COURSE CODE: ESST3103

COURSE TITLE: Environmental Health

Assignment #1

Water compromises approximately 71% of the earth's surface and is one of the most abundant
compounds, essential to the survival to all living organisms. However, not all the water present
on earth is available for drinking. About 97% of water is found in oceans while the other 3% is
comprised of freshwater, which is the water source from which organisms can use. However, not
all this freshwater is available for immediate use for humans. It is found underground as ground
water, in lakes and swamps and found in its solid state in glaciers and ice caps, in which
groundwater and surface water is available for use, only compromising 1% of all water present.
(Bralower and Bice). Humans require water daily for consumption to maintain health and for
many other personal and everyday life purposes such as; for showers, sanitation, washing
clothing and dishes as well as for agriculture and industrial purposes. Water safety is
fundamental to a welling being and human development. Humans must have access to clean and
safe drinking water in order to maintain health and prevent diseases and illness. Having good
sanitation, proper hygiene and water management improves global health and economic benefits
as well as reducing disease burden. (WHO 2008). Over the years, water demand has been
increasing worldwide with increasing populations, and this has been decreasing the availability
and access to fresh, clean water. According to WHO at least in one in three people do not have
access to clean and steady supply of water, especially in underdeveloped and developing
countries. The lack of access to safe drinking water, puts lives at risk of being infected with
diseases which can lead to increasing mortality and is seen in countries such as Africa, South
America and parts of Asia, where water supply is limited. (Friis 2019, 211-213). It is a human
right to be able to access water and good sanitation as it serves as a fundamental part of human
well-being. (United Nations 2013). The use of unclean, contaminated water is a major factor
contributing to the transmission of many water-related diseases and viruses in the human
population.

There are a variety of factors which may cause water to become contaminated making it unsafe
to use. Human activities are also a major contributing factor to poor water quality. In heavily
urbanized areas and even in rural areas, domestic sewage (house cleaning products, bath
products and fecal matter) is disposed of in freshwater and oceans. These may contain a variety
of chemicals and bacteria which is harmful to human health and can become harmful in water
especially toxic chemicals. Agriculture also contaminates waterbodies such as rives when
chemicals such as fertilizers and pesticides leach into soil and run off into rivers and even
contaminate groundwater which is one of the main sources used for consumption. Animal farms
also contribute to pollution when sewage is disposed of and enters water ways. Chemicals such
as mercury and lead are normally disposed of into rivers and lakes as from industrial activities
and mining causing detrimental contamination and poisoning to aquatic animals and soils
nearby. (CDC 2014). Natural events such as flooding, and landslides introduces foreign matter
into water bodies in rivers, lakes and streams. Another natural factor includes changes in climate
such as increasing or decreasing pH levels in oceans, rivers and other water bodies may favor the
growth of many diseases. Droughts also increases the number of pathogens that live in a
waterbody as there is more of these organisms living in a lower volume of water. (NIH,2017).
The entrance of these materials into water introduces disease causing organisms, some of which
lives and multiplies such as bacteria and viruses. This is mostly seen in untreated freshwater
sources that provides a mode of transmission to humans. This means that the infecting agent
leaves the sources and travels through water which then reaches to its host. (PANDEM-SIM
2016). This can be done through consumption of food such as fish, drinking water, though
physical contact with water such as taking baths and washing.

When water becomes contaminated with waste and chemicals, it can cause many types of
microorganisms to live in water, giving rise to a few water-related diseases that can be classified
into four main types; water-borne, water washed, waster-based and water- vector borne diseases.
Water-borne diseases happen when human and animal fecal matter as well as toxic chemicals
come in contact with humans though consumption by drinking water, we are exposed to a variety
of illness from bacteria, protozoa and viruses and chemicals as water serves as a carrier for these.
Humans may then experience cholera, anemia, hepatitis and ring worms. This mostly happens in
rural areas and countries such as Africa and parts of Asia where some of the population lives in
poverty and there is no access to clean drinking water from treatment plants. Most families
usually rely on water from rivers, streams and wells which are the most vulnerable and likely
water sources to be contaminated. In some cases, this can happen in developed countries and
urban cities as some pathogens and microorganisms still live in water and chemicals are not
always removed. Water-borne diseases depends on the volume of water consumed by a human
and provides relevance to risk assessments. If little to no water is consumed, the risk of being
infected by parasites or showing symptoms of toxicity to chemicals is very little. If the same
water source is used daily, then the risk of being infected and showing symptoms is severely
high. (Grandjean and Bartram 2011)
Water Washed diseases, also called water scarce diseases are caused by limited water
availability, causing people to develop poor personal hygiene and sanitization. Small quantities
of water contain higher amounts of chemicals and microorganisms. There is also the possibility
of re-using water to wash utensils, clothing and for taking baths and not washing hands after
defecating. This causes diseases to affect the eyes, skin and intestines such as conjunctivitis, flea
and tick-borne illness and diarrhea which is mostly prevalent in children leading to high
morbidity and mortality rates. There is also risk of infection of roundworms and hookworms
(WHO 1988).
Water based diseases happens when some pathogens and microorganisms spend their life cycle
in water systems as their habitat and even live in aquatic animals for example snails and fish.
They are then transmitted to humans through consumption and skin contact.
Water-vector borne diseases is an indirect mode of transmission of disease as the water is not
contaminated or harbors the organism that causes the illness. It results from organisms that spend
part of their life cycle in water and is a carrier for the disease. Examples includes flies which can
carry bacteria and mosquitoes which is known to carry many types of illness such as dengue,
malaria, zika and chikungunya. (ECDC 2016)
Another form of water related disease can come from the contact of chemicals found in water,
aquatic organisms and even in treatment plants and metal pipes that is used to transport water.
The most common ones include mercury (one of the most dangerous), lead, cadmium and
aluminum. They can be transmitted to humans though consumption of water and aquatic
organism such as fish, and through skin contact.

Illness caused by contaminated water sources is due to the presence of microbes (parasites,
viruses and bacteria). Bacterial related diseases are caused by E coli (Escherichia coli) which is
mostly found in fecal waste that is found in the intestines of humans and animals. When
ingested, humans may experience diarrhea, vomiting and respiratory complications. Another
type of bacterium known as Vibiro Cholerae is responsible for the illness cholera, which causes
similar symptoms as E coli and comes from the same source of contamination and transmission.
Salmonella is another common infection which causes stomach cramps, fever and diarrhea.
(CDC 2019)
Common types of parasitic related diseases include malaria, hookworms, and cryptosporidium.
Malaria is mainly caused by four types of parasites, one of which is known as Plasmodium
falciparum which is responsible for more severe symptoms such as chills, high fever and flu-like
symptoms and even resulting in death. However, these parasites do not live in water, they are
found in female Anopheles mosquitoes. Malaria is an indirect water related disease because it is
transmitted to humans through mosquito bites. They are more likely to breed in waters that are
stagnant. In the early stages of a mosquito life cycle, the larvae grow in water which is then
infested with the parasite and develops into an adult can pass it onto humans when feeding.
(CDC 2020). Hookworms eggs are usually found in human feces and when washed into waters
and can be directly transmitted to another person though water consumption and skin contact.
They can also spread from one person to another. Hookworms are usually found in temperate
climate and where is unsanitary conditions. The symptoms vary for each person as some may
show no symptoms and others experience weight and appetite loss as well as abdominal pain.
(CDC 2020). Cryptosporidiosis is caused by the agent, Cryptosporidium parvum which produces
gastrointestinal symptoms like vomiting, abdominal cramps as well as fever. They are normally
found in sewage and can infect a person through skin contact and consumption.
Cryptosporidiosis is unique in that it does not only occur in unsanitary conditions or where
people rely on water from rivers and wells, but also in developed countries that use treated water.
This parasite is resistant to chlorine which is used in the water treatment process to kill bacteria
and other microbes and as a result, this increases the number of people at risk of being infected.
Viruses is also another type of disease caused by contaminated water sources. According to
WHO, viral pathogens that are transmitted by water, have moderately to high significance on
health. Dengue is a viral related water-borne disease transmitted indirectly by mosquitoes,
specifically the Ades age. Symptoms of dengue varies as some people may show little to no
signs of infection, while severe cases include stomach aches, bleeding from the nose and
vomiting. Other types include hepatitis A and E, adeno and enteroviruses. These causes similar
symptoms such as vomiting, diarrhea and fever. (Gall, Marinas,Yi Lu and Shisler 2015).

Toxic chemicals in water is also known to cause a variety of illness depending on the chemical.
Fertilizers and pesticides are both organic and inorganic leach into soil and runs off into
groundwater and surface water. Compounds containing nitrates is known to cause cancers and
high blood pressure while chloride containing substances are linked to kidney failure. (Aqua
Carpatica 2018). Methylmercury is also one of the most common chemical contaminants and one
of great health concern, with people being affected in both developed and underdeveloped
countries. Mercury comes from natural sources such as volcanic activity and weathering of
rocks; however, the majority being released in the environment comes from human activities
such as burning fossil fuels and is also used in the production of some materials and equipment.
This increased mercury finds its way into water through run off from soils and chemical spills.
Once in water it becomes very toxic as it is converted to methyl mercury and bioaccumulates and
biomagnifies in food chains. When humans consume fish from contaminated water sources they
are then being exposed to mercury and can cause detrimental effects when ingested at high
levels. A case study showed the severe effects of methyl-mercury poisoning in Minamata, Japan,
when the Chisso Corporation dumped tonnes of mercury into nearby waters. The villagers
usually fished in these waters and eventually began showing symptoms of brain damage and
denigrated nervous systems. (Gill 2014). Another common metal is lead which can even
contaminate treated tap water as metal pipes being used to transport contains lead. Symptoms are
more common and severe in children, causing hearing loss, vomiting, appetite and weight loss.

All the waterborne diseases shown above affects millions of people yearly, where most cases
come from South East Asia, Sub-Saharan Africa and in South America where poverty is
dominant, and water is limited. Persons who are at higher risk of showing severe symptoms are
children, the elderly, pregnant women and those with comorbidities and pre-existing medical
conditions as their immune systems being weak and account for most of the morbidity and
mortality rates for these diseases.
In order to reduce the risk of persons being infected with water-related diseases, individuals can
practice personal hygiene and proper sanitation methods. This includes washing hands
thoroughly after defecating, boiling water before using it for consumption or for other personal
uses and avoiding using water from rivers and other areas where water is dirty or prone to
flooding and droughts. The government also plays an important role by raising awareness and
encouraging individuals to practice good hygiene and most importantly, providing a safe source
of water through water treatment plants and regularly treating open water sources. (Khambete
2019). They can also implement easy access to sanitation such as shower areas and latrines to
reduce fecal contact with water reducing contamination.

In conclusion, water is an essential requirement for all humans across the world. Every person
has a right to access safe and clean water for good health and development. Globally,
approximately 2 billion people do not have access to clean water services and so are forced to
live in unsanitary conditions which put their lives at risk for diseases. Water related diseases are
more evident in under-developed and developing countries, however they can still occur in
developed countries as well. By preventing and reducing the risk of people getting infected with
water related diseases, we can reduce the number of deaths yearly from water diseases as well as
economic benefits from decreased money spent on treating diseases and increasing productivity.
(WHO 2018).

References
 1. Bralower, Timothy and Bice, David. n.d. "Distribution of Water on the Earth’s Surface".
Accessed October 10, 2020.
https://www.e-education.psu.edu/earth103/node/701#:~:text=The%20distribution%20of
%20water%20on,lakes%2C%20rivers%2C%20and%20swamps.
2. Centers for Disease Control and Prevention. 2020. "Hookworm FAQs". Last Modified
September 17,2020.
https://www.cdc.gov/parasites/hookworm/gen_info/faqs.html#:~:text=Hookworm%20is%20an
%20intestinal%20parasite,Ancylostoma%20duodenale%20and%20Necator%20americanus.
3. Centers for Disease Control and Prevention. 2019. "Salmonella". Last Modified
December 05, 2019.
https://www.cdc.gov/salmonella/general/index.html#:~:text=Most%20people%20with
%20Salmonella%20infection,experience%20symptoms%20for%20several%20weeks.
4. Centers for Disease Control and Prevention. 2014. "Water-related Diseases and
Contaminants in Public Water Systems". Last Modified April 07,2014)
https://www.cdc.gov/healthywater/drinking/public/water_diseases.html
5. European Centre for Disease Prevention and Control. 2016. "Aedes aegypti - Factsheet
for experts". Last Modified Dec 20, 2016.
https://www.ecdc.europa.eu/en/disease-vectors/facts/mosquito-factsheets/aedes-aegypti
6. Friis, Robert H. 2019. Essentials of Environmental Health.
7. Gall, Aimme M., Marinas, Benito J., Yi, Lu and Shisler, Joanna L. 2015. "Waterborne
Viruses: A Barrier to Safe Drinking Water". Last Modified June 25, 2015.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482390/#:~:text=Water%2Dtransmitted
%20viral%20pathogens%20that,coxsackieviruses%20and%20polioviruses%20%5B5%5D.
8. Gill, Tom. 2014. "New Lives: Some Case Studies of Minamata". August 24, 2014.
https://apjjf.org/2014/12/34/Tom-Gill/4169/article.html
9. Khambete, Aarti. 2019. "When water kills". Jan 09, 2019.
https://www.indiawaterportal.org/articles/when-water-kills
10. National Institute of Environmental Health Sciences. 2017. "Waterborne Diseases". Last
Modified July 20,2017.
https://www.niehs.nih.gov/research/programs/geh/climatechange/health_impacts/waterbo
rne_diseases/index.cfm
11. PANDEM-SIM. 2016. "How Microorganisms Cause Disease". Accessed October 11,
2020
http://www.pandemsim.com/beta/CauseDisease.html#:~:text=Once%20pathogens%20are
%20inside%20body,that%20is%20released%20into%20cells.
12. Science Direct. n.d. "Waterborne Diseases. Accessed October 11,2020)
https://www.sciencedirect.com/topics/earth-and-planetary-sciences/waterborne-
disease#:~:text=Water%2Dwashed%20diseases%2C%20such%20as,by%20eating
%20insufficiently%20cooked%20fish.
13. United Nations. n.d. "Human Rights to Water and Sanitation". Accessed October 11,
2020.
https://www.unwater.org/water-facts/human-rights/
14. World Health Organization. 1988. "Water related diseases and their public health
importance". Accessed October 11, 2020)
https://www.who.int/water_sanitation_health/resources/envmanparta.pdf?ua=1
15. World Health Organization. 2019. "1 in 3 people globally do not have access to safe
drinking water – UNICEF, WHO". Last Modifed June 18, 2019.
https://www.who.int/news-room/detail/18-06-2019-1-in-3-people-globally-do-not-have-access-
to-safe-drinking-water-unicef-who#:~:text=Billions%20of%20people%20around%20the,and
%20the%20World%20Health%20Organization.&text=It%20is%20estimated%20that%201,who
%20drink%20untreated%20surface%20water.
16. World Health Organization. 2008. "How does safe water impact global health?" Last
Modified June 25, 2008.
https://www.who.int/news-room/q-a-detail/how-does-safe-water-impact-global-
health#:~:text=Efforts%20to%20improve%20water%2C%20sanitation,human%20waste%20and
%20reduces%20infections.