The risk of enteric infections associated with wastewater reuse: the effect of season and degree of storage of wastewater

The effect of season and wastewater storage on the risk of Ascaris lumbrico ides infection and diarrhoeal disease associated with wastewater reuse was studied in Mexico in 1991. Data were collected from 10 489 individuals duri ng a dry-season survey. Exposure was to untreated wastewater, or effluent f rom 1 reservoir (less than or equal to 1 nematode egg/L), or no wastewater irrigation (control group). The results were compared with a previous rainy -season survey which included effluent from 2 reservoirs in series. Direct exposure to untreated wastewater was associated with an excess risk of A. l umbricoides infection in children aged < 5 years (OR = 18.0) and persons ag ed > 5 years (OR = 135) and an increased risk of diarrhoea, particularly to children aged < 5 years (OR = 1.75); effects were stronger in the dry than in the rainy season. There was also an excess risk associated with the I-r eservoir group for A. lumbricoides infection (OR = 21 2 and 9.4) and for di arrhoeal disease (OR = 1.1 and 1.5) but little excess associated with the 2 -reservoirs group. Therefore, wastewater retention in 1 reservoir (quality 10(5) faecal coliforms/100 mL, less than or equal to 1 egg/L) does not sign ificantly reduce risks of Ascaris infection and diarrhoeal disease whereas retention in 2 reservoirs in series (quality 10(3) faecal coliforms/100 mL, no detectable eggs/L) does.