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in bush/field.” National survey data do not Results 2007). The largest chemical concerns from
typically characterize shared facilities because Global pit latrine coverage. Globally, there is excreta disposed in on‑site sanitation systems
they are considered unimproved sanitation. great variability in latrine coverage. We esti- are considered to be nitrate [British Geological
Therefore, for shared sanitation, we applied mate that approximately 1.77 billion people Survey (BGS) 2002; Fourie and Vanryneveld
the average proportion of facilities that were around the world use some form of pit latrine 1995; Pedley et al. 2006], phosphate (Fourie
pit latrines (44%) based on seven national as their primary means of sanitation [Figure 1; and Vanryneveld 1995), and chloride (BGS
surveys that provided more detailed informa- see also Supplemental Material, Table S1 2002) (see Supplemental Material, Table S3).
tion (see Supplemental Material, Table S1). (http://dx.doi.org/10.1289/ehp.1206028)]. Microbiological contaminants associated
Groundwater use comprised both improved In addition, we estimate that 48% of people with pit latrines. Concentrations of most fecal
and unimproved modes of accessing ground using pit latrines use facilities characterized microorganisms decline after excretion, but
water, including tube wells and boreholes, as improved, whereas the remainder uses these microorganisms may still impair ground
protected wells, protected springs, unprotected shared or unimproved facilities (e.g., tradi- water quality. Several approaches have been
wells, and unprotected springs, but not cen- tional latrines or pit latrines without slabs). used to define the quantities and transport
tralized water sources that may originate from The number of users per latrine varies by distances of latrine-derived microbial contami-
groundwater. locale, but based on the excreta produc- nants. The majority of studies that assessed
To calculate the global totals for pit latrine tion rates of Feacham et al. (1983), globally microbiological quality of groundwater in rela-
use, we multiplied the country-wide percent- per day, as much as 2.1 billion kilograms of tion to pit latrines applied culture-based assays
ages by the UN estimates of 2010 populations urine and 0.6 billion kilograms of feces are to measure fecal indicator bacteria (Table 1),
(UN 2011) and summed all data presented deposited into latrines. In the countries where including total coliforms, fecal coliforms, and
in Supplemental Material, Table S1 (http:// pit latrines are prevalent (see Supplemental Escherichia coli (previously known as Bacillus
dx.doi.org/10.1289/ehp.1206028). We used Material, Table S1), > 2 billion people depend coli), which occur in high concentrations in
our estimate of global latrine use in conjunc- on groundwater for their primary drinking the feces of healthy adults and have epide-
tion with estimated excreta production rates of water supply. miological evidence to support their use as
1,200 g urine/person/day and 350 g wet feces/ These calculations are among the first indicators of water quality (Wade et al. 2003).
person/day for rural developing country settings estimates of the numbers of people using pit Caldwell conducted five experimental stud-
(Feacham et al. 1983) to estimate daily quanti- latrines and groundwater in low-income coun- ies in the 1930s and included the colon
ties of urine and feces deposited into latrines. tries. Because some national survey data are aerogenes group and anaerobic bacteria, in
Review of studies on groundwater contami several years old, estimates have a fair degree addition to B. coli, in the analyses (Caldwell
nation from pit latrines. To find relevant of uncertainty at the country level. However, 1937a, 1937b, 1938a, 1938b; Caldwell and
documents describing groundwater contami- our estimate for the total number of people Parr 1937). Only one study analyzed viruses
nation derived from pit latrines, we searched without any sanitation facility (1.11 billion) (adenov irus and rotav irus) to charact erize
the Web of ScienceSM (http://webofknowl- is in agreement with the independently cal- groundwater quality in relation to pit latrines
edge.com/), PubMed (http://www.ncbi.nlm. culated Joint Monitoring Program 2010 esti- (Verheyen et al. 2009). We found no studies
nih.gov/pubmed), and Google (http://www. mate for open defecation (1.1 billion people) that assessed protozoa or helminths, which
google.com/) using the following keywords: (WHO/UNICEF 2012c), which suggests that typically exhibit little movement in ground
“pit latrine” AND “groundwater”; “privy” our approximations may be more robust at the water because of their size (Lewis et al. 1982).
AND “groundwater”; “toilet” AND “ground global level. In addition, our estimate of the The extent to which microbes from pit
water”; “sanitation” AND “groundwater”; total 2010 population for countries included latrine wastes may be transported and con-
“pit latrine” AND “aquifer”; “privy” AND in this analysis (5.22 billion) is consistent taminate groundwater largely depends on the
“aquifer”; “toilet” AND “aquifer”; “sanitation” with the UN population estimate for “less environmental context of the area, particularly
AND “aquifer”; “pit latrine” AND “ground developed regions” [or “all regions of Africa, hydrological and soil conditions. Nearly half
water”; “privy” AND “ground water”; “toi- Asia (excluding Japan), Latin America and the of the studies assessing microbial contami-
let” AND “ground water”; “sanitation” AND Caribbean plus Melanesia, Micronesia and nants used experimental approaches. These
“ground water”; “pit latrine” AND “water Polynesia”] of 5.66 billion (UN 2011). studies included either the installation of test
quality”; “privy” AND “water quality”; “toi- Studies on groundwater contamination wells to measure the quality of water sampled
let” AND “water quality”; “pit latrine” AND from pit latrines. Twenty-four studies directly downgradient of pit latrines, the collection of
“well water”; “privy” AND “well water”; and assessed the transport of contaminants or soil samples, or both. Kligler (1921) sampled
“toilet” AND “well water.” We also searched applied statistical methods to estimate a soil at varying distances from > 50 pit latrines
the resulting reference lists and contacted measure of risk associated with the presence under wet and dry conditions. The maximum
experts to identify additional articles. To pro- of pit latrines (Table 1); these studies assessed distance of bacterial contamination found was
vide a critical review of the literature on the either chemical contaminants (4 studies), 5.5 m from latrines and occurred under wet
occurrence of microbiological and chemical microbial contaminants (2 studies), or and sandy soil conditions. Kligler (1921) sug-
contaminants originating from pit latrines, both (18 studies). Human excreta are the gested that a vertical distance of ≥ 3–4.5 m
we more fully characterized the studies that main input to pit latrines, although other between the bottom of the pit and the water
either directly assessed the fate and transport inputs may contribute significantly to pit table would maintain safe groundwater qual-
of contaminants from pit latrines or studies contents depending on local practices [see ity. In several experim ental studies on pit
that applied statistical methods to estimate a Supplemental Material, Inputs to Pit Latrines, latrines and groundwater, Caldwell (1937a,
measure of risk associated with the presence of p. 3, for additional details (http://dx.doi. 1937b, 1938a, 1938b) and Caldwell and
pit latrines. By synthesizing existing results in org/10.1289/ehp.1206028)]. Human feces Parr (1937) found varying transport distances
terms of siting guidelines for pit latrines and harbor a large number of microbes, including (ranging from 3 to 25 m) among B. coli (i.e.,
well installation, we identified research gaps bacteria, archaea, microbial eukarya, viruses, E. coli), colon aerogenes (i.e., total coliform
that must be addressed in order to make better- and potentially protozoa and helminths (see bacteria), and anaerobes, depending on the
informed decisions to protect water quality Supplemental Material, Table S2) (Feachem degree of soil saturation and the groundwater
and safeguard human health. et al. 1983; Ley et al. 2006; Ramakrishna flow velocity. In a study of a latrine placed in
an alkaline alluvium soil, Dyer (1941) reported quality in preexisting wells and factors such source and at least 1 latrine within a radius
that movement of total coliforms was limited as proximity of pit latrines to assess latrine of 50 m (Figure 2). These authors hypothe
to < 7 m from the pit. A relatively short trans- impacts on groundwater. At a study site in sized that during the wet season, viruses were
port distance was also found in South Africa, India characterized by a shallow water table transported by groundwater flow in the upper
where high fecal coliform counts [> 10 colony and fractured rock aquifer, high concentrations part of the soil, whereas viral transport in the
forming units (cfu)/100 mL] were detected of fecal coliforms were found in domestic wells dry season was more likely a result of virus-
only 1 m from a pit latrine (Still and Nash located near pit latrines and septic tanks (Pujari contaminated surface water.
2002). Dzwairo et al. (2006) found fecal and et al. 2012). At a contrasting site, characterized Associations between groundwater con-
total coliform contamination greatly reduced by alluvial formations, the authors detected tamination and factors related to sanitation
> 5 m from pit latrines. no or low levels of fecal contamination (Pujari facilities are complicated by the co-occurrence
In a study of 12 pour/flush latrines, Banerjee et al. 2012). In a georeferenced spatial study of multiple contaminant sources, particu-
(2011) found that transport of total and fecal of viral contamination, Verheyen et al. (2009) larly when information on groundwater flow
coliforms increased during the monsoon period sampled 287 drinking-water sources (247 water patterns is not available. A study of ground
and in sandy soils. The author noted that the wells, 25 pumps, and 15 surface water samples) water quality in an informal settlement of
maximum travel distance of bacteria was 10 m proximate to 220 latrines. Adenoviral DNA Zimbabwe found detectable total and fecal
from pits (Figure 2). In contrast, in a study in was repeatedly detected in 26 water sources, coliforms in more than two-thirds of study
Zimbabwe, Chidavaenzi et al. (1997) found and rotaviral RNA was detected in 1 source. boreholes and existing domestic wells (Zingoni
that groundwater contamination was higher In multiple rounds of sampling, 40 of the et al. 2005). The abundance of pit latrines,
in the dry season than in the wet season, with 287 drinking-water sources were positive for used in > 75% of the households, and the
coliforms detected up to 20 m from a pit. viral contamination at least once. Verheyen presence of informal trading areas within the
Nearly one-fourth of the studies analyzed et al. (2009) found a significant positive asso- settlement were likely sources of fecal pollu-
associations between microbiological water ciation between viral contamination of a water tion. The authors suggested that shallow wells
Population using
pit latrines for sanitation
0–20%
21–40%
41–60%
61–80%
81–100%
No data
Population using
groundwater for drinking
0–20%
21–40%
41–60%
61–80%
81–100%
No data
Figure 1. Percentage of low-income country populations using pit latrines as a primary sanitation facility (A) and groundwater as a primary drinking water source
(B). Countries with no data presented were not included in the analysis.
and boreholes in the study area, as well as the (2002) found fecal coliforms and streptococci liners as a way to reduce groundwater con-
incomplete lining of most latrines, contributed in sediments 10 m below latrines. tamination from pit latrines, Nichols et al.
to high levels of groundwater contamination Movement of bacteria from latrines is (1983) found fecal coliforms in soil samples
(Zingoni et al. 2005). In a study conducted often limited by formation of a “scum mat,” taken adjacent to only one of five peat-lined
in Moldova, Banks et al. (2002) concluded which develops around the latrine pit and pits, compared with three of three unlined
that groundwater pollution within villages was reduces the movement of fecal bacteria pits. The one peat-lined pit that showed con-
likely caused by latrines, livestock and stored (BGS 2002; Caldwell 1937a). This mat (also tamination was located in shallow and rocky
manure, solid-waste landfills, and leakage from referred to as a “biologically active layer,” soil and was under saturated conditions.
wastewater pits. “biolayer,” or “clogged” zone) enhances bac- Chemical contaminants associated with
Even in areas with a high density of pit teria removal through filtration and predation pit latrines. Nitrate. Because of high con-
latrines, microbiological groundwater contami by antagonistic organisms, but it may take centrations of nitrogen in human excreta,
nation may not necessarily be detected. Three several months to develop around new latrines its adverse impacts to human health, and its
studies found no strong positive association (Caldwell and Parr 1937). In addition, clog- use as an indicator of fecal contamination,
between poor bacteriological water quality ging may result from blockage of soil pores by nitrate has been the most widely investi-
and sanitary surveys or proximity to latrines solids that have been filtered out, swelling of gated chemic al contaminant derived from
(Ahmed et al. 2002; Howard et al. 2003; clay minerals, and precipitation of insoluble pit latrines. Consumption of high concentra-
Tandia et al. 1999), although Ahmed et al. salts (Franceys et al. 1992). In a study testing tions of nitrate in drinking water is known to
Table 1. Summary of selected studies that assessed groundwater or soil contamination associated with pit latrines.a
No. of latrines Experimental Subsurface Sampling Water quality
Source Country in studyb design conditions time frame parametersc Conclusions
Vinger et al. 2012 South Africa 15 Sampled existing No data June–July Ammonia, nitrate, nitrite Higher levels of contaminants
wells observed at distances < 11 m
from pit latrines
Pujari et al. 2012 India 7 Sampled existing Fine loamy silt, Summer and Fecal coliforms, total No to low levels of nitrate and
wells sandy loam, monsoon dissolved solids, nitrate fecal coliforms observed
intermittent clay seasons
Banerjee 2011 India 12 Installed test Saturated and Premonsoon Total coliforms, fecal Movement of chloride tracers and
wells unsaturated soils and monsoon coliforms, chloride coliforms limited to < 10.2 m
of gravel, sand, seasons solution used as tracer from pits
silt, clay, and
laterite
Verheyen et al. Benin 220 Sampled existing No data Wet and dry Adenovirus, rotavirus Viral contamination of
2009 wells seasons, groundwater associated with
2003–2007 latrine proximity
Dzwairo et al. Zimbabwe 3 Installed test Saturated and February–May Ammonia, nitrate, Fecal coliform movement greatly
2006 wells unsaturated sandy 2005 turbidity, pH, reduced > 5 m from pits; all
soils conductivity, total nitrate levels and 99% of
coliforms, fecal ammonia levels met WHO
coliforms drinking water standards
Zingoni et al. Zimbabwe Not specified Sampled existing No data No data Na, Zn, Cu, Co, Fe, Elevated levels of nitrate and
2005 wells and phosphate, nitrate, coliform bacteria in most parts
installed test total coliforms, fecal of study area
wells coliforms
Mafa 2003 Botswana Not specified Sampled existing Fractured rock July and Broad set of Elevated levels of nitrate in
wells overlain by August 2000 hydrochemical analyses several zones where pit latrines
alluvial sediment, were common
clay, sand, and
weathered rock
Banks et al. 2002 Kosova, Not specified Sampled existing No data 1996–2000 Chloride, sulfate, Elevated levels of nitrate likely
Moldova, wells and potassium, nitrate from latrines
Siberia springs
Howard et al. Uganda Not specified Sampled Highly variable: clay Monthly, Fecal streptococci, fecal No significant relationship
2003 protected to sandy soils March 1998 coliforms, nitrate between microbiological
springs through April contamination and pit latrine
1999 proximity
Still and Nash South Africa 1 Installed test No data Bimonthly, Fecal coliforms, nitrate Low levels of nitrate (< 10 mg/L)
2002 wells 2000–2002 and fecal coliforms (10 cfu/100
mL) found > 1 m of latrine
Ahmed et al. 2002 Bangladesh Not specified Sampled existing Two aquifer systems; 2- to 8-week Fecal streptococci, fecal Bacteriological water quality
wells clay, silt, and fine intervals, coliforms, broad set of generally good (< 10 fecal
to coarse sand 1998–1999 hydrochemical analyses coliforms/100 mL); water quality
poorly correlated with sanitary
surveys
Chidavaenzi et al. Zimbabwe 2 Installed test Stratified fine-grain Wet and dry Nitrogen, coliforms Rapid reductions in coliform,
2000 wells sandy soils seasons sulfate, and nitrogen levels
within 5 m from pits; contami
nation present up to 20 m
Table continued
cause methemoglobinemia, and associations groundw ater nitrate concentrations near Vinger et al. 2012); and nitrate can be formed
with cancer in humans have been observed, latrines were above local background lev- and lost through natural soil processes (Jacks
although not consistently (Fewtrell 2004; els, even if they remained below or near the et al. 1999). Jacks et al. (1999) used mass-
WHO 2011). The WHO-recommended WHO guideline (Baars 1957; Caldwell and balance calculations to estimate that 1–50%
guideline for nitrate in drinking water is Parr 1937; Chidavaenzi et al. 2000; Jacks et al. of nitrogen leached to groundw ater from
50 mg/L (WHO 2011). Concentrations of 1999; Zingoni et al. 2005). latrines in Botswana. Although significant
nitrate in well water near latrines are highly High nitrate concentrations have been quantities of leached nitrate may have been
variable. Although a number of studies that attributed to latrines through association and lost to denitrification in poorly drained soils,
detected total or fecal coliforms did not assumptions based on general proximity, but the calculations suggested that nitrogen loss
detect elevated nitrate concentrations in wells pinpointing the actual sources of nitrate in from latrines helped describe the high nitrate
(Ahmed et al. 2002; Dzwairo et al. 2006; groundwater has proved challenging (WHO concentrations of groundwater (50 mg/L) in
Howard et al. 2002; Padmasiri et al. 1992; 2006). Nitrate may be derived from numerous the area. The authors concluded that moving
Still and Nash 2002), other studies have potential sources in urban and rural environ drinking wells outside of the habituated area
reported nitrate concentrations > 100 mg/L ments, including latrines, plant debris, animal would help avoid nitrate contamination of
(Banks et al. 2002; Girard and Hillaire-Marcel manure, garbage repositories, livestock pens, drinking water.
1997; Lewis et al. 1980; Mafa 2003; Pujari soil, and fertilizers (Girard and Hillaire-Marcel, Girard and Hillaire-Marcel (1997) used
et al. 2012; Tandia et al. 1999). Frequently, 1997; Howard et al. 2002; Melian et al. 1999; nitrogen isotopes to determine the source of
Table 1. Continued.
No. of latrines in Experimental Subsurface Sampling Water quality
Source Country studyb design conditions time frame parametersc Conclusions
Jacks et al. 1999 Botswana 4 Sampled existing Well-drained and No data Phosphorous, nitrogen Variable nitrate leaching from pit
wells poorly drained soils isotopic ratios, chloride latrines
Tandia et al. 1999 Senegal Not specified Sampled existing Fine to coarse sand July and Broad set of Nitrate contamination in water
wells November hydrochemical strongly correlated with latrine
1989 analyses, fecal proximity
coliforms
Nichols et al. USA 8 Installed test 3 latrines on clayey June and Nitrate, phosphorus, Latrines with peat liners reduced
1983 wells soil; 3 on shallow August fecal coliforms movement of phosphorus and
loam; 2 on sand; all 1975–1979 fecal coliforms but not nitrate.
soils well-drained
Lewis et al. 1980 Botswana 30 pit latrines in Sampled existing Clayey soils and October 1977 Broad set of Contamination of wells near
the study area wells and test fissured rock through hydrochemical latrine with E. coli and nitrate;
wells February analyses, E. coli, rapid transport of chloride tracer
1978 chloride solution used
as tracer
Baars 1957 Netherlands Not specified Sampled soil and Unsaturated sandy September Ammonia, E. coli, nitrate Contamination in soil samples
existing wells soils 1951 and limited to < 1.5 m from latrines
January and
March 1952
Dyer 1941 India 1 Installed test Saturated and December– Chloride, nitrate, total Movement of total coliforms
wells unsaturated September coliforms limited to < 7 m from pit
alkaline alluvium
soils
Caldwell 1938a USA 3 Installed test Fine gravel to clayey May– Bacillus aerogenes, B. coli movement limited to 3 m
wells soils November anaerobes, odor, pH, from pits
1933 B. coli
Caldwell 1938b USA 1 Installed test Fine gravel to clayey November Nitrate, dissolved Limited movement of B. coli to
wells soils 1932– oxygen, chloride, 3 m from pit and chemicals to
November nitrite, pH, odor, colon 24 m
1933 aerogenes group,
B. coli, anaerobes
Caldwell and Parr USA 8 bored hole Installed test Partially saturated May 1932– Nitrate, dissolved Movement of bacteria and
1937 latrines wells fine gravel to May 1933 oxygen, chloride, chemicals to within 10 m and
clayey soils nitrite, pH, odor, colon 26 m of latrine, respectively
aerogenes group,
B. coli, anaerobes
Caldwell 1937b USA 1 envelope pit Installed test Unsaturated fine May– Colon aerogenes group, Bacteria greatly reduced to within
latrine wells gravel to clayey November pH, odor, B. coli, 2 m from pit
soils 1933 anaerobes
Caldwell 1937a USA 1 Installed test Saturated fine gravel August 1932– Colon aerogenes group, Movement of bacteria to within
wells to clayey soils November pH, odor, B. coli, 25 m of latrine
1933 anaerobes
Kligler 1921 USA 50 Sampled soil Saturated and Wet and dry B. coli, B. aerogenes Bacterial movement limited to
at varying unsaturated sand, seasons, < 5.5 m from pit
distances sandy clay, and clay 1918–1919
Abbreviations: Co, cobalt; Cu, copper; Fe, iron; Na, sodium; Zn, zinc.
aOnly studies that either directly assessed the transport of contaminants from pit latrines or studies that applied statistical methods to estimate a measure of risk associated with the
presence of pit latrines are included. bNo specific data were provided on the density or number of pit latrines in the study area. cCulture-based assays were used for all microbiological
tests, except for Verheyen et al. (2009), who used genotyping methods.
nitrate pollution in a fractured rock aquifer contamination of well water; an area with shal- downstream. In a small study, Padmasiri et al.
of Niger. Due to fermentation of feces and low groundwater was more susceptible to pol- (1992) observed decreases in soil nitrate con-
ammonia volatilization in latrines, isotopic lution from latrines than an area with a deeper centrations at 1.5 m from the latrine. Overall,
enrichment of residual matter creates a nitrate water table. In eastern Botswana, buildup of although data are sparse, direct measurements
source that is isotopically distinguishable from nitrogenous latrine effluent in soils and subse- and estimates of lateral transport distances
nitrate of other sources. Nitrate concentrations quent downward leaching of nitrate appeared for high levels of pit latrine–derived nitrate—
in wells reached 11.6 milliequivalents/L, which to promote dissolved nitrate concentrations where it has been detected—range from
may have been a consequence of contamina- > 500 mg/L in groundw ater (Lewis et al. approximately 1 to 25 m (Caldwell 1938b;
tion by latrines and deforestation (Girard and 1980); the authors concluded that the fissured Caldwell and Parr 1937; Chidavaenzi et al.
Hillaire-Marcel 1997). The authors cautioned bedrock aquifer allowed for rapid contami- 2000; Lewis et al. 1980; Still and Nash 2002;
that, given annual population growth rates nant transport. Whereas soil type immediately Vinger et al. 2012) (Figure 2).
and increased latrine densities, wells that had below the pit is likely to influence the degree Chloride. After nitrate, chloride has been
safe nitrate concentrations at the time of the of nitrate transport (Caldwell and Parr 1937), the most commonly investigated chemical
study might become polluted in the future. associations with soil type have not always been indicator of groundwater contamination from
A more common approach in identify- observed (Nichols et al. 1983). In addition, latrines because of its high concentrations in
ing nitrate sources has been to compare areas in an area with high nitrogen loading from excreta and its relative mobility in the sub-
with similar environmental characteristics but latrines but where groundwater was devoid of surface. Although there are no known health
different population and latrine densities. By oxygen, nitrate concentrations were minimal, risks from chloride in drinking water, con-
analyzing water samples from installed bore- presumably because of denitrification (Ahmed centrations > 250 mg/L may affect the taste
holes in an informal settlement in Zimbabwe, et al. 2002). and acceptability of water (WHO 2011). In
Zingoni et al. (2005) demonstrated that the Thus, both environmental conditions and a study from Botswana, Lewis et al. (1980)
highest nitrate concentrations in groundwater human factors are major drivers of nitrate con- found the highest chloride concentrations in
(20–30 mg/L) were associated with the high- tamination from latrines, and the highest con- soils closest to latrines. In Bangladesh, dis-
est population and pit latrine densities of the centrations in well water are expected to be solved concentrations reached 400 mg/L
settlement. In Siberia and Kosova, nitrate found downstream of areas with high latrine at shallow depths, but then decreased with
concentrations were sometimes > 100 mg/L use (Chidavaenzi et al. 2000; Mafa 2003; depth and distance from latrines (Ahmed
in groundwater of villages with high latrine Vinger et al. 2012). After nitrate is leached et al. 2002). Chloride is typically transported
densities and minimal septic tanks, but con- from latrines, a number of factors may control with minimal retention during groundwater
centrations were below hazardous levels in travel distance. Certain chemical contaminants flow, and concentrations frequently track with
agricultural and unpopulated settings (Banks may be transported farther than microbial nitrate levels (Banks et al. 2002; Caldwell
et al. 2002). Groundwater nitrate concentra- contaminants because they are not as inhib- 1938b; Caldwell and Parr 1937; Jacks et al.
tions have also been correlated with proximity ited by the biolayer that commonly forms 1999; Lewis et al. 1980; Tandia et al. 1999)
to pollution sources, including pit latrines, in around latrines (Caldwell and Parr 1937). unless subsurface conditions promote nitrate
Senegal and South Africa (Tandia et al. 1999; Similarly, peat-lined pits were associated with reduction (Ahmed et al. 2002). Variable distri-
Vinger et al. 2012). reduced bacterial and phosphate transport butions of latrine contaminants resulting from
Environmental factors also play a role in from latrines but appeared to be ineffective in pumping and seasonal fluctuations have been
governing groundwater pollution from latrines. limiting nitrate (Nichols et al. 1983). In con- demonstrated by studies using chloride salts as
Pujari et al. (2012) compared the impacts of trast, Chidavaenzi et al. (2000) estimated that tracers (Banerjee 2011; Lewis et al. 1980).
on‑site sanitation in two Indian megacities and the nitrogen influence from latrines extended Ammonia. Ammonia, derived either
concluded that hydrogeological conditions only 5 m from the latrine source, whereas directly from latrine waste or following
were strong predictors of the threat of nitrate microbial contamination extended up to 20 m denitrification of nitrate released from latrines,
has not been reported to accumulate apprecia-
60 bly in groundwater near latrines. In a study
of three pit latrines, Dzwairo et al. (2006)
Lateral travel distance from latrine (m)
Bacteria
50
Viruses f WaterAid 2011 observed only one incidence of ammonium
Chemicals
Latrine siting guidelines
(NH4+) > 1.5 mg/L in well water that was
40 microbiologically contaminated by latrines. In
groundwater with latrine-derived nitrate con-
30
Sphere Project 2011 centrations that exceeded 500 mg/L, Lewis
a
g
g et al. (1980) found NH4+ at < 0.2 mg/L in
20
c all wells but one, which had NH4+ at 3 mg/L.
h Lewis et al. 1982 and Similarly, NH4+ was below the South African
h Franceys et al. 1992
10
a e j
National Standard (2 mg/L) in all water
a a
b
e i samples analyzed by Vinger et al. (2012).
a
0
a d h
Padmasiri et al. (1992) reported that soil
concentrations of NH4+ decreased substan-
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latrines have typically been below drinking proximity, both environmental and anthropo- and should terminate no less than 1.5–2.0 m
water standards (Baars 1957; Vinger et al. genic factors must be considered. above the water table. Banerjee (2011) con-
2012), although when present, it has been Among the studies we reviewed, specific cluded that, with the exception of fissured
found in association with nitrate and chloride recomm endations for minimizing latrine rock, the safe distance between a pit latrine
(Caldwell 1938b; Caldwell and Parr 1937). effects on groundwater quality varied. Nichols and water source is 10 m. Vinger et al. (2012)
Phosphate is fairly immobile, and when it et al. (1983) suggested that pit liners, such as suggested that wells are likely to be contami-
was released from latrines, its penetration into peat liners, should not be used as a substitute nated if pit latrines are < 12 m away.
soils was minimal (Padmasiri et al. 1992); for proper soil conditions, and recommended Countries and development agencies often
peat liners further reduced potential transport that latrines not be built in thin, rocky soils. have siting standards for latrine construction.
(Nichols et al. 1983). Accordingly, phosphate Dzwairo et al. (2006) highlighted the need to In Haiti, for example, latrines must be sited
concentrations in well water have not been a) analyze critical parameters such as depth of at least 30 m from any surface water source
detected at concentrations above water quality the infiltration layer and direction of ground or drinking water source, and the bottom of
standards in association with pit latrines water flow; b) develop alternative sanitation the pit must be at least 1.5 m above the maxi-
(Zingoni et al. 2005). options, such as raised or lined pit latrines, to mum height of the water table (Reed 2010).
Elevated groundwater potassium concen- minimize groundwater impacts; and c) apply South Africa’s groundwater guidelines recom-
trations may also be derived from latrines, and an integrated approach, involving geotech- mend that pit latrines are located at least 75 m
concentrations have been shown to correlate nology and hydrogeology, to solve sanitation from water sources (Still and Nash 2002). The
with those of nitrate and chloride (Banks et al. problems. Pujari et al. (2012) recommended WHO suggests minimal risk of groundwater
2002). The effect of latrines on sulfate con- that latrines be discouraged in rocky areas with pollution where > 2 m of relatively fine soil
centrations remains unclear, perhaps because shallow water tables. They also suggested that exists between a pit and the groundwater table,
of the prevalence of sulfate sources and the systematic lithological and hydrogeological assuming fill rates are < 50 L/m²/day (Franceys
number of processes that may remove sulfate mapping be conducted and that parameters et al. 1992). Furthermore, 15 m is suggested as
from solution in the subsurface. Although such as the depth of the water table, soil charac the safe lateral separation between pit latrines
Banks et al. (2002) found no evidence that teristics, and rock strata be considered prior to and the groundwater supply; this distance can
latrines influenced sulfate concentrations in installing latrines. Pujari et al. (2012) advised be reduced if the well is not directly down
well water, Chidavaenzi et al. (2000) observed that groundwater sources in areas served by gradient of the pit (Franceys et al. 1992).
increases in sulfate concentrations near on‑site sanitation systems should be monitored However, in a more recent and conservative
latrines during the wet season. Latrines also by responsible agencies; monitoring should recommendation that seeks to account for a
have been associated with increased well-water include nitrate, chloride, and fecal coliforms. wide variety of contexts, WaterAid (2011)
turbidity (Dzwairo et al. 2006). Finally, Mafa To minimize the leaching of nitrate, Jacks et al. suggests that latrines and water sources should
(2003) measured high concentrations of dis- (1999) suggested a) painting latrine ventila- be at least 50 m apart (WaterAid 2011). For
solved organic carbon in wells downgradient tion tubes black to increase daytime ventilation disaster response situations, the Sphere Project
of latrines, which might contribute to reduc- rates; b) increasing the pH of latrine contents to (2011) has recommended 30 m as a mini-
ing conditions and elevated dissolved iron increase ammonia volatilization; c) sealing pits mum standard for the lateral distance between
concentrations (Zingoni et al. 2005). to prevent nitrate leaching and promote deni- on‑site sanitation systems and water sources,
trification; and d) diverting urine for use as a although this value could be adjusted based on
Discussion fertilizer for deep-rooted crops. Finally, a num- the nature of subsurface features.
Pit latrine guidelines for mitigating ground ber of the studies suggested that pit latrines did Overall, threats to groundw ater qual-
water impacts. In relation to on‑site sanitation, not appear to pose a major threat to ground ity from on‑site sanitation can be mitigated
the factors controlling transport of microbial water quality or public health (Caldwell 1938a, through technology design, risk assessment,
and chemical contaminants in the subsurface 1938b; Chidavaenzi et al. 2000; Howard et al. development of protection zones, and moni
have been the subject of several reviews (BGS 2003; Kligler 1921); this conclusion, which toring (Lawrence et al. 2001; Lewis et al.
2002; Dillon 1997; Gerba et al. 1975; Lewis runs counter to general consensus, may have 1982; Robins et al. 2007). For septic systems
et al. 1982; WHO 2006), and there is exten- been influenced by the specific latrine siting, and more complex on‑site sanitation tech-
sive literature that more broadly quantifies environmental conditions, and experimental nologies, manuals and siting guidelines are
contaminant transport processes in ground designs of the studies. widely accessible (e.g., U.S. Environmental
water (e.g., Schijven and Hassanizadeh 2000). Given the varying transport distances Protection Agency 2002), and technology
Soil/rock type, natural and human-altered observed for microbiological and chemical choices generally depend on the available land
groundwater flow rates and paths, and the contaminants originating from pit latrines area for drain fields and vertical separation
biogeochemical environment of the subsurface (Figure 2), researchers have identified a range to the water table. Step-by-step strategies for
all govern contaminant travel distances and of latrine siting guidelines. In their compre- site-specific analyses of safe sanitation options
rates. Tracking the movement of contami hensive review about the risks for groundwater appropriate for low-income countries have
nants is further complicated by microbial contamination by on‑site sanitation sources, been outlined by the BGS (Lawrence et al.
die-off and chemical transformations, which Lewis et al. (1982) noted the “traditional” 2001). The BGS guidelines provide a set of
may occur heterogeneously over space and guideline of 15 m as a safe distance between rules for determining the optimum horizontal
time. The potential for widespread ground wells and sanitation units. On the basis of separation between sanitation facilities and
water contamination from pit latrines is also statistical associations between latrines and drinking-water sources for a variety of hydro
affected by social factors, such as latrine use, nitrate concentrations in water sources, Tandia geological environments. These guidelines
latrine densities, maintenance, and ground et al. (1999) recommended distances of 20 m, have been tested in Bangladesh (Ahmed et al.
water pumping. Latrine type, design, materi- 36 m, and 48 m for pits that are in use for 2002), Uganda (Howard et al. 2003), and
als, and construction quality also influence < 1 decade, 1–2 decades, and > 2 decades, Argentina (Blarasin et al. 2002) and have been
contaminant containment and leaching from respectively. Banks et al. (2002) suggested advocated as sensible practice for aquifers for
pit latrines. Thus, to effectively evaluate the that pit latrines should be located no less than which data are limited and therefore do not
safety of pit latrine and groundwater source 15–30 m from groundwater abstraction points otherwise lend themselves to conventional
vulnerability assessment (Ahmed et al. 2002; not been investigated proximate to pit latrines, remains unclear whether these alternative sys-
Blarasin et al. 2002; Howard et al. 2003). but they should be quantified and their poten- tems are affordable and culturally acceptable
Moving forward. Pit latrine and ground tial for transport needs to be assessed. There to poor populations in low-income countries
water usage are prevalent in a rapidly growing has also been little research on disposal of other (Mariwah and Drangert 2011).
segment of the world population. Given that chemicals, such as lime, pesticides, and clean- Balancing risks. Despite the potential
approximately 1.11 billion people currently ing agents, into latrines. Finally, it remains for groundwater contamination, pit latrines
have no sanitation facility [see Supplemental unclear whether effects of latrine wastes on remain an important strategy for improving
Material (http://dx.doi.org/10.1289/ the geochemical environment of groundwater human excreta disposal. These systems are the
ehp.1206028)], pit latrine coverage is expected may increase downstream contamination. For most basic option for low-income countries to
to increase as people attempt to move up the instance, excreta contains high quantities of decrease rates of open defecation and increase
sanitation ladder from open defecation to basic organic carbon (Feacham et al. 1983), and access to improved sanitation. An intensive
sanitation (WHO/UNICEF 2012c). Our plumes of carbon from latrines may promote effort is needed to develop more robust—yet
analysis of existing literature reveals five key reducing conditions within groundwater (Mafa viable—approaches to siting pit latrines and
knowledge gaps that could be addressed to 2003), leading to reductive release of trace ele- water sources. Proposed guidelines should
improve our understanding and management of ments associated with native aquifer materials be tested empirically to ensure protection of
groundwater contamination from pit latrines. (Harvey et al. 2002). groundwater quality after implementation
Siting latrines in relation to wells. Global climate change. Global climate under local conditions.
Groundwater flow paths are among the change is widely recognized as a threat to the
most important factors controlling contami- safety and reliability of drinking water and Conclusions
nant transport from latrines to water points. sanitation supplies, particularly in low-income We estimate that approximately 1.77 billion
In many areas, the subsurface flow pattern countries (WHO 2009; World Bank 2012). people around the world use pit latrines. This
is unknown. Groundwater flow models are To date, no studies have specifically addressed number is expected to increase as popula-
needed to better define the limits of chemi- these threats in relation to pit latrines and tions grow and countries strive to meet the
cal transport and pathogen dispersion (Pedley groundwater quality. Many sprawling urban Millennium Development Goals. The use
et al. 2006), particularly for complex ground slums, as well as poor rural communities, are of groundwater as a primary drinking-water
water systems such as fractured rock aquifers. currently situated in coastal zones that are source is also increasing. Accordingly, there is
It is often difficult to determine whether a flood prone or have high groundwater tables, a growing need to understand how pit latrines
contamination source is a pit latrine or animal especially in East Asia (Djonoputro et al. may adversely impact groundwater quality
waste and agricultural sources; better assess- 2010). Rising sea levels will increase the preva and human health.
ment of groundwater flow conditions will lence of flooding and slowly raise groundwater Despite the widespread global reliance
enable identification of dominant contaminant levels, limiting the ability for safe vertical sepa- on both pit latrines and groundwater, we
sources. In locations where horizontal separa- ration between latrine pits and the saturated found a limited number of studies that have
tion of latrines and water points is not pos- zone. Over shorter time periods, escalation of explicitly examined links between ground
sible (e.g., routinely flooded regions), vertical storm intensities will increase the probability water pollution and contamination from pit
separation has been promoted (Lawrence et al. that groundwater tables will rise above the latrines. Within these studies, the quality of
2001), but such siting guidelines are not well bottoms of pits at some point during the year; experimental techniques and chosen indicator
defined. An improved understanding of con- thus, it is likely that contaminant transport contaminants varied greatly. In multiple studies
taminants leaching from pit latrines and the from pit latrines to groundwater will increase. conducted near the same location, there were
transport pathways involved is needed particu- Flooding will also likely undermine efforts to substantial differences in transport distances
larly for managing sanitation in densely popu- increase access to basic sanitation. Urban plan- of microbiological and chemical contaminants
lated areas, such as refugee camps and informal ning and housing development programs will (Caldwell 1937a, 1937b, 1938a, 1938b;
settlements, as well as areas with rapidly grow- need better estimates of the potential effects Caldwell and Parr 1937). Nevertheless, based
ing populations. Siting guidelines need to con- of climate change on on‑site sanitation, as well on available reports, researchers who looked for
sider population pressures and the potential as additional information to determine appro- groundwater contamination from pit latrines
for increased groundwater abstraction, which priate sanitation facility designs for different frequently detected it, and studies observed
will alter transport distances and rates. target populations. travel distances of up to 25 m, 50 m, and 26 m
Understudied and emerging contami- Improved sanitation technologies. for unsafe concentrations of bacteria, viruses,
nants. To date there has been a focus on a Technological upgrades to pit latrines may and chemicals, respectively (Caldwell 1937b;
limited number of contaminants that may substantially reduce microbiological and Caldwell and Parr 1937; Verheyen et al. 2009).
be found in human excreta. Microbiological chemical threats to groundw ater quality. Although these contaminant transport distances
monitoring has primarily relied on fecal indica- Latrine liners can minimize seepage of pit could potentially be exceeded under certain
tor bacteria, whereas nitrate has been the focus contents to groundwater, and raised latrines conditions (e.g., in fractured rock aquifers),
of most chemical studies. In a recent study of may help minimize groundwater contami- most studies of pit latrine–derived contaminants
groundwater in rural Bangladesh, Ferguson nation by increasing vertical separation and actually showed transport distances that were
et al. (2012) noted that culture-dependent fecal promoting aerobic digestion of waste (Dillon less than half of the maximum values. Areas
indicators were not always able to predict total 1997; Dzwairo et al. 2006; Nichols et al. with shallow groundwater and areas prone
bacterial pathogens. Pit latrine additives are 1983). Urine-diverting toilets, painted ven- to flooding present the greatest risks, because
used to reduce pit contents, odor, and insect tilation tubes, and chemical amendments to vertical separation is required between the base
problems, but little research exists on their latrines can minimize nitrate formation and of latrine pits and the saturated zone.
makeup or the prevalence of their use (Buckley release to groundwater (Jacks et al. 1999). The ability to make informed decisions
et al. 2008). Organic chemical contaminants, Composting toilets and ecological sanitation about water and sanitation options is largely
including endocrine disruptors and pharma technologies may reduce microbial risks and inhibited by a scarcity of data, especially
ceuticals, that may be excreted in urine and minimize chemical leaching from pit latrines regarding the influence of environmental con-
feces and may persist in the environment have (Dillon 1997; Endale et al. 2012). However, it ditions on potential contamination. Guidelines
are available for site-specific assessment, and Cairncross S, Bartram J, Cumming O, Brocklehurst C. 2010a. and Sanitation Program. Available: http://www.wsp.org/
general procedures for siting latrines with Hygiene, sanitation, and water: what needs to be done? sites/wsp.org/files/publications/wsp-rwanda-sanitation-
Plos Med 7(11):e1000365; doi:10.1371/journal.pmed.1000365 lessons.pdf [accessed 27 March 2013].
respect to water points are common (Lawrence [Online 16 November 2010]. Kligler IJ. 1921. Investigation on Soil Pollution and the Relation
et al. 2001). However, recommendations for Cairncross S, Hunt C, Boisson S, Bostoen K, Curtis V, Fung ICH, on the Various Types of Privies to the Spread of Intestinal
mitigating groundwater impacts can be both et al. 2010b. Water, sanitation and hygiene for the preven- Infections. New York:Rockefeller Institute for Medical
tion of diarrhoea. Int J Epidemiol 39(suppl 1):I193–I205. Research.
qualitatively and quantitatively variable, and it Caldwell EL. 1937a. Pollution flow from pit latrines when an Lawrence AR, Macdonald DMJ, Howard AG, Barrett MH,
remains unclear whether these guidelines can impervious stratum closely underlies the flow. J Infect Dis Pedley S, Ahmed KM, et al. 2001. Guidelines for Assessing
be implemented under local conditions. Many 61(3):270–288. the Risk to Groundwater from On-Site Sanitation. Keyworth,
Caldwell EL. 1937b. Study of an envelope pit privy. J Infect Dis Nottingham:British Geological Survey. Available: http://
countries already face serious developmental 61(3):264–269. www-esd.worldbank.org/esd/ard/groundwater/pdfreports/
challenges and may not have the resources— Caldwell EL. 1938a. Pollution flow from a pit latrine when perme- Guidelines_assessing_risk_to_Gdwtr.PDF [accessed
human and economic—to implement guide- able soils of considerable depth exist below the pit. J Infect 28 March 2013].
Dis 62(3):225–258. Lewis WJ, Farr JL, Foster SSD. 1980. The pollution hazard to
lines (Robins et al. 2007). Caldwell EL. 1938b. Studies of subsoil pollution in relation to village water supplies in eastern Botswana. ICE Proc
In general, siting guidelines vary greatly, possible contamination of the ground water from human 69(2):281–293.
and it is often unknown which (if any) empiri excreta deposited in experimental latrines. J Infect Dis Lewis WJ, Foster SSD, Drasar BS. 1982. The Risk of Groundwater
cal studies were used to derive the guidelines. 62(3):272–292. Pollution by On-Site Sanitation in Developing Countries.
Caldwell EL, Parr LW. 1937. Ground water pollution and the Duebendorf, Switzerland:International Reference Centre for
Thus, there is a need to empirically test the bored hole latrine. J Infect Dis 61(2):148–183. Waste Disposal.
effectiveness of specific guidelines under a vari- Chidavaenzi M, Bradley M, Jere M, Nhandara C. 2000. Pit latrine Ley RE, Peterson DA, Gordon JI. 2006. Ecological and evolu-
ety of conditions in order to better merge pit effluent infiltration into groundwater: the Epworth case tionary forces shaping microbial diversity in the human
study. Schriftenr Ver Wasser Boden Lufthyg 105:171–177. intestine. Cell 124(4):837–848.
latrine siting guidelines with realistic ground Chidavaenzi M, Jere M, Bradley M. 1997. Pit latrine effluent Mafa B. 2003. Environmental Hydrogeology of Francistown:
water threats. Given the scale of pit latrine infiltration into groundwater. In: Proceedings of the 23rd Effects of Mining and Urban Expansion on Groundwater
use, future studies must examine additional WEDC Conference, 1–5 September 1997, Durban, South Quality. Lobatse, Botswana:Botswana Department of
Africa. Available: http://wedc.lboro.ac.uk/resources/ Geological Survey and Federal Institute for Geosciences
contaminants beyond standard indicators, conference/23/Chidavae.pdf [accessed 29 March 2013]. and Natural Resources. Available: http://www.limpoporak.
monitor temporal changes in water quality Dillon P. 1997. Groundwater Pollution by Sanitation on Tropical org/_system/DMSStorage/3471en/EnvHydrogeology%20
parameters, and evaluate alternative technolo- Islands. IHP-V Project 6–1. Paris:UNESCO (United Nations FTown_sec.pdf [accessed 28 March 2013].
Educational, Scientific and Cultural Organization). Available: Mariwah S, Drangert JO. 2011. Community perceptions of
gies. In addition, efforts are needed to better http://unesdoc.unesco.org/images/0010/001065/106522eo. human excreta as fertilizer in peri-urban agriculture in
understand the effects of population pressures pdf [accessed 29 March 2013]. Ghana. Waste Manage Res 29(8):815–822.
and climate change in order to make more Djonoputro ER, Blackett I, Rosenboom JW, Weitz A. 2010. Melian R, Myrlian N, Gouriev A, Moraru C, Radstake F. 1999.
Understanding sanitation options in challenging environ- Groundwater quality and rural drinking-water supplies in
informed decisions that optimize latrine and ments. Waterlines 29(3):186–203. the Republic of Moldova. Hydrogeol J 7:188–196.
groundwater use and improve environmental Dyer BR. 1941. Studies of ground water pollution in an alkaline Nichols DS, Prettyman D, Gross M. 1983. Movement of bacteria
and human health. alluvium soil. Ind J Med Res 29(4):867–877. and nutrients from pit latrines in the Boundary Waters
Dzwairo B, Hoko Z, Love D, Guzha E. 2006. Assessment of the Canoe Area Wilderness. Water Air Soil Poll 20(2):171–180.
impacts of pit latrines on groundwater quality in rural Padmasiri JP, Jayatilake GM, Kotuwegedara JPK. 1992.
References areas: a case study from Marondera district, Zimbabwe. Groundwater pollution from double pit latrines. In: Water,
Phys Chem Earth 31(15–16):779–788. Environment and Management: Proceedings of the
Ahmed KM, Khandkar ZZ, Lawrence AR, Macdonald DMJ, Endale YT, Yirsaw BD, Asfaw SL. 2012. Pathogen reduction 18th WEDC Conference, 30 August–3 September 1992,
Islam MS. 2002. Appendix A: an investigation of the efficiency of on-site treatment processes in eco-sanitation Kathmandu, Nepal. 239–241. Loughborough, UK:Water,
impact of on-site sanitation on the quality of groundwater system. Waste Manage Res 30(7):750–754. Engineering and Development Centre, Loughborough
supplies in two peri-urban areas of Dhaka, Bangladesh. In: Feachem RG, Bradley DJ, Garelick H, Mara DD. 1983. Sanitation University of Technology.
Assessing Risk to Groundwater from On-site Sanitation: and Disease: Health Aspects of Excreta and Wastewater Pedley S, Yates M, Schijven JF, West J, Howard G, Barrett M.
Scientific Review and Case Studies. Keyworth, UK:British Management. New York:John Wiley & Sons Ltd. 2006. Pathogens: health relevance, transport and attenuation.
Geological Survey, 37–67. Available: http://r4d.dfid.gov.uk/ Ferguson AS, Layton AC, Mailloux BJ, Culligan PJ, Williams DE, In: Protecting Groundwater for Health: Managing the Quality
pdf/outputs/r68692.pdf [accessed 26 March 2013]. Smartt AE, et al. 2012. Comparison of fecal indicators with of Drinking-Water Sources (Schmoll O, Howard G, Chilton J,
Albonico M, Allen H, Chitsulo L, Engels D, Gabrielli AF, Savioli L. pathogenic bacteria and rotavirus in groundwater. Sci Total Chorus I, eds). Geneva:World Health Organization, 49–80.
2008. Controlling soil-transmitted helminthiasis in pre-school- Environ 431:314–322. Available: http://www.who.int/water_sanitation_health/
age children through preventive chemotherapy. PLoS Negl Fewtrell L. 2004. Drinking-water nitrate, methemoglobinemia, publications/PGWsection1.pdf [accessed 29 March 2013].
Trop Dis 2(3):e126; doi:10.1371/journal.pntd.0000126 [Online and global burden of disease: a discussion. Environ Health Pujari PR, Padmakar C, Labhasetwar PK, Mahore P, Ganguly AK.
26 March 2008]. Perspect 112:1371–1374. 2012. Assessment of the impact of on-site sanitation sys-
Baars JK. 1957. Travel of pollution, and purification en route, in Fourie AB, Vanryneveld MB. 1995. The fate in the subsurface of tems on groundwater pollution in two diverse geological
sandy soils. Bull World Health Organ 16:727–747. contaminants associated with on-site sanitation–a review. settings—a case study from India. Environ Monit Assess
Banerjee G. 2011. Underground pollution travel from leach pits Water SA 21(2):101–111. 184(1):251–263.
of on-site sanitation facilities: a case study. Clean Technol Franceys R, Pickford J, Reed R. 1992. A Guide to the Development Ramakrishna BS. 2007. The normal bacterial flora of the human
Environ Policy 13(3):489–497. of on-Site Sanitation. Geneva:World Health Organization. intestine and its regulation. J Clin Gastroenterol 41(5):S2–S6.
Banks D, Karnachuk OV, Parnachev VP, Holden W, Frengstad B. Available: http://www.who.int/water_sanitation_health/ Reed B. 2010. Emergency Excreta Disposal Standards and Options
2002. Groundwater contamination from rural pit latrines: hygiene/envsan/onsitesan.pdf [accessed 29 March 2013]. for Haiti. Leicestershire, UK:DINEPA (Direction Nationale de
examples from Siberia and Kosova. J Chartered Inst Water Gerba CP, Wallis C, Melnick JL. 1975. Fate of wastewater bac- l’Eau Potable et de l’Assainissement) and Global WASH
Environ Manage 16(2):147–152. teria and viruses in soil. J Irrig Drain Div 101(3):157–175. Cluster. Available: http://wedc.lboro.ac.uk/resources/pubs/
BGS (British Geological Survey). 2002. Assessing Risk to Girard P, Hillaire-Marcel C. 1997. Determining the source of Emergency_EDS_and_options_for_Haiti.pdf [accessed
Groundwater from On-site Sanitation: Scientific Review and nitrate pollution in the Niger discontinuous aquifers using 28 March 2013].
Case Studies. Keyworth, UK:BGS. Available:http://r4d.dfid. the natural 15N/14N ratios. J Hydrol 199:239–251. Robins NS, Chilton PJ, Cobbing JE. 2007. Adapting existing
gov.uk/pdf/outputs/r68692.pdf [accessed 28 March 2013]. Harvey CF, Swartz CH, Badruzzaman AB, Keon-Blute N, Yu W, experience with aquifer vulnerability and groundwater
Blarasin M, Cabrera A, Frigerio C, Bettera S. 2002. Appendix C: Risk Ali MA, et al. 2002. Arsenic mobility and groundwater protection for Africa. J Afr Earth Sci 47(1):30–38.
of groundwater pollution by on-site sanitation, geochemical extraction in Bangladesh. Science 298(5598):1602–1606. Rosa G, Clasen T. 2010. Estimating the scope of household
models and geoindicators, Rio Cuarto City, Argentina. In: Howard G, Pedley S, Barrett M, Nalubega M, Johal K. 2003. water treatment in low- and medium-income countries.
Assessing Risk to Groundwater from On-site Sanitation: Risk factors contributing to microbiological contamination Am J Trop Med Hyg 82(2):289–300.
Scientific Review and Case Studies. Keyworth, UK:British of shallow groundwater in Kampala, Uganda. Water Res Schijven JF, Hassanizadeh SM. 2000. Removal of viruses by soil
Geological Survey, 94–105. Available: http://r4d.dfid.gov.uk/ 37(14):3421–3429. passage: overview of modeling, processes and param-
pdf/outputs/r68692.pdf [accessed 28 March 2013]. Howard G, Teuton J, Luyima P, Odongo R. 2002. Water usage eters. Crit Rev Environ Sci Technol 30(1):49–127.
Buckley CA, Foxon KM, Brouckaert CJ, Rodda N, Nwaneri C, patterns in low-income urban communities in Uganda: Sphere Project. 2011. Minimum standards in water supply,
Balboni E, et al. 2008. Scientific Support for the Design and implications for water supply surveillance. Int J Environ sanitation and hygiene promotion. In: Humanitarian
Operation of Ventilated Improved Pit Latrines (VIPS) and the Health Res 12(1):63–73. Charter and Minimum Standards in Disaster Response.
Efficacy of Pit Latrine Additives. WRC Report No. TT 357/08. Jacks G, Sefe F, Carling M, Hammar M, Letsamao P. 1999. Geneva:The Sphere Project. Available: http://www.ifrc.
Gezina, South Africa:Water Research Commission. Available: Tentative nitrogen budget for pit latrines–eastern Botswana. org/PageFiles/95530/The-Sphere-Project-Handbook-20111.
http://www.wrc.org.za/Knowledge%20Hub%20Documents/ Environ Geol 38(3):199–203. pdf [accessed 28 March 2013].
Research%20Reports/TT357-08%20-Developing%20 Jain N. 2011. Getting Africa to Meet the Sanitation MDG: Still DA, Nash SR. 2002. Groundwater contamination due to
communities.pdf [accessed 29 March 2013]. Lessons from Rwanda. Washington, DC:World Bank Water pit latrines located in a sandy aquifer: a case study from
Maputaland. In: Water Institute of Southern Africa Biennial van Ryneveld MB, Fourie AB. 1997. A strategy for evaluating http://whqlibdoc.who.int/publications/2011/9789241548151_
Conference. Durban, South Africa:Water Institute of the environmental impact of on-site sanitation systems. eng.pdf [accessed 1 April 2013].
Southern Africa, 1–6. Available: http://www.sswm.info/sites/ Water SA 23(4):279–291. WHO (World Health Organization)/UNICEF. 2010. Progress on
default/files/reference_attachments/STILL%20and%20 Verheyen J, Timmen-Wego M, Laudien R, Boussaad I, Sanitation and Drinking-water–2010 Update. Available:
NASH%202002%20Groundwater%20contamination%20 Sen S, Koc A, et al. 2009. Detection of adenoviruses http://whqlibdoc.who.int/publications/2010/9789241563956_
due%20to%20pit%20latrines%20located%20in%20a%20 and rotaviruses in drinking water sources used in rural eng_full_text.pdf [accessed 5 December 2012].
sandy%20aquifer.pdf [accessed 29 March 2013]. areas of Benin, West Africa. Appl Environ Microbiol WHO (World Health Organization)/UNICEF. 2012a. Estimates for
Tandia AA, Diop ES, Gaye CB. 1999. Nitrate groundwater pol- 75(9):2798–2801. the Use of Improved Sanitation Facilities: China. Available:
lution in suburban areas: example of groundwater from Vinger B, Hlophe M, Selvaratnam M. 2012. Relationship http://www.wssinfo.org/fileadmin/user_upload/resources/
Yeumbeul, Senegal. J Afr Earth Sci 29(4):809–822. between nitrogenous pollution of borehole waters and CHN_san.pdf [accessed 1 April 2013].
UN (United Nations). 2008. The Millennium Development distances separating them from pit latrines and fertilized WHO (World Health Organization)/UNICEF. 2012b. Estimates
Goals Report 2008. New York:UN. Available: http://www. fields. Life Sci J 9(1):402–407. for the Use of Improved Drinking-Water Sources: China.
un.org/millenniumgoals/pdf/The%20Millennium%20 Wade TJ, Pai N, Eisenberg JNS, Colford JM Jr. 2003. Do U.S. Available: http://www.wssinfo.org/fileadmin/user_upload/
Development%20Goals%20Report%202008.pdf [accessed Environmental Protection Agency water quality guidelines resources/CHN_wat.pdf [accessed 1 April 2013].
27 March 2013]. for recreational waters prevent gastrointestinal illness? WHO (World Health Organization)/UNICEF. 2012c. Progress on
UN (United Nations). 2011. World Population Prospects: The A systematic review and meta-analysis. Environ Health Drinking Water and Sanitation: 2012 Update. Available: http://
2010 Revision, CD-ROM Edition. Data download available: Perspect 111:1102–1109. www.unicef.org/media/files/JMPreport2012.pdf [accessed
http://esa.un.org/unpd/wpp/Excel-Data/population.htm WaterAid. 2011. Technology Notes. Available: http://www. 5 December 2012].
[accessed 1 April 2013]. wateraid.org/documents/plugin_documents/technology_ World Bank. 2012. Turn Down the Heat: Why a 4oC Warmer
UNICEF. 2012. Multiple Indicator Cluster Surveys. Available notes_2011.pdf [accessed 5 December 2012]. World Must Be Avoided. Washington, DC:The World
Reports/Datasets. Available: http://www.childinfo.org/ WHO (World Health Organization). 2006. Protecting Groundwater Bank. Available: http://climatechange.worldbank.org/sites/
mics_available.html [accessed 25 October 2012]. for Health: Managing the Quality of Drinking-water Sources. default/files/Turn_Down_the_heat_Why_a_4_degree_
USAID. 2012. Measure DHS: Available Datasets. Available: Geneva:WHO. Available: http://www.who.int/water_ centrigrade_warmer_world_must_be_avoided.pdf
http://www.measuredhs.com/data/available-datasets.cfm sanitation_health/publications/protecting_groundwater/en/ [accessed 27 March 2013].
[accessed 25 October 2012]. [accessed 26 March 2013]. World Bank. 2013. How We Classify Countries. Available:
U.S. Environmental Protection Agency. 2002. Onsite WHO (World Health Organization). 2009. Protecting Health http://data.worldbank.org/about/country-classifications
Wastewater Treatment Systems Manual. EPA/625/R- from Climate Change: Connecting Science, Policy and [accessed 3 April 2013].
00/008. Washington DC:U.S. Environmental Protection People. Geneva:WHO. Available: http://whqlibdoc.who. Zingoni E, Love D, Magadza C, Moyce W, Musiwa K. 2005.
Agency. Available: http://water.epa.gov/type/groundwater/ int/publications/2009/9789241598880_eng.pdf [accessed Effects of a semi-formal urban settlement on groundwater
uic/class5/upload/2007_12_12_uic_class5_techguide_ 29 March 2013]. quality Epworth (Zimbabwe): case study and groundwater
uic-class5_2002_onsite_wwt_sys_man.pdf [accessed WHO (World Health Organization). 2011. Guidelines for quality zoning. Phys Chem Earth 30(11–16):680–688.
26 March 2013]. Drinking-water Quality. 4th ed. Geneva:WHO. Available: