Water deficit, exacerbated by global population increases and climate change, necessitates the investigation of alternative non-traditional water sources to augment existing supplies.Indirect potable reuse (IPR) represents a promising alternative water source in water-stressed 2 regions. Of high concern is the presence of pathogenic microorganisms in wastewater, such as enteric viruses, protozoa and bacteria. Therefore, a greater understanding of the potential impact to human health is required. The aim of this research was to use a quantitative microbial risk assessment (QMRA) approach to calculate the probability of potential pathogen infection to the public in surface waters used for a range of recreational activities under scenarios: 1) existing de facto wastewater reuse conditions; 2) after augmentation with conventionally treated wastewater; and 3) after augmentation with reclaimed wastewater from proposed IPR schemes. Fourty-four 31 L samples were collected from river sites and a coastal wastewater treatment works from July 2016-May 2017. Concentrations of faecal indicator organisms (enterococci, faecal coliforms, somatic coliphages and Bacteroides phages) determined using culture-based approaches and selected pathogens (adenovirus, Salmonella and Cryptosporidium) determined using molecular approaches (qPCR) were used to inform QMRA. The mean probability of infection from adenovirus under de facto conditions was high (>0.90) for all recreational activities, per single event. The risk of adenovirus and Cryptosporidium infection increased under augmentation scenario (2) (mean probability 0.95-1.00 and 0.01-0.06 per single event, respectively). Adenovirus and Cryptosporidium infection risk decreased under reclaimed water augmentation scenario (3) (mean probability <0.79, excluding swimming, which remained 1.00 and <0.01 per single event, respectively). Pathogen reduction after reclaimed water augmentation in surface waters impacted by de facto reuse, provides important evidence for alternative water supply option selection. As such, this evidence may inform water managers and the public of the potential benefits of IPR and improve acceptance of such practices in the future.
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