World Health Organization Water Quality and Health Joint Expert Meeting 18–22 March 2013 Organized in coordination with Eawag, Dübendorf, Switzerland Geneva, 2013 World Health Organization Water Quality and Health Joint Expert Meeting World Health Organization 2013 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications—whether for sale or for non-commercial distribution—should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html). 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However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. This publication contains the collective views of an international group of experts and does not necessarily represent the decisions or the policies of the World Health Organization. Joint Expert Meeting, 18–22 March 2013, Dübendorf CONTENTS ACRONYMS ............................................................................................................................ v 1. INTRODUCTION................................................................................................................ 1 1.1 Background ...................................................................................................................... 1 1.2 Objectives of the meeting ................................................................................................ 1 1.3 Participants ....................................................................................................................... 2 1.4 Organization of the meeting............................................................................................. 2 1.5 Opening session ............................................................................................................... 2 1.6 Declarations of interests ................................................................................................... 3 2. STRATEGY AND HARMONIZATION OF THE WHO WATER QUALITY GUIDELINES ...................................................................................................................... 4 2.1 The WHO Water Quality and Health Strategy ................................................................ 4 2.2 Harmonization of the three water quality guidelines: linking the guidelines at the policy level ...................................................................................................................... 7 2.3 Harmonization of health-based targets .......................................................................... 10 2.4 Capacity building with a focus on health-based targets................................................. 13 3. WATER QUALITY AND HEALTH EXPERT GROUP AND GUIDELINES DEVELOPMENT PROCESS ........................................................................................... 14 3.1 Expert group terms of reference .................................................................................... 15 3.2 Guideline development at WHO .................................................................................... 16 3.3 Policies and procedures for updating the WHO water quality guidelines ..................... 18 4. FEEDBACK ON GUIDELINES FROM WHO REGIONAL OFFICES: PERSPECTIVES ON THE WORKPLANS.................................................................... 19 4.1 WHO Regional Office for Africa .................................................................................. 20 4.2 WHO Regional Office for the Eastern Mediterranean .................................................. 21 4.3 WHO Regional Office for Europe ................................................................................. 22 4.4 WHO Regional Office for South-East Asia ................................................................... 23 4.5 WHO Regional Office for the Western Pacific ............................................................. 24 4.6 WHO Regional Office for the Americas ....................................................................... 25 4.7 Summary and discussion................................................................................................ 25 5. CROSS-CUTTING ACTIVITIES INCLUDED ON THE GDWQ POST–FOURTH EDITION WORKPLAN AND WATER SAFETY PLANS .......................................... 27 5.1 Vulnerable groups .......................................................................................................... 27 5.2 Indirect potable reuse ..................................................................................................... 29 5.3 Quantitative microbial risk assessment .......................................................................... 30 5.4 Update on water safety plans ......................................................................................... 32 6. BURDEN OF DISEASE ESTIMATES FOR WATER, SANITATION AND HEALTH ............................................................................................................................ 33 7. WASTEWATER WORKPLAN ....................................................................................... 36 7.1 Draft wastewater workplan ............................................................................................ 36 7.2 Update on sanitation safety plans .................................................................................. 38 iii Joint Expert Meeting, 18–22 March 2013, Dübendorf 8. RECREATIONAL WATER WORKPLAN AND CROSS-CUTTING ISSUES ......... 41 8.1 Draft recreational water workplan ................................................................................. 41 8.2 Summary of overall work conducted by the WHO Regional Office for Europe on Volume 2 of the recreational water guidelines .............................................................. 43 8.3 Toxic cyanobacteria in water ......................................................................................... 48 8.4 Cyanobacteria fact sheets ............................................................................................... 50 8.5 Cylindrospermopsin and microcystin ............................................................................ 51 9. DRINKING-WATER GUIDELINES AND CROSS-CUTTING ISSUES ................... 52 9.1 WHO’s work on radiation protection and health ........................................................... 52 9.2 Draft drinking-water workplan: introduction ................................................................. 53 9.3 Turbidity ........................................................................................................................ 54 9.4 Alternative disinfectants ................................................................................................ 55 9.5 International Network on Household Water Treatment and Safe Storage .................... 58 9.6 WHO’s food safety programme: microbial and chemical risk assessment approaches ..................................................................................................................... 59 9.7 Update from Radiation Working Group ........................................................................ 61 9.8 Microbial Aspects Working Group workplan ................................................................ 63 9.9 Protection and Control Working Group workplan ......................................................... 65 9.10 Chemical Aspects Working Group workplan .............................................................. 66 10. OVERALL PRIORITIES FOR HARMONIZATION OF THE WATER QUALITY GUIDELINES ............................................................................................... 69 11. CLOSING OF THE MEETING ..................................................................................... 72 ANNEX 1: List of participants ............................................................................................. 74 ANNEX 2: Agenda ................................................................................................................. 83 ANNEX 3: Annotated agenda from Microbial Aspects Working Group for the WHO Guidelines for Drinking-water Quality ................................................