Sachet water consumption and its associated health problems

Introduction

According to Hazen and Toranzos (2010) water is one of the most essential and abundant commodities of man occupying about 70% of the earth’s surface. A greater percentage of the world’s population most especially in developing countries live without access to safe water because much of the water is not fresh and potable. They further added that water for drinking should be free of disease-causing microorganisms, harmful chemicals, objectionable taste and odour, excessive levels of colour and suspended materials.

DeVilliers (2012) stated that the hourly death toll from drinking contamination water is 400 deaths of children below age five. This he said that out the figure afore-stated, the developing world accounted for over 80%. According to him, in developing countries, the considerable pressure on already overburdened budgets and lack of political will of the government makes it difficult to increase the water supply infrastructure.

In Nigeria, the Nigerian Water Board Authority (NWBA) is in charge of the provision of water supply and has water coverage of less than 10% (Ainuson, 2009). In his study of peri-urban communities, it was found that there were two main problems that limited the access to potable water, namely, that whereas some communities lacked access to pipe-borne water, others had pipe-borne systems that were not functioning.

The main goal of the water sector reform has been geared towards introducing private sector participation (PSP) into the water supply sector. The introduction of packaged water to consumers was to provide safe, hygienic and affordable instant drinking water to the public. The increase in demand for packaged water has also been attributed to changes in fashion towards the consumption of designer water, increased concerns about the safety of municipal water and an increased influx of people into major urban areas with a dire need for good drinking water. In addition, convenience has also made the products meet the requirements of any lifestyle when needed (Gardner, 2009).

In Nigeria, the consumption of sachet water has become generally accepted as the most hygienic source of drinking water without paying attention to the manufacturer reputation, where it is being packaged and under the condition the packaging was done. The general assumption is that all sachet water irrespective of the manufacturer’s reputation is called “pure water”.

Conceptual framework

Sachet water or potable water is defined as packaged water usually 0.5 l for human consumption. It is meant to be packaged under hygienic and sanitary condition to achieve acceptable quality in terms of its physical, chemical, bacteriological and acceptability parameters so that it can be safely used for drinking (WHO, 2008).

World Health Organization (WHO, 2008) stated that sachet water is safe for drinking as long as it does not cause the population any significant health risks over a life time of consumption and effort should be made to maintain sachet water quality at the highest possible level. The Convention on Economic, Social and Cultural Rights (C.E.S.C.R) explicitly recognized water as a fundamental human right in November, 2002 and the countries which ratified the international C.E.S.C.R are compelled to ensure everyone has access to adequate and safe supply of drinking water.

Sachet water supply

According to Imalu (2010), the Environmental Protection Agency initiated regular monitoring programs in 1995 through NAFDAC to monitor the conditions under which the sachet water is being packaged. However, very little has been done to monitor standard of the underground water of the aquifer used by the sachet water manufacturers which serve as a source of drinking water for many people around the country. The principal purpose of improving water supply is to help overcome the scourge of killer diseases that afflict developing countries and to improve their well being and productivity. Various studies and estimates indicate that in these diseases typically takes up about a tenth of average person’s potentially productive time and in addition, affects risk taking and initiative adversely, disrupts the education and nurture of children, stunt physical development and causes vast suffering and hardship (WHO, 2008).

The provision of potable water must be paramount in the provision of social amenities in areas that are yet to receive such supplies. This can go a long way to cut the expenditure that governments and donor organizations spend in providing health care for these communities. It is very obvious that with the near eradication of waterborne disease in most advanced countries, the monies which otherwise would have been used in treating these diseases, have been channeled into other areas of the economy where they are yielding much fruits. Such monies could even be put into research projects that could help improve the current treatment and supply methods available. The necessity of water cannot be over emphasized and the entire society must make it a point to help increase potable water supply in all areas.

Sachet water quality

The importance of sachet water quality has been enhanced in the last few years by the increased awareness and attendant publicity afforded to the pollution of water courses, estuaries and coastal areas (Shaw, 2008). Globally, the UN declared an International Drinking water supply and Sanitation Decade between 1981 and 1991. Thus, Nigeria was provided the impetus to identify and provide solutions to the problems of existing water supply and sanitation systems and also expand coverage so that more people would enjoy the benefits of good drinking water and adequate sanitation (Water Resource Institute, 1998).

In the USA, the quality of water meant for drinking was regulated by the safe Drinking Water Act of 1974, as amended in 1977 and 1986. These standards represent maximum contaminant levels (MCL) allowable and consist of numerical criteria for specified contaminants (Buchholz, 2007). Water supplies, especially in developing countries, have been focused on quantity at the expense of quality and there are calls for marked improvement in quality-better management of chemicals and microorganism content (Barrow, 2005).

It is important to note, however, that issues of water quality cannot be considered separate from water quantity. In assessing the quality of drinking water, most consumers usually rely completely upon their senses. Water constituents may affect the appearance, smell or taste of water, thus, the consumer evaluates the quality and acceptability essentially on these criteria. However, we can no longer rely entirely upon our senses in the matter of quality judgement. The absence of any adverse sensory effects therefore does not guarantee the safety of drinking water.

In the submission on the drinking water quality control in small community supplies, WHO (2008) explains that although in the rural areas of developing countries, it is expected that a great majority of water quality problems are related to bacteriological contamination, a significant number of very serious problems may occur as a result of chemical contamination of water sources from agricultural practices and malpractices.

The traditional emphasis on chemical indicators of water quality must be supplemented by more comprehensive indicators based on the total properties of water body including: chemical, physical, biological and ecological parameters. It must also be recognized that fresh water quality is impacted directly by natural and human activities outside the water sphere such as land use practices, erosion and deforestation. Some are also tied to acid deposition or natural contamination. Such problems often require monitoring and protection at the local level, while some have significant transboundary components which are addressed at national and International levels (International Conference on Water and the Environment Report, 2012).

Sources of contamination of sachet water

There can be two sources of water pollution, point and non-point source pollution. According to Buchholz (2013) point sources are those that come from industrial facilities and municipal sewage systems. Thus, they can be said to be pollution that can be traced to a particular source. However, non-point source pollution is diffuse and cannot be traced. Some main causes of non-point pollution are; agricultural, urban runoff, construction sites and waste disposal.

Majority of the sachet waters contain significant levels of pollutants, especially those from manufactures who do not comply with the NAFDAC (2008) and  WHO (2008) sachet water quality standards and these are able to cause significant problems when ingested by humans (Cunningham, 2009). Due to poor standard of available surface water, borehole sources and hand-dug well, they easily receive foreign materials from various sources which negatively impact on the quality of the sachet water made from these sources. Pollution of surface water occurs when the quantity of wastes entering a body of water overwhelms its capacity to assimilate the pollutants these wastes contain. Thus, the natural cleansing ability of oxygen contained in the water is compromised and the water can no longer breakdown organic pollutants (Buchholz, 2010).

Cairncross and Cliff (2007) have shown that soakage pits and pit latrines can extend their influence on ground-water quality up to 10m or more as groundwater flow is either lateral or vertical. Additionally, filtration does not occur during lateral flow and could carry feacal pollution for much longer distances possibly resulting in contamination of well water with pathogens (Crain, 2008). Pye and Patric (2007) have shown that land disposal of sewage sludge, illegal dumping of septic tank pumpage, improper toxic waste disposal and run off from agricultural operations all contributed to surface and ground water contamination with chemicals and micro-organisms.

Sachet water can also be contaminated during treatment, sealing, storage, distribution, etc. Contamination can also be as a result of the material used in the making of the sachet. Cunningham (2009) further suggested that, often the best way to control non-point pollution is through improved land use practices.

Treatment of sachet water

The purpose of sachet water treatment is to eliminate particles and pathogenic organism that might be present in the water which causes contamination of water. In the sachet water treatment process shown above, water from water supply source (either borehole or deep well) is passed through raw water tank usually made of Poly Vinyl Choride (PVC) pipes. The water is passed through industrial modules consisting of sand bed filter and activated carbon and this is passed into a treated water tank.

The water from the treated water tank is passed through three different microfilters 1, 2 and 3 of sizes 5μm, 2μm and 0.5μm respectively to remove to remove solid particles from the water. The filtered water is passed through and ultraviolet (uv) rays sterilizer attached to the sachet water machine to kill micro-organisms in the water.

The sterilized water is passed on to passed on to the automatic heat sealing machine to seal the polythene sachet and the sealed sachet water into bigger bags for distribution.

Standard sachet water quality parameters

The parameters that were considered as standard sachet water parameters are:

1. p^H

The pH of water is a measure of how acidic or alkaline (basic) the water is on a scale of 0 to 14. Pure distilled water is neutral with a pH of 7. pH measurement below 7 indicate that the solution is acidic containing more H⁺ ions than OH^– ions. Measurement above 7 indicates that the reverse situation exists making the water alkaline. It is important to note that for every one unit change on the pH scale, there is approximately a ten–fold in how acidic or alkaline the sample is. The usual pH for fresh water aquatic system is 6 to 9 with most water ways around pH is an indicator of existence of biological life as most of them thrive in a quite narrow and critical pH range. However, WHO (2008) stipulated that drinking water should have pH range of 6.5 to 8.5.

2. Total solids

It refers to matter suspended or dissolved in water or wastewater, the greater the amount of total suspended solids (TSS), the murkier it appears and the higher the measured turbidity. Total solids include both TSS, the portion of total solids retained by a filter and total dissolved solids (TDS), the portion that passes through a filter. TSS is an indication of the amount of erosion that took place. According to WHO (2008),  a critical TDS value of 2450mg/l above which some long term health problems might be anticipated due to excessive concentrations of dissolved particles in drinking water.

3. Electrical conductivity

Conductivity is a measure of the ability of water to conduct an electrical current and is directly related to the total dissolved salt content of the water. Ions come from the breakdown of compounds and conduct electricity because they are negatively or positively charged when dissolved in water. Some ions also occur naturally as water flows over certain types of rocks or soil. Calcium and carbonate ions dissolve into water when calcite containing rocks such as, limestone and shale, are present. WHO (2008) recommended 1000μS/cm maximum contaminant limit for drinking water.

4. Turbidity

For water to be aesthetically accepted, its clarity must be ensured. Turbidity is defined as the light scattering and absorbing property that prevents light from being transmitted in a straight lines through the sample. Turbidity may be due to organic and / or inorganic constituents. Organic particulates may harbour microorganisms. Although it does not adversely affect human health, turbidity is an important parameter in that it can protect microorganisms from disinfection effects, can stimulate bacteria growth and indicates problems with treatment processes (WHO, 2008).

5. Nitrate

Nitrate (NO₃^–) is a water-soluble and is made up of nitrogen and oxygen. It is formed when nitrogen from ammonia or other sources combines with oxygenated water. Nitrate is a natural constituent of plants and is found in vegetables at varying levels depending on the amount of fertilizer applied and on other growing conditions. Due to potential toxicity and widespread occurrence in water, it is regulated and should not exceed 10mg/l in drinking water (WHO, 2008).

6. Total phosphorous and phosphate, PO^3-₄

Phosphates enter the water ways through both non-point sources and point sources. Nonpoint source (NPS) pollution refers to water pollution from diffuse sources. Nonpoint source pollution can be contrasted with point source pollution, where discharges occur to a body of water at a single location. The non-point sources of phosphates include: natural decomposition of rocks and minerals, storm water runoff, agricultural runoff, erosion and sedimentation, atmospheric deposition, and direct input by animals/wildlife; whereas: point sources may include: wastewater treatment plants and permitted industrial discharges. WHO (2008), set maximum contaminant level at 0.3mg/l.

7. Sulphate, SO₄^2-, and hydrogen sulphide, H₂S

Sulphate is combination of sulphur and oxygen and is part of naturally occurring minerals in some soil and rock formations that contain groundwater. The mineral dissolves over time and is released into groundwater, as water moves through soil and rock formations that contain sulphate minerals. Sulphates are discharged into the aquatic environment in wastes from industries that use sulphates and sulphuric acid, such as mining and smelting operations, kraft pulp and paper mills, textile mills and tanneries (Delisle et al., 2007).  WHO set the Maximum contaminant level of sulphate in drinking water at 250mg/l

8. Total coliform

Coliform bacteria describe a group of enteric bacteria that includes escherichia coli, Klebsiella species and Enterobacter species. They are gram negative, facultative anaerobes and non-sporing rods that may be motile or not which ferments lactose with the production of acid and gas when incubated at 37°C (WHO, 2008). Faecal coliform (thermotolerant coliform) is a smaller group within the total coliform family, which inhabits the intestine of mammals and has a relatively shorter life span. Detection of coliforms is used as an indicator of sanitary quality of drinking water or as a general indicator of sanitary condition in the food-processing environment. However, Escherichia coli are the most preferred faecal coliform used in assessing water quality. It also does not grow and reproduce in the environment. As a result, it is considered to be the species of coliform bacteria that is the best indicator of faecal pollution. They also indicate the possible presence of pathogenic bacteria, viruses and protozoans (Dada, 2009).

Sachet water quality parameters

Table: Physical parameters

(Source: WHO, 2008).

Table: Chemical parameters of inorganic constituents

(Source: Nigeria Industrial Standard, 2007).

Health implications of drinking contaminated water

According to Nduka (2004) faecal matter present in water shows that the water is contaminated with salmonella and Escherichia. This can be as a result of faeces from surface or sewage contaminants such as pit latrine that percolate through the soil of the borehole or deep well that is used in borehole or deep well that is used in producing the sachet water and as well known E. coli being a gram negative bacterial belonging to the genera enterobacter, it thrives in the intestine tracts of man and animals thereby causing pyelonephritis and cystitis particularly in women, it also causes sepsis in operation wounds and neonatal meningitis in babies, it also causes diarrhoeic condition in man because of the toxigenic strains.

Asbolt (2004) stated that faecal-oral illness such as cholera, typhoid fever, dysentery is an indication that the water is infected with pathogenic viruses such as protozoa and helminthes. Asbolt (2004) further stressed that the risk of contracting helminthes such as ascaris lumbricoides (some called it ascaris and ankalostorma duodenale and nacator Americanus (hookworm) is possible as these package water spend ample time in the harbouring soil during improper storage in unhygienic environment. Hunter (2007) state that apart from environmental contamination, that contaminants also result from improper vendor handlers, which pose threat to the health of the ignorant consumer. How do I know that often time you see people drinking sachet water without proper cleaning, the common procedure is to wipe the sachet with the back of their hands that is often dirty.

Dada (2009) state that common practice of many manufacturers, distributors, vendors and consumers of exposing sachet water to direct sunlight whereby the ray from the sun reacts with the chemical used in producing the sachet and as a result causes chronic health problems such as cancer, kidney failure, respiratory infection, etc.

Measures to prevent contamination of water

Many pollutants are put into the ground and into lakes, rivers and streams every day. The disposal of wastes into ground and surface waters can cause contamination of water that we use for drinking and that we expect to be of excellent quality. It takes many years and it is very costly to remove contamination affecting water supplies. Often the damage is irreparable and the water resource can never be used as a drinking water source again. Preventing pollution of drinking water sources the following measures according to WHO (2008) must be strictly adhere to;

• do not allow liquids or wastes from garbage and manure piles to drain towards water bodies
• do not locate dog runs around water collection facilities
• do not treat the area around water bodies with pesticides or fertilizer
• do not flush oils, detergents, paints, solvents or other chemicals down the toilet
• ensure that sanitary seals or well caps for hand dug wells are securely in place and watertight
• cap is at least 30 cm above the ground
• joints, cracks and connections in the well casing are sealed
• surface drainage near the well is directed away from the well casing
• water pump and distribution systems are checked regularly
• changes in the quantity and quality of water are investigated immediately
• water is tested for bacteria three times a year and after major plumbing work
• water is chlorinated and tested after any major repairs
• abandoned wells should be carefully sealed to prevent pollution of groundwater and any safety hazards.
• Sachet water should not be stored for too long before consumption.

References

Asbolt, K. C. (2004). Heavy metal hazards of sachet water in Nigeria. Archives  of Environmental & Occupational Health. 61(5):209–213.

Dada, A. C. (2009). Sachet Water Phenomena in Nigeria. African Journal of Microbiological Research 3(23): 78-91

Ezeugwunne, I. P., Agbakoba, N.R. & Nnamah, .N.K. (2009).The prevalence Bacteria in Packaged Sachet Water Sold in Nnewi, South East, Nigeria. World Journal of Dairy and Food Science. 4(10):19-21.

Gleick, H.P. (2008). Dirty Water: Estimated Death from Water-Related Diseases 2000-2020. Pacific Institute for Studies in Development, Environment and Security.

Hunter, P.R. (2007). Water-borne Diseases epidemiology and ecology. John Wisley and Sons, Chichster, UK. Pp. 112.

Hozan, T.C. & Toranzos, G.A. (2010). Drinking Water Microbiology. New York: Springler 32-52.

Imalu, I.C. (2010). Contamination of Sachet Water in Nigeria.: Assessment and Health. Journal of Health and Allied Sociology. 9(4):15.

Mustapha, S. & Adamu, E.A. (2011). Discussion on Water Problems in Nigeria : Focus on Bauchi State. National  Res. Inst.

NAFDAC (2009). Sachet Water Quality Requirement for Drinking Water, Part 1, NG 175.

World Health Organisation (WHO) (2008). Guidelines for the Establishment Food Industries. Geneva: WHO GL05/EFI01/2008.