State of the Art Review: An Epidemiological Approach to the Health Effects of Wastewater Reuse

The reuse of wastewaters for agricultural irrigation can be a means of reducing the pollution of surface waters including those in coastal areas used for bathing. The wastewater stream of a community carries within it the complete spectrum of pathogenic bacteria, viruses, protozoa and helminths which are endemic in the community. These pathogens can survive sufficiently long in the soil or on crops to infect, at least in theory, persons coming in direct contact. Thus, it is important to establish a sound epidemiological basis for health regulations related to the reuse of wastewater in agriculture. This paper presents the theoretical epidemiological considerations that should serve as the basis for a predictive model of the potential risks associated with wastewater irrigation. Empirical data from credible, quantifiable epidemiological studies have here been reviewed to validate the theoretical model. For developing countries, the authors have concluded that the ranking of pathogens as to the degree of risk associated with wastewater irrigation is as follows: high risk - helminths, medium risk - bacteria and protozoa and low risk - viruses.In order to effectively reduce the concentration of these pathogens wastewater treatment is recommended as the most effective control strategy.