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

http://dx.doi.org/10.1289/ehp.1509995



Table 1. Summary of epidemiological studies that assessed health risks associated with wastewater irrigation.
Authors Location Data sources Health risks Contamination pathways considered Study design
Amahmid and Bouhoum 2005 Marrakech Morocco Stool samples, survey Helminth infection (Ascaris, Trichuris) Children living in wastewater irrigation areas, water, sanitation and hygiene, occupational (parents) Cross-sectional study of an exposed group and control group children (n = 610)
Anh et al. 2007 Hanoi, Vietnam Survey, dermatologist examination Skin problems including infections, dermatitis and fungal growth Occupational (farmers practicing aquatic plant culture) Cross-sectional study with 2 follow-ups (n = 235 farmers) in 200 households in two communes, one using wastewater and another using river, rain, and well water
Anh et al. 2009 Phnom Penh, Cambodia Survey, dermatologist examination Skin problems including infections, dermatitis and fungal growth Occupational (farmers practicing aquatic plant culture) Cross-sectional study with 2 follow-ups (= 650 adults in 200 households) in 5 villages (using different water sources)
Blumenthal et al. 2001 Mezquital Valley, Mexico Stool samples, survey Ascariasis and diarrhoeal disease Occupational (workers and household), water, sanitation and hygiene, consumption of market vegetables Cross-sectional survey with 850 agricultural households using untreated wastewater for irrigation, 950 households using wastewater stored in a reservoir, and 930 control households (rain-fed agriculture), with a total of 10,489 children and adults
Chary et al. 2008 Musi River, India Samples of soils, vegetables, urine, blood, and livestock milk, survey Irritation of skin with black rashes and other reactions possibly linked to heavy metal consumption (Zn, Cr, Cu, Ni, Co, and Pb) Consumption of contaminated food (vegetables and milk) Samples were collected from residents in the study region of varying ages and compared with control participants residing in the campus area
Cifuentes et al. 2000a Mezquital Valley, Mexico Stool samples, water samples, survey Giardiasis Occupational (workers and household), source of vegetables, water, sanitation and hygiene Cross-sectional survey of farming households (children and adults). 2,257 individuals from an untreated wastewater group, 2,147 in a group using wastewater stored in a reservoir, and 2,344 in control group (rain-fed)
Cifuentes et al. 2000b Mezquital Valley, Mexico Blood samples, survey Health impacts linked to Pb exposure Occupational, use of Pb-glazed ceramics, crop consumption Cross-sectional survey of 735 individuals (children and adults) from a farming population (households with at least one agricultural worker)
Devaux et al. 2001 Clermont-Ferrand, France Sentinel reporting (physician/pharmacy), water and aerosol samples, health survey Skin and digestive illnesses Occupational (aerosol spraying), and accidental ingestion of those living in the area Sentinel system from GPs and pharmacies, retrospective cohort of farmworkers (= 100) and a prospective cohort of farmers using different water sources (= 37), with 22 farmers using wastewater matched to non-exposed family members.
Ensink et al. 2005 Faisalabad, Pakistan Stool samples, survey Hookworm infection Occupational (farmers and their children), water sanitation and hygiene, accidental ingestion of those living in the area, cattle ownership Cross-sectional survey of wastewater farmers, textile labourers and farmers using regular irrigation water, with children assigned to their fathers’ exposure group (= 1,704)
Ensink et al. 2006 Faisalabad, Pakistan Stool samples, survey Giardiasis Occupational (farmers and their children), water sanitation and hygiene, accidental ingestion of those living in the area, cattle ownership Cross-sectional survey of wastewater farmers, textile labourers and farmers using regular irrigation water, with children assigned to their fathers’ exposure group (= 1,704)
Ensink et al. 2008 Hyderabad, India Stool samples, survey, water samples Intestinal nematode infection Occupational (entire household), water, sanitation and hygiene, cattle ownership Cross-sectional survey with 3 exposure groups of farmers exposed to untreated, and partially treated wastewater and river water (= 1,078)
Gumbo et al. 2010 Malamulele, South Africa Stool, vegetable and wastewater samples, survey A range of parasitic infections including hookworm and Giardia lamblia infection Occupational (entire household), consumption of contaminated vegetables, water, sanitation and hygiene Cross-sectional survey of farmers and their children exposed to wastewater irrigation (= 194) and those not using wastewater for irrigation (= 249)
Habbari et al. 2000 Beni-Mellal, Morocco Stool samples, survey Helminth infection (Ascaris, Trichuris) in children Children living near wastewater irrigated areas, water, sanitation and hygiene, occupation of parents Cross-sectional survey of 740 children in communities using wastewater, and 603 children in communities not using wastewater irrigation
Hien et al. 2007 Hanoi, Vietnam Stool samples, clinical information collected Diarrhoeal diseases Children of occupationally exposed farmers Case–control study with 111 pairs of children
Lekouch et al. 1999 Marrakesh, Morocco Hair samples, survey Health risks linked to heavy metal (Pb and Cd) consumption (not specified) Children living near irrigated areas, occupational exposure of parents, food Cross-section survey of 327 children in a wastewater irrigation area, and 110 from control communities
Melloul and Hassani 1999 Marrakesh, Morocco Stool sample, survey Salmonella infection Children living near irrigated areas, occupational exposure of parents Cross-sectional survey of 390 children living a wastewater irrigation zone and 350 from control communities
Melloul et al. 2002 Marrakesh, Morocco Stool sample, survey Salmonella and protozoan infection Children living near irrigated areas, occupational exposure of parents Cross-sectional survey of children living in the wastewater irrigation zone and from control communities (= 603 for Salmonella and = 608 for protozoan infections)
Srikanth and Naik 2004 Asmara, Eritrea Stool, wastewater and vegetable samples, survey, hospital data Giardiasis and other gastrointestinal diseases Occupational exposure (vegetable cultivation), consumption of vegetables, water, sanitation and hygiene Cross-sectional health survey of 1,000 residents in farming community, stool samples collected from 75 occupationally exposed farmers
Trang et al. 2006 Nam Dinh city, Vietnam Stool samples, wastewater survey Helminth infection (Ascaris, Trichuris and hookworm) Occupational (rice cultivation), water, sanitation and hygiene, use of human excreta for agriculture Cross sectional survey, 202 households in a commune where wastewater was used for irrigation and 201 households in a commune that used river water, with a total of 1,088 individuals >15 years
Trang et al. 2007a Hanoi, Vietnam Stool samples, survey Diarrhoeal diseases Occupational (fish farming and cultivation of rice and vegetables) water, sanitation, and hygiene, use of human excreta for agriculture, animal husbandry Open cohort of 636 adults engaged in agricultural work, and a nested case-control study with 163 unmatched pairs of cases and controls
Trang et al. 2007b Hanoi, Vietnam Stool samples, survey Helminth infections (Ascaris, Trichuris and hookworm) Occupational (workers and children) water, sanitation, and hygiene, use of human excreta for agriculture, animal husbandry A cross-sectional study with 400 agricultural households (620 adults and 187 children)
Trang et al. 2007c Hanoi, Vietnam Dermatologist examination, survey Skin ailments (itching often accompanied by skin chaps, debris or light ulcer; irritant contact dermatitis Occupational (rice, aquatic and terrestrial vegetable cultivation), water, sanitation and hygiene, use of human excreta for agriculture, animal husbandry Open cohort of 636 adults engaged in agricultural work and nested case–control study with 108 case control pairs
Trang et al. 2007d Nam Dinh, Vietnam Dermatologist examination, survey Dermatitis, fungal infections, skin irritation (biological, inorganic and organic chemicals) Occupational (e.g. rice and vegetable cultivation, flower growing) water, sanitation, and hygiene Cohort of 400 households in two communes using wastewater and river water (1,103 individuals >15 years)