water

Review
Review of Slow Sand Filtration for Raw Water Treatment with
Potential Application in Less-Developed Countries
Kaldibek Abdiyev 1, * , Seitkhan Azat 1, * , Erzhan Kuldeyev 1 , Darkhan Ybyraiymkul 1 ,
Sana Kabdrakhmanova 1 , Ronny Berndtsson 2, * , Bostandyk Khalkhabai 1 , Ainur Kabdrakhmanova 1
and Shynggyskhan Sultakhan 1

1 Satbayev University, Satbayev St. 22a, Almaty 050013, Kazakhstan; [email protected] (E.K.);
[email protected] (D.Y.); [email protected] (S.K.); [email protected] (B.K.);
[email protected] (A.K.); [email protected] (S.S.)
2 Division of Water Resources Engineering, Lund University, Box 118, SE-22100 Lund, Sweden
* Correspondence: [email protected] (K.A.); [email protected] (S.A.);
[email protected] (R.B.)

Abstract: Providing safe drinking water to people in developing countries is an urgent worldwide
water problem and a main issue in the UN Sustainable Development Goals. One of the most
efficient and cheapest methods to attain these goals is to promote the use of slow sand filters. This
review shows that slow sand filters can efficiently provide safe drinking water to people living
in rural communities not served by a central water supply. Probably, the most important aspect
of SSF for developing and less-developed countries is its function as a biological filter. WASH
problems mainly relate to the spread of viruses, bacteria, and parasites. The surface and shallow
groundwater in developing countries around urban areas and settlements are often polluted by
domestic wastewater containing these microbes and nutrients. Thus, SSF’s function is to treat raw
water in the form of diluted wastewater where high temperature and access to nutrients probably
mean a high growth rate of microbes and algae but probably also high predation and high efficiency
Citation: Abdiyev, K.; Azat, S.;
of the SSF. However, factors that may adversely affect the removal of microbiological constituents
Kuldeyev, E.; Ybyraiymkul, D.;
are mainly low temperature, high and intermittent flow rates, reduced sand depth, filter immaturity,
Kabdrakhmanova, S.; Berndtsson, R.;
and various filter amendments. Further research is thus needed in these areas, specifically for
Khalkhabai, B.; Kabdrakhmanova, A.;
Sultakhan, S. Review of Slow Sand
developing countries.
Filtration for Raw Water Treatment
with Potential Application in Keywords: slow sand filtration; developing countries; microbes; turbidity; safe drinking water
Less-Developed Countries. Water
2023, 15, 2007. https://doi.org/
10.3390/w15112007
1. Introduction
Academic Editors: Ioannis Sarris
and Vasileios Bartzis In view of population increase and climate change, the issue of providing everyone
with safe drinking water is one of the most acute problems in the world. In addition, the
Received: 24 April 2023 rapid development of industry and emerging pollutants increase the risk of water pollution
Revised: 15 May 2023
by substances harmful to human health. More than 1 billion people do not have access to
Accepted: 22 May 2023
safe drinking water, and 80% of them live in rural areas [1,2]. The greatest risk associated
Published: 25 May 2023
with the ingestion of water is harmful microbial infection risk due to human and/or animal
fecal contamination. Drinking contaminated water and poor hygiene are the major causes
of death among children worldwide, after respiratory disease [3]. Annually, more than half
Copyright: © 2023 by the authors.
a million deaths in low- and middle-income countries are due to drinking poor-quality
Licensee MDPI, Basel, Switzerland. water [4]. Water, sanitation, and hygiene (WASH) problems cause stunted children and
This article is an open access article great economic losses in the developing world.
distributed under the terms and Slow sand filtration (SSF) has historically been one of the most important methods to
conditions of the Creative Commons treat water for drinking and eradicate WASH problems. Due to its efficiency and low cost,
Attribution (CC BY) license (https:// SSF is still considered an effective and inexpensive way to provide clean drinking water in
creativecommons.org/licenses/by/ developing countries with limited resources. SSF is recognized by the U.S. Environmental
4.0/). Protection Agency (USEPA) and WHO as an inexpensive and reliable way to provide

Water 2023, 15, 2007. https://doi.org/10.3390/w15112007 https://www.mdpi.com/journal/water

Water 2023, 15, 2007 2 of 22

safe drinking water [5,6]. Therefore, this method is still used in rural areas and even
in some larger cities of the world to provide the population with good-quality drinking
water [7]. Characteristic features of SSF are simple construction, low energy consumption,
low filtration rate, no chemical pre-treatment of water, and cleaning of filtering layers by
scraping the surface or sand removal [8]. However, surprisingly, only about half a million
people in developing countries at present use SSF for drinking purposes [7].
In view of the above, the objective of this review article was to critically summarize
and synthesize the features and advantages of SSF methods for developing countries to
improve the quality of drinking water. Recently, Maiyo et al. [9] provided a comprehensive
review of SSF with applications to drinking water. Their review prioritized aspects on
the removal of turbidity and microbes with general applications in developing countries.
However, our review particularly emphasizes developing countries and specific aspects
of SSF that are important for these countries such as temperature effects, pollutant load,
and modifications to the filter media. Many developing countries are located in the tropics
and subtropics. However, less-developed countries are also located in temperate and
continental climates where diurnal or seasonal temperature may go well below 0 ◦ C. This
is expected to significantly affect the biological function of SSF methods; therefore, it is
important to summarize the existing literature on temperature effects. Since surface and
groundwater are increasingly affected by wastewater pollutants, especially in developing
countries where wastewater often is not properly treated before discharge, it is important
to review the effects of varying pollutant loads on SSF methods. For example, algae blooms
and related pollutants can be pronounced phenomena in warm and sunny climates. Finally,
intermittent raw water delivery to the SSFs may be expected in developing countries
due to the appearance of long dry periods and high-intensive rainfalls. This will also
significantly affect the function of SSF. As well, optimal sand quality with proper particle
size distribution may not be readily available, and the pollutant kind and load of raw water
may differ distinctly between different regions and geologic and anthropogenic settings. It
is therefore pertinent to review how amendments to SSF can be made.
The literature search was carried out using keywords related to the above discussion
using Web of Science and Google Scholar including SCI and SSCI indexed papers, research
reports, and studies up to 2023. The reference lists of the research literature found were
further studied to complement the Internet search. These searches included both the English
and Russian languages. This resulted in about 300 potentially interesting publications, out
of which 147 were finally selected (see References). Consequently, we start by giving a brief
introduction to the main raw water purification methods that are often used in combination
with SSF. Then, SSF characteristics and function depending specifically on temperature,
raw material of filter media, and typical pollutant load characteristics for less-developed
countries are summarized and reviewed. We close with a conclusion and a reflection on
research needs to further improve SSF methods with application to developing countries.

2. Contemporary Raw Water Purification Methods

To date, there are various methods of treatment of raw water for drinking purposes.
These can be combined with SSF depending on the type of pollutant and pollutant load and
can be applied in developed as well as developing countries. Which treatment method to
be used to treat the water depends on its chemical composition, turbidity, size of particles
(impurities) present, and purpose of use and distribution system to end users. Below
follows a brief description of the main methods used to treat raw water.

2.1. Mechanical Filtration

Mechanical filtration, such as SSF, is considered the simplest among the known meth-
ods of water purification. This method is usually used to purify water of turbidity and
various insoluble substances. For this purpose, the water to be treated is passed through a
porous medium constituting a filter or a grid. Various solids and filters (sand, gravel, clays,
zeolites, bentonites, activated carbon, etc.) are used as a permeable porous medium [10–12].
Water 2023, 15, 2007 3 of 22

Normally, the size of the detained (not passing through the filter) particles must be larger
than the diameter of “holes” between the filtering particles or grid gaps. However, if the
diameter of homogeneous spherical filter particles is equal to d, particles with a diameter
more than 0.15 × d may not pass through the filter pores. When passing water through a
column filled with powdered activated carbon with particle sizes of 0.1–1 mm, particles of
about the same size are detained.
With purely mechanical filtration, it is often difficult to treat water contaminated with
microorganisms, bacteria, and viruses due to their size range of 0.005 to 3 × 10−3 mm. The
mechanical filtration method is usually used for the pre-treatment of water taken from open
water bodies (rivers, lakes, reservoirs) containing relatively large particles of pollutants. In
mechanical filtration, the treated water usually passes through the filter by gravity [13].

2.2. Reverse Osmosis

In reverse osmosis, water is passed through a membrane under pressure. The water
passes freely through the membrane while other substances present in the water are
retained [14]. Using this method, water can be purified of various (even from monovalent)
ions, obtaining water of high quality (by composition close to distilled water). However,
this method has several drawbacks [15,16]. First, this method has low selectivity, i.e.,
all “useful” and “harmful” substances for the human body are retained during water
purification by the membrane. Therefore, to use water purified by this method as drinking
water, it will be necessary to repeatedly add salts needed for the body. Secondly, the cost of
reverse osmosis units is relatively high, and the productivity of the process is usually rather
low (20–30 L/day). Thirdly, before using reverse osmosis, the water must be cleaned of
relatively large mechanical impurities by filtration. Because large particles clog the pores of
the membrane, the performance of the process drops, and the service life of the installation
is dramatically reduced.

2.3. Ion Exchange

This method is based on the ion-exchange process occurring between water and the
sorbent (ion-exchange resin) [17,18]. The ion exchange method can selectively purify water
of ions. For this purpose, the raw water is passed through the sorbent (ion exchanger).
In this case, the ions present in the water are adsorbed on the surface of the sorbent, and
the water from the ion-exchange resins is transferred to an equivalent number of ions
with the same charge with respect to the adsorbed ions. For example, the ion exchange
process is often used to eliminate water hardness (to reduce the concentration of Mg2+ and
Ca2+ ). For this purpose, ion exchangers (cation exchangers) containing a harmless cation
(e.g., Na+ ) are used. When hard water is passed through the cation exchange resin, an ion
exchange process occurs between the water and the ion exchange resin, because of which
the calcium and magnesium cations present in the water are adsorbed on the surface of
the cation exchange resin, and sodium cations from the ion exchange resin are transferred
to the water. The ion exchange process is often used to remove heavy metal cations from
water and to extract various ions from industrially polluted water [19–21]. The efficiency
of the ion-exchange process for water treatment largely depends on the exchange capacity
of the sorbent, i.e., the ability of the sorbent to adsorb a certain amount of ions from the
solution composition, and on the cost of regeneration of the spent sorbent.

2.4. Electrochemical Purification

Electrochemical treatment is based on passing a strong electric current through the
water to be treated [22,23]. When an electric current is applied, substances in the water
participate in redox reactions (electrolysis), because of which they are transformed into
other “harmless” substances. The electrochemical method is more efficient in terms of
economy, and its performance is very high. With this method, it is possible to purify
water of almost all microorganisms and obtain high-quality water [24]. However, if the
water contains various organic substances, under the influence of a strong current, they
Water 2023, 15, 2007 4 of 22

can undergo complex changes, resulting in the formation of harmful substances to the
environment. Therefore, before using this method, it is necessary to know in advance what
substances the impurities present in the composition of water can be transformed into
during electrolysis.

2.5. Distillation
The distillation method is based on the conversion of water to steam by heating the so-
lution and then condensing the water vapor [25,26]. With this method, water can be cleaned
of dissolved solid impurities, resulting in chemically pure (distilled) water. However, this
method is expensive and the components (salts) necessary for human organism should be
added to the distilled water to be used as drinking water. The main disadvantage of this
method is the inability to purify water of low volatile organic substances by distillation.
Therefore, to remove volatile organic compounds, the water is usually first passed through
an adsorbent (e.g., activated carbon).

2.6. Sorption
Sorption refers to the adsorption by solid particles of components of gas mixtures and
liquid solutions [27–29]. In this method, for the purpose of treatment, contaminated water
is passed through a vessel filled with sorbent medium. The impurities in the water are
adsorbed on the surface of the sorbent particles, and the purified water flows out from the
bottom of the sorbent. In this method, the degree of water purification depends on many
factors: size of the particles (specific surface area) of the adsorbent, nature of the interaction
of components present in the water with the adsorbent surface, pressure, and temperature.
With decreasing particle size (with increasing specific surface area), the sorption capacity of
a solid increases dramatically. Various substances can be used as adsorbents, e.g., zeolites
or activated carbon [30,31]. To date, the most common sorbent for water treatment is
activated carbon. By activation, the specific surface area of carbon can be increased up to
1000–1500 m2 /g. Activated carbon can be used to purify water of substances of different
chemical natures. Therefore, activated carbon is one of the main sorbents used in many
commercial filtration plants today.

2.7. Coagulation and Flocculation

Coagulation and flocculation are processes of precipitation of suspended dispersed
particles present in solutions by adding electrolytes (coagulants) and water-soluble poly-
mers (flocculants) [32–35]. They can be used to concentrate impurities in a flocculent
form, which can be easily removed by sedimentation. Introduction of coagulants into a
suspension leads to a reduction in the electrostatic repulsion force of dispersed particles
due to the neutralization of surface charges and reduction in electro-kinetic (zeta) potential
of particles. Flocculation is a form of coagulation, when fine suspended dispersed particles
in a liquid or gaseous medium form loose flocculated clusters, i.e., floccules. Natural [36,37]
and synthetic water-soluble polymers [38,39] and their polycomplexes [40,41] are used as
flocculants for raw water treatment.

2.8. Disinfection
Disinfection is performed to kill off remaining microbes such as bacteria, parasites,
and viruses after standard treatment. Chlorination is used to prevent the spreading of
waterborne diseases such as cholera, dysentery, and typhoid. Raw water chlorination is
usually performed by adding chlorine or chlorine compounds such as sodium hypochlorite.

3. Slow Sand Filtration

3.1. History
Filtration methods are traditional techniques of water purification used by mankind
since ancient times. By filtering, water can be cleaned of sand, silt, turbidity, scale, and
other suspended particles. According to [42], people have used sand and gravel filters as
Water 2023, 15, 2007 5 of 22

early as 2000 BC in ancient India. In ancient times, the Romans built canals near lakes to
take advantage of natural filtration through the canal walls.
Modern slow sand filters (SSFs) for water purification were first used in the 19th
century in England. Therefore, they are often called English filters. The first slow filter
was built by the English engineer James Simpson in 1829 in London to purify water from
the river Thames [43,44]. However, various designs of sand filters were used for water
purification in earlier years in several Scottish cities: Paisley (1804), Glasgow (1807), and
Greenock (1827) [45,46]. In Berlin, slow filters were built in 1853, in Warsaw in 1880,
and in Moscow in 1902 [47]. In the United States, the first SSFs were built in 1872 at
Poughkeepsie, New York [48,49], which operated until 1959 [50]. Thus, slow filtration of
water has been an effective way to prevent the spread of various gastrointestinal diseases
through drinking water for over 150 years [51,52]. In 1855, John Snow, in his essay “On the
Means of Transmitting Cholera”, suggested a correlation between the spread of the cholera
epidemic and the quality of the water supply in Soho [53].
According to Wegelin [54], “no other simple purification process can improve the
physical, chemical, and bacteriological quality of surface waters better than SSF.” In 19th
century Europe, SSF of water was recommended as one of the effective ways to prevent
the spread of an infectious disease, the cholera epidemic [55]. SSFs can eliminate 90–99%
of bacteria and viruses, remove 93.3% of fecal coliforms, and completely remove Giardia
lamblia cysts and Cryptosporidium oocysts [1]. In view of its efficiency for basic raw water
treatment and low-cost characteristics, it is noteworthy that only about half a million
people in developing countries use SSFs to obtain a basic quality of drinking water [7,51].
Obviously, SSF has a much larger role to play in this regard to help reach the UN Sustainable
Development Goals.

3.2. SSF Requirements

A distinction can be made between rapid sand filtration and SSF of water [56–58].
SSFs have an effective particle size diameter of 0.15–0.35 mm and a uniformity factor of
1.5–3.0. The effective particle size for trapping in fast filters is greater than 0.55 mm, with
a uniformity factor of less than 1.5. The water filtration rate in fast filters varies between
4 and 21 m/h (100–475 m3 × m−2 × day−1 ) [59] and in SSF varies from 0.1 to 0.4 m/h
(1–8 m3 × m−2 × day−1 ) [60]. The difference between these two methods is not only in
the filtration rate but most importantly in the technology of water purification. Table 1
provides a list of particles frequently present in raw water [61]. Table 1 can represent a
typical surface water source in a developing country affected by untreated wastewater
since the contents include various kinds of microbial pollutants.

Table 1. Examples of elements found in raw water [61].

Category Group/Name Size (µm)

Clays (colloidal) 0.001–1
Mineral Silicates No data
Non-Silicates No data
Viruses 0.001–0.1
Bacteria 0.3–10
Algae, unicellular 30–50
Biological Giardia cysts 10
Parasite eggs 10–50
Nematode eggs 10
Cryptosporidium oocysts 4–5
Amorphous debris, small 1–5
Other particles
Organic colloids No data

SSF refers to biological water treatment methods, although filtering also refers to a
mechanical and chemical (inertial collision and attachment, diffusion, adsorption, and
Water 2023, 15, 2007 6 of 22

sedimentation) separation of dispersed particles [61]. Fast sand filtration is a purely

mechanical method of water treatment. Fast sand filters remove mainly relatively large,
suspended particles. Fast sand filters can be either operated by gravity or pressure. SSF is
an effective way to remove microbial contaminants and bacteria as well [62,63]. Particles
are mainly removed in the upper part of the sand layer (schmutzdecke layer—German
for “dirt layer”) [64]. Nonpathogenic aerobic microorganisms deposited on the surface of
the sand filter can metabolize organic matter that enters the filter with the incoming water.
These microorganisms can prey on bacteria and viruses present in the water [9].
The biological treatment functioning of the SSF is especially important in developing
countries where wastewater and greywater usually are discharged without prior treatment.
However, most surface water microbial quality studies have been performed for developed
countries and temperate climates [65]. Thus, the dynamic distribution of pathogens is
poorly quantified for developing countries. Usually, the same indicator organisms (com-
monly fecal coliform, E. coli and Enterococci) are used in both developed and developing
countries. However, the indicator organisms for, e.g., temperate regions, may not be
completely relevant for tropical regions. In warmer climates, the foremost waterborne
pathogens can be V. cholerae, Salmonella, Shigella, C. perfringens, cyanobacteria, Entamoeba,
rotavirus, and Giardia [65,66].
SSFs represent many advantages over other water treatment methods. They do not
require chemical reagents and qualified specialists, are easy to operate, and have minimal
maintenance and manpower requirements, low capital and operating costs, and low energy
requirements [67–69]. For this reason, SSF has found widespread use in rural areas to
provide good-quality drinking water [70]. However, there are some limitations, e.g., SSF
is not recommended for water treatment with turbidity greater than five nephelometric
turbidity units (NTU), because high turbidity can lead to filter clogging and thereby shorten
the life of the filter [71]. Apart from turbidity, for successful application of SSF treatment,
chlorophyll content in feed water must be <0.05 µg/L; iron and manganese must not
exceed 0.3 and 0.05 mg/L, respectively. The quantity of dissolved heavy metals, pesticides,
and colorants must be minimal, and the presence of residual oxidant before filtration is
not desired [71]. At the same time, SSFs are better at purifying water contaminated with
non-clayey impurities [72].
In Saskatchewan, Canada [73], a modular SSF polyethylene system was developed
and tested that incorporated pre-treatment and post-treatment processes such as ozone
oxidation, pre-treatment, and biological activated carbon (BAC) filters to provide signif-
icant reduction in turbidity, heavy metals, color, and organics. In the initial period, the
filtration efficiency without the schmutzdecke layer may not be more than 60% [52]. Several
studies [74,75] summarize work on the modification of SSFs, which help to eliminate the
limitations of the application of this method.
Currently, for the preparation of potable water in many cases, chemical methods of
treatment are used. However, the use of reagent methods at small treatment plants may
create problems associated with the lack of qualified specialists and with the high cost
of equipment and chemical reagents used for water treatment. These facts lead to the
conclusion that reagent-free water treatment methods often are better-suited for rural areas
in developing countries.

3.3. SSF Biological Processes

There are two important mechanisms regarding the filtration of particles and mi-
croorganisms through a slow sand layer: the transport mechanism and the attachment
mechanism [75]. According to the transport mechanism, particles in water that are larger
than the pore diameter of the sand layer cannot pass through the filter and are retained
on the surface of the sand layer. Larger particles are mainly retained by the transport
mechanism. However, as the particles settle and the biofilm schmutzdecke “matures”
on the surface of the sand layer, the pore diameter of the sand filter gradually decreases.
Because of this, particles and microorganisms much smaller than the pore diameter of the
 the pore diameter of the sand layer cannot pass through the filter and are retained on the
surface of the sand layer. Larger particles are mainly retained by the transport mechanism
However, as the particles settle and the biofilm schmutzdecke “matures” on the surface
of the sand layer, the pore diameter of the sand filter gradually decreases. Because of this
Water 2023, 15, 2007 particles and microorganisms much smaller than the pore diameter of the sand 7 of 22 bed can

be retained on the surface of the sand bed [76]. The particles (microorganisms) present in
the water adhere to the sand layer surface through Van der Waals or electrostatic forces
of attraction
sand bed can be[77,78]. Inon
retained this
thecase, theofformation
surface of chemical
the sand bed (e.g., hydrogen)
[76]. The particles bonds between
(microorganisms)
present in the water adhere to the sand layer surface through Van der Waals or electro-
particles and solid surface cannot be excluded as well [79,80]. Bacteria (size 0.01–10 µm
static forces of attraction [77,78]. In this case, the formation of chemical (e.g., hydrogen)
[81], viruses (0.01–0.1 µm) [82,83], and colloidal particles (0.001–1 µm) [77] are mainly re
bonds between particles and solid surface cannot be excluded as well [79,80]. Bacteria (size
tained by this
0.01–10 µm) [81],mechanism.
viruses (0.01–0.1 µm) [82,83], and colloidal particles (0.001–1 µm) [77] are
mainly retained by this mechanism.
3.4. General Design of SSF
3.4. General Design of SSF
Traditional slow filters are usually tanks up to 6 m wide, up to 60 m long, and consisting
of four layers (Figure
Traditional 1) [9]. Drainage
slow filters are usually is placed
tanks upon to
the6bottom
m wide, of up
the to
tank.
60 Hollow
m long, pipes,
and bricks
consisting of four layers (Figure 1) [9]. Drainage is placed on the bottom of the tank.
or concrete slabs with gaps are usually used as drainage [75,80]. A supporting layer (approxi
Hollow pipes, bricks, or concrete slabs with gaps are usually used as drainage [75,80]. A
mate thickness of 0.5 m) of gravel, pebbles, or crushed stone is placed on the surface of the
supporting layer (approximate thickness of 0.5 m) of gravel, pebbles, or crushed stone
drainage.
is placed on Thetheparticle
surfacesize of the
of the supporting
drainage. The layer cansize
particle varyof from 2 to 30 mm.
the supporting Above
layer can the sup
porting
vary from layer, a filtering
2 to 30 mm. Above layertheof supporting
sand (thickness
layer,450–1250
a filteringmm) layerisofplaced with a developed
sand (thickness
surface and high porosity. The sand particle size can vary from
450–1250 mm) is placed with a developed surface and high porosity. The sand particle 0.2 to 2 mm [84,85].
size On the
surface
can varyof the0.2
from filtration
to 2 mm layer, theOn
[84,85]. supernatant
the surfacewater
of the is located.layer,
filtration The thesupernatant
supernatant layer mus
provide the necessary head to filter water through the porous sand layer [8]. The flow rate can
water is located. The supernatant layer must provide the necessary head to filter water
be regulated
through by changing
the porous sand layerthe
[8].difference between
The flow rate can be the head of
regulated by the supernatant
changing water and the
the difference
between the head of the supernatant water and the height at which the discharge pipe is
height at which the discharge pipe is open to the atmosphere.
open to the atmosphere.

Figure 1. Schematic of a general SSF design (adapted from Wikimedia Commons).

Figure 1. Schematic of a general SSF design (adapted from Wikimedia Commons).
It is regarded that a sand layer thickness of 0.3 m is sufficient for the proper removal
It is regarded
of turbidity that abacteria
and coliform sand layer
and athickness
thickness of
of 0.3 m for
0.6 m is sufficient for the
the significant proper
removal of remova
of turbidity
virus from theand coliform
water bacteria
composition [80].and a thickness
Changing of 0.6 moffor
the thickness thethe
sandsignificant removal o
layer affects
virus
the from rates
removal the water composition
of bacteria and viruses.[80].
ForChanging
example, athe thickness
decrease of layer
in sand the sand layer affect
thickness
from 0.6 m to 0.3 m resulted in a 0.04% decrease in poliovirus removal (from 99.98% to
99.94%) [9,86] and a 2% decrease in coliform removal (from 97% to 95%) observed when
filter layer thickness was reduced from 0.97 m to 0.48 m [61,87].
Depending on the weather conditions, the slow-filter tank can be located outdoors or
indoors. During the cold winter period, it is recommended to conduct the filtration process
indoors, especially at subzero temperatures when the filter may not work at all. Over time,
as the biofilm thickens, the SSFs gradually lose their efficiency and the flow rate through
the filter decreases. In this case, it is necessary to rebuild the filter. As a rule, the duration
of an SSF is from 30 to 60 days, but sometimes it can reach more than 100 days [75,80]. This
depends on the water flow and pollutant load. Water containing algae is known to clog up
Water 2023, 15, 2007 8 of 22

SSF in short periods of time. This may be a specific problem in developing countries with
surface water containing nutrients.

3.5. SSF Regeneration

There are two main methods of filter layer regeneration: (1) removal of the upper
contaminated layer of sand and (2) washing of the contaminated sand surface layer directly
in the filter by mechanical or hydraulic loosening and removal of contaminants by a
stream of clean water (wet harrowing) [88,89]. In the first method, the top layer of sand
is periodically (2–3 times a month) removed and washed several times with clean water.
After that, the cleaned sand is loaded back into the tank. After cleaning the filter, it takes
some time for the filter to regain its full treatment capacity. Depending on which of the
above methods are used, it is expected that this time is several weeks to about a month
depending on the external environment [9].

3.6. SSF Speed Mode

The slow filtration rate depends on the suspended solids content of the raw water. At
a particle concentration of not more than 25 mg/L, the filtration speed is 0.08–0.4 m/h [88],
and at a particle concentration exceeding 25 mg/L, the filtration speed varies from 0.1 to
0.2 m/h.
Contaminated water in slow filters is purified with the help of the biological schmutzd-
ecke film or hypogeal layer that forms on the surface of the filtering sand layer of algae,
bacteria, and settled contaminant particles [61,76,90–94]. The duration of filter maturation
significantly affects the rate and degree of removal of microbial and organic contaminants
by the filter [7,86]. An effective biological film forms during the first 10–40 days of the SSF
process of water [7,95–97] as mentioned above and provides detention of up to 90–98% of
highly dispersed solids, bacteria [88], reduction in fecal coliform bacteria, turbidity per
log10 [94], and reduction in total coliforms and turbidity to 97% [98]. A low filtration rate
is necessary for complete biological processes in the filter [99,100].
SSF can remove pathogenic microorganisms, suspended organic and inorganic con-
taminants [84,101], turbidity [101], bacteria, viruses, and enteroparasite cysts [86,101,102].
Meanwhile, the main biological mechanisms responsible for the removal of bacteria in slow
sand filters are predation by algae, eating detritus by aquatic worms, natural mortality,
inactivation, metabolic breakdown, and adsorption on the sticky zoogleal surface of the
sand [92,100–103].
The sorption capacity of the schmutzdecke layer is estimated through the sorption
coefficient (Kd ), which is calculated using [104]:

Cs
Kd = (1)
Ce

where Cs is the milligram of sorbed antimicrobial per kilogram of solid, mg/kg; Ce is

the aqueous antimicrobial concentration mg/L after 24 h equilibration. Sorption coef-
ficients are normalized to the share of organic carbon (Koc = Kd /foc ) and organic matter
(Kom = Kd /fom ) where foc and fom are the mass fraction of organic carbon and organic matter
in the schmutzdecke layer, respectively.

3.7. Influence of Filter Media and Hydraulic Residence Time

The size and homogeneity of sand particles essentially influence the efficiency of
water purification with an SSF [45]. The homogeneity of the particles is determined by
the homogeneity coefficient. The homogeneity coefficient of sand is defined as the ratio:
coarseness at which 60% (by weight) of the sand sample passes through the sieve divided
by the coarseness at which 10% of the same sample (by weight) passes through the sieve,
i.e., K60/10 = d60 /d10 . A uniformity factor of one means that all particles are the same size.
As the uniformity of the sand particles increases, the filtration efficiency increases. If the
sand particles vary greatly in size, the smaller sand particles will fill the gaps between the
Water 2023, 15, 2007 9 of 22

larger particles, resulting in filter clogging [105]. The most effective sand particle size for
slow filtration is 0.15–0.35 mm and a uniformity factor of less than two [106].
The thickness of the sand layer has a significant influence on the degree of removal of
contaminants from the water composition by the method of SSF. It is generally assumed
that the thicker the sand layer, the greater the retention of fine and colloidal particles and
viruses and the better the discoloration of water. According to [107], a sand layer 200 mm
thick removes 99.5% of fecal bacteria. The minimum thickness of the sand layer to remove
turbidity and coliform bacteria is 300 mm, while 600 mm sand thickness is sufficient to
remove all viruses [80].
According to [9], the key design parameter of SSF controlling water quality is the
filter’s hydraulic residence time (HRT). HRT is determined by:

HRT = V × n/Q (2)

where Q is the water volume flow rate, m3 /h; V is the total sand volume, m3 ; and n is the
sand porosity. The porosity of sand usually ranges from 0.35 to 0.50. This means that 35 to
50% of the volume of the active filter is water in contact with microorganisms attached to
the sand grains. Reducing the sand particle size increases the water–sand contact surface
area and the porosity of the material. On the other hand, a wide range of particle sizes
reduces the porosity of the sand layer, which leads to lower HRT. Therefore, the sand must
have a sufficiently high homogeneity. According to [9], the use of a sand layer consisting of
particles with a size of 0.35–1.5 mm provides a high degree of water purification at HRT
from 8 to 12 h.

3.8. Purification of Water of Ions, Bacteria, and Microbes

SSF can also be used to purify water of ions. However, there are chemical impurities
that cannot be effectively removed by SSF alone. These include sulfate (SO4 2− ), nitrate
(NO3− ), sodium (Na+ ), calcium (Ca2+ ), and magnesium (Mg2+ ) ions and water hardness
(as CaCO3 ) [108,109]. According to [109], biological treatment converts most ammonium
ions (NH4 + ) to nitrate ions (NO3 − ). In addition, stable colloidal particles are also difficult
to remove by SSF [72,73].
In the last two decades, so-called bio-sand filters (BSFs) have become widespread.
For example, the company CAWST (Center for Accessible Water Supply and Sanitation
Technology) in Calgary, Canada, has developed concrete filters made of bio-sand, which are
used in 450 organizations in more than 55 countries [52,74]. Triple Quest of Grand Rapids,
USA, offers bio-sand filters: 60 L HydrAid filters made of plastic [9]. Plastic bio-sand filters
are relatively cheap and lighter than concrete BSFs [110–112]. The authors [9] proposed a
modified household plastic filter (BSF). In the new filter design, the gravel layer is replaced
by a thin porous plastic plate placed in a plastic bag. This replacement reduces the required
filter media and increases the total pore volume in the core. As a result, the cost and labor
required to install and maintain the filter is reduced.
A study [113] proposed a household SSF for the removal of As, Fe, and Mn from
the composition of groundwater for rural areas in Vietnam. The sand for filtration was
collected from the banks of the Red River. It was found that nitrate-reducing, Fe(II)-
oxidizing, and Fe(III)-reducing bacteria were present in the dry sand, while microaerophilic
Fe(II)-oxidizing bacteria were absent. Mn-oxidizing bacteria were found in the composition
of the dry sand. Based on the analysis of the composition of the microbial community, the
authors concluded that the abiotic processes of oxidation of Fe(II) prevail over the biotic
oxidation of Fe(II) on the filter. Moreover, Mn-oxidizing bacteria played an important
role in Mn(II) oxidation and deposition of Mn(III/IV) oxide in a separate layer of the
sand filter. The formation of Mn(III/IV) oxides promoted abiotic oxidation of As(III) and
immobilization of As(V) by sorption onto (oxy-hydro) oxides of Fe(III). This resulted in a
significant reduction in As, Fe, and Mn concentrations in filtered groundwater.
In several studies [114–116], the design and principle of operation of a slow self-
cleaning filter for natural water deferrization were proposed. A Birm Regular filter was
Water 2023, 15, 2007 10 of 22

used as a filter load, which simultaneously acts as a catalyst for the reaction of oxidation of
Fe2+ by oxygen to Fe3+ . Trivalent iron cations are hydrolyzed to Fe(OH)3 , and then posi-
tively charged colloidal particles of Fe(III) hydroxide are formed [117]. Positively charged
colloidal particles of iron (III) hydroxide are adsorbed on the negatively charged surface
of the particles of filter media, resulting in the formation of a dense, gel-like adsorption
layer on the surface. Such a layer is an effective filtering material. The concentration
of Fe(OH)2 varied from 6.0 to 16 mg/L in the model’s natural water (simulant). It was
established that the output of the filter to the working mode at Fe3+ concentration in the
model solution of 16.0 mg/L was not more than 2.0 h. The analysis of the experimental
data obtained for water with an iron concentration of 16.0 mg/L showed that at the first
stage of filter operation the Fe3+ concentration in the treated water decreased from 16.0 to
0.9 mg/L after 20 min of filtration, and after 1.5 h it was 0.1 mg/L. The maximum allowable
concentration for Fe3+ in drinking water is 0.3 mg/L [118]. According to the authors, the
use of the proposed design for the pre-treatment of water contaminated with iron ions will
significantly reduce the load on the stage of the final purification of water of iron.
In [119], the possibility of removing cyanobacterial hepatotoxins (microcystins) from
the composition of water taken from Berlin lakes using SSFs was studied. Two full-scale
experiments were performed: One experiment was performed with dissolved microcystins
extracted from a cyanobacterial flower in one of the Berlin lakes. The second experiment
was performed with a longer exposure of live cyanobacterial cells (collected from the same
lake) to the filter. It was found that the experiment with dissolved microcystins revealed
high rates of microcystin elimination (95%) within the sand filter bed and with a half-life
for microcystins of about 1 h. In the second experiment, where cell-bound microcystins
were used, rather good results (elimination of 85%) were also obtained in the first days after
application of cyanobacteria. However, as the temperature decreased to 4 ◦ C, elimination
decreased to 60%, which, according to the authors, is associated with a slowing down of
bacterial biodegradation at low temperature. Thus, it was concluded that at moderate plus
temperatures, slow filtration through sand can serve as an effective method of removing
microcystins from drinking water composition.
In [104], the efficiency of removal of water-soluble antimicrobials such as sulfamet-
hazine (SMZ), tylosin (TYL), sulfamethoxazole (SMX), trimethoprim (TRI), and lincomycin
(LIN) from water in rural areas by SSF was studied. Basalt sand was used as filtering
material. Water-soluble antimicrobials are used in livestock and poultry production to
promote growth and prevent bacterial infections. In rural areas, surface water may be
contaminated by antimicrobials from wastewater or by diffuse contamination from the
application of manure and processed biological solids containing antimicrobial residues
to the soil [120–122]. Experiments were carried out using coarse (fast) and SSF methods.
The coarse filter showed low antimicrobial removal efficiency. SSF showed effectiveness
in removing antimicrobials, with the sorption of drugs on the surface of the filter layer
changing as follows: TYL > TRI > LIN > SMX > SMZ. At the end of the 14-day period of
the SSF study, the following results were obtained: >99% TRI removal, <25% LIN removal,
and <4% sulfonamide antimicrobial removal from the contaminated river water.
In [60], slow and fast sand filtration methods were used to remove Triactinomyxon
actinospores (Tams) of the salmon parasite Myxobolus cerebralis from contaminated water.
Sand with a particle diameter of 0.180 mm was used as the filter material. The sand cushion
of the filter was 17.8 cm, and the support gravel was 17.8 cm. Aquarium fish were used
as targets of Tams infestation. Tams were introduced into fish-rearing systems over sand
filters. The rapid filtration method was tested with two backwashing regimes. In the first, a
continuous backwash was performed, and in the second, flow was diverted past the fish
tanks for 5 min after backwashing. SSF through a sand filter without backwashing served
as a control for the two fast filters. After 60 days, clinical signs of circling behavior and
black tails were seen among the positive controls. Polymerase chain reaction (PCR) analysis
for Myxobolus cerebralis showed that infections were absent in both fast sand filter water
treatments, whereas 1.6% of all fish were infected with the SSF treatment. Based on these
Water 2023, 15, 2007 11 of 22

results, the authors concluded that both fast and SSFs can be used to remove Tams from the
water composition, and the backwash method is important for the reliable functioning of
fast sand filters [60].
Studies have indicated different removal mechanisms for bacteria and viruses in
SSF. In [123], it was found that most of the E. coli was removed through filtration by
the schmutzdecke. Consequently, the residence time in the SSF’s biologically active part
had no significant effect on the E. coli removal. On the other hand, most MS-2 viruses
were removed through longer residence time and effects in the biologically active layer.
The schmutzdecke filtration did not have a significant effect on the MS-2 virus removal.
However, ZVI (zero-valent iron as a waste byproduct from the iron industry)-amended
filtering removed 100% of both E. coli and MS-2.

3.9. Temperature Effects

Temperature effects on a variety of pollutants for different SSF designs have not been
extensively studied. Table 2 shows a summary of temperature effects on treatment efficiency
for SSF. As seen from the table, temperature has significant effects on the treatment efficiency.
The references mainly contain results for microbiological constituents.

Table 2. Temperature effects on SSF treatment efficiency.

Temperature Change Treatment Efficiency Reference

Microcystins were eliminated >85%, decreasing to <60% due to slowing down
Decrease from 20 ◦ C to <4 ◦ C [119]
of bacterial biodegradation at low temperature.
Higher temperature had 2.5 times more efficient microbial removal rates for
Decrease from 21 ◦ C to 5.5 ◦ C [124]
Bacillus spores and E. coli due to biological respiration.
Virus removal was reduced from an average of 99.997% to 99.68%.
Bacteriophages appeared not to be significantly affected. Coliform bacteria
Decrease from 16–18 ◦ C to 5–8 ◦ C [86]
removal decreased from >99.5% to 97.6% while E. coli concentration increased
from >88.0% to >94.6%.
Findings suggested that Cryptosporidium may not be adequately removed
Decrease from about 20 ◦ C to 0.5 ◦ C from a contaminated source water under very cold operating conditions or if [125]
the filtration plant does not comply with accepted design standards.
Decrease from 17 ◦ C to 2 ◦ C Giardia was not affected, while coliform bacteria increased 100 times. [87]
Removal rates of turbidity, COD, color, and total bacterial counts decreased by
Decrease from 23–25 ◦ C to 10–14 ◦ C [126]
12.5%, 26.5%, 22.9%, and 5.8% (advanced wastewater treatment).
Removal of Total coliform bacteria decreased from 97% to 87%. Standard plate
Decrease from 17 ◦ C to 5(2) ◦ C [101]
bacteria increased 100 times.
Experiments and modeling showed that removal of microorganisms
◦C ◦C (Bacteriophage, Escherichia coli) is most sensitive to changes in temperature and
Decrease from 19.5 to 4 [127]
age of the schmutzdecke. Change in filtration rate had small effect on
microorganism removal.
Temperature has effect on pH, BOD, COD, and TOC removal by about
Decrease from 14 ◦ C to 2 ◦ C [128]
50% decrease.
Decrease from 24 ◦ C to 8 ◦ C E. coli Log removal rate decreased from 2.2–2.5 to 1.6–1.7. [129]

However, [128] states clear effects on pH, BOD, COD, and TOC removal as well
(50% decrease by temperature decrease from 14 ◦ C to 2 ◦ C). SSF is highly efficient by means
of removing enteroviruses from contaminated water [86]. Factors affecting this removal
rate in a negative way are temperature, high flow rates, reduced sand depth, and filter
immaturity [86]. Variation in removal rates is also stated to be mostly determined by
temperature and the age of the schmutzdecke [127]. Change in filtration rate had a small
effect on microorganism removal [127]. It has been suggested that for normal temperature,
predation of bacteria is the most important of all biological removal mechanisms [93]. Con-
Water 2023, 15, 2007 12 of 22

sequently, at normal temperature, adsorption to biomass is the least significant mechanism

due to reduced biological activity [130].

3.10. Modifications to the Filter Media

Different sand particle size distributions and various additions to the sand will affect
the HRT and adsorption properties of the SSF. Adding biologically or chemically active
amendments to the filter can improve the treatment efficiency. In this section, we review
various amendments to the filter media. In [131], the effect of modifying a slow sand filter
with quartz sand or Anadara granosa shells on the removal efficiency of turbidity, total
suspended solids, and iron from the water composition of the Kali Jagir Surabaya River
(Indonesia) was investigated. The data were processed using the Design Expert 11 software.
The SSF reactor was operating continuously for 6 days. The optimum results were obtained
in the SSF reactor plant filled with quartz sand and with a filtration rate of 0.1 m/h. The
efficiency of removing turbidity was 82.1%, total suspended solids was 89.5%, and iron
was 50.1%.
The possibility of using wood pellets and granulated cork as carbon sources in lab-
oratory biofilters working under water-saturated and water-unsaturated conditions was
studied in [132]. The efficiency of biofilters was monitored by determining the reduction
in nitrate ions (200 mg/L) and pesticides (mecoprop, diuron, atrazine, and bromacil, each
at a concentration of 5 µg/L) and by determining the formation of nitrite and pesticide
transformation products. Microbiological characterization of each biofilter was also carried
out. It was found that the highest nitrate removal (>99%) occurred in water-saturated
wood biofilters, while cork biofilters lost all denitrifying capacity over time (38% to no
removal). Unsaturated bio-filter columns were ineffective for nitrate removal (20–30%
removal). Regarding pesticides, all biofilters showed high removal of mecoprop and diuron
(>99% and >75%, respectively). Atrazine removal in wood pellet biofilters was better than
in granulated cork (68–96% vs. 31–38%). Bromacil was removed only in the water-saturated
granulated cork biofilter (67%). However, a product of bromacil transformation was formed.
It should be noted that the water-saturated wood biofilter contained the largest number of
de-nitrifying microorganisms, the characteristic representative of which was Methylover-
satilis. Overall, the results showed that biofilters based on wood pellets operate under
water-saturated conditions and can be applied for the treatment of groundwater polluted
by nitrates and pesticides.
Prospects for the use of organic coagulant–flocculant for the pre-treatment of water
to improve the reduction in microbial contamination and turbidity in combination with
sand filtration for domestic conditions (point-of-use, POU) were studied by [133]. Chitosan
was used as a flocculant. In this case, tabletop periodic sand filters with a 16 cm layer of
sand and two different grain sizes, representing slow and fast sand filters, were dosed daily
for 57 days with the addition of microbes to the surface water. E. coli bacteria and MS2
coliphage virus counts were determined every two weeks (N = 17) using culture methods.
The removal of bacteria and viruses was found to be significantly improved compared to
sand filtration without pre-treatment with chitosan (Wilcoxon Rank-Sum, p < 0.05). When
water was pre-treated with an optimum dose of chitosan (10 mg/L) followed by filtration
through the sand, a log10 decrease in the number of bacteria and viruses in the water was
observed. The reduction in microbial activity and turbidity generally improved over the
life of the filter but was independent of the filtration rate.
The effect of sand particle size, filter thickness, and filtration rate on the disinfection
efficiency, bacterial community, and metabolic function of slow bio-sand filters was studied
in [134]. It was shown that the average removal efficiency of fine sand was about 4% higher
than that of coarse sand and that the thick filter layer showed a more stable performance. In
water treatment, the schmutzdecke layer played an overwhelming role and removed most
of the turbidity and organic contaminants. The filtration rate was a key factor in shaping
the bacterial community structure. As filtration rate increased, the relative abundance of
Proteobacteria and Cyanobacteria decreased and increased significantly, respectively. Co-
Water 2023, 15, 2007 13 of 22

occurrence patterns were dominant in the bacterial communities. Functional bacteria (e.g.,
Hyphomicrobium and Methylophilus) and rare genera (Curvibacter and Simplicispira) were
identified as nodule genera in the networks. Bacterial communities exhibited metabolic
versatility. Some secondary metabolic pathways shifted significantly under different condi-
tions, such as biodegradation and xenobiotic metabolism. Moreover, the filtration rate and
predominant species strongly influenced the efficiency of contaminant removal.
In [135], the effectiveness of four models of domestic slow sand filters (HSSFs) to
remove microorganisms from river water throughout their biological development in the
schmutzdecke was investigated. Two models were designed for continuous operation
(HSSF-CC and HSSF-CT) and two models intermittently (HSSF-ID and HSSF-IF). The
filters were fed with 48 L of pre-treated river water daily. Coarse solids in the river water
were sedimented for 24 h, and then the water was passed through a non-woven synthetic
blanket. The water samples were quantified with E. coli group bacteria and analyzed using
light-field microscopy to visualize the microorganisms. Microorganisms such as algae,
protozoa, and helminths were detected in raw water and pre-treated water. After passing
through the sand filters, the total reduction in coliform bacteria in the water was between
1.42 ± 0.59 log and 2.96 ± 0.58 log, with continuous models showing better performance
(p < 0.004). Escherichia coli reduction ranged from 1.49 ± 0.58 log to 2.09 ± 0.66 log, and
HSSF-IF, HSSF-CC, and HSSF-CT showed similar performance (p > 0.06), slightly better than
that represented by HSSF-ID (p = 0.04). The results of the study confirmed the feasibility of
using HSSF in rural communities in domestic settings (POU) to reduce microbiological risk
from river water.
The effect of the household sand filter process mode on the effectiveness of turbidity
and color reduction, as well as on the reduction in E. coli and E. coli concentrations in
the water after treatment, was studied in [136]. Two PVC house slow sand filters (HSSFs)
were operated in continuous (C-HSSF) and intermittent (I-HSSF) flow regimes for eight
consecutive months. A non-woven blanket was placed on top of the fine sand to facilitate
cleaning. The results of the experiment showed that there were no differences between the
continuous-flow and intermittent-flow modes in physicochemical parameters and overall
E. coli reduction parameters. However, C-HSSF showed a better result in the reduction in
E. coli in water (p = 0.02). Measurement of dissolved oxygen concentration in the adherent
biofilm using a Clark microsensor also showed no significant difference between I-HSSF
and C-HSSF (p = 0.98).
The effectiveness of the application of sand coated with graphene oxide on the degree
of removal of two representative micropollutants (MPs)—atrazine (ATZ) and atenolol
(ATL)—from the composition of groundwater by the SSF method was studied in [137]. A
layer of graphene oxide (GO) on the surface of sand particles was applied using a simple
thermal method. The results showed that the GO-coated sand removes ATZ, ATL, and total
organic carbon (TOC) better and reduces water turbidity stronger than the simple sand.
From this, it is assumed that the enhanced removal capacity of coated sand with respect to
ATZ, ATL, and TOC may be mainly due to the GO coating layer and not to the formation of
a biofilm (schmutzdecke). Consequently, the application of GO-coated sand in the SSF field
to remove organic contaminants can eliminate the schmutzdecke biofilm growth phase.
In [138], to improve the efficiency of bacteria removal from water, biochar produced
at different temperatures (400 ◦ C, 550 ◦ C, and 700 ◦ C) and arginine-modified biochar
were added (0.5 and 1 wt. %) to sand filtration columns as filter layers. The addition of
biochar to the sand columns was shown to increase the removal efficiency of Escherichia
coli and Bacillus subtilis under both slow (4 m/day) and fast (240 m/day) filtration con-
ditions. At the same time, the removal efficiency of bacteria in sand columns with the
addition of biochar made at 700 ◦ C was higher than that of columns with the addition of
biochar made at 400 ◦ C and 550 ◦ C. Moreover, the modification of biochar with arginine
further improved bacteria removal efficiency. For example, complete removal of bacteria
(1.35 × 107 ± 10% cells/mL) was achieved under both slow and fast filtration conditions
in sand columns with the addition of biochar modified with 1 wt. % arginine. Increased
Water 2023, 15, 2007 14 of 22

adsorption capacity of bacteria was observed in columns with the addition of biochar modi-
fied with arginine. Bacteria are more closely associated with arginine-modified biochar than
with simple biochar. Moreover, complete removal of bacteria in the combined presence of
5 mg/L humic acid in suspensions was achieved in columns with the addition of 1 wt. %
arginine-modified biochar. The results of this study showed that arginine-modified biochar
has great potential for cleaning water contaminated by pathogenic bacteria.
The effect of exposure to solar energy in combination with HSSF on the quality of
drinking water was considered in [139]. For this purpose, a filter was built from PVC
tubes, sand, and gravel. Solar water disinfection was performed according to the Solar
Water Disinfection (SODIS) methodology. At a filtration rate of 2.38 m3 /(m2 day), turbidity
removal was 97%, and for all E. coli it was 99.9% and E. coli 99.1%.
In [140], the possibility of using a mixed layer of sand with activated carbon for the
post-treatment of wastewater containing surfactants was investigated. The activated car-
bon was obtained from waste coffee grounds and the surfactant concentration in the
wastewater in the Sewage Treatment Plant (STP)-Vila City (Brazil) varied from 21 to
39 mg/L. The slow filtration rate was 15 m3 /(m2 day). The removal of surfactants was
about 9% and 7% in Upflow Anaerobic Sludge Bed reactors (UASB-RALF) and in secondary
treatment, respectively, in STP-Vila City plants. At the subsequent stage of water treatment
by filtration/adsorption through a mixed layer of sand with activated carbon, a reduction
of 94% turbidity (NTU) and 95% surfactant removal was achieved.
The possibility of treating natural water taken from the Blue Nile and White Nile
(Egypt) with a domestic slow sand filter (HSSF) using local materials was investigated
in [141]. Two filters were used to purify natural water. The first filter consisted of the
following layers: standing water (30 cm), fine sand column (40 cm), and gravel (20 cm). The
second filter consisted of the following layers: standing water (30 cm), fine sand column
(25 cm), coarse (natural river) sand column (20 cm), and gravel (20 cm). The results showed
that both filters were very effective in removing E. coli and all E. coli. The mean log10
removal of all E. coli and E. coli for the first filter ranged from 1.9 log to 1.7 log compared
to a range of 1.1 log to 1.2 log for the second filter. The relationship of total coliform
log10 with turbidity and TSS changed dramatically after filtration. In this case, the best
performance of filter 1 was noted for bacteria removal, turbidity, iron (Fe), TSS, K, NO2 ,
and Zn, respectively, compared to NO2 , Fe, and Zn for filter 2 in the same order. All soluble
ions after filtration did not exceed WHO limits. It is assumed that the first filter is more
effective for treating natural water than the second filter.

4. Conclusions
SSF is in many ways well suited to treat raw water for drinking purposes in developing
and less-developed countries. SSF is highly efficient in removing bacteria, viruses, and
chemicals to produce safe drinking and household water to improve the UN SDGs. If SSF
is designed properly with the right kind of sand material, sand depth, HRT, and reasonable
knowledge of potential pollutants, filters will be reliable, easily operated, inexpensive, and
not dependent on imported chemicals. Some disadvantages include the requirements of a
relatively large land area. Moreover, in warm and sunny regions, the occurrence of algae in
the raw water can clog the filter. Color and odor in the water may not be easily removed,
and intermittent operation of the SSF can decrease the filter´s efficiency. Besides this, the
SSF needs to be periodically cleaned by cleaning the layer of the matured schmutzdecke
on top of the filter. However, this can be performed by unskilled labor, which makes it
adaptable to developing countries.
The SSF works both as a mechanical and biological filter. Probably, the most important
aspect of SSF for developing and less-developed countries is its function as a biological filter.
WASH problems mainly relate to the spread of viruses, bacteria, and parasites. The surface
and shallow groundwater in developing countries around urban areas and settlements
are often polluted by domestic wastewater containing these microbes and nutrients. Thus,
SSF’s function would be to treat raw water in the form of diluted wastewater where high
Water 2023, 15, 2007 15 of 22

temperature and access to nutrients probably mean a high growth rate of microbes and
algae but probably also high predation and high efficiency of the SSF. As seen from this
review, factors that may adversely affect the removal of microbiological constituents are
mainly low temperature, high flow rates, reduced sand depth, and filter immaturity.
As surface and shallow groundwater are becoming increasingly affected by wastew-
ater from households, industry, and agriculture, it is important that SSF techniques are
continuously developed for a variety of existing and emerging pollutants. SSF technology
has an important role in providing safe drinking and household water. Besides treating sur-
face and groundwater, SSF has a relevant function in providing clean water from rainwater
harvesting and greywater. Thus, continued research into these processes is needed.

5. Future Perspectives
The above review shows that there are ample possibilities for simple, cost-effective,
yet effective applications for the extended use of slow sand filtration (SSF), especially
in rural areas that are difficult to reach by central raw water treatment plants. This is
a typical situation in developing and less-developed countries. The efficiency and cost-
effectiveness of SSF make this method especially suited for these countries. Filters are
easy to manufacture from local material and do not require expensive additional chemicals
or complicated operation and maintenance. The following reflections regarding future
perspectives and research needs can be made regarding SSF and possibilities to extend
its use:
1. SSF functions well as bio-filters that are especially important for developing and
less-developed countries. However, to further continue to develop methods for SSF,
combined use with disinfection techniques for additional water purification from
microbiological pollutants such as bacteria, microbes, viruses, and parasites can be
performed. These techniques can be applied before or after the SSF application. It is
important to develop these techniques using local materials.
2. Studies are needed to investigate SSF using other types of basic material in areas
where suitable sand and gravel are not readily available. Possible local material may
be constituted by inert or semi-inert material from processes such as ash from energy
use and biomaterial from agricultural waste.
3. It is becoming important, especially for developing and less-developed countries,
to test and advance SSF methods to reduce the contents of emerging environmental
pollutants such as protozoa, cyanobacteria, surfactants, and microplastics. Thus,
further studies are needed to determine design criteria (particle size distribution,
depth of media, residence time, temperature, etc.) for different types of pollutants,
existing and emerging.
4. Further research is needed to advise on life-cycle time, operation (e.g., batch or
continuous flow), and maintenance procedures (cleaning of media, backflushing, etc.)
for used porous media in SSF. This is especially important in developing countries
where intermittent raw water input may affect the function of the SSF due to drought
and wet periods.
5. Surprisingly few people in developing and less-developed countries still have no
access to SSF to obtain safe drinking and household water. This is noteworthy in view
of SSF’s simplicity and efficiency in preventing typical WASH diseases. Obviously, SSF
has a much larger role to play in helping to reach the UN Sustainable Development
Goals. Further research is needed on experiences with SSF in developing countries
such as SFF media materials, process removal efficiency, regeneration time, etc.

Author Contributions: Conceptualization, S.A. and K.A.; methodology, S.K. and B.K.; software,
R.B. and S.A.; formal analysis, A.K., D.Y. and S.S.; investigation, S.K. and S.A.; resources, E.K.;
writing—original draft preparation, K.A.; writing—review and editing, S.A. and R.B.; visualization,
B.K.; supervision, E.K.; project administration, S.A.; funding acquisition, E.K. All authors have read
and agreed to the published version of the manuscript.
Water 2023, 15, 2007 16 of 22

Funding: This research was funded by the Science Committee of the Ministry of Science and Higher
Education of the Republic of Kazakhstan (program number BR11765599). Program title “Development
and improvement of natural water purification technologies and improvement of drinking water
quality in the regions of Kazakhstan”.
Data Availability Statement: Data used in this study can be received upon request.
Conflicts of Interest: The authors declare no potential conflict of interest. The funders had no role
in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the
manuscript; or in the decision to publish the results.

Abbreviations
ATL Atenolol
ATZ Atrazine
BSF Bio-Sand Filters
BOD Biological Oxygen Demand
CAWST Center for Accessible Water Supply and Sanitation Technology
Ce Aqueous antimicrobial concentration mg/L after 24 h equilibration
Cs Sorbed antimicrobial per kilogram of solid, mg/kg
C-HSSF Continuous Household SSF
COD Chemical Oxygen Demand
d Diameter for typical particles in filter media
d60 Diameter at which 60% (by weight) of sand passes through the sieve
d10 Diameter at which 10% (by weight) of sand passes through the sieve
foc Mass fraction of organic carbon matter in the schmutzdecke layer
fom Mass fraction of organic matter in the schmutzdecke layer
GO Graphene Oxide
HRT Hydraulic Residence Time (V × n/Q)
HSSF Household SSF
HSSF-CC Household SSF Continuous Compact
HSSF-CT Household SSF Continuous Traditional
HSSF-ID Household SSF Intermittent Diffusor
HSSF-IF Household SSF Intermittent Float
I-HSSF Intermittent Household SSF
K60/10 Homogeneity coefficient of sand (d60 /d10 )
Kd Sorption coefficient
Koc Normalized sorption coefficient to the share of organic carbon (Kd /foc )
Kom Normalized sorption coefficient to the share of organic matter (Kd /fom )
LIN Lincomycin
MS2 virus Bacteriophage Emesvirus zinderi
n Sand porosity
NTU Nephelometric Turbidity Unit
PCR Polymerase Chain Reaction
POU Point Of Use
PVC Polyvinyl Chloride
Q Water flow rate (m3 /h)
SCI Science Citation Index
SMX Sulfamethoxazole
SMZ Sulfamethazine
SODIS Solar Water Disinfection
SSCI Social Sciences Citation Index
SSF Slow Sand Filtration
STP Sewage Treatment Plant
Tams Triactinomyxon actinospores
TOK Total Organic Carbon
TRI Trimethoprim
TYL Tylosin
UASB-RALF Upflow Anaerobic Sludge Bed Reactor
Water 2023, 15, 2007 17 of 22

UN SDGs United Nations Sustainable Development Goals

USEPA U.S. Environmental Protection Agency
V Total sand volume (m3 )
WASH Water, sanitation, and hygiene
WHO World Health Organization
ZVI Zero-Valent Iron

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