title: Wastewater treatment and public health in Nunavut: a microbial risk assessment framework for the Canadian Arctic.
abstract: Wastewater management in Canadian Arctic communities is influenced by several geographical factors including climate, remoteness, population size, and local food-harvesting practices. Most communities use trucked collection services and basic treatment systems, which are capable of only low-level pathogen removal. These systems are typically reliant solely on natural environmental processes for treatment and make use of existing lagoons, wetlands, and bays. They are operated in a manner such that partially treated wastewater still containing potentially hazardous microorganisms is released into the terrestrial and aquatic environment at random times. Northern communities rely heavily on their local surroundings as a source of food, drinking water, and recreation, thus creating the possibility of human exposure to wastewater effluent. Human exposure to microbial hazards present in municipal wastewater can lead to acute gastrointestinal illness or more severe disease. Although estimating the actual disease burdens associated with wastewater exposures in Arctic communities is challenging, waterborne- and sanitation-related illness is believed to be comparatively higher than in other parts of Canada. This review offers a conceptual framework and evaluation of current knowledge to enable the first microbial risk assessment of exposure scenarios associated with food-harvesting and recreational activities in Arctic communities, where simplified wastewater systems are being operated.
authors.affiliation: Centre for Water Resources Studies, Dalhousie University, Halifax, NS, Canada. kiley.daley@dal.ca.
authors.forename: Kiley
authors.identifier: http://orcid.org/0000-0002-3199-0073
authors.initials: K
authors.lastname: Daley
authors.affiliation: Department of Process Engineering and Applied Science, Dalhousie University, Halifax, NS, Canada.
authors.forename: Rob
authors.initials: R
authors.lastname: Jamieson
authors.affiliation: Environmental Science Program, Dalhousie University, Halifax, NS, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rainham
authors.affiliation: National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Truelstrup Hansen
mesh_terms: D001110:Arctic Regions; D061006:Bays; D060766:Drinking Water / Q000382:microbiology; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D004930:Inuit; D020957:Nunavut; D011634:Public Health; D018570:Risk Assessment / Q000379:methods*; D012499:Sanitation; D014865:Waste Disposal, Fluid / Q000379:methods*; D062065:Wastewater / Q000382:microbiology*; D000069578:Waterborne Diseases / Q000209:etiology; D053833:Wetlands
chemical_list: D060766:Drinking Water; D062065:Wastewater
keywords: Conceptual model; Environmental exposures; Indigenous health; Inuit; Quantitative microbial risk assessment (QMRA); Rural health; Wastewater; Water, Sanitation, and Hygiene (WASH)