Evaluation of transparent 20L polyproylene buckets for household solar water disinfection (SODIS) of drinking water in resource-poor environments.

Solar water disinfection (SODIS) is an appropriate technology for treating drinking water in developing communities, as it is effective, low- or zero-cost, easy to use. The WHO recognises SODIS as an appropriate intervention to provide drinking water after manmade or natural disasters. Nevertheless, uptake is low due partially to the burden of using small volume polyethylene terephthalate (PET) bottles (1.5-2 L). A major challenge is to develop a low cost transparent container for disinfecting larger volumes of water. This study examines the capability of transparent polypropylene (PP) buckets of 5 and 20 litres volume, as SODIS containers using three waterborne pathogen indicator organisms: E. coli, MS2-phage and Cryptosporidium parvum oocysts

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Good optical transparency is not an essential requirement for effective solar water disinfection (SODIS) containers

The efficacy of 10 L polypropylene (PP) transparent jerry cans (TJCs) to inactivate E. coli, MS2-phage and Cryptosporidium parvum via solar water disinfection (SODIS) was tested in well water or general test water under natural sunlight. Food-safe PP was used to manufacture the TJCs and a clarifying agent was added to improve optical transparency in the UV–visible range. 10 L PP TJCs and 2 L polyethylene terephthalate (PET) bottles were filled with well water, spiked separately with (∼106 CFU/mL of E. coli, ∼106 PFU/mL of MS2 phage and 5 ×105C. parvum oocysts per litre) and exposed to natural sunlight for 6 h. While the 10 L PP TJC prototype had poorer transparency (UV-B 0.001%, UV-A 4.29%, and visible 92% for TJCs without clarifier and UV-B 1.36%, UV-A 8.01%, and visible 90.01% for TJCs with clarifier) than standard 2 L PET (UV-B 0.72%, UV-A 10–85%, and visible 80–90%); log reduction values (LRVs) > 5, 2 and 0.8 for E. coli, MS2-phage, and C. parvum, respectively, were observed for the TJCs within six hours respectively, which is a minimum standard for drinking water established by the World Health Organisation (WHO). We observed similar inactivation kinetics for all three organisms in PP TJCs and PET bottles despite the poorer optical transparency properties of the SODIS jerry cans. Therefore, for effective SODIS, container optical transparency is not as important as previously believed. We conclude that good visible transparency is not a necessary requirement for containers intended for SODIS use.</p

Good optical transparency is not an essential requirement for effective solar water disinfection (SODIS) containers

The efficacy of 10 L polypropylene (PP) transparent jerry cans (TJCs) to inactivate E. coli, MS2-phage and Cryptosporidium parvum via solar water disinfection (SODIS) was tested in well water or general test water under natural sunlight. Food-safe PP was used to manufacture the TJCs and a clarifying agent was added to improve optical transparency in the UV–visible range. 10 L PP TJCs and 2 L polyethylene terephthalate (PET) bottles were filled with well water, spiked separately with (∼106 CFU/mL of E. coli, ∼106 PFU/mL of MS2 phage and 5 ×105C. parvum oocysts per litre) and exposed to natural sunlight for 6 h. While the 10 L PP TJC prototype had poorer transparency (UV-B 0.001%, UV-A 4.29%, and visible 92% for TJCs without clarifier and UV-B 1.36%, UV-A 8.01%, and visible 90.01% for TJCs with clarifier) than standard 2 L PET (UV-B 0.72%, UV-A 10–85%, and visible 80–90%); log reduction values (LRVs) > 5, 2 and 0.8 for E. coli, MS2-phage, and C. parvum, respectively, were observed for the TJCs within six hours respectively, which is a minimum standard for drinking water established by the World Health Organisation (WHO). We observed similar inactivation kinetics for all three organisms in PP TJCs and PET bottles despite the poorer optical transparency properties of the SODIS jerry cans. Therefore, for effective SODIS, container optical transparency is not as important as previously believed. We conclude that good visible transparency is not a necessary requirement for containers intended for SODIS use.</p

Climate change-induced increases in precipitation are reducing the potential for solar ultraviolet radiation to inactivate pathogens in surface waters

Abstract Climate change is accelerating the release of dissolved organic matter (DOM) to inland and coastal waters through increases in precipitation, thawing of permafrost, and changes in vegetation. Our modeling approach suggests that the selective absorption of ultraviolet radiation (UV) by DOM decreases the valuable ecosystem service wherein sunlight inactivates waterborne pathogens. Here we highlight the sensitivity of waterborne pathogens of humans and wildlife to solar UV, and use the DNA action spectrum to model how differences in water transparency and incident sunlight alter the ability of UV to inactivate waterborne pathogens. A case study demonstrates how heavy precipitation events can reduce the solar inactivation potential in Lake Michigan, which provides drinking water to over 10 million people. These data suggest that widespread increases in DOM and consequent browning of surface waters reduce the potential for solar UV inactivation of pathogens, and increase exposure to infectious diseases in humans and wildlife