A Critical Overview of Household For Water Treatment

Water Research 208 (2022) 117870
Contents lists available at ScienceDirect
Water Research
journal homepage: www.elsevier.com/locate/watres
Review
A critical overview of household slow sand filters for water treatment

B.L.S. Freitas a, U.C. Terin a, N.M.N. Fava a, P.M.F. Maciel a, L.A.T. Garcia a, R.C. Medeiros b,
M. Oliveira a, P. Fernandez-Ibañez c, J.A. Byrne c, L.P. Sabogal-Paz a, *
a
Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo,
13566-590, Brazil
b
Department of Engineering and Environmental Technology, Federal University of Santa Maria, Linha 7 de Setembro, BR 386, Km 40, Frederico Westphalen, Rio Grande
do Sul, 98400-000, Brazil
c
Nanotechnology and Integrated Bioengineering Centre, School of Engineering, Ulster University, Jordanstown, BT37 0QB, Northern Ireland, United Kingdom
A R T I C L E I N F O A B S T R A C T
Keywords: Household, or point-of-use (POU), water treatments are effective alternatives to provide safe drinking water in
Water treatment locations isolated from a water treatment and distribution network. The household slow sand filter (HSSF) is
Point-of-use amongst the most effective and promising POU alternatives available today. Since the development of the
Biosand filter
patented biosand filter in the early 1990s, the HSSF has undergone a number of modifications and adaptations to
Schmutzdecke layer
Slow sand filtration
improve its performance, making it easier to operate and increase users’ acceptability. Consequently, several
HSSF models are currently available, including those with alternative designs and constant operation, in addition
to the patented ones. In this scenario, the present paper aims to provide a comprehensive overview from the
earliest to the most recent publications on the HSSF design, operational parameters, removal mechanisms, ef
ficiency, and field experiences. Based on a critical discussion, this paper will contribute to expanding the
knowledge of HSSF in the peer-reviewed literature.
1. Introduction Sizirici et al., 2019; Yildiz, 2016).

As a slow sand filter, water purification by HSSF occurs through a
The lack of water, sanitation, and hygiene (WaSH) is a worldwide combination of physicochemical and biological processes along and on
concern that highlights social and economic disparities. In addition to the sand filter media. This combination promotes, in addition to the
evident barriers caused by poverty, one of the main obstacles of uni retention of impurities, the removal of organic/inorganic compounds
versal access to drinking water is the isolation of communities in low- and several pathogens responsible for diarrhoeal events (Jenkins et al.,
and middle- income countries, whether by geographic distribution or by 2011; Mahlangu et al., 2012). Overall, many of the lessons, benefits, and
peripheral status. In these cases, Point-Of-Use (POU) technologies limitations of HSSF were efforts from the conventional SSF literature
emerge as a solution as their promise is to enable people to improve the (Huisman and Wood, 1974). Although these many findings were
quality of drinking water at home through simple, safe, and low-cost important for the HSSF development; there are still gaps in the HSSF
treatment methods. A promising POU technology is the Household literature that require specific studies due to different scales and flow
Slow Sand Filter (HSSF), a home scale of the slow sand filter, whose regimes.
main widespread model is the patented biosand filter (BSF). Developed Given the lack of a paper summarizing the findings and experiences
by Dr. David Manz in the early 1990s, the BSF presents specific con with HSSF, this manuscript aims to present a comprehensive and critical
struction instructions in which only the intermittent operation is overview of HSSF design, operation parameters, removal mechanisms,
recognized (i.e., on-demand operation) (CAWST, 2012). Meanwhile, efficiency, and field studies, amongst other key aspects of the filters
HSSF also encompasses continuous operation (Maciel and Sabogal-Paz, presented in the literature. By elucidating the findings and scientific
2020; Souza Freitas and Sabogal-Paz, 2020; Terin and Sabogal-Paz, gaps of the HSSF literature, this paper allows for further development
2019; Young-Rojanschi and Madramootoo, 2014) and different designs and optimization, as well as enabling proper deployment in vulnerable
(Ahammed and Davra, 2011; Napotnik et al., 2020; Ngai et al., 2007; communities, based on efficient and affordable engineering to improve
* Corresponding author.
E-mail address: lysaboga@sc.usp.br (L.P. Sabogal-Paz).
https://doi.org/10.1016/j.watres.2021.117870
Received 21 July 2021; Received in revised form 26 October 2021; Accepted 13 November 2021
Available online 16 November 2021
0043-1354/© 2021 Elsevier Ltd. All rights reserved.
B.L.S. Freitas et al. Water Research 208 (2022) 117870
drinking water access. Webster, 2009; Fiore et al., 2010). Therefore, studies began to evaluate
the use of plastic in other HSSF components in addition to the outlet
2. Construction materials and design for HSSF tube, as the body, lid, diffuser, and valves (Jenkins et al., 2011; Mahaffy
et al., 2015; Napotnik et al., 2020). Despite being easier to acquire and
2.1. Filter design handle, some of these novel designs have never been field-tested,
whereas some of the old BSFs have shown high rates of sustained use
An HSSF comprises a structure filled with granular materials con in diverse field settings. Moreover, plastic may provide toxicity to
nected to an outlet tube (CAWST, 2012). Fig. 1 shows a cross-section of drinking water (Higashi, 2016). This plastic toxicity has recently been
the HSSF standard model and the water flow within the unit. The solved by using Modified Polyvinylchloride (MPVC), a non-toxic plastic
filtration layer is mainly responsible for the water treatment, while the material used in drinking water distribution systems (Andreoli and
separation and drainage layers serve as a support to prevent the filter Sabogal-Paz, 2020). However, despite being commercially distributed,
media from moving down and blocking the outlet tube. Finally, the MPVC pipe is more expensive than other plastics. Other construction
outlet tube conveys water from the lower layers (i.e., separation and materials have also been used in the filter structure, such as acrylic
drainage) to a storage reservoir. (Sabogal-Paz et al., 2020; Young-Rojanschi; Madramootoo, 2014) and
In addition to the filter structure, other devices can assist the oper galvanized iron (Smith, 2013). The former is a common structural ma
ation and the purification process, as shown in Fig. 1. Placing a lid terial for laboratory studies used to better visualize the treatment within
prevents contamination and proliferation of pests in the HSSF. The feed the HSSF.
reservoir stores raw water and allows draining by gravity through the These deficiencies underscore the need for caution while selecting
filter bed. The diffuser (e.g., perforated metal plate or a device with the material and further studies for investigating ideal structures for
small holes) acts as an energy dissipation system to prevent biofilm HSSFs. Notwithstanding, the ideal material must consider socio-
disturbance and keep the filtration layer stable (Manz et al., 1993). A economic characteristics of target communities.
small hole at the top end of the outlet tube (i.e., no-syphon device) can
reduce the effects of siphoning and possible emptying of the HSSF 2.3. Filter media
(Palmateer et al., 1999), while a valve at the end of the tube can control
the maximum filtration rate (Devi et al., 2008). The filtration layer commonly comprises sand extracted from
Other examples of HSSF design projects different from the standard different sources, e.g., soil, quarry, and river (CAWST, 2012), while the
model are illustrated in Figure S1 (Supplementary Material), including separation and drainage layers are a combination of sized pebbles and
those with different sizes, structure materials, filter media depths, flow gravels.
regimes, amongst others. Due to this variety of designs and operating Filter media characteristics, such as effective size (d10), uniformity
conditions, full-scale HSSF can vary in height from 20 cm to more than coefficient (UC= d10/d60), percentage of fine particles (i.e., the per
one metre (Maciel and Sabogal-Paz, 2020; Napotnik et al., 2020). centage that passes through the # 150 sieve), density, and porosity, are
important design parameters for the performance of HSSFs. Use of fine
sand (d10 in the 0.15 mm range) as the filtration layer is recommended
2.2. Construction materials for HSSF
to increase the retention of suspended solids and microorganisms
(Jenkins et al., 2011). Overall, the filtering material must have d10 be
A standard HSSF features a concrete structure with a plastic outlet
tween 0.15 and 0.20 mm, UC between 1.5 and 2.5, and a percentage of
tube. This model was widely spread, field-tested, and presents high user
fines lower than 4% (CAWST, 2012). The drainage and separation layers
acceptability and evaporative cooling (Earwaker and Webster, 2009;
should have grain sizes between 1 and 12 mm to provide support
Fabiszewski de Aceituno et al., 2012). However, concrete as an HSSF
(CAWST, 2012).
structure, in addition to its limiting portability, is susceptible to cracks
Although there is consensus in the literature on the filter media
and leaks when subjected to disturbances that can occur in a home (e.g.,
characteristics; the filtration layer depth is still a variable that could be
accidental collisions and impacts caused by transport) (Earwaker and
further researched. The Centre of Affordable Water and Sanitation
Technology (CAWST) recommends 53.4 cm of filtration layer for a
standard HSSF (CAWST, 2012), however, in the literature this value
varies between 10 cm (Napotnik et al., 2020) and 80 cm (Ghe
bremichael et al., 2012). Several laboratory studies investigated HSSF
with a media depth greater than 40 cm (Andreoli and Sabogal-Paz,
2020; Baig et al., 2011; Ghebremichael et al., 2012; Lynn et al., 2013;
Murphy et al., 2010a; Nasser Fava et al., 2020; Young-Rojanschi and
Madramootoo, 2015), while others evaluated reduced depths (i.e., ≤ 25
cm) to assess the feasibility of compact systems (Adeyemo et al., 2015;
Freitas et al., 2021; Medeiros et al., 2020; Mwabi et al., 2012; Napotnik
et al., 2017, 2020). However, despite being promising and efficient, the
laboratory studies with novel HSSF designs must be field-tested to
evaluate their sustained use.
Furthermore, to provide proper support and prevent the sand from
washing into the outlet tube, the recommended thickness of the support
layer can vary from 10 to 18 cm (Devi et al., 2008; Elliott et al., 2008).
3. Operational parameters
3.1. Flow regime
The HSSF was successfully implemented around the world adopting

the intermittent flow regime (I-HSSF). In this operation, it is stated that
Fig. 1. Cross-section of the Household Slow Sand Filter standard model. the top sand layer should be kept wet the whole time (Manz et al., 1993).
2
To reach this aim, the most acceptable design of an I-HSSF adopts an end and 5 cm stirring (Table S1 - supplementary material). Some studies also
of the outlet tube near 5 cm above the height of the sand layer (CAWST, carried out maintenance by removing 5 cm of the filtration media
2012). The intermittent operation does not require an external supply (Singer et al., 2017) and by the wet harrowing method (Jenkins et al.,
unit and the area occupied in the residence is around 0.1 m2 (Sabo 2011; McKenzie et al., 2013; Tiwari et al., 2009).
gal-Paz et al., 2020). The premise of this operation mode is that the filter Singer et al. (2017) compared three cleaning methods for I-HSSF
works at its best capacity with an action of the biolayer during a pause media: surface agitation (< 1 cm), 5 cm stirring, and 5 cm replacement.
period, which is a concept defined in Section 3.5. The cleaning methods recovered 76, 82, and 138% of the initial filtra
With some modifications to the intermittent model, the HSSF can tion rate, respectively. Despite the significant improvement of the third
also be operated in a continuous flow regime (C–HSSF). The household method, procedures of draining, scraping, and restarting the system can
would need one reservoir external to the HSSF and a control of the take several days, even for a small system (i.e., bench scale), and the
filtration rate, which can be performed both by direct pumping ability to remove bacteria can be reduced by causing extensive distur
(Young-Rojanschi and Madramootoo, 2014) or by gravity feed (Maciel bance to the biological layer (Barrett et al., 1991). The average time for
and Sabogal-Paz, 2020). Continuous operation requires bigger infra recovery of post-maintenance filters can vary depending on the opera
structure; however, the user can benefit with a decrease in demand of tional mode and the maintenance method (Duke and Mazumber, 2009;
effort to fill with water of the intermittent one. Figure S2 (Supplemen Kennedy et al., 2013; Nair et al., 2014; Singer et al., 2017). According to
tary Material) illustrates differences between the I-HSSF and C–HSSF in Singer et al. (2017), recovery times after cleaning vary from 8.5 to 23
terms of infrastructure and occupying area. days using the methods of surface agitation and 5 cm replacement,
Although the continuous flow regime does not count on the pause respectively. Furthermore, frequent maintenance activities can affect
period, its lower flow rate, compared to an intermittent regime (Section the biological layer stability and the HSSF overall efficiency. For
3.2), allows the unit to reach good efficiencies in turbidity and micro instance, Maciel and Sabogal-Paz (2020) reported that an intermittent
organism reductions. When comparing C–HSSF and I-HSSF treating the HSSF was unable to achieve an E. coli removal rate greater than 1 log due
same daily volume, the authors have found a better performance of the to frequent maintenance.
continuous ones. Andreoli and Sabogal-Paz (2020) found 4.3 log and 2.7 Recently mentioned in the literature, one of the optimizations for
log of E. coli reduction in continuous and intermittent operation, improving HSSF maintenance is using materials at the filter media top,
respectively. Similarly, Young-Rojanschi and Madramootoo (2014) such as non-woven blankets. These materials retain some particles and
observed 3.7 log and 2.1 log of E. coli reduction in C–HSSF and I-HSSF, consequently prevent impurities from passing directly to the filter
respectively. media, prolonging the filter run, and improving the HSSF performance.
Nevertheless, some authors argue that users of I-HSSF can consider a It is also easily removed, washed, and replaced in the unit (Maciel and
low filtration rate as an obstacle for the filter acceptance (CAWST, 2012; Sabogal, 2020; Souza Freitas and Sabogal-Paz, 2020; Terin and Sabo
Earwaker and Webster, 2009; Ghebremichael et al., 2012). The low gal-Paz, 2019).
filtration rate is inherent to the continuous operation.
3.4. Feeding volume
3.2. Filtration rate
The volume that fills the I-HSSF inlet reservoir in each batch is so-
The filtration rate, or hydraulic loading rate, is defined as the flow called feeding volume, or charge volume. The I-HSSF is generally
rate divided by the surface area of a filter. This operational parameter is designed with reservoir dimensions corresponding to the maximum
expressed in units of length over time. In the HSSF literature, the volume that can be poured into the filter at one time. The concrete-made
filtration rate is more commonly expressed in terms of m h− 1, given that CAWST (CAWST, 2012) filter admits 12 litres feeding volume, while
the filtration cycle takes hours, rather than days as seen for SSFs. there is a plastic version designed to receive 20 L, as the Hydraid from
The I-HSSF presents relatively high filtration rates, compared to The Dow Chemical Company (Triple-Quest, 2010).
other household water treatment methods, achieving its maximum just Results obtained in laboratories pointed out that better efficiencies in
after the introduction of a charge and declining to zero between filter microorganism reductions were achieved when the feed volume was
feedings (Kubare and Haarhoff, 2010; Ngai, 2014; Napotnik et al., equal or less than the filter media and support layer pore volume
2017). The high filtration rate in the filter cycle of I-HSSF lasts just a few (Baumgartner et al., 2007; Elliott et al., 2008; Nair et al., 2014). The
minutes. Terin et al. (2021) demonstrated the lowering of the filtration operational parameter pause period, defined in the next section (3.5),
rate after 40 and 20 min in I-HSSF models with and without the has implications for the selection of feeding volume, frequency of
maximum level of water control, respectively, following asymptotic feeding, and duration of filtration cycles (Elliott et al., 2008).
decay of the flow. The Biosand filter construction manual states a Additionally, the feeding volume is also related to the hydrostatic
maximum filtration rate of 0.40 m h − 1 (CAWST, 2012), while filtration head, the height of water after filling the I-HSSF reservoir. A reduced
rates up to near 1.50 m h − 1 are also applied (Baig et al., 2011). nominal head results in a lower filtration rate and lower biofilm shear
The researchers who have studied C–HSSF presented a filtration forces at the beginning of batch filtration, improving the efficiency of
rate ranging from 0.010 m h − 1 (Young-Rojanschi and Madramootoo, the water treatment (Jenkins et al., 2011). For that reason, the
2014) to 0.063 m h − 1 (Medeiros et al., 2020). In this operation mode, a maximum elevation head is a filter design parameter considered when
higher filtration rate favours the higher daily production of treated defining the feeding volume (Elliott et al., 2015). Nevertheless, although
water, while the lower filtration rate favours the higher quality of the the reduction in feeding volume generates better quality water, it should
treated water. However, it should be noted that the drawback of the be pondered if it is worth the loss of daily water production. Moreover,
lower filtration rate is related to the user’s immediate demand for water any design changes for improved performance must be weighed up
(filling a cup), rather than the daily volume production. against acceptability and their potential effects on consistent, exclusive
use.
3.3. Maintenance
3.5. Pause period
The cleaning (or maintenance) of the HSSF filter media must be done
as clogging results in insufficient water production, that is, when the The I-HSSF cycle has steps as the fill of the influent reservoir, the flow
filtration rate is so low that during a day the filter is unable to produce of the water through the filter, and a resting time before the next feed.
enough water for household consumption (Elliott et al., 2008). The The time after the water stops flow and before a new water addition is
cleaning methods most often used were superficial agitation (< 1 cm) called the pause period, or idle time. The Biosand filter construction
3
manual states that the pause period should be a minimum of 1 hour and schmutzdecke (Pompei et al., 2017; Wang et al., 2014) due to their low
no longer than 48 h (CAWST, 2012). sizes, high growth rates, adaptation capacity, and extracellular polymer
Since the filtration rate declines with the filter retaining impurities, it production (Characklis and Marshall, 1990). However, algae, fungi,
is not possible to predict when the water will stop flowing through the helminths, microcrustacean, protozoa, rotifers, and several insect larvae
filter media. Due to this, daily measuring of the pause period is not may also be present (Andreoli and Sabogal-Paz, 2020; Medeiros et al.,
practical. On the contrary, it is easier to monitor the total retention time, 2020; Terin and Sabogal-Paz, 2019). This biodiversity tends to come
which includes the pause period time plus the filtration time (Ngai and into balance with the time of operation, creating a self-regulating food
Baker, 2014). In line with this, the scheduled times in which the I-HSSF chain that is essential to the efficiency of the schmutzdecke (Nakamoto
will be fed should be equal or higher than the total retention time. et al., 2014).
The pause period has been appointed as essential for the I-HSSF Although bacterial activity is most prominent in the upper filter
treatment. Biological and physicochemical processes inside the sand layer, it remains along the filter bed, gradually decreasing as the supply
column need appropriate time to clear pore spaces and biofilm adsorp of oxygen and food becomes scarce (Ranjan and Prem, 2018). This
tion sites filled with contaminants (Jenkins et al., 2011). This opera deeper zone is, therefore, a continuation of the schmutzdecke with
tional parameter is trusted to hold an efficient water treatment process considerable microbial diversity and expressive concentrations of car
in such a way that higher filtration velocities can be used in I-HSSF bohydrates and protein (Unger and Collins, 2008).
compared with SSF (Kubare and Haarhoff, 2010). The mechanisms that Water purification can be attributed to biological processes occur
act in the pause period are (i) the predation of pathogens at the top of the ring simultaneously within the schmutzdecke and along the filter bed,
filter in the biolayer, (ii) predation below the biolayer, (iii) natural such as natural die-off, predation, excretion of toxins, and competition
die-off of microorganisms in the bed in the absence of sufficient oxygen for food (Huisman and Wood, 1974). While some macroinvertebrates
and nutrients and (iv) adsorption in the filter media (Ghebremichael can prey on algae and diatoms (Haarhoff and Cleasby, 1991), some algae
et al., 2012; Kennedy et al., 2013; Singer et al., 2017). and protozoa actively contribute to the reduction of suspended and
Summarizing the HSSF process parameters, Table S2 (supplementary attached bacteria (Guchi, 2015; Ribalet et al., 2008; Siqueira-Castro
material) presents the maximum filtration rates, feeding volumes, and et al., 2016; Wichard et al., 2005) and (oo)cysts of Cryptosporidium
pause periods reported in the literature, for both I-HSSF and C–HSSF. parvum and Giardia duodenalis (Siqueira-Castro et al., 2016). Some
genera of algae may also contribute to the reduction of bacteria
4. Mechanism of HSSF including coliforms by producing and excreting polyunsaturated alde
hydes - a toxin with an antibacterial effect (Ribalet et al., 2008; Wichard
4.1. Biological processes et al., 2005). Moreover, the bacterial population acquires energy for
replication and metabolic functions through the oxidation of organic
Biological processes occur along and on the HSSF media bed. With matter suspended in water, including dead pathogens (Guchi, 2015).
the water flow, microorganisms and organic matter are adsorbed fa However, the demand for food is greater than the supply, forcing mi
voring the development of biofilm around the sand granules (Elliot et al., croorganisms to compete for food (Huisman and Wood, 1974; Ranjam
2011; Wang et al., 2014). However, the main removals have been and Prem, 2018).
demonstrated to take place within the schmutzdecke due to the high Biological processes directly impact filter efficiency, promoting an
pathogen adsorption rate on this biological layer (Young-Rojanschi and inhospitable environment that, in addition to hindering the multiplica
Madramootoo, 2014). tion or reproduction of many pathogens, is also responsible for their
Schmutzdecke (the German word for dirty layer) is a biological layer deaths and/or inactivation (Ranjam and Prem, 2018). Studies reported
or biofilm on the first 5 cm of the sand-water interface within a slow that when these processes are combined with the physicochemical
sand filter (Unger and Collins, 2008; Young-Rojanschi and Madramoo mechanisms inherent to the HSSF, removal rates can increase between 3
too, 2014). This biolayer originates from the adsorption of organic and 5 logs for bacteria, protozoa, and viruses (Adeyemo et al., 2015;
matter, especially microorganisms, attached to a solid surface (i.e., Freitas et al., 2021; Terin et al., 2021; Wang et al., 2014).
sand) and imbued in a matrix of mineral precipitates and extracellular Additionally, sorption in the biofilms is not compound-specific
polymeric substances (EPS) (Huisman and Wood, 1974; Ranjam and (Flemming et al., 2016); therefore, in addition to microorganisms,
Prem, 2018). Its development goes through a cyclical process, starting other contaminants can also be trapped, including nutrients, nitrogen,
with the bacteria producing an extracellular gelatinous matrix for pro phosphorus, iron, aluminium, potassium, chloride, enzymes, and toxins
tection, which also increases microorganisms’ attachment (Law et al., (Sabogal-Paz et al., 2020), considerably improving the water quality.
2001), followed by the formation of microcolonies and the increase of
cell-cell communication, and ending with the detachment and disper 4.2. Physicochemical filtration
sion of some cells into the environment, potentially starting a new cycle
(Sauer et al., 2002). While the filter is not fully mature, physicochemical filtration
In HSSF, as well as SSF, the HRT is the key factor for schmutzdecke’s mechanisms are prominent regarding particle removal and improving
initial establishment and maintenance, because it allows particles sus water quality (Weber-Shirk, 2002). Some of these mechanisms are
pended in water to settle and come into contact with the filter media top straining, sedimentation, inertial and centrifugal forces, diffusion, and
(Huisman and Wood, 1974), and is integrated into it by mass attraction electrostatic attraction (Huisman and Wood, 1974).
or electrical forces (Balen, 2018). The biolayer formation in HSSF is The presence of bivalent ions (Ca2+; Mg2+) in water may favour the
expected to happen within 40 days (CAWST, 2012). However, this time complexation process (Wang et al., 2014), whereas the presence of
may vary depending on the temperature, source water, nutrient levels, aluminium may coat the filter media surfaces increasing particle
and colonizing microorganisms (Elliot et al., 2008; Napotnik et al., attachment or it may cause some reduction of the pores by the deposi
2017). tion of hydrous aluminium complex (Weber-Shirk and Chan, 2007) and,
EPS is the major component of the biofilm matrices and is respon similar to iron, it may benefit precipitation, increasing the settling ve
sible for its cohesion and stability (Decho, 2000). Other properties of locity of the suspended particles (Huisman and Wood, 1974). Adsorp
EPS include aggregation of bacterial cells, water retention, binding of tion is a result of mainly electrical forces, chemical attraction which are
enzymes, and enzymatic activity. All these features combined generate a related to the colloidal size, solution ionic strength, sand surface area
microenvironment favourable to the biological development that allows and physicochemical nature of the particles in the filters (Huisman and
microorganisms to survive (Flemming et al., 2016). Wood, 1974; Treumann et al., 2014; Weber-Shirk and Dick, 1997a). The
Bacteria are generally the predominant microorganism in the HSSF attachment efficiency depends on suspended particles, porous media,
4
solution chemistry, and filter medium length (Tufenkji and Elimelech, (Andreoli and Sabogal-Paz, 2020; CAWST, 2012; Elliott et al., 2008;
2004). Sand composition could be modified by the presence of elements Jenkins et al., 2011; Kennedy et al., 2013; Napotnik et al., 2017; Souza
such as iron and aluminium, for instance, favouring electrostatic Freitas and Sabogal-Paz, 2020; Young-Rojanschi and Madramootoo,
attraction and adsorption capacity (Ahammed and Davra, 2011; Brad 2014).
ley et al., 2011; Hijnen et al., 2004; Napotnik et al., 2020). Detachment The declining flow due to ripening improves the efficiency of HSSF in
occurs when hydrodynamic forces are greater than adhesive forces. It removing turbidity (Ahammed and Davra, 2011; Elliott et al., 2008;
can be affected by the chemical (pH, temperature, ionic strength) and Nair et al., 2014). In this context, schmutzdecke development can in
physical (flow rate, hydraulic retention time) properties of the liquid crease the turbidity removal, without direct relation to the influent
(Song et al., 2020; Weber-Shirk and Chan, 2007). From these mecha water turbidity (Adeyemo et al., 2015). Operational mode also affects
nisms, in general, turbidity, bacteria, virus, and protozoa are reduced the turbidity removal because of differences in feeding strategies and
within the HSSF. output flows. The constant and low filtration rate of C–HSSF promotes
Filter maturation may happen because of physicochemical processes, higher turbidity removal than the higher and declining rate of I-HSSF. In
with clogging of filter media due to particle settling (Napotnik et al., bench-scale HSSFs, Young-Rojanschi and Madramootoo (2014)
2017) removing turbidity. Particle concentration decreases with the observed 96% and 87% turbidity removal by continuous and intermit
increase in particle size and larger particles (around 50 µm) are removed tent filters, respectively. As it is more efficient, C–HSSF is less depen
more superficially by straining (Napotnik et al., 2017; Song et al., 2020). dant on the influent water quality than I-HSSF (Maciel and Sabogal-Paz,
Colloids smaller than the void size are removed by attractive forces 2020), however, its biological layer developed is more sensitive to in
(Song et al., 2020). Previously removed particles may improve the terruptions in the feeding (Souza Freitas and Sabogal-Paz, 2020).
straining mechanism even further through interparticle attraction Napotnik et al. (2017) observed that deeper filter beds (54 cm) do
(Weber-Shirk and Dick, 1997a). not necessarily appear to improve turbidity removal in I-HSSF as long as
For the removal of microorganisms, bacteria (e.g., E. coli) are pre the feed volume corresponds to the void volume of the unit. On the other
dominantly removed by adsorption, interception, straining and diffusion hand, in cases of higher feed volumes, deeper beds may enhance particle
(Napotnik et al., 2020; Schijven et al., 2003; Weber-Shirk and Chan, retention. Another operational parameter that affects the I-HSSF effi
2007), while two of the most important physicochemical mechanisms ciency is the pause period. Pause period may provide sedimentation and
for removing virus are adsorption and molecular diffusion (Napotnik reduce turbidity (Souza Freitas and Sabogal-Paz, 2020; Young-
et al., 2020; Schijven et al., 2003), and finally, regarding protozoa, Rojanschi and Madramootoo, 2015). Jenkins et al. (2011) achieved up
Cryptosporidium oocyst and Giardia cyst removals are ruled by straining, to 5.9% greater turbidity removals by increasing the pause period from
mainly when the media consists of irregular sand grains and, physico 5 h to 16 h. Removal improvements were also observed in longer resi
chemical filtration (Hsu et al., 2001; Schijven et al., 2003; Tufenkji et al., dence times (> 24 h) (Young-Rojanschi and Madramootoo, 2015).
2004). Additionally, microorganisms can attach to particles in water Although necessary for the proper functioning, the maintenance
forming an aggregate easier to be removed by filtration (Bradley et al., activity removes the clogged particles at the bed top, increasing the
2011; Wang et al., 2014). intergranular voids, which consequently decreases the head loss, the
Individual and synergistic contributions of physical, operational, and particles settling, and the HSSF’s ability to remove turbidity. Singer
biological characteristics still need further research (Wang et al., 2014). et al. (2017) observed reductions of up to 4.6% in the removal of
Understanding these mechanisms may give insight into filters’ potential, turbidity after cleaning processes. In addition, the time after mainte
regarding physical, chemical, and microbiological treatment of raw nance was reported as one of the operational variables most correlated
water (Weber-Shirk and Chan, 2007). with the turbidity removal (Jenkins et al., 2011; Maciel and Sabo
gal-Paz, 2020).
5. Effect of HSSF treatment on physicochemical water quality
5.2. Organic matter
As previously described, the biological and physicochemical mech
anisms in filters play a crucial role in HSSF performance. Moreover, Organic matter removal can be indirectly evaluated by total organic
different filters’ design, operational modes (i.e., pause period, ripening, carbon (TOC), colour, amongst other water quality parameters. HSSFs
and hydraulic rate), maintenance, and water source quality strongly are not as efficient for removing organic matter (Table S3) due to its low
influence the filter efficiency. Since filter operation has multifactor capacity to remove dissolved compounds, such as humic substances,
conditions, there are wide values for the average removal of physico which are capable of attributing colour and taste to water (CAWST,
chemical water quality parameters. Furthermore, these average values 2012).
may differ under other experimental conditions. For instance, removal The reported TOC displays average removals between 2% and 30%
values range from 0 to 98% for turbidity, 2% to 91% for organic matter, (Bradley et al., 2011; Freitas et al., 2021; Mahlangu et al., 2012; Lynn
<50% to >90% for metals, <5% to 53% for nitrogen compounds and et al., 2013; Ghebremichael et al., 2016; Andreoli and Sabogal-Paz,
≤20% to 99% for emerging pollutants. Table S3 (supplementary mate 2020, Terin et al., 2021). The best results were sometimes associated
rial) presents these removal values reported in the HSSF literature. with lower filtration rates, probably because of organic matter sedi
mentation. Despite this limitation, modified HSSFs can achieve high
5.1. Turbidity TOC removals (up to 91%), for instance, the version operated with a
hybrid approach (Sizirici et al., 2019) and the alternative enriched with
Several studies have evaluated the ability of HSSFs to remove an iron oxide layer (Maeng et al., 2015) – a well-known coagulant,
turbidity. In general, filters present average removal efficiencies of 75% which contributes to the removal of dissolved organic matter through
or greater, often reaching removals above 90% (Jenkins et al., 2011; aggregation and flocculation.
Murphy et al., 2010a; Singer et al., 2017; Young-Rojanschi and As mentioned, colour can be used as a surrogate for OM. Colour
Madramootoo, 2014). However, some studies have reported low removal rates vary between 5% and 25% (Medeiros et al., 2020; Souza
removal (i.e., ≤ 50%), mainly in conditions with low turbidity in Freitas and Sabogal-Paz, 2020). Higher removal rates were reported
influent water (e.g., preserved groundwater and pre-treated water) (95–97%) when associated with removal of cyanobacteria, which were
(Adeyemo et al., 2015; Andreoli and Sabogal-Paz, 2020; Medeiros et al., the main source of colour in the influent water evaluated by Terin and
2020; Young-Rojanschi and Madramootoo, 2015). HSSFs can produce Sabogal-Paz (2019).
water with turbidity within the limit recommended by WHO for home
water treatment, of 5 NTU (WHO, 2017), and, frequently, below 1 NTU
5
5.3. Metals improving the nitrogen removal in HSSF, but they can be controlled by
the amount of organic carbon. Despite this, researchers should be careful
CAWST defines HSSF as inefficient removing iron and dissolved about the concentrations of nitrite and nitrate in treated water, which is
chemical compounds (CAWST, 2011); however, some studies observed an undesirable result given the consequences of their ingestion for
considerable removal of metals and often simple modifications to the human health. The formation of anoxic zones is most common in I-HSSF
BSF model provided promising results. The reported metal removals with long pause periods (Young-Rojanschi and Madramootoo, 2014).
depended on the filter design parameters, but mostly on water
chemistry. 5.5. Emerging pollutants
Palmateer et al. (1999) reported 75% toxicity reduction after the
filtration of water containing mercury, based on Microtox essay, and an There is little information on emerging contaminants removal by
HgCl2 removal of more than 92%. The authors stated that mercury HSSF. While no significant and oscillating removal rates (0.00 - 93.3%)
removal was partially impaired by a break in the schmutzdecke due to were reported for the pesticide metaldehyde (Outhwaite and Campos,
turbulence caused by a leakage around the diffuser, hence, HSSF effi 2010), the retention of the herbicide metolachlor exceed 99% (Pal
ciency could be even higher (Palmateer et al., 1999). mateer et al., 1999). However, both studies had aspects that need to be
Arsenic removal by HSSF was more extensively studied than any considered. Outhwaite and Campos (2010) presented a short-duration
other metal (Table S3) due to its worldwide presence in groundwater. study. Considering that the schmutzdecke was already mature at the
Nevertheless, removal rates vary considerably, ranging from 39% beginning of the tests, it is reasonable to expect that the microbiological
(Chiew et al., 2009) to 95% (Avilés et al., 2013). Modifications such as community would pass through an adaptation period before being able
adding a layer of crushed bricks, adding nails to the sand or to the to metabolize the pesticide; therefore, longer studies are needed. On the
diffuser and using oxidized commercial fibre showed to considerably other hand, Palmateer et al. (1999) based metolachlor removal on the
increase HSSF efficiency removing arsenic by providing the filtration cumulative retention, which should not be compared to mean removal
with additional mechanisms of adsorption and/or co-precipitation rates.
(Avilés et al., 2013; Devi et al., 2008; Ngai et al., 2007; Smith et al., Recently, it has been shown that HSSF is efficient for removing
2017). Furthermore, water composition plays an important role in pharmaceuticals and personal care products (PPCP) (e.g., paracetamol,
arsenic removal by household filtration (Berg et al., 2006; Chiew et al., diclofenac, naproxen, ibuprofen, methylparaben and benzophenone-3)
2009). For example, while the oxidation of the iron in water may and resilient to its effects, individually and as a mixture (Pompei
improve arsenic removal in filters, phosphate may compete for et al., 2017, 2019). However, there is preliminary evidence that the
adsorption sites, hindering arsenic removal (Chiew et al., 2009). PPCPs may affect the schmutzdecke development and microbial com
Regarding iron removal, mean rates ranged from 73% (Mahlangu munity, possibly affecting the HSSF’s efficiency in the long term
et al., 2012) to > 93% (Ngai et al., 2007) were reported. Phosphate (Pompei et al., 2017).
removals can vary between 39% (Mwabi et al., 2011) and 90% (Berg Poor removals were reported for endocrine disruptors bisphenol-A
et al., 2006). Although 99.9% removal of fluoride was reported for a and oestrogen. Sabogal-Paz et al. (2020) reported 3 ± 8% of removal
HSSF treating synthetic water (Mwabi et al., 2011), poor removal rates of bisphenol-A from rainwater by a bench-scale I-HSSF. While Kennedy
(0% - 26%) were observed for natural waters (groundwater and surface et al. (2013) observed between 11.4 and 15.6% removal of estrone,
water) (Mahlangu et al., 2012; Mwabi et al., 2011). Similar behaviour estriol and 17α- ethinyl oestradiol, using full-scale I-HSSF fed with
was observed for calcium removal (Mwabi et al., 2011). Magnesium spiked lake water, results which were compatible to SSF, according to
removal rates were reported to be around 50% (Mwabi et al., 2011); the authors. Both studies propose using a post-filtration step to improve
Mahlangu et al., 2012). As seen in arsenic removal, amendments to the contaminant removal (activated carbon and chlorination, respectively).
BSF CAWST model have the potential to increase the removal of some of Sabogal-Paz et al. (2020) suggested using activated carbon to remove
the considered metals (Mahlangu et al., 2012; Ngai et al., 2007). DOC and bisphenol-A, while Kennnedy et al. (2013) showed that
Furthermore, HSSF showed to be able to reduce the aforementioned oxidation by chlorine can result in more than 98% removal of estrogens.
metal concentrations to acceptable levels.
It is noteworthy, however, that the presence of inorganic compounds 6. Effect of HSSF treatment on microbiological water quality
in water could be increased after filtration by HSSF if the influent water
has low concentrations of such contaminants. Sabogal-Paz et al. (2020) A summary of several studies of microbiological reduction by HSSF is
reported an increase in the concentration of chloride, sulphate, silica, presented in Table S4 (supplementary material). Since filter operation
aluminium, calcium, iron, potassium, magnesium, and sodium after the has multifactorial conditions, as well as for the physicochemical water
filtration of simulated rainwater by bench-scale HSSF. According to the quality parameters, there are wide values for the average removal of
authors, these results can be attributed to filter media leaching, as pre microbiological parameters.
viously reported by Young-Rojanschi and Madramootoo (2015) (Sabo
gal-Paz et al., 2020). 6.1. Bacteria
5.4. Nitrogen compounds Bacteria removal by HSSF is widely reported and most studies show
an average reduction between the 1.00 and 2.00 log; nevertheless, a
Nitrate removal rates in HSSF vary between < 5% to 53% (Mwabi wide efficiency range was noticed due to the diverse experimental pa
et al., 2011; Kennedy et al., 2012; Mahlangu et al., 2012; Avilés et al., rameters (Table S4).
2013; Romero et al., 2020). However, some studies have also shown an Different sand sizes used in HSSF showed diverse bacterial removal
increase in the concentration of nitrate and nitrite in HSSF effluent, performance. Most studies used effective sand size (d10) smaller than
especially when influent waters presented high nitrogen content (Chiew 0.24 mm, showing an average reduction over time from 1.17 to 3.90 log
et al., 2009; Pompei et al., 2017; Sabogal-Paz et al., 2020). According to (Andreoli and Sabogal-Paz, 2020; Elliott et al., 2008; Maciel and Sabo
Murphy et al. (2010), the high nitrate and nitrite concentration in the gal-Paz, 2020; Jenkins et al., 2011; Lynn et al., 2013; Napotnik et al.,
effluent is a result of a dynamic nitrogen cycling (i.e., nitrification and 2017, 2020; Nasser Fava et al., 2020; Singer et al., 2017; Souza Freitas
denitrification) that can occur within the filter media. and Sabogal-Paz, 2020; Terin et al., 2021; Young-Rojanschi and
Complete denitrification was achieved only by Snyder et al. (2016) Madramootoo, 2014). HSSF with greater sand sizes (between 0.30 and
in a vinegar-amended anaerobic biosand filter. Although not common in 0.90 mm) seems to have lower bacteria removal rates (0.33 to 2.60 log)
HSSF, anoxic and anaerobic metabolisms could be an option for (Ghebremichael et al., 2012; Sizirici et al., 2019; Yildiz, 2016).
6
Modifications on filter media composition have been tested to bacteria when the water presented high turbidity (Mwabi et al., 2012;
improve HSSF efficiency. Ahammed and Drava (2011) used 10 cm of 2013). Moreover, it is inferred that each additional NTU in influent
iron coated sand in the filter media and reached an average E. coli water may increase the bacterial removal by 0.0035 log (Jenkins et al.,
reduction of 3.10 log, an improvement of almost 1.00 log compared with 2011). This could be explained by the fact that bacteria are more likely
a standard biosand filter. The presence of iron oxides could neutralize to be attached to larger particles when in water sources with high
the negative charge of bacteria, enhancing the adsorption on sand grains turbidity, which will be easily retained within HSSF.
(Ahammed and Davra, 2011; Napotnik et al., 2020). However, other Temperature can alter the HSSF performance, however, studies
modifications in filter media did not positively impact the removal of reporting it are limited. Arnold et al. (2016) placed filters in rooms with
bacteria (Baig et al., 2011; Devi et al., 2008; Elliot et al., 2015; Ghe controlled temperatures (4, 12, 18 and 27 ◦ C) after the ripening period.
bremichael et al., 2012; Mwabi et al., 2012; 2013; Sizirici et al., 2019; Filters placed at lower temperatures had an efficiency decrease, but after
Yildiz, 2016). 25 days all filters showed similar efficiency. Another work observed that
Analysing the depth profile in the HSSF sand bed, some authors have lowering influent water temperature affected E. coli reduction by HSSF
reported that most of the bacterial removal occurs within the top 5–10 (Maciel and Sabogal-Paz, 2020).
cm layer. Nair et al. (2014) showed that approximately 1.00 log of total
coliform reduction occurs in the first 10 cm. Another study demon 6.2. Virus
strated that E. coli removal in the top 10 cm was significantly higher in
an I-HSSF, when compared to deeper layers, reaching more than 2.00 Virus adsorption in HSSF relies on chemical and electrostatic in
and 1.50 log in a C–HSSF and I-HSSF, respectively (Young-Rojanschi teractions between virus and the sand surface. Viruses with a lower
and Madramootoo, 2014). Results reported by Freitas et al. (2021) also isoelectric point (e.g., MS2) present a highly negative surface and higher
suggested a higher removal in the first 5 cm layer. These results high repulsion by sand in neutral pH water, in contrast with viruses with
light the importance of the schmutzdecke on HSSF performance. higher isoelectric point (e.g., rotavirus) (Michen and Graule, 2010;
Several studies reported that HSSF efficiency is improved after the Wang et al., 2016). Therefore, changes in influent water pH and
ripening period, with an average bacterial reduction of ≤ 1.00 log before composition (ions) have direct influence on viral charge and conse
ripening and a significant increase in the following days (Arnold et al., quently on removal by HSSF.
2016; Baig et al., 2011; Kennedy et al., 2013b; Maciel and Sabogal-Paz, Wang et al. (2014; 2016) showed high removal rates (> 5.00 log) of
2020; Nair et al., 2014). MS2 bacteriophage by HSSF in natural groundwater with a high con
Despite the importance of the schmutzdecke in HSSF, maintenance is centration of cations (Ca2+ and Mg2+) and pH 6.2. Moreover, in a
eventually necessary and, by removing most of the biofilm layer, it has cation-free buffer (pH 8.1), MS2 reduction of 1.20 log was observed
an adverse impact on the bacterial removal efficiency. Singer et al. (Wang et al., 2016).
(2017) reported a decrease in efficiency by 0.16 – 0.83 log, varying with Cation influence on viral removal was also observed by studies that
the maintenance method used. Freitas and Sabogal-Paz (2019) and changed the filter media composition. In this aspect, modifications
Kennedy et al. (2013) also demonstrated lower removal rates after related to enhanced virus removals include adding iron particles to the
cleaning and 15–17 days to recover. Furthermore, Maciel and Sabo sand bed (Bradley et al., 2011), an addition of an iron nail layer
gal-Paz (2020) presented a positive correlation, showing higher E. coli (Napotnik et al., 2020), use of a zeolite layer (Adeyemo et al., 2015) and
reduction with a greater time after maintenance. replacement of sand by crushed granite (Elliot et al., 2015).
Schmutzdecke development and particle straining lead to head loss Another factor that seems to affect viral removal is the filter media
and a reduced HSSF filtration rate, which may also influence bacterial depth. Young-Rojanschi and Madramootoo (2014) observed that nearly
removal. Kennedy et al. (2012) demonstrated that the decrease in the 2.50 log removal of MS2 in a C–HSSF occurred in the first 30 cm, and
flow rate from 0.74 L min− 1 to 0.42 L min− 1 resulted in an increased approximately 0.5 log in the last 25 cm. Bradford et al. (2003) empha
faecal coliform removal. Jenkins et al. (2011) also reported that size the importance of the filter media depth, providing a greater op
decreasing the flow rate by reducing the nominal head above the static portunity for viruses to diffuse into the sand.
water level from 30 cm to 20 or 10 cm, improves the bacterial removal Furthermore, the filter ripening also has a role in removing viruses in
by 0.10 – 0.16 log. HSSF by increasing the residence time. Longer residence time has been
Some studies demonstrated that longer residence time resulted in described as more efficient to achieve higher virus reduction values
higher bacterial removal by predation and natural die-off (Baumgartner (Napotnik et al., 2020; Wang et al., 2014; 2016; Young-Rojanschi and
et al., 2007; Elliott et al., 2006, 2008; Souza Freitas and Sabogal-Paz, Madramootoo, 2014). Some authors showed a linear removal of MS2
2020). Ghebremichael et al. (2012) indicated that 20 and 22 h of idle along the sand bed in unripened filters and an exponential removal of
time increased E. coli reduction by 2.00 log, compared to 1.5 h. Jenkins rotavirus and MS2 according to filter depth in ripened filters (Wang
et al. (2011) showed that longer resting periods (15 h) enhance the et al., 2014; 2016). Another long-term study also demonstrated higher
bacterial removal by 0.29 log, compared with shorter idle time (5 h). viral removal when the filter achieves full maturation (Bradley et al.,
However, too long pause periods (> 24 h), did not improve the bacterial 2011).
removal any further (Ghebremichael et al., 2012; Napotnik et al., 2020; Filter maturation can contribute to enhancing virus adsorption to
Young-Rojanschi and Madramootoo, 2015). Furthermore, using feed surfaces, and removal by predation and protease activity (Elliott et al.,
charges with more than 50% of the filter pore volume generated lower 2011). Indeed, the intensification of biological mechanisms in ripened
bacterial removal caused by shorter residence time (Elliott et al., 2008; filters may be responsible for virus reduction in HSSF. Elliot et al. (2011)
Nair et al., 2014). demonstrated that suppression of microbial activity by sodium azide
The operation regime may also have an impact on removing bacteria. showed slower reduction rates of MS2 and PDR-1.
Kereita et al. (2008) showed that C–HSSF was able to reduce more than Additionally, higher idle time also enhances the chance of virus
2.00 log. Another study with traditional and compact HSSF (i.e., 50 and adhesion in sand, and the action of proteolytic enzymes (Elliott et al.,
25 cm of filtration layer) in continuous flow showed an average of 2.00 2011; Napotnik et al., 2020). Finally, MS2 removal was also directly
log and maximum of 3.62 log reduction (Freitas et al., 2021). Maciel and correlated to influent turbidity and inversely correlated to sand size
Sabogal-Paz (2020) and Young-Rojanschi and Madramootoo (2014) (Jenkins et al., 2011).
reported superior efficiency by continuous filters compared to inter
mittent, with average removal higher than 2.00 log. 6.3. Protozoa
Non-microbiological influent water characteristics may also affect
HSSF efficiency. Biosand filters had superior performance removing Data indicating the HSSF efficiency for protozoa removal are limited.
7
Palmateer et al. (1999) assessed the efficiency of a biosand filter in respectively (Curry et al., 2015; Earwaker and Webster, 2009; Mah
removing Cryptosporidium spp. and Giardia lamblia (oo)cysts after one mood et al., 2011; Murphy et al., 2010a; Rayner et al., 2016; Sisson
massive contamination event (106 and 105, respectively). Cryptospo et al., 2013a; Stauber et al., 2006, 2012b, 2012a; Tiwari et al., 2009;
ridium spp. oocyst removal was always higher than 3.00 log, and oocysts Vanderzwaag et al., 2009). Additionally, the majority of evaluated
were no longer found after 22 days. Giardia lamblia cysts were HSSFs were able to produce water with bacteria concentration within
completely retained (removal higher than 5.00 log). Using influent the range considerable as acceptable for drinking water (≤ 10 CFU 100
waters with plausible contamination values (i.e., up to 103 (oo)cysts d − mL− 1), and often reached removal of bacteria to levels below the
1
), removal rates of Crytosporidium spp. oocysts vary from 0.45 to 2.50 detection limit (< 1 CFU 100mL− 1) (WHO, 2017). Some studies, how
log, and those of Giardia spp. cysts vary from 1.00 to 3.00 log (Andreoli ever, reported no removal, or even increase, of bacteria concentration
and Sabogal-Paz, 2020; Freitas et al., 2021; Medeiros et al., 2020; Terin (including E. coli) after filtration (Fewster et al., 2004; Murphy et al.,
et al., 2021). 2010a; Sisson et al., 2013a; Stauber et al., 2006). The main reasons were
Napotnik et al. (2020) demonstrated an average removal of oocysts related to environmental factors (e.g., low bacteria concentration in the
of 4.00 log. The authors used I-HSSFs with different sand depths (i.e., 10, influent water) and incorrectly operation and/or maintenance of the
15 and 50 cm), which did not influence protozoa removal. On the other HSSF (e.g., loose diffuser plate, standing water deeper than recom
hand, Adeyemo et al. (2015) observed poor protozoa removal rates mended, cleaning the HSSF out of routine rather than necessity) (Few
(1.10 – 1.40 log) using an I-HSSF with a reduced filtration layer (i.e., 15 ster et al., 2004; Murphy et al., 2010a; Stauber et al., 2006).
cm). This difference may be due to influent water quality in terms of A noteworthy question raised by several of the considered field
protozoa, amongst other water quality parameters and filter design. In studies was the issue of recontamination of the filtered water during
C–HSSFs, reducing the filter media depth from 50 cm to 25 cm also did storage, which can considerably reduce the treatment efficiency (Curry
not influence protozoa removal (Freitas et al., 2021). et al., 2015; Duke et al., 2006; Fiore et al., 2010; Liang et al., 2010;
Murphy et al., 2010a; Spowart, 2012; Stauber et al., 2012a). The range
6.4. Algae and cyanobacteria of recontamination went from negligible (Sisson et al., 2013a) to be
observed in all HSSF systems surveyed by Spowart (2012). The absence
Studies on algae and cyanobacteria removal by HSSF are scarce. The of recontamination observed by Sisson et al. (2013a) was attributed to
first report was made by Bojcevska and Jergil (2003), which observed using chlorine as post-treatment. Recontamination events highlight that
removal between 95 and 100% of the cyanobacterial biomass. Recently, water, sanitation, and hygiene education must be combined with
Terin and Sabogal-Paz (2019) assessed the efficiency in removing multi-barrier treatment interventions to provide safe water (Curry et al.,
Microcysts aeruginosa and showed an average reduction of 2.00 and 2.40 2015).
log10 by I-HSSF and C–HSSF, respectively. Unlike bacteria, an increase HSSF efficiencies to remove additional water quality parameters of
in HSSF performance during operation was not observed. Moreover, it interest were also evaluated by field studies. Lee (2001) observed that
was reported that 75% cyanotoxin (microcystin) removal was achieved the HSSF removed, on average, 72% of H2S producing bacteria in Nepal.
in both filters (Terin and Sabogal-Paz, 2019). Murphy et al. (2010a) reported 40 to >99% removal of iron and >97%
removal of manganese by HSSF in Cambodia. The same authors reported
7. Field experiences an increase in nitrate, nitrite, and fluoride concentrations after filtration
(Murphy et al., 2010a). Increases in nitrate and nitrite concentrations
In 2015, more than 800 thousand BSFs had been implemented in at were also reported by Liang et al. (2010).
least 60 countries, potentially helping more than 5 million people Evidently, operational, geographical, cultural, and other factors
(CAWST, 2016). Table S5 (supplementary material) presents the year influenced HSSF efficiency throughout evaluated field studies; however,
and country in which the 28 field studies included in this review took these studies frequently conclude that HSSF is an effective and robust
place. These studies evaluated almost 1900 filters, mostly concrete and option for household water treatment in rural communities. The liter
plastic BSFs. Mentions of other field studies were found by the authors, ature shows that, after implementing HSSFs, cases of diarrhoeal diseases
however, the lack of access to these studies’ reports made them reduced between 47% and 74%, including amongst children under 5
impossible to be considered in this review. (Aiken et al., 2011; Liang et al., 2010; Stauber et al., 2009, 2014, 2012b,
The main water quality parameters evaluated in the field studies 2012a; Tiwari et al., 2009). HSSF use also reduced the duration of the
were turbidity and bacteria removals. Due to the wide range of opera reported cases of diarrhoea by 1.5 days (Stauber et al., 2012b), and the
tional conditions (e.g., time of operation, and influent water source and overall incidence of waterborne bacterial diseases, related or not with
quality, amongst others), quantification methods, and even methods to diarrhoea, by 23% (Sheikh et al., 2016). It can be observed, however,
calculate and denote the results, the reported efficiencies vary that no significant reduction of diarrhoeal diseases was observed by
considerably. Fabiszewski de Aceituno et al. (2012) following the implementation of
Mean turbidity removals in the field varied from <5% (Fabiszewski the HSSF. Additionally, it is important to mention that the reporting bias
de Aceituno et al., 2012) to 98% (Rayner et al., 2016), with most field plays a great role in studies evaluating diarrhoeal illness reduction due
studies reporting removal rates above 80% (Curry et al., 2015; Duke to HWTS use; and may have overestimated diarrhoeal reductions in the
et al., 2006; Lee, 2001; Liang et al., 2010; Mahmood et al., 2011; Rayner aforementioned field studies (Schmidt and Cairncross, 2009; Aiken
et al., 2016; Sisson et al., 2013a; Stauber et al., 2006; Vanderzwaag et al., 2011). To the best of the authors’ knowledge, no HSSF blind study
et al., 2009). HSSFs were frequently reported to be able to produce water was published to this date.
with mean turbidity below 5 NTU (Curry et al., 2015; Duke et al., 2006; The approaches used to describe the relationship between HSSF use
Earwaker and Webster, 2009; Hurd et al., 2001; Lee, 2001; Liang et al., and water and health improvement have their limitations. A major
2010; Mahmood et al., 2011; Rayner et al., 2016; Sisson et al., 2013a; limitation is the self-report of diarrhoeal cases, which has the potential
Stauber et al., 2006; Vanderzwaag et al., 2009), considered acceptable to overestimate the reduction of cases (Aiken et al., 2011; Fabiszewski
for household water treatment systems according to WHO (WHO, 2017). de Aceituno et al., 2012; Spowart, 2012; Stauber et al., 2012a, 2012b).
Furthermore, some HSSFs were reported to produce water with mean Another cited limitation includes small sizes or numbers of clusters,
turbidity below 1 NTU (Hurd et al., 2001; Lee, 2001; Mahmood et al., unblinded participants, lack of a placebo, participants using other
2011; Rayner et al., 2016; Sisson et al., 2013a; Vanderzwaag et al., drinking water sources, and short duration of studies (Aiken et al., 2011;
2009). Fabiszewski de Aceituno et al., 2012; Rayner et al., 2016; Sheikh et al.,
Mean bacteria removal in the field were reported to be around 1.0 2016; Spowart, 2012; Stauber et al., 2012a, 2012b, 2009; Tiwari et al.,
log (90%), reaching 2.9 log and 3.7 log for E. coli and total coliform, 2009).
8
In addition to being able to produce water meeting international water quality (e.g., turbidity, metals, and microorganisms) in remote
guidelines for drinking water quality (WHO, 2017) and improve health, areas, presenting simple operation and maintenance processes. Despite
the HSSFs also presented positive results regarding community accep this, the filter still needs further studies, especially focusing on the
tance and perception. Most users generally report being satisfied with physicochemical processes involved in the filtering and support layers,
the filters. The main cited reasons were cleaner water, having better since some elements (e.g., Fe, Al, Ca, Mg), that are present in different
taste, appearance (colour and/or opacity) and smell, easy to use and concentrations depending on the filter media source, can affect the filter
better health of family members (Duke et al., 2006; Earwaker and overall efficiency. Regarding the schmutzdecke, there is a gap concerning
Webster, 2009; Fewster et al., 2004; Fiore et al., 2010; Hurd et al., 2001; its physicochemical and structural properties and their relationship with
Klopfenstein et al., 2011; Manz et al., 1993; Ogunyoku et al., 2011; microorganisms, as well as the interrelationship between microorgan
Rayner et al., 2016; Sheikh et al., 2016; Spowart, 2012; Stauber et al., isms in the biofilm. The better understanding of this microenvironment
2012b). Besides quality, water quantity is also an important aspect of a could help optimize the biological mechanism within the HSSF. Modi
household water treatment system. In the HSSF case, users specifically fications to improve the HSSF efficiency are also required, particularly in
reported that the filters were able to provide enough water to meet the topics with few studies in peer-reviewed literature, such as organic
family’s needs, which varied from only drinking to bathing and washing matter, nitrogen compounds, protozoa, and cyanobacteria. In addition,
dishes, depending on the study (Duke et al., 2006; Hurd et al., 2001; there are still several problems that require attention to assure a sus
Lee, 2001; Mol, 2001; Rayner et al., 2016). tainable use of HSSFs in the field. Particularly, target-user education,
Besides the already mentioned issues, some of the more common training, and follow-up, due to its potential to prevent most of the
problems reported by researchers, technicians, or users themselves subsequent problems. However, this issue may be complex, since it is not
were: broken parts or cracks in the filters, leading or not to leakage of related to the HSSF itself, but with the HSSF implementation programs
water or sand and an insufficient, or lack of, education, training and, and adaptations to provide a proper end-user experience. Therefore,
mostly, follow-up (Aiken et al., 2011; Curry et al., 2015; Duke et al., statements about improvements in filtered water quality/treatment
2006; Earwaker and Webster, 2009; Fiore et al., 2010; Hurd et al., 2001; performance should be weighed up in the context of possible effects on
Klopfenstein et al., 2011; Mahmood et al., 2011; Ogunyoku et al., 2011; user acceptability (plus sustained use and adherence).
Rayner et al., 2016; Sisson et al., 2013b; Spowart, 2012; Vanderzwaag
et al., 2009). Some of the less reported problems were low-quality water, Declaration of Competing Interest
ant infestation, low flow rates, use of inadequate sand, user’s negative
perception or dislike of the filter, incompatibility with user’s lifestyle, The authors declare that they have no known competing financial
siphoning, and problems with storage reservoir (Aiken et al., 2011; interests or personal relationships that could have appeared to influence
Duke et al., 2006; Fewster et al., 2004; Fiore et al., 2010; Klopfenstein the work reported in this paper.
et al., 2011; Ogunyoku et al., 2011; Sisson et al., 2013b; Spowart, 2012).
The available literature shows that the sustained use of HSSF varies Acknowledgements
considerably across different experiences. While some studies reported
between 85 and 100% of the HSSFs still in use, for periods of up to 8 This work was supported by the Global Challenges Research Fund
years (Aiken et al., 2011; Duke et al., 2006; Earwaker and Webster, (GCRF) UK Research and Innovation (SAFEWATER; EPSRC Grant
2009), others showed high abandonment rates, such as 93% in Reference EP/P032427/1), The Royal Society (ICA\R1\201373 - Inter
Nicaragua after only 2 years (Vanderzwaag et al., 2009). According to national Collaboration Awards 2020), and the Coordination for the
Sisson et al. (2013b), the factors that most compromise the sustainable Improvement of Higher Education Personnel (CAPES-PROEX - Brazil,
and effective use of HSSF includes: inadequate or insufficient educa Financial code 001) for PhD and master’s scholarships awarded to
tion/training, poor understanding of the relationship between water Bárbara Luíza Souza Freitas, Ulisses Costa Terin and Milina de Oliveira.
quality and sanitation, inadequate water source causing filter clogging,
water recontamination due to human or animal contact, cracks, low flow Supplementary materials
and inadequate maintenance (Sisson et al., 2013b). Fortunately, aban
doned filters can usually be brought back into operation (Earwaker and Supplementary material associated with this article can be found, in
Webster, 2009; Sisson et al., 2013b). the online version, at doi:10.1016/j.watres.2021.117870.
Earwaker and Webster (2009) argued that, in addition to the project
implementation, the active and sustainable long-term adoption of HSSF References
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A Critical Overview of Household For Water Treatment

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Water Research 208 (2022) 117870

Contents lists available at ScienceDirect

A critical overview of household slow sand filters for water treatment

1. Introduction Sizirici et al., 2019; Yildiz, 2016).

3.1. Flow regime

The HSSF was successfully implemented around the world adopting

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