Pond KR, Pedley S (2011) Background, In: Cameron J, Hunter P, Jagals P, Pond K (eds.), Valuing Water, Valuing Livelihoods.1pp. 1-14 IWA on behalf of World Health Organization
Hunter PR, Pond K, Jagals P, Cameron J (2009) An assessment of the costs and benefits of interventions aimed at improving rural community water supplies in developed countries, SCIENCE OF THE TOTAL ENVIRONMENT407(12)pp. 3681-3685 ELSEVIER SCIENCE BV
Pond KR, Pedley S (2011) Current situation in access to drinking-water, In: Cameron J, Hunter P, Jagals P, Pond KR (eds.), Valuing Water, Valuing Livelihoods4pp. 55-74 IWA on behalf of World Health Organization
Pond KR, Rees G, Kay D, Bartram J, Santo Domingo J (2010) Safe Management of Shellfish and Harvest Waters, pp. 1-346 IWA on behalf of World Health Organization
Pond KR, Rangdale R, Meijer WG, Brandao J, Falcao L, Rince A, Masterson B, Greaves J, Gawler A, McDonnell E, Cronin AA, Pedley S (2004) Workshop report: Developing pollution source tracking for recreational and shellfish waters, ENVIRONMENTAL FORENSICS5(4)pp. 237-247 TAYLOR & FRANCIS LTD
Cameron J, Jagals P, Hunter PR, Pedley S, Pond K (2011) Economic assessments of small-scale drinking-water interventions in pursuit of MDG target 7C, Sci Total Environ410(411)pp. 8-15
This paper uses an applied rural case study of a safer water intervention in South Africa to illustrate how three levels of economic assessment can be used to understand the impact of the intervention on people's well-being. It is set in the context of Millennium Development Goal 7 which sets a target (7C) for safe drinking-water provision and the challenges of reaching people in remote rural areas with relatively small-scale schemes. The assessment moves from cost efficiency to cost effectiveness to a full social cost-benefit analysis (SCBA) with an associated sensitivity test. In addition to demonstrating techniques of analysis, the paper brings out many of the challenges in understanding how safer drinking-water impacts on people's livelihoods. The SCBA shows the case study intervention is justified economically, though the sensitivity test suggests 'downside' vulnerability.
Pond KR, Charles K (2015) Drinking water quality regulations,In: Bartram J, Baum R, Coclinis PA, Gute DM, Kay D, McFayden S, Pond K, Robertson W, Rouse MJ (eds.), Routledge Handbook of Water and Health44pp. 447-454
Pond KR, Bartram J, Chartier Y, Lee JV (2007) Legionella and the Prevention of Legionella, pp. 1-252 World Health Organization
Pond KR, Murcott S, Gute D (2015) Introduction to interventions to reduce water-related disease, In: Bartram J, Baum R, Coclanis P, Gute DM, Kay D, McFayden S, Pond K, Robertson W (eds.), Routledge Handbook of Water and Health17pp. 185-190 Routledge
Swimming pools provide an excellent facility for exercise and leisure but are also prone to contamination from microbial pathogens. The study modelled a 50-m x 20-m swimming pool using both a small scale physical model and computational fluid dynamics to investigate how water and pathogens move around a pool in order to identify potential risk spots.
Our study revealed a number of lessons for pool operators, designers and policy makers: disinfection reaches the majority of a full scale pool in approximately 16 minutes operating at the maximum permissible inlet velocity of 0.5m/s. This suggests that where a pool is designed to have 15 paired inlets it is capable of distributing disinfectant throughout the water body within an acceptable time frame.
However, the study also showed that the exchange rate of water is not uniform across the pool tank and that there is potential for areas of the pool tank to retain contaminated water for significant periods of time. ?Dead spots? exist at either end of the pool where pathogens could remain. This is particularly significant if there is a faecal release into the pool by bathers infected with Cryptosporidium parvum, increasing the potential for waterborne disease transmission.
Background The Ebola virus disease outbreak that started in Western Africa in 2013 was unprecedented because it spread within densely populated urban environments and affected many thousands of people. As a result, previous advice and guidelines need to be critically reviewed, especially with regard to transmission risks in different contexts.
Methods Scientific and grey literature were searched for articles about any African filovirus. Articles were screened for information about transmission (prevalence or odds ratios especially). Data were extracted from eligible articles and summarised narratively with partial meta-analysis. Study quality was also evaluated.
Results 31 reports were selected from 6552 found in the initial search. Eight papers gave numerical odds for contracting filovirus illness, 23 further articles provided supporting anecdotal observations about how transmission probably occurred for individuals. Many forms of contact (conversation, sharing a meal, sharing a bed, direct or indirect touching) were unlikely to result in disease transmission during incubation or early illness. Amongst household contacts who reported directly touching a case, the attack rate was 32% (95% CI 26-38%). Risk of disease transmission between household members without direct contact was low (1%; 95% CI 0-5%). Caring for a case in the community, especially until death, and participation in traditional funeral rites were strongly associated with acquiring disease, probably due to a high degree of direct physical contact with case or cadaver.
Conclusions Transmission of filovirus is unlikely except through close contact, especially during the most severe stages of acute illness. More data are needed about the context, intimacy and timing of contact required to raise the odds of disease transmission. Risk factors specific to urban settings may need to be determined.
Pond K, Kim R, Carroquino MJ, Pirard P, Gore F, Cucu A, Nemer L, MacKay M, Smedje G, Georgellis A, Dalbokova D, Krzyzanowski M (2007) Workgroup report: developing environmental health indicators for European children: World Health Organization Working Group., Environ Health Perspect115(9)pp. 1376-1382
A working group coordinated by the World Health Organization developed a set of indicators to protect children's health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children's Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children's Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002.
Cronin AA, Pond K (2008) Just How Big is the Schism Between the Health Sector and the Water and Sanitation Sector in Developing Countries?, Environ Health Insights2pp. 39-43
Water, sanitation and hygiene are all key aspects to a healthy environment but often they suffer from a lack of coherence within the sector itself and also a lack of synergy with the health sector. This is not acceptable given one quarter of all child deaths are directly attributable to water-borne disease. This lack of synergy is evident at many different layers including planning, resource allocation and donor commitment. Developing countries must, in consultation with their communities, examine their biggest health risks and allocate resources accordingly. Sustained dialogue and increased in-depth analysis are needed to find consensus and an improved synergy across these vital sectors.
The first of these, 'Guidelines for drinking water quality', is particularly useful to all
those concerned with issues related to water quality and health, including
environmental and public health scientists, water scientists, policy-makers and
Pond KR, Pedley S, Joyce E (2011) Interventions for water provision, In: Pond K, Cameron J, Hunter P, Jagals P (eds.), Valuing Water, Valuing Livelihoods7pp. 121-148 IWA on behalf of World Health Organization
Kim R, Carroquino MJ, Cucu A, Georgellis A, Gore F, Mackay M, Nemer L, Pirard P, Pond K, Ramirez-Gonzalez A, Smedje G, Dalbokova D (2006) Developing environmental health indicators for European children, EPIDEMIOLOGY17(6)pp. S166-S166 LIPPINCOTT WILLIAMS & WILKINS
Kinzelman JL, Singh A, Ng C, Pond KR, Bagley RC, Gradus S (2005) Use of IDEXX Colilert-18 (R) and Quanti-Tray/2000 as a rapid and simple enumeration method for the implementation of recreational water monitoring and notification programs, LAKE AND RESERVOIR MANAGEMENT21(1)pp. 73-77 NORTH AMER LAKE MANAGEMENT SOC
Pond KR, Pedley S (2011) Water and Environmental Health, In: Battersby S (eds.), Clay's Handbook of Environmental Health12pp. 522-576 Spon Press
Pond KR, Lewis L (2015) Regulation of swimming pools, In: Bartram J, Baum R, Cochlanis P, Gute D, Kay D, McFayden S, Pond K, Robertson W, Rouse MJ (eds.), Rouledge Handbook of Water and Health46pp. 468-475 Routledge
Pond KR (2005) Water recreation and Disease. Plausibility of associated infections: acute effects, sequelae and mortality., pp. 1-239 IWA on behalf of World Health Organization
Drinking-water supply and sanitation services are essential for human health, but their technologies and management systems are potentially vulnerable to climate change. An assessment was made of the resilience of water supply and sanitation systems against forecast climate changes by 2020 and 2030. The results showed very few technologies are resilient to climate change and the sustainability of the current progress towards the Millennium Development Goals (MDGs) may be significantly undermined. Management approaches are more important than technology in building resilience for water supply, but the reverse is true for sanitation. Whilst climate change represents a significant threat to sustainable drinking-water and sanitation services, through no-regrets actions and using opportunities to increase service quality, climate change may be a driver for improvements that have been insufficiently delivered to date.
Pond KR, Cameron J, Hunter P, Jagals P (2011) Valuing Water, Valuing Livelihoods, pp. 1-239 IWA on behalf of World Health Organization
Edmunds KL, Abd Elrahman S, Bell DJ, Brainard J, Dervisevic S, Fedha TP, Few R, Howard G, Lake I, Maes P, Matofari J, Minnigh H, Mohamedani AA, Montgomery M, Morter S, Muchiri E, Mudau LS, Mutua BM, Ndambuki JM, Pond K, Sobsey MD, van der Es M, Zeitoun M, Hunter PR (2016) Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach,BULLETIN OF THE WORLD HEALTH ORGANIZATION94(6)pp. 424-432
WORLD HEALTH ORGANIZATION
Pond KR (2015) Introduction to exposure pathways, In: Bartram J, Baum R, Coclanis PA, Gute DM, Kay D, McFayden S, Pond K, Robertson W, Rouse M (eds.), Routledge Handbook of Water and Health12pp. 137-143 Routledge
Pedley S, Pond K (2003) Emerging issues in water and infectious disease,
This publication helps to broaden awareness of emerging issued in water and infectiousdisease and to guide readers to sources of information that deal with ...
Pond K, Kim R, Kay D, Aertgeerts R, Dalbokova D (2006) Development of water and sanitation indicators to monitor children's health, EPIDEMIOLOGY17(6)pp. S181-S181 LIPPINCOTT WILLIAMS & WILKINS
Background: The 2013-15 Ebola outbreak was unprecedented due to sustained
transmission within urban environments and thousands of survivors. In 2014 the World
Health Organization stated that there was insufficient evidence to give definitive
guidance about which body fluids are infectious and when they pose a risk to humans.
We report a rapid systematic review of published evidence on the presence of
filoviruses in body fluids of infected people and survivors.
Methods: Scientific articles were screened for information about filovirus in human
body fluids. The aim was to find primary data that suggested high likelihood of actively
infectious filovirus in human body fluids (viral RNA). Eligible infections were from
Marburg virus (MARV or RAVV) and Zaire, Sudan, Taï Forest and Bundibugyo species
of Ebola.  Cause of infection had to be laboratory confirmed (in practice either tissue
culture or RT-PCR tests), or evidenced by compatible clinical history with subsequent
positivity for filovirus antibodies or inflammatory factors. Data were extracted and
Results: 6831 unique articles were found, and after screening, 33 studies were eligible.
For most body fluid types there were insufficient patients to draw strong conclusions,
and prevalence of positivity was highly variable. Body fluids taken >16 days after onset
were usually negative. In the six studies that used both assay methods RT-PCR tests
for filovirus RNA gave positive results about 4 times more often than tissue culture.
Conclusions: Filovirus was reported in most types of body fluid, but not in every sample
from every otherwise confirmed patient. Apart from semen, most non-blood, RT-PCR
positive samples are likely to be culture negative and so possibly of low infectious risk.
Nevertheless, it is not apparent how relatively infectious many body fluids are during or
after illness, even when culture-positive, not least because most test results come from
more severe cases. Contact with blood and blood-stained body fluids remains the major risk for disease transmission because of the known high viral loads in blood.
Boldo E, Medina S, Kozisek F, Cambra K, Gonzalez M, Le Tertre A, Beaudeau P, Pirard P, Mouly D, Stilianakis N, Mekel O, Pond K, Kay D, Aergeerts R, Posada M, Carroquino MJ, Ramirez A, Elreedy S, Dalbokova D, Krzyzanowski M (2006) Assessing the implementation of health impact assessment for drinking-water pollution in European countries, EPIDEMIOLOGY17(6)pp. S446-S446 LIPPINCOTT WILLIAMS & WILKINS
Drinking-water supply and sanitation services are essential for human health, but their technologies and management systems are potentially vulnerable to climate change. An assessment was made of the resilience of water supply and sanitation systems against forecast climate changes by 2020 and 2030. The results showed very few technologies are resilient to climate change and the sustainability of the current progress towards the Millennium Development Goals (MDGs) may be significantly undermined. Management approaches are more important than technology in building resilience for water supply, but the reverse is true for sanitation. Whilst climate change represents a significant threat to sustainable drinking-water and sanitation services, through no-regrets actions and using opportunities to increase service quality, climate change may be a driver for improvements that have been insufficiently delivered to date. © IWA Publishing 2010.
Lewis L, Chew J, Woodley I, Colbourne J, Pond K (2015) The application of computational fluid dynamics and small-scale physical models to assess the effects of operational practices on the risk to public health within large indoor swimming pools, JOURNAL OF WATER AND HEALTH13(4)pp. 939-952 IWA PUBLISHING
Edmunds KL, Elrahman SA, Bell DJ, Brainard J, Pond KR, Hunter P (2016) Risk Factors for Community Transmission of Filovirus infections (Ebola and Marburg): A Systematic Review and Meta-analysis, International Journal of Epidemiology
Objective: The current outbreak of the Zaire strain of Ebola virus disease (ZEBOV) within West Africa is on a scale unprecedented for any human filovirus, resulting in a public health situation requiring a multiagency international response to address a medical and socioeconomic emergency in one of the world?s most deprived regions. The aim of this research was to assess the risks associated with the disposal of human waste outside of healthcare settings, within communities experiencing Ebola virus (EBOV) outbreaks and to generate recommendations mitigating these risks.
Methods: This research utilises the Hazard Analysis of Critical Control Points (HACCP) framework: an ideal tool for this scenario as it is low-cost, fit-for-purpose and encourages interdisciplinary expertise whilst enabling generation of evidence-based recommendations. This work builds upon the successes of Water Safety Plans, which have been applied in over 70 countries, utilizing the HACCP framework to improve regulation and safe management of drinking-water supplies to reduce risks of waterborne diseases.
Findings: We identify practices associated with health care and faecal waste disposal which present unacceptable risk levels for potential EBOV transmission, as well as other blood-borne or faecal-oral diseases such as respectively, hepatitis and cholera. We make recommendations, based-on existing evidence, for strategies which can reduce and mitigate transmission-risks. These strategies, in turn, will reduce the threat to human health, the burden on health services and the pressure on national/regional economies.
Conclusion: This assessment provides compelling evidence that HACCP assessments have strong potential as a tool to rapidly respond to emerging infectious disease outbreaks.
Kinzelman JL, Dufour AP, Wymer LJ, Rees G, Pond KR, Bagley RC (2006) Comparison of multiple point and composite sampling for monitoring bathing water quality, LAKE AND RESERVOIR MANAGEMENT22(2)pp. 95-102 NORTH AMER LAKE MANAGEMENT SOC
Pond KR, Kinzelman J, Kay D (2011) Relating MST results to fecal indicator bacteria, pathogens, and standards, In: Hagedorn C, Blanch AL, Harwood VJ (eds.), Microbial Source Tracking: Methods, Applications, and Case Studies15pp. 337-359 Springer
Among the many uncertainties presented by poorly studied pathogens is possible transmission via human faecal material or wastewaters. Such worries were a documented concern during the 2013 Ebola outbreak in West Africa. Using published experimental data on virus inactivation rates in wastewater and similar matrices, we extracted data to construct a model predicting the T90 (1 x log10 inactivation measured in seconds) of a virus. Extracted data were: RNA or DNA genome, enveloped or not, primary transmission pathway, temperature, pH, light levels and matrix. From the primary details, we further determined matrix level of contamination, genus and taxonomic family. Prior to model construction, three records were separated for verification. A censored normal regression model provided the best fit model, which predicted T90 from DNA or RNA structure, enveloped status, whether primary transmission pathway was faecal-oral, temperature and whether contamination was low, medium or high. Model residuals and predicted values were evaluated against observed values. Mean values of model predictions were compared to independent data, and considering 95% confidence ranges (which could be quite large). A relatively simple model can predict virus inactivation rates from virus and matrix attributes, providing valuable input when formulating risk management strategies for little studied pathogens.
Health data in low- and middle-income countries are often inconsistent and of poor quality, or simply non-existent. This impedes the ability of countries themselves and the international community to arrive at a precise understanding of national burden of disease patterns. The sophisticated statistical modeling and projection methods used internationally to compensate for missing country data cannot provide more than ?best estimates,? with no possibility of verifying their outputs. The result is continuing unnecessary morbidity and mortality, often in children under five years of age, as data deficiency translates into insufficient information to guide policy and technical interventions, and to enable prioritization in resource dissemination.
This research therefore aims to assess the quality and quantity of data available at country level for the purpose of estimating the burden of disease. It highlights the frequently weak and fragmented nature of what data is present, together with capacity deficiencies at both institutional and individual level to gather, analyse and interpret health and related data. A particular focus is placed on assessing the burden of disease attributable to environmental risk factors, specifically for unsafe water, sanitation and hygiene, together with those elements of malnutrition deriving directly from these factors. Combining these two sets of risk factors to derive estimates of their burden of disease at country level is a new approach and not yet undertaken by countries.
Case-study is the central method used. Two country cases (Uganda and Mozambique) were selected by convenience sampling as WHO missions on related topics were taking place at this time. Detailed information on institutional and individual data understanding and capacity was obtained through semi-structured interviews. Extensive evaluation or assessment of existing data and internationally applied methodologies has also been carried out to demonstrate the extent and impact of the present data weakness and paucity that form the rationale for carrying out this work. Other cases have been used to demonstrate the synthesis of water, sanitation and hygiene statistics and methods with those of malnutrition.
Enabling a move from globally generated estimates based on limited national data in which country users have little confidence, to better quality and reliable statistics based on stronger national data is the root of this study. Having clarified the health impacts of data deficiency, its principal contribution is the development and testing of a tool to overcome these deficiencies, offering country users a way to radically improve their national data systems.
A prototype National Burden of Disease (NBD) Toolkit had earlier been developed by WHO but had operational weaknesses and hence poor uptake by countries. Moving from problem analysis to problem solving, this study has devised a method of linking the various spreadsheets comprising the NBD, creating a logical, simplified, and systematic interface between its elements and thereby making it easier and more appealing to the user. The tool, with its user-friendly interface, can thus now become a suitable support to national-level burden of disease estimation work, and contribute to creating further awareness of the value of timely data and their role in health development.
The present scope of work with the tool and interface fills a pressing gap, yet is limited. Further testing in a wider range of countries in different geographic regions is needed. Nonetheless, the initial results and growing uptake give confidence that this and similar future approaches will fall on fertile ground. As country-level institutions become more accustomed to using tools of this kind to fill long-standing data gaps and quality issues, it can be anticipated that they will feel greater confidence in their own data, reduced reliance on internationally-generated
The framework for safe drinking-water recommended by the WHO guidelines for drinking-water quality promotes
a risk-based preventive management approach to ensure safety of drinking-water. Independent drinking-water
surveillance is one of the core components of this framework and is an essential public health function. To be
effective, drinking-water surveillance needs to be aligned with risk-based principles, including prioritization of
monitoring parameters and surveillance efforts based on water safety plan outcomes. Risk-based drinking-water
surveillance comprises an independent and periodic review of all aspects of drinking-water quality and public health
safety in which water-quality monitoring, on-site inspections, hazard identification and risk and trend analysis are
important components. Applying a risk-based approach in drinking-water surveillance helps countries to focus on
the issues that are most important for the protection of public health and so maximizes the benefits that can accrue
from limited resources.
Small drinking-water supplies face particular challenges in terms of their management. Being vulnerable to contamination but often not monitored regularly nor well-maintained, small
drinking-water supplies may pose consequences for health of users. Sanitary inspection (SI) is a risk
assessment tool to identify and manage observable conditions of the water supply technology or circumstances in the catchment area that may favour certain hazardous events and introduce hazards which may become a risk to health. This qualitative research aimed to identify the strengths and
weaknesses of the SI tool as published by the World Health Organisation to inform a review and
update of the forms and to improve their robustness. The study identified a number of benefits
of the approach, such as its simplicity and ease of use. Challenges were also identified, such as
potential for inconsistencies in perception of risk between inspectors, in interpreting questions, and
lack of follow-up action. The authors recommend a revision of the existing SI forms to address
the identified challenges and development of complementary advice on possible remedial action to
address identified risk factors and on basic operations and maintenance.