 Mental health qu 159
6.5 HEALTH IMPACT EVALUATION – BRADFORD CASE STUDIES 160
6.5.1 Utley 160
6.5.2 Devonshire Park 161
6.5.3 Quantification methodology 162
6.5.3.1 Flood risks to people 162
6.5.3.2 WHO methodology 163
6.5.3.3 Summary of health impacts and quantification measures 163
6.5.4 Results 164
6.5.4.1 Deaths and serious harm 164
6.5.4.2 Physical symptoms 164
6.5.4.3 Mental health problems 164
6.5.4.4 Overall health impac 164
6.6 DISCUSSION 165
6.6.1 Vulnerability and hastened mortality 165
6.6.2 Mental health problems 166
6.6.3 Case studies 167
6.6.4 Lack of data and data uncertainty 167
6.6.4.1 Health data 167
6.6.4.2 DALY quantification 168
6.6.4.3 Flooding data 168
6.7 ACKNOWLEDGEMENTS 169
6.8 REFERENCES 169
Chapter 7: An exploratory quantitative microbial risk assessment of urban flooding and gastro intestinal illness 176
7.1 INTRODUCTION 176
7.2 MICROBIAL CONTAMINATION OF FLOOD COMPONENTS 178
7.2.1 Sewage 178
7.2.1.1 Literature values 178
7.2.1.2 Experimental values 180
7.2.2 Urban non foul 181
7.2.2.1 Literature values 181
7.2.3 Rivers 182
7.2.3.1 Literature values 183
7.2.3.2 Opportunistic sampling 184
7.3 EXPOSURE 185
7.3.1 Evacuation behaviour 185
7.3.2 Depth of flooding and likelihood of immersion 186
7.3.3 Volume ingested on immersion 187
7.3.4 Flood clean-up 187
7.4 QMRA 188
7.4.1 Hazard characterization 188
7.4.1.1 Campylobacter spp. 188
7.4.1.2 Cryptosporidium spp. 188
7.4.1.3 Viruses 189
7.4.2 Dose-response assessment 189
7.4.3 Exposure 190
7.4.3.1 Evacuation 190
7.4.3.2 Clean-up 191
7.4.3.3 Flood composition 191
7.4.4 Risk characterization 192
7.5 DISCUSSION 193
7.6 REFERENCES 194
Chapter 8: Mupfure irrigation project, Zimbabwe. HIA of a water resources development 200
8.1 BACKGROUND 200
8.2 PROJECT DETAILS 201
8.3 SCREENING 202
8.4 SCOPING 202
8.5 FULL-SCALE HIA 202
8.5.1 Schistosomiasis 203
8.5.1.1 Environmental factors 203
8.5.1.2 Community vulnerability 204
8.5.1.3 Capabilities of the health protection agencies 205
8.5.1.4 Schistosomiasis summary 206
8.5.2 Malaria 206
8.5.2.1 Environmental factors 206
8.5.2.2 Community vulnerability 207
8.5.2.3 Capability of health protection agencies 208
8.5.2.4 Malaria summary 208
8.5.3 Agrochemical poisoning 209
8.5.3.1 Environmental factors 209
8.5.3.2 Community vulnerability 210
8.5.3.3 Capability of health protection agencies 211
8.5.3.4 Agrochemical poisoning summary 212
8.5.4 Sexually transmitted diseases (STDs) 212
8.5.4.1 Environmental factors and community vulnerability 212
8.5.4.2 Capacity of the health protection agencies 213
8.5.4.3 STDs summary 213
8.5.5 Water-washed diseases 214
8.5.6 Nutritional aspects 214
8.5.7 Other health impacts 215
8.6 HEALTH IMPACT ASSESSMENT SUMMARY 215
8.7 SAFEGUARDS AND MITIGATION MEASURES 215
8.8 HIA CONCLUSIONS 215
8.9 MUPFURE REVISITED 215
8.10 ACKNOWLEDGEMENTS 218
8.11 REFERENCES 219
Chapter 9: Nam Theun 2 hydroelectric project, Lao PDR 220
9.1 INTRODUCTION 220
9.2 IDENTIFICATION OF HEALTH ISSUES 223
9.3 ASSESSMENT PROCESS 224
9.3.1 Potential impact areas of concern (PIAOCs) 227
9.4 SELECTED ASSESSMENT RESULTS 229
9.4.1 Nakai plateau resettlement area 230
9.4.2 Construction camps 234
9.4.2.1 Respiratory diseases 236
9.4.2.2 Vector-related diseases 236
9.4.2.3 Food, water and soil-borne diseases 237
9.4.2.4 Accidents and injuries 237
9.4.2.5 Exposure to hazardous materials 237
9.4.2.6 Psychosocial (social determinants of health) 238
9.4.2.7 Cultural health practices 239
9.4.2.8 Health infrastructure and capacity 239
9.4.2.9 Project management system delivery 239
9.4.3 Villages along the Nam Kathang and upper Xe Bang Fai 239
9.5 MITIGATION 242
9.5.1 TB control 243
9.5.2 Housing design 243
9.5.3 Vector-borne diseases 246
9.5.4 Sexually-transmitted infections 247
9.5.5 Food and water-related diseases 247
9.6 CONCLUSIONS 247
9.7 POSTSCRIPT 249
9.8 ACKNOWLEDGEMENTS 250
9.9 REFERENCES 250
Chapter 10: Raw wastewater use in agriculture; risk versus benefits 254
10.1 WASTEWATER USE IN AGRICULTURE 254
10.2 PAKISTAN 255
10.3 HEALTH IMPACT EVALUATION 256
10.3.1 Risks 257
10.3.2 Benefits 258
10.4 COST-BENEFIT ANALYSIS 258
10.4.1 Farmer 258
10.4.1.1 Conclusion 263
10.4.2 Consumers 264
10.4.2.1 Conclusion 266
10.4.3 Municipality 266
10.4.4 Downstream water users 267
10.5 CONCLUSIONS 267
10.6 RECOMMENDATIONS FOR SAFE USE 267
10.7 REFERENCES 269
Chapter 11: Concluding remarks 270
11.1 INTRODUCTION 270
11.2 CHALLENGES AND EMERGING ISSUES 273
11.2.1 Creating an enabling environment 273
11.2.2 Establishing institutional arrangements 274
11.2.3 Developing intersectoral decision-making skills 275
11.2.4 Ensuring independent quality control 275
11.2.5 Stakeholder participation 277
11.3 ATTRIBUTES 278
11.3.1 Quantification 278
11.3.2 Data needs and availability 279
11.3.3 Vulnerable groups 280
11.3.4 Multi-disciplinary nature 281
11.3.5 Monitoring and surveillance 281
11.3.6 International organizations 282
11.4 REFERENCES 283

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