Med Pregl 2017; LXX (9-10): 297-306. Novi Sad: septembar-oktobar. 297 Institute of Public Health of Vojvodina, Novi Sad, Republic of Serbia Original study Originalni naučni rad UDK 614.777(497.113) https://doi.org/10.2298/MPNS1710297B RISK ASSESSMENT OF DRINKING WATER FROM PUBLIC WELLS PROCENA RIZIKA ISPRAVNOSTI VODE ZA PIĆE IZ JAVNIH BUNARA Sanja V. BIJELOVĆ, Marija JEVTIĆ, Nataša DRAGIĆ, Emil ŽIVADINOVIĆ, Danijela LUKIĆ and Deana MEDIĆ Summary Sažetak Introduction. The safety of drinking water should be con- Uvod. Utvrđivanje zdravstvene ispravnosti vode treba posmatra- sidered in the context of managing the risk from hazards that ti kroz proces analize rizika, koji podrazumeva procenu, uprav- may compromise it. The aim of this study was to identify ljanje i komunikaciju u vezi sa rizikom. Procena rizika definiše microbiological, chemical and physical hazards of drinking aktivnosti kao što su prepoznavanje i karakterizacija opasnosti koje water from public wells which may impact human health, mogu usloviti obolevanje ljudi, procenu izloženosti i karakteriza- and to evaluate the results of routine drinking water analysis, ciju rizika. Cilj rada bio je prepoznavanje mikrobiološke, hemijske not taking into account the national legislation, but the risk i fizičke opasnosti u vodi za piće javnih bunara koje mogu uticati management approach. Material and Methods. Drinking na zdravlje ljudi i sagledati rezultate analiza zdravstvene ispravno- water was sampled from 20 public wells in South Bačka Dis- sti vode za piće javnih bunara analizom rizika, a ne primenom trict and analyzed at the Institute of Public Health of Vojvo- nacionalnih propisa. Materijal i metode. Uzimanje i analiza uzo- dina according to accredited national standards during 2016. raka vode za piće iz 20 javnih bunara na teritoriji Južnobačkog The drinking water hazards were defined according to in- upravnog okruga tokom 2016. obavio je Institut za javno zdravlje ternational recommendations. Risk assessment was done Vojvodine u skladu sa akreditovanim, standardizovanim i propi- using a semi-quantitative approach, which assesses the like- sanim metodama. Opasnosti su definisane u skladu sa međunarod- lihood and consequences of a hazard, rating the risks as low, nim preporukama. Rizik je procenjen semikvantitavnom metodom, medium, high and very high. Results. Of 218 drinking water koja ukrštanjem verovatnoće pojavljivanja i posledica po zdravlje samples, according to national regulations, only 10% were ljudi, kategoriše rizik kao mali, srednji, visok i veoma visok. Re- healthy for consumption. The recognized hazards were ther- zultati. Od ukupno 218 analiziranih uzoraka vode za piće, samo motolerant coliforms (especially Escherichia coli), entero- 10% je zdravstveno ispravno u odnosu na propisane normative. cocci (genus Streptococcus), Pseudomonas aeruginosa, Pro- Prepoznate opasnosti u vodi za piće javnih bunara su termotole- teus species and nitrates above legal limits. The risk was rantni mikroorganizmi (posebno Escherichia coli), eneterokoke rated high, with an impact on the morbidity of sensitive (genus Streptococcus), Pseudomonas aeruginosa, Proteus vrste populations in 2/3 of controlled public wells, in 1/3 as me- i koncentracija nitrata iznad propisanih graničnih vrednosti. Rizik dium, leading to abandonment of drinking water sources. upotrebe vode za piće koji doprinosi obolevanju osetljive popula- Conclusion. The proposed risk assessment methodology is cije, procenjen kao visok, utvrđen je u 2/3 kontrolisanih javnih a tool that provides easily understandable and clear informa- bunara, dok u 1/3 upotreba vode za piće predstavlja srednji rizik, tion on the possibility of using public wells with a consequent uslovljavajući promenu izvorišta vode za piće među stanovniš- impact on human health. The management of drinking water tvom. Zaključak. Procena rizika predstavlja alatku koja obezbe- safety is the greatest challenge, systematically prioritizing đuje lako razumljive i jasne informacije o mogućnosti upotrebe risk assessment of drinking water from public wells for the vode JB sa posledičnim uticajem na zdravlje ljudi, te je sistemska health of the population in the Republic of Serbia. primena principa procene rizika kao načina utvrđivanja zdrav- Key words: Risk Assessment; Drinking Water; Water Wells; stvene ispravnosti vode za piće najveći izazov za upravljanje Public Health; Environmental Medicine; Escherichia coli; Ni- zdravstvenom bezbednošću vode za piće u Republici Srbiji. trates Ključne reči: procena rizika; voda za piće; javni bunari; javno zdravlje; humana ekologija; Escherichia coli; nitrati Introduction right [2]. According to the World Health Organiza- tion (WHO) [1], safe drinking-water does not rep- Water is essential to sustain life of all living be- resent any significant risk to health over a lifetime ings [1]. Adequate amount of safe and easily acces- of consumption, including different sensitivities sible water must be available to all, as a basic human (infants, young children, chronically ill and immu- Corresponding Author: Dr Sanja V. Bijelović, Institut za javno zdravlje Vojvodine, 21000 Novi Sad, Futoška 121, E-mail: [email protected] 298 Bijelović VS, et al. Risk Assessment of Drinking Water from Public Wells Abbreviations Pseudomonas aeruginosa, a member of the family WHO – World Health Organization Pseudomonaceae (aerobic, Gram-negative rods), is a WSP – Water Safety Plan common environmental organism and it can be found E. coli – Escherichia coli in feces, soil, water and sewage. It multiplies in water HPC – heterotrophic plate count environments and also on the surface of suitable or- IOS – International Organization for Standardization ganic materials in contact with water. It has been iso- SMEWW – Standard Methods for the Examination of Water and lated from a range of moist environments such as sinks, Wastewater water baths, hot water systems, showers and spa pools. APV – Autonomous Province of Vojvodina Pseudomonas aeruginosa in drinking water can be considered as an indicator of secondary fecal pollution nocompromised people, the elderly) that may occur of water distribution systems caused by lack of disin- during one’s lifespan. The WHO recommends that fection after new mains have been laid, inadequate the safety of drinking water should be considered water flow, old and damaged pipes and taps where the in the context of managing the hazard risks that may precipitation of organic matter is high and tends to form compromise it. biofilms. The main route of infection among humans Hazards (any biological, chemical or physical is by exposure of susceptible tissue, notably wounds agent that has the potential to cause harm) [1] may and mucous membranes, to contaminated water, in- occur or be introduced throughout the water system, struments and other surfaces. Ingestion of drinking from catchment to consumer. Therefore, effective water is not an important source of infection [1, 8–11]. risk management requires identification of all poten- The genus Proteus includes Gram-negative, fac- tial hazards, their sources, possible hazardous events, ultative anaerobic, heterotrophic, and proteolytic rods and assessment of the risks they may occur [1]. Main- being human opportunistic pathogens. Human and ly, for organized drinking water systems, these ac- animal feces are probably an important source of tivities are defined by the Water Safety Plan (WSP), these rods in natural environments. The presence of but for public wells, WSP is usually not sufficient. In Proteus spp. bacteria in water and soil may indicate the Republic of Serbia, there is a National Bylaw a fecal pollution of the environment, being a threat which defines the microbiological, chemical and of poisoning if the contaminated water is consumed. physical parameters and guidelines, as well as fre- The health risk may also be connected with drug quency and minimal number of controls of the drink- resistant strains sourcing from intestines. Proteus ing water safety [3], but it is not based on risk man- spp. strains are able to adapt to different environmen- agement approach. tal conditions, such as high concentrations of heavy If routine analysis of drinking water in the Re- metals or toxic substances, which may be exploited public of Serbia is concerned [3] (so called “A” vol- as sources of energy and nutrition by the bacteria and ume for analysis according to national legislations), could be used in bioremediation and environmental the biological and chemical hazards are represented protection [12]. as the thermotolerant coliforms, especially Es- Heterotrophic plate count (HPC) bacteria repre- cherichia coli (E. coli), Enterococci (genus Strep- sent a wide spectrum of heterotrophic microorgan- tococcus), Pseudomonas aeruginosa, Proteus spe- isms among which are some sensitive to disinfection cies and excessive concentrations of nitrates/nitrites. processes (coliform bacteria), some are resistant to Thermotolerant coliforms, with predominant disinfection (spore formers) and some rapidly prolif- genus of Escherichia, but also with some types of erate in treated water in the absence of residual dis- Citrobacter, Klebsiella and Enterobacter, are colif- infectants. The HPC can be a useful tool in monitor- orm bacteria that ferment lactose at 44 – 45 °C. E. ing, treatment and as a disinfectant indicator, with coli is present in human and animal feces and thus the objective to keep numbers as low as possible. The it is most commonly used as an indicator of fecal HPC