Persistence of pharmaceutical compounds and other organic wastewater contaminants in a conventional drinking-water-treatment plant

In a study conducted by the US Geological Survey and the Centers for Disease Control and Prevention, 24 water samples were collected at selected locations within a drinking-water-treatment (DWT) facility and from the two streams that serve the facility to evaluate the potential for wastewater-related organic contaminants to survive a conventional treatment process and persist in potable-water supplies. Stream-water samples as well as samples of raw, settled, filtered, and finished water were collected during low-flow conditions, when the discharge of effluent from upstream municipal sewage-treatment plants accounted for 37–67% of flow in stream 1 and 10–20% of flow in stream 2. Each sample was analyzed for 106 organic wastewater-related contaminants (OWCs) that represent a diverse group of extensively used chemicals.Forty OWCs were detected in one or more samples of stream water or raw-water supplies in the treatment plant; 34 were detected in more than 10% of these samples. Several of these compounds also were frequently detected in samples of finished water; these compounds include selected prescription and non-prescription drugs and their metabolites, fragrance compounds, flame retardants and plasticizers, cosmetic compounds, and a solvent. The detection of these compounds suggests that they resist removal through conventional water-treatment processes. Other compounds that also were frequently detected in samples of stream water and rawwater supplies were not detected in samples of finished water; these include selected prescription and non-prescription drugs and their metabolites, disinfectants, detergent metabolites, and plant and animal steroids. The non-detection of these compounds indicates that their concentrations are reduced to levels less than analytical detection limits or that they are transformed to degradates through conventional DWT processes. Concentrations of OWCs detected in finished water generally were low and did not exceed Federal drinking-water standards or lifetime health advisories, although such standards or advisories have not been established for most of these compounds. Also, at least 11 and as many as 17 OWCs were detected in samples of finished water. Drinking-water criteria currently are based on the toxicity of individual compounds and not combinations of compounds. Little is known about potential human-health effects associated with chronic exposure to trace levels of multiple OWCs through routes such as drinking water. The occurrence in drinking-water supplies of many of the OWCs analyzed for during this study is unregulated and most of these compounds have not been routinely monitored for in the Nation’s source- or potable-water supplies. This study provides the first documentation that many of these compounds can survive conventional water-treatment processes and occur in potable-water supplies. It thereby provides information that can be used in setting research and regulatory priorities and in designing future monitoring programs. The results of this study also indicate that improvements in water-treatment processes may benefit from consideration of the response of OWCs and other trace organic contaminants to specific physical and chemical treatments

Disaster Mental and Behavioral Health

OVERVIEW Communities exposed to disasters experience multiple traumatic events including threats to life, loss of property, exposure to death, and often economic devastation. Disasters by definition overwhelm institutions, health care, and social resources and require from months to years for both individuals and communities to recover.In the aftermath of disasters, human-caused or otherwise, a range of behaviors and symptoms emerge with profound clinical and population-level public health implications. A number of terms have been used to describe the social, psychological, and emotional health of affected populations in the aftermath of disasters and acts of terrorism. “Behavioral and mental health” has emerged as the phrase meant to embrace the broad range of human reactions to disasters. The use of the term “behavior” captures the actions people take to reduce perceived threats to safety, health, and well-being. These coping behaviors also have social and emotional impacts that may alter the extent of loss and change triggered by the disaster or its aftermath.Characteristics of the disaster event may greatly increase the stress experienced, such as lack of familiarity with the prevailing hazard (e.g., anthrax in the U.S. mail in 2001), use of fear as a weapon (i.e., terrorism), intensity of impact (e.g., degree of direct exposure to harm, loss, and change), predictability of the event (e.g., no warning, inability to avoid, unclear targets, protracted or stuttering course), or caused by human action (purposeful intent to harm vs. accidental)

Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.

There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities

Means or proportions with standard deviations for participant characteristics (n = 1893).

<p>¹ Mean</p><p>²%</p><p>Means or proportions with standard deviations for participant characteristics (n = 1893).</p

Parameter estimates of two multilevel linear regression models on Depressive Symptom Severity (n = 1893).

<p>*p < 0·05;</p><p>**p < 0·01</p><p>Parameter estimates of two multilevel linear regression models on Depressive Symptom Severity (n = 1893).</p

Posttraumatic Stress Disorder, Depression, and Alcohol and Tobacco Use in Public Health Workers After the 2004 Florida Hurricanes

OBJECTIVE: We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. METHODS: Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. RESULTS: Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. CONCLUSIONS: Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce