Friend or foe? We need water and air to live, but both can carry - and disperse - dirt

Before Louis Pasteur and Robert Koch formulated 'germ
theory' in the 19th century, people thought that diseases
were transmitted by foul-smelling air, known as a miasma. When
cholera first broke out in London in 1832, the belief that it was
transmitted through the air - not the water system - had
devastating consequences. To get rid of cholera from the air,
sewage was diverted into the river Thames, London's main source of
drinking water. After
John Snow proved the disease was waterborne, a new sewer
network was built in London, and today throughout the UK tap water
is safe to drink.
Watch a film illustrating the
movement and agglutination of both typhoid and cholera bacilli
(c.1910).
However, in the over-populated slums of low-income
countries, poor sanitation and inadequate sewerage systems mean
cholera and other water-borne diseases are still thriving. Wellcome
Trust-funded researchers in Brazil have shown that
Salvador's city-wide project to improve the sewer network and water
supply reduced cases of diarrhoea in children by over 40 per
cent in some areas - evidence that city-wide sanitation is an
extremely effective intervention against water-borne disease.
At the start of 2008, the International Year of Sanitation,
nearly two-thirds of people living sub-Saharan Africa didn't have a
toilet in their homes. The Scientists Networked for Outcomes
from Water and Sanitation (SNOWS) consortium of
universities across the continent and beyond, funded by the Trust's
African Institutions Initiative, aims to begin to redress the
balance by building African capacity for interdisciplinary research
on water supply, sanitation and environmental health.
Water carries disease and death, but it is also essential to
life: without it all our organs and bodily functions would
fail. In England from the 1840s onwards, belief in the curative
powers of water drove the rapid rise of new hydropathic resorts
alongside the traditional spas. Trust-funded historian Hilary
Marland notes that these
coincided with the growth of industry and were presented as healing
environments in contrast to polluted, unhealthy urban
communities. Home treatments gave the patient a central role in
the therapeutic process and ushered in a new era of self-help.
After three months of treatment at Malvern, Charles Darwin built an
outdoor douche and bath in his garden, which he used daily for five
years. In the latter of the 20th century the NHS withdrew its
support for these therapies, which are now largely delivered by the
private leisure sector.
As with pure water, the curative powers of clean, fresh air were
highly valued in 19th-century Europe. Mountain sanatoriums opened
in the hope that pure, invigorating mountain air and low
atmospheric pressure would increase blood levels of oxygen and lung
capacity in people with tuberculosis, as well as containing
outbreaks by isolating carriers.
Mechanisation took over from fresh air, and people with TB are
nowadays isolated in mechanically ventilated negative-pressure
rooms. However, fresh air may be making a comeback. In 2007, in a
study of eight hospitals in Lima, Peru, Trust-funded researchers at
Imperial College London showed that
opening windows was a better form of ventilation and is
likely to reduce transmission of TB.
Infections aren't the only threat from 'dirty' air. In the
poorest parts of the world, traditional solid-fuel household stoves
are used for both cooking and heating, and the levels of indoor
pollutants they generate increase the risk of respiratory and heart
diseases in adults.
Last year an
international consortium of researchers exploring the health
effects of policies to reduce greenhouse gas emissions found
that, in India, a ten-year programme to introduce 150 million
low-emission cooking stoves would dramatically lower rates of these
diseases.