Oliver Schmoll Federal Environment Agency Bad Elster, Germany

Water Safety in Small Scale Water Suppliesin the European Region

Warsaw, Poland18 June 2009

Oliver Schmoll

Federal Environment AgencyBad Elster, Germany

Water Safety in Small Scale Water Supplies in the

European Region: Common Challenges and Needs

Warsaw, 18 June 2009



Water supply … are you talking 19th century?



“Sanitary revolution” won the “Oscar”



Big utility’s perspectives 1/2



Big utility’s perspectives 2/2



Why to focus on small scale water supplies?

They are plenty!

In the European Union, 1 in 10 citizens (= 50 of 500 Mio) receive drinking water from small scale water supplies

In Germany:• One third of the population receives water from more than 3,600 public

supplies serving less than 5,000 people

• One million people use water from ca. 200,000 private or hamlet wells




Backbone of drinking-water supply in the rural areas in all parts of the European Region:• Permanent residents mainly in rural, often not densely populated areas

• Transient users (tourists, holiday makers etc.)

Need for decentralised solutions:• Economic reasons

• Hygienic reasons




EU Drinking Water Directive revision process:• More focus on small supplies (see data collection by EC)

• Water Safety Plan approach

International momentum:• Protocol on Water and Health

• WHO Guidelines for Drinking-water Quality:



“Small scale water supplies”

Babylonian language jumble …• … small supplies, very small supplies, small scale supplies, small

community supplies, small public supplies, private supplies …

Size of the supply or number of people connected:• Widely varying classification schemes

• Often derived from regulatory definitions

Organisational set-up:• Community managed

• Publicly or municipality managed

• Regional water board associations

• Privately owned and operated



Different shapes …

Lithuania Germany

Tajikistan KyrgyzstanDenmark



Different shapes …

Germany

Germany



… similar characteristics and challenges 1/4

Differently regulated or non-regulated

Less “political” attention than large supplies

Lack of awareness and in sense of responsibility

Inaccurate perception of water-related health risks




Administration and management differs from organised utilities

Limited technical, personnel and financial resources

Less effective or inadequate source protection in the local context

Relatively greater capital costs




Typical staffing profiles:• Involvement of ordinary or untrained staff

• Staff is working part-time or have other jobs to do

• Labour may be voluntary or unpaid

Lack of “support networks”:• Widely dispersed over large areas

• Limited access to information and technical support

• Little degree of networking in scientific and professional communities

• Difficult recruitment of trained operators




Regulatory approach: “undivided” health protection

Need for intelligent surveillance strategies:• Plenty of supplies in widespread areas

• Limited manpower to advise, inspect and control

• One sample per year at best

Enforcement of compliance-based approaches debatable• Advice-based approaches

• Risk-based approaches



Germany

Germany

Private supplies inGermany



What do we know?

Compliance with microbiological standards remains a challenge in many small scale supplies :• Little readily available “hard data” from routine monitoring

and sanitary inspection

• Data are often informal or “hidden”

• High degree of anecdotal evidence

Chemical contamination is of less priority but can be locally relevant (e.g. natural constituents)



Microbial contamination

Analysis of database from by 150 local authorities in England:• 34,904 microbial water quality results from

• 11,233 private water supply sites

• 1996 to 2003

E. coli was detected in 6,588 (19 %) of samples

At least one positive sample being detected from 3,638 (32 %) water supply sites

Hunter et al 2008



Probable failure rate

Source Groundwater 1.000 9.09E-12

Surface water 2.347

Spring 2.342

Treatment Treatment 1.000 3.77E-07

No treatment 1.781

Rain on day prior to sample/mm

0 1.000 0.0016

1-9 1.325

10-99 1.364

100-999 1.707

1000-9999 2.066

Hunter et al 2008



What do we know?

Most detected outbreaks of water-borne disease are associated with “small scale water supplies” and single household supplies

Data on waterborne disease is difficult to collect systematically

Anecdotal evidence suggests comparatively higher disease burden

Ongoing literature review by ISS (Italy)



Country,year

Cases Description Causative agents Water quality (cause) Reference

Slovenia, 1997-2007

5-181 cases/ outbreaks

Between 1997 and 2007, 20 waterborne outbreaks notified .

In 12 outbreaks , more causative agents

Often contamination of drinking water from water supply systems

Kopilović et al., 2008

Slovenia, 2008

408 cases In June and July 2008, outbreak of acute gastro-enteritisin the town of Piran (17,400 inhabitants)

Several causative agents were isolated

water samples with faecal contamination on the basis of bacterial indicators

Kopilović et al., 2008

Albania, 2000

2,722 children Tirana Hospital (also outside the town); main age group : 0-5 years

Rotavirus in 26/28 faecal samples, but also astrovirus, adenovirus and calicivirus

Environmental contamination

Divizia et al., 2004

Gastroenteritis outbreaks in small communities

Funari et al 2008




Country,year

Cases Description Causative agents Water quality (cause)

Reference

England and Wales, 1992-2003

89 outbreaks of waterborne infectious intestinal diseases, 4321 people

From 2000 consistent decline of the number of outbreaks of WRDs

Crypt. (69%) Camp. (14% )E. coli 0157 (3%)Giardia (2%)

Private water supplies: 28% outbreaks

Smith et al., 2006

England and Wales, 1970-2000

25 outbreaks 16 outbreaks reported after the introduction of enhanced surveillance.

Campylobacter was the main pathogen, implicated in 13 (52%) outbreaks

Private water supplies

Said et al., 2003

Austria, 2006

160 cases August Unknown aetiology, rural village

Contaminated drinking water Heavy rains before the outbreak

2007

Funari et al 2008



Country,year

Cases Description Causative agents Water quality (cause)

Reference

Italy, 2006

2,806 patients admitted or seen by hospitals (District of Taranto)

Acute diarrhoeaRotavirus and Norovirus in 48 % and 40% of cases

No faecal indicators found in tap waters.

Martinelli et al., 2007

Bulgaria, 2007

977 cases of acute gastroenteritis

34.6% children 3-36 months old

Norovirus (also rotavirus) as probable cause of the outbreak

No faecal indicators were found in drinking water

Kamenov et al., 2007

France, 2000

202 cases and 62 probable cases population 709

in stool sample analysed: Rotavirus 71%E. coli 31%Norovirus 21%

Groundwater probably contaminated by agricultural runoff

Gallay et al., 2006


Funari et al 2008



Is it worth to improve?

“Undivided” health protection?

Cost-benefit studies:• Costs of legislation and interventions

• Proportion of illnesses likely to be prevented by interventions

• Direct cost of illness (health care)

• Indirect cost of illness (loss of work, loss of schooling)



Cost-Benefit-Ratio for water interventionsaiming at reducing acute diarrhoeal illness

Hunter et al 2008

Region Cost-Benefit-Ratio

Mean L95%CI U95%CI

Eur-A 2.52 0.78 5.88

Eur-B 21.34 6.64 49.89

Eur-C 3.91 1.22 9.14



Bas Elster conclusions 1/5

Small scale systems are vital to water supply of significant parts of the population

Need for strengthening epidemiological evidence base on health impacts of small systems

There is a positive cost/benefit ratio for investment in improving small scale systems




Development and dissemination of advocacy material aiming at increasing the awareness of decision-makers on the importance of small systems:• Need for political will

• Need for dedicated “piece of thinking” for developing effective management and surveillance strategies




There is a lack of consistent and coherent application of internationally recognised good practices and standards

WSP are seen as a viable approach for small scale supplies, including private wells

Experience from Switzerland, Scotland, Finland




Need for enabling environment:• Provision of external expertise

• Promotion of partnerships and twinning arrangements between major water services and small scale water suppliers

• Preparation and distribution of easy to understand guidance (useful WSP manuals available)

• Development of specialised training programs targeting owners and operators of small systems

• Increasing competence for the application of WSP approaches




Challenges to the health system:• Lack of awareness of health risks by users of small scale systems

• Underreporting of water related disease

• Need to revise and strengthen outbreak detection and response mechanisms

The need for international networking was recognised, including within• Protocol on Water and Health as platform for information sharing within

the European Region

• WHO Network on Community Supply



International Small Community Water Supply Network

To promote the achievement of improvements to the safety of small water supplies

Networking idea:• Advocate for political support

• Sharing of good practices, experiences and information

• Fostering Research

• Development of internationally-recognized guidance and tools for the management of small water supplies

Face-to-face meetings and information on “virtual forum” in the internet



Tools to assist

Access to over 500 training tools

Access to over 300 examples of risk communication tools

Access to over 50 examples of risk assessment tools

Online searchable database of terms (Lexicon)







International Small Community Water Supply Network

Open to anyone working on the topic of small water supplies:

• Government and non-government organizations, universities

• There are over 40 countries currently represented in the Network

For more information, please email to [email protected]

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Oliver Schmoll Federal Environment Agency Bad Elster, Germany

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