caa a22 4500 397516541 CHVBK 20180308164620.0 cr unu---uuuuu 161202s1995 xx s 000 0 eng 10.1093/eurpub/5.2.75 doi (NATIONALLICENCE)oxford-10.1093/eurpub/5.2.75 Residual microbiological risk after simple chlorine treatment of drinking ground water in small community systems [Elektronische Daten] [D. ZMIROU, S. REY, X. COURTOIS, J-P. FERLEY, J-F. BLATIER, P. CHEVALLIER, J. BOUDOT, J-L. POTELON, R. MOUNIR] In order to assess the residual health risk after mere disinfection of drinking ground water, an epidemiological study was conducted in 24 French villages, among 2,033 schoolchildren aged 7-11 years. Thirteen villages which delivered drinking water that did not need to be treated because the water naturally met microbiological standards were used as a reference. Eleven other villages were selected, which were required to disinfect the spring water before distribution because of microbiological contamination. However, after a well-conducted chlorine-only treatment, tap water also complied with microbiological standards. Acute gastrointestinal (Gl) conditions (diarrhoea and/or vomiting) were recorded daily during 8 months using standard questionnaires. The bacteriological quality of the water was assessed bi-monthly. The crude incidence rate of diarrhoea was 1.4 times more frequent among children drinking treated water than among controls (95% confidence interval: 1.30-1.50). This rate ratio was not significantly influenced by the chlorine concentration after treatment. The excess risk was associated with the occurrence of small epidemics. However, when discarding the epidemic events, the background endemic morbidity also differed between the 2 groups. This study shows that after a disinfection-only treatment that produces finished water meeting the current bacteriology quality and treatment efficiency indicators, a low but significant risk of acute Gl infection persists, probably associated with the survival of some chlorine-resistant micro-organisms. Effective drinking water management should primarily aim at protecting the quality of natural water. If this does not suffice, this study suggests that the treatment of contaminated water should encompass multiple barriers, not merely disinfection. © European Journal of Public Health ENVIRONMENT nationallicence drinking water nationallicence chlorine disinfection nationallicence resistance nationallicence microbiological contamination nationallicence epidemiological study nationallicence ZMIROU D. Centre Rhone-Alpln de Recherche Epidémiologue et de Prévention Sanitaire (CAREPS), Centre Hosprtalier Universitaire de Grenoble and School of Medicine, Public Health Laboratory, Grenoble University France aut REY S. CAREPS; currently at Direction Départementale des Affaires Sanitaires et Sociales (DDASS) de l'Isère Grenoble aut COURTOIS X. CAREPS, Centre Hosprtalier Universitaire de Grenoble France aut FERLEY J-P CAREPS, Centre Hosprtalier Universitaire de Grenoble France aut BLATIER J-F CAREPS; currently at Caisse Régionale Mutualiste des Alpes Grenoble aut CHEVALLIER P. Laboratoire Régional des Eaux, Faculté de Médecine de Grenoble aut BOUDOT J. Direction Régionale des Affaires Sanitaires et Sociales, région Rh⊙ne-Alpes Lyon aut POTELON J-L DDASS de I'Isère Grenoble aut MOUNIR R. CAREPS, Centre Hosprtalier Universitaire de Grenoble France aut The European Journal of Public Health Oxford University Press 5/2(1995), 75-81 1101-1262 5:2<75 1995 5 eurpub https://doi.org/10.1093/eurpub/5.2.75 text/html Onlinezugriff via DOI 1 other jats NATIONALLICENCE 856 40 https://doi.org/10.1093/eurpub/5.2.75 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- ZMIROU D. Centre Rhone-Alpln de Recherche Epidémiologue et de Prévention Sanitaire (CAREPS), Centre Hosprtalier Universitaire de Grenoble and School of Medicine, Public Health Laboratory, Grenoble University France aut NATIONALLICENCE 700 1- REY S. CAREPS; currently at Direction Départementale des Affaires Sanitaires et Sociales (DDASS) de l'Isère Grenoble aut NATIONALLICENCE 700 1- COURTOIS X. CAREPS, Centre Hosprtalier Universitaire de Grenoble France aut NATIONALLICENCE 700 1- FERLEY J-P CAREPS, Centre Hosprtalier Universitaire de Grenoble France aut NATIONALLICENCE 700 1- BLATIER J-F CAREPS; currently at Caisse Régionale Mutualiste des Alpes Grenoble aut NATIONALLICENCE 700 1- CHEVALLIER P. Laboratoire Régional des Eaux, Faculté de Médecine de Grenoble aut NATIONALLICENCE 700 1- BOUDOT J. Direction Régionale des Affaires Sanitaires et Sociales, région Rh⊙ne-Alpes Lyon aut NATIONALLICENCE 700 1- POTELON J-L DDASS de I'Isère Grenoble aut NATIONALLICENCE 700 1- MOUNIR R. CAREPS, Centre Hosprtalier Universitaire de Grenoble France aut NATIONALLICENCE 773 0- The European Journal of Public Health Oxford University Press 5/2(1995), 75-81 1101-1262 5:2<75 1995 5 eurpub Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford