H2S as an Indicator of Water Supply Vulnerability and Health Risk in Low-Resource Settings: A Prospective Cohort Study

Ranjiv S. Khush The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Benjamin F. Arnold The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Padma Srikanth The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Suchithra Sudharsanam The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Padmavathi Ramaswamy The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Natesan Durairaj The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Alicia G. London The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Prabhakar Ramaprabha The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Paramasivan Rajkumar The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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Kalpana Balakrishnan The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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John M. Colford Jr. The Aquaya Institute, San Francisco, California; School of Public Health, University of California, Berkeley, California; Department of Microbiology, Department of Physiology, and Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India

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In this large-scale longitudinal study conducted in rural Southern India, we compared a presence/absence hydrogen sulfide (H2S) test with quantitative assays for total coliforms and Escherichia coli as measures of water quality, health risk, and water supply vulnerability to microbial contamination. None of the three indicators showed a significant association with child diarrhea. The presence of H2S in a water sample was associated with higher levels of total coliform species that may have included E. coli but that were not restricted to E. coli. In addition, we observed a strong relationship between the percent positive H2S test results and total coliform levels among water source samples (R2 = 0.87). The consistent relationships between H2S and total coliform levels indicate that presence/absence of H2S tests provide a cost-effective option for assessing both the vulnerability of water supplies to microbial contamination and the results of water quality management and risk mitigation efforts.

Author Notes

* Address correspondence to Ranjiv S. Khush, The Aquaya Institute, 1004B O'Reilly Avenue, San Francisco, CA 94129. E-mail: ranjiv@aquaya.org

Financial support: This study was supported by a grant from the Open Square Foundation to The Aquaya Institute.

Authors' addresses: Ranjiv S. Khush, The Aquaya Institute, San Francisco, CA, E-mail: ranjiv@aquaya.org. Benjamin F. Arnold, School of Public Health, University of California, Berkeley, CA, E-mail: benarnold@berkeley.edu. Padma Srikanth and Suchithra Sudharsanam, Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, E-mails: srikanth_padma@rediffmail.com and suchisanam_84@yahoo.com. Padmavathi Ramaswamy and Prabhakar Ramaprabha, Department of Physiology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, E-mails: drpadmavathi@yahoo.com and abyrr@yahoo.com. Natesan Durairaj, Kalpana Balakrishnan, and Paramasivan Rajkumar, Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, E-mails: n_durai2008@yahoo.com, kalpanasrmc@gmail.com, and rkpk16@yahoo.co.in. Alicia G. London, San Francisco, CA, E-mail: alicialgray@gmail.com. John M. Colford Jr., School of Public Health, University of California, Berkeley, CA, E-mail: jcolford@berkeley.edu.

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