Back in 1671, flushing toilets were not common in the city of Berlin and the toilet systems of most of the poorer classes simply involved a glass urinal or metal chamber that was emptied through doors or windows right out onto the street.
The resulting piles of human waste on the streets grew so high that the government passed a law forcing all visiting rural peasants from the country to take some home with them on their way back – a special souvenir from the people of the city which the peasant could not only touch but also smell.
Unfortunately, such poor plumbing systems and infrastructure were common throughout the Dark Ages, according to a recent publication entitled The Role of Plumbers in Managing Current and Emerging Public Health Hazards published by the Victorian Pluming Industry Commission (PIC). What limited underground drainage that actually existed was haphazard, often too big or two small, sometimes constructed of only rough brickwork or masonry, or constructed to run uphill or turn at right angles.
The result? Poor sanitation practices contributed to a range of dysentery, typhus and typhoid epidemics throughout Europe – the Bubonic Plague (known as the Black Death) alone wiped out one-third of the continent’s between 1348 and 1352.
Good plumbing to the rescue
But disease associated with inadequate plumbing systems is not limited to the past. Even today, PIC says, around 3.1 million people around the world die from preventable waterborne diseases, including gastrointestinal diseases (e.g. Cryptosporidiosis, Giardiasis, Cholera), vectorborne diseases (e.g. malaria, dengue fever), and legionnaires disease, which is spread by inhalation of contaminated water droplets.
The spread of many such diseases is directly related to plumbing infrastructure issues. Outbreaks of gastrointestinal diseases, for example, can be caused by shallow bores which are susceptible to bacteria carrying animal waste or rainwater tanks carrying animal faeces or dead animals and insects being washed into tanks via rainwater runoff from roofs.
And whilst such diseases are more common in developing nations and better plumbing infrastructure has improved public health across developed nations, the PIC warns that health issues related to plumbing infrastructure remain a concern in the developed world. Potential problems, it says, revolve around failure and mechanical difficulties with chlorine pumps, filters and other control systems; overloading of sewerage treatment plants, resulting in sludge solids being discharged into clean water; contamination of pipes which are not adequately constructed or maintained; and restricted access or an inability to fix older systems.
On the flip side, however, improvements in plumbing infrastructure have made a significant impact, a fact duly acknowledged by American immunologist Dr Lewis Thomas. In a paper in 2009, Thomas wrote that:
“There is no question that our health has improved spectacularly in the past century. One thing seems certain: it did not happen because of improvements in medicine, or medical science, or even the presence of doctors; much of the credit should go to the plumbers and sanitary engineers of the western world”.
Three Elements of Safe Plumbing Infrastructure
Indeed, so important are plumbing systems to public health that the need for good plumbing regulations and quality assurance systems, along with ongoing information programs to help plumbers develop their understanding of the health risks they need to manage has been recognised by both the World Health Organisation (WHO) and the World Plumbing Council (WPC).
Together, in their publication Health Aspects of Plumbing, the two bodies spell out three key goals for good plumbing works to successfully manage the risks of disease. These are:
- The supply of water needs to be adequate in terms of quantity, safety and reliability
- The design of liquid waste systems needs to allow the quick and hygienic disposal of waste
- Effective quality assurance standards of plumbing work need to be maintained by using high quality materials and workmanship and following accepted quality standards that include testing and disinfecting plumbing installations.
By designing standards, rules, codes of practice around these three key objectives, the WHO and WPC say, the global plumbing industry can maximise the effectiveness of good plumbing works in helping to prevent disease and death.
Challenges Going Forward
Whilst improvement in plumbing systems has helped to provide community access to clean water and help prevent the spread of disease, the PIC says that individual plumbers and the industry as a whole has a number of challenges to confront in the 21st century.
First there are new diseases or the adaption of old diseases to new environments. In the 27 year period between 1972 and 1999, a total of 35 new agents of disease were discovered, according to a WHO report in 2003. A particular area of concern relates to airborne viruses (SARS, swine flu) which although not strictly waterborne and nonetheless assisted by poor plumbing and sanitation facilities.
Then there is new technology, which can improve water supply systems but can entail risks of their own as the technology to run them becomes more complex. Recycled water systems, which are often installed close to drinking water systems, pose challenges due to the potential for cross contamination.
Finally, climate change may well impact the way disease causing micro-organisms and humans interact. One particular area of concern relates to efforts to conserve water in times of drought, where problems can occur in areas such as uncovered or poorly installed tanks, gutters or downpipes, all of which allow water to stagnate and create breeding grounds for mosquitoes that spread vectorborne diseases.
In order to best design, construct and maintain plumbing systems so as to minimise dangers to human health going forward, it is imperative that technology and the plumbing industry adapt to these emerging challenges.