Examining differences in the implementation of school water-quality practices and water-access policies by school demographic characteristics

Thirsty? Choose Water! A regional perspective to promoting water consumption in secondary school students

OBJECTIVE

Adolescents are high consumers of sugar-sweetened beverages (SSB), which contribute to overweight and obesity - a significant public health issue. Evidence suggests that replacing SSB with water and school-based interventions can reduce consumption. This study examines the acceptability of a previously trialled intervention (Thirsty? Choose Water!) in regional and remote secondary schools.

DESIGN

An open-label randomised controlled trial using a two-by-two factorial design tested the outcomes of a behavioural and/or environmental intervention on SSB and water consumption.

SETTING

Regional and remote secondary schools (public, catholic and independent) within the boundaries of two regional Local Health Districts within New South Wales.

PARTICIPANTS

Twenty-four schools participated in the study. The target group was year 7 students (n 1640) - 72 % of eligible students completed baseline data. The study followed students into year 8 (n 1188) - 52 % of eligible students completed post-intervention data. Forty teachers undertook training to deliver the intervention.

RESULTS

Interventions showed high levels of acceptability. Students demonstrated changes in knowledge, attitudes and consumption behaviours. Multivariable ordinal logression analysis demonstrated that all interventions increased the odds of students increasing their water consumption (though not statistically significant). Conversely, the combined (OR: 0·75; 95 % CI: 0·59, 0·97) or environmental intervention (OR: 0·68; 95 % CI: 0·51, 0·90) had greater odds of reducing SSB consumption and was statistically significant.

CONCLUSIONS

This study builds on recent Australian evidence regarding the impact of school-based interventions on water and SSB consumption. In this study, despite a minor intervention change, and the impacts of fires, floods and COVID-19 on study implementation, the interventions were highly regarded by the school communities with positive outcomes.

Microbial bio-film calcite mediated removal of heavy metals from industrial wastewater of Kasur, Pakistan

Heavy metals in the industrial wastewater are an area of great concern as act as source of bioaccumulation in edible plants and posing a major health risk to humans like cancers. This study was planned by exploiting the bio-film producing microbes that have the potential to remediate heavy metals by calcite mediated removal from industrial wastewater. Samples (n = 10) from a marble factory wastewater were collected. Samples were serially diluted and were spread on nutrient agar media supplemented with 2% urea and 0.28 g calcium chloride. All the isolates were observed for colony morphology, gram staining, and spore staining, for biochemical profile and for their efficacy in producing calcium carbonate crystals. All isolates showed cell densities at varying metal (chromium) concentrations ranging from 100 to 500 µg/mL. Determination of biofilm formation is performed by recording Optical density (OD = 600 nm). Normalized biofilm (570/600 nm) was formed. Different concentrations of chromium were used to measure their reduction ability and also by using tannery water. In tannery wastewater, significant reduction was recorded (p = 0.05) by AS4 bacterial isolate as compared to rest of the isolates and treatments. It showed remarkable chromium VI reduction ability.

Mechanism of Water Use Behavior of College Students Based on the Improved TPB Model

Colleges and universities are a typical service water consumers in China, i.e., with a dense population, single structure, and regular water use. This means it is crucial to strengthen the management of their water use behavior. In this paper, first of all, the main water devices and water use behavior of students were elucidated by investigating and analyzing the structure and scenarios of water use in colleges and universities. Then, a model of water use behavior of college students with sociodemographic and environmental characteristics was constructed based on the theory of planned behavior (TPB). By investigating and analyzing the water use behavior, the theoretical judgment of the improved TPB model that “behavior is the result of interaction between individual and environmental characteristics” was proved, which provides a reference for studying the water demand requirements of college students and supports scientific water-use management in colleges, our results also help the exploration of potential water-saving solutions in order to construct water-conservative colleges and universities.

Elevated water lead levels in schools using water from on-site wells

Only 8% of US public schools operate their own community water systems, and thus are subject to the federal Lead and Copper Rule's regulation of water lead levels (WLLs). To date, the absence of parallel water testing data for all other schools has prevented the comparison of WLLs with schools that do not face federal regulation. This study compiled and analyzed newly available school-level WLL data that included water source (on-site well water or public utility) and pipe material data for public schools in New York State located outside of New York City. Despite direct federal regulation, schools that used water from on-site wells had a substantially higher percentage of water fixtures with elevated WLLs. Schools that used both on-site well water and iron pipes in their water distribution system had the highest percentage of elevated fixtures. Variation in water treatment practices was identified as a potential contributing mechanism, as schools that used on-site well water were less likely to implement corrosion control. The study concluded that information about water source and premise plumbing material may be useful to policymakers targeting schools for testing and remediation.

Lead Concentrations in US School Drinking Water: Testing Programs, Prevalence, and Policy Opportunities, 2016‒2018

Objectives. To detail baseline drinking water sample lead concentrations and features of US state-level programs and policies to test school drinking water for lead in 7 states' operating programs between 2016 and 2018. Methods. We coded program and policy documents using structured content analysis protocols and analyzed state-provided data on lead concentration in drinking water samples collected in public schools during initial testing phases. Results. We analyzed data from 5688 public schools, representing 35% of eligible schools in 7 states. The number of samples per school varied. The proportion of schools identifying any sample lead concentration exceeding 5 parts per billion varied (13%-81%). Four states exceeded 20%. Other program features varied among states. Instances of lead above the state action level were identified in all states. Conclusions. In 2018, many US public school students attended schools in states without drinking water lead-testing programs. Testing all drinking water sources may be recommended. Public Health Implications. Initiating uniform school drinking water lead testing programs and surveillance over time could be used to reduce risk of lead exposure in drinking water. (Am J Public Health. 2022;112(S7):S679-S689. https://doi.org/10.2105/AJPH.2022.306961).

The outcomes of [project name removed for blinding - subsequently documented as XX] Determining the effects of a behavioural and an environmental intervention on water and sugar sweetened beverage consumption in adolescents: A randomised controlled trial

ISSUE

Childhood obesity is a serious public health challenge. Consumption of sugar-sweetened beverages (SSBs) is one contributing factor, with adolescents being the highest consumers.

METHODS

This study used a randomised controlled trial and two-by-two factorial design to determine the effectiveness of a school-based behavioural intervention (including education/promotional messages) and/or environmental intervention (chilled water station), on encouraging adolescents to choose water instead of SSBs. Sixty-one secondary schools (n=8,992 eligible students) were recruited and randomly allocated to one of four study groups, the behavioural intervention, the environmental intervention, both interventions or neither.

RESULTS

The primary outcome was increased water consumption; secondary outcomes included changes in students' knowledge and attitudes about water and SSBs and changes in SSBs consumption. For students who received at least one intervention there was an increased odds (though not statistically significant) of higher water consumption compared to those that received no intervention. There was a decrease in SSBs consumption for students who received both interventions combined (OR = .67; 95% confidence interval, 0.55-.082; P<0.01).

CONCLUSIONS

The combined intervention had a greater effect on decreasing SSBs consumption. This is noteworthy given SSBs are a key contributor to overweight and obesity. SO WHAT?: To our knowledge this is the first Australian study examining combined school-based interventions to specifically promote the consumption of water and decrease the consumption of SSBs in adolescents. The study findings add to the evidence regarding the benefits of delivering multi-component school-based interventions which add value to existing interventions that address the complex public health issue of overweight and obesity.

School and childcare center drinking water: Copper chemistry, health effects, occurrence, and remediation

The study goal was to better understand the risks of elevated copper levels at US schools and childcare centers. Copper health effects, chemistry, occurrence, and remediation actions were reviewed. Of the more than 98,000 schools and 500,000 childcare centers, only 0.2% had copper water testing data in the federal Safe Drinking Water Information System database. Of the facilities designated public water systems, about 13% had reported an exceedance. Schools that were not designated a public water system (PWS) also had exceedances. Few studies document levels in schools and childcare centers. Widely different sampling and remedial actions were reported. Flushing contaminated water was the most evaluated remedial action but was unreliable because copper quickly rebounded when flushing stopped. Building water treatment systems have been used, but some were not capable of making the water safe. The health risk was difficult to determine due to the limited occurrence data and lack of best management practice studies. A national drinking water testing campaign and field studies are recommended.

Prevalence of opportunistic pathogens in a school building plumbing during periods of low water use and a transition to normal use

The spread of opportunistic pathogens via building water supply and plumbing is of public health concern. This study was conducted to better understand microbial water quality changes in a LEED-certified school building during low water use (Summer) and normal water use (Autumn). The copper plumbed building contained water saving devices, a hot water recirculation system, and received chloraminated drinking water from a public water system. Three separate sampling events were conducted during the summer break inside the building and another three sampling events were conducted after the school returned to session. Using quantitative PCR, Legionella spp. were detected in all water samples, followed by Mycobacterium spp. (99%). Mycobacterium avium (75%) and Acanthamoeba spp. (17.5%) throughout the building water system. Legionella pneumophila and Naegleria fowleri were not detected in any of the samples. The mean concentrations of Legionella spp., Mycobacterium spp., Mycobacterium avium, and Acanthamoeba spp. detected in water samples were 3.9, 5.7, 4.7, and 2.8 log₁₀ gene copies per 100 ml, respectively. There was a statistically significantly difference in the mean concentrations of Legionella spp., Mycobacterium spp. and M. avium gene markers in water samples between school breaks and when school was in session. Cultivable Legionella were also detected in water samples collected during periods of low water use. This study highlights the need for routine proactive water quality testing in school buildings to determine the extent of drinking water quality problems associated with plumbing and direct action to remediate microbial colonization.

Thirsty? Choose Water! Encouraging Secondary School Students to choose water over sugary drinks. A descriptive analysis of intervention components

BACKGROUND

Childhood obesity is a significant public health issue. Sugar-sweetened beverage (SSB) consumption contributes to this and adolescents are high consumers. This paper provides a descriptive overview of a school-based intervention to address this.

METHODS

61 secondary schools in New South Wales were randomised to receive a behavioural intervention (BI), a chilled water station (CWS), both interventions or neither (control). The BI was delivered through classroom lessons, school-based promotion and vaccination clinic. The CWS intervention included the installation of one CWS per school. Intervention effectiveness over time was assessed via student surveys at baseline, post-intervention and follow-up (individual-level outcomes), feedback from teachers and vaccination nurses, a school information survey, and remotely monitored CWS water usage (school-level outcomes).

RESULTS

Teachers reported the BI was useful in teaching students about drinking water and negative consequences of SSBs. Nurses considered the post-vaccination waiting period a good opportunity to deliver health promotion messages. Students in this group showed statistically significant changes in knowledge about SSBs, dehydration effects and changes in daily SSB consumption (T1 23.18%; T3 18.20%). Positive feedback regarding CWSs was received with an increase in water consumption reported for students in this group (T1 86.15% to T3 89.66%) and a statistically significant increase in students carrying a water bottle to school and filling it observed.

CONCLUSIONS

Both interventions were readily implemented with high levels of acceptability and impact on students' knowledge and SSB consumption. The study demonstrates how to promote water consumption in schools utilising two different interventions. SO WHAT?: Evidence regarding how to decrease SSB consumption amongst secondary school students has been strengthened.

Water Safety in California Public Schools Following Implementation of School Drinking Water Policies

Introduction

Recent legislation requires public and charter schools in California to test drinking water for lead. Our objective was to describe 1) results from this testing program in the context of other available water safety data and 2) factors related to schools and water utilities associated with access to safe drinking water in schools.

Methods

Our study focused on a random sample of 240 California public and charter schools. We used multivariable logistic regression, accounting for clustering of tested water sources in schools, to examine school-level factors associated with failure to meet lead-testing deadlines and any history of water utility noncompliance.

Results

Of the 240 schools, the majority (n = 174) tested drinking water for lead. Of the schools tested, 3% (n = 6) had at least 1 sample that exceeded 15 parts per billion (ppb) (California action level) and 16% (n = 28) exceeded 5 ppb (bottled water standard). Suburban schools had lower odds of being served by noncompliant water systems (OR = 0.17; CI, 0.05–0.64; P = .009) than city schools. Compared with city schools, rural schools had the highest odds of not participating in the water testing program for lead (OR = 3.43; CI, 1.46–8.05; P = .005). Hallways and common spaces and food services areas were the most frequent school locations tested; one-third of all locations sampled could not be identified.

Conclusion

In our study, geography influenced access to safe drinking water in schools, including both water utility safety standards and school lead-testing practices. Considerations for improving the implementation of state lead-testing programs include establishing priority locations for sampling, precisely labeling samples, and developing well-defined testing and reporting protocols.