Waterborne Disease in the United States

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The United States has one of the safest drinking water supplies in the world. Yet, the water we use for drinking, swimming, and even cooling high-rise buildings can be safer. About 7.2 million Americans get sick every year from diseases spread through water.

CDC’s first estimates of the impact of waterborne disease in the United States cover illnesses tied to all types of water use. They detail how many waterborne diseases, emergency department visits, hospitalizations, and deaths occur every year, and what these cost our healthcare system. This type of information is referred to as the burden of waterborne disease.

While the United States has made tremendous strides in preventing waterborne disease over the last century, these new estimates provide a better understanding of the waterborne disease challenges we face in the 21 st century. CDC, policymakers, related industries (for example, owners of large buildings and recreational water facilities), the public health community, and others can use this information to prioritize next steps in protecting the public from waterborne disease.

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Water-Associated Infectious Diseases pp 1–3 Cite as

Introduction to Water-Associated Infectious Diseases

  • Shailendra K. Saxena 2 ,
  • Swatantra Kumar 2 ,
  • Amrita Haikerwal 2 &
  • Vimal K. Maurya 2  
  • First Online: 22 November 2019

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2 Citations

Considerable advancement in the area of biomedical research and biotechnology has attributed a new shape to the lifestyle and healthcare. However, emerging and re-emerging infectious diseases have always been a major threat coupled with immense challenges, suggesting the necessity of implication of innovative approaches and advanced technologies. Contaminated water is the predominant cause of human exposure to the infectious etiological agents including pathogens, toxins, and organic and inorganic contaminants. Water safety plans (WSP) have been included in the WHO guidelines for drinking-water quality with several imperative primary objectives.

  • Emerging pathogens
  • Contaminated water
  • Water safety plans

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Saxena, S.K., Kumar, S., Haikerwal, A., Maurya, V.K. (2020). Introduction to Water-Associated Infectious Diseases. In: Saxena, S.K. (eds) Water-Associated Infectious Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-13-9197-2_1

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Waterborne Diseases: Still a Challenge

Related articles.

water borne diseases assignment

One of our nation’s greatest public health achievements of the 20th century was drinking water disinfection, which was key in eliminating cholera and typhoid as leading disease killers in the US. Waterborne diseases worldwide remain a significant problem. What waterborne diseases still bedevil us, and what is to be done?

water borne diseases assignment

The first city in the US to routinely disinfect water was Jersey City, New Jersey, in 1908. Water disinfection is a broad term that includes all methods of killing microbes in drinking water. The primary disinfection methods are chlorine, ozone, ultraviolet light, and chloramines.    

Waterborne Diseases Today

Although waterborne diseases have been greatly reduced in the US, they have not been eliminated. Most waterborne diseases today are not from inadequate disinfection at drinking water treatment plants but from microbes that grow and spread in the plumbing inside buildings and in recreational water venues such as swimming pools and hot tubs. These microbes grow in biofilms (bacterial build-up) that attach to the walls inside pipes, pools, and plumbing fixtures.

In addition, many illnesses today are not from direct drinking water but from breathing in tiny droplets of contaminated water. Legionella , which causes Legionnaires’ disease, is an example of this type of microbe.  

It is challenging to obtain an accurate count of waterborne disease illnesses and deaths because states report waterborne diseases to the CDC through a variety of surveillance systems, none of which adequately capture all waterborne disease illnesses and deaths. In some instances, outbreaks are investigated by local and state public health officials and not reported to the CDC. Some of the most prevalent waterborne diseases are not even on the CDC’s National Notifiable Diseases Surveillance System, including Nontuberculous mycobacteria, Otitis externa, and Pseudomonas , which monitors about 120 diseases.

Until recently, there were no national counts on the number of deaths from waterborne pathogens in the US. A 2017 article documented 6,301 deaths from 2003 – 2009 from 13 waterborne disease infections in the US [1]. A 2021 article examined US data from 2000- 2015 and estimated that there were 118,000 hospitalizations and 6,630 deaths due to waterborne illnesses.

Legionnaires’ Disease is probably the most well-known of all the waterborne diseases discovered after an outbreak of pneumonia among American Legionnaires attending a convention in Philadelphia. The cause was determined to be Legionella bacteria that were breeding in the cooling towers of the hotel’s air conditioning system, which then spread throughout the building. Legionnaires’ disease is a severe respiratory illness characterized by fever, cough, chest pains, and diarrhea. Legionella bacteria can also cause Pontiac fever, a flu-like illness usually self-limiting and less severe.

Legionella is found in fresh water and rarely causes illness. However, in plumbing systems, Legionella may multiply and cause disease. People become infected when small droplets of water containing the bacteria get into the air, and people breathe them in. In 2014, there were an estimated 995 deaths from Legionnaires’ disease.

The Grim Reapers

Typhoid fever and cholera are the two diseases responsible for most global deaths. Both are rare in the US.   

Typhoid fever is caused by the bacteria Salmonella typhi found in contaminated food or water. While related, this is not the same bacteria that cause Salmonella poisoning (salmonellosis) from food. In the 1900s, there were tens of thousands of cases of typhoid fever in the US; today, less than 400 cases per year are reported, most occurring among international travelers. Despite an available vaccine, typhoid fever has remained a global problem , with about 11 million - 20 million cases annually and 128,000 - 161,000 deaths yearly. Most of these cases are in impoverished countries in South Asia and Sub-Saharan Africa.

water borne diseases assignment

EPA Regulations

EPA has three main rules to control microbes in public drinking water systems [2]

water borne diseases assignment

  • Surface Water Treatment Rule : Requires all drinking water systems that use surface water to use disinfection resulting in 99.9% removal of viruses, Giardia , and Cryptosporidium . Giardia and Cryptosporidium are both protozoa that cause gastrointestinal upset, characterized by diarrhea, stomach cramps, and nausea.
  • Ground Water Rule : Groundwater is usually cleaner and contains fewer contaminants than surface water, and not all drinking water systems using groundwater require disinfection. This rule requires groundwater systems to identify if they are susceptible to fecal contamination and, if they are, to disinfect and take other actions to prevent the growth of viruses.   

Water treatment plant operators must carefully manage the amount of disinfectants, such as chlorine, that they add to water. This is because additional EPA regulations limit disinfectant by-products, the chemical compounds formed when chlorine or other disinfectants react with organic compounds in water, creating hazardous chemicals.

What to Do?

There are no easy fixes to eliminate waterborne diseases today. The US has made tremendous progress in eliminating waterborne diseases. There needs to be better data and non-traditional solutions to build on our progress.

For public water systems, the EPA regulations do a good job of preventing contamination at the water plant. If you own a private well, you should be testing for microbial contamination. However, the problem is that microbes often hide in plumbing systems and cooling towers beyond the reach of traditional regulations.

Data is essential to develop solutions. We don’t even know the extent of the problem! The available data is a patchwork of information drawn from numerous sources. The CDC needs to work with the states and local public health agencies to develop a national collection system for waterborne diseases.

Additionally, there needs to be a mix of public-private partnerships to address drinking water contamination issues beyond the treatment plant. For example, the CDC has developed a set of recommendations for offices and hospitals with concrete steps to reduce the spread of Legionella and other microbes spreading within their buildings. These programs need to be expanded to include hotels, recreational facilities, and other establishments that often unknowingly become sources of waterborne disease.   

[1] The microbes included: Campylobacter, Cryptosporidium, E. coli, Giardia, Hepatitis A, Salmonella, non-typhoidal Shigella, Free-living amoebae, Legionella (Legionnaires’ Disease), Nontuberculous mycobacteria, Otitis externa, Pseudomonas Vibrio

[2] These rules do not apply to private wells and other non-public drinking water systems.

View the discussion thread.

water borne diseases assignment

By Susan Goldhaber MPH

Susan Goldhaber, M.P.H., is an environmental toxicologist with over 40 years’ experience working at   Federal and State agencies and in the private sector, emphasizing issues concerning chemicals in drinking water, air, and hazardous waste.  Her current focus is on translating scientific data into usable information for the public. 

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4.7: Foodborne Diseases

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Picnics like this one can be a lot of fun. Food always seems to taste better when eaten outdoors. Ants and other insects can be attracted to picnic foods and be annoying. However, a greater potential hazard may lurk within the picnic foods themselves: microorganisms that cause foodborne disease.

people Picnicking

What Is Foodborne Disease?

Foodborne disease, commonly called food poisoning, is any disease that is transmitted via food. Picnic foods create a heightened risk of foodborne disease mainly because of problems with temperature control. If hot foods are not kept hot enough or cold foods are not kept cold enough, foods may enter a temperature range in which microorganisms such as bacteria can thrive.

Many people do not think about food safety until a foodborne disease affects them or a family member. While the food supply in the United States is one of the safest in the world, the CDC estimates that 76 million Americans a year get a foodborne disease, of whom more than 300,000 are hospitalized and 5,000 die. Preventing foodborne disease remains a major public health challenge.

Causes of Foodborne Disease

Most foodborne diseases are caused by microorganisms in food. Some are caused by toxins in food or adulteration of food by foreign bodies.


Microorganisms that cause foodborne diseases include bacteria, viruses, parasites, and prions. The four most common foodborne pathogens in the United States are a virus called norovirus and three genera of bacteria: Salmonella species (such as Salmonella typhimurium, pictured below), Clostridium perfringens, and Campylobacter jejune. Although norovirus causes many more cases of foodborne disease, Salmonella species are the pathogens in food that are most likely to be deadly. Parasites that cause human foodborne diseases are mostly zoonoses — animal infections that can be transmitted to humans. Parasites such as pork tapeworm (Taenia solium) are ingested when people eat inadequately cooked infected animal tissue. The prions that cause mad-cow disease have been transmitted to people through the ingestion of contaminated beef.

Salmonella bacteria

Toxins are another common cause of foodborne disease. Toxins may come from a variety of sources. Foods may be contaminated with toxins in the environment. Pesticides applied to farm fields are common examples of environmental food toxins. Toxins may be produced by microorganisms in food. An example is botulism toxin that is produced by the bacterium Clostridium botulinum. Some toxins occur naturally in certain plants and fungi. A common example is mushrooms. Dozens of species are poisonous and some are deadly, like the aptly named death-cap mushroom pictured below. Many deadly mushrooms look similar to edible species, making them even more dangerous. Food plants can also be infected with fungi that make people sick when they eat the plants. Fungi in the genus Aspergillus are frequently found in nuts, maize, and corn. They produce a toxin called aflatoxin, which targets the liver, potentially causing cirrhosis of the liver and liver cancer.

death-cap mushroom

Adulteration by Foreign Bodies

Another potential cause of the foodborne disease is the adulteration of foods by foreign bodies. Foreign bodies refer to any substances or particles that are not meant to be foods. They can include pests such as insects, animal feces such as mouse droppings, hairs (human or nonhuman), cigarette butts, and wood chips, to name just a few. Some foods are at risk of contamination with lead or other toxic chemicals because they are stored or cooked in unsafe containers, such as ceramic pots with lead-based glaze.

Characteristics of Foodborne Diseases

Foodborne diseases differ in specific characteristics but they share some commonalities, often including similar symptoms.

Symptoms and Incubation Period

Foodborne diseases commonly cause gastrointestinal symptoms such as vomiting and diarrhea. They also frequently cause fevers, aches, and pains. The length of time between the consumption of contaminated food and the first appearance of symptoms is called the incubation period. This concept is illustrated in the figure below. The incubation period for a foodborne disease can range from a few hours to several days or even longer, depending on the cause of the disease. Toxins generally cause symptoms sooner than microorganisms. When symptoms do not appear for days, it is difficult to connect them with the agent that caused them.

concept graph of incubation period of bacteria

During the incubation period, microbes generally pass through the stomach and into the small intestine. Once in the small intestine, they attach to cells lining the intestinal walls and begin to multiply. Some types of microbes stay in place in the intestine, although they may produce toxins that are absorbed into the bloodstream and carried to cells throughout the body. Other types of microbes directly invade deeper body tissues.

Infectious Dose

Whether a person becomes ill from a microbe or a toxin depends on how much of the agent was consumed. The amount that must be consumed to cause disease is called the infectious dose. It varies by disease agent and also by host factors, such as age and overall health.

Sporadic Cases vs. Outbreaks

The vast majority of reported cases of foodborne disease occur as sporadic cases in individuals. The origin of most sporadic cases is never determined. Only a small number of foodborne disease cases happen as part of disease outbreaks. An outbreak of a foodborne disease occurs when two or more people experience the same disease after consuming food from a common source. The majority of foodborne disease outbreaks originate in restaurants, but they also originate in nursing homes, hospitals, schools, and summer camps.

An example of a foodborne disease outbreak in the United States is the Salmonella outbreak shown in Figure \(\PageIndex{5}\). The CDC map below shows where most of the cases occurred. The reported cases began in July and were traced back to onions produced in California. Within 2 weeks the onions were recalled. The outbreak was over by October. Overall, a total of 1,127 people across 48 states, were infected with the outbreak strain of Salmonella Newport. There were 167 hospitalizations and no deaths reported.

CDC salmonellosis map

Factors that Increase the Risk of Food Contamination

The foodborne disease usually arises from food contamination through improper handling, preparation, or storage of food. Food can become contaminated at any stage from the farmer’s field to the consumer’s plate.

Poor Hygiene

Many foods become contaminated by microorganisms because of poor hygienic practices, such as handling or preparing foods with unwashed hands. Consider norovirus, the leading cause of foodborne disease in the United States. The virus can easily contaminate food because it is very tiny and highly infective. People sick with the virus shed billions of virus particles. Unfortunately, It takes fewer than 20 virus particles to make someone else sick. Food can become contaminated with virus particles when infected people get stool or vomit on their hands and then fail to wash their hands before handling food. People who consume food can ingest the virus particles and get sick.


Another major way that foods become contaminated is through cross-contamination. This occurs when microbes are transferred from one food to another. Some raw foods commonly contain bacteria such as Salmonella, including eggs, poultry, and meat. These foods should never come into contact with ready-to-eat foods, such as raw fruits and vegetables or bread. If a cutting board, knife, or counter-top is used to prepare contaminated foods, it should not be used to prepare other foods without proper cleaning in between.

Failure of Temperature Control

Foods contaminated with bacteria or other microorganisms may become even more dangerous if failure of temperature control allows the rapid multiplication of microorganisms. Bacteria generally multiply most rapidly at temperatures between about 4 and 60 degrees C (40 and 140 degrees F). Perishable foods that remain within that temperature range for more than two hours may become dangerous to eat because of rapid bacterial growth.

Prevention of Foodborne Disease

Preventing foodborne disease is both a personal and a society-wide problem. Both governments and individuals must work to solve it.

The Government’s Role

In the United States, the prevention of foodborne disease is mainly the role of government agencies such as the Food and Drug Administration and local departments of health. Such government agencies are responsible for setting and enforcing strict rules of hygiene in food handling in stores and restaurants (see the sign below). Government agencies are also responsible for enforcing safety regulations in food production, from the way foods are grown and processed to the way they are shipped and stored. Government regulations require that food to be traceable to their point of origin and date of processing. This helps epidemiologists identify the source of foodborne disease outbreaks.

Clean Hands Guardians Of Health sign

Food Safety at Home

At home, the prevention of foodborne disease depends mainly on good food safety practices.

  • Regular handwashing is one of the most effective defenses against the spread of foodborne diseases. Always wash hands before and after handling or preparing food and before eating.
  • Rotate food in your pantry so older items are used first. Make sure foods have not expired before you consume them. Be aware that perishable foods such as unpreserved meats and dairy products have a relatively short storage life, usually just a few days in the refrigerator.
  • Rinse fresh produce before eating. This is especially important if the produce is to be eaten raw. Even if you do not plan to eat the outer skin or rind, wash it because microbes or toxins on the surface can contaminate the inside when the food is cut open or peeled.
  • Many bacteria in food can be killed by thorough cooking, but food must reach an internal temperature of at least 74 degrees C (165 degrees F) to kill any bacteria the food contains. Use a cooking thermometer like the one pictured below to ensure food gets hot enough to make it safe to eat.
  • Foods meant to be eaten hot should be kept hot until served, and foods meant to be eaten cold should be kept refrigerated until served. Perishable leftovers should be refrigerated as soon as possible. Any perishable foods left at a temperature between 4 and 60 degrees C (40 and 140 degrees F) for more than two hours should be thrown out.

Pork thermometer

  • Make sure the temperature in the refrigerator is kept at or below 4 degrees C (40 degrees F) to inhibit bacterial growth in refrigerated foods. If your refrigerator does not have a built-in thermometer, you can buy one to monitor the temperature. This is especially important in a power outage. If the temperature stays below 40 degrees F until the power comes back on, the food is safe to eat. If the temperature goes above 40 degrees F for two hours or more, the food may no longer be safe and should not be consumed.
  • Keep the temperature of the freezer below 18 degrees C (0 degrees F). Foods frozen at this temperature will keep indefinitely, although they may gradually deteriorate in quality.
  • Do not thaw foods at room temperature. Freezing foods does not kill microbes; it preserves them. They will become active again as soon as they thaw. Either thaw frozen foods slowly in the refrigerator or thaw them quickly in the microwave, cool water, or while cooking. Never refreeze food once it has thawed.

Feature: Myths vs. Reality

Myths about foodborne diseases abound. Some of the most common myths are debunked below.

Myth: It must have been the mayonnaise.

Reality: Mayonnaise is acidic enough that it does not provide a good medium for the growth of bacteria unless it becomes heavily contaminated by a dirty utensil or is mixed with other foods that decrease its acidity. Mayo may have gotten a bad rap because it is often consumed at picnics, where temperature control may be poor and lead to bacterial growth in other, non-acidic foods.

Myth: Foodborne disease is caused by food that has “gone bad.”

Reality: Eating spoiled or rotten food is seldom the cause of foodborne disease. Most cases of foodborne disease are caused by contamination of food by unwashed hands or cross-contamination of food by unwashed utensils or cutting boards.

Myth: Foodborne disease is caused by eating restaurant foods.

Reality: Foodborne disease is caused by contamination of foods in the home as well as in restaurants. Restaurant kitchens must be regularly inspected to ensure sanitary conditions for food preparation. There are no such inspections of home kitchens.

Myth: Foodborne disease is caused by the last food eaten.

Reality: Symptoms of the foodborne disease may not strike for several hours to several days following infection, so the last meal eaten may not be the culprit. This makes it very difficult to know which food caused the symptoms.

  • What is a foodborne disease?
  • How common are foodborne diseases in the United States?
  • What are the main causes of foodborne disease? Give examples of each cause.
  • Define the incubation period and infectious dose.
  • Discuss similarities and differences among foodborne diseases.
  • Compare and contrast sporadic cases and disease outbreaks of foodborne disease.
  • What are the three main ways that food becomes contaminated?
  • List three food safety practices that can help prevent transmission of foodborne disease in the home.
  • If you store cooked leftovers at room temperature (about 68 degrees F) for more than two hours, are they safe to eat if you heat them up well first? Explain your answer.
  • True or False . There is no need to wash a melon before cutting it because you will not be eating the rind.
  • True or False . Foodborne diseases can sometimes cause a form of cancer.
  • Explain why it can be hard to trace the source of a foodborne disease if it has a long incubation period.
  • Clostridium perfringens
  • Taenia solium
  • All of the above
  • Why do you think the incubation period for a foodborne disease is generally shorter when the agent is a toxin compared to a microorganism?
  • Why do you think it is often recommended to rapidly cool a large quantity of homemade soup by putting the pot in an ice water bath before storing it in the refrigerator?


  • Picnic by Dylan Lake , licensed CC BY 2.0 via Wikimedia Commons
  • Salmonella by US gov, public domain via Wikimedia Commons
  • Amanita phalloides by George Chernilevsky , public domain via Wikimedia Commons
  • Concept of incubation period by Patilsaurabhr , public domain via Wikimedia Commons
  • Salmonella outbreak by CDC, public domain
  • Clean hands guardians of health by CDC/ Minnesota Department of Health, R.N. Barr Library; Librarians Melissa Rethlefsen and Marie Jones, public domain via Wikimedia Commons
  • Pork thermometer by USDA , public domain via Wikimedia Commons
  • Text adapted from Human Biology by CK-12 licensed CC BY-NC 3.0

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b Institute of Leather Engineering and Technology, University of Dhaka, Bangladesh

Kudrat Ullah Jim

Bangladesh – one of the most densely populated countries of the world— has plentiful water sources, but these sources are being polluted continuously. Both surface water and groundwater sources are contaminated with different contaminants like toxic trace metals, coliforms as well as other organic and inorganic pollutants. As most of the population uses these water sources, especially groundwater sources which contain an elevated amount of arsenic throughout the country; health risk regarding consuming water is very high. Death due to water-borne diseases is widespread in Bangladesh, particularly among children. Anthropogenic sources such as untreated industrial effluents, improper disposal of domestic waste, agricultural runoffs are the main contributors regarding water pollution. A total water pollution status of this country, as well as the sources of this severe condition, is crucial to evaluate public health risk. For this purpose, we reviewed hundreds of well recognized international and national journals, conference proceedings and other related documents to draw a complete picture of recent water pollution status and its impact on public health; also the sources of water pollution are identified.

1. Introduction

Why are we able to live in this planet? Why are other animals and plants allowed to live here? If we endeavor to find out the answer of these inquisitions, we may easily perceive that water is the spring of life. According to biologists, all life form came from the sea means water. We are living on this planet due to the blessing of water. From the dawn of civilization to till now, humans (cave dwellers to city dwellers) have been using water for various seminal purposes: drinking, bathing, watering animals, and irrigating lands. However, this limited resource means source of life under threat from the population, chiefly generated by human factors. Almost 71% of the earth's total surface is covered with water, only 2.5% of this amount can be considered as freshwater ( Shiklomanov, 1993 ). At present, 1.6 billion of people are facing economic water shortage, and two-thirds of the world's population is experiencing water scarcity at least one month in a year ( FAO, 2007 ; Mekonnen and Hoekstra, 2016 ). Recently scientists have found that 21 of the world's 37 largest aquifers around the world have crossed their sustainability tipping points ( Richey et al., 2015 ). The condition of water stress and scarcity will be worsened. Almost 1.8 billion people living in various regions all over the world may face absolute water scarcity by 2025 ( WWAP, 2012 ).

However, these limited water resources are under threat from the pollution, chiefly generated by human factors. The agricultural sector, industrial production, mining, power generation, and other factors are some of the contributors to the pollution of water bodies, which will eventually affect humans in general ( UN-Water, 2001 ). Diseases: cholera, diarrhea, dysentery, hepatitis A, etc. are directly linked to the unhygienic and contaminated potable water. It is estimated that each year more than 842,000 people die from diarrhea globally ( WHO, 2017a , b ). Arsenic pollution is one of the major groundwater contaminations, and it affects nearly 70 million people worldwide ( UNESCO, 2009 ).

Like the rest of the third world country, Bangladesh ( Fig. 1 ), one of the most densely populated countries, is facing severe water pollution and scarcity. Although 97% of the total population has access to water, the quality of water is always questionable ( WHO, 2018 ). Bangladesh is a riparian country, consisting of more than 230 large and small rivers (Figs.  2 and ​ and3). 3 ). But these rivers are now choked by the pollution caused by mainly human intervention ( Majumder, 2009 ). Groundwater is not also safe as the threat of arsenic contamination is very high all over the country. 97% of the total population in rural areas depend on the tubewells for drinking water; as a result, 35 to 77 million people have been chronically exposed to arsenic in the first decade of the millennium ( Flanagan et al., 2012 ). 8.5% of the total death in Bangladesh is caused by water, sanitation and hygiene-related issues ( UN-Water, 2013 ).

Fig. 1

Administrative map of Bangladesh [source: ( Map, 2019 )].

Fig. 2

Rivers of Bangladesh [Source: ( Banglapedia, 2019 )].

Fig. 3

Land usage of Bangladesh ( Reddy et al., 2016 ).

Adequate knowledge about the pollution status of all the water sources is thus crucial for ensuring safe and hygiene potable water. A detailed country wide drinking water quality survey was conducted by Bangladesh Bureau of Statistics which was titled as ‘Bangladesh National Drinking Water Quality Survey’ (BNDWQS) of 2009 with the technical help from UNICEF. Samples were collected from 300,000 household sources in 15,000 randomly selected clusters around the country. The report suggested that 97.8 of the population were using safe drinking water and 13.4% of the samples exhibited a higher concentration of arsenic ( Statistics, 2009 ). But various individual studies on smaller scale revealed the much severe condition of water pollution. The Department of Environment (DoE) of Bangladesh regularly monitor the surface and groundwater quality of the country. These year-long monitoring programs have shown the increasing pollution rates in rivers and other surface water sources over time ( DoE, 2014 ).

The complete picture of overall water pollution situation of Bangladesh is of great importance from every perspective. In this paper, we have compiled the recent data in this regard. Hundreds of journal articles, conference proceedings, reports published by renowned organizations, books and other reliable national and international materials have been reviewed to extract meaningful information about the present pollution status which is then arranged and presented systematically. Furthermore, the impact of this pollution on the public health of Bangladesh is also discussed in detail.

2. Main text

2.1. physicochemical properties of water sources.

The physicochemical properties of water can influence the development of biological life form in water and subsequently can cause an impact on the quality of water ( Soja and Wiejaczka, 2014 ). Physical properties such as temperature, turbidity, electrical conductivity and chemical properties for instance dissolved oxygen (DO), Biological oxygen demand (BOD), Chemical oxygen demand (COD), all come under this group.

Biological Oxygen Demand (BOD, or more specifically BOD 5 ) can be used as an indication of the extent of organic pollution in the aquatic systems, which adversely affect the water quality ( Jonnalagadda and Mhere, 2001 ). Though there is no guideline value of BOD set by WHO, Bangladesh Standard doesn't allow more than 0.2 mg/L BOD in drinking water. A very high value of BOD can be seen in heavily polluted surface water of Bangladesh. Many studies found the elevated value of BOD in water sources in Barapukuria, Dinajpur ( Bhuiyan et al., 2010 ), Dhaka-Narayanganj-Demra (D.N.D) Embankment ( Sultana et al., 2009 ), Buriganga river ( Ahmed et al., 2011b ). Chemical Oxygen Demand (COD) is also a very practical parameter in the determination of polluted water ( Zuane, 1996 ). WHO didn't set any guideline value for COD, but Bangladesh Standard for COD is maximum 4 mg/L. Only one study calculated the COD value of groundwater which was slightly higher than the recommended value ( Table 1 ). Dissolved Oxygen (DO) is also measured in water quality testing. For drinking water, Bangladesh Standard described its maximum allowable concentration at 6 mg/L. The maximum concentration DO (12.77 mg/L) was found in the surface water near Barapukuria coal mine area, Dinajpur ( Bhuiyan et al., 2010 ). A high concentration of DO (above 12–14 mg/L) can cause ‘gas bubble disease’ in fishes of the water body ( Puri & Kumar, 2012 ); whereas a low concentration of DO has a direct effect on the corrosion of water supply line pipe and psychological results for consumers ( Zuane, 1996 ).

Table 1

Physicochemical properties parameters in Bangladesh in surface water and groundwater. Data are extracted from various individual studies and arranged chronologically based on year of publication of the reviewed articles. Values given represent the mean values or mean values plus-minus standard deviation (S.D.), where the values with ± in the parenthesis () represents average ± S.D.

The temperature of the water should be 20–30 °C according to WHO standard. The temperature of water influences the aquatic life, solubility of solids, taste and odor, dissolved oxygen (DO), etc ( Zuane, 1996 ). Although pH has no direct impact on the consumer, it is one of the most necessary operational water quality parameters ( WHO, 2011 ). WHO recommended that the pH of the water be within 6.5–8.5. All studies found the pH of water sources within a suitable range. Total dissolved solids (TDS) constitute inorganic salts and small amounts of organic matter that are dissolved in water. TDS less than 600 mg/L is suitable for drinking water; but if the concentration level exceeds 1000 mg/L, the water becomes unpalatable ( WHO, 2011 ). Some of the studies have found TDS level above the recommended limit. The conductivity of water can indicate the presence of minerals. Potable waters usually register conductivity from 50 to 500 micromhos/cm, but with mineralized water registering values over 500 ( Zuane, 1996 ). No guideline value was proposed by WHO or Bangladesh Standard. A variety of conductivity value can be seen in different water sources based on various studies.

2.2. Major pollutants

2.2.1. trace metals pollution.

Trace element contamination of water is now a primary worldwide concern because even at low concentration these elements can show an adverse effect on living beings ( Demira et al., 2015 ). Natural substances leached from the soil, run-off from agricultural activities, controlled discharge from sewage treatment works and industrial plants, and uncontrolled releases or leakage from landfill sites and chemical accidents or disasters are the sources of both surface and groundwater pollution ( Leeuwen, 2000 ). Some of the trace elements are found to be essential for the human body ( Bogden, 2000 ), but a negative impact on the living organism can be seen if the permissible limit is exceeded ( Izah et al., 2016 ). In Bangladesh, trace elements in ground and surface water often exceed the guideline values recommended by WHO. Table 2 comprises the result of different studies on trace elements in water, which was conducted in the various area of Bangladesh in a different time.

Table 2

Trace elements concentration (mg/L) in Bangladesh in surface water and groundwater. Data are extracted from various individual studies and arranged chronologically based on year of publication of the reviewed articles. Values given represent the mean values or mean values plus-minus standard deviation (S.D.), where the values with ± in the parenthesis () represents average ± S.D.

Chromium (Cr) presents in nature chiefly in two oxidation states, Cr (III) and Cr (VI), which possess contrasting physiological effects ( Aranda et al., 2010 ). According to WHO and Bangladesh standards, the maximum concentration of chromium in drinking water is 0.05 mg/L. BNDWQS report showed that 97.7% of the total samples contained less than 0.005 mg/L of Cr. Other individual studies reported that surface water in different location exceeds the maximum concentration value and it varied from 0.005 to 1.02 mg/L; whereas in groundwater, the values remain in between less than 0.0002–0.093 mg/L of Cr ( Table 2 ). Balu river and Buriganga river shows a higher concentration of chromium. Ahmed et al. (2011b) found that the average concentration of chromium is 0.587 mg/L in river Buriganga. A study conducted by Hasan et al. (2014) in Balu river showed that the concentration of chromium is in between 0.62 to 1.37 mg/L in the dry season, but absent in rainy season. A selected few studies focused on the chromium content in groundwater. The highest chromium concentration (0.093 mg/L) in groundwater was found in Singair Upazila, Manikgonj ( Halim et al., 2014 ). Overall, surface water contains significantly more chromium than that of groundwater. Chromium in its Cr(VI) oxidation state, is responsible for lung cancer, nasal irritation, nasal ulcer, hypersensitivity reactions, and contact dermatitis when it entered into human bodies via dermal and inhalation routes ( Shrivastava et al., 2002 ).

Copper (Cu) is an indispensable trace element which shows a significant role in the biochemistry of all living organisms ( Bremner and Beattie, 1990 ). WHO prescribed the maximum acceptable concentration of 2 mg/L for Cu. BNDWQS (2009) report suggested that 100% of the samples had less amount of Cu than the WHO and Bangladesh standards. Various studies calculated the Cu content in both surface and groundwater throughout the country, but concentration never exceeded the maximum limit. The highest mean concentration of Cu in surface water (0.239 mg/L) and groundwater (0.08 mg/L) was reported from Buriganga river ( Bhuiyan et al., 2015 ) and Rajshahi city ( Mostafa et al., 2017 ), respectively. Excess copper accumulation leads to copper toxicosis which results in hepatic cirrhosis, hemolytic anemia, and degeneration of the basal ganglia ( Harris and Gitlin, 1996 ).

Iron (Fe) is one of the most abundant trace elements found in earth's crust, but iron deficiency is a global concern ( Quintero-Gutiérrez et al., 2008 ). It was calculated that only 60% of water samples were below the Bangladesh standard (1.0–0.3 mg/L) in BNDWQS (2009) report. This survey also indicated the high average concentration of Fe present in the shallow (2.65 mg/L) and deep tubewell (1.37 mg/L) water throughout the country. Various individual studies also showed the exceeding present of iron in water of Bangladesh. High degree of Fe contamination in surface water has been reported in the rivers near Barapukuria coal mine, Dinajpur due to anthropogenic inputs (3.1 mg/L) ( Bhuiyan et al., 2010 ), followed by Surman river during monsoon (1.834 mg/L) ( Alam et al., 2007 ). Groundwater Fe contamination is even more severe; the concentration range varies from 0.02 to 28.9 mg/L. The maximum average Fe concentration (28.9 mg/L) was determined in the arsenical well water of Chuadanga ( Nahar et al., 2014 ). Table 2 shows that groundwater of different districts from different parts of Bangladesh is severely contaminated with Fe. Overdosing of iron is potentially hazardous and plays a vital role in causing diabetes ( Swaminathan et al., 2007 ), anemia and hemochromatosis ( Toyokuni, 2009 ), lung and heart disease ( Milman et al., 2001 ).

Manganese (Mn) has been reported to be exigent in every animal species studied ( Goldhaber, 2003 ). In Bangladesh, none of the studies indicated any Mn contamination is surface water ( Table 2 ); however, the existence of Mn above the WHO standard limit (0.5 mg/L) was reported in ground water throughout the country. The highest mean concentration of Mn in groundwater was found in the water sample of the tubewell water in Singair, Manikgonj ( Halim et al., 2014 ). An elevated level of Mn was found in shallow tubewell (1.87 mg/L) in Cox's Bazar area; the deep water sample collected from the same area also showed a significant presence of Mn due to high rock-groundwater interaction ( Seddique et al., 2016 ). A study conducted in Greece reported that individuals who consumed drinking water containing more than 1.8 mg/L Mn, exhibited neurologic symptoms which are similar to Parkinson's disease ( Kondakis et al., 1989 ). Hallucinations, memory impairment, disorientation, and emotional instability also caused by Mn overdose ( Gupta and Gupta, 1998 ).

Nickel (Ni) is a nutritionally essential trace element for humans as well as other animal species and plants. But Ni can affect the mass population through contaminated drinking water and food intake ( Cempel and Nikel, 2005 ). According to WHO standards, Ni concentration should not exceed 0.02 mg/L in drinking water; whereas Bangladesh standard allows the presence of Ni up to 0.1 mg/L in drinking water and 1 mg/L for industrial discharge. Studies suggested the average concentration ranges between 0.005-0.18 mg/L and >0.00006–0.043 mg/L in surface water and groundwater, respectively. The maximum average concentration (0.18 mg/L) of this trace element was found in the wetlands near Barapukuria coal mine, Dinajpur ( Bhuiyan et al., 2010 ). Nickel hypersensitivity also responsible for asthma, conjunctivitis, inflammatory reactions to nickel-containing prostheses and implants ( Nielsen et al., 1999 ). Moreover, Nickel compounds can cause cancer ( Bal et al., 2000 ).

Zinc (Zn) is a natural trace element found in all plants and animals which maintaining the healthy growth of the human body, especially for infants and young children's growth and development ( Askary et al., 2011 ). Bangladesh standard and WHO permissible limit of Zn for drinking water is 5 mg/L and 3 mg/L respectively for drinking water. The highest level of Zn was found in the Dhalai Beel and Bangshi River which was slightly above (3.32 mg/L) the WHO limit. Ingestion of acute zinc can cause vomiting, diarrhea, neurological damage ("Zn shakes") ( Gupta and Gupta, 1998 ) and chronic exposure to Zinc is responsible for depressed Cu utilization ( Sandstead, 1978 ), Fe deficiency, lowered levels of HDL cholesterol ( Hooper, 1980 ).

Cadmium (Cd) is considered as a very toxic trace metal because of its extremely long half-life ( Jihen et al., 2008 ). According to WHO standards, its concentration should not exceed 0.003 mg/L in drinking water. But, in Bangladesh separate investigation showed a significant amount of Cd present throughout the country in different forms of surface water ( Table 2 ). Although there are almost no data about the condition of Cd contamination in groundwater, a recent study reported the mean concentration of Cd almost five times higher (0.014 mg/L) than the WHO limit in the tubewell water in Rajshahi city ( Mostafa et al., 2017 ). The maximum concentration of Cd (0.221 mg/L) was reported in the Airport lake of Dhaka city ( Mokaddes et al., 2013 ).

Lead (Pb) is a ubiquitous trace metal and significant public health concern, particularly in developing countries ( Flora et al., 2012 ). The highest admissible concentration set by WHO and Bangladesh standard for Pb in drinking water is 0.01 mg/L and 0.05 mg/L respectively. In some region of Bangladesh, water sources contain a much higher amount of Pb than WHO permissible limit. The ranges of Pb concentration varied between 0.00 to 0.23 mg/L for surface water and 0.00004–1.167 mg/L for groundwater. Bhuiyan et al. (2010) evaluated trace metals in the wetlands near Barapukuria, Dinajpur and indicated exceed the amount of Pb (0.23 mg/L) in the analyzed samples. Rivers like Buriganga ( Bhuiyan et al., 2015 ), Korotoa ( Islam et al., 2015b ), Paira ( Islam et al., 2015a ), Khiru ( Rashid et al., 2012 ), Bangshi ( Rahman et al., 2014 ) showed elevated amount of Pb. In groundwater, however, the maximum mean concentration of Pb was more than hundred times (1.167 mg/L) that of WHO limit which was found in deep tubewell water of Rajshahi city ( Mostafa et al., 2017 ). Arsenic pollution

Arsenic is a fatal element ( Lindsay and Maathuis, 2017 ) which is named as a category 1 carcinogenic element by WHO ( Driscoll et al., 2004 ). The first survey done in Bangladesh to identify arsenic was in late 1990s ( Ravenscroft, 2011 ). In 1999, groundwater from 64 districts of Bangladesh was analyzed where 52 districts contained arsenic levels greater than 0.01 mg/L, and 42 districts where the level was greater than 0.042 mg/L ( Uttam and Chowdhury, 2000 ). The allowable concentration of arsenic for drinking water indicated by WHO is 0.01 mg/L where 0.05 mg/L is permitted in Bangladesh but studies found that 8.4% tube-wells in Bangladesh contain more than 0.3 mg/L arsenic ( Smith et al., 2000 ).

Several local and foreign organization examined the level of arsenic contamination in Bangladesh. Among them, BBS/UNICEF (2011) found that 8% of samples they tested, surpassed the Bangladesh standard value and 18% samples surpassed the WHO guideline value according to their research center information. According to the Digital Arsenator data, they also found that 13.4% and 32% samples surpassed the Bangladesh standard value and WHO guideline value respectively. Similarly, another survey collected samples throughout the whole nation and found that 12.6% of samples surpassed the Bangladesh standard value ( BBS/UNICEF, 2010 ).

In Bangladesh, groundwater from “tableland” territory contains more arsenic than “flood plain” and “delta” area. Deposition of Holocene sediments may be the possible reasons behind this difference ( Chakraborti et al., 2015 ). Pond water also is not free from high level of arsenic ( Yokota et al., 2001 ). Arsenic contamination level in different cities/districts of Bangladesh is summarized in Table 3 .

Table 3

Arsenic contamination in various cities/districts of Bangladesh. All values are given in μg/L. Source: ( Chakraborti et al., 2010 )

In short, arsenic pollution is a genuine risk to drinking water in Bangladesh, overexposure of arsenic not only increases the probability of diseases like lung cancer, renal cancer, skin cancer but also it may create a generation like “arsenic orphans” ( Flanagan et al., 2012 ).

2.2.2. Major cations and anions

Water of surface and ground sources contain several cations and anions; among those, cations like sodium (Na + ), potassium (K + ), calcium (Ca 2+ ), magnesium (Mg 2+ ), ammonium (NH 4 + ) and anions like chloride (Cl − ), fluoride (F − ), nitrates (NO 3 - ), bicarbonate (HCO 3 - ), sulfates (SO 4 2- ), phosphates (PO 4 3- ) etc. are found to be essential for humans. Nevertheless, an excess amount of these ions can make the water unsuitable for humans as well as other living organisms. Table 4 represents the summarized data of the condition of different ions in various water sources, which are extracted from numerous studies throughout the country.

Table 4

Cation and anion concentration (mg/L) in Bangladesh in surface water and groundwater. Data are extracted from various individual studies and arranged chronologically based on year of publication of the reviewed articles. Values given represents the mean values or mean values plus-minus standard deviation (S.D.), where the values with ± in the parenthesis () represents average ± S.D. Cations

Sodium (Na + ) is very common is drinking water and mostly found as NaHCO 3 and Na 2 SO 4 ( Whelton et al., 2007 ). WHO and Bangladesh standard for the maximum Na + concentration is 200 mg/L. A few studies found Na + limit above the standard in many water sources; mostly in groundwater sources. In case of surface water, the highest mean concentration of Na+ (252.78 mg/L) throughout the different season was found in Buriganga river ( Ahmed et al., 2011b ). Although most of the studies reported a mild concentration of Na + in selected groundwater, water in some territory showed a higher amount of Na + . The maximum level of Na+ (863 mg/L) in groundwater was reported in the shallow tube well of Barguna district ( Islam et al., 2017d ). Sodium is one of the leading constituents of the blood plasma of humans and because of that reason alteration of its normal concentration in the human body may have direct and vital effects on the osmotic pressure of the plasma, on plasma and interstitial fluid volumes, on acid-base balance, on the maintenance of the electrical activity of body cells, and on the responsiveness of the cardiovascular system to circulating endogenous pressor agents ( Grollman, 1961 ).

The amount of potassium (K + ) found in water is less than other major cations, and it is mostly present in water as KHCO 3 , K 2 SO 4 and KCl ( Whelton et al., 2007 ). 93% of the tested sample collected from all over the country reported in BNDWQS (2009) result did not surpass the Bangladesh standard value for K + . This particular report also indicated that Jhaloka, Noakhali, Chuadanga, and Meherpur were the four districts, which exhibited a higher concentration of K + than the standard value in drinking water. Individual investigations also agreed with the BNDWQS report on K + contamination in Bangladesh. Same as Na+, Buriganga river water contained the highest amount of K + , which is more than thrice that of standard value (40.25 mg/L) ( Ahmed et al., 2011b ). Apart from the water of the Karatoa river, most of the surface water sources contained an insignificant amount of K + ( Table 4 ). Shallow tube well water in Khulna showed the highest concentration of K + (17.05 mg/L) found in groundwater sources ( Islam et al., 2017e ). Potassium enters into the human body mostly through the intake of different solid foods, and this metal helps to decrease blood pressure and also reduces cardiovascular disease. But high potassium intake may result in Hyperkalaemia, which eventually can lead to cardiac arrhythmias ( He and MacGregor, 2008 ).

Calcium (Ca 2+ ) is the amplest mineral in the human body, and this metal plays a vital role in cellular activities, hormones, cancer, heart disease, and muscle and neurodegenerative diseases, as well as the descent of the testis ( Tandouan and Ulusu, 2005 ). None of the studies found Ca 2+ above the safe limit in surface water; however, some of the groundwater sources showed an excess amount of Ca 2+ . 294 mg/L of Ca 2+ was found in the water of arsenates well of Chuadanga district ( Nahar et al., 2014 ). Individual studies and BNDWQS report showed the similar condition of Ca 2+ in the water of districts like Rajshahi, Faridpur, Dhaka, Munshiganj, which are above the recommended limit. The significant side effects from excessive consumption of calcium are hypercalcemia, hypercalciuria, urinary tract calculi, calcification in a variety of soft tissues, notably in the kidney and in arterial walls, and suppression of bone remodeling ( Heaney et al., 1982 ).

Magnesium (Mg 2+ ) is a vital nutrient for human as well as other animals, and it is the second most abundant mineral in the human body ( Vallee et al., 1960 ). Higher concentration of Mg 2+ in any source of water is uncommon in Bangladesh. Studies suggested that water of Khulna and Chittagong territory possessed a higher amount of Mg 2+ in both surface and groundwater ( Table 4 ). Although very little data can be found regarding the Mg 2+ in surface water, one study conducted in the river Mouri situated in Khulna, reported the excess amount of Mg 2+ (48.33 mg/L) in that stream ( Kamal et al., 2007 ). In addition, investigation in the water of shallow tubewell of Khulna showed 78.28 mg/L mean concentration of Mg 2+ ( Islam et al., 2017e ). But the highest average concentration of Mg 2+ (155 mg/L), which is almost five times that of standard value; was found in the shallow tube well of Barguna district which is also situated in Khulna division ( Islam et al., 2017d ).

The non-ionized ammonia (NH 3 ) and ionized ammonium (NH 4+ ) in the environment originate from metabolic, agricultural and industrial processes, and from disinfection with chloramine ( WHO, 2011 ). There is no specific guideline value for NH 4+ set by WHO. A few studies calculated the amount of NH 4+ present in the water of Bangladesh. According to the studies, the highest concentration (9.48 mg/L) of ammonium was found in the groundwater of Chandpur ( Zahid et al., 2008 ). Ammonia does not directly affect health, but it can compromise the disinfection efficiency of water ( WHO, 2011 ). Anions

Chloride (Cl − ) is a naturally occurring anion, which can be found in every water sources, and it is a relatively minor contaminant ( Kelly et al., 2012 ). In case of Cl − , there is no guideline value provided by WHO, whereas Bangladesh standard for Cl − ranges between 150-500 mg/L for drinking water and 600 mg/L for industrial effluent discharge. Different studies on water sources revealed the amount of Cl − in water. The highest mean concentrations of Cl − have been reported from surface water near D.N.D (Dhaka- Narayanganj-Demra) embankment which was 3699.83 mg/L; more than six times higher than the standard industrial discharge limit because of the high discharge rate of the textile dyeing effluents ( Sultana et al., 2009 ). In case of groundwater, the highest amount of Cl − (1776.74 mg/L) was recorded from the shallow tube well in Khulna area ( Islam et al., 2017e ). Different studies also found an elevated amount of Cl − in the groundwater sample of Noakhali ( Ahmed et al., 2011a ) and Chandpur ( Zahid et al., 2008 ). Chloride is present in water can increase the rate of metal corrosion in the distribution pipeline. Also, the excess amount of chloride can change the natural odor and taste of water ( WHO, 2011 ).

Fluoride (F − ) is often found in minerals, and it can be leached out due to erosion by rainwater, which leads to contamination of ground and surface waters; also, industrial effluents contribute increasing the amount of F − ( Sun et al., 2011 ). The average concentration of the F- present in the water according to BNSWQS (2009) report is only 0.20 mg/L. Only two individual studies investigated F − content in surface and groundwater respectively. An article on the highly polluted surface water of D.N.D embankment found 3.33 mg/L mean concentration of fluoride ( Sultana et al., 2009 ).

Nitrate (NO 3 - ) is a naturally occurring ion, which is concerned with the nitrogen cycle ( Fewtrell, 2004 ). Contamination of drinking water supplies with NO 3 - and nitrite (NO 2 - ) is one of the three major water-quality problems today, ranking with contamination of water with bacteria and toxic chemicals ( Johnson and Kross, 1990 ). WHO guideline value for NO 3 - and NO 2 - is 50 mg/L and 3 mg/L respectively whereas Bangladesh standard for this ion is maximum of 10 mg/L. Tejgaon is one of the major industrial areas of Dhaka city which is severely polluted. One study was undertaken in this area showed a very high average concentration of NO 3 - in the nearby lagoon, which was 198.3 mg/L ( Mondol et al., 2011 ). Another study conducted in another industrial area near Dhaka found NO 3 - concentration just above the safe limit in surface water ( Sultana et al., 2009 ). None of the studies found and groundwater containing NO 3 - above the WHO standard, but several areas exceeded Bangladesh standard. Bacterial conversion of the relatively innocuous nitrate ion to nitrite can lead to the development of Methemoglobinemia, which can be the cause of infant death ( Winton et al., 1971 ). Many types of research have shown the relation between consumption of high nitrate containing drinking water and the incidence of different cancers.

Bicarbonate (HCO 3 - ) is a simple single carbon molecule that plays surprisingly vital roles in diverse biological processes ( Casey, 2006 ). HCO 3 - is associated with the hardness of water; hardness of water is usually expressed as milligrams of calcium carbonate per liter ( WHO, 2011 ). There is no particular guideline value for bicarbonate ion. Different studies found the bicarbonate content in groundwater varied from 27 mg/L to 700.2 mg/L ( Table 4 ). Sulfate (SO 4 2- ) is another naturally occurring mineral, which can be found in surface and groundwater. There is no definite guideline value set by WHO for SO 4 2- , but more than 500 mg/L of sulfate in drinking water is not recommended ( WHO, 2011 ). In Bangladesh, both surface and groundwater sources showed an insignificant amount of SO 4 2- present in water. The only surface water of D.N.D embankment areas exhibited a very high concentration of SO 4 2- , which was 1443.87 mg/L ( Sultana et al., 2009 ). Higher concentration of sulfate present in drinking water can cause a mild laxative effect manifested by slightly looser and heavier stools and may lead to disease like diarrhea ( Heizer et al., 1997 ). Phosphate (PO 4 3- ) in water bodies can cause eutrophication, hence the amount of PO 4 3- should be low ( Zhang et al., 2011 ). WHO hasn't established any guideline value for this particular ion. Only one investigation found overplus amount of PO 4 3- (292.89 mg/L) in the surface water near D.N.D embankment ( Sultana et al., 2009 ).

2.2.3. Bacteriological contamination

Microbial examination of water is typically occurred to identify mostly fecal coliforms ( Azizullah et al., 2011 ). Generally, fecal coliforms found in the dung of different warm-blooded species like human, domestic animals ( Geldreich, 1996 ). Scientist uses it as an indicator of water pollution as the presence of waterborne human disease-causing bacteria is indicated by this coliform ( Shiekh, 2006 ). WHO standard for fecal and total coliforms for drinking water is 0 coliform per 100mL of water samples ( WHO, 2004 ). A considerable lot of the revealed types of bacteria can cause serious medical issues in Table 5 . Numerous examinations uncover overwhelming bacteriological contamination of drinking water in the country which is summarized in Table 6 .

Table 5

List of bacteria reported in drinking water in Bangladesh and their possible health effects.

Table 6

Bacteriological contamination of drinking water in different areas of Bangladesh. Data are collected from various studies done in Bangladesh.

Most of the rural people in Bangladesh use tube-well water for drinking purposes, but this tube-well water is contaminated by micro-organisms ( Islam et al., 2001 ). In Gakulnagar village in the Dhaka district, 60% of tube-well water is contaminated by coliform bacteria ( Rahman, 2009 ). Moreover, another study found three tube-wells are highly contaminated with total coliforms in Sardarkandi village under Dhaka district ( Ferguson et al., 2011 ). Similarly, from Comilla, Brahmanbaria and Sirajganj districts 207 samples of tube-well water were collected, and among them, 41% samples were polluted by total coliforms, also 29% samples by thermos-tolerant coliforms and 13% samples by Escherichia coli ( Luby et al., 2008 ). Another study collected samples from 21 shallow tube-wells from Shinduria village under Savar sub-district of Dhaka district and found total coliforms ranging from 1.5×10 1 to 4.98 × 10 4 cfu/100mL and fecal coliforms 0 to 3.49 × 10 3 cfu/100mL ( Rahman, 2013 ). A recent study collected 53 tube-well water samples from different districts of the country and found that 81.2% of them were contaminated with coliforms ( Parvez, 2016 ).

In Bangladesh, pond water also is not free from fecal coliforms and other pathogenic bacteria ( Albert, 2000 ; Alam, 2006 ). A study collected 120 samples from 5 ponds around Dhaka city, and among the five, four ponds were highly polluted by fecal coliforms ranging from 1.63×10 4 to 6.48 × 10 5 cfu/100mL ( Islam, 1994 ). Similarly, a recent study tested 12 pond water samples across the country and found all of the ponds were contaminated with coliforms ( Parvez, 2016 ). People from coastal areas of Bangladesh drink pond water in the dry season ( Frisbie, 2002 ) and the alarming fact is those pond waters contain fecal coliforms. In coastal regions of Dacope and Mongla sub-district of the Khulna and Bagerhat districts, a study collected 39 samples of pond water and found fecal coliforms ranging from 12 to 10 4 cfu/100mL ( Islam, 2011 ).

Though one study found no bacterial contamination in the WASA treated water ( Acharjee, 2011 ), several other studies found bacterial contamination not only in the WASA treated water but also in other government and non-government water treating agency including in the bottled mineral water. A study found high numbers of pathogenic bacteria both in the WASA supply points and in the consumer points. They found high amount of Salmonella spp ., Shigella spp ., Aeromonas spp ., Vibrio spp ., Listeria spp ., Pseudomonas spp . and Staphylococcus spp . bacteria's in those supply points ( Acharjee et al., 2014 ). Similarly, another study tested ten municipal tap water samples, eight filtered water samples, eight mineral water samples and found total coliform ranging from 150 to 1100 cfu/100mL in the municipal tap water, 63 to 1100 cfu/100mL in the filtered water and 2 to 47 cfu/100mL in the mineral water samples. They also found Escherichia coli (60%), Klebsiella (40%), Enterobacter (20%), Pseudomonas (70%), Proteus (10%), Staphylococcus (40%) and Salmonella (0%) in the municipal tap water samples ( Islam, 2010 ). Moreover, another study found that the water supplied by WASA in Dhaka city is highly contaminated with fecal coliforms such as fecal coliforms found in Basabo (2.8×10 3 c.f.u/100mL), in Sobujbag (5.2×10 6 c.f.u/100mL), in Shagun Bagichaa and Mohammadpur (5.0×10 3 c.f.u/100mL) ( Sabrina, 2013 ). In Chittagong city, water supplied by CWASA was also contaminated by fecal coliforms ( Zuthi, 2009 ). Similarly, another study reported that 75% of water samples collected from tube-wells of Rajshahi city is polluted by total coliforms, of which 59% polluted by fecal coliforms ( Rasul, 2010 ).

Escherichia coli is also a detector of fecal contamination ( Ferguson, 2012 ; Talukdar, 2013 ). A study collected samples from rural shallow tube-wells of the country and found that Escherichia coli concentrations were within ranges of 1–10, 10–100 and 100–2000 MPN/100mL on 30%, 9%, 4% samples respectively ( van Geen et al., 2011 ). In Dhaka city, out of 175 tap water samples 80% of their water samples were contaminated with fecal coliforms, 38% samples had fecal coliforms more than 10 4 cfu/100 mL, and also 63% of total water samples contained E. coli ( Talukdar, 2013 ). In Mymenshing district, among the tube-well water samples, in 14% of the samples, E. coli were average ten cfu/100mL, and in 3% of the samples, E. coli were 100cfu/100mL ( Ercumen, 2015 ).

There are several causes for contamination of drinking water. Groundwater might be polluted by various kinds of human activities. Residential, metropolitan, business activities would all be able to affect groundwater quality. Contamination of tube well water seems identified with various components, including nearness of toilets or channels to the tube wells, depth of the tube-wells. Distribution pipes might pollute supplied water because of spillage ( Parvez, 2016 ).

2.2.4. Pesticides

Pesticides are lethal to living beings which are used for controlling plant bugs ( Chowdhury et al., 2013 ). In 1951, pesticide was first used in Bangladesh for treating pest during cultivation and for improving production ( Rahman, 1997 ). The use of pesticide in Bangladesh is increasing day by day ( Matin et al., 1998 ). Rahman et al. (1995) reported that the consumption of pesticide in Bangladesh was double within six years. Moreover, Rahman (1997) reported that in 1956–57, around 2 tons of pesticide imported in Bangladesh and the consumption of pesticide increased per year such a high rate that eight metric ton pesticide was imported in Bangladesh in 1993. A few data is available regarding pesticide pollution of drinking water in Bangladesh. Lack of funds and laboratory facilities are the main obstacles in the availability of data in the country. The results of different examinations detailing pesticide deposits in ground and surface water of Bangladesh are abridged in Table 7 , and WHO standards for different pesticide residues are in Table 8 .

Table 7

Pesticide concentrations (ppm) in surface and groundwater sample of Bangladesh. Data are extracted from different studies and values given represent the mean values or the range from minimum to maximum.

ND, not detected; BDL, below detection Limit.

Table 8

WHO standards of pesticide residues for drinking water quality ( WHO, 2008 ).

Rice, wheat, jute, potato, sugarcane, vegetables, and tea are the main crops cultivated in the country ( Chowdhury et al., 2013 ). The paddy fields consume 70% of the total pesticides ( Bhattacharjee, 2013 ). In Bangladesh, insecticides are largely used than herbicides, fungicides, acaricides, and rodenticides. Miah (2014) also found that 20 types of insecticides, 18 types of fungicides and two types of rodenticides are applied in Bangladesh. Similarly, Rahman et al. (1995) reported that 95% of total pesticides, used in Bangladesh, are insecticides and the remaining 5% are fungicides, weedicides, and rodenticides. They also reported that among the pesticides, 60.4% are organophosphorus, 28.6% are carbamates, 7.6% are organochlorines and 3.4% are other compounds. Another study found that in Bnagladesh, carbamates are used in 64% of the area used for crop production and organophosphates are used in 35% of that area ( Chowdhury et al., 2012 ).

After applying pesticide, rain runoff, the residues to the nearest water bodies and they become contaminated ( Kreuger, 1998 ). ( Islam, 2007 ) collected 48 agricultural field water samples from different regions in the country and found water samples from 10 locations were polluted by P, P-DDT, heptachlor, and lindane. P, P-DDT was found at Rajbari and Bogra districts, heptacholor was found at Dhaka, Magura, and Chittagong districts, lindane was found at Dhaka, Sylhet, Shariatpur and Noakhali districts, also the highest concentration of P, P-DDT residue was found Bogura, and it was 0.5401 ppm. In Savar and Dhamrai Upazila, out of 27 water samples, Diazinon and carbofuran were found in water samples from Savar Upazila at 0.9 ppm and 198.7 ppm, respectively. Malathion was found from Dhamrai Upazila at 105.2ppm. Carbaryl was also found ranging from 14.1 ppm to 18.1 ppm and carbofuran at 105.2 ppm in the Dhamrai Upazila ( Chowdhury, 2012 ). In Savar Upazila, out of 12 water samples beside the agricultural fields, carbaryl residues were found ranging from 4.6 ppm to 6.3 ppm, carbofuran residues at 43.2 ppm, cypermethrin in three water samples ranged from 54.36 ppm to 80.5 ppm ( Hossain et al., 2015 ). Similarly, Chowdhury et al. (2012) collected 16 water samples from paddy fields and lakes in Rangpur city and found chlopyrifos ranging from 0.554 ppm to 0.895 ppm, carbofuran ranging from 0.949 ppm to 1.671 ppm and carbaryl in one sample at 0.195 ppm in the lake water samples. In the paddy field water samples, they found, cholrpyrifos in seven samples ranging from 0.477 ppm to 1.189 ppm, carbofuran in seven samples ranging from 0.934 ppm to 3.395 ppm and carbaryl in two samples at 0.055 ppm and 0.163 ppm. Moreover, Chowdhury et al. (2013) collected irrigated water samples from 22 districts in Bangladesh. They found DDT residue in Feni, Rajshahi and Nawabganj districts. The highest DDT concentration was 8.29 ppm. They also found heptachlor residues in Natore, Sunamganj, and Madaripur districts and the highest concentration was 5.24 ppm. They also found both DDT and heptachlor residues in water samples from Chhatak at Sunamganj district.

Pond water can be contaminated by the pesticides used in crops field situated around the pond ( Chowdhury et al., 2013 ). Several studies found pesticide residues in pond water samples. Bagchi (2009) collected 20 pond water samples and found DDE and heptachlor in one water sample and DDT, DDE, DDD in another sample but their concentration level was within the WHO guideline value of the water quality. They also found carbofuran residues in 10 water samples but that also within the WHO guideline value. Similarly, another study collected 25 pond water samples from Nabinagar Upazila (Brahmanbaria district) and found Malathaion in three samples ranging from 0.0241 ppm to 0.0463 ppm and that also within the WHO guideline value of water quality ( Uddin, 2012 ). Another study done in the Rangpur district collected seven pond water samples, but they found no water samples contaminated with pesticide residues ( Chowdhury et al., 2012 ). In Meherpur district, out of 20 pond water samples, diazoin was found in three samples ranging from 0.0328 ppm to 0.0790 ppm, and chlorpyriphos was found in two samples ranging from 0.0107 ppm to 0.0143 ppm ( Uddin, 2013 ). In Dhamrai Upazila, Hasanuzzaman et al. (2016) collected six pond water samples for the analysis of Malathion residue and found Malathion residue ranging from 261.06 ppm to 922.8 ppm.

Groundwater levels in Bangladesh are high, and soil is mainly coarse, so there is a chance that groundwater can have polluted by pesticide residues. Matin et al. (1998) collected 144 groundwater samples from underground sources and found most of the samples were free from pesticide residues. All DDT values they found were ranging from 0.051 ppm to 1.653 ppm that were below the WHO recommended values. Also, they found heptachlor residues ranging from 0.025 ppm to 0.789 ppm.

Over the years it has been seen that the consumption and use of pesticide in the agricultural sector have increased and this is expected to continue for the next decades due to socio-economic and technological progress ( Bempah, 2011 ). Most farmers in Bangladesh use pesticides excessively and purposelessly as they have little consciousness and knowledge about the use ( Miah, 2014 ). Overuse of pesticides can cause genuine public health insecurity particularly as residues in food ( Chowdhury, 2013 ). Several studies found pesticide residues in different vegetable samples like in tomato, Lady's finger, eggplant, long yard bean ( Fatema, 2013 ; Miah, 2014 ; Rahman, 2015 ). Pesticide residues were also detected in meat, milk and dry fish samples ( Rahman, 1997 ; BHUIYAN, 2009 ; Shoeb, 2016 ).

Most farmers used mainly organochlorine, organophosphorous and carbamate pesticides in Bangladesh ( Dasgupta, 2007 ). Organochlorine pesticides like DDT, lindane, heptachlor, dieldrin were used in agricultural fields and to treat diseases like malaria in Bangladesh from the early fifties ( Rahman, 2000 ). Organochlorine (DDT) was banned in 1993 in Bangladesh but there were reports that it is consumed illegally ( Shoeb, 2016 ). Several studies found residues of DDT and its metabolites in fresh fish, dry fish and poultry feeds ( Nahar, 2008 ; Shoeb, 2009 ). All the pesticides have negative effects on human. Organochlorine pesticide residues having low polarity, low aqueous solubility, high lipophilicity and a very stable half-life in the environment make it a potential threat to human health and environment as it can bioaccumulation in the food chain ( El-Mekkawi, 2009 ; Afful, 2010 ). As organophosphorous pesticides are cheap and their effectiveness is very good, farmers are encouraged to use it. But these pesticides are harmful to farmer's health, and those pesticides are also genotoxic and carcinogenic ( Chowdhury, 2012 ; Hayat, 2010 ). Chlorpyrifos can cause attention deficit hyperactivity disorder and development disorder both in fetuses and children ( Rauh, 2006 ). Carbamate pesticides such as carbofuran cause major problems in the reproductive system ( Goad, 2004 ) and carbaryl can cause nausea, vomiting, blurred vision and breathing difficulties ( Kamrin, 1997 ).

2.3. Sources of water pollution

Water can be polluted by both natural and anthropogenic sources ( Harrison, 2001 ). Majority of the water sources, chiefly surface water bodies, however, are polluted because of the industrial growth; urbanization and man-made problems ( Pandey, 2006 ) (see Table 9 ). In Bangladesh, sewage and solid waste & industrial waste & effluents are the main cause of surface water pollution. Arsenic contamination in groundwater is devastating in case of Bangladesh, and an estimated 35 to 77 million people of this particular country have been chronically exposed to arsenic in their drinking water ( Flanagan et al., 2012 ).

Table 9

Point and non-point sources of water pollution in Bangladesh.

Industrial pollutants are the major cause of surface water pollution in the urban region in Bangladesh. According to an industrial survey conducted by Bangladesh Center for Advanced Studies (BCAS) in 2009, only about 40% of industries had ETPs. In 10% of industries, ETPs were under construction at that time, and about 50% of industries have no ETP establishment ( Amin, 2015 ). In terms of overall emission (indicated as BOD and TSS) into water, pulp and paper industry is the major contributor (47%), followed by pharmaceuticals (16%), metal (14%) and food industries (12%), fertilizers/pesticides (7%), industrial chemicals (1%) and other industries (3%) which includes the cumulative contribution of cement and clay, textile, wood and furniture, tanneries and leather and petroleum industries ( Rasul et al., 2006 ). Dhaka and it's adjacent districts like Gazipur, Narayanganj are the worst victim of unplanned industrialization; hence, exhibit drastic pollution in water sources. Although Dhaka City is surrounded by some peripheral rivers, the water of these rivers is too contaminated to use as potable water. There are 19 primary and at least 41 secondary discharge points to the rivers within the city ( IWM, 2007 ). Improper discharge of untreated wastewater from various industries neighboring these rivers adulterates the water quality ( Rahman and Hossain, 2008 ; Subramanian, 2004 ; Karn and Harada, 2001 ; Kamal et al., 1999 ). A World Bank study reported that peripheral rivers of Dhaka took 1.5 million cubic meters of wastewater every day from 7,000 industrial units in surrounding areas and another 0.5 million cubic meters from other sources ( Islam, 2010a ). Before relocating to Savar Upazila, Dhaka ( Roy, 2017 ), tanneries located in Hazaribagh and Rayer Bazar in Dhaka city were responsible for discharging 15,000 cubic meters of liquid wastes, 19,000 kilograms of solid wastes and 17,600 kilograms of BOD into Buriganga river daily ( Rahman and Bakri, 2010 ). Kaliakoir Upazila of Gazipur is only 25 km northeast of the capital city where an unplanned industrial cluster has been developed in the past 20 years. These industries are discharging 30 billion liters of effluent water annually in the nearby waterbodies such as Mokosh Beel, Turag river and Ratanpur Khal ( Chowdhury and Clemett, 2006 ). Large numbers of textile dyeing industries along with other industries situated surrounding D.N.D embankment discharge a large amount of effluents and solid wastes into different waterbodies which eventually enter into the Shitalakshya River. Almost 80% of the total industries does not have any treatment plant and hence discharge toxic untreated industrial effluent into those waterbodies ( Sultana et al., 2009 ).

A vast amount of untreated effluents from industries such as spinning mills, dying, cotton, textile, steel mills, oil refineries, and others industries is discharged regularly into the Karnaphuli river, Chittagong ( Ali et al., 2016 ). Ship Breaking industry is one of the fastest growing industries in Bangladesh which is a significant contributor of trace metal pollution in seawater and groundwater in the coastal region of Bangladesh ( Hasan et al., 2013 ).

Pollution of closed water bodies caused by human waste is a major problem in Bangladesh ( Chowdhury, 2010 ). According to previous statistics, it is estimated that 16,380 tons of waste were produced in Bangladesh every day ( Sujauddin et al., 2008 ). Urban cities are the worst victim of this kind of water pollution. The wastewater discharge from Dhaka city dwellers is about 1.22 million m3/day, whereas the only sewage treatment plant in Dhaka, namely “Pagla Sewage Treatment Plant” can treat 0.12 million m3 wastewater per day ( Akter et al., 2017 ). The surface water quality in the two river systems and other surface water bodies, e.g. khals (small waterbody) and ponds in Dhaka have very high BOD, COD, and E-coli content which indicates discharge of untreated industrial effluents and domestic sewage. Moreover, only 50% of the municipal solid waste being collected by the two city corporations of Dhaka results in most of the wastes dumped into water bodies, low lying areas and khals ( Anonymous, 2010 ). Among the total habitat of Dhaka, 15% use pit latrines and 30% use open latrines; the sewage generated from these latrines are mostly released without any treatment into low-lying areas and river water ( Alam, 2009 ).

The agriculture sector is the economic backbone of Bangladesh which represents 15.33% of the Gross Domestic Product (GDP) and contributes almost half of the country's economic output ( Uddin, 2013 ). Different types of organophosphorus and carbamate pesticides are used extensively by the local farmers, but due to the lack of proper knowledge and instruction, they overuse these pesticides ( Chowdhury, 2012 ; Bhattacharjee et al., 2012 ). Haphazard use of pesticides leads to both surface and groundwater pollution, chiefly caused by rain or runoff water from the agricultural land ( Hasanuzzaman et al., 2016 ). A World Bank survey reported that 6% of the total pesticides applied to crops are extremely hazardous ( Meisner, 2004 ). Nitrate, phosphate, potassium, aldrin, dieldrin, chlardane, indrin, cadmium, arsenic, chromium and other toxins extracted from different kinds of agrochemical eventually get mixed with the water of various waterbodies ( Rahman and Debnath, 2015 ). Furthermore, pesticide leaching into groundwater can contaminate the water ( Anwar and Saing, 2010 ).

Arsenic contamination in groundwater is a major threat to public health in Bangladesh ( Smith et al., 2000 ). Groundwater pollution is very alarming for Bangladesh as 95% of drinking water is derived from groundwater sources ( Chowdhury, 2010 ). Although the sources of higher concentration of arsenic present in the groundwater in Bangladesh is ambiguous, different theories have been developed ( Islam et al., 2000 ; Das et al., 2004 ). Initially, various anthropogenic sources such as pesticides, industrial waste, tubewell filters, etc. were considered as the leading sources of arsenic in groundwater, but field observations reported that the source of this trace metal was in geological deposits ( Fazal et al., 2001 ). Even though there is three arsenic ore in the world, Fazal et al. (2001) stated that Arsenopyrite or ferrous arsenic sulfide (FeAsS) is the main source of arsenic pollution in Bangladesh. Pyrite Oxidation and Oxy-hydroxide Reduction are the two hypotheses developed to explain the mobilization of arsenic.

Other minor sources also contribute to the contamination of water bodies. Bhuiyan et al. (2010) showed that Barapukuria coal mine is responsible for heavy metal and thermal pollution in nearby water systems. Accidental oil spill also can cause severe damage to the water quality and aquatic life forms of large water bodies. A recent ‘oil spill from a crashed tanker’ incident resulted in an estimated 350,000 liters of the oil spill; spreading over a 60 km-long area in the Shela and Passur rivers inside Sundarbans, the largest mangrove forest of the country (AFP, 2014).

2.4. Human health effects

Water pollution has increased in both developed and developing countries, threatening the physical and environmental health of billions of people ( Javier et al., 2017 ). About 3.4 million people die worldwide each year from water-related diseases like cholera, typhoid, polio, ascariasis, cryptosporidiosis and diarrheal diseases ( UNEP, 2016 ). Water tainted with defecation puts individuals in danger of contracting cholera, looseness of the bowels, typhoid, and polio ( WHO, 2017a , b ).

In Bangladesh, every year more than one hundred thousand children under five years old die due to diarrhea-related diseases ( Rana, 2009 ). In 2004 Bangladesh Demographic and Health Survey (BDHS) also reported that 5.1% of deaths of children under five years and 1.2% neonatal deaths were related to diarrhea. Another study reported that 6.9% of deaths of children under five years and 0% neonatal deaths were related to diarrhea ( Halder, 2009 ). Another study reported that 1% neonatal deaths, 15% post-neonatal deaths and 6% under five age children deaths were associated with diarrhea ( WHO, 2016 ). ( WHO, 2017a , b ) also reported that more than 45,000 under-five youngsters die each year in Bangladesh from diarrhea brought about by sullied water.

Arsenic has been reported as a threat in many parts of the country. Every year, an expected 43,000 individuals die from arsenic harming in the nation. The legislature has made various strides and made strategies to attempt to address the issue. Be that as it may, regardless of a nationwide campaign and social assembly exercises by the legislature and NGOs, information and mindfulness levels among networks stay far beneath desires ( Jahan, 2016 ). Overexposure to arsenic can cause skin lesions, diabetes mellitus, high blood pressure and chronic disease ( Yunus et al., 2011 ). A study collected information from 52 districts of Bangladesh and found that about 40 million people are at risk due to arsenic. They also found that the most common diseases affected by people are melanosis, keratosis, hyperkeratosis, dorsum, gangrene, and skin cancer ( Karim, 2000 ). Another study found that arsenic-related diseases were responsible for 9136 deaths per year in Bangladesh ( Alam, 2003 ). Similarly, another study examined 811 patients with arsenic skin lesions from Pabna, Jessore, Kustia, Chuadanga, Narayanganj and Meherpur districts and found that about 16.6% of those patients had died due to cancer during the last 9–12 years ( Chakraborti et al., 2010 ).

Drinking water polluted by microbial contamination increases the risk of some diseases like typhoid, dysentery, diarrhea, hepatitis A and hepatitis B ( Shar et al., 2007 ). A study found that typhoid, bacillary dysentery, and diarrhea are very common among the bacterial origin waterborne diseases (Parveen, Microbial Contamination of water in around Dhaka city, 2008). Another study revealed that there is a significant correlation between the microbiological quality of water and gastrointestinal diseases ( Oguntoke, 2009 ).

Pesticide contamination in surface water is another threat to public health in Bangladesh. Studies found that pesticide residues can cause nausea, vomiting, blurred vision, coma, difficulty in breathing, deficit hyperactivity disorder in the human body ( Rauh et al., 2006 ). A study found that 26.3%, 24.4% and 18.8% farmers of their study reported excessive sweating, burning eyes and fatigue respectively due to occupational exposure of pesticides ( Bhattacharjee, 2013 ). A daily newspaper published that 11 children were died by diseases which were provoked by pesticides at Dinajpur medical college hospital between May 30 to June 20 ( Roy and Karmakar, 2015 ). Another study reported that many pesticide residues increase the possibility of some diseases like cancer and heart diseases. It also reported that pesticide residues could cause respiratory and neurological damages ( Galloway and Handy, 2003 ). Another study reported that food products containing pesticide residues could cause cancer, teratogenesis and genetic damage ( Chowdhury, 2011 ).

As heavy metals are non-biodegradable, it can show its toxic effect at points which are far from the source of pollution ( Tilzer, 1993 ). Exposure to heavy metals can cause several diseases like kidney damage, cancer, abortion, effect on mind and behavior and sometimes even death in the cases of high exposure ( Saha, 2011 ). Vegetables and fruits contained a high concentration of trace elements like copper, cadmium, and lead which increased the probability of upper gastrointestinal cancer ( Türkdoğan et al., 2002 ). Several studies found different effects of different ions or compounds such as chromium compounds increases the risk of lung cancer ( Ishikawa et al., 1994 ), high consumption of nickel increases the probability of lung and nasal cavity cancer ( Ahmed et al., 2015 ), excessive consumption of zinc can cause electrolyte imbalance, nausea, anemia and lethargy ( Prasad, 1984 ), long term consumption of cadmium increases the rate of kidney failure, softening of bones ( Ahmed et al., 2015 ), and prostate cancer ( Gray, 2005 ).

2.5. Environmental legislation in Bangladesh and it's effectiveness

Water Pollution Control Ordinance 1973 was the first legislation in Bangladesh about water pollution. Then in 1977, Environment Pollution Control Ordinance was declared. Department of Pollution Control Ordinance was organized in 1985 which was renamed as Department of Environment (DoE) afterward. In 1992 another Environmental Policy was declared and The Government of Bangladesh has additionally organized various supplementary arrangements such as the Forest Policy (1994), the Fisheries Policy (1998), the Water Policy (1998), the New Agriculture Extension Policy (1995), the Energy Policy (1995) ( Aminuzzaman, 2010 ).

Bangladesh Environment Conservation Act (ECA), 1995 was passed for the protection of environment models and moderating environmental contamination but the main impediments of the Act are its hushes on the benchmarks, parameters, discharge levels and administration components in view of which the ecological clearance ought to have been connected and gotten ( Aminuzzaman, 2010 ).

The Environmental Conservation Rules, 1997, were proclaimed in promotion of the destinations of the ECA, 1995. As to of poisonous and hazardous substances, the Principles have extensively characterized rules for transfer of waste from various classes of ventures, but it has not indicated the admissible degree of outflows or the commitments of restorative activities ( Aminuzzaman, 2010 ).

Ministry of Water Resources formulated National Water Policy in 1999 to guarantee effective and impartial administration of water assets, appropriate outfitting, and advancement of surface and groundwater, accessibility of water to all concerned, and institutional limit working for water resource administration. The Bangladesh Water Act, 2013 is for the most part given the National Water Policy of 1999, and it is intended for coordinated improvement, administration, appropriation, utilization, security and preservation of water assets in Bangladesh. The demonstration proclaims all type of water inside the region of Bangladesh as the property of the government. Notwithstanding, the surface water in private property can be utilized by the proprietor for all the required reason. The demonstration requires permit for pulling back expansive size of surface or groundwater; notwithstanding, the most significant measure of water that can be pulled back isn't said in the law ( BanDuDeltAS, 2015 ).

Ministry of Environment and Forest formulated the National Environmental Policy 2013 which depends on 17 essential issues and 12 goals pertinent to economic advancement, valuation of environment administrations, sustenance wellbeing, polluter's compensation standard, and adjustment and alleviation to combat environmental change. The activity designs incorporate some new instrument or activities like environmental auditing, agriculture, nearby and national contingency for keeping pollution from sea/water car crash, EIA for lodging and urban advancement ventures, squander heat Recovery activities and so on ( BanDuDeltAS, 2015 ).

Though the defined environment policy genuinely rich in content, it isn't bolstered by essential activities of execution. Several studies reported that the execution of the environmental arrangement and the Environmental Protection Act had been hindered because of some institutional and utilitarian impediments ( Khan, 1999 ; Hanchett, 1997 ). Different operational guidelines for successful execution of the policy and act would require corresponding and nitty-gritty operational guidelines, a considerable lot of which have not yet been figured. Besides, surges and typhoons are real worries for ecological administration in Bangladesh. However, the Environmental Protection Act still have restricted concern and intercession for such catastrophes. Other problems for a successful execution of environmental policy are insufficient funding, skilled human, lack of inter-agency relation, irregularity with different policies, absence of inter-sectoral arrangement, lack of administrative and institutional capacity, impediments of the environment laws, Outdated environmental laws as well as ignorance about these laws, non-punitive approach of laws, political corruption and so on ( Aminuzzaman, 2010 ).

3. Conclusion

The present investigation demonstrates that most of the water bodies in Bangladesh are contaminated with several contaminants and not suitable for human consumption without proper treatment. Besides heavy metal contamination, pesticide contamination of surface water sources is the most prospective menace for the people of Bangladesh. Bacteriological contamination is also a great source of surface water which causes threats to both urban and rural people. Among the heavy metals, Arsenic found in groundwater at an alarming rate all over the country. High level of iron, chromium, nickel, and lead is also worrying. Copper, zinc, and manganese are found below the standards limit in most of the sources. In addition, most of the cations like Na + , K + , Ca 2+ , Mg 2+ found in water sources are mostly below the standards limit. Lack of proper monitoring, laws implementation, adequate human resources as well as lack of modern treatment plants and water supply systems, and poor awareness and education about water use and safety are the main prompt of water pollution in Bangladesh. There are little records mainly longitudinal data about water-borne diseases in the nation, so more surveys need to be done to get a better idea of water-related diseases.


Author contribution statement.

All authors listed have significantly contributed to the development and the writing of this article.

Funding statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Competing interest statement

The authors declare no conflict of interest.

Additional information

No additional information is available for this paper.

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  1. SOLUTION: Water borne diseases

    water borne diseases assignment

  2. 4 Types of Water Related Diseases : Water Borne, Water Based, Water

    water borne diseases assignment

  3. 8 Common Water Borne Diseases in India: Treatment & Prevention

    water borne diseases assignment

  4. What Is Waterborne Disease And How To Prevent It?

    water borne diseases assignment

  5. PPT

    water borne diseases assignment

  6. PPT

    water borne diseases assignment


  1. PDF Introduction to water- related infectious diseases

    Cryptosporidium. 13 species - C. hominis and C. parvum predominant in humans. Self-limiting abdominal pain and diarrhea (1 week on average); can be prolonged and severe in immunosuppressed. Large waterborne outbreaks, and outbreaks associated with visiting farms and contact with animals.


    The objective of this assignment was To enlist the risk factors of water-borne diseases Water is essential for life and is very important to use safe drinking water to prevent water-related diseases. Typically water-related diseases are categorized into four classes: (1) Water-borne (caused by bacteria, viruses, and protozoans)

  3. (PDF) Water and Waterborne Diseases: A Review

    Faecal pollution in water sources can lead to various waterborne infectious diseases transmitted through the faecal-oral route. In regions with limited access to clean water, waterborne diseases ...

  4. Waterborne Disease

    CDC's first estimates of waterborne disease in the US indicate that every year, waterborne pathogens cause 7,000 deaths, 120,000 hospitalizations, 7 million illnesses, and $3 billion in healthcare costs. Increased recreational water use, aging drinking water infrastructure, a warming climate, and the increasingly complex ways that we use ...

  5. Water-Borne Diseases

    The US Centers for Disease Control and Prevention (CDCs) refer to water-borne disease as an "illness that occurs after consumption or use of water intended for drinking (potable), or the ingestion or use of recreational water. Recreational water includes pools, spas, water park water, and fresh and marine surface waters" (Jamul 2007, p. 264).

  6. Narrative Review of Primary Preventive Interventions against Water

    1. Introduction. Water-borne diseases (WBDs) are infectious diseases, such as cholera, shigella, typhoid, hepatitis A and E, and poliomyelitis, that are transmitted to humans through contaminated water [].These infections are caused by a number of bacterial, viral, and parasitic organisms where there is inadequate sanitation, hygiene, and safe water for drinking, cooking and cleaning [].

  7. 2021 Waterborne Disease Outbreaks Annual Surveillance Report

    Number and percentage* of reported waterborne disease outbreaks (N = 52) and associated cases, hospitalizations, and deaths, by type of water exposure — Waterborne Disease and Outbreak Surveillance System, United States, 2021. Recreational. 32 (62%) 284 (56%) 37 (36%) 1 (10%) Drinking.

  8. Addressing Risk for Waterborne Disease

    Contributors to this chapter discuss a broad range of responses to the threat of waterborne disease, including drinking water disinfection, increasing access to water, improving sanitation, and investment in and implementation of public health interventions. Among these, the most seemingly straightforward approach—water treatment—is actually far from simple, as Philip Singer, of the ...

  9. Waterborne Disease in the United States

    Yet, the water we use for drinking, swimming, and even cooling high-rise buildings can be safer. About 7.2 million Americans get sick every year from diseases spread through water. CDC's first estimates of the impact of waterborne disease in the United States cover illnesses tied to all types of water use. They detail how many waterborne ...

  10. Introduction to Water-Associated Infectious Diseases

    1.1 Introduction. The escalating number of cases and emergence of antiquated pathogens have created an immense worldwide burden on humanity. Considerable advancement in the area of biomedical research and biotechnology has attributed a new shape to the lifestyle and healthcare. However, emerging and re-emerging infectious diseases have always ...

  11. Climate Change Impacts on Waterborne Diseases: Moving Toward Designing

    This review combines water-borne disease outbreak epidemiology with known pathogen behaviors illustrated in a conceptual model and highlights the need for quantitative modeling approaches to measure the sometimes counteracting effect of climate change on infection risks . For example, summer droughts could concentrate pathogens due to lower ...

  12. (PDF) Polluted Water Borne Diseases: Symptoms, Causes ...

    It was reported that 80% infectious diseases are water borne (Pons et al., 2015), such as cholera, typhoid fever (Fazal-ur-Rehman, 2019), gastroenteritis, diarrhoea, vomiting, skin and kidney ...

  13. PDF Water Borne Disease

    The first case of Hepatitis E virus (HEV) was reported in Ethiopia in 1985. In 1988-1989 a water borne outbreak was detected in a military camp where 93% of icteric hospitalized patients were infected with HEV. Its case fatility rate is higher in pregnant women (23%) than in the general population (11%).(28).

  14. (PDF) An Overview of the Micro- Organisms Associated with Water-Borne

    Results The study finds the prevalence of water borne disease among the elderly is more in the rural (22.5%) areas compared to the urban counterparts (12.2%) due to the use of unimproved water ...

  15. Waterborne Diseases: Still a Challenge

    Legionnaires' disease is a severe respiratory illness characterized by fever, cough, chest pains, and diarrhea. Legionella bacteria can also cause Pontiac fever, a flu-like illness usually self-limiting and less severe. Legionella is found in fresh water and rarely causes illness. However, in plumbing systems, Legionella may multiply and ...

  16. Waterborne Disease: Epidemiology and Ecology

    Water borne disease is responsible for millions of deaths worldwide every year. Within both developed and developing countries the demand for clean drinking and bathing water is ever increasing and the control of water borne disease is therefore of extreme importance. The book first addresses the magnitude of the problem, with subsequent chapters on specific diseases including Crytosporidiosis ...

  17. The nexus between improved water supply and water-borne diseases in

    Introduction. The sub-Saharan Africa (SSA) has experienced the highest annual urban population growth rate (more than 3.5%) in the world 1.However, the growth of urban infrastructure has been slower, leading to populations without access to adequate resources including water services, health facilities, and housing 2, 3. Globally, it is estimated that one in every two people will be living in ...

  18. 7 Most Common Waterborne Diseases (and How to Prevent Them)

    Nausea. Vomiting. Diarrhea. Muscle cramps. Prevention and Treatment. Cholera is a waterborne illness that's easily prevented when traveling. Wash your hands often, only eat foods that are completely cooked and hot (no sushi), and only eat vegetables you can peel yourself, like avocados, bananas, and oranges.


    Person-to-person spread of giardiasis can be prevented through strict handwashing, care with diaper disposal, and treatment of symptomatic patients. The local health department should be contacted when an outbreak of giardiasis is suspected. Waterborne Giardia infection can be prevented through effective treatment of drinking water.

  20. Water borne diseases

    Water borne diseases More to explore. Max. Article (5) Press release (1) Zambia (6) Zimbabwe (1) Article. 23 January 2024 A day in the life of a Community-Based Volunteer LUSAKA, Zambia, January 2024 --- "As a nurse, I am inspired by the profound impact volunteers bring to healthcare facilities. Witnessing their contributions firsthand has ...

  21. 4.7: Foodborne Diseases

    Fungi in the genus Aspergillus are frequently found in nuts, maize, and corn. They produce a toxin called aflatoxin, which targets the liver, potentially causing cirrhosis of the liver and liver cancer. Figure 4.7.3 4.7. 3: The death-cap mushroom (Amanita phalloides) contains toxins that are not affected by cooking.

  22. Water pollution in Bangladesh and its impact on public health

    Death due to water-borne diseases is widespread in Bangladesh, particularly among children. Anthropogenic sources such as untreated industrial effluents, improper disposal of domestic waste, agricultural runoffs are the main contributors regarding water pollution. A total water pollution status of this country, as well as the sources of this ...