Trade off between coverage and safety of piped water supply

in urban slums- Evidence from Bhubaneswar City

Pre-PhD Coursework (2014-2015)

Niladri Chakraborti

Environmental Science/02/Seminar-1

POST GRADUATE DEPARTMENT OF BOTANY

UTKAL UNIVERSITY, VANI VIHAR
BHUBANESWAR-751004, ODISHA

1
 Content
Introduction 3

Literature Review 4

Material and methods 8

Result and Discussion 11

Conclusions 18

Acknowledgement Error! Bookmark not defined.

References 18

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Introduction

India no-longer lives only in village. The size of its urban population has increased from 26 million in
1901 to 377 million in 2011(Census 2011). Eventually with its limited resources the nation is finding it
difficult to cope up with the consequences of such first paced urbanization. A plethora of complex
problems started cropping up in terms of land use, environmental degradation, infrastructure and
transport. One of the most visible and ubiquitous problems is the failure of housing to keep pace with
demand. As a result a sizable proportion, particularly in big cities is found to live either in poor quality
housing or to take shelter on pavement, or public place like bus stand, railway platform etc. A major
issue with housing is its affordibily that has given rise to „slum‟ and „squatter colonies‟. Census 2011
revealed that 17.4% of the urban households in India are located within the slums. It took more than 30
years for Govt. to accept that such settlements- which are mostly illegal- are not threat to established
order but a symptom of lack of alternative means for low income people to secure housing (Hardoy,
Mitlin, & Satterthwaite, 2001).

A „slum‟ for the Census purpose has been defined as “residential areas where dwellings are unfit for
human habitation by reasons of dilapidation, overcrowding, faulty arrangements and design of such
buildings, narrowness or faulty arrangement of street, lack of ventilation, light or sanitation facilities or
any combination of these factors which are detrimental to the safety or health‟‟ (Slum area improvement
and clearance Act, 1956). Census further classifies slum as „notified‟ ; „recognized‟ and „identified‟ based
on their legal status. Often living conditions and health status are found slightly better in notified slums
in comparison to other two categories (Sajjad, 2014). Along with other basic amenities unrecognized
slums in developing nations always lack legal access to municipal water supplies (Subbaraman, et al.,
2013). Census 2011 however gives us a paradoxical statistics about the drinking water coverage of Indian
slums irrespective of their legal status. 74% of households located at slums are having access to tap water,
where as urban as a whole has coverage of 71%. This statistics indicates that along with 34.3% of Indian
notified slums a substantial portion of its recognized (28.5 % of total enumerated slums) and identified
slums (37.2% of total enumerated slums) are also enjoying access to „improved1‟ water sources. Global
access to safe drinking water is assessed jointly by WHO & UNICEF and they consider “use of improved

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Joint Monitoring Program (JMP) of WHO/UNICEF categories a drinking water source type as improved if “by
nature of its construction or through active intervention it is protected from outside contamination with fecal matter.
Improved source types include piped water into dwelling; yard or plot, stand pipe, borehole, protected dug well, or
spring and rain water.

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sources” as an indicator. However, use of improved source doesn't account for water quality and
associated risks of the water sources for microbial contamination (Bain, et al., 2014)

Here comes the relevance of the current study. It explores how safe the water supply is even with
enhanced coverage of so called “improved” drinking water sources in the Indian slums with evidence
from Bhubaneswar, the state capital of Odisha. Odisha has been emerged in recent Census as one of the
top five states with higher proportion of urban households residing in slums (23%). Like any other fastest
growing cities in third world countries slums are becoming dominant type of human settlement in
Bhubaneswar, craving their way into the fabric of the main city. According to Bhubaneswar Municipal
Corporation (BMC) survey 2008, the city has total 3772 slums of which only 99 are recognized. Close to
0.3 million people reside in those slums which is almost one third of its total population size.

Literature Review

The importance of water to human health and wellbeing is encapsulated in human rights to safe water and
sanitation. The rights entitle everyone to “sufficient safe, acceptable physically accessible and affordable
water for personal and domestic use” (UN, 2010). Further Millennium Development Goal (MDG) in its
target 7c-which aims environmental sustainability-, says to halve, by 2015 the proportion of people
without sustainable access to safe drinking water and basic sanitation. Proportion of population using
“improved” drinking water sources is being considered as indicator to measure the increasing access to
„safe‟ water. Joint monitoring Program (JMP) of WHO/UNICEF uses this indicators and when its reports
in 2013 reveal that 89% population across the globe are having access to “safe” water it implies that they
are having access to “ improved” water sources like piped water connection; stand post or bore well etc.
In this line when current Indian Census statistics present the impressive coverage of tap water sources,
(improved source) that too in urban slums, it seems India is progressing commendably towards achieving
the target 7c of MDG. But a considerable number of researches proved that “improved sources” do not
always render “safe” water. The tradeoff between coverage and safety is a crucial aspect of the water
supply.

Treating use of „improved‟ sources as an proxy indicator for use of „safe‟ water is likely to
overestimate the population using safe water since some improved sources may provide water that is
microbiologically or chemically contaminated whether at source or by the time it reaches to consumer
(Onda, LoBuglio, & Bartman, 2012) .A recent research on fecal contamination of drinking water in low

2
Latest Rajiv Awas Yojana (RAY) Survey however telling the number of slums has increased to 436. Final report
is yet to be published.

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and middle income countries (Bain, et al., 2014) depicts that fecal contamination of drinking water is
rampant in low and middle income courtiers. Though performance of “improved” sources against this
type of contamination is better but they are not universally or consistently free from fecal contamination.

In case of improved source like piped water supply water becomes vulnerable and perishable following
abstraction and treatment as it enters in the distribution system as because the integrity of the system may
be damaged and contamination through ingress can be occurred (Robertson, Standfield, Howard, &
Bartram, 2003). The disintegrity can be attributed to poor site selection or protection such as apron and
lining; construction difficulties and structural deterioration with age (Lloyd & Bartram, 1991) . The rate
of leakages –major manfestation of disintegration-can be in a range of 10-20% even in case of well
operated system (WHO & UNICEF, 2000). A cross sectional study which assessed the enteric disease
risk associated with water quality describes that in Hydrabad city of India approximately 181 leakes are
reported every day and these refers only the leakes visible to consumers (Mohanty et al, 2002) .
Supplying piped water intermittent throughout the world increases the risk of microbial contamination
through multiple mechanisms. According to Robertson et.al ( 2003) intermittent operation leads to low
pressure zone within the distribution system. Such pressure gradient along with presence of contaminated
water in subsurface material sorrounding distribution system form leaking sanitary or storm swerage and
leakage in the sytem leads to infiltration .Converting an intermittent supply to continuous supply has the
potential to improve the quality of the water. A comparative study between intermittent and continuous
water supply network was conducted over one year at Hubli –Dharwad. The study found more frequent
presence of fecal contamination indicator bacteria at higher concentration in sample collected from
intermittent water supply compared to those from continuous water supply( p<0.01) (Kampel & Nelson,
2013).

Low line pressure also leads to back siphonage. In which contaminated surface water is drawn into the
distribution system through a back flow mechanism. Low lying area where the tap gets emerged in pool
of water, such corss connection can occur( (Robertson et.al , 2003) .

The water in the distributing system turns perishable when its microbial quality can be deteriorated
because of either treatment failure or poor treatment (Robertson, Standfield, Howard, & Bartram, 2003).
Sporadically treatment train can be overwhelmed because of occurrence of source water with high
turbidity mostly after a heavy rain fall (Robertson, Standfield, Howard, & Bartram, 2003). Disinfactant
residual- if it is present at all- only can guard a small amount of reintroduced pathogen in distribution
systme through cross contamination like infiltartion and backsyphonage (Gadgil, 1998). It was found in
Trinidad that as the residual chlorine concentration got reduced from 4.6 ppm at water treatment plant to

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mare 0.2ppm at household end there was statistically significance increase in the count of total
thermotolerant colifoem in water (Agard, et al., 2002). A study conducted in the Eldoret municipality of
Kenya reports that the available residual chlorine within the distribution network failed to render safe
water with an event of 0.1% raw sewage contamination (Nadambuki, 2006) . Though the water entered
in distribution system was treated and was carrying residual disinfection because of cross connection3 it
got contaminated. In another study which tried to assess the coliform4 contamination in drinking water
from source to point of use in Mysore City of Karnataka, India found 20% of the sample collected from
tap was contaminated (Raju, Roopavathi, Kini, & Niranjana, 2011) .

Existence of slums worldwide and especially in developing country has been described as the
manifestation of urbanization and consequent unplanned urban development (Bolay, 2006). When human
started living in close proximity to each other around 5,000 years ago health challenges included the
import of water, food and other essentials to the population, and transport of excreta and other waste
products away from the population (Kjellstrom, et al., 2007). Providing access to safe water, garbage
removal, and sanitation in the late 19th and early 20th centuries created the conditions for the dramatic
reductions in mortality from infectious diseases in developed nations (Vlahov, et al., 2007).Many million
people living in low-income and informal settlement (slums) in cities are facing similar challenges now
(Kjellstrom, et al., 2007). Slums are often characterized by attributes like lack of basic amenities viz. safe
drinking water; safe sanitation; solid and liquid waste disposal along with overcrowding and unhealthy or
hazardous location like waste landfill sites in developing countries (Vlahov, et al., 2007) . Several
empirical studies suggest that improved water supply should be combined with improved sanitation
(Kjellstrom, et al., 2007). Sanitation is abroad concept that encompasses the safe removal, disposal and
management of household solid waste, wastewater and industrial waste. Access to improved sanitation in
urban areas on the other hand is defined as the direct connection to a public piped sewer, direct
connection to a septic system or access to pour flash or ventilated improved pit latrine (Sheuya, 2008).
According to Census 2011 slums in India has sanitation coverage of around 81% but the wastewater
outlet of 63% slum households are connected to either open drainage or no drainage at all. As the water
supply service level is increasing (74%, Census 2011) consumption will eventually increase and will lead
to production of increased volume of wastewater (Howard, Reed, McChesney, & Taylor, 2006). The
inability to remove storm water from slums creates pool of contaminated standing water (Sheuya, 2008)
which may lead to infiltration or back siphonage into piped water distribution system routed through the
slums (Robertso et al , 2003 and Lee & Schwab, 2005)

3
A cross connection refers to „any connection between a potable drinking water supply and a non-potable ,
undesirable , polluted or contaminated source‟(Herrick, 1997)
4
Indicative microorganism for fecal contamination

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Several epidemiological studies through environmental investigation identified pipe line leakage and its
cross connection with sewerage, open-drain, stagnant storm water pool etc. as a causal factor associated
with outbreak of various waterborne diseases. A large outbreak of Hepatitis E occurred in 2005 in
Hyderabad City. Cases were centered around open sewage drains that crossed the old city. The attack rate
was significantly higher in neighborhood blocks supplied by water supply lines that crossed open drains
(Sailaja, et al., 2009).

In 2006 a cholera outbreak took place in a slum located within Garulia municipality of North 24 Pargana
Distrcit West Bengal. The cause was attributed to rapid urban growth in absence of proper planning
leading to insufficient water and sanitation infrastructure. Environmental unsanitary conditions, dense
population and large slum population facilitate Cholera outbreak. The outbreak affected a high risk slum
supplied by an old piped water supply with no regular chlorination. The probable source of infection was
non-chlorinated piped water that has sucked the nearby swage (Bhunia et al, 2009).

Gayshpur municipality located in Kolkata metropolitan district in 2007 witnessed a waterborne outbreak
of diarrhea caused by Shigella flexneri. Environmental investigation identified the leakage and subsequent
submerging of the 25 years old network of water distribution pipe from over head tank in ward number 2
was source of contamination (Saha et al, 2009). In the same year a typhoid fever outbreak occurred in
slums of South Dum Dum. Here again the pipeline supplying non chlorinated water intermittently thrice
a day and running closely to a open drainage system was identified as source of contamination (Bhunia, et
al., 2009).

The developing urban settlement of Mayurbhanj district of Odisha had an outbreak of cholera in 2009.
Here sewage contaminated flooded water entered into drinking water pipeline through open valve
chamber and damaged the valve point (Home & Posts, 2014) . Urban Bangladesh reported outbreak of
Cholera in 2011 at Bogra and Kishorgunj districts. In both areas leakage in pipeline and pipeline running
close to sewerage were attributed as causal factors for cross contamination of drinking water (Haque, et
al., 2013).

The common attributes of all the above cited studies were the “study location” which was urban or
precisely slums. Rapid urbanization, population growth etc is causing stress on distribution system
(WHO, 2014) All the studies conducted in different year and in different places are empirically
showing that deficiency of water distribution system and its exposure to persisting environmental hazard
ultimately translated into outbreaks of fatal water-borne diseases. However during the course of literature
review no such study could be identified which actually quantifies the extent of risks or hazard associated
with the so called „safe‟ source distribution in urban slums landscape. According to Lee & Schwab (2005)

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the impact that distribution networks have on reducing water quality has been inadequately addressed due
to limited information avialble on the magnitude of the public helath problem. Existing statistics are often
optimistics rather than ralistics estimates of the actual conditions of the distribution network. Little
research is being conducted towards determining whether distribution system inadequacies are result of
sporadic breaks downs or continually occuraing. Current study tried to quntify the likelihood of risks
associated with water distribution system when it is exposed to hazardous factors present in urban slum
environemnt. It also examined if any of the hazoudous factors has significant contribution to the
bacterilogical contamination of the water.

Material and methods

a. Study Area:

Bhubaneswar city has total 377 slums across 60 municipal wards. Current study was confined in 155
numbers of slums across 21 wards. All the slums have access to piped water supply.

Figure 1| Study area in Bhubaneswar City

b. Research Methods

The study relied on Source-pathway-receptor model of contamination. In this model the source is the
source of hazards, the receptor is the water supply (in current study the pipes that form the distribution
system) and pathway are means by which the hazard can leave the „source‟ and reach the receptor
(Godfrey & Howard, 2004). The model recognizes that the presence of hazards in the environment is

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insufficient on its own to represent a risk. A feasible pathway must exist that allow hazards to travel from
source to water supply. Adopting the model the current study followed the footprint of “Rapid
Assessment of Drinking Water Quality” conducted jointly by WHO and UNICEF in year 2004-
2005(Onda et al, 2012).

Box: 1 Source, Pathway, Receptor relationship

Source Pathway Receptor

Source- Hazard event/ environment

Pathway- Vulnerability of the piped supply

Receptor – Receiving water infrastructure

The study tried to estimate the sanitary risks associated with all the public stand posts5 (N= 293) located
within the study area by using WHO recommended standard sanitary survey format followed by
microbial quality assessment and examining the presence of residual chlorine.

i. Risk assessment by onsite sanitary inspection

Sanitary inspection formats follow the principle of checking the potential faults that may reduce the
quality of water supply during onsite inspection. WHO prescribed sanitary inspection format was
customized and translated in Odia for current study. The standardized survey format consist of a set of 11
diagnostics questions which captures dichotomous response either “yes” or “no” for on- site inspection of
various categories of drinking water sources. The questions are structured in a way, so that „‟yes‟‟ answer
indicates that there is a risk of contamination and „‟no” answer indicates that the particular risk is absent.
Each “yes” answer scores “1” and “no” answer scores “0” attributing same value and weightage to each
risk factor (Usually 1/10-12) based on statistical correlation between the importance of microbiological
/chemical contamination as determined by laboratory analysis and different diagnostic information
identified through sanitary survey (Ferretti et al, 2010) . At the end of the inspection all the assertive
responses collectively decide the risk of contamination of each source. Based on the score, risk of
contamination is classified as low [0-2]; intermediate [3-5]; high [6-8] and very high [9 and above]

ii. Water testing by H2S vial

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Piped water supply through stand post consists of a water lifting mechanism from source, a distribution network
through pipe lines and individual delivery points such as public stand posts. Treated water is generally supplied
through piped network

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In order to test the faecal contamination, the sample water collected in H 2S vial from each stand-post
which was inspected. Hydrogen Sulphide (H2S) vial is a potentially useful tool for screening water
sources and drinking water for fecal contamination6. It is easy to use and readily available. The method
of testing by the kit involves:
1. Dry and sterile media are provided in the screw-capped bottles, which are ready for use. Fill the
water to be tested in bottle up to the mark and cap it.
2. Shake the bottle gently after 5 minutes to dissolve the contents completely.
3. Keep at room temperature preferably at 25-35 degree Celsius temp for 24 to 48 hours (WHO,
2002).
4. Observe for blackening of the contents.
5. If turns brown or black, it is likely that water is not fit for drinking
H2S test uses a medium with thiosulphate as a sulphur source and ferric ammonium citrate as indicator.
During incubation hydrogen sulphide is produced by some enteric bacteria viz. E. coli by reducing
thiosulpahte. Hydrogen sulphide then reacts with ferric ammonium citrate producing a black insoluble
precipitate and indicating the presence of the desired bacteria (Mosley & Sharp, 2005).
iii. Water Testing by Residual Chlorine Field Test kit

The presence of chlorine residual in drinking water indicates that:

1) A sufficient amount of chlorine was added initially to the water to inactivate the bacteria and some
viruses that cause diarrheal diseases
2) The water is protected from recontamination during transportation and storage. The presence of free
residual chlorine in drinking water is correlated with the absence of disease-causing organisms, and thus
is a measure of the potability of water.
In current sanitary survey water samples from all inspected stand post were collected and tested for
residual chlorine with a DPD (N, N-diethyl-p-phenylenediamine – FAS(Ferrous Ammonium Sulphate)
titration based filed test kit.
DPD (N, N-diethyl-p-phenylenediamine), is the most common method for measuring free chlorine. At
near neutral pH chlorine oxidizes the DPD to form a pink colored compound. Utilizing this, the
quantitative technique suitable to measure free chlorine at site has been developed. A reducing agent,
Ferrous Ammonium Sulphate (FAS) is used as a titrant which reacts and changes the pink colored
solution to a colorless solution at the end point (Harp, 2002)
A buffered DPD indicator powder is added to a water sample (as per the method of test given with the kit)
which reacts with chlorine to produce the pink color characteristic of the standard DPD test. Ferrous

6
H2S vial just is indicates presence or absence of fecal bacteria. To quantify it further laboratory testing is required.

10
Ammonium Sulfate (FAS) solution of appropriate strength is then added drop by drop until the pink color
completely and permanently disappears, signaling the endpoint of the reaction. To get the reading, the
number of drops used to obtain this color change is multiplied by the factor (as it was given 0.1 in this test
method along with the test kit) for the concentration of free chlorine in the water sample.

Figure 2| Chemical Reaction of DPD -FAS

iv. Software used for data analysis

Software like MS Excel 2010, SPSS v16 etc. were used for data warehousing and subsequent analysis.
Other than calculating simple frequency and percentage some bivariate and multivariate correlation,
regression was done to find the association between contamination and several risk factors as per the
standard protocol. Considering the cross sectional nature of the study Odds ratio was calculated in 95%
confidence interval and Chi-square test was done to explore if there is any significance association in
between risk factors and contamination. ArcView GIS 3.2 was used for mapping the study area and
plotting the area with potential higher risk of contamination.

Result and Discussion

In present study total 293 stand posts were inspected out of which 27% was found belonging to „low risk‟
category, 45% was found in „intermediate risk‟ category and 28% was found in‟ high risk „category. No
stand post was found in the „very high risk‟ category. Figure 3 suggests that the median risk score for
stand post is 4[IQR 2, 6] means on average each stand is associated with 4 sanitary risks. It is evident
from the data that in slum context safety of pipe water supply has intermediate potentiality to be
compromised at any given time and space.

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10% of the total inspected stand posts were found with bacteriological contamination (n=293), 11% of the
total sources under intermediate risk category (n= 132) and 15% of the total sources belonging to high
risk category (n=81) were found contaminated. As we know water quality varies seasonally (Godfrey et
al, 2006), water quality in such sources mostly gets affected post rain event (Howard et al, 2003).
Eventually a single measure may often present such ambiguous findings which otherwise can be ruled out
by more frequent assessment. (Luby, et al., 2008).

Following table gives us a glimpse of the

persisting situation of all the inspected stand post
against the prescribed risk factors. Surrounding
area insanitary, stagnant water surrounding stand
post (hazard factors),plinth cracked and eroded
(pathway factors) and animal having access to
source (indirect factors) emerged as predominant
risk factors associated with pipe water supply alias
stand post in Bhubaneswar slums.
Figure 3| Box and whisker plot of risk score for stand post
Stand post, n=293

Risk factors %

Leakage in tap 21

Surrounding area insanitary 72

Stagnant water surrounding stand post 46

Discontinuity of water supply for last 10 days 6

Leakage in distribution pipe 21

Stand post below ground level 38

User reported pipe breaks last week 9

Plinth cracked and eroded 45

Animal has access to stand post 83

Cracks and leakage in adjacent tank 8

Table 1| Existing situation of stand post in Bhubaneswar Slums

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The cross tabulation of the associated risks obtained through sanitary inspection and water quality data
are presented below.

Risk factors % reported with H2S test positive

Leakage in tap (n=62) 13

Surrounding area insanitary (n=210) 12

Stagnant water surrounding stand post(n=135) 17

Discontinuity of water supply for last 10 days(n=16) 19

Leakage in distribution pipe(n=61) 20

Stand post below ground level (n=110) 9

User reported pipe breaks last week(n=27) 11

Plinth cracked and eroded (n=132) 10

Animal has access to stand post(n=244) 10

Table 2| Distribution of contaminated sources against each risk factor

Stand post with leakage in distribution pipe, where water supply was discontinued for last 10 days and
surrounded by stagnant water were found more contaminated. To test whether this contamination was
just happened by chance or there is statistically significant association between each or multiple risk
factors and bacteriological contamination odds ratio (OR) was calculated along with Chi-square test for
each risk factors in 2 X 2 contingency table (Howard et al, 2003).

Odds are the probability of an event occurring divided by the probability of not occurring. An odds ratio
is the odds of the event (here bacteriological contamination) in one group for example those stand posts
exposed to certain risk factor divided by odds in another groups - stand posts not exposed to certain risk
factor(David et al. 2008). Odds ratio above 1 indicates a positive relationship between the risk factors and
water contamination. Confidence interval and p-value gives an indication of the statistical significance of
the odds ratio and eventually about the relationship of the risk factor and water quality compromisation
(Howard et al, 2003). The findings are placed in the following contingency table for stand post. In the
following table only two risk factors that is „‟surrounding area insanitary” and “leakage distribution
pipe line” have been found to have significant association with water contamination at p value
0.024<0.05 and .004<0.05.

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Risk factors Water sample detected with
bacteriological contamination

OR 95% CI p-value

Leakage in tap 1.481 .622 ,4.032 0.372

Surrounding area insanitary 3.77 1.108,12.820 .024

Stagnant water surrounding stand post 1.753 .805,3.815 0.083

Discontinuity of water supply for last 10 days 2.227 .595,8.333 .223

Leakage in distribution pipe 3.095 1.388,6.896 .004

Stand post below ground level 1.159 0.518,2.592 0.72

User reported pipe breaks last week 1.154 0.325,4.095 0.825

Plinth cracked and eroded 1.010 0.467,2.183 .98

Animal has access to stand post 1.042 0.377,2.878 .937

Cracks and leakage in adjacent tank 1.167 .259,5.249 .841

Table 3| Contingency table for stand post

In other way round Odds ratio in both the cases are greater than 1 and 95% Confidence interval which
provide information about precision excludes 1(Odds ratio =1 signify no association between exposure
and outcome), and thus signifying positive association.

Multivariate Logistic regression models were developed using SPSS to further investigate the causes of
exceeding water quality targets (Howard et al, 2003). Such model is used to explore association between
one out come variable (dichotomous, contamination=1, no contamination=0) and two or more exposure
variables. In our present study all the risk factors are exposure variables. This model helps in isolating the
relationship between the exposure variable and outcome variable from the effect of one or more other
variables called covariates or more precisely confounder. While doing the regression however only those
covariates where Odds ratio showed relationship significant at least to 95% confidence interval level.

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„‟Surrounding area of stand post insanitary‟‟ and „‟Leakage in distribution pipeline” are two such
covariates. The result of binary logistic regression model is shown below.

Model -2LL Variables Log S.E. df Sig. Exp(B) 95.0% C.I.for

EXP(B)
estimate(B)
Lower Upper

Source found 177.468 Constant -3.467 .599 1 .000 .031

contaminated[H2S Area 1.189 .630 1 .059** 3.285 .956 11.292

test positive] insanitary

Leakage in 1.011 .414 1 .015** 2.747 1.221 6.183

distribution
pipe line
Table 4| Logistic regression for stand post in Bhubaneswar Slums

**p<.05
The model explains that leakage in distribution of pipeline is 2.747 times more likely to have
contamination in the water supplied through piped connection and insanitary area surrounding stand post
are 3.285 times more likely to have contamination. Such findings are in agreement with other similar
studies. Infiltration of contaminated surface or sub surface water occurs when there is reduced pressure
within the supply pipeline and simultaneously there is existence of a physical route i.e. leakage caused
either by corrosion, cracks or outright breaks. Leakage rates are typically found high with even well
operated system experiencing rates of 10-20 %( LeChevallier, 1999, WHO & UNICEF, 2000). This is
likely to be associated with large number of points of leakage and therefore presents an increased risk of
intrusion of pathogenic organisms.

WHO recommend that the residual chlorine in the treated drinking water should be within the range of 0.2
to 0.5 ppm (mg/l) for preventing further growth of bacteria during transportation of water through pipe
line and in the course of storage. Residual chlorine of water sample from all the stand posts were tested
with the field test kit. Sample from total 293 stand post were found with a minimum 0.0 ppm to 5.50 ppm
residual chlorine with a mean of .47ppm and a standard deviation of .479. Slight higher standard
deviation indicates that there is wide variation of the presence of residual chlorine found in different

15
sample and presence of outlier as well. Excessive high amount of residual chlorine determined in a few
number of sources is the evidence against the existence of such outliers.
With reference to permissible limit of residual chlorine in drinking water (0.2-0.5 ppm) the entire stand
post were further classified into four categories. Results are presented in the table below.

Residual chlorine Frequency Percent (%)

Absent 3 1.0
Below permissible limit 45 15.4
Within permissible limit 180 61.4
Above permissible limit 65 22.2
Total 293 100.0
Table 5|Presence of residual chlorine in water from stand post

In majority of sample collected (61.4%, n=293) from stand post the residual chlorine was found within
permissible limit (0.2-0.5 ppm). However a significant percent of sample i.e. 22.2% was detected with
chlorine above permissible limit. One third of (n=22) of such sources were further tested and in 32%
cases the second time test also resulted with above permissible limit. In surveyed stand post chlorine was
absent in case of 1.0% sample (n=293) and 15 % water samples from stand post were found with chlorine
below permissible level. Even disparity in the level of presence of residual chlorine was found between
morning and evening supply. In some stand post morning supply was carrying excessive chlorine where
as evening supply was within permissible limit. Quality control of chlorine dosing at water treatment
point, or the proximity of the stand post from water treatment plant, flow rate of water in pipeline, all can
be attributed to the presence of residual chlorine below or above permissible level in supplied drinking
water. Since both the conditions have significant public health implications this area demands further
exploration

A cross tabulation [Table 6] of presence of chlorine and trace of fecal contamination revealed that 41% of
the total number of stand-post found contaminated (n=29) were carrying water with chlorine below
permissible level. The contradictory fact is that another 41% which was also found contaminated were
carrying water with chlorine above permissible level. This finding is consistent with the findings form
Agard, et al. (2002) and Nadambuki( 2006). There is a diare need to explore such sources as sewage
failure or shortcircutting in distribution system due to other deficiencies may the contributing factors.

Bacterial Residual chlorine level

Quality

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H2S test result Absent Below Within Above Total
Permissible permissible permissible
limit limit limit
Negative 1% 13% 66% 20% n= 264
Positive 0% 41% 17% 41% n=29
Table 6| Contamination and residual chlorine cross tabulation

A logistic regression considering presence of contamination as dichotomous dependent variable and

presence of residual chlorine within permissible limit or not as categorical exposure variable were
undertaken. The result is depicted in the following table

Model -2LL Variables Log S.E. df Sig. Exp 95.0% C.I.for

estimate(B) (B) EXP(B)
Lower Upper
Source found 99.679 Constant -3.555 .454 1 .000 .029
contaminated[H2S Chlorine 2.457 .563 1 .000** 11.667 .3.871 35.161
test positive] within
permissible
limit
Table 7| Logistic regression of permissible level of residual chlorine and bacteriological contamination

**p<.001

The model reveals that stand post with carrying water with residual chlorine are 11.6 times less likely to
be contaminated.

It is to be noted that both the absence of residual chlorine and excessive residual chlorine can attribute to
the risk regime. Though WHO(1993) promotes “the risk of death from pathogen is at least 100 to 1000
times greater than the risk of cancer from disinfection by products (DBP)” but the same document quotes
“Because of the formation of the byproduct the chemical risk increases with increasing level of
chlorine”(Morris, 1978). Morris also cited, with raised chlorine level and exceeding test and odor
threshold consumer may switch to unsafe sources. In our current study area that possibility cannot be
totally ruled out. However there was no scope to generate empirical evidence in current study design.

17
Conclusions

Presence of pipe water connectivity in 155 slums irrespective of their legal status definitely indicates
staggering coverage of “improved” water sources. But the coverage does not taking into account the
safety issues. Eventually piped water supply in Bhubaneswar slums evolved as a source associated with
an average four sanitary risks factors of which two were identified as significant contributor for fecal
contaminations. Predominant risk factors comprise off all three categories i.e. hazard, pathway and
indirect factors. Hazards factors can only be adverted by proper solid and liquid waste management.
Without drainage more coverage will generate more liquid wastes and potential risks of contamination to
a bigger extent. Pathway factors demand an intensive maintenance and management where as
involvement of community can only put a check on indirect factors. In a nutshell water supply and
specially in slum context cannot be a standalone responsibility of public health engineering department. It
has to be in tandem with other concerned departments responsible for slums development, waste disposal
and of course the end-user or community.

Conducting sanitary survey at regular interval along with water quality surveillance can reduce the risk of
the outbreaks of deadly disease to a greater extent. This is another area where community as well as front
line workers from department like Health can play a crucial role.

Current study identified remarkable inconsistency in the presence of residual chlorine. This is one area
which needs immediate attention. There should be standard protocol and following that protocol has to be
ensured. Sources identified with fecal contamination even after having chlorine beyond permissible level
needs quick addressing as it indicates possibility of severe short-circuiting.

Considering intermittent nature of the water supply household level water treatment alias point of use
water treatment should be promoted intensively.

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