Reverse osmosis plant maintenance and efficacy in chronic kidney disease endemic region in Sri Lanka

Abstract

Objective Chronic Interstitial Nephritis in Agricultural Communities (CINAC) causes major morbidity and mortality for farmers in North-Central province (NCP) of Sri Lanka. To prevent the CINAC, reverse osmosis (RO) plants are established to purify the water and reduce the exposure to possible nephrotoxins through drinking water. We assessed RO plant maintenance and efficacy in NCP. Methods We have interviewed 10 RO plant operators on plant establishment, maintenance, usage and funding. We also measured total dissolved solids (TDS in ppm) to assess the efficacy of the RO process.Results Most RO plants were operated by communitybased organizations. They provide clean and sustainable water source for many in the NCP for a nominal fee, which tends to be variable. The RO plant operators carry out RO plant maintenance. However, maintenance procedures and quality management practices tend to vary from an operator to another. RO process itself has the ability to lower the TDS of the water. On average, RO process reduces the TDS to 29 ppm. Conclusions The RO process reduces the impurities in water available to many individuals within CINAC endemic regions. However, there variation in maintenance, quality management, and day-to-day care between operators can be a cause for concern. This variability can affect the quality of water produced by RO plant, its maintenance cost and lifespan. Thus, uniform regulation and training is needed to reduce cost of maintenance and increase the efficacy of RO plants.

Assessment of Groundwater Quality in CKDu Affected Areas of Sri Lanka: Implications for Drinking Water Treatment

“…However, the technology requires application after critically characterizing the source water, otherwise the technology may become unusable. Presently, community scale membrane treatment plants that are based on reverse osmosis (RO) are installed throughout the CKDu prevailing areas [16]. This study developed a WQI values for rapid demarcation of the source to suggest an appropriate treatment methods.…”

“…Presently, over 500 small scale (0.5 m 3 /day–3 m 3 /day of treated water) RO drinking water treatment stations are in operation in the CKDu prevailing areas, which sell water at the nominal price (US $ 0.01/L) or provided for free (with the support from individual donors or organizations). As most of the plants are operated by different individuals and/or community organizations, no two plant necessarily follow the same protocols in plant operation, maintenance, and management [16]. During rainy seasons, people tend to use rain water for consumption, which results in a considerable reduction in water demand/production occurring in most of these RO plants during the wet season.…”

Glyphosate’s Synergistic Toxicity in Combination with Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin

“…This would, for example, help reduce water pollution and prevent the overgrowth of toxin-producing cyanobacteria [156]. Switching from chemical-based phosphate fertilizers to organic fertilizers would also help reduce arsenic exposure [167].…”

“…Government agencies and other institutions can conduct environmental and bio-monitoring in CKDu-affected areas to better understand local factors in the web of causation. Efforts to treat contaminated water with reverse osmosis filters could be expanded [167]. With regard to the treatment of CKDu, it is beyond the scope of this paper to discuss specific drugs and protocols.…”

Community response to the provision of alternative water supplies: A focus on chronic kidney disease of unknown aetiology (CKDu) in rural Sri Lanka

“…Relatively little has been written specifically about the implementation and acceptance of preventive efforts to replace drinking water sources in Sri Lanka. Jayasumana et al (2016) examine aspects of the operation of reverse osmosis treatment for CKDu prevention, but focus on a sample of only 10 treatment plants in two CKDu-affected districts. Rajakarunanayake and Ariyananda (2018) survey the challenges of sustaining rainwater harvesting systems used by about 950 households with a focus on three districts, only two of which are considered to be CKDu affected.…”