WastewaterandHealth

TimOSheaMD,FRCPC,MPH
AssociateProfessor
DepartmentofMedicine
McMasterUniversity,

Outline
WastewaterandHealth TheCanadian
context
Healtheffectsofwastewater focuson
infectiousdiseases
ImplicationsforPeruandfuturedirections

WastewaterandHealth
InMay2000thedrinkingwatersupplyin
WalkertonOntariobecamecontaminatedwith
E.coli
Thelocalwatersupplywassourcedfrom
groundwaterwhichwasexposedtorunoff
fromacattlefarmafterparticularlyheavyrain
fall

WalkertonTragedy
Theresultofthiscontaminationwasseveral
thousandacutegastrointestinalillnesses,7
deathsandmanyindividualsleftwithlong
termillnesses
Resultedincriminalchargesagainst
individualsresponsibleforwatersystem

WastewaterandHealth
Theuseofwastewaterforagricultural
irrigationhasseveralpotentialbenefits:
Releaseofhigherqualitysourcesforalternative
uses
Increasewatersupply
Providenutrientsforfertilization

WastewaterandHealth
Themainrisksassociatedwithwastewateruse
arerelatedtopublichealth:
Presenceofbacterial,viral,protozol orheminthic
pathogens
Presenceofchemicals/pesticidesandpotentialfor
healtheffects

Theriskofwastewateruseisexacerbated
whenitsuseisunintentionalorindirect

WastewaterandHealth
Indirectuseoccurswhentreated,partially
treatedoruntreatedwastewaterentersthe
agriculturalirrigationsystem
Healthrisksaresimilarwithplannedand
unplannedwastewaterusebutwhen
unintentionalsystemstomitigateriskare
usuallynotpresent

InfectiousDiseases
Humanfecescontain~1010 bacteriapergram,
themajorityofwhicharenonpathogenic
Inthesettingofinfectionwithgastrointestinal
pathogens,stoolwillcontainlargequantitiesof
theinfectingorganism
Gastrointestinalillnesssuchascholera,typhoid
andE.coliO157:H7canallbepassedthrough
exposuretocontaminatedwater

InfectiousDiseases
Viralpathogenscanalsobeimportantcauses
ofwaterborneillness,particularlyhepatitisA
virus,adenoviruses,enteroviruses and
noroviruses
Parasiticinfections,especiallyhelminthic
infectionswhoselifecycleincludesasoil
phase,areparticularlyimportantin
discussionsofwastewaterandhealth

WastewaterandHealth
Importanttorememberthathealthrisksare
presentbothfor:
Agriculturalworkersexposedtopathogens/toxins
inwastewater
Thosewhoeventuallyconsumepotentially
contaminatedfoods

WastewaterandHealth
Overallrisktohumanhealthdependson:
Excretedload
Abilityoforganismtopersistinenvironment
Minimuminfectiousdose
Abilityoforganismtoenterlatency
Responseofhumanhost(influencedbypossible
immunity)

WastewaterandHealth
Giventhesefactorsmostmodelsrankrelative
importanceofinfectiousagentsasfollows:
1. Helminth infections
2. Protozoal andbacterialinfections
3. Viralinfections

GastrointestinalIllnessinPeru

FIGURE 3. Prevalence of diarrhea in Peruvian children aged 035 months, 19951998.

William Checkley et al. Am. J. Epidemiol. 2003;157:166-175

2003 by Oxford University Press

WastewaterinPeru

Questions?

osheat@mcmaster.ca