The World Health Organization and others have proposed international guidelines for the safe reuse of domestic wastewater. Treatment and microbial standards have been suggested with varying microbial water quality targets to suit local circumstances of affordability and health risks. However, it is important to recognize that universal application of bacterial standards for water quality assessment will not yield the same risks from microbial pathogens in reclaimed wastewater around the world. The concentration and types of pathogens in raw wastewater varies from one region of the world to another depending on the incidence in the community. This is influenced by the general hygiene, season, and per capita water use. Also, different treatment processes may be more effective in removing indicator bacteria and certain groups of pathogens than others. Proposed guidelines have also neglected the importance of water in the transmission of viral and bacterial diseases in developed countries and their impact on morbidity and mortality. Additional research is needed to better reduce the uncertainly of proposed guidelines for water recycling and to better define the risks associated to the exposed populations.

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