Drinking water quality as a risk factor for pupils’ health in rural schools in Serbia

Abstract Background Access to safe drinking water in schools is essential for a good health, wellbeing, learning and dignity of pupils. The rural schools are most frequently connected to the rural water supply system or own water supply source, where the monitoring of drinking water quality is scarced. The study was conducted in the rural regions in Serbia in 2016, aiming at assessing drinking water quality and sanitary conditions of school water supply facilities. Methods In total 238 school facilities, including 108 in Šumadija and 130 in Pomoravlje District were investigated using laboratory testing of drinking water and sanitary inspection. Results Study revealed that 32% of analysed samples showed microbiological faecal contamination with bacteria E. coli, while 52% of samples showed physico-chemical non-compliance with the national standards, where higher nitrates were the most common cause. Overall non-compliance of drinking water from school rural water supply systems amounted to 66% of tested water samples. This study also showed the main technical shortcomings of school water supply facilities and distribution networks such as the lack of fencing of the water source, damaged or absence of drainage channels from the well concrete floor and poor construction characteristics of wells. Conclusions The results of this study, particularly presence of E. coli in drinking water may affect pupils’ health and is a consequence of poor sanitary conditions and maintenance of small rural drinking water supply systems and individual wells. It is necessary to provide continuous disinfection of water available in schools and to undertake measures for technical improvements in order to provide better sanitary protection of water sources and other water supply facilities in rural schools. Key messages • Drinking water quality in schools is vital for children public health. • Raise awareness of local community on drinking water safety and enforce continuous monitoring of drinking water quality in small rural water supply systems in schools.


Background:
Peristomal skin complications (PSCs) are one of the main post-operative complications of ostomy surgery. They have a considerable impact on patients' quality of life and represent a challenge for healthcare professionals involved in their management. The majority of PSCs is preventable and costly. Knowing their burden could guide decision makers on the ostomy patients' management who are predominantly cancer and chronic bowel disease patients. Thus, the aim of this study was to summarize existing literature regarding the clinicalepidemiological burden of PSCs in ostomy patients.

Methods:
A systematic literature review was performed querying three database (PubMed, Scopus, Web of Science) from January 2012 to February 2022. It included studies in English language and focused on the clinical and epidemiological burden of PSCs in the adult patients with ileostomy and colostomy.

Results:
Overall, 35 studies were considered. Epidemiological data on PSCs were not systematically collected in the available literature. The principal underlying disease requiring the ostomy surgery were rectal, colon and gynaecological cancers, inflammatory bowel diseases, diverticulitis, occlusion and intestinal perforation. It was described a range of PSCs from 11% to 45%. The PSCs were most commonly erythema, papules, erosion, ulceration and vesciculation. Skin complications increased the average number of hospitalization days and of hospital readmission within 120-day following surgery.

Conclusions:
The data on PSCs are still limited. Estimating the PSCs burden could support healthcare professionals and decision makers called upon to identify the most appropriate responses to patients' health needs. The management of these complications plays a vital role to improve patient's quality of life and a multidisciplinary approach with the active involvement of stomatherapist, surgeon and dermatologist is critical. Furthermore, a better patient education and empowerment is needed.

Key messages:
Developing a multidisciplinary approach to managing PSCs is essential in order to provide the best treatment possible and the best outcomes for patients. Further studies should be conducted in order to better define the clinical-epidemiological burden of ileo-and colostomies and to support better health planning.
Abstract citation ID: ckac131.576 Drinking water quality as a risk factor for pupils' health in rural schools in Serbia

Background:
Access to safe drinking water in schools is essential for a good health, wellbeing, learning and dignity of pupils. The rural schools are most frequently connected to the rural water supply system or own water supply source, where the monitoring of drinking water quality is scarced. The study was conducted in the rural regions in Serbia in 2016, aiming at assessing drinking water quality and sanitary conditions of school water supply facilities.

Methods:
In total 238 school facilities, including 108 in Šumadija and 130 in Pomoravlje District were investigated using laboratory testing of drinking water and sanitary inspection.

Results:
Study revealed that 32% of analysed samples showed microbiological faecal contamination with bacteria E. coli, while 52% of samples showed physico-chemical non-compliance with the national standards, where higher nitrates were the most common cause. Overall non-compliance of drinking water from school rural water supply systems amounted to 66% of tested water samples. This study also showed the main technical shortcomings of school water supply facilities and distribution networks such as the lack of fencing of the water source, damaged or absence of drainage channels from the well concrete floor and poor construction characteristics of wells.

Conclusions:
The results of this study, particularly presence of E. coli in drinking water may affect pupils' health and is a consequence of poor sanitary conditions and maintenance of small rural drinking water supply systems and individual wells. It is necessary to provide continuous disinfection of water available in schools and to undertake measures for technical improvements in order to provide better sanitary protection of water sources and other water supply facilities in rural schools. Key messages: Drinking water quality in schools is vital for children public health.
Raise awareness of local community on drinking water safety and enforce continuous monitoring of drinking water quality in small rural water supply systems in schools.
Abstract citation ID: ckac131.577 Strengths and weaknesses in the implementation of the IHR (2005)