The combination of standard quantitative microbial risk analysis (QMRA) techniques and 10,000-trial Monte Carlo risk simulations was used to estimate the human health risks associated with the use of wastewater for unrestricted and restricted crop irrigation. A risk of rotavirus infection of 10(-2) per person per year (pppy) was used as the reference level of acceptable risk. Using the model scenario of involuntary soil ingestion for restricted irrigation, the risk of rotavirus infection is approximately 10(-2) pppy when the wastewater contains < or =10(6) Escherichia coli per 100ml and when local agricultural practices are highly mechanised. For labour-intensive agriculture the risk of rotavirus infection is approximately 10(-2) pppy when the wastewater contains < or = 10(5) E. coli per 100ml; however, the wastewater quality should be < or = 10(4) E. coli per 100ml when children under 15 are exposed. With the model scenario of lettuce consumption for unrestricted irrigation, the use of wastewaters containing < or =10(4) E. coli per 100ml results in a rotavirus infection risk of approximately 10(-2) pppy; however, again based on epidemiological evidence from Mexico, the current WHO guideline level of < or =1,000 E. coli per 100ml should be retained for root crops eaten raw.
The use of wastewater in agriculture is occurring more frequently because of water scarcity and population growth. Often the poorest households rely on this resource for their livelihood and food security needs. However, there are negative health implications of this practice that need to be addressed. WHO developed Guidelines for the Safe Use of Wastewater in Agriculture in 1989. The Guidelines are currently being revised based on new data from epidemiological studies, quantitative microbial risk assessments and other relevant information. WHO guidelines must be practical and offer feasible risk management solutions that will minimize health threats and allow for the beneficial use of scarce resources. To achieve the greatest impact on health, guidelines should be implemented with other health measures such as: health education, hygiene promotion, provision of adequate drinking water and sanitation, and other health care measures.
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