Guidelines for Household Water Treatment

Legal basis, policy intent, and purpose

The Department of Health directs implementation of household water treatment using 1.25% Sodium Hypochlorite as part of efforts to ensure safe to drink water at the point of consumption/use.
The guidelines are intended to address household-level contamination, including contamination arising from distribution network leaks and cross-contamination reaching consumers.
The Order identifies household water treatment and safe water storage as priorities during outbreaks and emergencies where access to safe water becomes difficult.
Objective of the Order is to set standards and procedures on household-based disinfection of drinking water with 1.25% Sodium Hypochlorite Solution (Na(HOCl)).

Core definitions for household treatment

Chlorination means the act of disinfection using chlorine.
Disinfection means the process of eliminating or reducing to safe levels the number of potentially infectious microorganisms by physical or chemical means.
Filtration means a treatment process for removing solid (particulate) matter from water using porous media such as sand or man-made filters.
NTU means nephelometric turbidity unit.
pH measures hydrogen ion concentration, where below 7 is acid and above is alkaline, and also refers to unit of measure of how water reacts with substances or impurities.
Raw water refers to water coming from a source that is subject for treatment.
Turbidity is a measure of the water’s ability to scatter and absorb light, and also means a cloudy condition due to suspended silt or organic matter.

Coverage, who must follow it

The guidelines serve as a guide/reference for public health managers, health workers, communities and families for appropriate treatment of drinking water.
The guidelines are designed to effectively control an outbreak of diarrheal diseases through household-based disinfection and safe storage.
LGUs and the private sector are encouraged to adapt the policy.

Standards for raw water quality and containers

Chlorine disinfection works best when raw water is clear and free of suspended or floating materials.
Households may treat water collected or sourced from any water sources, primarily un-improved or doubtful sources such as open wells, springs, rivers, [and] lakes, and shallow pump wells.
Untreated water from communal faucets or waterworks systems may be treated using the chlorine solution.
If raw water is turbid, households should clarify it by settling and/or filtration before treating with chlorine.
If settling and/or filtration are unavailable or not commonly practiced, contaminated turbid water must be treated with a double dose of sodium hypochlorite solution.
Water with turbidity less than 5 NTU is usually acceptable, but effective disinfection requires turbidity of 0.1 NTU.
Highly turbid water must be initially treated by filtration before chlorination because high turbidity can protect microorganisms, stimulate bacterial growth, and create a significant chlorine demand.
The water container should preferably have at least 5 gallons (20 liters) capacity with a lid cover and a faucet.
The container must be cleaned and washed with cleansing solution or soap and water before every refilling, including the lid cover and faucet.
When the faucet is not in use, the faucet must be covered with clean plastic wrap or cloth to prevent contamination from flies or other insects.
If smaller or bigger containers are used, the chlorine dose must be adjusted correspondingly to match the container volume.

Prescribed dosing and allowable water-treatment steps

Use 1.25% sodium hypochlorite (Na(HOCl)) as a clear green-yellow chlorinated bleach.
The solution is alkaline and has pH > - 11.5.
Higher concentrations are used for industrial purposes; 1.25% is used for household treatment.
Sodium hypochlorite is less effective in highly turbid water and in pathogens like amoeba.
The 1.25% solution is a mild to moderate irritant and causes eye and skin irritation, but generally causes no symptoms when it touches skin or the eye because the solution is dilute.
For 20 liters of water, add 3.5 ml (appropriately 3/4 teaspoon) of 1.25% sodium hypochlorite.
The hypochlorite solution should ideally be packaged with a 3.5 ml measuring lid or cap for dosing.
If a 20-liter container is not available, the chlorine solution must be proportioned to the volume of water to be treated.
Household treatment steps require: fill the container with water, allow a small air space, add the measured chlorine solution, and properly close the lid.
After dosing, the container must be shaken to allow mixing.
Treated drinking water must stand for at least 30 minutes before use.
The smell of chlorine indicates the water is properly treated, and the smell will weaken as water is kept longer on storage.
When dispensing treated water, use the container’s faucet.
When getting treated water, use clean glass or small containers and cover the faucet with plastic wrap or cloth when not in use.

Implementation, responsible agencies, and program actions

The Central Office jointly implements small pilot demonstration projects with CHDs and concerned LGUs.
Small pilot demonstration projects must be conducted in areas with high incidence of diarrheal cases and low coverage of households with safe water to determine effectiveness and social acceptability.
Health education and promotion on prevention of diarrheal diseases through proper use of chlorine solution must be part of the program.
Health education and promotion may be done through social mobilization, interpersonal communication, and use of mass media.
Local manufacturers of chlorine solution must be encouraged to make products available in the market at a reasonable cost.
Training on the guidelines must be made available to field personnel.
Procurement of 1.25% Sodium Hypochlorite must be done by DOH for distribution to affected communities, particularly during emergencies.
LGUs (provincial/city/municipal) must take the lead in implementation in partnership with DOH.
LGUs may tap barangay officials or health workers to train residents on proper use in accordance with the Order.
The National Center for Disease Prevention and Control (NCDPC) through the Environmental and Occupational Health Office (EOHO) must provide technical assistance on use of the solution and must develop strategies to scale up implementation of the HWTS program.
The NCDPC must encourage private sector investment in local production to make the solution easily available in the market.
The Centers for Health Development must monitor LGUs on implementation and provide necessary technical and logistic assistance.
The National Center for Health Promotion must develop a national campaign for HWTS and develop necessary IEC materials, including health advisories.

Monitoring, evaluation, and sampling

NCDPC and CHDs must conduct simple random sampling studies every year in areas using 1.25% sodium hypochlorite.
The sampling must determine factors that influence effectiveness of the technology, including its social impact.

Revising, repealing inconsistent provisions

Provisions of previous orders and other related issuances that are inconsistent or contrary to the Order are revised, modified, repealed, or rescinded accordingly under the Repealing Clause.
All other provisions of existing issuances not affected by the Order remain valid and effective.