Reductions in Children's Blood Lead Levels from a Drinking-Water Intervention in Madagascar, Sub-Saharan Africa.

One in three children globally is estimated to have blood lead levels (BLL) at or above the BLL reference value of 5 µg/dL with increased burden falling on low- and middle-income countries (LMIC). Within developed countries, aqueous lead is the predominant exposure route. However, aqueous lead exposure is rarely examined in the LMIC, leaving a gap in the literature that ignores a potentially significant route of exposure. Furthermore, limited lead-based remediation efforts around consumer products have been examined. This study investigates the importance of lead exposure from the water supply through a case study in Toamasina, Madagascar. The project measured aqueous lead and BLL of children pre- and postremediation efforts (i.e., removal of leaded pump components in hand pumps) to verify the impact of aqueous lead exposure within this community. Removal of the leaded pump components (i.e., piston and foot valves) and replacement with nonleaded components decreased aqueous lead levels below the World Health Organization provisional guideline of 10 µg/L in all but 4% of pumps tested. Measured BLL concentrations indicated a statistically significant decrease in BLL from pre- to postremediation. Furthermore, the remediation resulted in a decrease in BLL for 87% of children with the greatest changes in BLL observed for children with the highest preremediation concentrations. These findings point to a need for greater consideration of lead in drinking and cooking waters as an important exposure route in LMIC.

Autotrophic denitrification supported by sphalerite and oyster shells: Chemical and microbiome analysis.

This research evaluated the metal-sulfide mineral, sphalerite, as an electron donor for autotrophic denitrification, with and without oyster shells (OS). Batch reactors containing sphalerite simultaneously removed NO3- and PO43- from groundwater. OS addition minimized NO2- accumulation and removed 100% PO43- in approximately half the time compared with sphalerite alone. Further investigation using domestic wastewater revealed that sphalerite and OS removed NO3- at a rate of 0.76 ± 0.36 mg NO3--N/(L · d), while maintaining consistent PO43- removal (∼97%) over 140 days. Increasing the sphalerite and OS dose did not improve the denitrification rate. 16S rRNA amplicon sequencing indicated that sulfur-oxidizing species of Chromatiales, Burkholderiales, and Thiobacillus played a role in N removal during sphalerite autotrophic denitrification. This study provides a comprehensive understanding of N removal during sphalerite autotrophic denitrification, which was previously unknown. Knowledge from this work could be used to develop novel technologies for addressing nutrient pollution.

Childhood blood lead levels and environmental risk factors in Madagascar.

One-third of children globally have blood lead levels (BLLs) exceeding the (former) US CDC reference value of 5 µg/dL; this value may be as high as one-half for children in low- and middle-income countries (LMICs). Lead exposure occurs through a variety of routes (e.g., water, dust, air), and in LMICs specifically, informal economies (e.g., battery recycling) can drive lead exposures due, in part, to absent regulation. Previous work by our team identified a ubiquitous source of lead (Pb), in the form of Pb-containing components used in manually operated pumps, in Toamasina, Madagascar. Characterization of BLLs of children exposed to this drinking water, and identification of additional exposure routes were needed. BLLs were measured for 362 children (aged 6 months to 6 years) in parallel with surveying to assess 14 risk factors related to demographics/socioeconomics, diet, use of pitcher pumps, and parental occupations. BLL data were also compared against a recent meta-review of BLLs for LMICs. Median childhood BLL (7.1 µg/dL) was consistent with those of other Sub-Saharan African LMICs (6.8 µg/dL) and generally higher than LMICs in other continents. Risk factors significantly associated (p < 0.05, univariate logistic regression) with elevated BLL (at ≥ 5 µg/dL) included male gender, living near a railway or major roadway (owing potentially to legacy lead pollution), having lower-cost flooring, daily consumption of foods (beans, vegetables, rice) commonly cooked in recycled aluminum pots (a previously identified lead source for this community), and a maternal occupation (laundry-person) associated with lower socioeconomic status (SES). Findings were similar at the ≥ 10 µg/dL BLL status. Our methods and findings may be appropriate in identifying and reducing lead exposures for children in other urbanizing cities, particularly in Sub-Saharan Africa, where lead exposure routes are complex and varied owing to informal economics and substantial legacy pollution.

COVID-19 and urban rivers: Effects of lockdown period on surface water pollution and quality- A case study of the Zarjoub River, north of Iran.

Due to the spreading of the coronavirus (COVID-19) in Iran, restrictions and lockdown were announced to control the infection. In order to determine the effects of the lockdown period on the status of the water quality and pollution, the concentrations of Al, As, Ba, Cr, Cu, Mo, Ni, Pb, Se, and Zn, together with Na+, Mg2+, Ca2+ and electrical conductivity (EC), were measured in the Zarjoub River, north of Iran, in both pre-lockdown and post-lockdown periods. The results indicated that water pollution and associated human health risk reduced by an average of 30% and 39%, respectively, during the lockdown period. In addition, the multi-purpose water quality index also improved by an average of 34%. However, the water salinity and alkalinity increased during the lockdown period due to the increase of municipal wastewater and the use of disinfectants. The major sources of pollution were identified as weathering, municipal wastewater, industrial and agricultural effluents, solid waste, and vehicular pollution. PCA-MLR receptor model showed that the contribution of mixed sources of weathering and municipal wastewater in water pollution increased from 23 to 50% during the lockdown period. However, the contribution of mixed sources of industrial effluents and solid wastes reduced from 64 to 45%. Likewise, the contribution of traffic-related sources exhibited a reduction from 13% in the pre-lockdown period to 5% together with agricultural effluent in the post-lockdown period. Overall, although the lockdown period resulted in positive impacts on diminishing the level of water pollution caused by industrial and vehicular contaminants, the increase of municipal waste and wastewater is a negative consequence of the lockdown period.

Health and Economic Consequences of Lead Exposure Associated with Products and Services Provided by the Informal Economy.

In low- and middle-income countries (LMICs), the presence of an informal economy can lead to human exposure to toxic metals such as lead (Pb). This paper demonstrates the local health and economic benefits of modifying practices within the informal economic sector in Madagascar. Specifically, leaded components in 504 locally manufactured household water pumps were replaced with unleaded components. Prior to the intervention, 32% of the household systems exhibited lead concentrations above the World Health Organization (WHO) provisional drinking water guideline of 10 µg/L, but after the intervention, fewer than 3% of the systems were in exceedance. The reduction of lead concentration is modeled to reduce the fraction of children with elevated BLLs (>5 µg/dL) from 34 to 13%. The reduction in BLLs is estimated to provide an average economic benefit of US$11 800 per child based on predicted increases in lifetime productivity. This corresponds to a total benefit of US$8.7 million for the 730 children aged 1-5 associated with the pumps, representing a return on investment of greater than 1000-to-1. Results demonstrate how the formation of partnerships between public, private, and civil society entities, as suggested by UN Sustainable Development Goal 17, can realize important local economic and health benefits in LMICs.

Assessment of nutrient fluxes and recovery for a small-scale agricultural waste management system.

The efficiencies of removing or recovering nitrogen and phosphorus in widely implemented small-scale tubular anaerobic digesters are not well understood, as the technology is primarily promoted for its recovery of energy, not nutrients. The purpose of this study was to use nutrient mass balances to assess the fate of nitrogen and phosphorus in two tubular anaerobic digesters, specifically designed to digest animal manure, that were integrated with a conical batch reactor to precipitate struvite (MgNH4PO4) from the digester effluent. The field study showed that locally available products, bittern and soda ash, can be used as a magnesium source and for pH adjustment (respectively) in the struvite precipitation reactor. Results from the mass balances showed that PO43- and NH4+ were released from the manure during anaerobic digestion, increasing the concentrations of PO43- and NH4+ in the liquid phase (by 130% and 120%, respectively). Despite this increase in liquid-phase concentrations, average removals were 25% for total phosphorus and 4% for total nitrogen via sedimentation in the digesters. The digesters also removed an average of 87% of total suspended solids and 84% of chemical oxygen demand from the influent waste stream. During struvite precipitation, an average of 79% of PO43--P and 14% of NH4+-N was removed from the digester effluent. Harvested precipitate comprised (by mass) 9.9% Mg, 2.4% N, and 12.8% P, consistent with struvite formation. The treatment system offers dual benefits: improved sanitation and recovery of nutrients as a fertilizer that may also indirectly reduce surface water and groundwater degradation. Quantifying nutrient recovery from small-farm-generated agricultural waste and understanding recovery mechanisms can improve environmental management and facilitate progress toward the achievement of multiple Sustainable Development Goals by improving sanitation, promoting sustainable management of wastes and natural resources, improving food security, and supporting the ecological restoration of local agroecosystems.

Mass fluxes of nitrogen and phosphorus through water reclamation facilities: Case study of biological nutrient removal, aerobic sludge digestion, and sidestream recycle.

At water reclamation facilities, recycling of nutrients (nitrogen and phosphorus) from solids-handling processes to the mainstream treatment process can have detrimental effects on biological nutrient removal systems. In this study, mass fluxes of nitrogen and phosphorus were quantified through the treatment trains at the Northwest Regional Water Reclamation Facility (NWRWRF) and the adjoining Biosolids Management Facility (BMF), which receives sludge from several water reclamation facilities in Hillsborough County, Florida. The driving objectives were to determine (a) whether the return stream from BMF to NWRWRF (i.e., the "sidestream") represents a significant source of nitrogen and phosphorus to NWRWRF, and (b) whether the sidestream return from BMF is interfering with biological nutrient removal processes at NWRWRF. We determined that nearly half of the overall phosphorus flux into NWRWRF is recycled from the BMF sidestream. This leads to an increased cost of treatment, for example, for alum used in phosphorus removal at NWRWRF. In contrast to phosphorus, the flux of nitrogen from BMF to NWRWRF is small (~3%) compared with the flux of nitrogen entering NWRWRF in raw wastewater. However, nitrogen in the sidestream is mostly in the form of nitrate, which prevents anaerobic conditions from developing in the fermentation basin at NWRWRF, and thereby interferes with the enhanced biological phosphorus removal (EBPR) process. Some measurements suggest that fermentation and release of phosphorus may occur in the return activated sludge line (despite the relatively short residence time in that line), which supports EBPR and may partially compensate for anoxic (denitrifying) conditions in the fermentation basin. Therefore, overall, NWRWRF is able to meet its permit limits for phosphorus through a combination of EBPR and alum addition. Although the fluxes measured here are particular to the treatment systems under consideration, the general trends observed are likely to apply to many similar facilities that employ biological nutrient removal, aerobic digestion, and sidestream recycle, particularly those with regional biosolids management facilities. We recommend that such facilities consider (a) removal or recovery of phosphorus from their sidestreams and (b) returning sidestreams downstream of fermentation basins to avoid inhibition of EBPR processes. PRACTITIONER POINTS: Sidestreams from aerobic digestion can represent significant sources of phosphorus to mainstream wastewater treatment. Recycle of nitrate in aerobic digestion sidestreams can interfere with enhanced biological phosphorus removal (EBPR) during mainstream treatment. Fermentation of return activated sludge (RAS) can support EBPR, even under short average hydraulic residence times (minutes).

Municipal wastewater treatment plants coupled with electrochemical, biological and bio-electrochemical technologies: Opportunities and challenge toward energy self-sufficiency.

Municipal wastewater treatment plants (WWTPs) will face challenges in the coming decades including reducing energy consumption and decreasing carbon emissions. These challenges can be addressed by combining electrochemical, biological, and bio-electrochemical technologies within existing WWTPs. The results from this review indicate that electrochemical technology is an effective advanced treatment method for WWTPs. However, electrochemical technology is not yet economically suitable as a stand-alone unit for treating wastewater because it consumes energy in the operation process. Electricity generation from biological and bio-electrochemical technologies can provide the power supply needed for WWTP electrochemical processes while reducing greenhouse gas emissions. WWTPs coupled with electrochemical, biological, and bio-electrochemical technologies can increase electricity recovery in WWTPs, impart energy self-sufficiency to the WWTPs, and decrease greenhouse gas emissions.

Bioregeneration of Chabazite During Nitrification of Centrate from Anaerobically Digested Livestock Waste: Experimental and Modeling Studies.

Nitrification of high total ammonia nitrogen-strength wastewaters is challenging due to free ammonia (FA) inhibition of nitrification. FA inhibition can potentially be alleviated by temporarily adsorbing ammonium (NH4+) to natural zeolite, such as chabazite, followed by direct zeolite bioregeneration via nitrification. In this research, the effectiveness of chabazite addition for reducing nitrification inhibition during treatment of centrate from anaerobic digestion of swine waste was quantified. A mathematical model was developed that accounts for ion exchange of NH4+ and sodium at the chabazite surface, surface diffusion of adsorbed NH4+ within the chabazite grains, sequential nitrification of aqueous NH4+ to nitrite and nitrate, and inhibition of nitritation and nitratation rates by NH4+. The model was calibrated using results of abiotic ion exchange and nitrification studies. Subsequently, nitrification tests were carried out with synthetic wastewater with a NH4+-N concentration of 1000 mg L-1, with and without chabazite. A chabazite dose of 150 g L-1 decreased the FA concentration to below the inhibitory level and increased the nitrification rate from 0.16 to 0.36 mg-N (g-VSS)-1 h-1. Following calibration, the model could predict the experimental data with no additional fitting parameters or parameter adjustment, in both the presence and absence of chabazite. The results suggest that the mathematical model provides a theoretically sound conceptual understanding of ion exchange assisted nitrification.

Biological Limitations of Dechlorination of cis-Dichloroethene during Transport in Porous Media.

We applied a mathematical model to data from experimental column studies to understand the dynamics of successful and unsuccessful reductive dechlorination of chlorinated ethenes in groundwater under different flow conditions. In laboratory column experiments (reported previously), it was observed that complete dechlorination of cis-dichloroethene to ethene was sustained at high flow velocity (0.51 m/d), but that dechlorination failed at medium or low flow velocity (0.080 or 0.036 m/d). The mathematical model applied here accounts for transport of chlorinated ethenes in flowing groundwater, mass transfer of chlorinated ethenes between mobile groundwater and stationary biofilms, and diffusion and biodegradation within the biofilms. Monod kinetics with competitive inhibition are used to describe biodegradation. Nearly all parameters needed to solve the model are estimated independently from batch and nonreactive transport experiments. Comparing the model predictions to the experimental results permits the evaluation of three hypothesized biological limitations: insufficient supply of electron donor, decay of dechlorinators' biomass, and reduction in bacterial metabolism rates. Any of these three limitations are able to adequately describe observed experimental data, but insufficient supply of electron donor is the most plausible explanation for failure of dechlorination. Therefore, an important conclusion of this investigation is that insufficient hydrogen production occurs if groundwater flow is too slow to provide adequate flux of electron donor. Model simulations were in good agreement with experimental results for both successful and unsuccessful dechlorination, suggesting the model is a valid tool for describing transport and reductive dechlorination. An implication of our findings is that in engineered or natural bioremediation of chloroethene-contaminated groundwater, not only must the proper dechlorinating organisms be present, but also proper groundwater flow conditions must be maintained or else dechlorination may fail.

Cost-effective treatment of swine wastes through recovery of energy and nutrients.

Wastes from concentrated animal feeding operations (CAFOs) are challenging to treat because they are high in organic matter and nutrients. Conventional swine waste treatment options in the U.S., such as uncovered anaerobic lagoons, result in poor effluent quality and greenhouse gas emissions, and implementation of advanced treatment introduces high costs. Therefore, the purpose of this paper is to evaluate the performance and life cycle costs of an alternative system for treating swine CAFO waste, which recovers valuable energy (as biogas) and nutrients (N, P, K+) as saleable fertilizers. The system uses in-vessel anaerobic digestion (AD) for methane production and solids stabilization, followed by struvite precipitation and ion exchange (IX) onto natural zeolites (chabazite or clinoptilolite) for nutrient recovery. An alternative approach that integrated struvite recovery and IX into a single reactor, termed STRIEX, was also investigated. Pilot- and bench-scale reactor experiments were used to evaluate the performance of each stage in the treatment train. Data from these studies were integrated into a life cycle cost analysis (LCCA) to assess the cost-effectiveness of various process alternatives. Significant improvement in water quality, high methane production, and high nutrient recovery (generally over 90%) were observed with both the AD-struvite-IX process and the AD-STRIEX process. The LCCA showed that the STRIEX system can provide considerable financial savings compared to conventional systems. AD, however, incurs high capital costs compared to conventional anaerobic lagoons and may require larger scales to become financially attractive.

Viability and fate of Cryptosporidium parvum and Giardia lamblia in tubular anaerobic digesters.

In many developing countries where pathogenic diseases of animal waste origin, such as giardiasis and cryptosporidiosis, are often prevalent, facilities are limited to treat livestock waste. However, household-scale anaerobic digesters are currently being promoted for bioenergy production from livestock manure. Since the effluent is often used as a fertilizer for food crops, it is critical to understand the effect of environmental conditions within household-scale digesters on the viability of Cryptosporidium parvum oocysts and Giardia lamblia cysts. In this study, key environmental parameters affecting (oo)cyst inactivation were measured in four tubular anaerobic digesters, which are a type of household-scale digester promoted for treatment of swine waste in rural Costa Rica. Interviews and participant observations were used to understand digester operation and maintenance procedures. Ambient temperatures (21-24°C), near-neutral pH, total ammonia nitrogen (TAN) concentrations<250 mg/L and hydraulic retention times (HRTs) between 23 and 180 days were observed. Laboratory (oo)cysts inactivation studies were performed in bench-scale digesters, which were maintained under conditions similar to those observed in the field. Apparent first-order inactivation rate coefficients for Giardia lamblia and Cryptosporidium parvum were 0.155 ± 0.041 and 0.054 ± 0.006 day(-1), respectively. Temperature and volatile fatty acids were the main factors contributing to Cryptosporidium parvum and Giardia lamblia inactivation. A mathematical model was developed that predicts the concentration of (oo)cysts in the liquid effluent of tubular digesters like those observed in Costa Rica. A mathematical model was developed that predicts the concentration of (oo)cysts in the liquid effluent of tubular digesters like those observed in Costa Rica. Two dimensionless groups can be used to predict the performance of the digesters for inactivating pathogens; both dimensionless groups depend upon the average HRT in the digester. This is the first study to combine mathematical modeling with qualitative analysis, field and laboratory studies to predict the concentrations of (oo)cysts in tubular digester effluents.

Lead (Pb) contamination of self-supply groundwater systems in coastal Madagascar and predictions of blood lead levels in exposed children.

Thousands of households in coastal Madagascar rely on locally manufactured pitcher-pump systems to provide water for drinking, cooking, and household use. These pumps typically include components made from lead (Pb). In this study, concentrations of Pb in water were monitored at 18 household pitcher pumps in the city of Tamatave over three sampling campaigns. Concentrations of Pb frequently exceeded the World Health Organization's provisional guideline for drinking water of 10 µg/L. Under first-draw conditions (i.e., after a pump had been inactive for 1 h), 67% of samples analyzed were in excess of 10 µg/L Pb, with a median concentration of 13 µg/L. However, flushing the pump systems before collecting water resulted in a statistically significant (p < 0.0001) decrease in Pb concentrations: 35% of samples collected after flushing exceeded 10 µg/L, with a median concentration of 9 µg/L. Based on measured Pb concentrations, a biokinetic model estimates that anywhere from 15% to 70% of children living in households with pitcher pumps may be at risk for elevated blood lead levels (>5 µg/dL). Measured Pb concentrations in water were not correlated at statistically significant levels with pump-system age, well depth, system manufacturer, or season of sample collection; only the contact time (i.e., flushed or first-draw condition) was observed to correlate significantly with Pb concentrations. In two of the 18 systems, Pb valve weights were replaced with iron, which decreased the observed Pb concentrations in the water by 57-89% in one pump and by 89-96% in the other. Both systems produced samples exclusively below 10 µg/L after substitution. Therefore, relatively straightforward operational changes on the part of the pump-system manufacturers and pump users might reduce Pb exposure, thereby helping to ensure the continued sustainability of pitcher pumps in Madagascar.

Effect of solids retention time on the bioavailability of organic carbon in anaerobically digested swine waste.

Anaerobic digestion (AD) can be used to stabilize and produce energy from livestock waste; however, digester effluents may require further treatment to remove nitrogen. This paper quantifies the effects of varying solids retention time (SRT) methane yield, volatile solids (VS) reduction and organic carbon bioavailability for denitrification during swine waste AD. Four bench-scale anaerobic digesters, with SRTs of 14, 21, 28 and 42 days, operated with swine waste feed. Effluent organic carbon bioavailability was measured using anoxic microcosms and respirometry. Excellent performance was observed for all four digesters, with >60% VS removal and CH4 yields between 0.1 and 0.3(m(3)CH4)/(kg VS added). Organic carbon in the centrate as an internal organic carbon source for denitrification supported maximum specific denitrification rates between 47 and 56(mg NO3(-)-N)/(g VSS h). The digester with the 21-day SRT had the highest CH4 yield and maximum specific denitrification rates.

Hydraulic modeling of clay ceramic water filters for point-of-use water treatment.

The acceptability of ceramic filters for point-of-use water treatment depends not only on the quality of the filtered water, but also on the quantity of water the filters can produce. This paper presents two mathematical models for the hydraulic performance of ceramic water filters under typical usage. A model is developed for two common filter geometries: paraboloid- and frustum-shaped. Both models are calibrated and evaluated by comparison to experimental data. The hydraulic models are able to predict the following parameters as functions of time: water level in the filter (h), instantaneous volumetric flow rate of filtrate (Q), and cumulative volume of water produced (V). The models' utility is demonstrated by applying them to estimate how the volume of water produced depends on factors such as the filter shape and the frequency of filling. Both models predict that the volume of water produced can be increased by about 45% if users refill the filter three times per day versus only once per day. Also, the models predict that filter geometry affects the volume of water produced: for two filters with equal volume, equal wall thickness, and equal hydraulic conductivity, a filter that is tall and thin will produce as much as 25% more water than one which is shallow and wide. We suggest that the models can be used as tools to help optimize filter performance.

Effect of pore velocity on biodegradation of cis-dichloroethene (DCE) in column experiments.

Column experiments were conducted to evaluate the effect of pore velocity on the extent of biodegradation of cis-dichloroethene (cis-DCE) during transport in porous media. Columns were filled with homogeneous glass beads and inoculated with a culture capable of complete dechlorination of tetrachloroethene to ethene. A constant concentration of cis-DCE was maintained in the columns' influent. Three different pore velocities were tested in duplicate, subjecting each column to a constant velocity. At high flow velocity, degradation of cis-DCE to ethene was nearly complete within the residence time of the columns. However, at medium and low flow velocities, incomplete dechlorination was observed. After 7 weeks, DNA was harvested from the columns to determine differences in the microbial populations. Results suggest that Dehalococcoides sp. were present in higher quantities in the high-velocity columns, consistent with the observed dechlorination. These results suggest that, at contaminated groundwater sites, heterogeneity of groundwater velocity may be one factor that contributes to heterogeneous distribution of biological activity.

Palladium-catalyzed hydrodehalogenation of 1,2,4,5-tetrachlorobenzene in water-ethanol mixtures.

Palladium-catalyzed hydrodehalogenation (HDH) was applied for destroying 1,2,4,5-tetrachlorobenzene (TeCB) in mixtures of water and ethanol. This investigation was performed as a critical step in the development of a new technology for clean-up of soil contaminated by halogenated hydrophobic organic contaminants. The main goals of the investigation were to demonstrate the feasibility of the technology, to determine the effect of the solvent composition (water:ethanol ratio), and to develop a model for the kinetics of the dehalogenation process. All experiments were conducted in a batch reactor at ambient temperature under mild hydrogen pressure. The experimental results are all consistent with a Langmuir-Hinshelwood model for heterogeneous catalysis. Major findings that can be interpreted within the Langmuir-Hinshelwood framework include: (1) the rate of hydrodehalogenation depends strongly on the solvent composition, increasing as the water fraction of the solvent increases; (2) the HDH rate increases as the catalyst concentration in the reactor increases; (3) when enough catalyst is present, the HDH reaction appears to follow first-order kinetics, but the kinetics appear to be zero-order at low catalyst concentrations. TeCB is converted rapidly and quantitatively to benzene, with only trace concentrations of 1,2,4-trichlorobenzene appearing as a reactive intermediate. The results obtained here have important implications for the further development of the proposed soil remediation technology, and may also be important for the treatment of other hazardous waste streams.

Intraobserver and interobserver reliability in laryngopharyngeal sensory discrimination thresholds: a pilot study.

OBJECTIVES: Laryngopharyngeal sensory discrimination threshold (LPSDT) testing is a method used to detect sensory deficits in patients in whom swallowing disorders are suspected. LPSDTs have been used to stratify patient risk status with regard to aspiration and to guide dietary management. The aim of this pilot study was to evaluate the intraobserver and interobserver reliability of LPSDT testing among a group of examiners with differing levels of testing experience. METHODS: Twenty-seven healthy volunteers were enrolled in the study to elicit LPSDTs for intraobserver and interobserver reliability measurements. The examiners represented 3 levels of testing experience: an attending laryngologist, a laryngology fellow, and an otolaryngology resident. With the examiners blinded to test results, each subject was examined twice by one examiner and once by a different examiner in an alternating fashion. RESULTS: Six subjects were unable to tolerate the examinations because of coughing and gagging. Spearman rank correlations revealed strong intraobserver reliability for the experienced endoscopists (ie, attending and fellow) but poor reliability for the novice endoscopist (ie, resident). Poor interobserver reliability regardless of endoscopy experience was found. Eighteen percent of the participants demonstrated LPSDTs of more than 4.0 mm Hg (above normal). CONCLUSIONS: 1) Intraobserver reliability was good for experienced endoscopists. 2) Interobserver LPSDT agreement between endoscopists was poor. 3) Eighteen percent of the subjects demonstrated elevated LPSDT thresholds of more than 4 mm Hg.

Contaminant degradation in physically and chemically heterogeneous aquifers.

This paper examines the importance of the correlation between hydraulic conductivity (K) and degradation rate constant (k) during the transport of reactive contaminants in heterogeneous aquifers. We simulated reactive transport in an ensemble of two-dimensional heterogeneous aquifers. Two sets of transport simulations were conducted: one in which a perfect positive correlation was assumed between ln(K) and ln(k), and one in which a perfect negative correlation was assumed. We found that the sign of the correlation has important consequences for the contaminant transport. Qualitatively, a negative correlation leads to significantly more pronounced "fingering" of the contaminant plume than does a positive correlation, with potentially important consequences for downgradient receptors. Quantitatively, the expected behavior (as quantified by the contaminant mass remaining in the aquifer) is statistically different between the positive and negative cases: on average, more contaminant mass persists when K and k are negatively correlated. Also, the negative correlation leads to more variability between realizations of the ensemble, whereas a positive correlation induces relatively little variability between realizations. We discuss the implications of these findings for the management of contaminated aquifers.