Dampaknya pada Kesehatan Manusia

Pipa limbah. Foto © Joe Miller

Contamination of drinking water is the primary pathway for pathogens in human waste to spread diseases to and from people. People are also exposed to these patogen melalui tanah, makanan yang ditanam di tanah yang terkontaminasi, makanan laut yang dipanen dari air yang terkontaminasi, dan mandi serta berkembang biak di perairan yang tercemar.

Tanda kontaminasi limbah brian auer creative commons

Tanda peringatan kontaminasi limbah di pantai. Foto © Brian Auer, Creative Commons

Infectious diseases from exposure to human waste include bacterial salmonella, parasitic giardia and hookworm, diantara yang lain. Exposure can also lead to topical ailments, such as rashes, and skin infections. ref

Patogen dan Penyakit Menular

Diarrheal diseases, such as rotavirus, cholera, and typhoid, are the dominant health concern related to wastewater pollution, causing 1.6 million deaths in 2017. ref Penyakit-penyakit ini dapat menyebabkan dehidrasi parah, malnutrisi, dan stunting pada anak-anak, sehingga mengganggu pertumbuhan dan perkembangan mental mereka. ref The result can be lifelong health complications and damaging consequences for entire communities. See the case study from Bavu and Namaqumaqua villages in Fiji detailing the implementation of sanitation systems to address typhoid outbreaks and other impacts of wastewater pollution.

Pathogens in oysters and other shellfish cause 4 million cases of Hepatitis A and E every year, with roughly 40,000 deaths and another 40,000 cases of long-term disability from chronic liver damage. ref

In a recent study along the coast of Myanmar, Littman and colleagues (2020) ref identified 5,459 bacterial pathogens in oyster tissue, marine sediments, and seawater. They reported that 51% of the pathogens found in the oyster samples were known to be detrimental and of emerging concern to human health.

In addition to gastrointestinal infections, terbuka di jendela baruswimmers exposed to polluted waters are at risk for chest, ear, eye, and skin infections, as well as hepatitis.

Contact with human waste represents an urgent challenge particularly in developing areas, and has led to the development of the Water, Sanitation, and Hygiene (WASH) sector.

MENCUCI
The Water, Sanitation, and Hygiene (WASH) sector is a field dedicated to sanitation services for the protection of human health. This work includes improving the access and quality of drinking water, safe and effective sanitation systems, and hygienic behaviors. It is focused primarily on the development of areas without water or sanitation infrastructure.
 

Lack of Access to Sanitation, by Region ref

DaerahNumber of People without Access to Sanitation
Asia selatan953 juta
Sub-Sahara Afrika695 juta
Asia Timur337 juta
South Eastern Asia176 juta
Amerika Latin dan Karibia106 juta
daerah lain98 juta

Kontaminan Lainnya

Other contaminants from human waste are hazardous for humans as well, including high nutrient concentrations. Chemicals of emerging concern (CECs) are often not removed from wastewater during treatment and easily enter the marine environment. Exposure can occur through ingestion of contaminated seafood or direct contact with small concentrations in water over time. Some examples include:

  • Heavy metals can impede critical bodily functions when ingested and accumulated. ref
  • Obat-obatan, produk perawatan pribadi, dan produk pembersih rumah tangga termasuk di antara KTK yang diketahui menyebabkan gangguan endokrin pada manusia, yang menyebabkan konsekuensi negatif pada kesehatan reproduksi. ref
  • Karenia brevis, the marine dinoflagellate that causes red tides, a type of harmful algal bloom, produces brevetoxins that can aerosolize. These toxins have been associated with increased incidence of asthma, and a 40% increase in emergency room admissions for gastrointestinal disease during red tide events. ref

Nitrat dalam air minum bisa menyebabkan Methemoglobinemia pada anak-anak dan paparan neurotoksin yang dihasilkan oleh alga biru-hijau dapat menyebabkan gejala Alzheimer. ref Recent studies have linked nitrates in drinking water to colon, ovarian, thyroid, kidney, and bladder cancer in adults. ref In fact, numerous studies have shown that increased risk of cancer occurs with nitrates at levels below the U.S. standard of 10 parts per million. ref A Danish study reported increased risk of colon cancer with nitrate levels above 3.87 parts per million. ref

Spesies ganggang tertentu, Pseudo-nitzchia australiis, menghasilkan asam domoat, yang terakumulasi dalam organisme akuatik dan menyebabkan gangguan neurologis yang disebut ASP pada manusia. Kejang, halusinasi, kehilangan ingatan, dan muntah yang bergejala dapat disebabkan oleh paparan dosis kecil dari waktu ke waktu, yang merupakan bahaya kesehatan yang khas dari racun yang ditularkan oleh alga. ref

Contamination from wastewater not only compounds health concerns, it jeopardizes fisheries, an essential source of protein for nutrition and livelihoods, and threatens coral reefs, which also provide food, livelihood security, coastal protection, and homes to many species essential to medical products. ref

Resistensi antimikroba

The increase in antibiotic-resistant pathogens, or “superbugs,” is probably the most concerning human health impact we face related to wastewater pollution. Antimicrobial resistance is responsible for 700,000 deaths annually, a number that is growing because of terbuka di jendela barupoor antibiotic stewardship (i.e., over-prescribing antibiotics), lack of sanitation, insufficient wastewater treatment, and discharge into the environment. ref Superbugs originate with illness that is treated – often liberally – with antibiotics. These antibiotics make it into wastewater, where they mingle with microbes. The antibiotics kill many microbes, while other microbes that have the genetics to resist lower doses of antibiotics, are selected for and increase in relative abundance. If not properly treated, these new superbugs make their way into the environment. It is a dangerous feedback loop of disease, antibiotics, commingling, and exposure. There is a growing realization that wastewater treatment plants are a breeding ground for superbugs. ref Improving sanitation and wastewater treatment is a critical component of addressing this threat to human health.

Reducing pollution and the prevalence of superbugs also benefits ocean health. With the COVID-19 pandemic, the importance of public health in even distant places has never been more appreciated. Local or regional wastewater pollution challenges have the potential to create global health crises. Taneja and Sharma ref document an excellent example of the severity of this situation in India. Throughout the country, there has been liberal and injudicious use of antibiotics to treat many illnesses. This practice has led to one of the highest rates of resistance to antimicrobial agents used to treat humans and food animals, and to one of the highest concentrations of drug-resistant microbes in natural water bodies. Their findings are a warning to the rest of the global community, while the containment plans now being put in place (reduction in antibiotic use and ban of wastewater sludge application to agricultural fields) serve as a model of how to abate the issue.

Konsekuensi Kesehatan Tidak Langsung

Open defecation or unsafe sanitation facilities (without lights or privacy) are particularly concerning for women, creating opportunities for harassment or violence. Gender disparities resulting from inadequate sanitation are furthered when girls miss school during menstruation or women spend excess time finding clean drinking water. Sanitation interventions often require contact with human waste during collection and treatment and minimizing this contact is increasingly recognized as essential for public health.

While raw human waste and partially treated wastewater present the most significant threats to human health, hazards also exist in byproducts of treated wastewater as well. Disposal of biosolid menempatkan populasi di dekatnya pada risiko terhirup atau tertelannya patogen yang terbawa udara. ref

Sanitasi yang aman telah ditentukan oleh Program Pemantauan Bersama (JMP) as systems that address the entire sanitation service chain. Improved sanitation includes consideration of waste beyond containment on site. Contact with human waste during collection and treatment, or because of the lack of collection and treatment, has become an important component of implementing sanitation solutions, and minimizing this contact is increasingly recognized as essential for human health. Although progress is being made, most of the world’s population does not have access to adequate sanitation to protect public health. According to the World Health Organization (WHO), nearly 6 in 10 people did have access to safely managed sanitation services in 2017. ref

 

Gangguan akses global ke layanan sanitasimembuka file IMAGE

Rincian akses global ke layanan sanitasi (gambar kiri) dan Tangga Sanitasi (gambar kanan) yang digunakan oleh JMP untuk mengevaluasi intervensi sanitasi. Sumber: terbuka di jendela baruWHO dan UNICEF

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