How flooding, antimicrobial resistance and groundwater impact drinking water safety

Climate change is leading to increased flooding events globally, which poses a significant threat to drinking water safety. This review explores the current literature available on flooding, antimicrobial resistance and groundwater as a source of drinking water. Highlighted within the review is the incorrect assumption that a country’s economic status does guarantee access to water, sanitation and hygiene (WASH) facilities. While high-income countries are better equipped to deal with flooding events, there are areas within these countries where people lack access to basic WASH facilities. It’s largely accepted that floodwaters contain contaminants which are harmful to animal, environmental and human health, but recommendations regarding floodwater surveillance appear limited in the current literature. Despite evidence that waterborne disease incidence and antimicrobial resistance are increasing post major flooding events, the risk that floodwaters pose to public health is largely unquantified at present. The introduction of monitoring of floodwaters could be a potential solution for revealing disease outbreaks and patterns during times of flooding emergencies. Groundwater, which is increasingly used as a source of drinking water, is also impacted by flooding and therefore brings into question the safety of this source of water for consumption. In Europe, currently, microbiological testing of private drinking water sources does not include all sources of water for consumption. Based on emerging evidence of antimicrobial-resistant bacteria from such water sources, it’s advised that these regulations be reviewed and all water sources be included in drinking water legislation. Additionally, routine microbiological testing of drinking water remains limited to faecal indicator bacteria and total coliforms, despite the evidence of pathogenic and antimicrobial-resistant bacteria. We recommend review and expansion of the current guidelines in order to safeguard public health.