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Report of Duhok new water
treatment plant visit in
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Khrabdeem
Faculty of medical sciences /school of
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nursing
Prepared by :
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Raveen Ismail
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2. Report of Duhok new water treatment plant visit in
Khrabdeem
Physical environment of the institute:
1. Withdrawing the water from river to the main water channel by using special
machines also a network barrier has been put in water entrance way to the
channel to prevent entering stuffs into the channel such as stones ,wood parts
,fishes ……..etc
2. After water transferred to inside the uncovered channel for conditioning the water
odors under the natural air of nature, adding chlorine for killing microorganisms.
3. Water was transferred to the pool for separating sand from water by using special
sweeper inside the pool.
4. Water was transferred to the flash mixture pool in which chlorine and aluminum
sulfate were added, chlorine for killing microorganisms, aluminum sulfate for
sedimentation of mud and sand.
5. Water was transferred to the four pools for further cleansing and separating sand
from water.
6. The Water filtered by sand filter for removing the lifted sand from water it
considered as a last step of water treatment
7. Water stored in large tanks then a sample of water is taken to the lab for chemical
analysis of water for example if the chlorine amount is not within normal range
the team work will add chlorine or decrease concentration of chlorine within the
tank water.
8. . The chlorine level should be at least 0.5 mg/L. This residual, consisting of
hypochlorous acid and/or chloramines, must kill microorganisms already present
in the water and must also kill any pathogens which may enter the distribution
system through cross-connections or leakage. In order to ensure that the water is
free of microorganisms when it reaches the customer, the chlorine residual should
be about 0.2 mg/L at the extreme ends of the distribution system. This residual in
the distribution system will also act to control microorganisms in the distribution
system which produces slimes, tastes, or odors.

3. Report of Duhok new water treatment plant visit in
Khrabdeem
Water born diseases:
are caused by pathogenic microorganisms that most commonly are transmitted in
contaminated fresh water. Infection commonly results during bathing, washing,
drinking, in the preparation of food, or the consumption of food thus infected.
Protozoal infections
Disease and Sources of Agent in Water
Microbial Agent General Symptoms
Transmission Supply
Protozoan
Amoebiasis Abdominal discomfort, fatigue,
(Entamoeba Sewage, non-treated drinking
weight
histolytica) (Cyst- water, flies in water supply
(hand-to-mouth) loss,diarrhea, bloating, fever
like appearance)
Collects on water filters and Flu-like symptoms, watery
Protozoan
Cryptosporidios membranes that cannot diarrhea, loss of appetite,
(Cryptosporidium
is(oral) be disinfected, animal manure, substantial loss of weight, bloating,
parvum)
seasonalrunoff of water. increased gas, nausea
Protozoan parasite
Sewage, non-treated drinking cramps, nausea, vomiting, muscle
Cyclosporiasis (Cyclospora
water aches, fever, and fatigue
cayetanensis)
Untreated water, poor
disinfection, pipe breaks,
Giardiasis Protozoan (Giardia leaks, groundwater contaminati
lamblia) Most on, campgroundswhere humans Diarrhea, abdominal
(fecal-oral) common intestinal and wildlife use same source of discomfort, bloating, andflatulence
(hand-to-mouth) parasite water. Beavers and muskrats cr
eate ponds that act
as reservoirs for Giardia.
Protozoan phylum Encephalitozoon
Diarrhea
Microsporidiosi Microsporidia), but intestinalis has been detected
and wasting in immunocompromis
s closely related in groundwater, the origin of
edindividuals..
to fungi drinking water [5]

4. Report of Duhok new water treatment plant visit in
Khrabdeem
Parasitic infections (Kingdom Animalia)
Sources of Agent in
Disease and Transmission Microbial Agent General Symptoms
Water Supply
Fresh water
Blood in urine (depending on
contaminated with
Members of the the type of infection), rash or
Schistosomiasis(immersion) certain types of snails
genusSchistosoma itchy skin. Fever, chills, cough
that
and muscle aches
carry schistosomes
Stagnant water
Allergic reaction, urticaria rash,
Dracunculiasis (Guinea Dracunculus containing larvae,
nausea, vomiting, diarrhea,
Worm Disease) medinensis generally in
asthmatic attack.
parasitised Copepoda
Drinking water Intestinal disturbances,
Tapeworms of the
Taeniasis contaminated with neurologic manifestations, loss
genus Taenia
eggs of weight, cysticercosis
GIT disturbance, diarrhea, liver
Drinking water
enlargement, cholangitis,
Fasciolopsiasis Fasciolopsis buski contaminated with
cholecystitis, obstructive
encysted metacercaria
jaundice.
Drinking water Abdominal pain, severe weight
Hymenolepiasis (Dwarf
Hymenolepis nana contaminated with loss, itching around the anus,
Tapeworm Infection)
eggs nervous manifestation
Drinking water Liver enlargement, hydatid cysts
Echinococcosis(Hydatid Echinococcus contaminated with press on bile duct and blood
disease) granulosus feces (usually canid) vessels; if cysts rupture they
containing eggs can causeanaphylactic shock

5. Report of Duhok new water treatment plant visit in
Khrabdeem
multiceps contaminated drinking
coenurosis increases intacranial tension
multiceps water with eggs
Mostly, disease is asymptomatic
or accompanied
Drinking water by inflammation, fever, and
Ascaris contaminated with diarrhea. Severe cases
Ascariasis
lumbricoides feces (usually canid) involve Löffler's syndrome in
containing eggs lungs, nausea,
vomiting, malnutrition,
and underdevelopment.
Drinking water Peri-anal itch, nervous
Enterobius
Enterobiasis contaminated with irritability, hyperactivity
vermicularis
eggs and insomnia
Bacterial infections
Disease and Sources of Agent in Water
Microbial Agent General Symptoms
Transmission Supply
Dry
mouth, blurred and/or double
Bacteria can enter an open
vision, difficulty swallowing,
wound from contaminated water
muscle weakness, difficulty
sources. Can enter the
Botulism Clostridium botulinum breathing, slurred
gastrointestinal tract by
speech, vomiting and
consuming contaminateddrinking
sometimes diarrhea. Death is
water or (more commonly) food
usually caused by respiratory
failure.
Produces dysentery like
Campylobacteri Most commonly caused Drinking water contaminated
symptoms along with a high
osis byCampylobacter jejuni with feces
fever. Usually lasts 2–10 days.

6. Report of Duhok new water treatment plant visit in
Khrabdeem
In severe forms it is known to
be one of the most rapidly
fatal illnesses known.
Symptoms include very
watery
Spread by the Drinking water contaminated
Cholera diarrhea, nausea, cramps, no
bacterium Vibrio cholerae with the bacterium
sebleed, rapid pulse,
vomiting, and hypovolemic
shock (in severe cases), at
which point death can occur
in 12–18 hours.
Mostly diarrhea. Can cause
death
Certain strains in immunocompromised indi
E. Water contaminated with the
of Escherichia viduals, the very young, and
coli Infection bacteria
coli(commonly E. coli) the elderly due
to dehydration from
prolonged illness.
Naturally occurs in water, most Symptoms
cases from exposure include lesions typically
M. in swimming pools or more located on the elbows, knees,
marinuminfecti Mycobacterium marinum frequentlyaquariums; rare and feet (fromswimming
on infection since it mostly pools) or lesions on the
infectsimmunocompromised in hands (aquariums). Lesions
dividuals may be painless or painful.
Caused by a number of
Frequent passage
species in the
Water contaminated with the of feces with blood and/or mu
Dysentery genera Shigella andSalmon
bacterium cus and in some cases
ella with the most common
vomiting of blood.
being Shigella dysenteriae
Legionellosis ( Pontiac fever produces
Caused by bacteria
two distinct milder symptoms resembling
belonging to Contaminated water: the
forms: acute influenza withoutpneu
genus Legionella (90% of organism thrives in warm
Legionnaires’ monia. Legionnaires’ disease
cases caused by Legionella aquatic environments.
disease and has severe symptoms such
pneumophila)
Pontiac fever) as fever, chills, pneumonia
(with cough that sometimes

7. Report of Duhok new water treatment plant visit in
Khrabdeem
produces sputum), ataxia, an
orexia, muscle
aches, malaise and
occasionally diarrhea and
vomiting
Begins with flu-like
symptoms then resolves. The
Water contaminated by the
Caused by bacterium of second phase then occurs
Leptospirosis animal urine carrying the
genusLeptospira involvingmeningitis, liver da
bacteria
mage (causes jaundice),
and renal failure
Otitis Caused by a number Swimming in water
Ear canal swells causing pain
Externa(swim of bacterialand fungal speci contaminated by the
and tenderness to the touch
mer’s ear) es. responsible pathogens
Drinking water contaminated Symptoms
Caused by many bacteria of with the bacteria. More include diarrhea, fever,
Salmonellosis
genus Salmonella common as a food borne vomiting, and abdominal
illness. cramps
Characterized by sustained
fever up to 40°C (104°F),
profuse sweating, diarrhea,
less commonly a rash may
Ingestion of water
occur. Symptoms progress
Typhoid fever Salmonella typhi contaminated with feces of an
to delirium and
infected person
the spleen and liverenlarge if
untreated. In this case it can
last up to four weeks and
cause death.
Can enter wounds from Symptoms include explosive,
Vibrio vulnificus, Vibrio
contaminated water. Also got watery diarrhea, nausea,
Vibrio Illness alginolyticus, and Vibrio
by drinking contaminated water vomiting, abdominal cramps,
parahaemolyticus
or eating undercooked oysters. and occasionally fever.

8. Report of Duhok new water treatment plant visit in
Khrabdeem
Viral infections
Disease and Sources of
Microbial
Transmissio Agent in Water General Symptoms
Agent
n Supply
SARS (Sever
Manifests itself Symptoms
e Acute
Coronavirus in improperly include fever, myalgia, lethargy, gastrointestinal symptoms, co
Respiratory
treated water ugh, and sore throat
Syndrome)
Can manifest Symptoms are only acute (no chronic stage to the virus) and
Hepatitis A
Hepatitis A itself in water include Fatigue, fever, abdominal pain, nausea, diarrhea,
virus (HAV)
(and food) weight loss, itching, jaundice and depression.
Enters water 90-95% of patients show no symptoms, 4-8% have minor
Poliomyelitis through symptoms (comparatively) with delirium, headache, fever, and
Poliovirus the feces of occasional seizures, and spastic paralysis, 1% have symptoms
(Polio) infected of non-paralytic aseptic meningitis. The rest have serious
individuals symptoms resulting in paralysis or death
Two of Very
Polyomavirs widespread,
BK virus produces a mild respiratory infection and can infect
: can manifest
the kidneys of immunosuppressed transplant patients. JC virus
Polyomaviru itself in water,
infects the respiratory system, kidneys or can
s infection JC ~80% of the
cause progressive multifocal leukoencephalopathy in
virus and population
thebrain (which is fatal).
hasantibodies t
BK virus o Polyomavirus

9. Report of Duhok new water treatment plant visit in
Khrabdeem
Health and safety hazards presented in the physical
environment of work setting :
Unstable chlorine room temperature.
Risk for gas Inhalation and Fire.
Uncovered pools increase the incidence of living pathogens in the pools
Health services provided for workers
1. Lack of health assurance for team workers in institute.
2. Lack of health center .
3. Lack of first aid trainings for workers .
Preventive measures in institute :
Automatic chlorine gas leakage detective system prevent incidence of
occurring gas inhalation in chlorine room.
Using heaters inside chlorine room for preventing gas freezing.
Negative points of institute
Not using to much preventable measurements such as gown ,gloves ,gas masks…et
Lack of health assurance and health centers.
Uncovered pools increase the incidence of becoming contaminated again .
Positive points of institute
Clean environment
Using filter back wash system
Automatic chlorine gas leakage detective system prevent incidence of
occurring gas inhalation in chlorine room.
Sending a sample of water to the lab before distributing to the homes.
Using chlorine gas and aluminum sulfate for water treatment.
My Suggestions
Covering the pools with fine networks.
Using gas masks – a canister type with a full face piece and a self contained
breathing apparatus.
Protective clothing.
Emergency showers and eye-wash stations
Putting health assurance for workers & building health center nearby the plant .

10. Report of Duhok new water treatment plant visit in
Khrabdeem
Educating the team workers about first aids such as in case of :
chlorine gas Inhalation
1. Remove the injured party to an uncontaminated outdoor area. Use
appropriate respiratory equipment during rescue—do not become another
victim.
2. Check for breathing and pulse. If not breathing, give artificial respiration. If
breathing is difficult, have trained personnel administer oxygen as soon as
possible. If no pulse, perform CPR.
3. Call for medical assistance as soon as possible.
4. Check for other injuries.
5. Keep the injured party warm and at rest.