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Monday, 23 January 2012

Waterborne outbreaks and Canada's dirty water secrets

Canadians are blessed with fresh water.  Our less than perfect drinking water infrastructure was discussed October 17, 2011 DrPHealth.   It was noted that there remain some 1800 drinking water systems on boil water advisories, with the highest proportion in BC, Saskatchewan and Newfoundland.  First Nations infrastructures are benefiting from a long term investment in improvements, a program which was renewed in 2011 with an additional $330 Million investment. The first five years of the plan saw 108 of 193 high risk systems improved. 

The converse of the lagging infrastructure is the history of outbreaks that have plagued Canadians.  First to reader’s minds will be Walkerton, and the likely North Battleford.  The known list however is  much longer.  Hence several studies that have looked at drinking water outbreaks are of interest.  From the PHAC enterics group located in Guelph came in 2005 article on  CJPH Waterborne outbreaks .  Just prior to the CJPH article was the work by Hrudey and Hrudey on Safe Drinking Water: Lessons from recent outbreaks in affluent nations .

A consultant’s report commissioned by PHAC and the National Collaborating Centre on Environmental Health (NCCEH) looked at outbreaks and retrospective data up to 2008 using different methodologies.   Finally NCCEH undertook a review of outbreaks in small water systems Small water system outbreaks 

There are consistent features that should be a reminder to all:
·         Lack of treatment or inadequate water treatment
·         Lack of source water protection
·         Problems in the water distribution system

And often associated with:
·         Precipitation event, spring thaw or change in demonstrable change in source water quality
·         Human mistakes in system operation.

To the above needs to be added several factors that should be addressed.
·         Disjointed or inconsistent regulatory oversight at a provincial level
·         Lack of recognition by government s and the public of the “public good” provided in drinking water (ie as a utility)
·         Lack of consistent national surveillance and reportability

There are several bright lights. Look to Quebec for both expertise and as an example. The responses of both Saskatchewan and Ontario in the wake of the two disasters are building solid systems - and perhaps shining examples of the legal liability that governments carry for failing in their public duty.  The National Collaborating Centres are collectively looking at issues related to small water systems.  Hopefully the collective work of these centres of excellence will contribute to reducing public vulnerability NCCPH small water system project.  

Core to Canada's drinking water problem is the misguided belief that we have a pristine resource in ample abundance that doesn't require the same level of rigorous pan-Canadian concern that we afford food, health care or the economy.  

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