Brian Morgan – What are the health risks in our rivers? – Dec 21

It is a sad and sorry picture I bring to you following changes in society, in regulation, in travel and in manufacturing.   There are now many new risks which vary from very low to high, many are unassessed.   There are far too many to other than to briefly describe them all here.

The causes come in different forms.

Chemicals: These arise from industry, fertilisers, pesticides, from farm run-off, along with domestic chemicals present in sewage.   There are now literally thousands of newly synthesised chemicals used for many purposes throughout society, with the persistence and consequences of most being largely unknown.   Their toxic profile includes carcinogens, endocrine disruptors, and immuno-suppressants.

For example, certain brominated flame retardants which have been banned under international treaty years ago, antifouling paints, foams and many more.   Despite being banned, they still persist in our environments.   The harm caused by many hundreds of these is largely unknown.   Yet they persist in our waterbodies with no concerted attempts to study, track or remove them.   Some cogently are called “The Forever Chemicals”.

Of our 4,679 streams, lakes and rivers, all have recently failed to meet even minimum chemical standards.

Bacteria: These originate largely from sewage and from agricultural run-off from fields.   Their source is directly animals along with discharges from sewage treatment works, or from the run-off of sewage sludge when it is spread upon fields as a fertiliser.   These bacteria also originate from neighbouring woodlands and other ecosystems.   These bacteria vary from harmless to highly pathogenic.   However few of the bacteria are being monitored for their pathogenic nature, nor are they being removed.

Other water-borne pathogenspathogens A virus, bacterium or parasite which causes disease is a pathogen. Disease causing pathogens live in the environment, and both humans and animals are hosts to them. Pathogenic viruses, bacteria and parasites are present in sewage, originating from humans and animals, and thus it is essential that sewage is given proper treatment in order to disable (kill) these pathogens before the end-products of sewage treatment (solids and water effluent) are returned to the environment.: These include protozoa (microscopic sized single-celled animals), fungi, and viruses such as giardia, cryptosporidia, shigella and norovirus (see below: ref. F).

Generally speaking, very few of our rivers at present are even reasonably safe for bathing or swimming in, even for healthy and immune resistant people.   This is because the whole nature of the pollution now present in rivers has changed.

Despite the recorded presence of some highly pathogenic bacteria, viruses and other life-forms forms being present in both open-range and battery farms, it seems to me a sad neglect by the Environment Agency’s that it has left its responsibility to test for faecal bacteria from open-range and battery farms to the water companies.   As a result, I can find no records of any testing having been done at all (ref. A), other than by my own private testing.

Normally our immune systems would give us some protection.   But now we have reduced protection because over-used antibiotics have lost their potency, and there has been the development among common bacteria of resistance to antibiotics.   Also, a new danger is the increasing ability of pathogens to transfer their pathogenic factors genetically to other organisms.

The increasing damage to our immune systems from ultrafine particulate pollution, from both industry and traffic, is breaking down our normal immune response and its resistance to many diseases.   This has led to an escalation of highly fatal sepsis over the past decade.   Excess deaths from this cause in certain geographical areas is over 50%.

We also now have the introduction of new or re-emerging water-borne diseases, such as hepatitis A, tuberculosis, typhoid fever, vibrio, salmonella, shigella etc.   This has arisen through poor health regulation of world-wide travel, and through economies made in local government.

In most cases the symptoms following bathing in our polluted waters were traditionally minor stomach upsets, which could last for days into weeks.   While causing minor sickness in some people, they can cause serious disablement in others and even prove fatal.

The Big Three Ailments, out of a long list

Bacteria are single-celled organisms, which occur abundantly in nature.   They occur naturally and especially in lakes, rivers and streams.

Most are harmless to us, but some of those which are normally in the guts of warm-blooded animals are able to cause us sickness and disease.   These occur in our untreated sewage discharges, and in normal run-off from fields bearing sheep and cattle.   The latter carry the greater number of dangerous pathogenic types, such as in E coli 0157 (ref. H7)

Protozoa are also single celled organisms, but tend to be larger.   As these increase in numbers, so do many other harmful pathogens.   While frightening, this does need to be kept in perspective.

The number of fatal cases is increasing because of pollution, along with the return of ‘lost diseases’ largely due imports through globalised travel and reductions in local services.   But while the consequences are high, most risks are relatively low.   Nevertheless this is still unacceptable, and the price can be high.

An overlooked aspect is that many of these pathogens are carried by domestic pets with high daily defecation rates.   Eventually their wastes drain via rainwater into streams.

Present levels of these diseases are given in government and NHS data (refs. B, C and D).

Giardiasis is the commonest of these diseases, is regional and seasonal, and its incidence worse in the south.   This microscopic parasite lives in the guts of cattle and other ruminants.   It has increased in recent years due also to lack of health regulation in foreign travel.   It increased from 3,342 cases in England and Wales in 2012 to 4,793 cases in 2017.   It can also be carried in poorly treated tap drinking water which, when it occurs, needs to be boiled; with the North West seeming to suffer the most.

Cryptosporidiasis is another of the three dominant diseases.   It is caused by cryptosporidia present in the gut of cattle, and is the cause of death in many calves.

This mostly affects children about 1 to 5 years and gives watery diarrhoea.   Cases recently per year have varied from about 3,600 to 5,880.   These parasites encyst, so are fairly resistant to chlorination in swimming pools as well as treatment in sewage works.

Escherichia Coli infection is the third commonest cause of disease.   It is a bacterial ailment, causing stomach ailments which can vary from mild to lengthy and serious.

“Evidence Gaps” : quoted directly from Environment Agency (ref. A).

“The main evidence gap is in confirming the source of faecal bacteria, which is very challenging due to:

° The multitude of potential pathways and sources.

° The varying decay rates of different pathogens under different weather conditions.

° The intensity and cost of monitoring that is required.

° A further potential evidence gap may exist in the use of the generic faecal indicator (E coli) when the actual health risk may vary between sources.

° The EA does not routinely monitor ‘DrWPA’s ( Drinking Waters Protected Areas) for bacterial contamination.   Water companies are required to monitor their supplies, and alert us if they detect an issue.”

I see these above two sentences as a double confession of neglect from the EA.

Determined swimmers can decrease the risks though personal on spot hygiene, and washing down immediately after leaving the water.   But this does not help if they have swallowed a trace of infected water or got it in already sore eyes, or done a very long swim.   None of this really protects children nor the vulnerable.

Classic cases of illness were the Big Thames Swim with David Walliams, 2011 (See BBC report and The Guardian Report who became quite ill with giardia.   The Henley swim in 2012 where 338 out of 1000 swimmers became ill, also probably due to giardia.   And nurse Melissa Compton, 2019, in the Severn.   All involving accomplished swimmers.

Ref A: EA Faecal Contamination Pressure Narrative, 2019. https://consult.environment-agency.gov.uk/++preview++/environment-and-business/challenges-and-choices/user_uploads/faecal-contamination-pressure-rbmp-2021.pdf

Ref B: PHE Giardia data, to 2017, gov.uk www.gov.uk/government/publications/giardia-national-laboratory-data/giardia-data-2008-to-2017

Ref C: Cryptosporidiosis: guidance, data and analysis, gov.uk www.gov.uk/government/collections/cryptosporidiosis-guidance-data-and-analysis

Ref D: Waterborne Escherichia coli 0157, Pub Med, 2000 https://pubmed.ncbi.nlm.nih.gov/10880187

Ref E: chemtrust.org/chemical-pollution-in-rivers/ 2021.   https://chemtrust.org/chemical-pollution-in-rivers

Ref F: Pinon, Survival of Viruses in Water, Intervirology 2018;61;214-222.   www.karger.com/Article/Fulltext/484899

Ref G: This is a list of new chemicals, with maps and data:

River Pollution by priority chemical substances, under the Water Framework Directive; a provisional pan-European assessment Pistochii, 2019, Science of the Total Environment.   https://digital.csic.es/handle/10261/176538

Ref H: Kaper, Pathogenic Escherichia coli, Nature Reviews Microbiology,2004.   www.nature.com/articles/nrmicro818

Ref I: PLOS and related substances; sources, pathways and environmental data, EA, 2019. www.gov.uk/government/publications/poly-and-perfluoroalkyl-substances-pfas-sources-pathways-and-environmental-data

Ref J: Toxic Synthetic “Forever Chemicals” are in our Water and on our Plates. Nova, Riley, 2020 www.pbs.org/wgbh/nova/article/pfas-synthetic-chemicals-water-toxic

Giardia: Giardia is a tiny parasite (germ) that causes the diarrhoeal disease giardiasis.   Giardia is found on surfaces or in soil, food, or water that has been contaminated with faeces from infected people or animals.   You can get giardiasis if you swallow Giardia germs.   Giardia spreads easily, spreading from person to person or through contaminated water, food, surfaces, or objects.   The most common way people get sick is by swallowing contaminated drinking water or recreational water (for example, lakes, rivers, or pools).

E coli 157 bacteraemia: Escherichia coli 157 (0157), sometimes called VTEC, is a bacterial infection that can cause severe stomach pain, bloody diarrhoea and kidney failure.   E. coli O157 is found in the gut and faeces of many animals, particularly cattle.   It is an uncommon cause of gastroenteritis but can be caught by:

◦ Eating contaminated food (such as raw leafy vegetables or undercooked meat).   Always wash all vegetables (including salad leaves) that will be eaten raw, unless they have been pre-prepared and are labelled ‘ready to eat’.   Washing may reduce the risk of infection, but will not eliminate any risk of infection completely.

◦ Touching infected animals or accidentally coming into contact with their faeces.

◦ Contact with people who have the illness, particularly if you do not wash your hands thoroughly after using the toilet or before handling food.

◦ Drinking water from inadequately treated water supplies.

◦ Swimming or playing in contaminated water, such as ponds or streams.

Sepsis: Sepsis is the body’s extreme response to an infection.   It is a life-threatening medical emergency.   Sepsis happens when an infection you already have triggers a chain reaction throughout your body.   Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract.   Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.

Infections can put you at risk for sepsis.   When germs get into a person’s body, they can cause an infection.   If you don’t stop that infection, it can cause sepsis.   Bacterial infections cause most cases of sepsis.   Sepsis can also be a result of other infections, including viral infections, such as COVID-19 or influenza.

You can’t spread sepsis to other people.   However, an infection can lead to sepsis, and you can spread some infections to other people.

 
The following graphs have been compiled by Brian Morgan from data published by Public Health England, Office of National Statistics, the National Health Service, Royal College of Nursing and the Sepsis Trust.