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Abstract: Household water treatment (HWT) technologies are used to improve microbiological water quality and reduce diarrheal disease among users without access to safe drinking water. There is ongoing interest in developing new HWT technologies, which are typically evaluated by controlled laboratory microbiological efficacy testing, followed by diarrheal disease reduction through randomized contr... read moreolled trials. In households, technologies should be both microbiologically effective and consistently used to achieve maximum health gains, yet industry standard metrics to evaluate household use are lacking. HWT technology regulation is limited both globally and nationally; few regulation frameworks exist, and most existing performance standards focus on efficacy. Given the state of rapid HWT technology development, lack of industry standard metrics, and weak regulation frameworks, this dissertation aimed to investigate methodologies of evaluating HWT technology performance for both technology improvement and regulatory decision-making. Six research projects spanning laboratory, field, and policy domains were conducted: two evaluations of field laboratory methods for analyzing water quality indicators; three field evaluations of existing and prototype HWT technologies, including investigations of use, performance, and failure mechanisms in realistic household settings; and one demonstration of a national HWT regulation framework considering technology efficacy, toxicity, manufacturing consistency, and usability. Results confirmed field water quality test methods, recommended standard HWT evaluation metrics and evaluations in realistic settings, and demonstrated a simple national HWT regulation framework. Overall, six main themes emerged: 1) evaluations in realistic settings are important, particularly to identify design flaws and establish technological limitations before widely distributing technologies; 2) there is a need to refine HWT field evaluation methods and regularly report consistent use and effectiveness alongside disease reduction; 3) determining HWT "success" remains difficult in disparate field study settings; 4) HWT regulation must begin with basic parameters; 5) technology is important, but behavior change cannot be ignored if health gains are to be achieved; and finally, 6) HWT is a complex public health intervention depending on many actors. HWT technologies are a viable solution, but it is critical that technologies be evaluated and regulated to ensure they are effective for those who need it most.
Thesis (Ph.D.)--Tufts University, 2017.
Submitted to the Dept. of Civil Engineering.
Advisor: Daniele Lantagne.
Committee: Elena Naumova, Jeffrey Griffiths, Joe Brown, and Mark Woodin.
Keyword: Environmental engineering.read less
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