Evaluation of sanitation hygiene implementation at refill drinking water depot in Lembursitu Sub-District, Sukabumi City

Refill drinking water is an alternative to fulfill drinking water needs in Lembursitu District, Sukabumi City. People choose to consume refilled drinking water because the price is low and easy to get. There are 17 Refill Drinking Water Depots in Lembursitu Sub-District, Sukabumi City, and study areas at four depots based on various raw water sources and daily water production. The objective of this study was to assess the application of sanitary hygiene at drinking water depots based on the Regulation of the Minister of Health No. 43 of 2014 about Hygiene and sanitary of Drinking Water Depots including the Quality of Water Production. This research is descriptive research. Methods of data collection through field observations, interviews, and analysis of the quality of water production. Based on laboratory results, all physical and chemical parameters meet the quality standard requirements. The bacteriological analysis of the water production revealed that E. coli and Coliform bacteria were present in two of the four samples, with values ranging from 0-1 to 0-3 per 100 ml sample. The requirements for drinking water quality outlined in the Regulation of the Minister of Health No. 492 of 2010 are not met under these circumstances. Depots 1 and 5 have satisfied the requirements after evaluating the implementation of hygiene and sanitation from a variety of perspectives and determining physical feasibility, according to the observation format in the Regulation of the Minister of Health No. 43 of 2014. The scores ranged from 79 to 83.


Introduction
For both present and future drinking water management business owners, the demand for safe and appropriate drinking water represents a commercial opportunity.This is indicated by the increasing number of similar businesses that have sprung up, including in the Lembursitu Sub-District, Sukabumi City.Based on data from the Lembursitu Sub-District Health Center, the number of drinking water depots in 2017 was only 10 depots, and based on field surveys in 2020 it will increase to 17 depots.
In Lembursitu Sub-District, Sukabumi City, refilling drinking water is an alternative to meeting those needs.Refillable drinking water is popular since it is inexpensive and simple to obtain.Increased public interest in refilling drinking water is matched by the many businesses that have sprung up at the Refill Drinking Water Depot (RDWD).Choosing a RDWD as an alternative to drinking water can be a risk that can endanger health if the quality of RDWD is still in doubt, especially if consumers do not pay attention to its safety, cleanliness, and sanitation.Diarrhea is one of the illnesses brought on by the presence of E. Coli and Total Coliform in water.Diarrhea is the sixth most common disease in Lembursitu Sub-District, Sukabumi City.Based on the health report book of the Lembursitu Sub-District Health Center in 2019, the number of cases of diarrhea was 1149 cases.To determine whether drinking water is one of the causes of diarrheal disease, it is important to evaluate the bacteriological content of replenished drinking water.
Refill drinking water depots are businesses that produce drinking water and sell it directly to consumers who consume it.The production process in principle is filtration and disinfection.The purpose of the filtration process, in addition to separating suspended contaminants, is also to separate colloids including microorganisms in water, while disinfection is intended to kill microorganisms harmful to the body that were not filtered in the previous process [1][2].
According to the Republic of Indonesia's Regulation of the Minister of Health No. 43 of 2014, the goal of refilling drinking water depot hygiene and sanitation is to protect those who drink from these facilities.In this way, the community will avoid the possibility of being exposed to waterborne diseases and the socialization of hygiene and sanitation in drinking water depots will be carried out at all levels of society [3].
Based on findings from a preliminary assessment carried out at each drinking water depot in the Lembursitu Sub-District, it can be seen that employees working at RDWD do not use personal protective equipment such as masks, gloves, and special clothing so it is likely to cause contamination in the packaging process.Apart from that, the conditions of some RDWDs seem to be neglected in terms of hygiene and sanitation, both in terms of buildings and equipment.In addition, periodic inspections of RDWDs by authorized agencies are also rarely carried out.
From the description above, it can be seen that it is necessary to carry out research on sanitation hygiene at RDWDs to make sure that there is enough clean, wholesome drinking water available for everyone to use.The study aimed to analyze and find out the implementation of sanitation hygiene standards at refill drinking water depots in the Lembursitu Sub-District, Sukabumi City by the regulations set out in Regulation of the Minister of Health No. 43 of 2014 concerning hygiene and sanitation of drinking water depots.

Methods
The steps in this research are as follows:

Literature review
Search and study all types of references such as journals, articles, other scientific works, and government regulations.

Identification of raw water sources, processing capacity at 17 water depots in the Lembursitu Sub-District area
Identify and classify sources of raw water and the capacity of water that is treated daily at 17 depots.Based on the results of the identification of raw water sources, 17 refill drinking water depots use raw water from 4 different springs.Figure 1 shows the maps of Sukabumi City.

Selection of RDWD for research locations
After being classified based on raw water sources, RDWDs are then selected based on the volume of processed water that has the most in each different raw water.There are 4 RDWDs taken as research locations in the Lembusitu Sub-District, Sukabumi City.The Table 1 is a list of Drinking Water Depots in the Lembursitu Sub-District, Sukabumi City, which have been selected as research locations: The observation results refer to the format of the Regulation of the Minister of Health No. 43 of 2014 which is then added up for each of the points, and the percentage obtained from the calculation results is as follows: % Not qualify =       100 (2)  [5].The measurement results at each study location showed that the turbidity value of each drinking water at each depot was 0 NTU with a maximum permissible level of 5 NTU.And for odor and taste testing, refilled drinking water is odorless and tasteless.Therefore, for testing the physical parameters of drinking water, it meets the requirements (Table 2).And for odor and taste testing, refilled drinking water is odorless and tasteless.Therefore, for testing the physical parameters of refilled drinking water, it meets the requirements.

Analysis of drinking water samples based on chemicals parameters
In this study, tests were carried out on chemical parameters including pH and fluoride in drinking water from the processing of each depot (Table 3).The results of the analysis for each research location showed that the pH level ranged from 7.36-7.70and the Fluoride analysis results showed that the Fluoride content was still below 0.1.The pH level and fluoride content in drinking water at each depot still meet the quality standards of Regulation of the Minister of Health No. 492 of 2010.

Analysis of drinking water samples based on bacteriology parameters
The drinking water produced at each depot was tested for a variety of bacteriological factors in this investigation, including Escherichia coli and total coliform.Table 4 and 5 display the test outcomes.The results of testing the Escherichia Coli and Total Coliform parameters showed that 2 samples of drinking water (50%) of the 4 samples were positive for E.coli and Total Coliform bacteria, namely at Depot 12 and Depot 17, with a total of 1 per 100 mL sample and a total coliform was 2 and 3 per 100 mL sample at Depot 12 and Depot 15 respectively.The management of RDWD is vulnerable to contamination from various microorganisms, especially coliform bacteria and E.coli which are directly related to health.The high level of coliform bacteria contamination increases the risk of the emergence of other pathogenic bacteria.One example of pathogenic bacteria found in water contaminated with the feces of humans or warm-blooded animals is E.coli bacteria.Because their presence in water shows that the water is contaminated with feces, which may also contain other harmful germs, Escherichia coli bacteria are employed as an indicator of the quality of drinking water [6].The presence of coliform in water is an indication of inadequate processing or sanitation conditions.So hygiene and sanitation affect whether there is contamination of coliform bacteria in refilled drinking water [7].

Results of observation on the implementation of sanitation hygiene at RDWDs
The observation format for the implementation of sanitation hygiene at the Drinking Water Depots consists of 38 items which are divided into 4 aspects, namely the place aspect has 14 items, the equipment aspect has 11 items, the handler aspect has 7 items, and the raw water and drinking water aspects have 6 items with different scores for each item.The calculation of observation results show that each RDWD gets a different total score, which can be seen in Table 6.Assessment is the number of objects that meet the requirements by adding up the marked values (√).
1.If the inspection value reaches 70 or more, then it is stated that it meets the physical eligibility requirements.2. If the inspection value is below 70, then it is declared that it has not met the physical eligibility requirements, and the head entrepreneur is asked to immediately repair the problem object.3.If the value reaches 70 or more, but object number 38 (the quality of drinking water produced meets the standard physical, microbiological, and chemical requirements according to quality standards or drinking water quality requirements) does not meet the requirements, it means that the RDWD in question does not meet the health requirements Based on Table 6 it can be seen that the results of the RDWD physical examination that met the requirements were Depot 1 and Depot 5, and those that did not meet the requirements were Depot 12 and Depot 17.This can be seen from the total scores obtained, namely 77 and 62. Depot 12, got a total score reaches more than 70, but object number 38 does not meet the requirements, it is declared that it does not meet the physical eligibility requirements.

Conclusion
Based on the results of the analysis and observation, the implementation of RDWD sanitation hygiene in the Lembursitu Sub-District is quite good in terms of location, equipment, handlers, and quality of drinking water.However, from the total results of the physical inspection in the format provided in Regulation of the Minister of Health No. 43 of 2014 concerning Sanitation Hygiene of Drinking Water Depots, only two depots met the physical eligibility standards, namely Depot 1 and Depot 5.
[4].Sampling of processed water at each depotPhysical (turbidity, odor, and taste), chemical (pH, fluoride), and bacteriological (total coliform and Escherichia coli) factors were all examined.2.5.Analysis of the implementation of RDWD sanitation hygiene according to the regulation of the Minister of Health No. 43 of 2014Observing the implementation of sanitation hygiene by looking at various aspects, namely: Aspects of Place, Aspects of Equipment, Aspects of Handlers, Aspects of Raw Water and Drinking Water.A guidebook for the implementation of hygiene and sanitation in drinking water depots published by the Directorate of Environmental Sanitation, Ministry of Health in 2010 served as the basis for the observation guidelines employed in this study[4].The initial analysis involved testing four RDWDs' replenish drinking water for physical factors (turbidity, odor, and taste), chemical parameters (pH and fluoride), and bacterial parameters (total coliform and Escherichia coli).And for the second analysis, sanitation and hygiene practices at drinking water depots were observed.The data collection tool in this study was a checklist or observation sheet with several lists of questions made based on RDWD sanitary inspections by the regulation of the Minister of Health No. 43 of 2014 concerning Sanitation Hygiene of Drinking Water Depots.
Table 2 displays the outcomes of the testing of physical parameters.According to Table 2, all depots (100%) comply with the requirements of the regulation of the Minister of Health No. 492 of 2010 about Drinking Water Quality Requirements

Table 2 .
The result of physical parameter testing.

Table 2 ,
all depots (100%) comply with the requirements of the Regulation of the Minister of Health No. 492 of 2010.The measurement results at each research location showed that the turbidity value of each drinking water at each depot was 0 NTU with a maximum permissible level of 5 NTU.

Table 3 .
The result of chemical parameter testing.

Table 4 .
The result of Escherichia coli.

Table 5 .
The result of Total Coliform.

Table 6 .
Observation results of the physical examination of the RDWDs.