Evaluation of the Safe Water Optimization Tool to Provide Evidence-Based Chlorination Targets in Surface Waters: Lessons from a Refugee Setting in Uganda.
| Title: | Evaluation of the Safe Water Optimization Tool to Provide Evidence-Based Chlorination Targets in Surface Waters: Lessons from a Refugee Setting in Uganda. |
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| Authors: | Heylen C; Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.; String G; Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.; Civil and Environmental Engineering, Lehigh University, Bethlehem, Pennsylvania 18015, United States.; Naliyongo D; Oxfam, Kampala, P.O. Box 6228, Uganda.; Ali SI; Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario M3J 2S5, Canada.; Brown J; Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario M3J 2S5, Canada.; De Santi M; Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario M3J 2S5, Canada.; Ogira V; Oxfam, Kampala, P.O. Box 6228, Uganda.; Fesselet JF; Médecins Sans Frontières, Amsterdam 1018 DD, The Netherlands.; Orbinski J; Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario M3J 2S5, Canada.; Lantagne D; Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.; Friedman School of Nutrition, Tufts University, Boston, Massachusetts 02111, United States. |
| Source: | Environmental science & technology [Environ Sci Technol] 2024 Oct 22; Vol. 58 (42), pp. 18531-18540. Date of Electronic Publication: 2024 Oct 09. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: American Chemical Society Country of Publication: United States NLM ID: 0213155 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1520-5851 (Electronic) Linking ISSN: 0013936X NLM ISO Abbreviation: Environ Sci Technol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Washington DC : American Chemical Society; Original Publication: Easton, Pa. : American Chemical Society, c1967- |
| MeSH Terms: | Halogenation* ; Refugees*; Uganda ; Water Purification ; Chlorine ; Disinfection ; Water Quality ; Humans ; Escherichia coli |
| Abstract: | The Safe Water Optimization Tool (SWOT) generates evidence-based point-of-distribution free residual chlorine (FRC) targets to adjust chlorine dosing by operators and ensure water quality at point-of-consumption. To investigate SWOT effectiveness in surface waters, we conducted two before-and-after mixed-method evaluations in a Uganda refugee settlement served by piped and trucked surface water systems. We surveyed 888 users on water knowledge, attitudes, and practices; collected 2768 water samples to evaluate FRC,Escherichia coli, and disinfection by-products (DBPs) concentrations; and conducted nine key-informant interviews with system operators about SWOT implementation. After baseline data collection, SWOT chlorination targets were generated, increasing point-of-distribution FRC targets from 0.2 to 0.7-0.8 mg/L and from 0.3 to 0.9 mg/L for piped and trucked systems, respectively. At endline, household point-of-consumption FRC ≥ 0.2 mg/L increased from 23 to 35% and from 8 to 42% in the two systems. With these increases, we did not observe increased chlorinated water rejection or DBPs concentrations exceeding international guidelines. Informants reported that SWOT implementation increased knowledge and capacity and improved operations. Overall, SWOT-generated chlorination targets increased chlorine dosage, which improved household water quality in surface waters although less than previously documented with groundwater sources. Additional operator support on prechlorination water treatment processes is needed to ensure maximally effective SWOT implementation for surface water sources. |
| References: | Am J Trop Med Hyg. 2010 Jul;83(1):135-43. (PMID: 20595492); Bull World Health Organ. 2015 Aug 1;93(8):550-8. (PMID: 26478612); J Water Health. 2008 Mar;6(1):67-82. (PMID: 17998608); J Water Health. 2015 Sep;13(3):671-9. (PMID: 26322753); Environ Sci Technol. 2024 Mar 26;58(12):5548-5556. (PMID: 38471095); Water Res. 2021 Feb 1;189:116642. (PMID: 33246215) |
| Contributed Indexing: | Keywords: chlorine taste and odor; disinfection by-products; humanitarian crisis; microbiological water quality; user acceptability; water system operators; water, sanitation, and hygiene |
| Substance Nomenclature: | 4R7X1O2820 (Chlorine) |
| Entry Date(s): | Date Created: 20241009 Date Completed: 20241022 Latest Revision: 20241026 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11500394 |
| DOI: | 10.1021/acs.est.4c04240 |
| PMID: | 39383342 |
| Database: | MEDLINE |
Journal Article