A Review of Pollutant Concentrations in Urban Stormwater Across Eastern Australia, After 20 Years

Concerns about pollutants in urban stormwater were initially raised in the early 1970s. Australian investigations decades later, also found urban stormwater runoff contained elevated levels of sediment and nutrients, as well as heavy metals, that brought stormwater management to the forefront for regulators. Planning policies were implemented to integrate stormwater management into development in the form of water sensitive urban design (WSUD), also known internationally as low-impact design (LID) and Sustainable Urban Design solutions (SUDs). Since their introduction, comprehensive broad scale field research to verify their success in achieving load reduction targets (LRTs), has been limited. Paucity of field data on the performance of WSUD has prompted organisations to initiate their own locally-specific studies. Limited regulatory guidance on design of monitoring programs has resulted in various methodologies and meta-data recording. This research review collates urban stormwater data from 77 Australian studies, from geographic regions of east coast Australia. The raw dataset in this review included 2,836 events and 4,536 individual results, collected between 1993 and 2021 from local councils, research organisations and water authorities. The review examined total suspended solids (TSS), total phosphorus (TP) and total nitrogen (TN) concentrations, prior to any form of treatment measures as they are the focus of current guidelines and standards for stormwater management. Seminal research, used to inform stormwater guidelines and water quality modelling across Australia, is significantly different (p < 0.001), in this case approximately double the reviewed concentrations. International data is also >20% higher, on average. Geographic location of catchments had the greatest influence on pollutant concentrations, after accounting for the effects of land use and catchment urbanisation date (p < 0.001). Based on the findings of this review, generic load reduction targets (expressed as a percentage of annual inputs, e.g. 80% TSS reduction, 45% TN, 45% TP) typical in current Australian planning regulations, may be sub-optimal in achieving receiving water quality goals, particularly given the difficulty of removing pollutants when present in low concentrations. Alternately, place-based discharge targets which meet, or exceed, background water quality, or ecological and hydrological benchmarks may be a more appropriate tool to achieve environmental objectives

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Protecting the green behind the gold: catchment-wide restoration efforts necessary to achieve nutrient and sediment load reduction targets in Gold Coast City, Australia

The Gold Coast City is the tourist center of Australia and has undergone rapid and massive urban expansion over the past few decades. The Broadwater estuary, in the heart of the City, not only offers an array of ecosystems services for many important aquatic wildlife species, but also supports the livelihood and lifestyles of residents. Not surprisingly, there have been signs of imbalance between these two major services. This study combined a waterway hydraulic and pollutant transport model to simulate diffuse nutrient and sediment loads under past and future proposed land-use changes. A series of catchment restoration initiatives were modeled in an attempt to define optimal catchment scale restoration efforts necessary to protect and enhance the City's waterways. The modeling revealed that for future proposed development, a business as usual approach to catchment management will not reduce nutrient and sediment loading sufficiently to protect the community values. Considerable restoration of upper catchment tributaries is imperative, combined with treatment of stormwater flow from intensively developed sub-catchment areas. Collectively, initiatives undertaken by regulatory authorities to date have successfully reduced nutrient and sediment loading reaching adjoining waterways, although these programs have been ad hoc without strategic systematic planning and vision. Future conservation requires integration of multidisciplinary science and proactive management driven by the high ecological, economical, and community values placed on the City's waterways. Long-term catchment restoration and conservation planning requires an extensive budget (including political and societal support) to handle ongoing maintenance issues associated with scale of restoration determined here

Recent South East Queensland Developments in Integrated Water Cycle Management – Going Beyond WSUD

In the last 2-3 years, several major integrated water cycle management related developments have been proposed in South East Queensland, which, if they come to fruition, will challenge the conventional urban water cycle paradigm adopted in Australia and worldwide. These developments adopt key elements of what has been seen as conventional WSUD from a stormwater management perspective (e.g. the use of roadside swales for drainage and water quality control purposes in replacement of piped drainage and the capture and reuse of roofwater from individual houses), however they also embrace a much wider gamut of integrated water cycle management techniques including the capture and reuse of rainwater at several spatial scales, the reuse of wastewater for sub potable uses and the beneficial reuse of urban stormwater. The paper presents key details of these projects, the lessons learnt by the authors from their involvement in the projects, attempts to predict where the projects will go in coming years and highlights potential knowledge that will be gained from them. 1