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A Systematic Review and Meta-Analysis of Fecal Contamination and Inadequate Treatment of Packaged Water

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  • Ashley R Williams
  • Robert E S Bain
  • Michael B Fisher
  • Ryan Cronk
  • Emma R Kelly
  • Jamie Bartram

Abstract

Background: Packaged water products provide an increasingly important source of water for consumption. However, recent studies raise concerns over their safety. Objectives: To assess the microbial safety of packaged water, examine differences between regions, country incomes, packaged water types, and compare packaged water with other water sources. Methods: We performed a systematic review and meta-analysis. Articles published in English, French, Portuguese, Spanish and Turkish, with no date restrictions were identified from online databases and two previous reviews. Studies published before April 2014 that assessed packaged water for the presence of Escherichia coli, thermotolerant or total coliforms were included provided they tested at least ten samples or brands. Results: A total of 170 studies were included in the review. The majority of studies did not detect fecal indicator bacteria in packaged water (78/141). Compared to packaged water from upper-middle and high-income countries, packaged water from low and lower-middle-income countries was 4.6 (95% CI: 2.6–8.1) and 13.6 (95% CI: 6.9–26.7) times more likely to contain fecal indicator bacteria and total coliforms, respectively. Compared to all other packaged water types, water from small bottles was less likely to be contaminated with fecal indicator bacteria (OR = 0.32, 95%CI: 0.17–0.58) and total coliforms (OR = 0.10, 95%CI: 0.05, 0.22). Packaged water was less likely to contain fecal indicator bacteria (OR = 0.35, 95%CI: 0.20, 0.62) compared to other water sources used for consumption. Conclusions: Policymakers and regulators should recognize the potential benefits of packaged water in providing safer water for consumption at and away from home, especially for those who are otherwise unlikely to gain access to a reliable, safe water supply in the near future. To improve the quality of packaged water products they should be integrated into regulatory and monitoring frameworks.

Suggested Citation

  • Ashley R Williams & Robert E S Bain & Michael B Fisher & Ryan Cronk & Emma R Kelly & Jamie Bartram, 2015. "A Systematic Review and Meta-Analysis of Fecal Contamination and Inadequate Treatment of Packaged Water," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-27, October.
    • Handle: RePEc:plo:pone00:0140899
    DOI: 10.1371/journal.pone.0140899
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    References listed on IDEAS

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    1. E. Ejechi & B. Ejechi, 2008. "Safe drinking water and satisfaction with environmental quality of life in some oil and gas industry impacted cities of Nigeria," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 85(2), pages 211-222, January.
    2. Waziri Maimuna, 2012. "Assessment of the Microbial Quality of Sachet Water in Damaturu-Yobe State, Nigeria," Journal of Asian Scientific Research, Asian Economic and Social Society, vol. 2(2), pages 76-80, February.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    4. Robert Bain & Ryan Cronk & Jim Wright & Hong Yang & Tom Slaymaker & Jamie Bartram, 2014. "Fecal Contamination of Drinking-Water in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 11(5), pages 1-23, May.
    5. Waziri Maimuna, 2012. "Assessment of the Microbial Quality of Sachet Water in Damaturu-Yobe State, Nigeria," Journal of Asian Scientific Research, Asian Economic and Social Society, vol. 2(2), pages 76-80.
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    1. Mustafa Sikder & Elena N. Naumova & Anthonia O. Ogudipe & Mateo Gomez & Daniele Lantagne, 2021. "Fecal Indicator Bacteria Data to Characterize Drinking Water Quality in Low-Resource Settings: Summary of Current Practices and Recommendations for Improving Validity," IJERPH, MDPI, vol. 18(5), pages 1-19, February.
    2. Alasdair Cohen & Md Rasheduzzaman & Amanda Darling & Leigh-Anne Krometis & Marc Edwards & Teresa Brown & Tahmina Ahmed & Erin Wettstone & Suporn Pholwat & Mami Taniuchi & Elizabeth T. Rogawski McQuade, 2022. "Bottled and Well Water Quality in a Small Central Appalachian Community: Household-Level Analysis of Enteric Pathogens, Inorganic Chemicals, and Health Outcomes in Rural Southwest Virginia," IJERPH, MDPI, vol. 19(14), pages 1-12, July.

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