Tuesday, 20 March 2012

WaSH and One Health; Microbial impacts of animal agriculture on water quality and human health risks


Before he became the director of the Water Institute at the University of North Carolina at Chapel Hill in 2009, Dr. Jamie Bartram spent ten years at the World Health Organization coordinating water, sanitation, hygiene and health.  He has worked in about 40 developing and developed countries and describes himself as a “generalist” in water and health.

Dr. Bartram began his lecture by asking the audience for estimates on how much disease could be prevented by better managing water, sanitation and hygiene.  Estimates ranged greatly, reaching as high as 90%.  Although the correct answer was that “almost one tenth of the global disease burden could be prevented by improving water supply, sanitation, hygiene and management of water resources," we later learned that this is most likely an underestimation. 

Dr. Jamie Bartram, PhD (Professor, Department of Environmental Sciences & Engineering at UNC) discusses WaSH and One Health.

Water risk factors comprise a medium to transmit pathogens and toxic chemicals, services that contribute to disease prevention and conversely the absence of which increase diseases risk, the development of natural resources and ecosystems, and behaviors (far fewer people wash their hands after using the restroom than we would hope!).  The major causes of water-related morbidity and mortality include diarrhea, malnutrition and malnutrition-associated disease, drowning, malaria, intestinal infections, trachoma, and schistosomiasis.  Diarrhea and the consequences of diarrhea are responsible for 65% of the Disability-Adjusted Life Years (the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability).

Dr. Bartram’s other take home points were that 1) interventions to improve water safety are cost-effective, returning $3-$4 to each dollar invested; 2) policy goals such as the Millennium Development Goals are inadequately ambitious; and 3) multidisciplinary collaboration is necessary and water safety is in part the responsibility of health professionals.

The second speaker, Dr. Mark D. Sobsey, is a Kenan Distinguished Professor of Environmental Sciences and Engineering at the UNC Gillings School of Global Public Health.  Dr. Sobsey specializes in Environmental Health Microbiology and Water Sanitation and Hygiene.  His lecture focused on the human and environmental risks of waterborne pathogens associated with food animal production systems.

Dr. Mark Sobsey, MS, PhD (Professor, Department of Environmental Sciences & Engineering at UNC; Director, Environment Microbiology Laboratory at UNC) discusses the microbial impacts of animal agriculture on water quality and human health risks.


Food animals such as swine, poultry, and cattle are often fed antibiotics in their diet to fight pathogenic bacteria.  The use of antibiotics leads to the development and fecal excretion of high concentrations of both the antibiotic resistant bacteria and the antibiotics.  Dr. Sobsey explained the importance of managing the manure waste of these animals so that the bacteria, as well as other pathogens that infect the animals, do not contaminate ambient waters.  He presented evidence that these pathogens currently do infect ambient waters and that there presence might pose risks to human health such as waterborne outbreaks.

Dr. Sobsey’s presentation really emphasized the interconnectedness between humans, animals, and the environment as well as the value of One Health’s holistic approach to the prevention of disease and the maintenance of both animal and human health.

Post authored by Mary Key, A.B. (UNC Master’s in Public Health Candidate)

Up Next (20 March): 
                        A One Health approach to the leading cause of death in children
William Pan, PhD, Assistant Professor of Global Environmental Health at Duke

Public health issues related to industrial food animal production
                        Beth Feingold, MPH, PhD, Postdoctoral Fellow at Johns Hopkins University