Our work
Our work focuses on studying microbial water quality and quantity, using surveillance and modelling to understand how climate impacts health. We study interactions between climate and human-ecological systems to assess risks like flooding and drought on waterborne diseases.  Our work will inform improved surveillance and risk assessment tools.  

In our case studies, we will develop locally-appropriate and climate resilient water safety planning and work with communities and policy makers to assess and prioritize effective interventions for sustainable health and environmental policies.
Climate effects on key diarrheal pathogens
We aim to study specific waterborne pathogens associated with diarrheal diseases to better understand their impacts in the context of climate change.

Current research mainly focuses on all-cause diarrheal illness, but by examining four key pathogens – rotavirus, Campylobacter, Giardia, and Cryptoporidium – we can gain instights into how climate shifts disease incidence and distribution.  Rotavirus, for instance, is a leading cause of severe diarrheal globally, particularly affecting young children.  Campylobacter, on the other hand is a common bacterial diarrheal cause found in both high- and low-income settings.

By studying these pathogens, we can develop targeted interventions and strategies to reduce the risk of diarrheal diseases associated with climate change.
Climate effects on water quality and quantity
Understanding and predicting the local effects of global climate change on water quality and quantity is essential. Traditional water monitoring methods offer limited coverage, both geographically and temporally. Water quality models provide a cost-effective alternative, filling in monitoring gaps, especially at the scale of river basins. Our high-resolution spatial water quality model, ePiE, utilises global streamflow data to simulate contaminant transport through river networks. This model is particularly useful in resource-poor settings.

Hydro-climatic extremes, like flooding events, pose significant challenges to water systems, impacting water quality and health risks. Identifying areas vulnerable to flooding is crucial for vulnerability assessments and policy priorities. We are developing and applying a methodology using hydrologic-hydraulic models and remote sensing data to identify flooding risk hotspots in data-poor catchments.

Our project advances the state-of-the-art in two ways: firstly, by extending our water quality model to predict microbiological water quality changes under climate change in Romania and Ghana, specifically focusing on diarrheal pathogens. Secondly, we are developing a methodology to identify flooding risk hotspots using advanced modeling techniques and remote sensing data.
Local climate impacts on health risks
Waterborne health risks can be influenced by both gradual climate changes and sudden extreme weather events. While global climate models offer insights into future weather patterns, they often lack the detail needed for local planning.

That's where downscaling comes in. By refining global projections, downscaling provides more localised climate information, which is crucial for understanding regional health risks.

However, using downscaled climate models effectively for local impact research and adaptation has been limited. One challenge is that different global climate models produce varying regional projections.

We will aim to advance this field by using large downscaled climate model ensembles to create detailed regional climate projections relevant to health impacts. We're also combining two downscaling approaches tailored to research on diarrheal diseases, with input from anthropological sciences to ensure the information is accessible and useful for local communities. This represents a significant step forward in climate impact research, particularly regarding waterborne diseases in Europe and Africa.
Integrated surveillance strategies
Integrated surveillance strategies for water quality and diarrheal disease use Quantitative Microbial Risk Assessment (QMRA) to evaluate the risks associated with exposure to microbial pathogens. QMRA combines microbiology, epidemiology, statistics, and risk assessment to estimate pathogen-specific risks in different settings, such as water supply systems. By assessing water surveillance systems, QMRA helps optimise sampling frequency, locations, and types, identifying gaps and improvement strategies.

To support public health officers in European member states, a decision-making tool based on mathematical models was developed in collaboration with our partner RIVM under the ECDC project. Challenges include variability in microbial exposure levels and data availability across different socioeconomic and geographic settings.

Our project goes beyond the current state by collecting pathogen-specific environmental and diarrheal disease data across various income settings, improving the accuracy of climate-sensitive QMRA assessments. Additionally, QMRA assessments consider microbial exposures using high-resolution maps generated in SPRINGS, enhancing their ability to assess diarrheal risk under different climate scenarios. This helps guide interventions to decrease climate-dependent diarrheal risks, informing surveillance infrastructure and prioritising interventions.
Improved Water Safety Plans
Water Safety Plans are a proactive approach to ensuring the safety of drinking water, widely endorsed by the WHO and adopted globally. They leverage existing local knowledge and are considered the most effective means of maintaining water safety. Guidance materials and tools are available to support their implementation, with countries developing their own national guidelines based on this approach. WSPs are instrumental in supporting policy, investments, and decision-making across the entire water supply chain, while also enhancing risk communication to various stakeholders.

Despite their widespread adoption, challenges remain in ensuring effective implementation, particularly in resource-constrained settings, and in integrating climate resilience and equity into the planning process. This project aims to address these challenges by incorporating climate resilience and equity considerations into WSPs. It will utilize downscaled climate models and flooding hotspot analyses to identify climate-sensitive hazards and vulnerabilities in water supply systems.

Additionally, prospective collection of microbial water quality data under varying climatic conditions will enhance hazard assessments and surveillance. Stakeholder and community engagement, including participatory mapping, will further advance the state-of-the-art for WSPs.
Cross-sector health technology assessments
Prioritising adaptation interventions and mitigation strategies across climate and health policy involves using health technology assessment (HTA) to make evidence-based decisions. HTA evaluates the effectiveness, cost-effectiveness, feasibility, acceptability, and equity of various health interventions.

While common in healthcare, expanding HTA to environmental and planetary health presents challenges, including considering non-health outcomes, valuing costs and outcomes over time, and addressing uncertainty.

SPRINGS will develop a novel HTA framework for diarrheal disease and climate change, gathering new evidence on preferences, values, and costing approaches. This will improve decision-making and understanding of complex models in assessing interventions.
Closing the knowledge gap
While the European Commission recognizes waterborne diarrheal diseases as a key climate-sensitive health risk, there are information gaps hindering action among citizens, authorities, and policymakers. These include a lack of understanding about climate's impact on diarrheal disease, a misconception that these risks only affect low and middle-income settings, and challenges in translating climate and health model results for decision-makers.

SPRINGS aims to bridge these gaps by providing scientific, societal, and economic knowledge about climate-related diarrheal disease risks and interventions. Dissemination strategies, informed by participatory ethnography, will ensure effective engagement with diverse audiences. Collaborating with social scientists, policy analysts, and local partners, SPRINGS will customize dissemination methods to reach target groups effectively. This approach fosters community ownership and promotes shared learning across different income settings.

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