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Quantitative microbial risk assessments (QMRAs) of contaminated drinking water usually assume the daily intake volume is consumed once a day. However, individuals could consume water at multiple time points over 1 day, so the objective was to determine if the number of consumption events per day impacted the risk of infection from Campylobacter jejuni during short-term contamination events. A probabilistic hydraulic and risk model was used to evaluate the impact of multiple consumption events as compared to one consumption event on the health risk from the intake of contaminated tap water. The fraction of the population that experiences greater than 10-4 risk of infection per event at the median dose was 6.8% (5th-95th percentile: 6.5-7.2%) for one consumption event per day, 18.2% (5th-95th: 17.6-18.7%) for three consumption events per day, and 19.8% (5th-95th: 14.0-24.4%) when the number of consumption events varied around 3.49 events/ day. While the daily intake volume remained consistent across scenarios, the results suggest that multiple consumption events per day increases the probability of infection during short-term, high level contamination events due to the increased coincidence of a consumption event during the contamination peak. Therefore, it will be important to accurately characterize this parameter in drinking water QMRAs. [ABSTRACT FROM AUTHOR]

The absence of indicator organisms in drinking water does not provide sufficient guarantee for microbial safety. Therefore the water utilities are implementing water safety plans (WSP) to safeguard drinking water quality. Quantitative microbial risk assessment (QMRA) can be used to provide objective quantitative input for the WSP. This study presents several applications of treatment modelling in QMRA to answer the risk managers questions raised in the WSP. QMRA can estimate how safe the water is, how much the safety varies and how certain the estimate of safety is. This can be used in the WSP system assessment to determine whether treatment is meeting health-based targets with the required level of certainty. Quantitative data analysis showed that short events of only 8 hours per year can dominate the yearly average health risk for the consumer. QMRA also helps the design of physical and microbial monitoring. The study showed that the required monitoring frequency increases with increasing treatment efficacy. Daily monitoring can be sufficient to verify a treatment process achieving 2 log reduction of pathogens, but a process achieving 4 log reduction needs to be monitored every 15 minutes. Similarly, QMRA helps to prepare adequate corrective actions by determining the acceptable 'down time' of a process. For example, for a process achieving 2.5 log reduction a down time of maximum 6 hours per year is acceptable. These applications illustrate how QMRA can contribute to efficient and effective management of microbial drinking water safety. [ABSTRACT FROM AUTHOR]

Quantitative microbial risk assessment (QMRA) is increasingly applied to estimate drinking water safety. In QMRA the risk of infection is calculated from pathogen concentrations in drinking water, water consumption and dose response relations. Pathogen concentrations in drinking water are generally low and monitoring provides little information for QMRA. Therefore pathogen concentrations are monitored in the raw water and reduction of pathogens by treatment is modelled stochastically with Monte Carlo simulations. The method was tested in a case study with Campylobacter monitoring data of rapid sand filtration and ozonation processes. This study showed that the currently applied method did not predict the monitoring data used for validation. Consequently the risk of infection was over estimated by one order of magnitude. An improved method for model validation was developed, It combines non-parametric bootstrapping with statistical extrapolation to rare events. Evaluation of the treatment model was improved by presenting monitoring data and modelling results in CCDF graphs, which focus on the occurrence of rare events. Apart from calculating the yearly average risk of infection, the model results were presented in FN curves. This allowed for evaluation of both the distribution of risk and the uncertainty associated with the assessment. [ABSTRACT FROM AUTHOR]

The volume of cold tap water consumed is an essential element in quantitative microbial risk assessment. This paper presents a review of tap water consumption studies. Study designs were evaluated and statistical distributions were fitted to water consumption data from The Netherlands, Great Britain, Germany and Australia. we conclude that the diary is to be preferred for collecting water consumption data. If a diary is not feasible, a 24 h recall would be the best alternative, preferably repeated at least once. From the studies evaluated, the mean daily consumption varies from 0.10L to 1.55L. No conclusions could be drawn regarding the effects of season, age and gender on tap water consumption. Physical activity, yearly income and perceived health status were reported to influence water consumption. Comparison of the different statistical probability distribution functions of the datasets demonstrated that the Poisson distribution performed better than the lognormal distribution as suggested by Roseberry and Burmaster. For quantitative microbiological risk assessment (QMRA) it is recommended to use country-specific consumption data and statistical distributions, if available. If no country specific data are available we recommend to use the Australian distribution data from the Melbourne diary study (Poisson, λ = 3.49 glasses/d) as a conservative estimate. [ABSTRACT FROM AUTHOR]

Quantitative Microbiological Risk Assessment (QMRA) is increasingly being used to complement traditional verification of drinking water safety through the absence of indicator bacteria. However, the full benefit of QMRA is often not achieved because of a lack of appropriate data on the fate and behaviour of pathogens. In the UK, statutory monitoring for Cryptosporidium has provided a unique dataset of pathogens directly measured in large volumes of treated drinking water. Using this data a QMRA was performed to determine the benefits and limitations of such state-of-the-art monitoring for risk assessment. Estimates of the risk of infection at the 216 assessed treatment sites ranged from 10-6.5 to 10-2.5 person-1 d-1. In addition, Cryptosporidium monitoring data in source water was collected at eight treatment sites to determine how Cryptosporidium removal could be quantified for QMRA purposes. Cryptosporidium removal varied from 1.8 to 5.2 log units and appeared to be related to source water Cryptosporidium concentration. Application of general removal credits can either over- or underestimate Cryptosporidium removal by full-scale sedimentation and filtration. State-of-the-art pathogen monitoring can identify poorly performing systems, although it is ineffective to verify drinking water safety to the level of 10-4 infections person-1 yr-1. [ABSTRACT FROM AUTHOR]

The aim of the current study was to calculate the size of protection zones around (sub)oxic and anoxic sandy aquifers without confining layers using a virus infection and transport model. The maximum allowable virus infection risk was 10-4/person/year at the 95% confidence level. Model results demonstrated that phreatic (sub)oxic sandy aquifers in The Netherlands required protection areas with a residence time of 43–117 d to ensure that the maximum virus infection risk would not be exceeded. This was 0.7–2 × the current guideline of 60 d. In contrast, phreatic anoxic sandy aquifers without confining layers needed protection zones of 555–898 d to stay below the maximum virus infection risk, 9.5–15 × the current guideline. A sensitivity analysis of the model demonstrated that the calculated protection zone was most sensitive for virus inactivation rate and collision efficiency. Values of both parameters were predicted from values obtained from previously published field and laboratory studies. At present, as it is unknown if these values can also be used at other locations, model results should be interpreted with care. [ABSTRACT FROM AUTHOR]

The treatment efficacy for reducing Campylobacter concentrations by a drinking water treatment plant was assessed using a stochastic Monte Carlo model. The goal of the study was to reduce uncertainty of the results by combining microbiological and non-microbiological data in an advanced treatment assessment. Combining raw water Campylobacter and E. coil data reduced the uncertainty on raw water (peak) concentrations five-fold. Similar improvement was achieved for rapid sand filtration. Ozone disinfection was modelled based on ozone concentrations, contact time and temperature. Since this data was available, whereas most microbiological analyses at this point were negative, uncertainty was reduced three-fold. The slow sand filtration assessment could not be improved; however, since previous steps contained less uncertainty, this did not increase uncertainty by much. The study showed that using appropriate data for each treatment step can greatly reduce uncertainty in treatment assessment. [ABSTRACT FROM AUTHOR]

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The decimal elimination capacity (DEC) of slow sand filters (SSF) for viruses, bacteria and oocysts of Cryptosporidium has been assessed from full-scale data and pilot plant and laboratory experiments. DEC for viruses calculated from experimental data with MS2-bacteriophages in the pilot plant filters was 1.5-2 log10. E. coli and thermotolerant coliforms (Coli44) were removed at full-scale and in the pilot plant with 2-3 log10. At full-scale, Campylobacter bacteria removal was 1 log10 more than removal of Coli44, which indicated that Coli44 was a conservative surrogate for these pathogenic bacteria. Laboratory experiments with sand columns showed 2-3 and >5-6 log10 removal of spiked spores of sulphite-reducing clostridia (SSRC; C. perfringens) and oocysts of Cryptosporidium respectively. Consequently, SSRC was not a good surrogate to quantify oocyst removal by SSF. Removal of indigenous SSRC by full-scale filters was less efficient than observed in the laboratory columns, probably due to continuous loading of these filter beds with spores, accumulation and retarded transport. It remains to be investigated if this also applies to oocyst removal by SSF. The results additionally showed that the schmutzdecke and accumulation of (in)organic charged compounds in the sand increased the elimination of microorganisms. Removal of the schmutzdecke reduced DEC for bacteria by ±2 log10, but did not affect removal of phages. This clearly indicated that, besides biological activity, both straining and adsorption were important removal mechanisms in the filter bed for microorganisms larger than viruses. [ABSTRACT FROM AUTHOR]

Oocysts of Cryptosporidium parvum can survive for several months in surface water, one of the main factors determining their success in environmental transmission and thus their health hazard via water. Several factors in the environment, e.g. temperature, presence of predators and exo-enzymes will probably influence oocyst survival. The high persistence of oocysts may also limit the value of traditional faecal indicator bacteria. The aim of this study was to determine the rate at which C parvum oocysts, E coli, faecal enterococci and C perfringens spores die in surface water and the influence of temperature and the presence of autochthonous (micro)organisms on the die-off rate. Microcosms with autoclaved river water were inoculated with the organisms. Microcosms with untreated river water were inoculated with concentrated primary effluent containing the bacteria and with C parvum oocysts. Microcosms were incubated at 5°C or 15°C at 100rpm. Viability of oocysts was monitored by in vitro excystation and dye-exclusion; viability of the bacteria was determined on appropriate selective media. When pseudo first-order die-off kinetics were assumed, the die-off rate of oocysts at 5°C was 0.010 log10/d and at 15°C, 0.006-0.024 log10/d. These rates underestimate die-off since oocyst disintegration was not accounted for. Incubation in autoclaved or untreated water did influence the die-off rate of oocysts at 15°C but not at 5°C. The die-off rate of E coli and enterococci was faster in the non-sterile river water than in autoclaved water at both temperatures. At 15°C, E coli (and possibly E faecium) even multiplied in autoclaved water. In untreated river water, the die-off of E coli and enterococci was approximately 10x faster than die-off of oocysts but die-off rates of C perfringens were lower than those of oocysts. As for oocysts, die-off of the bacteria and spores was faster at 15°C than at 5°C. Oocysts are very persistent in river water: the time required for a 10x reduction in viability being 40-160d at 15°C and 100d at 5°C. Biological/biochemical activity influenced oocyst survival at 15°C and survival of both vegetative bacteria at 5 and 15°C. The rapid die-off of E coil and enterococci makes them less suitable as indicators of oocyst presence in water. As C perfringens survived longer in untreated river water than oocysts, it may prove useful as an indicator of the presence of C parvum. [ABSTRACT FROM AUTHOR]

As part of a prospective cohort study among triathletes to determine a relationship between the microbiological quality of fresh bathing water and the risk of acquiring an intestinal infection, the exposure of the triathletes to microbiological contaminants was assessed. Waters were collected at seven triathlons (swimming course 1-1.5km) held in the summer of 1993 and 1994 to have a range of water qualities. All were influenced by sewage effluents, most also by agricultural run-off. Samples were collected several weeks before the event to establish a sampling programme (1993) and during the actual exposure of the triathletes (1993 and 1994) and examined for thermotolerant coliforms alone (samples preceding the event) and for E. coli, faecal enterococci, Staphylococcus aureus, F-specific RNAphages, enteroviruses (1993 and 1994) and for thermophilic Campylobacter. Salmonella, Aeromonas, Plesiomonas shigelloides and Pseudomonas aeruginosa (1993). The samples taken in the weeks before the exposure showed significant differences in thermotolerant coliform concentration between locations, depths and times. Also during swimmer exposure, significant differences occurred in microorganism levels at the different sampling points over the swimming course. As the triathletes swam as a group, they were exposed to approximately the same water at the same time. The geometric mean concentration was used to characterise each site. In the epidemiological study, the risk of an intestinal infection correlated with the concentration of thermotolerant coliforms and E. coli but not with the other parameters. The geometric mean concentration of thermotolerant coliforms at the triathlons ranged from 11-330/100mL and 54-1,200/100mL E. coil Ranking of the seven sites by faecal pollution level, based on the geometric mean concentration of a faecal indicator, resulted in a different ranking for each indicator. At the fresh water sites studied, only the ratio between the geometric mean density of E. coli and thermotolerant coliforms was constant. The ratio between the other parameters related to faecal pollution (faecal enterococci, F-specific RNA phages, enteroviruses) varied considerably. Water quality standards relating to faecal pollution can only be based on parameters that show a significant correlation with risk of intestinal illness. [ABSTRACT FROM AUTHOR]