Land application of manure and Class B biosolids: an occupational and public quantitative microbial risk assessment

Assessing environmental exposure to viruses in wastewater treatment plant and swine farm scenarios with next-generation sequencing and occupational risk approaches

Occupational exposure to pathogens can pose health risks. This study investigates the viral exposure of workers in a wastewater treatment plant (WWTP) and a swine farm by analyzing aerosol and surfaces samples. Viral contamination was evaluated using quantitative polymerase chain reaction (qPCR) assays, and target enrichment sequencing (TES) was performed to identify the vertebrate viruses to which workers might be exposed. Additionally, Quantitative Microbial Risk Assessment (QMRA) was conducted to estimate the occupational risk associated with viral exposure for WWTP workers, choosing Human Adenovirus (HAdV) as the reference pathogen. In the swine farm, QMRA was performed as an extrapolation, considering a hypothetical zoonotic virus with characteristics similar to Porcine Adenovirus (PAdV). The modelled exposure routes included aerosol inhalation and oral ingestion through contaminated surfaces and hand-to-mouth contact. HAdV and PAdV were widespread viruses in the WWTP and the swine farm, respectively, by qPCR assays. TES identified human and other vertebrate viruses WWTP samples, including viruses from families such as Adenoviridae, Circoviridae, Orthoherpesviridae, Papillomaviridae, and Parvoviridae. In the swine farm, most of the identified vertebrate viruses were porcine viruses belonging to Adenoviridae, Astroviridae, Circoviridae, Herpesviridae, Papillomaviridae, Parvoviridae, Picornaviridae, and Retroviridae. QMRA analysis revealed noteworthy risks of viral infections for WWTP workers if safety measures are not taken. The probability of illness due to HAdV inhalation was higher in summer compared to winter, while the greatest risk from oral ingestion was observed in workspaces during winter. Swine farm QMRA simulation suggested a potential occupational risk in the case of exposure to a hypothetical zoonotic virus. This study provides valuable insights into WWTP and swine farm worker's occupational exposure to human and other vertebrate viruses. QMRA and NGS analyses conducted in this study will assist managers in making evidence-based decisions, facilitating the implementation of protection measures, and risk mitigation practices for workers.

Data-driven systematic analysis of waterborne viruses and health risks during the wastewater reclamation process

Waterborne viral epidemics are a major threat to public health. Increasing interest in wastewater reclamation highlights the importance of understanding the health risks associated with potential microbial hazards, particularly for reused water in direct contact with humans. This study focused on identifying viral epidemic patterns in municipal wastewater reused for recreational applications based on long-term, spatially explicit global literature data during 2000-2021, and modelled human health risks from multiple exposure pathways using a well-established quantitative microbial risk assessment methodology. Global median viral loads in municipal wastewater ranged from 7.92 × 104 to 1.4 × 106 GC L-1 in the following ascending order: human adenovirus (HAdV), norovirus (NoV) GII, enterovirus (EV), NoV GI, rotavirus (RV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Following secondary or tertiary wastewater treatment, NoV GI, NoV GII, EV, and RV showed a relatively higher and more stable log reduction value with medians all above 0.8 (84%), whereas SARS-CoV-2 and HAdV showed a relatively lower reduction, with medians ranging from 0.33 (53%) to 0.55 (72%). A subsequent disinfection process effectively enhanced viral removal to over 0.89-log (87%). The predicted event probability of virus-related gastrointestinal illness and acute febrile respiratory illnesses in reclaimed recreational water exceeded the World Health Organization recommended recreational risk benchmark (5% and 1.9%, respectively). Overall, our results provided insights on health risks associated with reusing wastewater for recreational purposes and highlighted the need for establishing a regulatory framework ensuring the safety management of reclaimed waters.

Quantitative microbial risk assessment associated with the use of container-based toilets in Haiti

A container-based toilet (CBT) is a type of ecological toilet that allows users to compost their feces. During emptying, bucket washing, and composting operations, operators are exposed to microbial risks. This paper aims to evaluate these risks using the Quantitative Microbial Risk Assessment (QMRA) method. Nine pathogens prevalent in Haiti were targeted: Ascaris lumbricoides, Campylobacter spp., Cryptosporidium parvum, Escherichia coli O157:H7, Giardia intestinalis, poliovirus, Salmonella spp., Shigella spp., and Vibrio cholerae. Information regarding pathogens' concentration in feces came from scientific literature data. The exposure scenarios considered were those in which operators accidentally ingested a low dose of feces during the aforementioned operations. A Monte Carlo simulation was conducted to address uncertainties. The results showed that the probability of infection is highly elevated, while the probability of illness is generally moderate or minor, except for poliovirus and Ascaris. Preventive measures can be implemented to reduce these risks during various operations, such as wearing gloves, disposable protective masks, and appropriate clothing. It is up to the political authorities to develop guidelines in this regard and to organize awareness-raising activities with the help of local organizations mandated by the relevant authorities to ensure the safer use of technology by households.

Evaluating the threshold limit value of acceptable exposure concentration for exposure to bioaerosols in a wastewater treatment plant: Reverse-quantitative microbial risk assessment and sensitivity analysis

Agitation operations produce numerous pathogenic bioaerosols in WWTPs¹. QMRA² can determine risks of persons exposed to these bioaerosols. However, QMRA framework cannot help stakeholders in immediately deciding whether a risk is intolerable. Thus, evaluating threshold of acceptable exposure concentration is an urgent issue but is still rarely addressed in WWTPs. This study analyzed TLV³ benchmarks of E. coli and S. aureus bioaerosols emitted from a WWTP by reverse-QMRA. Furthermore, variance of input parameters was clarified by sensitivity analysis. Results showed that, under conservative and optimistic estimates, TLV of technicians was 1.52-2.06 and 1.26-1.68 times as large as those of workers, respectively; wearing mask drive TLV up to 1-2 orders of magnitude; TLV of M⁴ was at most 1.33 and 1.31 times as large as that of RD⁵, respectively. For sensitivity analysis, removal fraction by equipping PPE enlarge TLV for effortlessly obtaining an acceptable assessment result; exposure time was dominant when without PPE excepting the scenario of technicians exposed to E. coli bioaerosol. This study helps establish threshold guidelines for bioaerosols in WWTPs and contribute innovative perspectives for stakeholders.

Evaluation of Seasonal Variation on the Health Risks Using the Quantitative Microbial Risk Assessment Approach in a Wastewater Treatment Plant in Hamadan, Iran

BACKGROUND

Wastewater treatment plants (WWTPs) are a source of airborne bacterial contamination that can pose health risks to staff. The aim of this study was to evaluate seasonal variations in the health risks of exposure to Staphylococcus aureus bioaerosols using the quantitative microbial risk assessment (QMRA) approach in a WWTP in Hamadan, Iran.

STUDY DESIGN

This was a descriptive cross-sectional study.

METHODS

This study determined the emission concentrations of S. aureus bioaerosols in summer and winter. Then, the health risks of three exposure scenarios (the worker, field engineer, and laboratory technician) were evaluated using the QMRA approach. The bioaerosol samples were collected every 12 days in both summer and winter of 2021 with a nutrient agar using a single-stage cascade impactor (Quick Take 30, SKC Inc.) in both outdoor and indoor environments.

RESULTS

The results demonstrated that in both seasons, S. aureus bioaerosol concentrations in outdoor and indoor environments were below the standard established by the American Conference of Governmental Industrial Hygienists (500 CFU/m3 ). While in summer, the annual infection risks and the disease burden for the three exposure scenarios in both outdoor and indoor environments were higher than the United States Environmental Protection Agency (≤10-4 pppy) and the World Health Organization (WHO) (≤10-6 DALYs pppy-1) benchmarks, respectively.

CONCLUSION

The findings provided high health risks for staff in the three exposure scenarios of an indoor environment, which should not be ignored, as well as emphasizing the use of the QMRA approach to estimate health risks caused by occupational exposure to bioaerosols and taking executive measures to protect staff working in the WWTPs.

Quantitative microbial risk assessment with nasal/oral breathing pattern for S. aureus bioaerosol emission from aeration tanks and residual sludge storage yard in a wastewater treatment plant

A large number of pathogenic bioaerosols are generated during the treatment process of wastewater treatment plants (WWTPs), and they can pose potential risks to human health. Therefore, this study systematically analyzed the emission characteristics of Staphylococcus aureus bioaerosols released from an inverted umbrella aeration tank, a microporous aeration tank, and a residual sludge storage yard in a WWTP, and quantitatively evaluated the health risks of four kinds of exposed populations with nasal/oral breathing patterns under optimistic and conservative estimations. The results displayed that the bioaerosol concentration in inverted umbrella aeration tank was higher than that in microporous aeration tank and residual sludge storage yard. Aerosolization ratio in residual sludge storage yard was an order of magnitude lower than that in aeration tanks. Sludge workers were at higher health risks than the other three exposed populations. The health risks of nasal breathers (infection risk: 1.62 × 10^-5-2.56 × 10^-3 pppy; disease burden: 4.24 × 10^-8-6.72 × 10^-6 DALYs pppy) were 0.61-0.63 times higher than those of oral breathers (infection risk: 9.95 × 10^-6-1.59 × 10^-3 pppy; disease burden: 2.61 × 10^-8-4.18 × 10^-6 DALYs pppy). For female field engineers using oral breathing, laboratory technicians, and researchers without personal protective equipment (PPE), infection risk and disease burden had the opposite results, which indicated that satisfying one certain benchmark did not mean absolute safety. In addition, health risks of exposed populations were reduced by an order of magnitude after wearing PPE. This study can provide a reliable theoretical basis for the risk prevention of bioaerosols and supply data support for the strategies of health risk control perspectives for local sewage utilities.

Bioaerosols emission characteristics from wastewater treatment aeration tanks and associated health risk exposure assessment during autumn and winter

Aeration tanks from activated sludge wastewater treatment plants (WWTPs) can release a large amount of bioaerosols that can pose health risks. However, risk characterization of bioaerosols emissions form wastewater treatment plants is currently not systematically carried out and still in its infancy. Therefore, this study investigated emission characteristic of two indicator model bioaerosols Staphylococcus aureus and Escherichia coli, emitted from aeration tanks of a municipal WWTP. Monte Carlo simulation was then used to quantitatively assess microbial risk posed by different aeration modes under optimistic and conservative estimates. Further to this, two different exposure scenarios were considered during 3 days sampling campaign in autumn and winter. Results showed that the bioaerosol concentration from microporous aeration tank (20-262 CFU m^-3) was one order of magnitude lower than rotating disc aeration tank. Average aerosolization rate was 7.5 times higher with mechanical aeration mode. Health risks of exposed populations were 0.4 and 9.6 times higher in winter than in autumn for E. coli and S. aureus bioaerosol, respectively. Health risks of staff members were 10 times higher than academic visitors. Interesting results were observed for academic visitors without personal protective equipment (PPE) respectively exposed to S. aureus and E. coli bioaerosol in autumn and winter: while the derived infection risk met the United States Environmental Protection Agency (U.S. EPA) benchmark under optimistic estimation, the disease risk burden was over the World Health Organization (WHO) benchmark under conservative estimation. These revealed that only satisfying one of the two benchmarks didn't mean absolute acceptable health risk. This study could facilitate the development of better understanding of bioaerosol quantitative assessment of risk characterizations and corresponding appropriate risk control strategies for wastewater utilities.

Minding the matrix: The importance of inoculum suspensions on finger transfer efficiency of virus

AIMS

The aim of this study was to determine how the transfer efficiency of MS-2 coliphage from the toilet seat to hands and fingertip to lip differs according to the suspension of the inoculum.

METHODS AND RESULTS

Hands were sampled after lifting a toilet seat which was inoculated with MS-2 on the underneath side. MS-2 was suspended in a spectrum of proteinaceous and non-proteinaceous solutions. Transfer efficiencies were greatest with the ASTM tripartite soil load (3.02% ± 4.03) and lowest with phosphate-buffered saline (PBS) (1.10% ± 0.81) for hand-to-toilet seat contacts. Finger-to-lip transfer rates were significantly different (p < 0.05) depending on suspension matrix, with PBS yielding the highest transfer (52.53% ± 4.48%) and tryptose soy broth (TSB) the lowest (23.15% ± 24.27%). Quantitative microbial risk assessment was used to estimate the probability of infection from adenovirus and norovirus from finger contact with a toilet seat.

CONCLUSIONS

The greatest transfer as well as the largest variation of transfer were measured for finger-to-lip contacts as opposed to toilet seat-to-finger contacts. These factors influence the estimation of the probability of infection from micro-activity, that is, toilet seat adjustment.

SIGNIFICANCE AND IMPACT

Viruses may be transferred from various human excreta with differing transfer efficiencies, depending on the protein content.

Tracking antibiotic resistance through the environment near a biosolid spreading ground: Resistome changes, distribution, and metal(loid) co-selection

The application of urban wastewater treatment plants (WWTPs) products to agricultural lands has contributed to the rising level of antibiotic resistance and drawn a critical public health concern. It has not been thoroughly investigated at which spatial scales a biosolid applied area as a potentially predominant source affects surrounding soil resistomes. This study investigated distribution and impact of WWTP biosolids treated with anaerobic digestion on an agricultural area. Heterotrophic plate counts (HPCs) and quantitative polymerase chain reaction (qPCR) were performed for detection of selected antibiotic-resistant bacteria (ARB), selected antibiotic resistance genes (ARGs), intI1 genes, and 16S rRNA genes. Biosolid samples contained significantly higher levels of selected ARGs than the raw agricultural soils (p < 0.05). The average relative abundances of intI1, sul1, bla_SHV, and ermB genes were significantly higher in biosolid-amended soils than nearby agricultural soils (p < 0.05). Spatial interpolation analysis of relative gene abundances of intI1, sul1, sul2, and tetW across the studied area further indicated directional trends towards the northwest and southeast directions, highlighting possible airborne spread. Concentrations of Co, Cu, Ni, and Fe were found to be significantly and positively correlated with relative abundances of intI1, sul1, and tetW genes (p < 0.05). The resistance ratios of culturable antibiotic-resistant bacteria in agricultural soils with biosolid amendments were generally identical to those without biosolid amendments. This study will advance the understanding of the antibiotic resistome in agricultural soils impacted by long-term waste reuse and inform the evaluation strategies for future biosolids application and management.

Manual emptying of ventilated improved pit latrines and hygiene challenges - a baseline survey in a peri-urban community in KwaZulu-Natal, South Africa

The presence of Escherichia coli and Staphylococcus spp. was determined on the skin, personal protective equipment, the municipal vehicle, and various surfaces at ten households in a peri-urban community (KwaZulu-Natal, South Africa) before and after manual emptying of ventilated improved pit latrines. Surface samples (n = 14) were collected using sterile wet wipes, and target bacteria were detected using standard procedures. Additionally, E. coli was enumerated in soil samples from an area of open defecation (log₁₀ 3.7 MPN/g) and areas where geophagia occurred (log₁₀ 2.7 - log₁₀ 3.3 MPN/g), using a most probable number (MPN) method. The detection frequency for the target bacteria on household surfaces (e.g., the walkway between the pit latrine and the municipal vehicle) and on municipal workers' hands (which were frequently contaminated before pit emptying), occasionally increased after the pits were emptied, indicating that manual pit emptying might pose a potential health risk to workers and community members.

Microbial characteristics of municipal solid waste compost: Occupational and public health risks from surface applied compost

Land application of MSW compost promotes the soil fertility and productivity, but there is concern about its chemical and microbial quality. Although, current microbial indicators of MSW compost are generally considered to be protective of human health, the use of these indicators doesn't adequately represent the presence of pathogens that might be more resistant to inactivation during composting process. This work aims evaluation of the microbial characteristics of MSW compost and estimation of the health risks associated with exposure to pathogens of potential concern in MSW compost. Although the recommended standards for fecal coliforms and Salmonella were met in a relatively high percentage of samples, there were detectable levels of microbial pathogens. The highest daily infection risk was estimated for Cryptosporidium (1.25 × 10^-3 per person) followed by Salmonella and Campylobacter, while the lowest related to adenovirus. Infection risks were low for both farmers and children in one-time exposure and all pathogen risks were decreased with increasing waiting time to near insignificant levels. However, the median annual risk of cryptosporidiosis or gastroenteritis was above the recommended value of 10^-3 per person per year. Because of potential presence of pathogens in MSW compost, some level of pathogen monitoring beyond conventional indicators may be required to estimate potential risks. The findings of this study could provide information to governments and local authorities in making decisions on measures to reduce risk from application of MSW compost. Further research is needed to obtain the reliable information about the inactivation of microorganisms in environment.

Human adenovirus in municipal solid waste leachate and quantitative risk assessment of gastrointestinal illness to waste collectors

Leachate is a variable effluent from waste management systems generated during waste collection and on landfills. Twenty-two leachate samples from waste collection trucks and a landfill were collected from March to December 2019 in the municipality of Rio de Janeiro (Brazil) and were analyzed for Human Adenovirus (HAdV), bacterial indicators and physico-chemical parameters. For viral analysis, samples were concentrated by ultracentrifugation and processed for molecular analysis using QIAamp Fast DNA Stool mini kit® for DNA extraction followed by nested-PCR and qPCR/PMA-qPCR TaqMan® system. HAdV was detected by nested-PCR in 100% (9/9) and 83.33% (12/13) of the truck and landfill leachate samples, respectively. Viral concentrations ranged from 8.31 × 10¹ to 6.68 × 10⁷ genomic copies per 100 ml by qPCR and PMA-qPCR. HAdV species A, B, C, and F were characterized using nucleotide sequencing. HAdV were isolated in A549 culture cells in 100% (9/9) and 46.2% (6/13) from truck and landfill leachate samples, respectively. Regardless of the detection methods, HAdV concentration was predicted by the quantity of total suspended solids. A quantitative microbial risk assessment was performed to measure the probability of gastrointestinal (GI) illness attributable to inadvertent oral ingestion of truck leachate, revealing the higher probability of disease for the direct splashing into the oral cavity (58%) than for the gloved hand-to-mouth (33%). In a scenario where waste collectors do not wear gloves as protective personal equipment, the risk increases to 67%. This is the first study revealing infectious HAdV in solid waste leachate and indicates a potential health risk for waste collectors.

Estimating acceptable exposure time for bioaerosols emission in a wastewater treatment plant by reverse quantitative microbial risk assessment based on various risk benchmarks

Populations exposed to bioaerosols over time in wastewater treatment plants (WWTPs) will be infected. Then, the reverse quantitative microbial risk assessment (QMRA) provides a quantitative framework for the estimation of acceptable exposure time to protect people from excessive exposure and then manage their health risk. In this study, the acceptable exposure time for staffs and visiting researchers exposed to S. aureus or E. coli bioaerosols emitted from aeration ponds in WWTPs was estimated and analyzed by Monte Carlo simulation-based reverse QMRA (using the 1E-4 pppy suggested by the US EPA or 1E-6 DALYs pppy suggested by the WHO as benchmarks). The 1E-3 and 1E-2 pppy were selected as a series of loose annual infection risk benchmarks to calculate a practical acceptable exposure time. The results showed that for the acceptable exposure time in each specific exposure scenario, the exposure of females was consistently 0.3-0.4 times longer than that of males; the exposure of staffs was 3.6-3.9 times shorter than that of visiting researchers; the exposures of populations in the rotating-disc aeration mode were consistently 6.3-6.6 and 2.8-3.1 times longer than those in the microporous aeration mode for S. aureus and E. coli bioaerosols, respectively. The acceptable exposure time with the use of personal protective equipment (PPE) was 33.4-35.0 times as long as that without PPE. The US EPA benchmark is stricter than the WHO benchmark with regard to the estimation of the acceptable exposure time of S. aureus or E. coli bioaerosols. The 1E-3 pppy is more appropriate and practical than the US EPA benchmark, but the 1E-2 pppy is notably too loose for health risk management. This research can assist managers of WWTPs to formulate a justified exposure time and develop applicable administrative and personal intervention strategies. The results can enrich the knowledge bases of reverse QMRA to elect a series of loose health-based target risk benchmarks for health risk management.

Inactivation and risk control of pathogenic microorganisms in municipal sludge treatment: A review

The rapid global spread of coronavirus disease 2019 (COVID-19) has promoted concern over human pathogens and their significant threats to public health security. The monitoring and control of human pathogens in public sanitation and health facilities are of great importance. Excessive sludge is an inevitable byproduct of sewage that contains human and animal feces in wastewater treatment plants (WWTPs). It is an important sink of different pollutants and pathogens, and the proper treatment and disposal of sludge are important to minimize potential risks to the environment and public health. However, there is a lack of comprehensive analysis of the diversity, exposure risks, assessment methods and inactivation techniques of pathogenic microorganisms in sludge. Based on this consideration, this review summarizes the control performance of pathogenic microorganisms such as enterovirus, Salmonella spp., and Escherichia coli by different sludge treatment technologies, including composting, anaerobic digestion, aerobic digestion, and microwave irradiation, and the mechanisms of pathogenic microorganism inactivation in sludge treatment processes are discussed. Additionally, this study reviews the diversity, detection methods, and exposure risks of pathogenic microorganisms in sludge. This review advances the quantitative assessment of pathogenic microorganism risks involved in sludge reuse and is practically valuable to optimize the treatment and disposal of sludge for pathogenic microorganism control.

Influence of pig farming on human Gut Microbiota: role of airborne microbial communities

It has been hypothesized that both genetics and diet influence the composition of the human cecal microbiota. However, it remains unclear whether and how occupational exposure to microbes impacts the microbial communities in human guts. Using a One Health approach, we visited pig farms (n = 26) and collected stool specimens from pig workers (n = 59), pig barn air samples (n = 19), and rectal swabs from pigs at three different growth stages (n = 144). Stool samples from cattle workers were included as a control group (n = 22). Each sample's microbiota was characterized using 16S rRNA gene sequencing and the DADA2 pipeline.We obtained a significantly different clustering of the microbial compositions of pig and cattle workers by permutational multivariate analysis of variance (PERMANOVA; P < .001). Workers primarily exposed to pigs had higher relative abundances of Prevotellaceae and less Bacteroidaceae than workers exposed to cattle. We also found that the microbial compositions of pig workers' stool samples shared extensive fractions with the samples from their pigs. We also identified amplicon sequencing variants (ASVs) in the airborne microbiota which were likely involved in zoonotic transmission events.We hypothesize that ASVs originating from pig feces are aerosolized and, through breathing, get trapped in the pig farm workers' upper respiratory tract from where they can get swallowed. Consequently, some of the animal associated ASVs are transferred into the gastrointestinal tracts (GITs) which leads to changes in the composition of the human gut microbiota. The importance of this finding for human health must be investigated further.

Risk assessment of Escherichia coli in bioaerosols generated following land application of farmyard slurry

Transfer of Escherichia coli in bioaerosols to humans during and shortly after the land application of farmyard slurry may pose human health hazards, but it has not been extensively explored to date. The present study developed a quantitative risk assessment model for E. coli through the air exposure route. The probabilistic model assessed the predicted number of microorganisms in the air (PN_air) to which humans may be exposed. A Gaussian air dispersion model was used to calculate the concentration of E. coli transmitted through aerosols. Human exposure (HE) to E. coli was estimated using a Monte Carlo simulation approach. This research predicted the mean HE as 26 CFU day^-1 (95th percentile 263 CFU day^-1) and suggests the importance of keeping a distance of at least 100 m for the residential population from land spreading activities. However, the simulated mean daily or annual (once a year application) risk of 2.65 × 10^-7 person^-1 year^-1 due to land application of slurry indicates very low occupational risk for farmworkers not equipped with the personal protective equipment (PPE), who are potentially exposed to E. coli indirectly. The model found that the decay constant of E. coli in air, duration of decay, and bio-aerosolisation efficiency factor (top three) could influence HE to airborne E. coli. Furthermore, this research recommends an average time lag of at least 2.5 h following the application of farmyard slurry to the field before humans access the field again without PPE, allowing the airborne pathogen to decay, thereby ensuring occupational safety. The model suggested that the bio-aerosolisation efficiency factor (E) for other pathogens requires further investigation. The information generated from this model can help to assess likely exposure from bioaerosols triggered by land application of farmyard slurry.

Quantitative Microbial Risk Assessment (QMRA) of Workers Exposure to Bioaerosols at MSW Open Dumpsites

The bioaerosol exposure data from the study by Akpeimeh, Fletcher, and Evans (2019) was used to compute the risk of infection from the exposure of dumpsite workers to Aspergillus fumigatus and Escherichia coli O157:H7. A stochastic (Markov Chain) model was used to model the transport of the inhaled dose though the human respiratory system and then integrated into the beta-Poisson dose-response model to estimate workers risks of respiratory and gastrointestinal (GI) infection. The infection risk was computed based on workers exposure to E. coli O157:H7 at 10-50% pathogen ingestion rate and pathogen-indicator ratio (P:I) of 1:10³ and 1:10⁴ , while exposure to A. fumigatus was based solely on the average initial exposure dose. The results showed that after 11 hours of exposure, workers engaged in scavenging, waste sorting, and site monitoring were at risk of respiratory and GI infection in the magnitude of 10^-1 . However, the risk estimates associated with specific areas of the dumpsite showed that, the risk of GI infection at the active area ranged between 3.23 × 10^-3 -1.56 × 10^-2 and 3.25 × 10^-4 -1.62 × 10^-3 ; dormant area 2.06 × 10^-3 -1.01 × 10^-2 and 2.09 × 10^-4 -1.04 × 10^-3 ; entrance 1.85 × 10^-3 -9.09 × 10^-3 and 1.87 × 10^-4 -9.27 × 10^-4 ; boundary 1.82 × 10^-3 -8.82 × 10^-3 and 2.09 × 10^-4 -8.94 × 10^-4 for P:I = 1:10³ and 1:10⁴ respectively, while the risk of respiratory infection risks were in the magnitude of 10^-1 for all four locations. The estimated risk of workers developing respiratory and gastrointestinal infections were high for all activities assessed at the dumpsite.

Quantitative microbial risk assessment for occupational health of temporary entrants and staffs equipped with various grade PPE and exposed to microbial bioaerosols in two WWTPs

Purpose

This study was to evaluate the occupational health risks of infection from Gram-negative bacteria and Staphylococcus aureus bioaerosols to temporary entrants and staffs equipped with various grade personal protection equipment (PPE) related to wastewater treatment plants (WWTPs).

Methods

This study determined the emission concentrations of Gram-negative bacteria and Staphylococcus aureus bioaerosols from two WWTPs under various aeration modes. Then, a strict quantitative microbial risk assessment (QMRA) was performed on several exposure scenarios associated with occupational health risks of temporary entrants (researchers, visitors, and inspectors) and staffs (field engineer and laboratory technician).

Results

Although the bioaerosol concentrations were generally regarded as safe according to existing standards, these bioaerosols’ health risks were still unacceptable. The microbial bioaerosols posed considerable infection health risks in WWTPs. These risks were generally above the WHO and US EPA benchmarks. The health risks of females were always smaller than those of male of grown-up age group. Staffs that had been exposed to bioaerosols for a long time were found to have higher health risks compared with temporary entrants. In addition, field engineers equipped with PPE rendered low health risks, thus revealing that wearing PPE could effectively reduce the occupational health risks.

Conclusion

This study provided novel data and enriched the knowledge of microbial bioaerosol emission’s health risks from various aeration modes in WWTPs. Management decisions could be executed by authorities on the basis of the results of QMRA for field engineers equipped with PPE to reduce the related occupational health risks.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01663-5.

Emission characteristics of bioaerosol and quantitative microbiological risk assessment for equipping individuals with various personal protective equipment in a WWTP

Wastewater treatment plants (WWTPs) are a nonnegligible source of bioaerosols that can pose health risks to workers and nearby residents. Thus, this study systematically investigated the emission characteristics of the size distribution and concentration of Staphylococcus aureus bioaerosol in a WWTP. Then, the research focused on the quantitative microbiological risk assessment (QMRA) of workers and nearby residents for equipping them with various grades personal protective equipment (PPE). Results showed that the peak proportion of the size distributions of bioaerosol particles in the three sources all obtained a size range between 3.3 and 4.7 μm. In the residential building, the peak proportion was larger (>7.0 μm). Referring to the three sources, the average bioaerosol concentrations were in the following sequence: inverted umbrella aerator tank > residual sludge storage yard > microporous aerator tank. The health risks of residents were generally 1-2 orders of magnitude higher than the other two exposure scenarios and were clearly beyond the benchmarks. Meanwhile, the health risks of the field engineer were usually lower than those of the staff at the residual sludge storage yard. In general, equipping workers and residents with PPE could at least decrease the health risks by one order of magnitude, and higher-grade PPE could appropriately promote the reduction of health risks. This research systematically delivered a series of novel data about the emission characteristics of Staphylococcus aureus bioaerosol in a WWTP. It advanced the understanding of the quantitative health risks of equipping individuals with various PPE.

Quantitative microbial risk assessment of occupational and public risks associated with bioaerosols generated during the application of dairy cattle wastewater as biofertilizer

The reuse or recycling of wastewater provides environmental and economic benefits, representing a sustainable and circular alternative for the management of liquid waste. However, the application of effluents to agricultural crops via spraying creates a potentially dangerous situation for individuals exposed to airborne pathogens. This study used Quantitative Microbial Risk Assessment (QMRA) tools to quantitatively assess the microbial risks of occupational and public exposures to bioaerosols in fertigation scenarios by spraying untreated and treated dairy cattle wastewater. Analyses of Escherichia coli (EC) and spores of Clostridium perfringens (CpSP) in raw and treated effluents as well as pathogen / indicator ratios from the literature were used to estimate the concentrations of Escherichia coli O157:H7 (EC O157:H7) and Cryptospodirium spp. (Crypto) in the air, and the results were applied to an atmospheric microbiological dispersion model. From the concentrations of pathogens in the air, infectious risks for downwind receptors were calculated. The risks of infection by EC O157:H7 to workers at 10 m and 50 m away from the emission source ranged between 3.81 × 10 1 and 2.68 × 10 3 pppy (per person per year), whereas to residents at 100 m and 500 m ranged from 4.59 × 10 1 to 1.51 × 10 4 pppy. Peak values (95th percentile) of occupational and public risks associated with the exposure to Crypto were 3.41 × 10 3 and 6.84 × 10 4 pppy at 10 m and 50 m from the source, respectively, and were lower than 1.48 × 10 6 pppy regarding exposures to CpSP. Anaerobic digestion reduced risks by approximately one order of magnitude. The distance from the source was inversely proportional to the risk of exposure. It is recommended that wastewater is treated prior to its reuse and the adoption of application methods with low aerosolization potential. In addition, the need for workers to use personal protective equipment (PPE) is highlighted.

Stochasticity in microbiology: managing unpredictability to reach the Sustainable Development Goals

Pure (single) cultures of microorganisms and mixed microbial communities (microbiomes) have been important for centuries in providing renewable energy, clean water and food products to human society and will continue to play a crucial role to pursue the Sustainable Development Goals. To use microorganisms effectively, microbial engineered processes require adequate control. Microbial communities are shaped by manageable deterministic processes, but also by stochastic processes, which can promote unforeseeable variations and adaptations. Here, we highlight the impact of stochasticity in single culture and microbiome engineering. First, we discuss the concepts and mechanisms of stochasticity in relation to microbial ecology of single cultures and microbiomes. Second, we discuss the consequences of stochasticity in relation to process performance and human health, which are reflected in key disadvantages and important opportunities. Third, we propose a suitable decision tool to deal with stochasticity in which monitoring of stochasticity and setting the boundaries of stochasticity by regulators are central aspects. Stochasticity may give rise to some risks, such as the presence of pathogens in microbiomes. We argue here that by taking the necessary precautions and through clever monitoring and interpretation, these risks can be mitigated.

Protecting wastewater workers from disease risks: Personal protective equipment guidelines

The 2013-2016 Ebola epidemic revived concerns about infection risks to wastewater workers. Prior research has shown that wastewater can contain a variety of known and emerging pathogens and that wastewater workers are at increased risk of infectious illnesses. However, guidelines on using personal protective equipment (PPE) to decrease these risks are lacking. We engaged 34 wastewater utility personnel and public health experts to conduct a job safety analysis identifying tasks in which workers could be exposed to pathogens and to develop a PPE selection matrix for preventing those exposures. We identified 43 relevant job tasks. Recommended PPE ranges from durable gloves (all tasks) to safety glasses (24 tasks), Tyvek suits or coveralls (4 tasks), and respiratory protection (N95 mask or face mask, depending on the activity, 10 tasks). The PPE selection matrix can serve as a guide for protecting the 120,000 wastewater workers in the United States from known and emerging pathogens. PRACTITIONER POINTS: Wastewater workers are at increased risk of infectious illnesses. Policies to protect wastewater workers from these illnesses are lacking. We developed guidelines for use of personal protective equipment by wastewater workers to prevent exposure to infectious agents.

Anaerobic digestion of agricultural manure and biomass - Critical indicators of risk and knowledge gaps

Anaerobic digestion (AD) has been identified as a potential green technology to treat food and municipal waste, agricultural residues, including farmyard manure and slurry (FYM&S), to produce biogas. FYM&S and digestate can act as soil conditioners and provide valuable nutrients to plants; however, it may also contain harmful pathogens. This study looks at the critical indicators in determining the microbial inactivation potential of AD and the possible implications for human and environmental health of spreading the resulting digestate on agricultural land. In addition, available strategies for risk assessment in the context of EU and Irish legislation are assessed. Storage time and process parameters (including temperature, pH, organic loading rate, hydraulic retention time), feedstock recipe (carbon-nitrogen ratio) to the AD plant (both mesophilic and thermophilic) were all assessed to significantly influence pathogen inactivation. However, complete inactivation of all pathogens is unlikely. There are limited studies evaluating risks from FYM&S as a feedstock in AD and the spreading of resulting digestate. The lack of process standardisation and varying feedstocks between AD farms means risk must be evaluated on a case by case basis and calls for a more unified risk assessment methodology. In addition, there is a need for the enhancement of AD farm-based modelling techniques and datasets to help in advancing knowledge in this area.

Risk assessments for quality-assured, source-segregated composts and anaerobic digestates for a circular bioeconomy in the UK

A circular economy relies on demonstrating the quality and environmental safety of wastes that are recovered and reused as products. Policy-level risk assessments, using generalised exposure scenarios, and informed by stakeholder communities have been used to appraise the acceptability of necessary changes to legislation, allowing wastes to be valued, reused and marketed. Through an extensive risk assessment exercise, summarised in this paper, we explore the burden of proof required to offer safety assurance to consumer and brand-sensitive food sectors in light of attempts to declassify, as wastes, quality-assured, source-segregated compost and anaerobic digestate products in the United Kingdom. We report the residual microbiological and chemical risks estimated for both products in land application scenarios and discuss these in the context of an emerging UK bioeconomy worth £52bn per annum. Using plausible worst case assumptions, as demanded by the quality food sector, risk estimates and hazard quotients were estimated to be low or negligible. For example, the human health risk of E. coli 0157 illness from exposure to microbial residuals in quality-assured composts, through a ready-to-eat vegetable consumption exposure route, was estimated at ~10^-8 per person per annum. For anaerobic digestion residues, 7 × 10^-3cases of E. coli 0157 were estimated per annum, a potential contribution of 0.0007% of total UK cases. Hazard quotients for potential chemical contaminants in both products were insufficient in magnitude to merit detailed quantitative risk assessments. Stakeholder engagement and expert review was also a substantive feature of this study. We conclude that quality-assured, source-segregated products applied to land, under UK quality protocols and waste processing standards, pose negligible risks to human, animal, environmental and crop receptors, providing that risk management controls set within the standards and protocols are adhered to.

Quantitative Microbial Risk Assessment for Workers Exposed to Bioaerosol in Wastewater Treatment Plants Aimed at the Choice and Setup of Safety Measures

Biological risk assessment in occupational settings currently is based on either qualitative or semiquantitative analysis. In this study, a quantitative microbial risk assessment (QMRA) has been applied to estimate the human adenovirus (HAdV) health risk due to bioaerosol exposure in a wastewater treatment plant (WWTP). A stochastic QMRA model was developed considering HAdV as the index pathogen, using its concentrations in different areas and published dose–response relationship for inhalation. A sensitivity analysis was employed to examine the impact of input parameters on health risk. The QMRA estimated a higher average risk in sewage influent and biological oxidation tanks (15.64% and 12.73% for an exposure of 3 min). Sensitivity analysis indicated HAdV concentration as a predominant factor in the estimated risk. QMRA results were used to calculate the exposure limits considering four different risk levels (one illness case per 100, 1.000, 10.000, and 100.000 workers): for 3 min exposures, we obtained 565, 170, 54, and 6 GC/m³ of HAdV. We also calculated the maximum time of exposure for each level for different areas. Our findings can be useful to better define the effectiveness of control measures, which would thus reduce the virus concentration or the exposure time.

Health risks from exposure to Legionella in reclaimed water aerosols: Toilet flushing, spray irrigation, and cooling towers

The use of reclaimed water brings new challenges for the water industry in terms of maintaining water quality while increasing sustainability. Increased attention has been devoted to opportunistic pathogens, especially Legionella pneumophila, due to its growing importance as a portion of the waterborne disease burden in the United States. Infection occurs when a person inhales a mist containing Legionella bacteria. The top three uses for reclaimed water (cooling towers, spray irrigation, and toilet flushing) that generate aerosols were evaluated for Legionella health risks in reclaimed water using quantitative microbial risk assessment (QMRA). Risks are compared using data from nineteen United States reclaimed water utilities measured with culture-based methods, quantitative PCR (qPCR), and ethidium-monoazide-qPCR. Median toilet flushing annual infection risks exceeded 10^-4 considering multiple toilet types, while median clinical severity infection risks did not exceed this value. Sprinkler and cooling tower risks varied depending on meteorological conditions and operational characteristics such as drift eliminator performance. However, the greatest differences between risk scenarios were due to 1) the dose response model used (infection or clinical severity infection) 2) population at risk considered (residential or occupational) and 3) differences in laboratory analytical method. Theoretical setback distances necessary to achieve a median annual infection risk level of 10^-4 are proposed for spray irrigation and cooling towers. In both cooling tower and sprinkler cases, Legionella infection risks were non-trivial at potentially large setback distances, and indicate other simultaneous management practices could be needed to manage risks. The sensitivity analysis indicated that the most influential factors for variability in risks were the concentration of Legionella and aerosol partitioning and/or efficiency across all models, highlighting the importance of strategies to manage Legionella occurrence in reclaimed water.

Antibiotic Resistant Bacteria in Municipal Wastes: Is There Reason for Concern?

Recently, there has been increased concern about the presence of antibiotic resistant bacteria (ARB) and antibiotic resistant genes (ARG), in treated domestic wastewaters, animal manures and municipal biosolids. The concern is whether these additional sources of ARB contribute to antibiotic resistance levels in the environment, that is, "environmental antibiotic resistance." ARB and ARG occur naturally in soil and water, and it remains unclear whether the introduction of ARB in liquid and solid municipal and animal wastes via land application have any significant impact on the background levels of antibiotic resistance in the environment, and whether they affect human exposure to ARB. In this current review, we examine and re-evaluate the incidence of ARB and ARG resulting from land application activities, and offer a new perspective on the threat of antibiotic resistance to public health via exposure from nonclinical environmental sources. Based on inputs of ARBs and ARGs from land application, their fate in soil due to soil microbial ecology principles, and background indigenous levels of ARBs and ARGs already present in soil, we conclude that while antibiotic resistance levels in soil are increased temporally by land application of wastes, their persistence is not guaranteed and is in fact variable, and often contradictory based on application site. Furthermore, the application of wastes may not produce the most direct impact of ARGs and ARB on public health. Further investigation is still warranted in agriculture and public health, including continued scrutiny of antibiotic use in both sectors.

Quantitative Microbial Risk Assessment for Spray Irrigation of Dairy Manure Based on an Empirical Fate and Transport Model

BACKGROUND

Spray irrigation for land-applying livestock manure is increasing in the United States as farms become larger and economies of scale make manure irrigation affordable. Human health risks from exposure to zoonotic pathogens aerosolized during manure irrigation are not well understood.

OBJECTIVES

We aimed to a) estimate human health risks due to aerosolized zoonotic pathogens downwind of spray-irrigated dairy manure; and b) determine which factors (e.g., distance, weather conditions) have the greatest influence on risk estimates.

METHODS

We sampled downwind air concentrations of manure-borne fecal indicators and zoonotic pathogens during 21 full-scale dairy manure irrigation events at three farms. We fit these data to hierarchical empirical models and used model outputs in a quantitative microbial risk assessment (QMRA) to estimate risk [probability of acute gastrointestinal illness (AGI)] for individuals exposed to spray-irrigated dairy manure containing Campylobacter jejuni, enterohemorrhagic Escherichia coli (EHEC), or Salmonella spp.

RESULTS

Median risk estimates from Monte Carlo simulations ranged from 10^-5 to 10^-2 and decreased with distance from the source. Risk estimates for Salmonella or EHEC-related AGI were most sensitive to the assumed level of pathogen prevalence in dairy manure, while risk estimates for C. jejuni were not sensitive to any single variable. Airborne microbe concentrations were negatively associated with distance and positively associated with wind speed, both of which were retained in models as a significant predictor more often than relative humidity, solar irradiation, or temperature.

CONCLUSIONS

Our model-based estimates suggest that reducing pathogen prevalence and concentration in source manure would reduce the risk of AGI from exposure to manure irrigation, and that increasing the distance from irrigated manure (i.e., setbacks) and limiting irrigation to times of low wind speed may also reduce risk. https://doi.org/10.1289/EHP283.

Assessment and risk modeling of airborne enteric viruses emitted from wastewater reused for irrigation

Reclamation of wastewater (WW) for irrigation, after treatment represents a challenge that could alleviate pressure on water resources and address the increasing demand for agriculture. However, the risks to human health must be assessed, particularly those related to human enteric viruses that resist standard treatments in most wastewater treatment plants (WWTP). The risks associated with exposure to viral bioaerosols near WWTP and near agricultural plots irrigated with WW are poorly documented. The objectives of this study were to 1) better characterize human enteric viruses found in bioaerosols near a "standard WWTP" and over fields irrigated with treated WW and 2) propose a numeric model to assess the health risk to populations located close to the irrigated areas, with particular attention to norovirus, which is responsible for most viral gastroenteritis in France. Water and air samples were collected at various locations in the largest French WW-irrigated site near Clermont-Ferrand, at the WWTP entrance and after treatment, in the air above activated sludge basins, and above fields irrigated with WW. Various enteric viruses were found in the water samples collected both before and after treatment. Norovirus was the most abundant with >10e4 genome copies/l (GC/L) before treatment and ~10e3 GC/L after treatment. Low quantities (<10e3GC/m³) were detected in the air above active sludge pools and irrigated plots. Hepatitis E virus was detected in all sampled compartments. A quantitative microbial risk assessment (QMRA) approach, including a simplified atmospheric dispersion model, allowed assessment of norovirus infection risk. The Bayesian QMRA approach considered wind speed measurements over 21years, and the variability and uncertainty of all measurements throughout the chain up to the risk. The probability of infection within one year for the most exposed WWTP employees was >10e-4 for strong wind speed (≥3m/s) and a constant emission rate of 8e3 GC/m³/s. This probability decreases by 3 log when the distance to the emission source is doubled. This information can aid development of safe water reuse policies in terms of local setback distance and wind conditions for wastewater reuse.

Anaerobic Membrane Bioreactor Effluent Reuse: A Review of Microbial Safety Concerns

Broad and increasing interest in sustainable wastewater treatment has led a paradigm shift towards more efficient means of treatment system operation. A key aspect of improving overall sustainability is the potential for direct wastewater effluent reuse. Anaerobic membrane bioreactors (AnMBRs) have been identified as an attractive option for producing high quality and nutrient-rich effluents during the treatment of municipal wastewaters. The introduction of direct effluent reuse does, however, raise several safety concerns related to its application. Among those concerns are the microbial threats associated with pathogenic bacteria as well as the emerging issues associated with antibiotic-resistant bacteria and the potential for proliferation of antibiotic resistance genes. Although there is substantial research evaluating these topics from the perspectives of anaerobic digestion and membrane bioreactors separately, little is known regarding how AnMBR systems can contribute to pathogen and antibiotic resistance removal and propagation in wastewater effluents. The aim of this review is to provide a current assessment of existing literature on anaerobic and membrane-based treatment systems as they relate to these microbial safety issues and utilize this assessment to identify areas of potential future research to evaluate the suitability of AnMBRs for direct effluent reuse.

Decay rates of zoonotic pathogens and viral surrogates in soils amended with biosolids and manures and comparison of qPCR and culture derived rates

AIMS

The purpose of this study was to establish inactivation decay constants of foodborne pathogens and coliphage in clay and sandy soils for future "downstream" analyses such as quantitative microbial risk analysis and to compare cultivation-dependent and -independent (e.g. qPCR) methods.

METHODS AND RESULTS

Salmonella enterica, Campylobacter jejuni, Listeria monocytogenes, Escherichia coli O157:H7, and Clostridium perfringens, were seeded together with MS2 and ØX174 phages, into three waste matrices (Class B biosolids, swine lagoon effluent, cattle manure), and phosphate buffered saline (PBS) as a control, and applied to two soil types (sandy loam, clay loam) using two management practices (incorporated, surface applied). S. enterica and L. monocytogenes inactivation rates were positively affected (e.g. slower rate) by solid wastes, while C. jejuni was quickly inactivated by day 7 regardless of waste type. The use of qPCR provided more conservative inactivation rates, with qPCR-based rates typically twice as slow as cultivation-based. The effect of soil type and management were less apparent as rates were variably affected. For instance, incorporation of waste negatively impacted (e.g. faster rate) inactivation of Salmonella when measured by qPCR, while the opposite was true when measured by cultivation. Inactivation rates were organism∗waste∗soil∗management dependent since the interactions of these main effects significantly affected most combinations.

CONCLUSIONS

Class B biosolids and cattle manure most often slowed inactivation when measured by cultivation, but the complex interactions between variables and organism made sweeping conclusions difficult. On the contrary cultivation-independent inactivation rates were negatively affected by solid wastes. Inactivation rates developed by cultivation-dependent and -independent assays needs further scrutiny as interprerations can vary by orders of magnitude depending on the organism∗environment combination.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study compares decay rate data based on waste, soil, management and assay type which can be further used in risk assessments.

Does the use of tubular digesters to treat livestock waste lower the risk of infection from Cryptosporidium parvum and Giardia lamblia?

Worldwide, high incidences of cryptosporidiosis and giardiasis are attributed to livestock waste. Quantitative microbial risk assessment can be used to estimate the risk of livestock related infections from Cryptosporidium parvum and Giardia lamblia. The objective of this paper was to assess the occupational and public health risks associated with management of raw and anaerobically digested livestock waste in two rural communities in Costa Rica based on fomite, soil and crop contamination and livestock waste management exposure pathways. Risks related to cattle waste were greater than swine waste due to cattle shedding more (oo)cysts. Cryptosporidium parvum also posed a greater risk than Giardia lamblia in all exposure pathways due to livestock shedding high loads of Cryptosporidium parvum oocysts and oocysts' lower inactivation rates during anaerobic digestion compared with Giardia lamblia cysts. The risk of infection from exposure to contaminated soil and crops was significantly lower for a community using tubular anaerobic digesters to treat livestock waste compared to a community where the untreated waste was applied to soil. The results indicate that treatment of livestock waste in small-scale tubular anaerobic digesters has the potential to significantly decrease the risk of infection below the World Health Organization's acceptable individual annual risk of infection (10^-4).

Bioaerosol Deposition to Food Crops near Manure Application: Quantitative Microbial Risk Assessment

Production of both livestock and food crops are central priorities of agriculture; however, food safety concerns arise where these practices intersect. In this study, we investigated the public health risks associated with potential bioaerosol deposition to crops grown in the vicinity of manure application sites. A field sampling campaign at dairy manure application sites supported the emission, transport, and deposition modeling of bioaerosols emitted from these lands following application activities. Results were coupled with a quantitative microbial risk assessment model to estimate the infection risk due to consumption of leafy green vegetable crops grown at various distances downwind from the application area. Inactivation of pathogens ( spp., spp., and O157:H7) on both the manure-amended field and on crops was considered to determine the maximum loading of pathogens to plants with time following application. Overall median one-time infection risks at the time of maximum loading decreased from 1:1300 at 0 m directly downwind from the field to 1:6700 at 100 m and 1:92,000 at 1000 m; peak risks (95th percentiles) were considerably greater (1:18, 1:89, and 1:1200, respectively). Median risk was below 1:10,000 at >160 m downwind. As such, it is recommended that a 160-m setback distance is provided between manure application and nearby leafy green crop production. Additional distance or delay before harvest will provide further protection of public health.

Emission and Dispersion of Bioaerosols from Dairy Manure Application Sites: Human Health Risk Assessment

In this study, we report the human health risk of gastrointestinal infection associated with inhalation exposure to airborne zoonotic pathogens emitted following application of dairy cattle manure to land. Inverse dispersion modeling with the USEPA's AERMOD dispersion model was used to determine bioaerosol emission rates based on edge-of-field bioaerosol and source material samples analyzed by real-time quantitative polymerase chain reaction (qPCR). Bioaerosol emissions and transport simulated with AERMOD, previously reported viable manure pathogen contents, relevant exposure pathways, and pathogen-specific dose-response relationships were then used to estimate potential downwind risks with a quantitative microbial risk assessment (QMRA) approach. Median 8-h infection risks decreased exponentially with distance from a median of 1:2700 at edge-of-field to 1:13 000 at 100 m and 1:200 000 at 1000 m; peak risks were considerably greater (1:33, 1:170, and 1:2500, respectively). These results indicate that bioaerosols emitted from manure application sites following manure application may present significant public health risks to downwind receptors. Manure management practices should consider improved controls for bioaerosols in order to reduce the risk of disease transmission.

Microbial dose response modeling: past, present, and future

The understanding of the risk to humans from exposure to pathogens has been firmly put into a risk assessment framework. A key element of applying this approach is the understanding of the relationship between dose and response for particular pathogens. This understanding has progressed from early use of threshold concepts ("minimal infectious dose") thru multiple generations of models. Generation 1 models describe probability of response to exposed dose. Generation 2 models incorporate host factors (e.g., age) and/or pathogen factors (e.g., particle size of inhaled agents). Generation 3 models describe the rate at which effects develop, i.e. the epidemic curve. These (generation 1 through three models) have been developed and used in multiple contexts. Beyond Generation 3 lies an opportunity for the deep incorporation of in vivo physiological responses and the coupling of the individual host dynamics to the dynamics of spread of contagious diseases in the population. This would enable more direct extrapolation from controlled dosing studies to estimate population level effects. There remain also needs to understand broader categories of infectious agents, including pathogenic amoebae and fungi. More advanced models need to be validated against well-characterized human outbreak data.

Determining pathogen and indicator levels in class B municipal organic residuals used for land application

Biosolids are nutrient-rich organic residuals that are currently used to amend soils for food production. Treatment requirements to inactivate pathogens for production of Class A biosolids are energy intensive. One less energy intensive alternative is to treat biosolids to Class B standards, but it could result in higher pathogen loads. Quantitative microbial risk assessments models have been developed on land application of Class B biosolids but contain many uncertainties because of limited data on specific pathogen densities and the use of fecal indicator organisms as accurate surrogates of pathogen loads. To address this gap, a 12-mo study of the levels and relationships between , , and human adenovirus (HAdV) with fecal coliform, somatic, and F-RNA coliphage levels in Class B biosolids from nine wastewater treatment plants throughout the United States was conducted. Results revealed that fecal coliform, somatic, and F-RNA coliphage densities were consistent throughout the year. More important, results revealed that HAdV ( = 2.5 × 10 genome copies dry g) and ( = 4.14 × 10 cysts dry g) were in all biosolids samples regardless of treatment processes, location, or season. oocysts were also detected (38% positive; range: 0-1.9 × 10 oocysts dry g), albeit sporadically. Positive correlations among three fecal indicator organisms and HAdV, but not protozoa, were also observed. Overall, this study reveals that high concentrations of enteric pathogens (e.g., , , and HAdV) are present in biosolids throughout the United States. Microbial densities found can further assist management and policymakers in establishing more accurate risk assessment models associated with land application of Class B biosolids.

Aeromicrobiology

Biological material including microorganisms and toxins can be found in air or the atmosphere, and the study of this area is termed “aeromicrobiology.” Airborne biological materials are known as bioaerosols. This chapter introduces the basics of aeromicrobiology including the nature of bioaerosols and fundamentals of the aeromicrobiological (AMB) pathway. The nature of the atmosphere as a microbial habitat, and the factors that influence microbial survival in the air are described. This is followed by a discussion of extramural aeromicrobiology related to aerosolization of indigenous soil pathogens; influenza pandemics; microbiology in the clouds; agriculture; waste disposal; and airborne toxins. Intramural microbiology within buildings is discussed with respect to public health within buildings, hospitals and laboratories. Finally, measures to control bioaerosols including biosafety in the laboratory are documented.

Including pathogen risk in life cycle assessment of wastewater management. 1. Estimating the burden of disease associated with pathogens

The environmental performance of wastewater and sewage sludge management is commonly assessed using life cycle assessment (LCA), whereas pathogen risk is evaluated with quantitative microbial risk assessment (QMRA). This study explored the application of QMRA methodology with intent to include pathogen risk in LCA and facilitate a comparison with other potential impacts on human health considered in LCA. Pathogen risk was estimated for a model wastewater treatment system (WWTS) located in an industrialized country and consisting of primary, secondary, and tertiary wastewater treatment, anaerobic sludge digestion, and land application of sewage sludge. The estimation was based on eight previous QMRA studies as well as parameter values taken from the literature. A total pathogen risk (expressed as burden of disease) on the order of 0.2-9 disability-adjusted life years (DALY) per year of operation was estimated for the model WWTS serving 28,600 persons and for the pathogens and exposure pathways included in this study. The comparison of pathogen risk with other potential impacts on human health considered in LCA is detailed in part 2 of this article series.

Microbial ecology, bacterial pathogens, and antibiotic resistant genes in swine manure wastewater as influenced by three swine management systems

The environmental influence of farm management in concentrated animal feeding operations (CAFO) can yield vast changes to the microbial biota and ecological structure of both the pig and waste manure lagoon wastewater. While some of these changes may not be negative, it is possible that CAFOs can enrich antibiotic resistant bacteria or pathogens based on farm type, thereby influencing the impact imparted by the land application of its respective wastewater. The purpose of this study was to measure the microbial constituents of swine-sow, -nursery, and -finisher farm manure lagoon wastewater and determine the changes induced by farm management. A total of 37 farms were visited in the Mid-South USA and analyzed for the genes 16S rRNA, spaQ (Salmonella spp.), Camp-16S (Campylobacter spp.), tetA, tetB, ermF, ermA, mecA, and intI using quantitative PCR. Additionally, 16S rRNA sequence libraries were created. Overall, it appeared that finisher farms were significantly different from nursery and sow farms in nearly all genes measured and in 16S rRNA clone libraries. Nearly all antibiotic resistance genes were detected in all farms. Interestingly, the mecA resistance gene (e.g. methicillin resistant Staphylococcus aureus) was below detection limits on most farms, and decreased as the pigs aged. Finisher farms generally had fewer antibiotic resistance genes, which corroborated previous phenotypic data; additionally, finisher farms produced a less diverse 16S rRNA sequence library. Comparisons of Camp-16S and spaQ GU (genomic unit) values to previous culture data demonstrated ratios from 10 to 10,000:1 depending on farm type, indicating viable but not cultivatable bacteria were dominant. The current study indicated that swine farm management schemes positively and negatively affect microbial and antibiotic resistant populations in CAFO wastewater which has future "downstream" implications from both an environmental and public health perspective.

Estimation of infectious risks in residential populations exposed to airborne pathogens during center pivot irrigation of dairy wastewaters

In the western United States where dairy wastewaters are commonly land applied, there are concerns over individuals being exposed to airborne pathogens. In response, a quantitative microbial risk assessment (QMRA) was performed to estimate infectious risks after inhalation exposure of pathogens aerosolized during center pivot irrigation of diluted dairy wastewaters. The dispersion of pathogens (Campylobacter jejuni, Escherichia coli O157:H7, non-O157 E. coli, Listeria monocytogenes, and Salmonella spp.) was modeled using the atmospheric dispersion model, AERMOD. Pathogen concentrations at downwind receptors were used to calculate infectious risks during one-time (1, 8, and 24 h) and multiday (7 d at 1 h d(-1)) exposure events using a β-Poisson dose-response model. This assessment considered risk of infection in residential populations that were 1 to 10 km from a center pivot operation. In the simulations, infectious risks were estimated to be the greatest in individuals closest to the center pivot, as a result of a higher pathogen dose. On the basis of the results from this QMRA, it is recommended that wastewaters only be applied during daylight hours when inactivation and dilution of airborne pathogens is highest. Further refinement of the dispersion and dose-response models should be considered to increase the utility of this QMRA.