No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Domestic water security in the Arctic: A scoping review
Abstract
Introduction
More than 50 million people living in the Arctic nations remain without access to safely managed drinking water services. Remote northern communities, where large numbers of Indigenous peoples live, are disproportionally affected. Recent research has documented water and health-related problems among Indigenous communities, including poor water quality and insufficient quantities of water.
Objective
The objective of this scoping review is to examine the extent of available water security evidence as well as identify research gaps and intervention priorities to improve access to domestic water in the Arctic and Subarctic regions of the eight Arctic nations (Canada, the Kingdom of Denmark (Greenland), Finland, Iceland, Norway, Sweden, Russia, and the United States (Alaska)).
Methods
An extensive literature review was conducted to retrieve relevant documentation. Arctic & Antarctic Regions, Compendex, Geobase, Georef, MEDLINE and Web of Science databases were searched to identify records for inclusion. The initial searches yielded a total of 1356 records. Two independent reviewers systematically screened identified records using selection criteria. Descriptive analyses were used to summarize evidence of included studies.
Results
A total of 55 studies, mostly conducted in Canada and the United States, were included and classified by four predetermined major dimensions: 1) Water accessibility and availability; 2) Water quality assessment; 3) Water supply and health; 4) Preferences and risk perceptions.
Conclusions
This scoping review used a global approach to provide researchers and stakeholders with a summary of the evidence available regarding water security and domestic access in the Arctic. Culturally appropriate health-based interventions are necessary to ensure inclusive water services and achieve the Sustainable Development Goals (SDG) targets for universal access to water.
... 24 Water retrieval in the Arctic and subarctic is mainly from surface sources such as lakes, rivers and icebergs. 25 Water harnessing of all regulated water supplies in Greenland is 100% from surface water and in the Faroe Islands it is 93%, whereas in Iceland it is 95% from groundwater. 26 Harper et al. 27 conducted a literature review on the drinking water system and health outcomes in the context of climate change in the Circumpolar North, in light of the existing high burden of waterborne diseases in those areas and concluded that more research is needed to understand current and future risks and how to adapt. ...
Climate change is leading to an increase in extreme weather events in the Arctic, which can significantly affect both the quality and availability of drinking water. Prolonged droughts lower groundwater levels and reduce soil moisture that elevates the risk of wildfires, which can contaminate water resources and damage water supply infrastructure. This case study examines the impact of wildfires on water quality in porous volcanic strata in the Arctic. The primary water extraction area for the capital region of Iceland supplies drinking water to six municipalities, representing approximately 64% of the country's population. The water source is mainly located in a postglacial porous lava field with thin volcanic strata and limited surface water. On May 4th, 2021, a large wildfire occurred in the watershed following a prolonged drought, burning 56.5 hectares of land. Three of the water intake zones for the capital region are situated 300 meters to a few kilometres from the fire-affected area. Water quality monitoring data from these zones, covering the period 2011–2023 and comprising 47 samples (28 pre-fire and 19 post-fire), were analysed. The results show the presence of polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), as well as an increase in certain metals after the wildfire. The total concentration of the five detected PAHs ranged from 1.1 to 7.3 ng l⁻¹, with PAHs detected up to five months post-wildfire. These were predominantly five- or six-ring carcinogenic PAHs, though levels remained well below the parametric values set by Icelandic drinking water regulations. Some VOCs were also detected after the wildfire, albeit mostly at a later stage. Additionally, several metals were found in concentrations up to nearly six times higher than the median values recorded from 2011 to 2020. These findings suggest that groundwater quality is vulnerable to contamination following wildfires, underscoring a critical knowledge gap regarding the impacts of climate change on the water sector and the need for enhanced risk mitigation strategies.
... shown that being informed about the environmental impacts of consumption choices or motivated to address climate change does not necessarily translate into adopting SC behaviors, underscoring the complexity of the water quality perception and SC (Cassivi et al., 2023;Dupont, 2005). Previous studies highlight the influence of PWQ. ...
Water is the lifeblood of our Earth, and sustainable water consumption is the key to preserving this scarce resource for future generations and upholding environmental sustainability. In this study, we investigate the relationship between environmental knowledge (EK), environmental policies and regulations (EPR), attitudes toward water resource management programs (APWRMP), perceived water quality (PWQ), and sustainable consumption (SC), enriching the existing literature by integrating the theoretical framework of the theory of planned behavior (TPB) alongside water management program (WMP) concepts. This integration forms a comprehensive model clarifying the influences on SC. Furthermore, this study investigates these relationships within the specific context of select regions in China, addressing a geographical gap in the current literature. With a sample size of ( N = 336) participants, we employ partial least squares structural equation modeling (PLS‐SEM) to explore the complex relationships within the proposed model. The finding confirms the hypothesized associations, validating the substantial positive impact of EK and EPR on APWRMP and SC. Additionally, we observe that PWQ notably strengthens the link between the perception and attitude of villagers toward SC of water. Our study explains the multifaceted dynamics underlying individuals' behavior and attitude in making decisions concerning sustainable water consumption.
The sanitary condition and environmental situation in Arctic waters largely depend on the functioning of wastewater treatment systems. This study is devoted to wastewater treatment and sewerage systems in urban cities and towns in the Arctic zone of Russia. Over the past 50 years, the total discharge of wastewater into individual river basins and seas of the Russian Arctic has decreased by almost 50%, while the volume of untreated wastewater has increased by 50–65%. In some small Arctic settlements, sewage systems have become unusable by 57–100%. Sewage treatment plants continue to function, but they are not able to provide high-quality wastewater treatment. Nevertheless, the population is required to make monthly payments for municipal sanitation services. Due to the degradation of wastewater treatment plants, wastewater treatment and sanitation services are not actually performed. It is important to note that many pollutants are unregulated. For example, persistent organic compounds found in Arctic waters can cause cancer in the female population because they are transmitted through the food chain. In Russia, there are no standards for the maximum permissible concentrations of these pollutants in wastewater, which makes it difficult to control them. Based on a comprehensive review and analysis of the literature, the authors conclude that sanitation problems in the Arctic are complex, and attention to the aspects discussed in this study once again confirms this.
Water (in)security is central to achieving sustainable development in Arctic communities. To characterize the pervasive and place-based challenges faced by Arctic residents and communities, water insecurity can be examined across five dimensions (i.e., availability, accessibility, safety, reliability and preference). Based on an analysis of 61 studies, this narrative review synthesizes how the human dimensions of Arctic water insecurity have been measured in the scientific literature. This review serves as a resource for researchers, policymakers and practitioners when selecting measures of water insecurity based on past studies, and for addressing knowledge gaps through the development of new measures in partnership with Arctic and Indigenous communities. Faced with rapid climatic and societal change, enhanced human-centered measures of water insecurity in the Arctic will enable future research, policy, monitoring, management and stewardship. This is necessary to achieve the human right to water and Sustainable Development Goal of clean water and sanitation for all.
Over recent decades, the Arctic has begun facing a range of climate-related challenges, from rising temperatures to melting ice caps and permafrost thaw, with significant implications for ecosystems and human well-being. Addressing the health impacts of these issues requires a comprehensive approach, integrating scientific research, community engagement, and policy interventions. This study conducts a literature review to assess the effects of climate change on human health in northern latitudes and to compile adaptation strategies from the Arctic countries. A literature search was performed between January and April 2024 for papers published after 2000, using the electronic databases Web of Science, Pubmed, Science Direct, Scopus, Google Scholar, and eLibrary.RU, with specific questions formulated to direct the search: (i) What are the climate changes? (ii) How does climate change affect human health? (iii) What adaptation measures and policies are required? The key phrases “climate change”, “human health”, “adaptation practices”, and “Arctic” were employed for searching. Ultimately, 56 relevant studies were identified, reviewing health risks such as infectious diseases, mental health issues, and diseases connected with extreme weather events; wildfires and their associated pollution; permafrost degradation; pure water; and food quality. The paper also examines mitigation and adaptation strategies at all levels of governance, emphasizing the need for international cooperation and policy action to combat negative health outcomes, investments in healthcare infrastructure, emergency preparedness, and public health education. Incorporating diverse perspectives, including Indigenous knowledge, Community-Based Adaptation, EcoHealth and One Health approaches, is crucial for effectively addressing the health risks associated with climate change. In conclusion, the paper proposes adaptation strategies to mitigate the health impacts of climate change in the Arctic.
Municipal water supply through truck-to-cistern system is common in northern Canada. Household satisfaction and concerns about water availability, quality, and accessibility likely impact user preferences and practices. This case study explores household perspectives and challenges with regard to domestic access to water in a decentralized truck-to-cistern system. A case study was conducted in the Northern Village of Kangiqsualujjuaq, Nunavik (Quebec, Canada). A paper-based questionnaire was completed by 65 households (one quarter of the population). Many households (37%) reported not drinking tap water from the truck-to-cistern system. Chlorine taste was a frequently reported concern, with those households being significantly less likely to drink water directly from the tap (p = 0.002). Similarly, households that reported a water shortage in the previous week (i.e., no water from the tap at least once) (33%) were more likely to express dissatisfaction with delivered water quantity (rs = 0.395, p = 0.004). Interestingly, 77% of households preferred using alternative drinking water sources for drinking purposes, such as public tap at the water treatment plant, natural sources or bottled water. The study underscores the importance of considering household perspectives to mitigate the risks associated with service disruptions and the use of alternative sources for drinking purposes.
Rainwater harvesting (RWH) is principally based on collecting, storing and using rainfall which would otherwise be lost as surface runoff. Runoff threatens in several ways: accelerating erosion, intensifying flooding and reducing groundwater recharge. Therefore, purposely retaining rainfall in the urban water cycle rather than draining has several positive impacts on designing sustainable cities. This work presents a proposal on how to avoid flooding in cities by systematically harvesting, storing rainwater, and using it for multiple purposes. The concept of RWH presented here has the potential to be a radical innovation to solve the social, economic and environmental challenges associated with flash flooding. Each residence is regarded as a water production unit. Depending on the climatic conditions, people can meet their water needs on a local household basis, or alternatively use piped water as a complement. By infiltrating rainwater, groundwater is locally recharged and downstream wells are more productive. The implementation of this idea involves entrepreneurial agency that challenges existing structures, rather than adapts to them. Clearly, social entrepreneurship and social innovation are expected to catalyse the realization of this social innovation, also in rural areas. It is about mobilizing ideas, capacities, and resources to create a sustainable social transformation.
Las aguas subterráneas del valle del río Sinaloa juegan un papel importante en el abastecimiento de agua para las actividades domésticas en el municipio de Guasave, Sinaloa México, ya que el abastecimiento proviene de pozos y se brinda a la población a través del sistema de tuberías de Distribución. Las autoridades municipales han reconocido que estas aguas contienen distintas concentraciones de manganeso, lo que puede causar problemas de salud en la población. Por lo tanto, el objetivo de este estudio es explorar la percepción del público sobre el daño causado por el manganeso en los hogares como consecuencia del uso de agua con altos niveles de este metal en actividades domésticas.Los resultados indican que aunque el 51,69% de los usuarios desconocen la presencia de manganeso en sus viviendas, sí han notado sus repercusiones, como en depósitos de agua, sanitarios y ropa. También, han observado taponamientos, principalmente en duchas eléctricas (51,05%) y en cañerías de agua (38,13%), y el 29,75% han notado sabores y colores indeseables en el agua. El noventa y nueve por ciento de los encuestados indicaron que prefieren comprar agua embotellada (purificada) para el consumo debido a la confianza que brinda.
The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.
Worry is influenced by environmental pollution and affects individual health and well-being; however, little is known about this association in Indigenous communities. Using logistic regression models, we examined self-reported responses among Cree adults to the question “Are you worried about the pollution of the environment (land, water or air) in Iiyiyiu Aschii?” to assess if increased worry was associated with proximity to industrial and hydroelectric development, whether increased worry was associated with self-reported behavioural changes of water consumption type in the community or bush, and days spent on-the-land. Proximity to multiple industrial and hydroelectric development sites was associated with increased worry about pollution. Notably, the decreased consumption of tap water in the community was significantly associated with increased worry, but time-on-the land was not. Overall, our study provides new findings concerning development in a Cree territory in northern Quebec, Canada, and the worry about pollution's association with self-reported behavioural changes.
Household water, sanitation and hygiene (WASH) practices in remote, rural, and unpiped communities are likely to impact exposure to pathogens beyond the fecal-oral transmission routes that are typically prioritized in WASH interventions. We studied 43 homes in two remote, rural, unpiped communities in Alaska to evaluate seasonal water haul, water sources, water quality, and water reuse, as well as greywater and human waste disposal over 1 year. Hauled quantities of water reportedly ranged from 3.0 to 5.4 gallons per capita per day (gpcd) depending on the community and season. Natural, untreated water sources contributed 0.5-1.1 gpcd to household water availability. Reported quantities of water hauled were significantly correlated with total water storage capacity in the home. Total coliforms were detected in 30-60% of stored household water samples from treated and untreated sources, and total coliform counts were significantly higher in specific sources and during specific seasons. Exposure to pathogens during periods of low water access, from untreated water reuse, from greywater disposal and from human waste disposal are important pathways of disease transmission in these remote, rural, unpiped communities. We discuss intermediate steps that can be taken at the household and community levels to interrupt exposure pathways before piped infrastructure is installed. This model of examining specific household practices to determine transmission routes can be applied to other remote communities or unique conditions to aid in the recommendation of targeted WASH interventions.
Background
In Ontario, Canada, Indigenous communities experience some of the province’s worst drinking water, with issues ranging from deteriorating water quality to regulatory problems and lack of support. When water is known, or suspected, to be unsafe for human consumption, communities are placed under a Drinking Water Advisory. Between 2004 and 2013, approximately 70% of all on-reserve communities in Ontario were under at least one Drinking Water Advisory. Despite the widespread impact of Drinking Water Advisories on health and wellbeing, little is known about First Nation individuals’ perceptions and experiences living with a Drinking Water Advisory. This study presents information shared by members of a community who have lived with Boil Water Advisories on and off for many years, and a long-term Boil Water Advisory since 2017. The goal of this paper is to unpack and explore the Boil Water Advisories from the perspective of community members and provide considerations for current and future Boil Water Advisory management.
Methods
Methodological choices were driven by the principles of community-based participatory research. Two data collection methodologies were employed: hard copy surveys and interviews.
Results
Forty-four individuals (19.5%) completed a survey. Eight Elders and 16 key informants participated in 20 interviews. Respondents expressed varying degrees of uncertainty regarding protective actions to take while under a Boil Water Advisory. Further, 79% of men but only 46% of women indicated they always adhere to the Boil Water Advisory. Knowledge gaps that could lead to risky behaviours were also identified. Finally, Boil Water Advisories were demonstrated to have physical, financial, and time impacts on the majority of respondents.
Conclusions
A direct outcome was the identification of a critical need to reinforce best practices for health protection through community education and outreach. More broadly, Chief and Council were able to use the findings to successfully advocate for improved drinking water for the community. Additionally, benefits of participatory research and community ownership include enhanced local research capacity, and increased awareness of, and desire for, research to inform decisions.
Many Indigenous communities across Canada suffer from the lack of access to clean drinking water; ensuring individuals and communities have safe water to drink either from their home or from their local environment requires the consideration of multiple factors including individual risk perception. In collaboration with local leaders, semi-structured interviews (n = 99) were conducted over a two-year period in the Dene Tha’ First Nation and Kátł’odeeche First Nation to unpack the issue of risk perception and its meaning to local community members. These local metrics of risk perception including smell, taste, safety, health fears and level of concern were then used to explore patterns in other data on drinking water consumption patterns and bottled water use. The results are consistent with previous research related to water insecurity and indicate that both communities consume more bottled water than the average Canadian. Results also varied by jurisdiction; those in Alberta indicated much higher levels of concern and a greater degree of bottled water consumption.
We reviewed the nature, range, and extent of literature on drinking water and human health outcomes in the context of climate change in the Circumpolar North. We used a systematic process to identify and synthesize articles. While the number of climate-water-health articles increased recently, this topic remains under-studied despite the transformational changes that the Circumpolar North has already experienced due to climate change. Of the climate-focused articles, most considered climate change to a major extent and discussed waterborne infections. Research examining and evaluating adaptation options and future impacts at the climate-water-health nexus is absent in the Circumpolar North. Responding to this research gap should become a top priority for research, given the urgent need for this evidence to inform climate change policies, actions, and interventions.
Drinking water samples were collected from the water source, water delivery truck, domestic water storage tanks, and at the point of use in a decentralized drinking water system in Pond Inlet, Nunavut, a predominantly Inuit community in Canada’s Arctic region. The samples were analyzed for standard water quality parameters (turbidity, colour, pH, conductivity), biological water quality parameters (coliforms, adenosine triphosphate), and free and total chlorine. The microbial communities in a subset of water and biofilm samples were characterized with DNA analysis. Physiochemical characteristics at the tap were influenced by source water quality and building-specific conditions. Multiple aesthetic water quality parameters were above recommended values including turbidity and colour. Turbidity and biological activity (measured as ATP) varied temporally in some locations. DNA analysis at the phylum, family, and genus level demonstrated that microbial ecology evolved from source water to tap and that individual storage tanks and taps were influenced by distinct microbial communities.
The term “water security” continues to gain traction in water resources literature with broad application to human health, water quality, and sustainability of water supply. These western science applications focus almost exclusively on the material value of water for human uses and activities. This paper offers voice to other interpretations of water security based on semi-structured interviews with Indigenous participants representing varied backgrounds and communities from Saskatchewan, a Canadian prairie province. The results indicate that water security from an Indigenous perspective embraces much more than the material value of water. Five themes emerged from this research that speak to a more holistic framing of water security to include water as a life form, water and the spirit world, women as water-keepers, water and human ethics, and water in Indigenous culture. This broader interpretation provides a more nuanced understanding of water security, which serves to enrich the water security narrative while educating western science.
Background:
Communities in rural Alaska have access to multiple types of water service (piped, vehicle-hauled, and self-hauled) and experience varying levels of water service coverage. We assessed the incidence rate of inpatient and outpatient infectious disease visits among communities with different water service types and coverage levels.
Methods:
We classified ICD-9 codes for inpatient and outpatient visits to the Yukon-Kuskokwim Health Corporation facilities between 2013 and 2015 into six infectious disease categories. Using Poisson models, we compared the incidence of visits in each category across communities with differing water service coverage levels as defined by water service billing data for the same years. Using census data, we adjusted for community median household income, median age, crowding, and health aide staffing.
Results:
We included 48 communities in this analysis. After adjusting for possible confounders, each 10% increase in piped water coverage was associated with a 4% lower incidence of pneumonia/influenza visits (adjusted incidence rate ratio [IRR] 0.96, 95% CI 0.93-0.98), a 2% lower incidence of other respiratory infection visits (adjusted IRR 0.98, 95% CI 0.97-0.99), an 8% lower incidence of methicillin-resistant Staphylococcus visits (adjusted IRR 0.92, 95% CI 0.87-0.97), and a 4% lower incidence of other skin infections visits (adjusted IRR 0.96, 95% CI 0.95-0.98). Each 10% increase in vehicle-hauled water coverage was associated with a 2% lower incidence of respiratory infection visits (adjusted IRR 0.98, 95% CI 0.97-0.996) and a 3% lower incidence of skin infection visits (adjusted IRR 0.97, 95% CI 0.95-0.99), also after adjustment.
Conclusions:
Higher levels of water service coverage were associated with lower incidence rates of visits for several infectious disease categories. These associations were more pronounced for communities with piped water service compared to vehicle-hauled water service.
Access to clean and safe drinking water is a perpetual concern in Arctic communities due to challenging climatic conditions, limited options for the transportation of equipment and process chemicals, and the ongoing effects of colonialism. Water samples were gathered from multiple locations in a decentralized trucked drinking water system in Nunavut, Canada, over the course of one year. The results indicate that point of use drinking water quality was impacted by conditions in the source water and in individual buildings and strongly suggest that lead and copper measured at the tap were related to corrosion of onsite premises plumbing components. Humic-like substances were the dominant organic fraction in all samples, as determined by regional integration of fluorescence data. Iron and manganese levels in the source water and throughout the water system were higher in the winter and lower in the summer months. Elevated concentrations of copper (>2000 µg L-1) and lead (>5 µg L-1) were detected in tap water from some buildings. Field flow fractionation coupled with an ICP-MS and a UV-Vis spectrometer was used to demonstrate the link between source water characteristics (high organics, iron, manganese) and lead and copper in point of use drinking water.
This paper is now open access and can be accessed at: https://pubs.acs.org/doi/abs/10.1021/acs.est.9b04691
Rural communities dependent on unregulated drinking water are potentially at increased health risk from exposure to contaminants. Perception of drinking water safety influences water consumption, exposure, and health risk. A community‐based participatory approach and probabilistic Bayesian methods were applied to integrate risk perception in a holistic human health risk assessment. Tap water arsenic concentrations and risk perception data were collected from two Saskatchewan communities. Drinking water health standards were exceeded in 67% (51/76) of households in Rural Municipality #184 (RM184) and 56% (25/45) in Beardy's and Okemasis First Nation (BOFN). There was no association between the presence of a health exceedance and risk perception. Households in RM184 or with an annual income >$50,000 were most likely to have in‐house water treatment. The probability of consuming tap water perceived as safe (92%) or not safe (0%) suggested that households in RM184 were unlikely to drink water perceived as not safe. The probability of drinking tap water perceived as safe (77%) or as not safe (11%) suggested households in BOFN contradicted their perception and consumed water perceived as unsafe. Integration of risk perception lowered the adult incremental lifetime cancer risk by 3% to 1.3 × 10⁻⁵ (95% CI 8.4 × 10⁻⁸ to 9.0 × 10⁻⁵) for RM184 and by 8.9 × 10⁻⁶ (95% CI 2.2 × 10⁻⁷ to 5.9 × 10⁻⁵) for BOFN. Probability of exposure to arsenic concentrations >1:100,000, negligible cancer risk, was 23% for RM184 and 22% for BOFN.
Indigenous communities in the Arctic often face unique drinking water quality challenges related to inadequate infrastructure and environmental contamination; however, limited research exists on waterborne parasites in these communities. This study examined Giardia and Cryptosporidium in untreated surface water used for drinking in Iqaluit, Canada. Water samples (n = 55) were collected weekly from June to September 2016 and tested for the presence of Giardia and Cryptosporidium using microscopy and polymerase chain reaction (PCR). Exact logistic regressions were used to examine associations between parasite presence and environmental exposure variables. Using microscopy, 20.0% of samples tested positive for Giardia (n = 11) and 1.8% of samples tested positive
for Cryptosporidium (n = 1). Low water temperatures (1.1 to 6.7 C) and low air temperatures (-0.1 to 4.5 C) were significantly associated with an increased odds of parasite presence (p = 0.047, p = 0.041, respectively). These results suggest that surface water contamination with Giardia and Cryptosporidium may be lower in Iqaluit than in other Canadian regions; however, further research should examine the molecular characterization of waterborne parasites to evaluate the potential human health implications in Northern Canada.
Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
The provision of safe drinking water is a key driver of public health and a pressing health issue facing First Nations communities in Canada. Contaminated water is a perennial issue for reserve communities across the country despite numerous government investments. Many First Nations communities rely heavily on cistern use for their drinking water supply; however, bacterial contamination within these systems is frequent and a common reason for household boil water advisories. The sources of contamination during the process of hauling water to cisterns in First Nations communities have received limited attention in academic research. The purpose of this research is to identify the risks to water quality through the truck-to-cistern water system. In partnership with a Saskatchewan First Nations community, drinking water quality was monitored in the treatment plant, in delivery trucks and at 142 household cisterns and taps from July to October, 2014. Risks to water supply were identified through monthly water sampling and laboratory analysis, key informant interviews, and observation. Coliform contamination in trucks, cisterns and taps was most common during August. Total coliforms were more likely to be found in cisterns compared to household taps and samples from trucks. Chlorine residuals were lower in household tap samples than in cisterns for August and September. Together with the community, investigators identified contamination and bacteriological growth in cisterns and household distribution systems, and variable levels of total chlorine concentrations depending on month and site of sampling. Recommendations are provided for advancing guidelines on management of truck-to-cistern drinking water supply chains in First Nations.
Previous studies have described concerns regarding tap water in Indigenous communities, yet there is little information on participants who report drinking their tap water and being satisfied with its quality. This study undertaken with members of 8 Indigenous communities in Saskatchewan, Canada, and identified factors associated with both the decision to drink tap water at home and being satisfied with its quality. We examined the importance of factors such as individual attributes, experiences, attitudes, household and community-based variables. Less than one-quarter of participants (23.4%) drank tap water and were satisfied with its quality. Individuals who did not boil tap water (odds ratio [OR] = 5.76, 95% confidence interval [CI] = 1.68–19.8), those who did not experience tap water odour (OR = 2.38, 95% CI = 1.26–4.50) and participants living in communities away from urban centres (OR = 2.74, 95% CI = 1.63–4.51) were more likely to drink and be satisfied with their tap water. Concerns about the environment had the most impact on community members aged 55+ years. Those not reporting concerns about environmental problems affecting water (OR = 11.4, 95% CI = 3.10–42.2) were much more likely to drink and be satisfied with their tap water. Programmes to improve water quality, reduce the need for boil water advisories and increase community confidence in the environment could improve tap water satisfaction and consumption.
This paper documents the association between water and sanitation infrastructure and health indicators in Canada for First Nations, Métis and Inuit individuals living on and off-reserve in Canada. We use two data sources: the Aboriginal Peoples Survey and a survey conducted in a First Nations community in northern Manitoba-St. Theresa Point First Nation. We find statistically significant relationships between water infrastructure and health status in both sources of data. In particular, among individuals living off-reserve, contaminated water is associated with a 5-7% lower likelihood of reporting good self-rated health and a 4% higher probability of reporting a health condition or stomach problem. Those in St. Theresa Point First Nation without running water are four times more likely to report an illness relative to those with running water. Off-reserve, this likely suggests a need for improved public education on the management of private water supplies and more frequent water testing. Our case study suggests that further investment in water/sanitation infrastructure and housing is needed in the community.
The present study aimed to survey the spatial and temporal trends of ambient concentration of PM2.5 and to estimate mortality attributed to short- and long-term exposure to PM2.5 in Isfahan from March 2014 to March 2019 using the AirQ⁺ software. The hourly concentrations of PM2.5 were obtained from the Isfahan Department of Environment and Isfahan Air Quality Monitoring Center. Then, the 24-h mean concentration of PM2.5 for each station was calculated using the Excel software. According to the results, the annual mean concentration of PM2.5 in 2014–2019 was 29.9–50.9 μg/m³, approximately 3–5 times higher than the WHO guideline (10 μg/m³). The data showed that people of Isfahan in almost 58% to 96% of the days of a year were exposed to PM2.5 higher than the WHO daily guideline. The concentrations of PM2.5 in cold months such as October, November, December and January were higher than those in the other months. The zoning of the annual concentrations of PM2.5 in urban areas showed that the highest PM2.5 concentrations were related to the northern, northwestern, southern and central areas of the city. On average, from 2014 to 2019, the number of deaths due to natural mortality, lung cancer (LC), chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and stroke associated with ambient PM2.5 were 948, 16, 18, 281 and 60, respectively. The present study estimated that on average, 14.29% of the total mortality, 17.2% of lung cancer (LC), 15.54% of chronic obstructive pulmonary disease (COPD), 17.12% of ischemic heart disease (IHD) and 14.94% of stroke mortalities were related to long-term exposure to ambient PM2.5. So provincial managers and politicians must adopt appropriate strategies to control air pollution and reduce the attributable health effects and economic losses.
Using a relational approach, I examine several cultural dimensions involved in household water access and use in Newtok, Alaska. I describe the patterns that emerge around domestic water access and use, as well as the subjective lived experiences of water insecurity including risk perceptions, and the daily work and hydro-social relationships involved in accessing water from various sources. I found that Newtok residents haul water in limited amounts from a multitude of sources, both treated and untreated, throughout the year. Household water access is tied to hydro-social relationships predicated on sharing and reciprocity, particularly when the primary treated water access point is unavailable. Older boys and young men are primarily responsible for hauling water, and this role appears to be important to male Yupik identity. Many interviewees described preferring to drink untreated water, a practice that appears related to cultural constructions of natural water sources as pure and self-purifying, as well as concerns about the safety of treated water. Concerns related to the health consequences of low water access appear to differ by gender and age, with women and elders expressing greater concern than men. These preliminary results point to the importance of understanding the cultural dimensions involved in household water access and use. I argue that institutional responses to water insecurity need to incorporate such cultural dimensions into solutions aimed at increasing household access to and use of water.
Drinking water in the vast Arctic Canadian territory of Nunavut is sourced from surface water lakes or rivers and transferred to man-made or natural reservoirs. The raw water is at a minimum treated by chlorination and distributed to customers either by trucks delivering to a water storage tank inside buildings or through a piped distribution system. The objective of this study was to characterize the chemical and microbial drinking water quality from source to tap in three hamlets (Coral Harbour, Pond Inlet and Pangnirtung-each has a population of <2000) on trucked service, and in Iqaluit (population ~6700), which uses a combination of trucked and piped water conveyance. Generally, the source and drinking water was of satisfactory microbial quality, containing Escherichia coli levels of <1 MPN/100 mL with a few exceptions, and selected pathogenic bacteria and parasites were below detection limits using quantitative polymerase chain reaction (qPCR) methods. Tap water in households receiving trucked water contained less than the recommended 0.2 mg/L of free chlorine, while piped drinking water in Iqaluit complied with Health Canada guidelines for residual chlorine (i.e. >0.2 mg/L free chlorine). Some buildings in the four communities contained manganese (Mn), copper (Cu), iron (Fe) and/or lead (Pb) concentrations above Health Canada guideline values for the aesthetic (Mn, Cu and Fe) and health (Pb) objectives. Corrosion of components of the drinking water distribution system (household storage tanks, premise plumbing) could be contributing to Pb, Cu and Fe levels, as the source water in three of the four communities had low alkalinity. The results point to the need for robust disinfection, which may include secondary disinfection or point-of-use disinfection, to prevent microbial risks in drinking water tanks in buildings and ultimately at the tap.
Background: Black Tickle-Domino is an extremely water-insecure remote Inuit community in the Canadian subarctic that lacks piped-water. Drinking water consumption in the community is less than a third of the Canadian national average. Water insecurity in the community contributes to adverse health, economic, and social effects and requires urgent action.
Objectives: To test the ability of domestic rainwater harvesting (DRWH) for the first time in the subarctic with the goal of improving water access and use in the community.
Design: This project utilised quantitative weekly reporting of water collection and use, as well as focus group discussions. DRWH units were installed at seven water-insecure households chosen by the local government. Results were measured over a 6-week period in 2016.
Results: Participants harvested 19.07 gallons of rainwater per week. General purpose water consumption increased by 17% and water retrieval efforts declined by 40.92%. Households saved $12.70 CDN per week. Participants reported perceived improvements to psychological health. Because no potable water was collected, drinking water consumption did not increase. The study identified additional water-insecurity impacts.
Conclusion: DRWH cannot supply drinking water without proper treatment and filtration; however, it can be a partial remedy to water insecurity in the subarctic. DRWH is appropriately scaled, inexpensive, and participants identified several significant benefits.
Background
Drinking water insecurity and related health outcomes often disproportionately impact Indigenous communities internationally. Understanding media coverage of these water-related issues can provide insight into the ways in which public perceptions are shaped, with potential implications for decision-making and action. This study aimed to examine the extent, range, and nature of newspaper coverage of drinking water security in Canadian Indigenous communities. Methods
Using ProQuest database, we systematically searched for and screened newspaper articles published from 2000 to 2015 from Canadian newspapers: Windspeaker, Toronto Star, The Globe and Mail, and National Post. We conducted descriptive quantitative analysis and thematic qualitative analysis on relevant articles to characterize framing and trends in coverage. ResultsA total of 1382 articles were returned in the search, of which 256 articles were identified as relevant. There was limited coverage of water challenges for Canadian Indigenous communities, especially for M?tis (5%) and Inuit (3%) communities. Most stories focused on government responses to water-related issues, and less often covered preventative measures such as source water protection. Overall, Indigenous peoples were quoted the most often. Double-standards of water quality between Indigenous and non-Indigenous communities, along with conflict and cooperation efforts between stakeholders were emphasized in many articles. Conclusion
Limited media coverage could undermine public and stakeholder interest in addressing water-related issues faced by many Canadian Indigenous communities.
With the exception of First Nations, Metis and Inuit people, most Canadians enjoy water security; Indigenous people are 90 times more likely than other Canadians to lack piped water. These disparities result from and maintain the colonial relationship between Canada and Indigenous peoples. As displaced people with values that are often in opposition to neo-liberalism, Indigenous people present an existential threat to Canadian identity, this identity having been created around possession of a vast land that extends to the North Pole, and subsequent heavy resource extraction throughout this land. To maintain Canada’s national identity and the activities that support it, Indigenous people have to be pushed to the figurative and literal fringes and rendered invisible. Five short case studies of water insecurity demonstrate how neo-liberalism props up and legitimizes decentralized water governance in Canada, which in turn promotes and maintains environmental inequality, Indigenous marginalization, and, ultimately, the Canadian identity.
Water-related health challenges on First Nations reserves in Canada have been previously documented. Our objective was to describe factors associated with self-reported health effects from tap water in 8 First Nations reserve communities in Saskatchewan, Canada. Community-based participatory approaches were used in designing and implementing cross-sectional household surveys. Individual, household, community, and contextual effects were considered in multilevel analysis. Negative health effects from tap water were reported by 28% of households (n = 579). Concerns about environmental factors affecting water quality (odds ratio [OR] = 3.4, 95% confidence interval [CI] = 1.8-6.7), rarely or never drinking tap water (OR = 2.9, 95% CI = 1.3-6.6), insufficient tap water (OR = 3.0, 95% CI = 1.4-6.3), paying for bottled water (OR = 3.2, 95% CI = 1.2-8.7), and dissatisfaction with tap water were associated with self-reported health effects (n = 393); however, the effect of dissatisfaction was modified by respondent age (P = .03). Quality and availability were associated with perceptions of health effects from drinking water, providing additional information on how ongoing concerns about drinking water influence self-reported health in some First Nations.
Key Messages
We facilitated an opportunity for on‐reserve youth to share perspectives on water and health.
Aesthetics, pollution, technological treatment, and the ubiquitous need for water emerged from the Postervoice methodology.
Encouraging youth to be involved in lateral exchanges to control their collective future by protecting resources contributes to cultural resilience.
Background:
Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted.
Objective:
The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs.
Design:
A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar). Online searches for grey literature using relevant government websites were completed.
Results:
Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature) met criteria for inclusion (contained keywords; publication year 2000-2015; peer-reviewed and from Canada). Studies were quantitative (8), qualitative (5) or mixed (3) and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of "health" was given (14/16), and the primary health issue described was gastrointestinal illness (12/16). Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data.
Conclusions:
Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a database to store and create access to research findings, increased funding and time frames for funding, and more decolonizing and community-based participatory research aimed at understanding the relationship between drinking water quality and health outcomes in First Nations communities in Canada are needed.
Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council’s Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents.
Background:
American Indians/Alaska Natives (AI/AN) have the highest prevalence of obesity for any racial/ethnic group. Previous studies examining risk factors for obesity have identified excessive sugar-sweetened beverage (SSB) and inadequate water consumption as major risk factors for this population group. The historical scarcity of water in rural Alaska may explain consumption patterns including reliance on SSBs and other packaged drinks.
Methods:
Our study was designed to assess SSB, water and other beverage consumption and attitudes towards consumption in Alaska Native children and adults residing in rural Alaska. During summer 2014, 2 focus groups were conducted employing community members in a small rural village more than 200 air miles west of Fairbanks, Alaska. Interviews were completed with shop owners, Early Head Start and Head Start program instructors (n=7). SSB and total beverage intakes were measured using a modified version of the BEVQ-15, (n=69).
Results:
High rates of SSB consumption (defined as sweetened juice beverages, soda, sweet tea, energy drink or sports drinks) and low rates of water consumption were reported for all age groups in the village. All adolescents and 81% of children reported drinking SSBs at least once per week in the last month, and 48% of adolescents and 29% of younger children reported daily consumption. Fifty-two per cent of adults reported consuming SSBs at least once per week and 20% reported daily consumption. Twenty-five per cent of adolescents reported never drinking water in the past month, and 19% of younger children and 21% of adults did not consume water daily.
Conclusion:
Alaska Native children and adults living in the Interior Alaska consume high amounts of SSBs including energy drinks and insufficient amounts of water. Interventions targeting beverage consumption are urgently needed for the Alaska Native population in rural Alaska.
Water insecurity in Northern Indigenous communities in Canada remains a pressing problem, with multiple dimensions and health impacts. We carried out a case study of long-term water insecurity in the Southern Inuit island community of Black Tickle, Labrador, where there is no piped water and people rely on an under-funded potable water dispensing unit (PWDU) and unmonitored water sources. Our community-based multi-disciplinary project involved qualitative and quantitative methods including key informant interviews, focus groups, a census, a literature review, water testing, and an engineering site visit. In Black Tickle, water security was chronically and severely compromised and was linked to poverty, food insecurity, men's health, and mental health. We have taken a materialist approach; accordingly, later project phases involve research aimed at identifying appropriate solutions, and conducting pre-engineering and engineering work. This article reports on the first two phases of the project, through which we described the problem and identified its impacts.
Introduction:
Canada has the second highest per capita water consumption in the world. However, little is known about complex socio-economic and cultural dynamics of water insecurities in Indigenous communities and the multiple health consequences. Most studies have concentrated on a simplified interpretation of accessibility, availability and quality issues, including some common water-borne infections as the only health outcomes. Thus, several government initiatives on potable water supply, particularly for remotely located communities, have failed to sustain and promote a healthy lifestyle. The objective was to explore the water insecurity, coping strategies and associated health risks in a small and isolated sub-Arctic Indigenous (Inuit) community in Canada.
Methods:
The study was based on a community-based survey (2013) in one of the most remote Inuit communities of Labrador. In-depth, open-ended key informant (KI) interviews (community leader (1), woman (1), nurse (1), teacher (1), and elder (1)) and focus group discussions (FGDs) were conducted with community leaders (5), community members (25), women (5), and high school students (8). Convenience sampling was followed in selection of the subjects for FGDs and approached some KIs. All the water sources (five in April and seven in October) were visited and tested for their physical, chemical and microbiological parameters. The FGDs and KI interviews were audio recorded and transcribed. In the analysis, the data (qualitative and quantitative) were broadly categorized into (a) water sources, access and quality, (b) coping, (c) health risks and (d) challenges to run a public water system.
Results:
The community did not have any piped water supply. Their regular sources of water consisted of several unmonitored local streams, brooks, and ponds. The public water system was not affordable to the majority of community members who solely depended on government aid. Animal fecal contamination (in natural sources such as streams, brooks, and ponds) and the presence of disinfection by-products (in the public water system) were the major quality issues. Gastro-intestinal infections were the most common disease in the community. Per capita water consumption was less than one-third of the Canadian national average (274 L/day/person), severely compromising personal hygiene and water intake. High-sugar-content beverages were the most common alternative to lack of accessible and affordable potable water, particularly for children. Mental stress due to water insecurity and chronic back and shoulder injuries due to carrying heavy water buckets every day were the commonly encountered adverse health outcomes.
Conclusions:
Water insecurity has put the community at risk of multiple serious adverse health outcomes. The scenario is not unique in Canada. There are many remote Indigenous communities facing similar kinds of water insecurity.
This study is one of very few studies of water insecurity in northern Indigenous communities in Canada. In this first phase, we aimed to understand the multiple dimensions and effects of long-term water insecurity in remote Indigenous communities in Canada and to identify coping strategies. This paper presents exploratory findings on water quality, access, use, impacts, and coping mechanisms in the Southern Inuit community of Black Tickle-Domino, Labrador. We used qualitative and quantitative methods and our research built on the participant observation of two research-team members. We also tested water samples and trained residents to do so. Chronic water insecurity is associated with poor community health, especially food security.
Water insecurity in Northern Indigenous communities in Canada is pervasive and complex with multiple dimensions and impacts. Yet the relevant literature is sparse, especially for Labrador. Our case study aimed to understand the multiple dimensions, health risks, and coping strategies of long-term water insecurity in the Southern Inuit island community of Black Tickle-Domino, Labrador, where there is no household running water system and people rely on an under-funded potable drinking water unit (PDWU) and unmonitored shared shallow wells. Using qualitative and quantitative methods, our exploratory work included research on water quality, access, contamination, uses, preferences, and cultural interpretations. In Black Tickle water security was chronically and severely compromised and the community did not meet the World Health Organization (WHO) guidelines for safe drinking water. Some water samples had contaminants and there were past records of outbreaks of water-borne illnesses. Water insecurity was linked to poverty, food insecurity, men’s health, and mental health and poses major health risks. There is an urgent need for a sustainable strategy to improve water quality and quantity in these communities, such as that outlined by WHO in 2005. Yet these communities lack the economic and political means to implement such strategies. Our materialist approach and ongoing commitment to this work has led to early-stage work with engineers and the community to identify possible solutions.
In this article, the authors provide the first in-depth account of why some Alaska Native people drink untreated water when treated water is available. Their qualitative research was conducted in four Alaska Native village communities that have treated water available from a centralized distribution point. Most respondents (n=172, 82%) reported that some of their household's drinking water came from an untreated source. motives for drinking untreated water emerged from analysis of open-ended questions about drinking water practice and could be categorized into six themes: chemicals, taste, health, access, tradition, and cost. Importantly, some residents reported consuming untreated water because they both liked untreated water and disliked treated water. As such, interventions to increase safe water consumption should address this dichotomy by providing education about the benefits of treated water alongside the risks involved with drinking untreated water. Based on the findings, the authors provide specific recommendations for developing behavior change interventions that address influences at multiple social-ecological levels.
Drawing on vulnerability approaches from the climate change literature, this paper explores the vulnerability of residents of the community of Rigolet, Nunatsiavut, Labrador, to changes in freshwater. Our approach emphasizes local preferences and values. We analyze the results from 89 household interviews (88% response) and targeted interviews in Rigolet to consider the human experience of climate variability and change. Residents report that changes in the spatial and temporal distribution of freshwater are currently challenging their ability to access preferred drinking water and food sources and are adding to the financial barriers that restrict their time spent on the land. The results of our study suggest that Rigolet residents are successfully adapting to existing freshwater changes in their watershed, though these adaptations have not come without sacrifice. The adaptive capacity of Rigolet residents has been supported by resource flexibility and experience-based knowledge of freshwater variability within their watershed, among other factors. Findings suggest that the exposure of sub-Arctic and Arctic communities to freshwater changes and their capacity to adapt are largely shaped by the lifeways of residents and the manner and degree to which they are dependent on local freshwater systems.
The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000-2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009-2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience.
Access to adequate quantities of water has a protective effect on human health and well-being. Despite this, public health research and interventions are frequently focused solely on water quality, and international standards for domestic water supply minimums are often overlooked or unspecified. This trend is evident in Inuit and other Arctic communities even though numerous transmissible diseases and bacterium infections associated with inadequate domestic water quantities are prevalent.
Our objective was to explore the pathways by which the trucked water distribution systems being used in remote northern communities are impacting health at the household level, with consideration given to the underlying social and environmental determinants shaping health in the region.
Using a qualitative case study design, we conducted 37 interviews (28 residents, 9 key informants) and a review of government water documents to investigate water usage practices and perspectives. These data were thematically analysed to understand potential health risks in Arctic communities and households.
Each resident receives an average of 110 litres of municipal water per day. Fifteen of 28 households reported experiencing water shortages at least once per month. Of those 15, most were larger households (5 people or more) with standard sized water storage tanks. Water shortages and service interruptions limit the ability of some households to adhere to public health advice. The households most resilient, or able to cope with domestic water supply shortages, were those capable of retrieving their own drinking water directly from lake and river sources. Residents with extended family and neighbours, whom they can rely on during shortages, were also less vulnerable to municipal water delays.
The relatively low in-home water quantities observed in Coral Harbour, Nunavut, appear adequate for some families. Those living in overcrowded households, however, are accessing water in quantities more typically seen in water insecure developing countries. We recommend several practical interventions and revisions to municipal water supply systems.
Access to safe drinking water is a pressing social policy issue globally. Despite the milestones reached in this area of Canadian public health, marginalized and vulnerable populations, including those founded on racialized identity, such as First Nations, continue to be plagued by accessibility issues. This work sheds new perspective on the issue, arguing for a research and policy focus that is inclusive of risk perception. A model of risk perception of drinking water is developed and tested for First Nations on reserve in Canada using the 2001 Aboriginal Peoples Survey. It is shown that the analytical use of racialized identity advances understanding of risk perception and the environment (water). Moreover, a large degree of heterogeneity within the First Nation population across a number of social determinants of risk perception illustrates the shortcomings of framing the issue in a simplistic manner (First Nation population versus general population). Implications for risk research, including risk communication & management, and policy are provided.
The food- and waterborne disease situation in Russia requires special attention. Poor quality of centralized water supplies and sewage systems, biological and chemical contamination of drinking water, as well as contamination of food products, promote widespread infectious diseases, significantly exceeding nationwide rates in the population living in the two-thirds of Russian northern territories.
The general aim was to assess the levels of food- and waterborne diseases in selected regions of Russian Arctic, Siberia and the Far East (for the period 2000-2011), and to compare disease levels among regions and with national levels in Russia.
This study is the first comparative assessment of the morbidity in these fields of the population of 18 selected regions of Russian Arctic, Siberia and the Far East, using official statistical sources. The incidences of infectious and parasitic food- and waterborne diseases among the general population (including indigenous peoples) have been analyzed in selected regions (per 100,000 of population, averaged for 2000-2011).
Among compulsory registered infectious and parasitic diseases, there were high rates and widespread incidences in selected regions of shigellosis, yersiniosis, hepatitis A, tularaemia, giardiasis, enterobiasis, ascariasis, diphyllobothriasis, opistorchiasis, echinococcosis and trichinellosis.
Incidences of infectious and parasitic food- and waterborne diseases in the general population of selected regions of the Russian Arctic, Siberia and the Far East (2000-2011) are alarmingly high. Parallel solutions must be on the agenda, including improvement of sanitary conditions of cities and settlements in the regions, modernization of the water supply and of the sewage system. Provision and monitoring of the quality of the drinking water, a reform of the general healthcare system and the epidemiological surveillance (including gender-divided statistics), enhancement of laboratory diagnostics and the introduction of preventive actions are urgently needed.
Safe drinking water and effective sanitation is a basic human right. The health of Aboriginal and Torres Strait Islander Peoples living on traditional Country in remote Australia can be supported or undermined by these essential services. Despite global and Australian commitments to the Sustainable Development Goals, water and sanitation service levels have regularly been identified as unreliable, unsafe, and of a lower standard than non-Indigenous and non-remote settlements. This research sought to identify the optimal conditions to enable consistent delivery of safe water and sanitation in remote Indigenous communities of Australia. Using a combination of literature reviews, interviews with key stakeholder groups and applied research findings, key conditions for improved water and sanitation outcomes were identified. These included technology for water and sanitation that is fit for purpose, people and place; capacity-building, training and ongoing support for local Indigenous service operators; and that all personnel involved in delivery require a level of cultural competency to the local and Indigenous context. These findings are intended to contribute to informing more sustainable water and sanitation outcomes in Indigenous communities.
Objective
To assess whether a community water service is associated with the frequency of sugar-sweetened beverages (SSB) consumption, obesity, or perceived health status in rural Alaska.
Design
We examined the cross-sectional associations between community water access and frequency of SSB consumption, body mass index categories, and perceived health status using data from the 2013 and 2015 Alaska Behavioral Risk Factor Surveillance System (BRFSS). Participants were categorized by zip code to ‘in-home piped water service’ or ‘no in-home piped water service’ based on water utility data. We evaluated the univariable and multivariable (adjusting for age, household income and education) associations between water service and outcomes using log-linear survey-weighted generalized linear models.
Setting
Rural Alaska, USA.
Subjects
Eight hundred and eighty-seven adults, aged 25 years and older.
Results
In unadjusted models, participants without in-home water reported consuming SSB more often than participants with in-home water (1·46, 95 % CI: 1·06, 2·00). After adjustment for potential confounders, the effect decreased but remained borderline significant (1·29, 95 % CI: 1·00, 1·67). Obesity was not significantly associated with water service but self-reported poor health was higher in those communities without in-home water (1·63, 95 % CI: 1·05, 2·54).
Conclusions
Not having access to in-home piped water could affect behaviours surrounding SSB consumption and general perception of health in rural Alaska.
This study analyzed the microbiological quality of drinking and source water from three First Nations communities in Manitoba, Canada that vary with respect to the source, storage and distribution of drinking water. Community A relies on an aquifer and Community B on a lake as source water to their water treatment plants. Community C does not have a water treatment plant and uses well water. Quantification of free residual chlorine and fecal bacterial (E. coli and coliforms), as well as detection of antibiotic resistance genes (sul, ampC, tet(A), mecA, vanA, blaSHV, blaTEM, blaCTX-M, blaOXA-1, blaCYM-2, blaKPC, blaOXA-48, blaNDM, blaVIM, blaGES and blaIMP) was carried out. While water treatment plants were found to be working properly, as post-treatment water did not contain E. coli or coliforms, once water entered the distribution system, a decline in the chlorine concentration with a concomitant increase in bacterial counts was observed. In particular, water samples from cisterns not only contained high number of E. coli and coliforms, but were also found to contain antibiotic resistance genes. This work shows that proper maintenance of the distribution and storage systems in First Nations communities is essential in order to provide access to clean and safe drinking water.
Indigenous communities in Canada suffer disproportionately from compromised water insecurity, with multiple negative implications. Some attention has been paid to gender and water insecurity in developing countries, especially in sub‐Saharan Africa, but the topic has been neglected for subarctic settings. We conducted long‐term research in Black Tickle, a remote Inuit community in Labrador, Canada, with no piped water and limited access to potable water. Our research was aimed at understanding the multiple dimensions of water security, identifying materialist responses, and conducting a pilot project in domestic rainwater harvesting. Water security emerged as a gendered phenomenon. We supplemented our reflective analysis on this research with two focus group discussions during which Inuit women described their experiences of water security. Participants reported that their physical and mental health are undermined by water insecurity and that water is a source of multiple stresses that demand resilience. Given a developing remittance economy, gender was identified as an increasingly significant determinant of water insecurity in this subarctic community. Having to retrieve water themselves, Inuit women experience altered gender norms and a persistent values conflict in addition to physical strain. Water acquisition is an added responsibility, impacting their labour load. Alternatively, in relying on available men to retrieve water, participants reported feeling guilty and anxious and they worried about men fetching water in dangerous weather conditions and in the vicinity of dangerous wildlife. Participants’ experiences make clear the urgency for a materialist response to water insecurity in the Indigenous subarctic.
The consumption of bottled water has been increasing consistently over the last decade, even in countries where tap water quality is considered excellent. This paper discusses some of the reasons why people decide for an option that is often more expensive and less comfortable than tap water. Consumer surveys usually stress two main factors: dissatisfaction with tap water organoleptics (especially taste) and health/risk concerns. However, many other factors are involved, including demographic variables and the perceived quality of the water source. Trust in tap water companies also seems to influence public behaviour. A clearer picture of bottled water consumption can be achieved when different aspects are considered.
Background:
Helicobacter pylori is one of the most common human infections in the world, and studies in Alaska Native people, as well as other Indigenous peoples, have shown a high prevalence of this gastric infection. This study was undertaken to determine the prevalence of H. pylori infection by urea breath test (UBT) and anti- H. pylori IgG among Alaskans living in four regions of the state and to identify factors associated with infection.
Methods:
A convenience sample of persons > 6 months old living in five rural and one urban Alaskan community were recruited from 1996 to 1997. Participants were asked about factors possibly associated with infection. Sera were collected and tested for anti- H. pylori IgG antibodies; a UBT was administered to participants > 5 years old.
Results:
We recruited 710 people of whom 571 (80%) were Alaska Native and 467 (66%) were from rural communities. Rural residents were more likely to be Alaska Native compared with urban residents (P < .001). Of the 710 people, 699 (98%) had a serum sample analyzed, and 634 (97%) persons > 5 years old had a UBT performed. H. pylori prevalence was 69% by UBT and 68% by anti- H. pylori IgG. Among those with a result for both tests, there was 94% concordance. Factors associated with H. pylori positivity were Alaska Native racial status, age ≥ 20 years, rural region of residence, living in a crowded home, and drinking water that was not piped or delivered.
Conclusions:
Helicobacter pylori prevalence is high in Alaska, especially in Alaska Native persons and rural residents. Concordance between UBT and serology was also high in this group. Two socioeconomic factors, crowding and drinking water that was not piped or delivered, were found to be associated with H. pylori positivity.
Concerns regarding the safety and aesthetic qualities of one's municipal drinking water supply are important factors influencing drinking water perceptions and consumption patterns (i.e. sources used and daily volume of consumption). In northern Canada, Inuit communities face challenges with drinking water quality, and many Inuit have reported concerns regarding the safety of their drinking water. The objectives of this research were to describe perceptions of municipal tap water, examine use of water sources and changes following the installation of a potable water dispensing unit (PWDU) in 2014, and identify factors associated with water consumption in the Inuit community of Rigolet. This study used data from three cross-sectional census surveys conducted between 2012 and 2014. Principal component analysis (PCA) was used to aggregate data from multiple variables related to perceptions of water, and logistic regressions were used to identify variables associated with water consumption patterns. Three quarters of residents reported using the PWDU after its installation, with concomitant declines reported in consumption of bottled, tap, and brook water. Negative perceptions of tap water were associated with lower odds of consuming tap water (ORPCAcomponent1=0.73, 95% CI 0.56-0.94; ORPCAcomponent2=0.67, 95% CI 0.49-0.93); women had higher odds of drinking purchased water compared to men (OR=1.90, 95% CI 1.11-3.26). The median amount of water consumed per day was 1L. Using brook water (OR=2.60, 95% CI 1.22-5.56) and living in a household where no one had full-time employment (OR=2.94, 95% CI 1.35-6.39) were associated with consuming >2L of water per day. Results of this study may inform drinking water interventions, risk assessments, and public health messaging in Rigolet and other Indigenous communities.
Approximately 20% of the 600 First Nations reserves across Canada are under a drinking water advisory, often due to unacceptable levels of bacteria. In this study, we detected fecal bacteria at an alarmingly high frequency in drinking water sources in a fly-in First Nations community, most notably in buckets/drums of homes without running water where Escherichia coli levels ranged from 20 to 62,000 CFU/100 mL. The water leaving the water treatment plant was free of E. coli and its free residual chlorine concentration (0.67 mg/L) was within the range typically observed for treated water in Canada. Water samples from taps in homes served by cisterns, and those sampled from the water truck and community standpipe, always showed unacceptable levels of E. coli (1 to 2100 CFU/100 mL) and free residual chlorine concentrations below the 0.2 mg/L required to prevent bacterial regrowth. Samples from taps in homes served by piped water had lower levels of E. coli (0 to 2 CFU/100 mL). DNA- and RNA-based 16S rRNA Illumina sequencing demonstrated that piped and cisterns water distribution systems showed an abundance of viable cells of Alphaproteobacteria indicative of biofilm formation in pipes and cisterns. The alpha diversity, based on observed OTUs and three other indices, was lowest in water truck samples that supplied water to the cistern and the low free residual chlorine concentration (0.07 mg/L) and predominance of Betaproteobacteria (63% of viable cells) that were immediately detected after the truck had filled up at the water treatment plant was indicative of contamination by particulate matter. Given these findings, First Nation residents living without running water and relying on inadequate water distribution systems are at higher risk of contracting water-born illnesses. We urge all governments in Canada to expand their investments in supporting and sustaining water as a human right in Canada's First Nations communities.
Approximately 20% of rural Alaskan homes lack in-home piped water; residents haul water to their homes. The limited quantity of water impacts the ability to meet basic hygiene needs. We assessed rates of infections impacted by water quality (waterborne, e.g. gastrointestinal infections) and quantity (water-washed, e.g. skin and respiratory infections) in communities transitioning to in-home piped water. Residents of four communities consented to a review of medical records 3 years before and after their community received piped water. We selected health encounters with ICD-9CM codes for respiratory, skin and gastrointestinal infections. We calculated annual illness episodes for each infection category after adjusting for age. We obtained 5,477 person-years of observation from 1032 individuals. There were 9,840 illness episodes with at least one ICD-9CM code of interest; 8,155 (83%) respiratory, 1,666 (17%) skin, 241 (2%) gastrointestinal. Water use increased from an average 1.5 gallons/capita/day (g/c/d) to 25.7 g/c/d. There were significant (P-value<0.05) declines in respiratory (16, 95% confidence interval (CI): 11-21%), skin (20, 95%CI: 10-30%), and gastrointestinal infections (38, 95%CI: 13-55%). We demonstrated significant declines in respiratory, skin and gastrointestinal infections among individuals who received in-home piped water. This study reinforces the importance of adequate quantities of water for health.
Background:
Alaska Native children have high invasive pneumococcal disease (IPD) rates, and lack of in-home running water has been shown to have a significant association with infection. Pneumococcal conjugate vaccines reduced IPD; however, this population saw substantial replacement disease and colonization with nonvaccine serotypes. We evaluated risk factors for nasopharyngeal pneumococcal colonization in Alaska Native adults and children.
Methods:
We conducted annual surveys from 2008 through 2011 of residents of all ages in 8 rural Alaskan villages. Interviews were conducted, medical charts were reviewed, and nasopharyngeal swabs were cultured for Streptococcus pneumoniae. Multivariate logistic regression models were developed for 3 age groups (under 10 years, 10-17 years, and 18 years and older) to determine risk factors for colonization.
Results:
We obtained 12 535 nasopharyngeal swabs from 4980 participants. Our population lived in severely crowded conditions, and 48% of households lacked in-home running water. In children <10 years, colonization was associated with lack of in-home running water, household crowding, and more children in the home. Pneumococcal vaccination status was not associated with colonization. In older children and adults, increased number of persons in the household was associated with pneumococcal colonization.
Conclusions:
Higher colonization prevalence may partially explain increased IPD rates seen in those lacking in-home water services. Improving availability of sanitation services and reducing household crowding may reduce the burden of IPD in this population.
Summary Food- and waterborne disease is thought to be high in some Canadian Indigenous communities; however, the burden of acute gastrointestinal illness (AGI) is not well understood due to limited availability and quality of surveillance data. This study estimated the burden of community-level self-reported AGI in the Inuit communities of Rigolet, Nunatsiavut, and Iqaluit, Nunavut, Canada. Cross-sectional retrospective surveys captured information on AGI and potential environmental risk factors. Multivariable logistic regression models identified potential AGI risk factors. The annual incidence of AGI ranged from 2·9-3·9 cases/person per year in Rigolet and Iqaluit. In Rigolet, increased spending on obtaining country foods, a homeless person in the house, not visiting a cabin recently, exposure to puppies, and alternative sources of drinking water were associated with increased odds of AGI. In Iqaluit, eating country fish often, exposure to cats, employment status of the person responsible for food preparation, not washing the countertop with soap after preparing meat, a homeless person in the house, and overcrowding were associated with increased odds of AGI. The results highlight the need for systematic data collection to better understand and support previously anecdotal indications of high AGI incidence, as well as insights into unique AGI environmental risk factors in Indigenous populations.
Access to household water connections remains low in sub-Saharan Africa, representing a public health concern. Previous studies have shown water stored in the home to be more contaminated than water at the source; however, the mechanisms of post-supply contamination remain unclear. Using water quality measurements and structured observations of households in Bagamoyo, Tanzania, this study elucidates the causal mechanisms of the microbial contamination of drinking water after collection from a communal water source. The study identifies statistically significant loadings of fecal indicator bacteria (FIB) occurring immediately after filling the storage container at the source and after extraction of the water from the container in the home. Statistically significant loadings of FIB also occur with various water extraction methods, including decanting from the container and use of a cup or ladle. Additionally, pathogenic genes of Escherichia coli were detected in stored drinking water but not in the source from which it was collected, highlighting the potential health risks of post-supply contamination. The results of the study confirm that storage containers and extraction utensils introduce microbial contamination into stored drinking water, and suggest that further research is needed to identify methods of water extraction that prevent microbial contamination of drinking water.