Quality of drinking and recreational water in the Hunter New England region of New South Wales: bridging the gap between research, practice and policy
Jaravani, Fidelis G. (2018) Quality of drinking and recreational water in the Hunter New England region of New South Wales: bridging the gap between research, practice and policy. PhD thesis, James Cook University.
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Abstract
Introduction
Population health research may include primary data collection and analysis; analysis of existing data; and systematic reviews for problem definition, solution generation, and evaluation. The main objective of this thesis was to analyse routinely collected data and primary data to assess drinking and recreational water quality management in the Hunter New England region of New South Wales (NSW), Australia. This research was practitionerled and designed to bridge the gap between research and policy in drinking water management in NSW. When used with a specific research goal, routinely collected data obtained for performance monitoring purposes is an important tool for improving the quality of water supplies. Such practitioner-led research may be directly translated into local practice to improve public health service delivery.
Continuous interactions between practitioner-researchers, academics, decision makers and other stakeholders throughout the research process provided impetus for evidence adoption through sustained evaluation of public health benefits. This thesis provides a firm foundation for the design of future environmental health interventions for the translation of research evidence to policy decision outcomes, leading to improved water quality and public health in rural areas.
Setting
In NSW, the NSW Public Health Act 2010 (NSW Government, 2010) regulates water suppliers to provide safe water to consumers. NSW Health provides drinking water supply protocols that include monitoring, reporting, and public notifications. The NSW Health's Drinking Water Monitoring Program provides free water testing for suppliers throughout the state. Public water suppliers (utilities) are allocated barcoded-labels for the recommended number of samples for each water supply system each year. Compliance is measured by the adequacy of sampling, in which at least 98% should yield no E. coli detections. The Program centrally manages the internet-based NSW Drinking Water Database, which has recorded more than 20 000 sample results per year since 2001. Therefore, there is sufficient routinely collected data to assess drinking water quality in NSW.
Method
A Participatory Action Research (PAR) process was applied using a mixed methods framework. The practitioner researcher's research and collaborations with academics, policy makers and stakeholders from the planning through to the implementation of projects ensured that expectations were clear. An 'adopt and intervene as-we-go' philosophy was applied. The evidence was interrogated and areas of intervention were applied. Further projects were then designed to evaluate the identified areas of intervention.
Four approaches were taken to explore and bring about change in drinking water quality management through advocacy:
• Working with departmental staff to analyse routinely collected microbiological water quality data for reticulated water supplies to improve drinking water quality management within existing work budgets;
• Working with recreational parks authorities to collect and analyse data to assess and improve private drinking water management;
• Working with an Aboriginal community to assess reticulated drinking water supply quality and acceptance and promote consumption of safe drinking water; and
• Working with departmental staff to pilot Enterococci testing to assess recreational swimming water quality at popular swimming sites to design new policy to reduce public health risk.
Regular research briefs and reports to share findings, dissemination and advocacy through peer reviewed journal articles and presentations at professional conferences were used to share the research evidence to stakeholders, policy-makers and peer environmental health practitioners.
Results and outcomes
Public drinking water sampling adequacy significantly improved (p = 0.002) during the study period. Sampling adequacy was significantly lower in smaller populations (p = 0.013). E. coli detections significantly improved (p < 0.0001) but were significantly higher in smaller communities (p< 0.001). There was a strong inverse correlation between sampling compliance and E. coli detection (p<0.001; R² Linear = 0.72). NSW Health has assisted utilities to develop and implement Drinking Water Management Systems throughout the State.
All recreational parks developed and implemented drinking water quality assurance programs. All recreational parks that provided water but do not treat or regularly monitor the quality of the water supplies have installed appropriate warning signs by the NSW Private Water Supply Guidelines, to warn visitors. Private drinking water supplies have now been included in the NSW Public Health Act, and Private Drinking Water Supply Guidelines were amended to include the development and implementation of drinking water quality assurance plans.
Aesthetic factors such as water hardness, taste, colour, odours and societal values influence perceptions of risk and quality. Plans are underway to soften town water supply, as requested by the participating Aboriginal community, as this was a major barrier to consumption.
All swimming sites exceeded the threshold NHMRC Enterococci illness transmission recreational level of 40 CFU/100 ml. There is a need for risk-based water quality management at informal recreational swimming sites.
Conclusion
The research demonstrated that improving drinking water sampling frequency was associated with enhanced microbiological water safety. However, there is room for improvement in sampling adequacy and water quality (E. coli detections) in smaller communities. Further dialogue, research, and policy focus is needed that includes partnerships with discrete NSW Aboriginal communities, in order to develop a deeper understanding of their perceptions of drinking water and to encourage consumption of safe water.
This research promoted interaction between practitioners, managers and academics in environmental health program development to promote public health. The research clearly demonstrated how using routinely collected data coupled with primary data collection results in strong environmental health practitioner-led research with important policy outcomes. Future research should build on these key strengths, linking environmental health practitioners' fieldwork with productive collaborative networks between academics and policy makers, to promote the development of knowledge that provides evidence-based policy changes for public health benefit.
| Item ID: | 62893 |
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| Item Type: | Thesis (PhD) |
| Keywords: | Aboriginal health, community experiences, community perceptions, drinking water monitoring, drinking water quality assurance program, drinking water quality, drinking water safety, drinking water, microbiological water samples, mixed method research design, national parks, private drinking water supply, private water supply, rainwater, recreational parks, sampling adequacy, warning signs, water quality warning signs |
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| Copyright Information: | Copyright © 2018 Fidelis G. Jaravani. |
| Additional Information: | Aboriginal and Torres Strait Islander people should be aware that this thesis may contain images or names of deceased persons. This is a thesis by publication. One published article included in chapter 4 has been redacted from the thesis due to copyright restrictions. Five publications arising from this thesis are stored in ResearchOnline@JCU, at the time of processing. Please see the Related URLs. The publications are: Chapter 3: Jaravani, Fidelis Godfrey, Butler, Michelle, Byleveld, Paul, Durrheim, David N., Massey, Peter D., Collins, Julie, Judd, Jenni A., and Oelgemöller, Michael (2020) Drinking water quality in regional Hunter New England, New South Wales, Australia, 2001-2015. Australasian Journal of Water Resources, 24 (1). pp. 73-83. Chapter 4: Jaravani, Fidelis Godfrey, Durrheim, David, Byleveld, Paul, Oelgemoeller, Michael, and Judd, Jenni (2015) Drinking water safety in recreational parks in northern New South Wales, Australia. Australasian Journal of Environmental Management, 22 (4). pp. 432-445. Chapter 4: Jaravani, Fidelis G., Durrheim, David N., Judd, Jenni, Oelgemoeller, Michael, Butler, Michelle, and Massey, Peter D. (2019) Improving drinking water safety in recreational parks through policy changes and regulatory support in the Hunter New England region, NSW, Australia. Australasian Journal of Environmental Management, 26 (4). pp. 386-406. Chapter 5: Jaravani, Fidelis G., Massey, Peter, Judd, Jennifer, Allan, Jason, and Allan, Natalie (2016) Closing the gap: the need to consider perceptions about drinking water in rural Aboriginal communities in NSW, Australia. Public Health Research & Practice, 26 (2). e2621616. Chapter 5: Jaravani, Fidelis G., Massey, Peter D., Judd, Jenni, Taylor, Kylie A., Allan, Jason, Allan, Natalie, Durrheim, David N., and Oelgemoeller, Michael (2017) Working with an Aboriginal community to understand drinking water perceptions and acceptance in rural New South Wales. International Indigenous Policy Journal, 8 (3). 4. pp. 1-29. |
| Date Deposited: | 28 Sep 2020 04:06 |
| FoR Codes: | 03 CHEMICAL SCIENCES > 0305 Organic Chemistry > 030505 Physical Organic Chemistry @ 34% 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111705 Environmental and Occupational Health and Safety @ 33% 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 33% |
| SEO Codes: | 96 ENVIRONMENT > 9611 Physical and Chemical Conditions of Water > 961103 Physical and Chemical Conditions of Water in Fresh, Ground and Surface Water Environments (excl. Urban and @ 34% 96 ENVIRONMENT > 9606 Environmental and Natural Resource Evaluation > 960608 Rural Water Evaluation (incl. Water Quality) @ 33% 92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 33% |
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