Reliability of pathogen control in direct potable reuse: Performance evaluation and QMRA of a full-scale 1 MGD advanced treatment train

Greywater recycling for diverse collection scales and appliances: Enteric pathogen log-removal targets and treatment trains

In light of increasingly diverse greywater reuse applications, this study proposes risk-based log-removal targets (LRTs) to aid the selection of treatment trains for greywater recycling at different collection scales, including appliance-scale reuse of individual greywater streams. An epidemiology-based model was used to simulate the concentrations of prevalent and treatment-resistant reference pathogens (protozoa: Giardia and Cryptosporidium spp., bacteria: Salmonella and Campylobacter spp., viruses: rotavirus, norovirus, adenovirus, and Coxsackievirus B5) in the greywater streams for collection scales of 5-, 100-, and a 1000-people. Using quantitative microbial risk assessment (QMRA), we calculated LRTs to meet a health benchmark of 10-4 infections per person per year over 10'000 Monte Carlo iterations. LRTs were highest for norovirus at the 5-people scale and for adenovirus at the 100- and 1000-people scales. Example treatment trains were designed to meet the 95 % quantiles of LRTs. Treatment trains consisted of an aerated membrane bioreactor, chlorination, and, if required, UV disinfection. In most cases, rotavirus, norovirus, adenovirus and Cryptosporidium spp. determined the overall treatment train requirements. Norovirus was most often critical to dimension the chlorination (concentration × time values) and adenovirus determined the required UV dose. Smaller collection scales did not generally allow for simpler treatment trains due to the high LRTs associated with viruses, with the exception of recirculating washing machines and handwashing stations. Similarly, treating greywater sources individually resulted in lower LRTs, but the lower required LRTs nevertheless did not generally allow for simpler treatment trains. For instance, LRTs for a recirculating washing machine were around 3-log units lower compared to LRTs for indoor reuse of combined greywater (1000-people scale), but both scenarios necessitated treatment with a membrane bioreactor, chlorination and UV disinfection. However, simpler treatment trains may be feasible for small-scale and application-scale reuse if: (i) less conservative health benchmarks are used for household-based systems, considering the reduced relative importance of treated greywater in pathogen transmission in households, and (ii) higher log-removal values (LRVs) can be validated for unit processes, enabling simpler treatment trains for a larger number of appliance-scale reuse systems.

Applying a novel mechanistic framework for drinking water management to mitigate emerging contaminants

A novel framework has been developed which summarizes the efficacy of treatment technologies for emerging contaminants (ECs) based on the general mitigation mechanisms of Removal, Inactivation/Degradation, and Destruction (i.e., RIDD). The RIDD framework allows for a concise critical evaluation of the efficacy of treatment processes for their mitigation potential, and provides an efficient methodology for drinking water system managers to identify knowledge gaps related to the management of ECs in water treatment with respect to current technologies available in practice. Additionally, the RIDD framework provides an understanding of the treatment processes which provide: (1) broad spectrum treatment, (2) effective mitigation for certain categories of contaminants or under certain circumstances, or (3) little or no mitigation of ECs. In the proposed format, this information is intended to assist water managers to make more informed treatment decisions. Four categories of ECs noted in recent literature as presently concerning to drinking water utilities, including both anthropogenic and microbial contaminants, were used in this study to provide examples of RIDD framework application. In many cases, broad-spectrum treatment barriers (e.g., high-pressure membranes) are expected to provide cost-effective management of a suite of ECs, which then can be compared to the costs and practicality of additional treatment barriers for individual ECs (e.g., selective ion exchange resins or tailored biological processes). Additionally, understanding the typical performance of existing treatment processes can help assist with capital planning for alternative treatment processes or upgrades, or for developing novel treatment approaches at the watershed scale such as integrated urban water management and One Water frameworks.

Drinking water QMRA and decision-making: Sensitivity of risk to common independence assumptions about model inputs

When assessing risk posed by waterborne pathogens in drinking water, it is common to use Monte Carlo simulations in Quantitative Microbial Risk Assessment (QMRA). This method accounts for the variables that affect risk and their different values in a given system. A common underlying assumption in such analyses is that all random variables are independent (i.e., one is not associated in any way with another). Although the independence assumption simplifies the analysis, it is not always correct. For example, treatment efficiency can depend on microbial concentrations if changes in microbial concentrations either affect treatment themselves or are associated with water quality changes that affect treatment (e.g., during/after climate shocks like extreme precipitation events or wildfires). Notably, the effects of erroneous assumptions of independence in QMRA have not been widely discussed. Due to the implications of drinking water safety decisions on public health protection, it is critical that risk models accurately reflect the context being studied to meaningfully support decision-making. This work illustrates how dependence between pathogen concentration and either treatment efficiency or water consumption can impact risk estimates using hypothetical scenarios of relevance to drinking water QMRA. It is shown that the mean and variance of risk estimates can change substantially with different degrees of correlation. Data from a water supply system in Calgary, Canada are also used to illustrate the effect of dependence on risk. Recognizing the difficulty of obtaining data to empirically assess dependence, a framework to guide evaluation of the effect of dependence is presented to enhance support for decision making. This work emphasizes the importance of acknowledging and discussing assumptions implicit to models.

Virus surrogates throughout a full-scale advanced water reuse system

Water reuse as an alternative water supply is increasing throughout the world due to water stress and scarcity; however, there are no standard practices for monitoring virus pathogens in such systems. This study aimed to identify suitable surrogates for virus fate, transport, and removal throughout a water reuse scheme. Various microbial targets (11 viruses, two phage, and three bacteria) were monitored using molecular and culture methods across all treatment stages in a wastewater reclamation facility and advanced water treatment facility. Criteria were established for identifying suitable surrogates, which included reliable detection, observable fate and transport, calculable log-reduction values (LRVs), correlations with other targets, and various morphological types. In total, five viruses (PMMoV, AiV, GII NoV, AdV, FRNA GII) met these stringent criteria and were suggested as potential virus surrogates. These surrogates enabled successful comparison of assigned versus actual LRVs throughout a water reuse scheme. Results suggest that virus pathogens are effectively removed throughout water reuse treatment and the suggested surrogates can be utilized for monitoring treatment performance and ensuring public health safety. This study provides a framework that water utilities across the world can reference for establishing virus monitoring practices.

A unit process log reduction database for water reuse practitioners

Pathogen reduction for the purpose of human health protection is a critical function provided by water reuse systems. Pathogen reduction performance potential is dependent on a wide range of design and operational parameters. Poor understanding of pathogen reduction performance has important consequences-under treatment can jeopardize human health, while over treatment can lead to unnecessary costs and environmental impacts. Documented pathogen reduction potential of the unit processes that make up water reuse treatment trains is based on a highly dispersed and unstructured literature, creating an impediment to practitioners looking to design, model or simply better understand these systems. This review presents a database of compiled log reduction values (LRVs) and log reduction credits (LRCs) for unit processes capable of providing some level of pathogen reduction, with a focus on processes suitable for onsite non-potable water reuse systems. Where reported, we have also compiled all relevant design and operational factors associated with the LRVs and LRCs. Overall, we compiled over 1100 individual LRV data entries for 31 unit processes, and LRCs for 8 unit processes. Results show very inconsistent reporting of influencing parameters, representing a limitation to the use of some of the data. As a standalone resource, the database (included as Supplemental Information) provides water reuse practitioners with easy access to LRV and LRC data. The database is also part of a longer-term effort to optimize the balance between human health protection, potential environmental impacts and cost of water reuse treatment trains.

Extension of probability models of the risk of infections by human enteric viruses

This study presents a novel approach for obtaining reliable models and coefficients to estimate the probability of infection caused by common human enteric viruses. The aim is to provide guidance for public health policies in disease prevention and control, by reducing uncertainty and management costs in health risk assessments. Conventional dose-response (DR) models, based on the theory elaborated by Furumoto and Mickey [1], exhibit limitations stemming from the heterogeneity of individual host susceptibilities to infection resulting from ingesting aggregate viruses. Moreover, the scarcity of well-designed viral challenge experiments contributes to significant uncertainty in these DR models. To address these issues, we conducted a review of infection models used in health risk analysis, focusing on Norovirus (NoV) GI.1, pooled Enterovirus group (EV), Poliovirus 1/SM, and Echo-12 virus via contaminated water or food. Using a mechanistic approach, we reevaluated the known DR models and coefficients for the probability of individual host infection in the mentioned viruses based on dose-infection challenge experiments. Specifically, we sought to establish a relationship between the minimum infectious dose (ID) and the ID having a 50% probability of initiating host infection in the same challenge experiment. Furthermore, we developed a new formula to estimate the degree of aggregation of GI.1 NoV at the mean infectious dose. The proposed models, based on "exact" beta-Poisson DR models, effectively predicted infection probabilities from ingestion of both disaggregated and aggregate NoV GI.1. Through a numerical evaluation, we compared the results with the maximum likelihood estimation (MLE) probability obtained from a controlled challenge trial with the NoV GI.1 virus described in the literature, demonstrating the accuracy of our approach. By addressing the indetermination of the unmeasured degree of NoV aggregation in each single infectious dose, our models reduce overestimations and uncertainties in microbial risk assessments. This improvement enhances the management of health risks associated with enteric virus infections.

Defining Risk-Based Monitoring Frequencies to Verify the Performance of Water Treatment Barriers

Preventing failures of water treatment barriers can play an important role in meeting the increasing demand for microbiologically safe water. The development and integration of failure prevention strategies into quantitative microbial risk assessment (QMRA) offer opportunities to support the design and operation of treatment trains. This study presents existing failure models and extends them to guide the development of risk-based operational monitoring strategies. For barriers with rapid performance loss, results show that a failure of 15 s should be reliably detected to verify a log reduction value (LRV) of 6.0; thus, detecting and remediating these failures may be beyond current technology. For chemical disinfection with a residual, failure durations in order of minutes should be reliably detected to verify a LRV of 6.0. Short-term failures are buffered because the disinfectant residual concentration sustains a partial reduction performance. Therefore, increasing the contact time and hydraulic mixing reduces the impact of failures. These findings demonstrate the importance of defining precise frequencies to monitor barrier performances during operation. Overall, this study highlights the utility of process-specific models for developing failure prevention strategies for water safety management.

Microbial Water Quality through a Full-Scale Advanced Wastewater Treatment Demonstration Facility

The fates of viruses, bacteria, and antibiotic resistance genes during advanced wastewater treatment are important to assess for implementation of potable reuse systems. Here, a full-scale advanced wastewater treatment demonstration facility (ozone, biological activated carbon filtration, micro/ultrafiltration, reverse osmosis, and advanced oxidation) was sampled over three months. Atypically, no disinfectant residual was applied before the microfiltration step. Microbial cell concentrations and viability were assessed via flow cytometry and adenosine triphosphate (ATP). Concentrations of bacteria (16S rRNA gene), viruses (human adenovirus and JC polyomavirus), and antibiotic resistance genes (sul1 and bla _TEM ) were assessed via quantitative PCR following the concentration of large sample volumes by dead-end ultrafiltration. In all membrane filtration permeates, microbial concentrations were higher than previously reported for chloraminated membranes, and log₁₀ reduction values were lower than expected. Concentrations of 16S rRNA and sul1 genes were reduced by treatment but remained quantifiable in reverse osmosis permeate. It is unclear whether sul1 in the RO permeate was from the passage of resistance genes or new growth of microorganisms, but the concentrations were on the low end of those reported for conventional drinking water distribution systems. Adenovirus, JC polyomavirus, and bla _TEM genes were reduced below the limit of detection (∼10^-2 gene copies per mL) by microfiltration. The results provide insights into how treatment train design and operation choices affect microbial water quality as well as the use of flow cytometry and ATP for online monitoring and process control.

Prevalence of ESKAPE pathogens in the environment: Antibiotic resistance status, community-acquired infection and risk to human health

The ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pathogens are characterised by increased levels of resistance towards multiple classes of first line and last-resort antibiotics. Although these pathogens are frequently isolated from clinical environments and are implicated in a variety of life-threatening, hospital-associated infections; antibiotic resistant ESKAPE strains have been isolated from environmental reservoirs such as surface water, wastewater, food, and soil. Literature on the persistence and subsequent health risks posed by the ESKAPE isolates in extra-hospital settings is however, limited and the current review aims to elucidate the primary reservoirs of these pathogens in the environment, their antibiotic resistance profiles, and the link to community-acquired infections. Additionally, information on the current state of research regarding health-risk assessments linked to exposure of the ESKAPE pathogens in the natural environment, is outlined.

Distributions of waterborne pathogens in raw wastewater based on a 14-month, multi-site monitoring campaign

The California State Water Resources Control Board is the first regulatory body in the United States to develop statewide regulations for direct potable reuse (DPR). To support this effort, a pathogen monitoring campaign was undertaken to develop and implement an optimized standard operating protocol to better characterize the concentration of human pathogens in raw wastewater. Methods to detect relevant viral and protozoan pathogens in raw wastewater were optimized and implemented during a 14-month monitoring campaign. Over 120 samples were collected from five wastewater treatment plants treating a quarter of California's population. Samples were analyzed for two protozoa (Cryptosporidium and Giardia) using microscopy methods, three enteric viruses (enterovirus, adenovirus, and norovirus) using culture and/or molecular methods, and male-specific coliphage using culture methods. The method recovery efficiency was measured in every protozoa sample and every other virus sample to confirm minimum recovery efficiencies were achieved and to correct the concentrations for pathogen losses during sample processing. The results from this study provide the industry with a large, high-quality dataset as demonstrated by the high degree of method sensitivity, method recovery, and QA/QC steps. Such high-quality data on pathogen concentrations in raw wastewater are critical for confirming the level of treatment needed to reduce pathogen concentrations down to acceptable levels for potable water in DPR projects.

Advanced Oxidation Processes for Water and Wastewater Viral Disinfection. A Systematic Review

Water and wastewater virological quality is a significant public health issue. Viral agents include emerging and re-emerging pathogens characterized by extremely small size, and high environmental stability. Since the mainly used conventional disinfection methods are usually not able to achieve complete disinfection of viral and other microbial targets, in real water and wastewater matrices, effective strategies for the treatment, use and reuse of water and the development of next-generation water supply systems are required. The scope of the present systematic review was to summarize research data on the application of advanced oxidation processes (AOPs) for viral disinfection of water and wastewater. A literature survey was conducted using the electronic databases PubMed, Scopus, and Web of Science. This comprehensive research yielded 23 records which met the criteria and were included and discussed in this review. Most of the studies (14/23) used only MS2 bacteriophage as an index virus, while the remaining studies (9/23) used two or more viral targets, including phages (MS2, T4, T7, phiX174, PRD-1, S2, ϕB124-14, ϕcrAssphage) and/or Adenovirus, Aichivirus, Norovirus (I, II, IV), Polyomavirus (JC and BK), Sapovirus, Enterovirus, Coxsackievirus B3, Echovirus, and Pepper mild mottle virus. The vast majority of the studies applied a combination of two or more treatments and the most frequently used process was ultraviolet light-hydrogen peroxide (UV/H₂O₂) advanced oxidation. The review is expected to highlight the potential of the AOPs for public health protection from the waterborne viral exposure.

Quantitative microbial risk assessment of a non-membrane based indirect potable water reuse system using Bayesian networks

Risk-based approaches are used to define performance standards for water and wastewater treatment to meet health-based targets and to ensure safe and reliable water quality for desired end use. In this study, a screening level QMRA for a non-membrane based indirect potable reuse (IPR) system utilizing the sequential managed aquifer recharge technology (SMART) concept was conducted. Ambient removals of norovirus, Campylobacter and Cryptosporidium in advanced water treatment (AWT) steps were combined in a probabilistic QMRA utilizing Bayesian networks constructed in Netica. Results revealed that all pathogens complied with disease burden at the 95th percentile, and according to the assumptions taken about pathogen removal, Cryptosporidium was the pathogen with the greatest risk. Through systematic sensitivity analysis, targeted scenario analysis, and backwards inferencing, critical control points for each pathogen were determined, demonstrating the usefulness of Bayesian networks as a diagnostic tool in quantifying risk of water reuse treatment scenarios.

Human Pathogenic Bacteria Detected in Rainwater: Risk Assessment and Correlation to Microbial Source Tracking Markers and Traditional Indicators

Roof-harvested rainwater (RHRW) was investigated for the presence of the human pathogenic bacteria Mycobacterium tuberculosis (M. tuberculosis), Yersinia spp. and Listeria monocytogenes (L. monocytogenes). While Yersinia spp. were detected in 92% (n = 25) of the RHRW samples, and L. monocytogenes and M. tuberculosis were detected in 100% (n = 25) of the samples, a significantly higher mean concentration (1.4 × 10³ cells/100 mL) was recorded for L. monocytogenes over the sampling period. As the identification of appropriate water quality indicators is crucial to ensure access to safe water sources, correlation of the pathogens to traditional indicator organisms [Escherichia coli (E. coli) and Enterococcus spp.] and microbial source tracking (MST) markers (Bacteroides HF183, adenovirus and Lachnospiraceae) was conducted. A significant positive correlation was then recorded for E. coli versus L. monocytogenes (r = 0.6738; p = 0.000), and Enterococcus spp. versus the Bacteroides HF183 marker (r = 0.4071; p = 0.043), while a significant negative correlation was observed for M. tuberculosis versus the Bacteroides HF183 marker (r = −0.4558; p = 0.022). Quantitative microbial risk assessment indicated that the mean annual risk of infection posed by L. monocytogenes in the RHRW samples exceeded the annual infection risk benchmark limit (1 × 10^–4 infections per person per year) for intentional drinking (∼10^–4). In comparison, the mean annual risk of infection posed by E. coli was exceeded for intentional drinking (∼10^–1), accidental consumption (∼10^–3) and cleaning of the home (∼10^–3). However, while the risk posed by M. tuberculosis for the two relevant exposure scenarios [garden hosing (∼10^–5) and washing laundry by hand (∼10^–5)] was below the benchmark limit, the risk posed by adenovirus for garden hosing (∼10^–3) and washing laundry by hand (∼10^–3) exceeded the benchmark limit. Thus, while the correlation analysis confirms that traditional indicators and MST markers should be used in combination to accurately monitor the pathogen-associated risk linked to the utilisation of RHRW, the integration of QMRA offers a more site-specific approach to monitor and estimate the human health risks associated with the use of RHRW.

Retention of E. coli and water on the skin after liquid contact

The frequent contact people have with liquids containing pathogenic microorganisms provides opportunities for disease transmission. In this work, we quantified the transfer of bacteria-using E. coli as a model- from liquid to skin, estimated liquid retention on the skin after different contact activities (hand immersion, wet-cloth and wet-surface contact), and estimated liquid transfer following hand-to-mouth contacts. The results of our study show that the number of E. coli transferred to the skin per surface area (n [E. coli/cm2]) can be modeled using n = C (10-3.38+h), where C [E. coli/cm3] is the concentration of E. coli in the liquid, and h [cm] is the film thickness of the liquid retained on the skin. Findings from the E. coli transfer experiments reveal a significant difference between the transfer of E. coli from liquid to the skin and the previously reported transfer of viruses to the skin. Additionally, our results demonstrate that the time elapsed since the interaction significantly influences liquid retention, therefore modulating the risks associated with human interaction with contaminated liquids. The findings enhance our understanding of liquid-mediated disease transmission processes and provide quantitative estimates as inputs for microbial risk assessments.

Application of QMRA to MAR operations for safe agricultural water reuses in coastal areas

A pathogenic Escherichia coli (E.coli) O157:H7 and O26:H11 dose-response model was set up for a quantitative microbial risk assessment (QMRA) of the waterborne diseases associated with managed aquifer recharge (MAR) practices in semiarid regions. The MAR facility at Forcatella (Southern Italy) was selected for the QMRA application. The target counts of pathogens incidentally exposed to hosts by eating contaminated raw crops or while bathing at beaches of the coastal area were determined by applying the Monte Carlo Markov Chain (MCMC) Bayesian method to the water sampling results. The MCMC provided the most probable pathogen count reaching the target and allowed for the minimization of the number of water samplings, and hence, reducing the associated costs. The sampling stations along the coast were positioned based on the results of a groundwater flow and pathogen transport model, which highlighted the preferential flow pathways of the transported E. coli in the fractured coastal aquifer. QMRA indicated tolerable (<10^-6 DALY) health risks for bathing at beaches and irrigation with wastewater, with 0.4 infectious diseases per year (11.4% probability of occurrence) associated with the reuse of reclaimed water via soil irrigation even though exceeding the E. coli regulation limit of 10 CFU/100 mL by five times. The results show negligible health risk and insignificant impacts on the coastal water quality due to pathogenic E. coli in the wastewater used for MAR. However, droughts and reclaimed water quality can be considered the main issues of MAR practices in semiarid regions suggesting additional reclaimed water treatments and further stress-tests via QMRAs by considering more persistent pathogens than E. coli.

Human Health, Economic and Environmental Assessment of Onsite Non-Potable Water Reuse Systems for a Large, Mixed-Use Urban Building

Onsite non-potable reuse (NPR) is being increasingly considered as a viable option to address water scarcity and infrastructure challenges, particularly at the building scale. However, there are a range of possible treatment technologies, source water options, and treatment system sizes, each with its unique costs and benefits. While demonstration projects are proving that these systems can be technologically feasible and protective of public health, little guidance exists for identifying systems that balance public health protection with environmental and economic performance. This study uses quantitative microbial risk assessment, life cycle assessment and life cycle cost analysis to characterize the human health, environmental and economic aspects of onsite NPR systems. Treatment trains for both mixed wastewater and source-separated graywater were modeled using a core biological process-an aerobic membrane bioreactor (AeMBR), an anaerobic membrane bioreactor (AnMBR) or recirculating vertical flow wetland (RVFW)-and additional treatment and disinfection unit processes sufficient to meet current health-based NPR guidelines. Results show that the graywater AeMBR system designed to provide 100% of onsite non-potable demand results in the lowest impacts across most environmental and human health metrics considered but costs more than the mixed-wastewater version due to the need for a separate collection system. The use of multiple metrics also allows for identification of weaknesses in systems that lead to burden shifting. For example, although the RVFW process requires less energy than the AeMBR process, the RVFW system is more environmentally impactful and costly when considering the additional unit processes required to protect human health. Similarly, we show that incorporation of thermal recovery units to reduce hot water energy consumption can offset some environmental impacts but result in increases to others, including cumulative energy demand. Results demonstrate the need for additional data on the pathogen treatment performance of NPR systems to inform NPR health guidance.

Controlling micropollutants in tertiary municipal wastewater by O3/H2O2, granular biofiltration and UV254/H2O2 for potable reuse applications

A comprehensive pilot study was carried out to experimentally assess the potential of newly developed treatment trains integrating two-stage AOPs and biofiltration to reach potable reuse water quality standards from municipal wastewater. The processes consisted of a two-stage AOPs with (carbon or limestone) biofiltration, the first AOP (O₃/H₂O₂) serving as pre-treatment to biofiltration and the second AOP (UV₂₅₄/H₂O₂) serving as post-biofiltration finishing step to ensure advanced disinfection. A comprehensive monitoring campaign was put in place resulting from the combination of targeted, non-targeted and suspect screening measurements. It was found that 13 organic micropollutants were detected from a list of 219 suspects although at ng/L level only. For the treatment conditions piloted in this study (O₃ = 13 ± 0.5 mg/L, H₂O₂ = 11 ± 0.4 mg/L for the O₃/H₂O₂ process, and UV = 410 ± 63.5 mJ/cm², H₂O₂ = 5 mg/l for the UV₂₅₄/H₂O₂ process), it was possible to estimate the overall removal efficacy for each unit process, which was found to follow this order: RO (99%)  > BAC (87%) > O₃-H₂O₂ (78%)  > BAL (67%)  > UV/H₂O₂ (43%)  > AOP contact chamber (19%)  > UF(0%), with the treatment train integrating two AOPs and granular biofiltration with activated carbon (O₃/H₂O₂ + BAC + UV₂₅₄/H₂O₂) showing superior performance with a 99% abatement in total micropollutants. No ecotoxicologically-positive response was generally observed for any of the effluent samples from the tested trains, even when pre-concentration factors up to 100-1000 times were employed to increase the sensitivity of the bioassay methods.

Evaluating the sustainability of indirect potable reuse and direct potable reuse: a southern Nevada case study

This case study presents a framework for evaluating the sustainability of indirect potable reuse (IPR) and direct potable reuse (DPR) in Las Vegas, Nevada. A system dynamics model was developed to simulate population growth, water supply, water quality, energy costs, net present worth (NPW), and greenhouse gas (GHG) emissions. The model confirmed that DPR could achieve a net reduction in energy costs of up to US$250 million while still ensuring an adequate water supply. However, the high NPW of DPR ($1.0-$4.0 billion) relative to the status quo IPR approach ($0.6 billion) represents a significant economic hurdle, although future monetization of salt loadings and GHGs could reduce that disparity. DPR with ozone-biofiltration would also be hindered by an estimated concentration of total dissolved solids of up to 1,300 mg/L. Despite these barriers to implementation in Las Vegas, certain site-specific conditions may make DPR more attractive in other locations.

Quantitative Microbial Risk Assessment and Infectious Disease Transmission Modeling of Waterborne Enteric Pathogens

PURPOSE OF REVIEW

Waterborne enteric pathogens remain a global health threat. Increasingly, quantitative microbial risk assessment (QMRA) and infectious disease transmission modeling (IDTM) are used to assess waterborne pathogen risks and evaluate mitigation. These modeling efforts, however, have largely been conducted independently for different purposes and in different settings. In this review, we examine the settings where each modeling strategy is employed.

RECENT FINDINGS

QMRA research has focused on food contamination and recreational water in high-income countries (HICs) and drinking water and wastewater in low- and middle-income countries (LMICs). IDTM research has focused on large outbreaks (predominately LMICs) and vaccine-preventable diseases (LMICs and HICs). Human ecology determines the niches that pathogens exploit, leading researchers to focus on different risk assessment research strategies in different settings. To enhance risk modeling, QMRA and IDTM approaches should be integrated to include dynamics of pathogens in the environment and pathogen transmission through populations.

Potable Water Reuse: What Are the Microbiological Risks?

PURPOSE OF REVIEW

With the increasing interest in recycling water for potable reuse purposes, it is important to understand the microbial risks associated with potable reuse. This review focuses on potable reuse systems that use high-level treatment and de facto reuse scenarios that include a quantifiable wastewater effluent component.

RECENT FINDINGS

In this article, we summarize the published human health studies related to potable reuse, including both epidemiology studies and quantitative microbial risk assessments (QMRA). Overall, there have been relatively few health-based studies evaluating the microbial risks associated with potable reuse. Several microbial risk assessments focused on risks associated with unplanned (or de facto) reuse, while others evaluated planned potable reuse, such as indirect potable reuse (IPR) or direct potable reuse (DPR). The reported QMRA-based risks for planned potable reuse varied substantially, indicating there is a need for risk assessors to use consistent input parameters and transparent assumptions, so that risk results are easily translated across studies. However, the current results overall indicate that predicted risks associated with planned potable reuse scenarios may be lower than those for de facto reuse scenarios. Overall, there is a clear need to carefully consider water treatment train choices when wastewater is a component of the drinking water supply (whether de facto, IPR, or DPR). More data from full-scale water treatment facilities would be helpful to quantify levels of viruses in raw sewage and reductions across unit treatment processes for both culturable and molecular detection methods.

Assessment of online bacterial particle counts for monitoring the performance of reverse osmosis membrane process in potable reuse

Safety of potable reuse can be enhanced by improved water quality monitoring techniques for assessing water treatment processes. This study evaluated the efficacy of online bacterial counting for continuous monitoring of reverse osmosis (RO) membranes to remove bacteria using real-time bacteriological commercial counters and an on-site pilot-scale RO system. Prior to on-site assessments, the online bacterial counting was verified by comparing the measurement of fluorescent particles in water with flow cytometry. During a seven day pilot test of RO treatment at a water reclamation plant, online bacterial counts in RO permeate were monitored below 15 counts/mL; whereas the bacterial counts in RO feed water were approximately 2500 to 10,000 counts/mL. Removal rates of bacterial counts ranged from 2.6 to 3.1-log (average = 2.9-log) by continuously monitoring bacterial removal. This is greater than a 2-log reduction frequently determined using other water quality surrogates (i.e., electrical conductivity). Overall, the continuous monitoring of bacteria in RO feed and permeate can be implemented without the addition of chemicals to provide near real-time bacterial counts to measure their reduction after RO treatment. This can be developed for continuous performance monitoring of the RO process, providing greater assurance of microbial water quality after RO treatment.

Human health risk assessment for the occurrence of enteric viruses in drinking water from wells: Role of flood runoff injections

We demonstrated that floods can induce severe microbiological contamination of drinking water from wells and suggest strategies to better address water safety plans for groundwater drinking supplies. Since 2002, the Italian Water Research Institute (IRSA) has detected hepatitis A virus, adenovirus, rotavirus, norovirus, and enterovirus in water samples from wells in the Salento peninsula, southern Italy. Perturbations in the ionic strength in water flow can initiate strong virus detachments from terra rossa sediments in karst fractures. This study therefore explored the potential health impacts of prolonged runoff injections in Salento groundwater caused by severe flooding during October 2018. A mathematical model for virus fate and transport in fractures was applied to determine the impact of floodwater injection on groundwater quality by incorporating mechanisms that affect virus attachment/detachment and survival in flowing water at microscale. This model predicted target concentrations of enteric viruses that can occur unexpectedly in wells at considerable distances (5-8 km) from the runoff injection site (sinkhole). Subsequently, the health impact of viruses in drinking water supplied from contaminated wells was estimated during the summer on the Salento coast. Specific unpublished dose-response model coefficients were proposed to determine the infection probabilities for Echo-11 and Polio 1 enteroviruses through ingestion. The median (50%) risk of infection was estimated at 6.3 · 10^-3 with an uncertainty of 23%. The predicted burden of diseases was 4.89 disability adjusted life years per year, i.e., twice the maximum tolerable disease burden. The results highlight the requirement for additional water disinfection treatments in Salento prior to the distribution of drinking water. Moreover, monthly controls of enteric virus occurrence in water from wells should be imposed by a new water framework directive in semiarid regions because of the vulnerability of karst carbonate aquifers to prolonged floodwater injections and enteric virus contamination.

The Water Microbiome Through a Pilot Scale Advanced Treatment Facility for Direct Potable Reuse

Advanced treatment facilities for potable water reuse of wastewater are designed to achieve high removal levels of specific pathogens, as well as many other constituents. However, changes to the microbial community throughout treatment, storage, and distribution of this water have not been well characterized. We applied high-throughput amplicon sequencing, read-based, assembly-based, and genome-resolved metagenomics, and flow cytometry to investigate the microbial communities present in a pilot-scale advanced water treatment facility. Advanced treatment of secondary-treated wastewater consisted of ozonation, chloramination, microfiltration, reverse osmosis (RO), advanced oxidation (UV/H₂O₂), granular activated carbon (GAC) filtration, and chlorination. Treated water was fed into bench-scale simulated distribution systems (SDS). Cell counts and microbial diversity in bulk water decreased until GAC filtration, and the bacterial communities were significantly different following each treatment step. Bacteria grew within GAC media and contributed to a consistent microbial community in the filtrate, which included members of the Rhizobiales and Mycobacteriaceae. After chlorination, some of the GAC filtrate community was maintained within the SDS, and community shifts were associated with stagnation. Putative antibiotic resistance genes and potential opportunistic pathogens were identified before RO and after advanced oxidation, although few if any members of the wastewater microbial community passed through these treatment steps. These findings can contribute to improved design of advanced treatment trains and management of microbial communities in post-treatment steps.

Roofing material and irrigation frequency influence microbial risk from consuming homegrown lettuce irrigated with harvested rainwater

Rooftop harvested rainwater has become an alternative, potable, and non-potable water source used around the world. In the United States, rooftop harvested rainwater is most commonly used for irrigation. Rooftop harvested rainwater may contain contaminants from bird or animal feces that may present a risk to water users. Different roofing materials may influence the survival of fecal bacteria on the rooftop prior to runoff during rainfall. In this study, three pathogen groups (E. coli, enterococci and Salmonella enterica) in rooftop runoff from three, replicated roof types (asphalt shingle, synthetic slate, and wood shake) were quantified in multiple rain events. Matched roofs were selected from locations with differing amounts of tree cover. Enterococci were the most frequently detected bacteria from all roof types. Wood shake and asphalt shingle roofing materials had the poorest microbial water quality. Rainwater runoff from two of the six buildings failed to meet United States Food and Drug Administration microbial standards for irrigation water. A quantitative microbial risk assessment indicated that the annual probability of illness from consuming lettuce irrigated with rooftop harvested rainwater varied by roofing material, irrigation water withholding period, and exposure frequency. Consuming lettuce immediately after irrigation with rooftop rainwater presented the highest human health risk based on the probability of illness from E. coli and enterococci exposure. Withholding irrigation by 1 day prior to harvest decreased the annual probability of illness from E. coli by 2 log, but had a minimal effect on the risk from enterococci.

Human health impact of non-potable reuse of distributed wastewater and greywater treated by membrane bioreactors

We assessed the annual probability of infection resulting from non-potable exposures to distributed greywater and domestic wastewater treated by an aerobic membrane bioreactor (MBR) followed by chlorination. A probabilistic quantitative microbial risk assessment was conducted for both residential and office buildings and a residential district using Norovirus, Rotavirus, Campylobacter jejuni, and Cryptosporidium spp. as reference pathogens. A Monte Carlo approach captured variation in pathogen concentration in the collected water and pathogen (or microbial surrogate) treatment performance, when available, for various source water and collection scale combinations. Uncertain inputs such as dose-response relationships and the volume ingested were treated deterministically and explored through sensitivity analysis. The predicted 95th percentile annual risks for non-potable indoor reuse of distributed greywater and domestic wastewater at district and building scales were less than the selected health benchmark of 10^-4 infections per person per year (ppy) for all pathogens except Cryptosporidium spp., given the selected exposure (which included occasional, accidental ingestion), dose-response, and treatment performance assumptions. For Cryptosporidium spp., the 95th percentile annual risks for reuse of domestic wastewater (for all selected collection scenarios) and district-collected greywater were greater than the selected health benchmark when using the limited, available MBR treatment performance data; this finding is counterintuitive given the large size of Cryptosporidium spp. relative to the MBR pores. Therefore, additional data on MBR removal of protozoa is required to evaluate the proposed MBR treatment process for non-potable reuse. Although the predicted Norovirus annual risks were small across scenarios (less than 10^-7 infections ppy), the risks for Norovirus remain uncertain, in part because the treatment performance is difficult to interpret given that the ratio of total to infectious viruses in the raw and treated effluents remains unknown. Overall, the differences in pathogen characterization between collection type (i.e., office vs. residential) and scale (i.e., district vs. building) drove the differences in predicted risk; and, the accidental ingestion event (although modeled as rare) determined the annual probability of infection. The predicted risks resulting from treatment malfunction scenarios indicated that online, real-time monitoring of both the MBR and disinfection processes remains important for non-potable reuse at distributed scales. The resulting predicted health risks provide insight on the suitability of MBR treatment for distributed, non-potable reuse at different collection scales and the potential to reduce health risks for non-potable reuse.

Direct potable reuse microbial risk assessment methodology: Sensitivity analysis and application to State log credit allocations

Understanding pathogen risks is a critically important consideration in the design of water treatment, particularly for potable reuse projects. As an extension to our published microbial risk assessment methodology to estimate infection risks associated with Direct Potable Reuse (DPR) treatment train unit process combinations, herein, we (1) provide an updated compilation of pathogen density data in raw wastewater and dose-response models; (2) conduct a series of sensitivity analyses to consider potential risk implications using updated data; (3) evaluate the risks associated with log credit allocations in the United States; and (4) identify reference pathogen reductions needed to consistently meet currently applied benchmark risk levels. Sensitivity analyses illustrated changes in cumulative annual risks estimates, the significance of which depends on the pathogen group driving the risk for a given treatment train. For example, updates to norovirus (NoV) raw wastewater values and use of a NoV dose-response approach, capturing the full range of uncertainty, increased risks associated with one of the treatment trains evaluated, but not the other. Additionally, compared to traditional log-credit allocation approaches, our results indicate that the risk methodology provides more nuanced information about how consistently public health benchmarks are achieved. Our results indicate that viruses need to be reduced by 14 logs or more to consistently achieve currently applied benchmark levels of protection associated with DPR. The refined methodology, updated model inputs, and log credit allocation comparisons will be useful to regulators considering DPR projects and design engineers as they consider which unit treatment processes should be employed for particular projects.