Epidemiology/Health Studies

The Epidemiology/Health Effects Studies section looks at different studies conducted that look at the safety of water reuse. The amount of health studies that have been conducted in the field of water reuse is actually quite limited, and more studies must follow if the field is to increase in size. Many of the main studies cited were conducted several years ago, in the absence of a lot of the technology that it present today. "Because of the lack of scientific rigour it is not possible to be confident, on the basis of these epidemiological studies, that the gastrointestinal risks associated with potable reuse are not greater than those associated with usual drinking water."(Department of Health and Aged Care, 2001)

Review of Health Issues Associated with Direct Potable Reuse of Wastewater is a report published by the Department of Health and Aged Care in Canberra Australia. It looks at several different contaminants in wastewater, their health effects, treatment technologies available for their removal, and recommendations for further health research. If you are looking for specific information on individual contaminants, this is the place to look.

The San Diego Health Effects Study was conducted in the mid to late 1980s. It investigated the cities advanced wastewater treatment system (Aqua II), specifically, it’s ability to producing potable water from wastewater. The study found that water produced from the treatment system was of equal or better quality than the current drinking water supply.

The Epidemiologic Assessment of Groundwater Recharge Activities in the Los Angeles Area was completed between 1987 and 1991 in the Montebello Forebay region of Los Angeles. The study compared incidences of cancer, mortality, and infectious disease in the region to similar areas that do not have access to reclaimed water.

As a continution to the study on cancer, mortality and infectious disease in the Montebello Forebay Area, a study on adverse birth outcomes was also conducted in the area. As with the previous study, the research is based on pre-existing data, comparing the Montebello Forebay Area to a control population not receiving reclaimed water.

Tertiary Treatment for Raw Eaten Vegetables and Hygienic Evaluation of Reclaimed Water Used to Irrigate Food Crops - A Case Study were prepared in the 1980s and investigated the safety of using reclaimed water to irrigate food crops. The study was prepared in an effort to prove the safety of reclaimed water to farmers in the area, and also showed benefits of using treated wastewater rather than the drinking water supply. The study backed the conclusions of those in the Pomona Virus Study conducted earlier by the Sanitation District of Los Angeles

The Pomona Virus Study was conducted in the 1970s by the Sanitation District of Los Angeles. It compared the virus removal efficiency of different tertiary treatment systems in the city of Pomona. A cost-efficiency comparison of the systems was also done. It found that there were several options that would obtain a 5 log removal of viruses. In the water reuse field, this study was used as the basis for many of the water reuse regulations in place today.

Another document worth looking for was published in 2003 by the WHO, entitled "State of the Art Report: Health Risks in Aquifer Recharge Using Reclaimed Water." It is extremely detailed, and provides a lot of information on the subject.


Department of Health and Aged Care. (2001). Review of health issues associated with potable reuse of wastewater, No. RFT200/00. Canberra, Australia: Department of Health and Aged Care.