Assessment of the impact of discharges from surface water sewers on receiving water quality

A broad based approach has been used to assess the impact of discharges to rivers from surface water sewers, with the primary objective of determining whether such discharges have a measurable impact on water quality. Three parameters, each reflecting the effects of intermittent pollution, were included in a field work programme of biological and chemical sampling and analysis which covered 47 sewer outfall sites. These parameters were the numbers and types of benthic macroinvertebrates upstream and downstream of the outfalls, the concentrations of metals in sediments, and the concentrations of metals in algae upstream and downstream of the outfalls. Information on the sewered catchments was collected from Local Authorities and by observation of the time of sampling, and includes catchment areas, land uses, evidence of connection to the foul system, and receiving water quality classification. The methods used for site selection, sampling, laboratory analysis and data analysis are fully described, and the survey results presented. Statistical and graphical analysis of the biological data, with the aid of BMWP scores, showed that there was a small but persistent fall in water quality downstream of the studied outfalls. Further analysis including the catchment information indicated that initial water quality, sewered catchment size, receiving stream size, and catchment land use were important factors in determining the impact. Finally, the survey results were used to produce guidelines for the estimation of surface water sewer discharge impacts from knowledge of the catchment characteristics, so that planning authorities can consider water quality when new drainage systems are designed.

Is there a trade-off between quality and productivity? The case of diagnostic technologies in Portugal

The purpose of this paper is twofold: first, we compute quality-adjusted measures of productivity change for the three most important diagnostic technologies (i.e., the Computerised Tomography Scan, Electrocardiogram and Echocardiogram) in the major Portuguese hospitals. We use the Malmquist–Luenberger index, which allows to measure productivity growth while controlling for the quality of the production. Second, using non-parametric tests, we analyse whether the implementation of the Prospective Payment System may have had a positive impact on the movements of productivity over time. The results show that the PPS has helped hospitals to use these tools more efficiently and to improve their effectiveness.