Drinking Water Consumption Patterns: An Exploration of Risk Perception and Governance in Two First Nations Communities

Domestic access to water in a decentralized truck-to-cistern system: a case study in the Northern Village of Kangiqsualujjuaq, Nunavik (Canada)

Municipal water supply through truck-to-cistern systems is common in northern Canada. Household satisfaction and concerns about water services likely impact user preferences and practices. This case study explores household perspectives and challenges with regard to domestic access to water in a decentralized truck-to-cistern system. A case study was conducted in the Northern Village of Kangiqsualujjuaq, Nunavik (Quebec, Canada). A paper-based questionnaire was completed by 65 households (one quarter of the population). Many households (37%) reported not drinking tap water from the truck-to-cistern system. Chlorine taste was a frequently reported concern, with those households being significantly less likely to drink water directly from the tap (p = 0.002). Similarly, households that reported a water shortage in the previous week (i.e., no water from the tap at least once) (33%) were more likely to express dissatisfaction with delivered water quantity (rs = 0.395, p = 0.004). Interestingly, 77% of households preferred using alternative drinking water sources for drinking purposes, such as public tap at the water treatment plant, natural sources or bottled water. The study underscores the importance of considering household perspectives to mitigate the risks associated with service disruptions and the use of alternative sources for drinking purposes.

Consumption of Tap Water and Sociodemographic-Associated Characteristics: A Nationwide Cross-Sectional Study

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N = 45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water made up 19,674, with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, people concerned about waste production and climate change, and those coming from the north-east regions of Italy. Underweight people showed a higher prevalence of TW consumption as well as those who less than occasionally drank carbonated drinks, drank alcohol, consumed vegetables more than once a day and snacks less than once a week, dairy products more than once a day, sweet less than once a week, cured meat less than once a week, and chicken meat less than once a week, those with no consumption of sheep meat, consumption of beef meat less than once a week and consumption of pork meat less than once a week, and those with a satisfactory level of perceived health status. Regressions showed that all other age classes are less likely to drink tap water than people younger than 20 years old. The category with "inadequate" economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as islands. A concern about waste production and climate change is associated with an increased likelihood of consuming tap water. Tap water consumption was negatively associated with obesity but not with a satisfactory self-perceived health status. Insights from this study can inform public health strategies.

Domestic water security in the Arctic: A scoping review

INTRODUCTION

More than 50 million people living in the Arctic nations remain without access to safely managed drinking water services. Remote northern communities, where large numbers of Indigenous peoples live, are disproportionally affected. Recent research has documented water and health-related problems among Indigenous communities, including poor water quality and insufficient quantities of water.

OBJECTIVE

The objective of this scoping review is to examine the extent of available water security evidence as well as identify research gaps and intervention priorities to improve access to domestic water in the Arctic and Subarctic regions of the eight Arctic nations (Canada, the Kingdom of Denmark (Greenland), Finland, Iceland, Norway, Sweden, Russia, and the United States (Alaska)).

METHODS

An extensive literature review was conducted to retrieve relevant documentation. Arctic & Antarctic Regions, Compendex, Geobase, Georef, MEDLINE and Web of Science databases were searched to identify records for inclusion. The initial searches yielded a total of 1356 records. Two independent reviewers systematically screened identified records using selection criteria. Descriptive analyses were used to summarize evidence of included studies.

RESULTS

A total of 55 studies, mostly conducted in Canada and the United States, were included and classified by four predetermined major dimensions: 1) Water accessibility and availability; 2) Water quality assessment; 3) Water supply and health; 4) Preferences and risk perceptions.

CONCLUSIONS

This scoping review used a global approach to provide researchers and stakeholders with a summary of the evidence available regarding water security and domestic access in the Arctic. Culturally appropriate health-based interventions are necessary to ensure inclusive water services and achieve the Sustainable Development Goals (SDG) targets for universal access to water.

Risk perception from the consumption of untreated drinking water in a small island community

A small island community in Malaysia uses gravity-fed drinking water, and rejected water treatment by the authorities. This study was conducted to evaluate the community's risk perception towards their untreated water supply by interviewing one adult per household in four out of eight villages on the island. The survey asked questions on risk perception, socioeconomic characteristics, and perception of water supply quality. Water samples were collected from a total of 24 sampling locations across the four villages, and 91.7% of them were positive for E.coli. The study surveyed 218 households and found that 61.5% of respondents agreed to some degree that the water is safe to drink without treatment, while 67.9% of respondents disagreed to some degree that drinking tap water is associated with health risks, and 73.3% of respondents agreed to some degree that it is safe to drink directly from taps that are fitted with water filters. Using factor analysis to group the risk perception questions and multivariable GLM to explore relationships with underlying factors, the study found that older respondents, lower income level, positive water odour perception and positive water supply reliability perception lowers risk perception. The village of residence also significantly affects the risk perception level in the model.

Water consumption habits of a north-western Turkish community: a cross-sectional study

The aim was to determine the drinking water preferences of people applied to a family health center. This cross-sectional study was carried out from 1 April to 31 May 2022. The data were evaluated using the chi-square test and percent ratios with a significance of p < 0.05. The mean age of all 432 respondents was 48.03 ± 15.86. It was determined that those aged 31-45 had drunk more bottled water (p < 0.01) and more spring water (p < 0.001), than those aged 65 and above and had more purified water (p < 0.001), than women who had more tap water (p < 0.001), than married people who had more demijohn and tap water (p < 0.001, each one), than divorced/widows who had more packaged and purified water (p < 0.001, each one), than the illiterate/literate who had bottled water (p < 0.001, per one) and than those who had no income/people who lived on the state or municipal assistance who had only carboy water (p < 0.001). This study suggests that the biggest factor that positively affected the drinking water preference was the packaging of the water. However, the drinking rates of mains water and spring water were quite low. Convincing the authorities to make the mains water drinkable is of great importance in terms of overcoming the public's distrust of mains water.

Do health risk perceptions motivate water - and health-related behaviour? A systematic literature review

Health-related risk perceptions are important determinants of health behaviours and components of behaviour change theories. What someone thinks or feels will motivate or hinder their intention or hesitancy to implement a certain behaviour. Thus, a perceived potential risk to our health and well-being can influence our health-promoting and/or health-seeking behaviour. We aimed to review and synthesize available peer-reviewed literature to better understand the links between water and health-related risk perceptions and behaviours. We conducted the first systematic review of peer-reviewed literature on risk perceptions and behaviours in the context of water and health, published between 2000 and 2021. A total of 187 publications met the inclusion criteria. We extracted data relating to study characteristics and categorized our results according to the major themes emerging from the literature, namely drinking water, sanitation, hygiene and wasterelated topics, health risk factors, diseases and mental health implications, and preventative measures. Our review shows that the literature has grown over the past twenty years, reporting information from different countries belonging to different income groups around the globe, conducted in various settings and contexts, among different target populations, from various disciplinary angles, using different methods, theories and approaches. Our review provides evidence of health risk perceptions determining behaviour particularly related to drinking water sources and water safety. Evidence on disease prevention, health seeking, variations and changes in perception and behaviour over space, geography, socioeconomic differences and time, and the relevance of cultural context is provided. Our review shows that risk perception studies are vital for WASH governance in terms of policy, raising awareness, education and behaviour change. In order to make risk perception and behaviour studies even more relevant to effective public health planning and health messaging, future research needs to increasingly focus on early culturally sensitive interventions and changes in perceptions and behaviours over time.

Integrated probabilistic-fuzzy synthetic evaluation of drinking water quality in rural and remote communities

An integrated probabilistic-fuzzy synthetic evaluation (PFSE) approach was developed for assessing drinking water quality in rural and remote communities (RRCs) through the lens of health risks and aesthetic impacts. The probabilistic health risk assessment can handle aleatory uncertainty raised by the variation of contaminant concentrations, and fuzzy synthetic evaluation (FSE) can address vagueness and ambiguity in human perception of risks and aesthetic impacts. The PFSE approach was applied to five RRCs in British Columbia, Canada where different drinking water quality issues, including high metal(loids) concentrations, the presence of coliforms, and poor aesthetics were reported. Cancer, non-cancer, and microbial risks assessed, as well as both quantitative and qualitative aesthetic impact assessment outcomes, were aggregated into synthetic water quality indices for water quality ranking. The probabilistic health risk assessment results revealed significant health risks for a community with relatively high arsenic concentrations (mean value = 7.0 μg/L) in the water supply. The microbial risks were also found significant (disability-adjusted life years >1 × 10^-6) for all communities because of the presence of coliforms in the water. The FSE results indicated that the drinking water quality of five RRCs was associated with high aggregated impacts, which concurred with the "poor" water quality ratings according to the Canadian Water Quality Index. The water quality of the five RRCs was ranked based on the synthetic water quality evaluation indices. The PFSE approach can help decision-makers prioritize RRCs in effective resource allocation for addressing drinking water quality issues.

Drinking water perception and consumption in Canadian subarctic Indigenous communities and the importance for public health

Resource development and climate change are increasing concerns regarding safe water for Indigenous people in Canada. A research study was completed to characterize the consumption of water and beverages prepared with water and identify the perception of water consumption in Indigenous communities from the Northwest Territories and Yukon, Canada. As part of a larger research program, data for this study were available from a 24-hour recall dietary survey ( n = 162), a health messages survey ( n = 150), and an exposure factor survey ( n = 63). A focus group was conducted with Elders in an on-the-land camp setting. The consumption of water-based beverages in winter was 0.9 L/day on average, mainly consisting of tea and coffee. Of the 81% of respondents who reported consuming water-based beverages in the previous 24 hours of the survey, 33% drank more bottled water than tap water. About 2% of respondents consumed water from the land (during the winter season). Chlorine smell was the main limiting factor reported to the consumption of tap water. Results from the focus group indicated that Indigenous knowledge might impact both the perception and consumption of water. These findings aim to support public health efforts to enable people to make water their drink of choice.