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      The public health significance of latrines discharging to groundwater used for drinking.

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          Faecal contamination of groundwater from pit latrines is widely perceived as a major threat to the safety of drinking water for several billion people in rural and peri-urban areas worldwide. On the floodplains of the Ganges-Brahmaputra-Meghna delta in Bangladesh, we constructed latrines and monitored piezometer nests monthly for two years. We detected faecal coliforms (FC) in 3.3-23.3% of samples at four sites. We differentiate a near-field, characterised by high concentrations and frequent, persistent and contiguous contamination in all directions, and a far-field characterised by rare, impersistent, discontinuous low-level detections in variable directions. Far-field FC concentrations at four sites exceeded 0 and 10 cfu/100 ml in 2.4-9.6% and 0.2-2.3% of sampling events respectively. The lesser contamination of in-situ groundwater compared to water at the point-of-collection from domestic wells, which itself is less contaminated than at the point-of-consumption, demonstrates the importance of recontamination in the well-pump system. We present a conceptual model comprising four sub-pathways: the latrine-aquifer interface (near-field); groundwater flowing from latrine to well (far-field); the well-pump system; and post-collection handling and storage. Applying a hypothetical dose-response model suggests that 1-2% of the diarrhoeal disease burden from drinking water is derived from the aquifer, 29% from the well-pump system, and 70% from post-collection handling. The important implications are (i) that leakage from pit latrines is a minor contributor to faecal contamination of drinking water in alluvial-deltaic terrains; (ii) fears of increased groundwater pollution should not constrain expanding latrine coverage, and (iii) that more attention should be given to reducing contamination around the well-head.

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          Author and article information

          Water Res.
          Water research
          Elsevier BV
          November 01 2017
          : 124
          [1 ] Independent Consultant, Cambridge, UK.
          [2 ] International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
          [3 ] Bangladesh Water Development Board, Green Road, Dhaka, Bangladesh.
          [4 ] Dhaka University of Engineering and Technology, Shimultoly Road, Gazipur, Bangladesh.
          [5 ] Department of Soil, Water & Environment, University of Dhaka, Dhaka, 1000, Bangladesh.
          [6 ] WaterAid Bangladesh, House 97/B, Road No 25, Block A, Banani, Dhaka, 1213, Bangladesh.
          [7 ] Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
          [8 ] International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. Electronic address:


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