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Environ Health Perspect; DOI:10.1289/ehp.1509995

A Review of Health Risks and Pathways for Exposure to Wastewater Use in Agriculture

Sarah K. Dickin,1,2 Corinne J. Schuster-Wallace,2 Manzoor Qadir,2 and Katherine Pizzacalla3
Author Affiliations open
1McMaster University, School of Geography and Earth Sciences, Hamilton, Ontario, Canada; 2United Nations University Institute for Water, Environment and Health, Hamilton, Ontario, Canada; 3Sciences Po, Paris School of International Affairs, Paris, France

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  • Background: Wastewater is increasingly being used in the agricultural sector to cope with the depletion of freshwater resources as well as water stress linked to changing climate conditions. As wastewater irrigation expands, research focusing on the human health risks is critical because exposure to a range of contaminants must be weighed with the benefits to food security, nutrition and livelihoods.

    Objectives: The goal of this paper was to review research examining health risks and exposure pathways associated with wastewater irrigation to identify research trends and gaps.

    Methods: We conducted a review of the literature and identified a total of 126 studies published from 1995-2013. Findings were summarized based on several themes including types of exposure pathways, wastewater contaminants, methodological approaches and the geographical distribution of research.

    Results: Only 23 studies used epidemiological methods, while most research applied alternative methods to estimate risk, such as quantitative risk assessment models or comparisons of crop contamination to established guidelines for wastewater reuse. A geographic breakdown demonstrated a focus on microbiological contaminants in specific regions such as Sub-Saharan Africa and Southeast Asia, despite growing chemical risks associated with rapid urbanization and industrialization that may change the types and distribution of wastewater contaminants.

    Conclusions: To provide a more comprehensive understanding of the health risks of wastewater use in agriculture, future research should consider multiple exposure routes, long-term health implications, and increase the range of contaminants studied, particularly in regions heavily dependent on wastewater irrigation.

  • This EHP Advance Publication article has been peer-reviewed, revised, and accepted for publication. EHP Advance Publication articles are completely citable using the DOI number assigned to the article. This document will be replaced with the copyedited and formatted version as soon as it is available. Through the DOI number used in the citation, you will be able to access this document at each stage of the publication process.

    Citation: Dickin SK, Schuster-Wallace CJ, Qadir M, Pizzacalla K. A Review of Health Risks and Pathways for Exposure to Wastewater Use in Agriculture. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1509995

    Received: 25 March 2015
    Accepted: 8 January 2016
    Advance Publication: 29 January 2016

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