Drinking Water Contamination & Health in Rural Appalachia
Start Year: 2020 | End Year: Ongoing
We are conducting a systematic review and meta analysis in order to better understand the nature and extent of drinking water contamination in the Appalachian region of the United States as well as associated health outcomes. Specifically, the objective of this work is to comprehensively evaluate published research (based on primary data collection) on drinking water contamination in the Appalachian region (with reference to national drinking water safety standards) and to evaluate the degree to which such exposures are associated with measured and self-reported negative health outcomes. Studies are considered eligible for inclusion in our review if they were situated in any part of the Appalachian region, data collection was completed on or after January 1, 2000, and drinking water was measured/assessed for indicators of microbiological and/or chemical contamination, and/or if health outcomes directly related to drinking water were measured/assessed. We pre-registered our study protocol and are now working on the data extraction and analysis stages of the project with the goal of submitting a manuscript for publication sometime in 2021.
Funding & Support
Wastewater & Coastal Environmental Health in the Philippines
Start Year: 2018 | End Year: Ongoing
This research collaboration between colleagues at the University of California Berkeley (UCB) and the University of the Philippines (UPD) was designed to advance methods for measuring, modelling, and assessing marine water quality and environmental health at three sites in the Philippines. One of the three study sites for this multi-year project is Boracay Island. A popular tourist destination, in recent years sewage and other contaminants have adversely impacted Boracay’s beaches and coastal water quality, with implications for both environmental and human health. This research project centers on the use of an autonomous surface vessel to collect a wide range of spatially referenced data which can be combined with data from water samples and lab-based analyses, as well as satellite and other remote sensed data. At the Boracay site, proxy sensor data (e.g., optical brighteners and tryptophan) and laboratory analyses of grab samples will be combined to map and model actual and estimated water quality and environmental health impacts from point and non-point runoff and wastewater effluent. Our planned research activities and associated timelines suffered from a variety of logistical setbacks and delays, but we are now working under a no-cost extension to complete our primary research objectives for Boracay, as well as the other research sites (Bolinao and Tubbataha).
Funding & Support
Electric Kettle Promotion Program in Rural China (RCT)
Start Year: 2017 | End Year: Ongoing
Results from our previous research in rural China suggests that increasing the use of electric kettles for boiling (i.e., treating) drinking water in low-income areas of rural China could help expand access to safer drinking water, reduce household air pollution, and improve environmental and health outcomes in rural Chinese households currently boiling drinking water with solid-fuels (or not treating their water, or drinking contaminated bottled water). Our study was designed to evaluate the impact of a pilot Rural Electric Kettle Promotion Program offered to low-income households in rural Anhui Province, China. Specifically, we used a parallel arm cohort cluster-randomized controlled (RCT) trial design with a 1:1 ratio to randomize 30 clusters (i.e., villages) to treatment or control using stratified randomization by geography and by cluster proportions of reported electric kettle use at baseline. [Note: Data cleaning and analysis have been delayed due to the COVID19 pandemic]
Funding & Support
Water Utilities & Intermittent Drinking Water Supply in China
Start Year: 2017 | End Year: 2019
Led by our colleague, Dr. Hongxing Li at the China CDC, this project focused on the management and use of drinking water supply in areas where utilities provide piped drinking water, but for a variety of reasons it is not provided continuously (i.e., piped connections are not supplied with treated drinking water 24 hours a day, 7 days a week). This situation – that of intermittent water supply (IWS) – is relatively widespread in many low- and middle-income countries, as well as in parts of China. This research project, conducted in two Chinese provinces (Shandong and Hubei), assessed and compared management and consumer adaptation strategies, as well as drinking water quality, storage practices, and behaviors and beliefs associated with IWS, with comparison to similar communities living under conditions of continuous water supply (CWS). Water samples (from taps and rooftop storage units) and survey data were collected from 400 households across four villages (2 IWS, 2 CWS) in the two provinces. One of the main reasons the utilities in these regions provided water intermittently was to reduce the electricity costs associated with water supply pumps. Indicators of microbiological contamination were higher in samples from the IWS villages compared with the CWS villages, and we observed higher rates of bottled water use in the IWS villages compared with the CWS villages. As a result of this work, we were able to offer evidence-based recommendations utilities could adopt to reduce water-and-health related risks associated with IWS or transition to CWS.
Funding & Support
Bottled Water Safety & Use in Low- & Middle-Income Countries
Start Year: 2016 | End Year: Ongoing
In the course of our work studying drinking water access, contamination, and treatment in rural areas, we have observed relatively high rates of bottled water use. The reasons for increasing bottled water use in rural areas of low- and middle-income countries are varied, but available data indicates that some of the primary reasons are related to perceptions that bottled water is convenient and safer than available drinking water sources. Results from some of our research studies suggest, however, that bottled water may not always be safe. To better understand increasing use of and reliance on bottled water in LMICs we studied available market data which shows that more than half of the top-ten bottled water consuming countries globally are LMICs, and that bottled water use in LMICs is growing rapidly. With respect to global environmental health this trend is problematic in a number of respects, and, we argue, this increasing reliance on bottled water will likely hamper efforts to provide safe and affordable drinking water for all – one of the key objectives of the UN Sustainable Development Goals. As part of this work, we wish to better understand the nature and extent of bottled water contamination; however, there is relatively little publicly available data on bottled water quality, in LMICs or in high-income countries. To complement one of the only systematic review studies examining bottled water use and safety in LMICs, we conducted a comprehensive systematic review and meta-analysis of publicly available research studies on bottled water quality and associated health outcomes in China. After reviewing 7,000+ Chinese-language records, we extracted and analyzed data from 200+ eligible articles and are now preparing a manuscript for publication.
Funding & Support
Evaluating Household-level Drinking Water Treatment in Rural China
Start Year: 2012 | End Year: 2014
After extensive discussion and planning, we started a collaborative research project with colleagues at the NCRWSTG and China CDC to characterize and assess methods of household water treatment (HWT) in low-income regions of rural China. During the first phase of this research, in the summer of 2013, we collected drinking water samples and administered surveys to 450 households across 15 rural villages in Guangxi province. To assess seasonal factors, we undertook a second round of data collection in the winter of 2013/2014 during which time we also affixed remote temperature sensors to kettles and pots to help corroborate reported boiling data. In 2014, under the supervision of China CDC colleagues Director Tao Yong and Dr. Qing Luo, we replicated the study in Henan province, collecting data from 450+ rural households during the summer. Using a variety of modeling approaches, we evaluated the microbiological effectiveness of the HWT methods used – including bottled water (large 19L bottles) – and isolated socioeconomic predictors associated with HWT and water-related beliefs and behaviors. Among other findings, we observed that indicators of fecal contamination were lowest in drinking water samples from households using electric kettles. Our analyses of boiling-associated air pollution indicated that switching from boiling with pots and solid fuels to boiling with electric kettles would result in a measurable reduction in indoor air pollution. We also observed relatively high rates of microbiological contamination in samples from households using bottled water; and our analyses of socioeconomic factors suggested that rural bottled water use will continue to increase in the future. Results from these studies – as well as a systematic review on boiling and health outcomes – were also used to support and inform the design of an intervention to promote the use of electric kettles in low-income rural communities (see project summary above).
Funding & Support
Refinement & Finalization of the Multidimensional Poverty Assessment Tool (MPAT)
Start Year: 2010 | End Year: 2014
Following the release of the working-paper User’s Guide for the Multidimensional Poverty Assessment Tool (MPAT) in 2009, a number of agencies and universities used the beta-version of MPAT in a variety of settings. In order to finalize MPAT and develop a comprehensive User’s Guide and associated resources, we built on the lessons learned from early adopters of the the tool (e.g., an NGO in Kenya) and iteratively used and evaluated the tool with IFAD-supported projects in Bangladesh and Mozambique. Details on the participatory expert elicitation methods we used are provided in a Journal of Development Studies paper. We developed an Excel-based data entry platform so users could easily calculate MPAT’s indicators at household, village, and project levels. We also wrote a comprehensive, 300+ page, 2014 MPAT User’s Guide which provides step-by-step instructions for using MPAT as well as training modules and materials, all with the goal of making MPAT an accessible open-source tool. The User’s Guide and accompanying resources were presented at a 2014 launch event in Rome. Since its 2014 release, MPAT has been translated into a number of languages, an optional 11th component focused on climate change was added, and MPAT has been used by a variety of agencies and institutions around the world. MPAT publications and related resources are available at www.ifad.org/mpat.
Funding & Support
Developing a Thematic Indicator for Rural Poverty Assessment (MPAT)
Start Year: 2008 | End Year: 2009
The Multidimensional Poverty Assessment Project was a collaborative, international initiative to develop, test, and pilot a new tool for local-level rural poverty assessment. The work was supported by IFAD and guided by a Sounding Board of experts from IFAD, other United Nations agencies, international and regional organizations, and universities around the world, with the majority of its members coming from the Asia region where we developed and tested the tool in China and India. Surveys (household and village level) were developed and tested in an iterative and participatory fashion, as was the indicator structure used to aggregate sub-components and components. The resulting Multidimensional Poverty Assessment Tool (MPAT) provides an assessment, an overview, of ten dimensions central to rural livelihoods, highlighting where additional support or interventions are likely to be most needed. The tool was designed to be universal enough to be relevant to most rural contexts around the world, yet specific enough to provide project managers and others a detailed overview of key dimensions relevant to rural poverty reduction efforts. MPAT was independently evaluated by the European Commission Joint Research Center and a working-paper version of MPAT User’s Guide was released in 2009 as well as the 2009 MPAT Book, which provides a detailed description of why and how the tool was developed. MPAT’s theoretical foundations are described in a 2010 article in Development and Practice.
Funding & Support