Diagnosis of an anaerobic pond treating temperate domestic wastewater: An alternative sludge strategy for small works

An anaerobic pond (AP) for treatment of temperate domestic wastewater has been studied as a small works sludge management strategy to challenge existing practice which comprises solids separation followed by open sludge storage, for up to 90 days. During the study, effluent temperature ranged between 0.1 °C and 21.1 °C. Soluble COD production was noted in the AP at effluent temperatures typically greater than 10 °C and was coincident with an increase in effluent volatile fatty acids (VFA) concentration, which is indicative of anaerobic degradation. Analysis from ports sited along the AP's length, demonstrated VFA to be primarily formed nearest the inlet where most solids deposition initially incurred, and confirmed the anaerobic reduction of sludge within this chamber. Importantly, the sludge accumulation rate was 0.06 m3 capita−1 y−1 which is in the range of APs operated at higher temperatures and suggests a de-sludge interval of 2.3–3.8 years, up to 10 times longer than current practice for small works. Coincident with the solids deposition profile, biogas production was predominantly noted in the initial AP section, though biogas production increased further along the AP's length following start-up. A statistically significant increase in mean biogas production of greater than an order of magnitude was measured between winters (t(n=19) = 5.52, P < 0.001) demonstrating continued acclimation. The maximum methane yield recorded was 2630 mgCH4 PE−1 d−1, approximately fifty times greater than estimated from sludge storage (57 mgCH4 PE−1 d−1). Anaerobic ponds at small works can therefore enable sludge reduction and longer sludge holding times than present thus offsetting tanker demand whilst reducing fugitive methane emissions currently associated with sludge storage, and based on the enhanced yield noted, could provide a viable opportunity for local energy generation

User perceptions and practical considerations for implementation of advanced sanitation technologies: a case study of the Nano Membrane toilet from Kumasi, Ghana

This is a conference paper.In response to the growing need for sustainable urban sanitation, technologies are being developed that will be completely novel to their target context. The successful adoption of such technologies will be dependent on their acceptability to end users and their adaptability to local settings. As part of the development of the Nano Membrane toilet, a design team conducted a field study in Kumasi, Ghana, to gauge acceptability of the design and to assess the perceived value of the designed outputs of the toilet. In addition, a physical survey was conducted of the residences of the interviews. Overall, the surveys provided information about site-specific attitudes and physical limitations which would need to be considered by designers. These types of survey can be used by technology developers to assist design or to identify areas that are appropriate for their technology. Conversely, similar surveys could be used as a community assessment tool to identify technologies that are best adapted for a specific circumstance

Selection of screw characteristics and operational boundary conditions to facilitate post-flush urine and faeces separation within single household sanitation systems

To ensure adequate access to sanitation in developing economies, off-grid single household sanitation has been proposed which obviates the need for significant infrastructure capital investment. Whilst treatment at this scale is most efficient when coupled to source separation (i.e. urine from faeces), existing source separation solutions have proved difficult to implement in this context. In this study, screw extrusion is therefore investigated to provide ‘post-flush’ source separation. Both screw characteristics and operational boundary conditions were evaluated. Preferential screw characteristics included tapering of the shaft and progressive pitch reduction, linked to a small extrusion aperture, the combination of which enhanced solids extrusion efficiency and promoted higher solids concentration in the extruded fraction. Whilst maximum extrusion efficiency was observed at high rotational speeds (over 400 rpm), this also promoted free water transport. Operating below 300 rpm instead introduced selectivity for transport of faecal sludge over urine, enabling phase separation. Constraining the volumetric ratio of urine to faeces also enhanced the extrusion rate of faecal sludge by increasing feed viscosity sufficient to overcome backpressure imposed by unmasticated food particles that would otherwise restrict separation. Importantly, this study demonstrates the feasibility of screw extrusion for ‘post flush’ separation of urine and faeces which constitutes a significant advancement towards realising sanitation at a single household scale

Development of a staged anaerobic pond for methane recovery from domestic wastewater

Since their inception in larger pond systems, the focus of anaerobic ponds has shifted from solids removal to optimising biogas production and reducing physical footprint to minimise land requirements. In this study, a horizontally baffled (HBAP) and vertically baffled (VBAP) anaerobic pond were compared. Distinct differences in the removal efficiency of COD fractions were observed, with particulate COD removal of 78% and 32%, and soluble COD removal of −26% and 19% in the HBAP and VBAP, respectively. A staged pond (SAP) was constructed through an HBAP placed upstream of a VBAP, with an additional HBAP used as a control (CAP). The SAP demonstrated superior biogas recovery potential over the control: methane production by the conclusion of the study was 6.09 and 9.04 LCH4 m−3 wastewater treated for the CAP and SAP, respectively. Methanogenic activity in the ponds was higher closer to the outlet, and hydrogenotrophic methanogenesis dominated over acetoclastic pathways

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Identification of Surgeon Burnout via a Single-Item Measure

BackgroundBurnout is endemic in surgeons in the UK and linked with poor patient safety and quality of care, mental health problems, and workforce sustainability. Mechanisms are required to facilitate the efficient identification of burnout in this population. Multi-item measures of burnout may be unsuitable for this purpose owing to assessment burden, expertise required for analysis, and cost.AimsTo determine whether surgeons in the UK reporting burnout on the 22-item Maslach Burnout Inventory (MBI) can be reliably identified by a single-item measure of burnout.MethodsConsultant (n = 333) and trainee (n = 217) surgeons completed the MBI and a single-item measure of burnout. We applied tests of discriminatory power to assess whether a report of high burnout on the single-item measure correctly classified MBI cases and non-cases.ResultsThe single-item measure demonstrated high discriminatory power on the emotional exhaustion burnout domain: the area under the curve was excellent for consultants and trainees (0.86 and 0.80), indicating high sensitivity and specificity. On the depersonalisation domain, discrimination was acceptable for consultants (0.76) and poor for trainees (0.69). In contrast, discrimination was acceptable for trainees (0.71) and poor for consultants (0.62) on the personal accomplishment domain.ConclusionsA single-item measure of burnout is suitable for the efficient assessment of emotional exhaustion in consultant and trainee surgeons in the UK. Administered regularly, such a measure would facilitate the early identification of at-risk surgeons and swift intervention, as well as the monitoring of group-level temporal trends to inform resource allocation to coincide with peak periods

Burnout Among Surgeons in the UK During the COVID-19 Pandemic: A Cohort Study

BackgroundSurgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic.MethodsThis cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Participants completed the Maslach Burnout Inventory and a bespoke questionnaire. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).ResultsA total of 142 surgeons reported having contracted COVID-19. Burnout prevalence was particularly high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was unrelated to COVID-19 status; however, the greater the perceived impact of COVID-19 on work, the higher the prevalence of emotional exhaustion and depersonalisation. Degree of worry about contracting COVID-19 oneself and degree of worry about family and friends contacting COVID-19 was positively associated with prevalence on all three burnout domains. Across all three domains, burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades.ConclusionsThese findings highlight potential undesirable implications for patient safety arising from surgeon burnout. Moreover, there is a need for ongoing monitoring in addition to an enhanced focus on mental health self-care in surgeon training and the provision of accessible and confidential support for practising surgeons

Anaerobic ponds for domestic wastewater treatment in temperate climates

Energy demand, greenhouse gas emissions, and operational costs are continuing to rise year on year in the wastewater treatment sector, with traditional treatment options unable to provide sustainable solutions to increasing volumes and tightening quality standards. Current processes produce inherent fugitive greenhouse gas (GHG) emissions, whilst also generating large quantities of sludge for disposal. Anaerobic ponds (APs) are natural wastewater treatment processes that have traditionally been confined to a pre-treatment stage of larger stabilisation pond systems. Consequently, current standard guidelines are not suited for low temperature, weak strength wastewaters, or for the emerging usage of APs for energy recovery and enhanced organic breakdown. To establish effective guidelines for adapting AP design for this purpose, this thesis explores the fundamental mechanisms with APs, in order to provide design alterations to enhance AP performance for full flow domestic wastewater treatment with a focus on the UK water sector. Initially, a literature review of current AP design guidelines was conducted to determine the current state of the art and understand the fundamental design processes currently adopted. The review found that most APs are currently underloaded, largely to avoid malodour emissions, but this leads to unnecessarily large footprints and inhibits the digestion process through restricting biomass/substrate contact. It was concluded that the current design guidelines are not suitable for recent AP developments and application, such as covering to prevent odour escape, and the use of baffling to improve mixing and enhance organic degradation. A pilot scale study was conducted on UK domestic wastewater to gain insight into the limitations of current AP design for this application and identify areas for optimisation. The pilot trial demonstrated the efficacy of AP usage for low temperature, weak strength wastewaters, even with unoptimised design. Decoupling hydraulic and solids retention time lead to biomass retention and subsequent acclimatisation, and was able to compensate for the low temperatures and weak wastewater. It was concluded that APs can provide an attractive alternative to current primary treatment options, through reducing GHG emissions and providing less frequent desludging requirements. To optimise AP design, the effect of baffle configuration on AP hydrodynamics and the subsequent impact on treatment efficiency was investigated, in order to develop structural designs specifically targeting enhanced anaerobic degradation. Advantages found in baffling APs included improving mixing patterns between baffles, enhancing biomass/substrate contact, and creating an overall plug flow effect through the entire pond enabling the retention of biomass. Furthermore, the removal mechanism with the pond can be manipulated with use of baffles, with different orientations generating different flow patterns and therefore creating conditions preferential for greater solids settlement and capture, or mixing and contact. Following trials on single stage alternate baffling configurations, the development of a novel two stage AP design was trialled, applying knowledge gained from trials of differing baffle orientations to target separate stages of organic breakdown. Further trials were conducted on the staged AP to establish optimal loading rates to be applied to APs in order to maximise performance and reduce physical footprint. These trials led to recommended design improvements including shorter hydraulic retention times (HRTs) to enhance mixing and decrease physical footprint, and improvements to the staged AP design to greater separate the stages of anaerobic digestion and provide optimal conditions for the stages at different points in the AP. Finally, the knowledge gained from experimental work was used to present evidence for the inclusion of APs into decentralised WWT through flowsheet modelling of a proposed AP treatment works compared to a current base case. Advantages were found in decreasing sludge management requirements whilst providing suitable primary treatment, with additional potential benefits in renewable energy generation, which could increase both with improved biogas yields and the option of combining with other renewable technologies. In some circumstances, it may be possible for an AP flowsheet to operate entirely off-grid, eliminating the need for costly infrastructure such as permanent access roads and national electrical grid connection

Tank costs for domestic rainwater harvesting in East Africa

Rainwater harvesting from hard roofing can provide safe water to meet the basic domestic needs of several hundred million people in low-income countries. However, rainwater harvesting has a higher household cost than other low-technology water supplies such as protected springs. The storage tank is the most expensive part of the infrastructure required for rainwater harvesting: reducing this cost will enable rainwater harvesting to become a viable water source for many more households in low-income countries. This paper assesses the overall costs and different cost components of rainwater storage tanks. Costs are compared across a selection of tanks prefabricated in factories in Uganda, Kenya and the UK and constructed in situ in Uganda. Constructed tanks were always found to be cheaper than prefabricated ones. Tank size was an important factor, and it was found that tank cost per litre decreases as size increases. For all tank types, materials were the greatest cost