Chapter 14

If we want more evidence-based practice, we need more practice-based evidence.*


Chapter 14
Community Water and Waste Control

Table of Contents


REFERENCES - since publication of 8th edition




Water represents an essential ingredient of life and health. Maintaining the supply of water in sufficient quality and quantity to protect health and quality of life has been a community responsibility since the earliest human settlements. Storing and moving water as needed was the technological turning point in the growth of cities, as marked historically by the Roman aqueducts. Having achieved remarkable success in controlling organic pollutants in water supplies, the challenge today is increasingly with inorganic pollutants. Our overall objective for this chapter is to imbue the an appreciation of the continuing vigilance required in controlling the quality of water while ensuring its equitable distribution and appropriate use for recreational, agricultural and industrial purposes. This balance requires skill in the management of both water and wastes.


The social importance of water to the survival and economy of communities sets the stage for this chapter. The epidemiology of infectious and toxic agents in water examines the distribution and trends in risks, water consumption and water sources. Sections on regulation and testing of water includes the latest development and uses of chlorine and other tests, safe drinking water legislation and current controversies. The contrasting issues confronting developing countries highlight the severe problems of safe water supply in some parts of the world. The remainder of the chapter addresses the issues and technologies of community waste management, including sewage, chemical wastes and solid wastes.


Hidden danger in the delta: Fragile levees threaten state's water. State's drinking water could be polluted with salt water if the winter rains overrun levees. (San Francisco Chronicle, Jan. 9, 2005). Greg Lucas. 

Japanese Technology May Help Islands Reap Pacific's Waters.  (The New York Times, March 23, 2003) - The Republic of Palau (in the western Pacific) is working to build a system with the ability to produce enough drinking water for its 20,000 residents, with the help of Saga University in Southern Japan.  The system will also be used to produce electricity for the country.

Just Like Bad Old Days: Chicago Sewage Dumped in Lake Michigan. CHICAGO (Tribune Environment Writer, Peter Kendall, June 15, 1999, p. 1)- Heavy rainstorms so overwhelmed new storm water systems that the Metropolitan Water Reclamation District had to let untreated broth of runoff and sewage flow into the lake.

UN Agencies Discuss Freshwater Crisis. (WMO Press Release, 12 February 1999). More than 119 delegates from 57 countries and 20 representatives of international organizations and invited experts participated in the Fifth UNESCO/WHO International Conference on Hydrology, held in Geneva from 8-12 February 1999. The aim of the Conference was to identify how the two UN agencies could best contribute jointly to the solution of the world's looming crises over the lack of freshwater.

Rwanda: New Water Ministry In February 1999, the Government of Rwanda created a Ministry of Energy, Water, and Natural Resources. Previously, the Water and Sanitation   Directorate was part of the Ministry of Public Works, and the Division of Management of Water Resources was part of the Ministry of Agriculture.

South Africa: Global Trade Union Protest Against Privitization Public Services International, the global federation of trade unions representing 20 million public service workers, protests against recent developments in South Africa. PSI has been informed that local government officials in the Dolphin Coast municipality have signed a 30-year contract with the French multinational company, SAUR International, regarding the delivery of water services. The PSI Research Unit (PSIRU) has published a critical research report

Zambia: Poor Water Supply Cause Chlora Outbreak, Districts on Alert. (The Times of Zambia, 11 February 1999). The Central Board of Health (CBO) cited poor water supply and sanitation as the major causes of the outbreak of cholera which has so far claimed 39 lives. The Department of Health in Chadiza urged that water samples be sent to Lusaka for testing because the water treatment works were not functioning properly.

China, Chengdu: Pilot Private Sector Water Supply Project. ASIAN DEVELOPMENT BANK PRESS RELEASE, 11 February 1999. The Asian Development Bank (ADB) and the European Investment Bank have approved loans to finance China's first pilot BOT (build, operate, and transfer) water supply project - a model project to encourage private sector participation in the water supply sector. The project will provide a reliable supply of water to nearly three million residents in Chengdu, the capital of Sichuan province and one of 108 cities classified as having serious water shortages.

Low-Cost Water Stabilization Prevents Water Pipe Corrosion. (Mail and Guardian, 12 February 1999. Scientists from Environmentek at the South African Council for Scientific and Industrial Research (CSIR) have developed a low-cost, water-stabilization system using limestone instead of conventional lime to neutralize corrosive water. Some 40% of South Africa's water is soft and acidic and pipe maintenance and repair due to corrosion is one of the hidden costs in water distribution. Stabilization systems were developed in three sizes for different users.:

Canada Wants Ban on Water Exports. (Environment News Service, 11 February 1999). The Canadian government has announced a new federal strategy to prohibit bulk exports of fresh water (excluding bottled water). It calls on provinces to declare a moratorium on large-scale water diversions and sales until a broader, national accord aimed at protecting Canadian watersheds can be put in place. The announcement comes after several recent business proposals to export water from Canada had raised alarms. The United States and Canadian federal governments have asked the International Joint Commission (IJC) to examine the use, diversion and removal of waters, including removals in bulk for export, along the common border. Canada has about 9% of the world's renewable water resources and 20% of the world's total freshwater resources.

EPA May Change Lead Paint Rules

EPA May Change Lead Paint Rules. WASHINGTON (AP, Feb. 17, 1999) - It's called the Alliance for Safe and Responsible Lead Abatement. Its target audience is Americans concerned about the environment. And its stated goal is to protect drinking water from being poisoned by lead paint removed from older homes and apartment buildings. But behind the alliance's efforts is a $50-million-a-year industry whose specialized service would be jeopardized by an Environmental Protection Agency proposal. The EPA wants to drop federal rules requiring that certain steps be taken to contain building debris contaminated with lead paint. Instead, the agency would let contractors dump the material in landfills. The lead abatement industry says that could result in drinking water contaminated with lead, which is especially harmful to children.

World Water Day 1999: Everyone Lives Downstream. Excessive floods in 1998 have resulted in thousands of deaths and caused enormous damage in China, Bangladesh, and India, where nearly half of the world population lives. They are not only the result of excessive rains, but also of interference by mankind in the river basins. These tragedies make us realize that virtually everybody in this world lives downstream, which is the theme of the 1999 World Water Day on 22 March. Background materials and further information on World Water Day are available at:


India, New Delhi: Clean Capital Drive INDIAN EXPRESS, Feb. 20, 1999. The Delhi government has launched a month-long "Clean-the-Capital" drive from 1 March 1999 to coincide with 'Visit India Year'. With the support of NGOs, welfare associations and the public, it aims to improve sanitation in the Capital. Special cells would be opened where people could register complaints against the municipal authorities. The focus will be on 100 colonies where garbage-collecting trucks go door to door. At present 5,800-6,000 metric tonnes of garbage is collected in a day. The government also prepared a 'module' on community involvement in garbage collection. Contact:,

Acid Leak Threatens England Site. GREATHAM, England (AP, Feb. 19, 1999) - Environmental teams were struggling Friday to dilute acid that leaked into a protected marshland popular with migrating birds. A drain at Tioxide Europe Ltd.'s Greatham Works plant failed Wednesday, sending hydrochloric acid on to the 750,000-square-foot marsh in northeast England. The marsh has been designated a site of "special scientific interest" for attracting many species of birds. "It is one of the worst incidents I have attended," said Steve Hardy, an environmental protection officer. "It was as acidic as you get." About half the site was affected, he said.

Tokyo Activist Dies of Cancer. TOKYO (AP, Feb. 19, 1999) - Teruo Kawamoto, who fought for victims of mercury poisoning in Japan, has died of liver cancer, a family member said Friday. He was 67. Kawamoto died Thursday at a hospital in his hometown of Minamata, in Kumamoto prefecture, or state, about 660 miles southwest of Tokyo, said his son, Aiichiro Kawamoto. Kawamoto headed a group of victims of "Minamata disease," the sickness that resulted from tons of mercury being dumped into the sea surrounding the town beginning in 1932 and ending in the 1960s. Hundreds died and thousands were disabled by the disease, which caused nervous system damage in the victims and birth defects in their children.

European Protocol On Water and Health (WHO/EURO Press Release, 12 February 1999) From 14-16 February 1999, high-level officials from the health and environment ministries of the 51 European countries met in Bled, Slovenia to prepare an action plan that will form the Declaration at the Third Ministerial Conference on environment and Health in London, 16-18 June 1999. The agenda for the London Conference will include a legally binding Protocol on Water and Health

An estimated 110 million people in Europe do not have access to safe water. This Protocol, a joint initiative between the World Health Organization (WHO) and the UN Economic Commission for Europe (ECE) sets targets and timetables in three areas: adequate drinking-water and sanitation; safe water for agriculture, aquaculture and recreation; and effective systems for monitoring and managing risks to human health. Contact: Bent Fenger, Environment and Health Management Support, WHO Regional Office for Europe,

Water Scarcity Threatens Food Production. (BBC, Feb. 1999). In a few years, water scarcity will have been translated into food scarcity, according to Dr. Lester Brown, at the presentation the Worldwatch Institute's 1999 State of the World report ( Between 1991 and 1996, the water table under the north China plain dropped by an average of 1.5 m a year. The area produces nearly 40% of China's grain harvest. Water tables in India are falling at 1-3 m each year as groundwater is being withdrawn at least twice as fast as it is being replenished. When the reserves run out, India's grain harvest could fall by as much as a quarter. Contact Worldwatch Institute,

UN Sees Severe Water Shortage. GENEVA (AP, Feb. 4, 1999) - A severe water shortage could have "catastrophic consequences" in some developing countries unless global solutions are found soon, the U.N. weather agency said Friday. Almost 1 billion people could be living in countries with moderate to severe water shortages caused by climate change, contamination and population growth by the year 2025, according to the World Meteorological Organization. That could double again by 2050. Although developing countries make up most of those with severe water shortages, potential problem areas in the future include the west coast of the U.S. More than 150 experts from around the world will hold a U.N.-sponsored meeting in Geneva next week to discuss safeguarding water supplies.

EPA Bungling Leaves Environmental Justice Elusive.  (USA Today July 20, 1998). Agency pulls back rules that hurt economic development.   Environmental justice highlights - 1987, 1989, 1993, 1994 and 1998.

$50 Million Grant Program Could Upgrade Rural Wastewater Treatment.  (Nation's Health April 1997). Many small rural communities have outdated wastewater treatment facilities, if any, and this program will provide the necessary cash to initiate programs to improve water quality.

Low-Birthweight Babies Born Near Landfill.  (Nation's Health October 1997) .Infants born to mothers living next to a New Jersey landfill had substantially lower birthweights and twice the risk of being born prematurely.

EPA to Require Monitoring for Cryptosporidium.  (Nation's Health May/June 1996) Cryptosporidium is a parasite commonly found in lakes and rivers and more recently in large drinking water systems. This parasite does not respond well to current contamination control.

Trash Outpaces Recycling. (Vancouver Sun June 27, 1996) Vancouver residents are willing to use the blue box recycling program but that's all. A recent poll found that residents were not willing to make extra efforts in reducing their garbage output.

Giuliani Attacks Recycling Goals as Suit is Filed. (New York Times July 3,1996) New York City is in violation of its own recycling laws. The Mayor states that they just can't meet the goals!

Huge Spill of Hog Waste Fuels An Old Debate in North Carolina. (New York Times June 25, 1995). 25 million gallons of hog wastes gushed into the New River killing fish and harming the environment.

In the Heat of the Moment. (The Japan Times August 21, 1995). As a result of a serious heat wave, 27 of Japan's 47 prefectures limited water service.

World Bank Warns of Wars Over Water. (Canadian Press August 8, 1995). Water will be to the 21st Century what oil has been to the later part of the 20th century. 80 countries with 40% of the world's population are already experiencing water shortages.


For related news stories, please click here. 


Arsenic Contamination and Control

See also: Source, 23 November 1998,

The following lectures have been added to the World Health Organization's (WHO) Supercourse Health, Environment and Sustainable Development: Arsenic contamination of drinking water in Bangladesh; Arsenic contamination in the world; Chemical nature of arsenic; Toxic effects of arsenic in humans; Arsenic detection in drinking water; and Control measures for arsenic contamination.

Aid with Water and the Environment to Deprived Peoples

Aquassistance is a voluntary association of the staff of the Suez Lyonnaise des Eaux Group, set up in 1994 for humanitarian activities concerned with water and the environment. Recent activities have included: water supply for a disabled children school in India; water supply for hospitals in the Ivory Coast and Irak; and mobile water treatment plants in the aftermath of Hurricane Mitch for Honduras, Nicaragua, and the Dominican Republic.

WELL Technical Briefs

Contact: Mike Webster,
mail to:

These Briefs include selections of recommendations made by WELL, primarily in response to immediate technical assistance and answers to commonly asked questions. So far briefs on the following topics are available: Micro-credit for sanitation; Waste disposal options; Anaerobic treatment methods; Hygiene promotion; Sanitation promotion; Statistics for water-related diseases; Bacteriological water testing; Low-cost sanitation in areas with shallow groundwater; and Impact analysis of water and sanitation.

World Health Organization   
Geneva, Switzerland, WHO (1999)                

Arsenic in drinking water. (Fact sheet ; no. 210).

This fact sheet provides basic information on the health effects of arsenic in drinking water, arsenic testing and arsenic removal. It gives an overview of arsenic crisis in Bangladesh and measures being taken, especially by the World Health Organization (WHO), to alleviate the situation.

Freshwater Foundation
2500 Shadywood Road
PO Box 90, Navaree, MN 55392-0090
Phone: (612) 471-8407

Monthly Health and Environmental Digest. Subscription rates are available for public sector organizations. Draws from network of 22 schools of public health and 50 state health departments.

National Technical Information Service (NTIS)
Department of Commerce
5285 Port Royal Road
Springfield, VA 22161
Phone: (703) 487-4600

Products indexed in the NTIS serial publications such as Environmental Pollution and Control and featured research summaries available from NTIS for a fee.

National Institute of Environmental Health Sciences (NIEHS)
Department of Health and Human Services
PO Box 12233
Research Triangle Park, NC 27709
Phone: (919) 541-3345

Directories of NIEHS research programs, bibliographies, and monographs on topics such as chemical pollutants in the environment. Bimonthly Environmental Health Perspectives, includes conference papers and state-of-the-art reviews.

Safe Drinking Water Hotline
Environmental Protection Agency
401 M Street, SW , 4604
Washington, DC 20460
Phone: (800) 426-4791

The SDW Hotline provides information about EPA's drinking water regulations and other related drinking water and ground water topics to the regulated community, State and local officials, and the public.

WASH Operation Center
1611 N. Kent Street, Room 1002
Arlington, VA 22209
Phone: (703) 243-8200

The Water and Sanitation for Health Project (WASH) sponsored by the U.S. Agency for International Development offers information and bibliographic searches.

US Environmental Protection Agency
Office of Ground Water and Drinking Water

An excellent resource for adults and children that provides easy to read information about drinking water.

Software For Urban Water and Sanitation Services

Their programs can be downloaded at:
Contact: Palmer Development Group, Contact: Palmer Development Group,

The Palmer Development Group has  developed for the South African Water Research Commission two new models - one for water supply and one for sanitation - to assist agencies in urban areas in the development and evaluation of investment scenarios and tariff policy.

The International Water and Sanitation Centre (IRC) and the Water Supply and Sanitation Council (WSSCC) Source Weekly News Service can be found at:


Health and Environment News

The bi-weekly newsletter for environmental health professionals.  To learn more, go to this website:   

You'll find news about phthalates, air toxics, PCBs, pesticides, bisphenol A, dioxins, indoor air, mercury, lead, herbicides, POPs, beach water, radiation, PVC, solvents, nitrogen oxide, particulates, drinking water, MTBE, organophosphates.  Go to our website. You'll be able to download articles from past issues;  read headlines from the current issue; order free copies, and place your  subscription order

 For table of contents of latest issues of journals, click on the journal name below.

Water, Air, & Soil Pollution: An International Journal of Environmental Pollution

Water Quality and Ecosystem Modeling

Water Resources


Iannantuono, A., & Eyles, J. (1999). Environmental Health Metanarratives: An Analysis Of Policy Making In Ontario, Canada. HEALTH AND PLACE 5 (2): 139-156.
    For the Journal's website, go to: .

Nagam, A. and Rasheed S. (1998). Financing Of Fresh Water For All : A Rights Based Approach. - New York, USA, United Nations Children's Fund, 1998. v, 20 p.: 1 fig., 3 boxes. Abstract also in French and Spanish.
This paper argues that the international declarations on human and child rights provide the political, moral, ethical and legal imperative for ensuring that the fundamental right to water is met. It is argued that the key constraint is not financial resources but the political decision by the state to implement the rights already conferred on individuals. Issues such as the role of the market, the role of the state, privatization, microfinance and community based management are also touched upon in this paper, which is available in full-text on the Internet. (html version: ; pdf file: )

The following articles can be found on the World Bank's Public Policy for the Private Sector (Viewpoint): Water Page:

Haarmeyer, D. and Mody A. (1998). Pooling Water Projects To Move Beyond Project Finance. - Washington, USA, World Bank. - 4 p. A summary is at:  
The full text in pdf format:

Haarmeyer, D. and Mody A. (1998). Financing Water And Sanitation Projects - The Unique Risks. - Washington, USA, World Bank. - 4 p. A summary is at
The full text in pdf format:

Silva, G., Tynan, N. and Yilmaz, Y (1998). Private Participation In The Water And Sewerage Sector - Recent Trends. - Washington, USA, World Bank. - 8 p. A summary is at:  
The full text in pdf format:  

UNDP/World Bank Water and Sanitation Program (1998). Community Water Supply & Sanitation Conference.- Washington, DC, USA, World Bank, 1998.
The conference focused on demand-based approaches to rural water supply and sanitation (RWSS) provision and the implications for management and sustainability of services. A series of presentations provided a
framework for understanding the demand responsive approach (DRA) including: managing water as an economic good and implementing this approach. The findings of a global study on institutional rules and the relationship between demand responsiveness and sustainability were shared. Six main case studies were presented during the conference and an additional thirty case studies were presented during parallel

P Phillimore. Uncertainty, Reassurance And Pollution: The Politics Of Epidemiology In Teesside. Health and Place Volume 4, 11-Sep-1998: 203-212 and web link to the journal for abstracts:   or

Slow-Release Iodine in Local Water Supplies Reverses Iodine Deficiency Disorders: Is It Worth Its Salt, Nutrition reviews. SEP 01 1998 v 56 n 9, 280. An alternative approach to supplying iodine to isolated populations through the use of slow-release iodine in silicone matrices that float in the water supply was tested in remote desert areas of the Sudan. There was a differential impact, as judged by indicators of iodine nutriture, and these indicators provided varying indications of the iodine status of the population.

UNCHS (1998). Privatization Of Municipal Services In East Africa : A Governance Approach To Human Settlements Management. Nairobi, Kenya, United Nations Centre for Human Settlements (Habitat). Full text:
    This report presents the findings of a study on the nature, extent of progress and effectiveness in decentralization and privatization of municipal services in Kenya, Uganda and Tanzania East Africa. It focuses mainly on solid waste (refuse) management and water supply.

Other References

MMWR Surveillance Summaries, Volume 51, Number SS-8, Nov 21, 2002 is available in PDF and HTML formats. This summary includes data regarding outbreaks occurring during January 1999 - December 2000 and previously unreported outbreaks occurring in 1995 and 1997.  For Adobe PDF format, Click Here.                                                                                                                                  Surveillance for Waterborne-Disease Outbreaks---United States,1999-2000                       Appendix A:  Selected Case Descriptions of Outbreaks Associated with Drinking Water Appendix B:  Selected Case Descriptions of Outbreaks Associated with Recreational Water Glossary

National Health Protection Survey of Beaches for the 2001 Swimming Season.


1. Water rationing as a way of life. This boxed item challenges you to come up with community actions to prevent the extensive rationing suggested. Contact the local agency responsible for water management in your community and find out what if any plans they have for water restriction in event of natural disasters, such as flood, hurricanes, and drought.

2. Reducing risks from infectious and toxic agents in drinking water. Compare and contrast the Year 2000 objectives for drinking water in the U.S. with goals of WHO's Decade program for drinking water in developing countries. Identify two infectious and toxic agents you might encounter in water in the United States and water in a developing country.

3. Bottled water. Bottled drinking water appears everywhere these days, from offices, to homes, to over-the-shoulder harnesses for the mobile. Why are so many drinking bottled water? What are the health gains or losses for the decisions they make? Examine the economic, health, and cultural influences of this trend.

4. Recycling. Explore the history of the recycling program in your community. How long has it been in existence? How have strategies changed over time? What are the future needs of the program? Pull out a map to identify where community landfills are located. What is their capacity and how close are they to reaching capacity?

5. Long and winding road. Trace what happens to waste products (use an emptied washing machine, if you wish) as they leave the site of production and move through the city’s water treatment system. Or start with water coming out of the faucet in your home and trace it back to its source. Either direction, the project involves contacting the local water management agency in your community. Further explorations might include considerations of products that contaminate the supply or points at which the supply is vulnerable.

6. Community action. Nicholas Freudenberg's book entitled Not in Our Backyards! Community Action for Health and the Environment, Monthly Review Press, New York, 1984; and the Student Environmental Action Coalition's Action Guide, Earth Works Press, 1991, offer examples of community projects such activities as developing a directory of recycling locations, registering voters, buying recyclable projects, and taking public transportation. Identify some future careers associated with shrinking water supplies, e.g., xeriscape architect.

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