<p>Human excreta contain plant nutrients and have the potentialto be used as a fertiliser in agriculture. Urine contributesthe major proportion of the nutrients (N, P and K) in domesticwastewater whereas faeces contribute a smaller amount andinvolves greater health risks if reused due to the possiblepresence of enteric pathogens. Human urine does not generallycontain pathogens that can be transmitted through theenvironment.</p><p>Source-separation of urine and faeces is possible by usingurine-separating (or urine-diverting) toilets, available assimple dry toilets or porcelain flush toilets with dividedbowls. The risk for transmission of disease when handling andreusing the urine is largely dependent on thecross-contamination by faeces. In this research, the presenceof human faeces in urine samples was successfully determined byanalysing for faecal sterols. Cross-contamination was evidentin 22% of the samples from urine collection tanks, and in thesequantified to an average (± SD) of 9.1 ± 5.6 mgfaeces per litre urine. Testing for indicator bacteria wasshown to be an unsuitable method for determining faecalcontamination in human urine since<i>E. coli</i>had a rapid inactivation in the urine and faecalstreptococci were found to grow within the system.</p><p>The fate of any enteric pathogens present in urine iscrucial for the risk for transmission of infectious diseases.Gram-negative bacteria (e.g.<i>Salmonella</i>and<i>E. coli</i>) were rapidly inactivated (time for 90%reduction, T₉₀<5 days) in source-separated urine at itsnatural pH-value of 9. Gram-positive faecal streptococci weremore persistent with a T₉₀of approximately 30 days. Clostridia sporenumbers were not reduced at all during 80 days. Similarly,<i>rhesus</i>rotavirus and<i>Salmonella typhimurium</i>phage 28B were not inactivated inurine at low temperature (5°C), whereas at 20°C theirT₉₀-values were 35 and 71 days, respectively.<i>Cryptosporidium</i>oocysts were less persistent with a T₉₀of 29 days at 4°C. Factors that affect thepersistence of microorganisms in source-separated human urineinclude temperature, pH, dilution and presence of ammonia.</p><p>By using Quantitative Microbial Risk Assessment (QMRA), therisks for bacterial and protozoan infections related tohandling and reuse of urine were calculated to be<10^-3for all exposure routes independent of the urinestorage time and temperature evaluated. The risk for viralinfection was higher, calculated at 0.56 for accidentalingestion of 1 ml of unstored urine. If the urine was stored at20°C for 6 months the risk for viral infection was reducedto 5.4 × 10^-4.</p><p>By following recommendations for storage and reuse, whichare dependent on the type of crop to be fertilised, it ispossible to significantly decrease the risk for infections. Sofar, the level of risk that is acceptable is unknown. Theacceptable risk will be one of the main factors determining thefuture utilisation of source-separated human urine inagriculture.</p><p><b>Keywords:</b>urine-separation, urine, wastewater systems,wastewater reuse, recycling, enteric pathogens, faecal sterols,indicator bacteria, hygiene risks, microbial persistence,microbial risk assessment, QMRA, fertiliser, crop.</p>

O lançamento de esgotos domésticos in natura, efluentes das estações de tratamento de esgoto e escoamento superficial, são relatados como importantes causas de poluição das águas superficiais. Sabe-se que a alteração da qualidade das águas dos rios restringe seus múltiplos usos e contribui para o aumento de doenças de veiculação hídrica, em decorrência da exposição oral a bioagentes patogênicos. Neste contexto, o objetivo do presente estudo foi identificar e quantificar bioagentes presentes na água do rio Pardo, Brasil, e estimar o risco de infecção e de doença por Cryptosporidium spp. e Giardia spp. para a população, devido ao uso do rio como fonte de abastecimento público e recreação de contato primário, por meio da abordagem da Avaliação Quantitativa de Risco Microbiológico (AQRM). Durante os anos de 2015 e 2016, foram realizadas seis coletas de amostras da água do rio Pardo (período chuvoso e período seco) em seis pontos, totalizando 36 amostras. Foram realizadas análises de identificação e quantificação de E. coli, Salmonella Não Tifóide, Cryptosporidium spp. e Giardia spp. Para estimativa de risco de infecção e de doença por Cryptosporidium spp. e Giardia spp. (AQRM), foram considerados diferentes populações (crianças e adultos), volumes de água ingerido, concentração de (oo)cistos e duração e frequência da exposição, de acordo com o cenário estabelecido. Os valores médios para E. coli variaram de 6,57 x 101 UFC/100 mL a 6,07 x 103 UFC/100 mL, apresentando diferenças estatisticamente significantes (p < 0,05) entre os períodos chuvoso e seco. As densidades de Salmonella Não Tifóide foram baixas (<0,6473 a 1,55 NMP/100 mL), com frequência de 13,9% das amostras positivas, evidenciando a circulação desse patógeno no ambiente. A concentração de (oo)cistos de Cryptosporidium spp. e Giardia spp. variou de <0,1 a 0,4 oocistos/L e <0,1 a 4,4 cistos/L, respectivamente. Para abordagem da AQRM devido a ingestão da água do rio Pardo usada para abastecimento público, a probabilidade anual de infecção por Cryptosporidium spp. e Giardia spp. foi maior para adultos do que para crianças, sendo que na maioria dos pontos apresentou resultados superiores ao risco anual tolerável pela USEPA (1 x 10-4). No que diz respeito ao uso da água do rio Pardo para recreação de contato primário, a probabilidade diária e anual de infecção, bem como a probabilidade de doenças, foi maior para crianças, seguida de adultos/homens e adultos/mulheres. A probabilidade de criptosporidiose e giardíase esteve abaixo do limite tolerável pela USEPA (3,6 x 10-2), exceto no Ponto 4, em que a estimativa de risco de doença por Giardia spp. para crianças esteve acima deste valor. A presença de bioagentes em amostras de água do rio Pardo pode estar relacionada à poluição das águas por fontes pontuais e difusas. Esses achados refletem a importância de priorizar os recursos para implantação e complementação das Estações de Tratamento de Esgoto na UGRHI 4, a fim de prevenir as doenças de veiculação hídrica em populações que utilizam a água do rio Pardo para abastecimento público e recreação de contato primário / The discharge of domestic sewage, effluents of wastewater treatment plants and surface runoff, are reported as important causes of surface water pollution. It is known that the alteration of river water quality restricts its multiple uses and contributes to the increase of waterborne diseases, due to oral exposure to pathogenic bioagents. In this context, the aim of the present study was to identify and quantify bioagents present in Pardo river water, Brazil, and to estimate the risk of infection and disease by Cryptosporidium spp. and Giardia spp. for the population, due to the use of the river as source of public supply and primary contact recreation, through the approach of Quantitative Microbial Risk Assessment (QMRA). During the years of 2015 and 2016, six samples of water from the Pardo river (rainy and dry season) were collected at six points, totaling 36 samples. Identification and quantification analyzes of E. coli, Non-typhoid Salmonella, Cryptosporidium spp. and Giardia spp. To estimate the risk of infection and disease by Cryptosporidium spp. and Giardia spp. (QMRA), different populations (children and adults), volumes of ingested water, concentration of (oo) cysts, duration and frequency of exposure were considered according to the established scenario. Mean values for E. coli varied from 6.57 x 101 CFU / 100 mL to 6.07 x 103 CFU / 100 mL, showing statistically significant differences (p <0.05) between the rainy and dry season. Non-typhoid Salmonella densities were low (<0.6473 at 1.55 MPN / 100 mL), with a frequency of 13.9% of the positive samples, evidencing the circulation of this pathogen in the environment. Cryptosporidium spp. and Giardia spp. concentration ranged from <0.1 to 0.4 oocysts / L and <0.1 to 4.4 cysts / L, respectively. In order to approach the QMRA due to the ingestion of Pardo river water used for public supply, the probability of annual infection by Cryptosporidium spp. and Giardia spp. was higher for adults than for children, and in most points presented results higher than the risk tolerable by USEPA (1 x 10-4). Regarding the use of Pardo river water for primary contact recreation, the daily and annual probability of infection, as well as the probability of illness, was higher for children, followed by adults / men and adults / women. The probability of cryptosporidiosis and giardiasis was below the limit tolerable by USEPA (3.6 x 10-2), except in Point 4, where the estimated risk of disease by Giardia spp. for children was above this value. The presence of bioagents in Pardo river water may be related to water pollution by point and diffuse sources. These findings reflect the importance of prioritizing the resources for implementation and complementation of wastewater treatment plants at UGRHI 4, in order to prevent waterborne diseases in populations that use Pardo river water for public supply and primary contact recreation

Vatten är ett livsmedel som vi kommer i kontakt med dagligen. För att inte råka ut för sjuk-domar och infektioner renas dricksvattnet på vattenverken, främst för att reducera antalet patogener, d.v.s. sjukdomsframkallande mikroorganismer. Man brukar prata om tre grupper mikroorganismer i vattenrening; bakterier, virus och parasiter. Dessa grupper är vitt skilda i många avseenden och reduceras därför olika bra av olika reningssteg. Ju mer kunskap man kan få om reningsprocessen, desto bättre kan reningen optimeras. Därmed minimeras riskerna för konsumenterna att drabbas av infektioner. I det här arbetet används två modeller för att beskriva och utvärdera Borgs vattenverk som drivs av Norrköping Vatten AB. Modellen God desinfeksjonspraksis (GDP) är ett resultat av ett norskt projekt och baserar sig på formler och tabeller. Först avgörs råvattenkvaliteten genom att vattenverkets storlek och förekomst av mikroorganismer bedöms. Därefter görs diverse avdrag för förebyggande åtgärder, rening utöver desinfektion m.m. Slutligen bedöms desinfektionsgraden genom att det tillsatta klorets avklingning bestäms för beräkning av Ct-värdet; produkten av kontakttiden och koncentrationen. Genom att jämföra råvattenkvaliteten med avdragen och desinfektions-graden kan en bedömning göras om huruvida reningsprocessen är tillräcklig eller inte. I Mikrobiologisk riskanalys (MRA) bygger man upp en modell av sitt vattenverk i ett program och väljer patogenhalter för råvattnet. Efter det beräknar programmet renings-processens reduktion, riskerna för daglig respektive årlig sannolikhet för infektion samt DALYs, som gör att man kan jämföra risken för vattenburen smitta med exempelvis risken att förolyckas i trafiken. Det amerikanska naturvårdsverket och WHO har satt gränsen för den acceptabla årliga sannolikheten för infektion på grund av vattenrelaterad sjukdom till 1/10 000 invånare respektive 1 µDALYs. Fördelen med MRA är att när man väl byggt upp sitt vattenverk i programmet kan olika scenarion simuleras genom att patogenhalterna varieras. Tyvärr är det svårt att uppskatta patogenhalterna då de provtagningar som skulle behövas sällan är gjorda. Även litteraturvärden kan vara svårt att hitta, särskilt för virus som är så små att de är svåra att analysera. Resultatet av bägge modellerna visade på att Borgs vattenverks reduktionsförmåga är tillräcklig med avseende på bakterier, men inte för virus och parasiter. I MRA är det emellertid svårt att säga hur korrekt detta påstående är, då endast litteraturvärden kunnat användas för de två sistnämnda patogenerna. En del provtagningar har gjorts och då har inga parasiter kunnat påvisas i råvattnet, men för att inte underskatta riskerna användes litteratur-värdena ändå. GDP påvisade inga stora brister i reduceringen av virus och parasiter och i MRA låg resultatet i samma storleksordning som gränsen för DALYs. Eventuellt behöver alltså inga stora åtgärder vidtas för att minska de mikrobiologiska riskerna. De viktigaste stegen i reningsprocessen är långsamfiltrering, desinfektion med fritt klor och fällning och sedimentering med efterföljande filtrering. Infektionsrisken blir störst om fällningssteget slås ut. I samtliga simulerade scenarion låg infektionssannolikheten för bakterier fortfarande på en acceptabel nivå. Det värsta scenariot av de modellerade är om avloppsledningen från Skärblacka skulle börja läcka samtidigt som det regnar kraftigt. Det skulle leda till att förorening från betesmark spolas med ut i Motala Ström där råvattnet hämtas. Detta ger den högsta patogenhalten och därmed också den största infektionsrisken. / Water is one of the most basic things in life and is something we come in contact with on a daily basis. To prevent diseases and infections, the drinking water is purified, mainly in order to reduce the number of pathogens. The most important groups of microorganisms in water purification are bacteria, viruses, and parasites. These groups are very different in many respects and are therefore reduced most efficiently by different purification processes. If more knowledge is gained, the waterworks can optimize the purification process. This would lead to a minimization of the risk of getting infections caused by consuming the drinking water. In this paper two models are used to describe and evaluate Borg’s waterworks, run by Norrköping Vatten AB. Good Disinfection Practice (GDP) is the result of a Norwegian project and is based on formulas and tables. First, the raw water quality is determined by evaluating the presence of microorganisms and the number of people supplied. Then deductions are made due to security precautions and water treatment besides disinfection etc.  Finally the disinfection is determined by calculating the reduction of the added chlorine to gain the Ct-value, which is the product of the contact time and concentration. By comparison of the raw water, the deductions and the disinfection, the purification process can be evaluated as sufficient or not. In Quantitative Microbial Risk Assessment (QMRA) the purification process is modelled and concentrations of pathogens in the raw water are chosen. The program then calculates the reduction of the pathogens by the purification process. The result is also presented as probability of daily or annual infection and DALYs, which makes it possible to compare the risks of waterborne diseases with for example, the risk of traffic accidents. The US Environmental Protection Agency and the World Health Organization have determined the limit for the acceptable annual probability of infection due to water-related disease to 1/10,000 and 1 µDALYs. The advantage of the QMRA is that once you have modelled your purification process a variety of scenarios can be simulated. Unfortunately, it is difficult to estimate the concentrations of pathogens in the raw water and the acquired analysis are rarely made. Even literature values can be difficult to find, especially for viruses due to the difficulties in analysing them because of their small size. Both the models’ results showed that Borg’s waterworks reduction capacity is sufficient for bacteria, but not viruses and parasites. It is however difficult to say how accurate this conclusion is. In QMRA only literature values have been used as a basis to determine the risk for viruses and parasites. In fact, no parasites have been found when samples have been run on the raw water. But since an overestimation of the risk is to be preferred, literature values were used anyway. GDP showed only small shortcomings in the reduction of viruses and parasites and the values obtained from QMRA were in the same order of magnitude as the limit of DALYs. Therefore only small measures might be needed to lower the microbiological risks. The most important steps in the purification process are slow sand filtration, disinfection with free chlorine and precipitation and sedimentation with subsequent filtering. Elimination of the precipitating step results in the greatest risk of infection. In all the scenarios simulated the likelihood of infections caused by bacteria is still acceptable.  The worst-case scenario would be a sewage water leak during heavy raining. The rain would cause excrement from cattle to be washed into and contaminate the raw water in addition to the sewage contamination. This provides the highest concentration of pathogens in the raw water and therefore also the greatest risk of infection.

O lançamento de esgotos domésticos in natura, efluentes das estações de tratamento de esgoto e escoamento superficial, são relatados como importantes causas de poluição das águas superficiais. Sabe-se que a alteração da qualidade das águas dos rios restringe seus múltiplos usos e contribui para o aumento de doenças de veiculação hídrica, em decorrência da exposição oral a bioagentes patogênicos. Neste contexto, o objetivo do presente estudo foi identificar e quantificar bioagentes presentes na água do rio Pardo, Brasil, e estimar o risco de infecção e de doença por Cryptosporidium spp. e Giardia spp. para a população, devido ao uso do rio como fonte de abastecimento público e recreação de contato primário, por meio da abordagem da Avaliação Quantitativa de Risco Microbiológico (AQRM). Durante os anos de 2015 e 2016, foram realizadas seis coletas de amostras da água do rio Pardo (período chuvoso e período seco) em seis pontos, totalizando 36 amostras. Foram realizadas análises de identificação e quantificação de E. coli, Salmonella Não Tifóide, Cryptosporidium spp. e Giardia spp. Para estimativa de risco de infecção e de doença por Cryptosporidium spp. e Giardia spp. (AQRM), foram considerados diferentes populações (crianças e adultos), volumes de água ingerido, concentração de (oo)cistos e duração e frequência da exposição, de acordo com o cenário estabelecido. Os valores médios para E. coli variaram de 6,57 x 101 UFC/100 mL a 6,07 x 103 UFC/100 mL, apresentando diferenças estatisticamente significantes (p < 0,05) entre os períodos chuvoso e seco. As densidades de Salmonella Não Tifóide foram baixas (<0,6473 a 1,55 NMP/100 mL), com frequência de 13,9% das amostras positivas, evidenciando a circulação desse patógeno no ambiente. A concentração de (oo)cistos de Cryptosporidium spp. e Giardia spp. variou de <0,1 a 0,4 oocistos/L e <0,1 a 4,4 cistos/L, respectivamente. Para abordagem da AQRM devido a ingestão da água do rio Pardo usada para abastecimento público, a probabilidade anual de infecção por Cryptosporidium spp. e Giardia spp. foi maior para adultos do que para crianças, sendo que na maioria dos pontos apresentou resultados superiores ao risco anual tolerável pela USEPA (1 x 10-4). No que diz respeito ao uso da água do rio Pardo para recreação de contato primário, a probabilidade diária e anual de infecção, bem como a probabilidade de doenças, foi maior para crianças, seguida de adultos/homens e adultos/mulheres. A probabilidade de criptosporidiose e giardíase esteve abaixo do limite tolerável pela USEPA (3,6 x 10-2), exceto no Ponto 4, em que a estimativa de risco de doença por Giardia spp. para crianças esteve acima deste valor. A presença de bioagentes em amostras de água do rio Pardo pode estar relacionada à poluição das águas por fontes pontuais e difusas. Esses achados refletem a importância de priorizar os recursos para implantação e complementação das Estações de Tratamento de Esgoto na UGRHI 4, a fim de prevenir as doenças de veiculação hídrica em populações que utilizam a água do rio Pardo para abastecimento público e recreação de contato primário / The discharge of domestic sewage, effluents of wastewater treatment plants and surface runoff, are reported as important causes of surface water pollution. It is known that the alteration of river water quality restricts its multiple uses and contributes to the increase of waterborne diseases, due to oral exposure to pathogenic bioagents. In this context, the aim of the present study was to identify and quantify bioagents present in Pardo river water, Brazil, and to estimate the risk of infection and disease by Cryptosporidium spp. and Giardia spp. for the population, due to the use of the river as source of public supply and primary contact recreation, through the approach of Quantitative Microbial Risk Assessment (QMRA). During the years of 2015 and 2016, six samples of water from the Pardo river (rainy and dry season) were collected at six points, totaling 36 samples. Identification and quantification analyzes of E. coli, Non-typhoid Salmonella, Cryptosporidium spp. and Giardia spp. To estimate the risk of infection and disease by Cryptosporidium spp. and Giardia spp. (QMRA), different populations (children and adults), volumes of ingested water, concentration of (oo) cysts, duration and frequency of exposure were considered according to the established scenario. Mean values for E. coli varied from 6.57 x 101 CFU / 100 mL to 6.07 x 103 CFU / 100 mL, showing statistically significant differences (p <0.05) between the rainy and dry season. Non-typhoid Salmonella densities were low (<0.6473 at 1.55 MPN / 100 mL), with a frequency of 13.9% of the positive samples, evidencing the circulation of this pathogen in the environment. Cryptosporidium spp. and Giardia spp. concentration ranged from <0.1 to 0.4 oocysts / L and <0.1 to 4.4 cysts / L, respectively. In order to approach the QMRA due to the ingestion of Pardo river water used for public supply, the probability of annual infection by Cryptosporidium spp. and Giardia spp. was higher for adults than for children, and in most points presented results higher than the risk tolerable by USEPA (1 x 10-4). Regarding the use of Pardo river water for primary contact recreation, the daily and annual probability of infection, as well as the probability of illness, was higher for children, followed by adults / men and adults / women. The probability of cryptosporidiosis and giardiasis was below the limit tolerable by USEPA (3.6 x 10-2), except in Point 4, where the estimated risk of disease by Giardia spp. for children was above this value. The presence of bioagents in Pardo river water may be related to water pollution by point and diffuse sources. These findings reflect the importance of prioritizing the resources for implementation and complementation of wastewater treatment plants at UGRHI 4, in order to prevent waterborne diseases in populations that use Pardo river water for public supply and primary contact recreation

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