Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117360

Itamar Grotto, MD, MPH, Epidemiology Department, Ben-Gurion University of the Negev, PO BOX 653, Beer-Sheva, 84105, Israel, 972 9 7434497, grotto@netvision.net.il, Rachel Baratz, MSc, RD, Desk of Environmental Structure, Israeli Navy, Military Post 01068, Tel-Aviv, Israel, Nadav Davidovitch, MD, Health Systems Management, Faculty for Health Sciences, Ben Gurion University, P.O. Box 653, Beer Sheva, 84105, Israel, Yitzhak Hadar, Faculty of Agricultural, Food and Environmental Quality Sciences, The Hebrew University of Jerusalem, PO BOX 12, Rehovot, 76100, Israel, and Ran D. Balicer, MD, MPH, Epidemiology and Health Managment, Ben-Gurion University of the Negev, PO BOX 653, Beer-Sheva, 84105, Israel.

The water supply to the Arava region in Southern Israel arises from local wells containing elevated sulfate levels. Since these high levels can cause diarrhea and may affect drinking habits due to bitter taste, the water supplier was directed to build a desalination facility in order to comply with existing standard (250 mg/L). However, this standard is not based on concrete evidence regarding health impact of such high levels. We were asked to determine if the population may continue drinking the water until the facility is established. In order to tackle this public health issue in lack of evidence-based guidelines, we applied a multidisciplinary approach by performing epidemiological and biochemical studies; by addressing legal, ethical and logistic issues; and by planning a risk communication strategy targeted at the involved population. Sulfate levels were found to be as high as 410 mg/L, and an excess in reporting of foul water taste in the exposed population was recorded (RR=1.30; 95% CI=1.06-1.59). However, no excess morbidity was observed in this group (RR=0.91; 95% CI=0.64-1.32). These data led to an interim policy of maintaining the status-quo until the desalination facility was to be established. The requirement to build a desalination facility was not altered, mainly due to legal and ethical considerations. These data were also used for risk communication, reassuring the population and minimizing public concern. This approach and data can be applied in similar settings elsewhere and stress out the importance of using evidenced-based multidisciplinary approach in policy making on environmental health issues.

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