Water availability is becoming a challenge at coral islands; exposure to unknown quality groundwater to meet water requirements may put local communities at risk of infection by pathogens. The current study determines integration of water quality data, and risk prioritization and impact quantification due to measures like having sewer network should be utilized towards sustainable water mitigation strategy. It utilizes statistical tools for understanding the degree of contamination; identification of critical sanitary risk factors and extent of access to sewer network affect groundwater quality. A total of 104 water samples were collected and analysed for Escherichia coli from 11 islands of Laamu Atoll. Alongside, an 11-point sanitary survey, with additional information about the presence of sewer network, was conducted at every sampling location to score risk of contamination (RoC). Nearly 87% samples showed the presence of E. coli. Stepwise multivariable linear regression model identified four significant sanitary factors concerning E. coli in water. Propensity score-matching concluded 9–11.1% reduction in E. coli counts on the existence of sewer network at islands. This study identifies an effective Water Safety Plan involving the assessment of an entire water system to identify hazards and associated risk to establish an effective monitoring and mitigation plan; therefore, it must be prepared at the island level to safeguard people from diseases.

Graphical abstract

中文翻译：

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偏远环礁的健康风险评估和与污染地下水的使用相关的致病因素的详细评估

在珊瑚岛，水的供应正成为一项挑战。接触未知质量的地下水以满足水的需求可能会使当地社区面临被病原体感染的风险。当前的研究确定了水质数据的整合，由于诸如下水道网络之类的措施而导致的风险优先级和影响量化应被用于可持续的减水战略。它利用统计工具了解污染程度；确定关键的卫生风险因素和下水道网络的使用范围会影响地下水质量。总共收集了104个水样本并进行了大肠杆菌分析来自11个岛屿的拉穆环礁。同时，在每个采样地点进行了11点卫生调查，其中包括有关下水道网络存在的其他信息，以对污染风险（RoC）进行评分。近87％的样品显示存在大肠杆菌。逐步多变量线性回归模型确定了与水中大肠杆菌有关的四个重要卫生因素。倾向得分匹配得出结论，大肠杆菌减少了9-11.1％依靠岛屿上的下水道网络的存在。这项研究确定了一项有效的水安全计划，其中涉及对整个水系统的评估，以识别危害和相关风险，从而建立有效的监测和缓解计划；因此，必须在岛屿一级进行准备，以保护人民免受疾病侵害。

图形概要