Risk to human health from protozoan (oo)cysts in water treatment plants / Risco à saúde humana por (oo)cistos de protozoários em estações de tratamento de água

ABSTRACT The presence of waterborne pathogens, when associated with the water supply system, poses risks to public health. This study investigated the occurrence of (oo)cysts of Cryptosporidium spp. and Giardia spp. in two Water Treatment Plants, with full-cycle technology, and assessed the microbiological risk to consumers' health. The membrane filtration technique was employed to identify the protozoan load in 24 samples of raw and filtered water. Physicochemical and bacteriological parameters were also analyzed. The Quantitative Microbial Risk Assessment model was used to determine the risk of daily and annual infection associated with the ingestion of filtered water. A total of 66.67% of raw water samples were positive for Cryptosporidium; and 33.33%, for Giardia. The maximum concentrations of 200 (oo)cysts/L and 50 cysts/L were detected in the Cerrado stream (located in Sanclerlândia, state of Goiás, Brazil), due to the predominance of grazing areas and intense agricultural activity. Water Treatment Plants did not completely remove the protozoa and the retention efficiency was lower than that recommended by the United States Environmental Protection Agency, with average values of 1.27 log for cysts and 1.04 log for oocysts. The probability of annual infection by cysts (100%) was higher than that of oocysts (86.61 - 98.32%) as for consumption of filtered water, and in the dry season, there was a higher risk of infection, due to the low performance of the Water Treatment Plants and higher concentration of pathogens. According to the results, the continuous intake of filtered water above the warning level can cause infectious diseases in the supplied population.

RESUMO A presença de patógenos de veiculação hídrica quando associados ao sistema de abastecimento de água causam risco à saúde pública. Esse estudo investigou a ocorrência de (oo)cistos de Cryptosporidium spp. e Giardia spp. em duas Estações de Tratamento de Água com tecnologia do tipo ciclo completo e avaliou o risco microbiológico à saúde dos consumidores. Utilizou-se a técnica de filtração em membranas para identificar a carga dos protozoários nas 24 amostras de água bruta e filtrada. Os parâmetros físico-químicos e bacteriológicos também foram analisados. O modelo de Avaliação Quantitativa de Risco Microbiológico foi empregado para determinar o risco de infecção diária e anual associada à ingestão de água filtrada. Um total de 66.67% das amostras de água bruta foram positivas para Cryptosporidium; e 33.33% para Giardia. As concentrações máximas de 200 oocistos/L e 50 cistos/L foram detectadas no ribeirão Cerrado (localizado em Sanclerlândia, Estado de Goiás, Brasil), devido ao predomínio de área de pastagens e à intensa atividade agropecuária. As Estações de Tratamento de Água não removeram completamente os protozoários e a eficiência de retenção foi inferior ao recomendado pela Agência de Proteção Ambiental dos Estados Unidos, com valores médios de 1,27 log para cistos e 1,04 log para oocistos. A probabilidade de infecção anual por cistos (100%) foi superior aos oocistos (86,61% a 98,32%) para o consumo da água filtrada, sendo que a estação seca, o risco de infecção foi maior, devido ao baixo desempenho das Estações de Tratamento de Água e à maior concentração de patógenos. Esses resultados indicam que a ingestão contínua de água filtrada acima do nível de alerta pode provocar doenças infecciosas na população abastecida.

Impact of treatment plant management on human health and ecological risks from wastewater irrigation in developing countries - case studies from Cochabamba, Bolivia.

Wastewater irrigation is a common practice in developing countries due to water scarcity and increasing demand for food production. However, there are health risks and ecological risks associated with this practice. Small-scale wastewater treatment plants (WWTPs) intend to decrease these risks but still face management challenges. This study assessed how the management status of five small-scale WWTPs in Cochabamba, Bolivia affects health risks associated with consumption of lettuce and ecological risks due to the accumulation of nutrients in the soil for lettuce and maize crops. Risk simulations for three wastewater irrigation scenarios were: raw wastewater, actual effluent and expected effluent. Results showed that weak O&M practices can increase risk outcomes to higher levels than irrigating with raw wastewater. Improving O&M to achieve optimal functioning of small-scale WWTPs can reduce human health risks and ecological risks up to 2 log10 DALY person-1 year-1 and to 2 log10 kg nitrogen ha-1 accumulated in soil, respectively.

Quantitative microbial risk assessment of SARS-CoV-2 for workers in wastewater treatment plants.

Faecal-oral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is yet to be validated, but it is a critical issue and additional research is needed to elucidate the risks of the novel coronavirus in sanitation systems. This is the first study that investigates the potential health risks of SARS-CoV-2 in sewage to wastewater treatment plant (WWTP) workers. A quantitative microbial risk assessment (QMRA) is applied for three COVID-19 scenarios (moderate, aggressive and extreme) to study the effects of different stages of the pandemic in terms of percentage of infected population on the probability of infection to WWTP workers. A dose-response model for SARS-CoV-1 (as a surrogate pathogen) is assumed in the QMRA for SARS-CoV-2 using an exponential model with k = 4.1 × 102. Literature data are incorporated to inform assumptions for calculating the viral load, develop the model, and derive a tolerable infection risk. Results reveal that estimates of viral RNA in sewage at the entrance of WWTPs ranged from 4.14 × 101 to 5.23 × 103 GC·mL-1 (viable virus concentration from 0.04 to 5.23 PFU·mL-1, respectively). In addition, estimated risks for the aggressive and extreme scenarios (2.6 × 10-3 and 1.3 × 10-2, respectively) were likely to be above the derived tolerable infection risk for SARS-CoV-2 of 5.5 × 10-4 pppy, thus reinforcing the concern of sewage systems as a possible transmission pathway of SARS-CoV-2. These findings are helpful as an early health warning tool and in prioritizing upcoming risk management strategies, such as Emergency Response Plans (ERPs) for water and sanitation operators during the COVID-19 and future pandemics.

Assessment of health risks from recreational exposure to Giardia and Cryptosporidium in coastal bathing waters.

Some Brazilian beaches are impacted by raw or poorly treated sewage. Thus, users (beachgoers, sports people, and children) are exposed to pathogens, which pose health concerns. This study aimed to estimate the probability of infection and disease by Giardia and Cryptosporidium, using the quantitative microbial risk assessment (QMRA), for three groups of bathers: children, adults, and open water swimmers. The concentrations of (oo)cysts were taken from a study run by CETESB (Environmental Company of Sao Paulo State) throughout 2011 and 2012, in which 203 samples were collected monthly and analyzed for (oo)cysts of Giardia and Cryptosporidium. Giardia was present in 43% of the samples, while Cryptosporidium in 13%. Infection probability was higher in beaches with more positive samples for Giardia cysts for the group of open water swimmers. In some cases, the highest annual risk obtained for giardiasis and cryptosporidiosis was 2.4 × 10-1 and 8.9 × 10-3 for open water swimmers, respectively, exceeding the incidence results found in the epidemiological study run in summer of 1999 in São Paulo state coast. The results bring insights to improve environmental quality in order to protect tourists' and residents' wellbeing.

A critical analysis of recreational water guidelines developed from temperate climate data and applied to the tropics.

Recreational water epidemiology studies are rare in settings with minimal wastewater treatment where risk may be highest, and in tropical settings where warmer temperature influences the ecology of fecal indicator bacteria commonly used to monitor recreational waters. One exception is a 1999 study conducted in São Paulo Brazil. We compared the risk and exposure characteristics of these data with those conducted in the United Kingdom (UK) in the early 1990s that are the basis of the World Health Organization's (WHO) guidelines on recreational water risks. We then developed adjusted risk difference models (excess gastrointestinal illness per swimming event) for children (<10 years of age) and non-children (≥10 years of age) across five Brazil beaches. We used these models along with beach water quality data from 2004 to 2015 to assess spatial and temporal trends in water quality and human risk. Risk models indicate that children in Brazil have as much as two times the risk of gastrointestinal illness than non-children. In Brazil, 11.8% of the weekly water samples from 2004 to 2015 exceeded 158 enterococci CFU/100 ml, the highest level of fecal streptococci concentration measured in the UK study. Risks associated with these elevated levels equated to median NEEAR-Gastrointestinal Illness (NGI) risks of 53 and 96 excess cases per 1000 swimmers in non-children and children, respectively. Two of the five beaches appear to drive the overall elevated NGI risks seen during this study. Distinct enteric pathogen profiles that exist in tropical settings as well as in settings with minimal wastewater treatment highlight the importance of regionally specific guideline development.

Modelling the combined effect of chlorine, benzyl isothiocyanate, exposure time and cut size on the reduction of Salmonella in fresh-cut lettuce during washing process.

This work aimed to study the effect of the combination of Sodium hypochlorite, the most used disinfectant by the vegetable industry, with a natural antimicrobial, benzyl-isothiocyanate (BITC), considering cutting surface and contact time, on the reduction of Salmonella in fresh-cut produce in washing operations under typical industrial conditions. Overall, the combinations of disinfectant and process parameters resulted in a mean reduction of Salmonella of 2.5 log CFU/g. According to statistical analysis, free chlorine and BITC concentrations, contact time and cut size exerted a significant effect on the Salmonella reduction (p ≤ 0.05). The optimum combination of process parameter values yielding the highest Salmonella reduction was a lettuce cut size of 15 cm2 washed for 110 s in industrial water containing 160 mg/L free chlorine and 40 mg/L BITC. A predictive model was also derived, which, as illustrated, could be applied to optimize industrial disinfection and develop probabilistic Exposure Assessments considering the effect of washing process parameters on the levels of Salmonella contamination in leafy green products. The present study demonstrated the efficacy of chlorine to reduce Salmonella populations in fresh-cut lettuce while highlighting the importance of controlling the washing process parameters, such as, contact time, cut size and concentration of the disinfectant to increase disinfectant efficacy and improve food safety.

Data fitting approach more critical than exposure scenarios and treatment of censored data for quantitative microbial risk assessment.

Recreational waters are a source of many diseases caused by human viral pathogens, including norovirus genogroup II (NoV GII) and enterovirus (EV). Water samples from the Arenales river in Salta, Argentina, were concentrated by ultrafiltration and analyzed for the concentrations of NoV GII and EV by quantitative PCR. Out of 65 samples, 61 and 59 were non-detects (below the Sample Limit of Detection limit, SLOD) for EV and NoV GII, respectively. We hypothesized that a finite number of environmental samples would lead to different conclusions regarding human health risks based on how data were treated and fitted to existing distribution functions. A quantitative microbial risk assessment (QMRA) was performed and the risk of infection was calculated using: (a) two methodological approaches to find the distributions that best fit the data sets (methods H and R), (b) four different exposure scenarios (primary contact for children and adults and secondary contact by spray inhalation/ingestion and hand-to-mouth contact), and (c) five alternatives for treating censored data. The risk of infection for NoV GII was much higher (and exceeded in most cases the acceptable value established by the USEPA) than for EV (in almost all the scenarios within the recommended limit), mainly due to the low infectious dose of NoV. The type of methodology used to fit the monitoring data was critical for these datasets with numerous non-detects, leading to very different estimates of risk. Method R resulted in higher projected risks than Method H. Regarding the alternatives for treating censored data, replacing non-detects by a unique value like the average or median SLOD to simplify the calculations led to the loss of information about the particular characteristics of each sample. In addition, the average SLOD was highly impacted by extreme values (due to events such as precipitations or point source contamination). Instead, using the SLOD or half- SLOD captured the uniqueness of each sample since they account for the history of the sample including the concentration procedure and the detection method used. Finally, substitution of non-detects by Zero is not realistic since a negative result would be associated with a SLOD that can change by developing more efficient and sensitive methodology; hence this approach would lead to an underestimation of the health risk. Our findings suggest that in most cases the use of the half-SLOD approach is appropriate for QMRA modeling.

Pesquisa de bioagentes na água do Rio Pardo, Brasil, e estimativa de risco de infecção e de doença por Cryptosporidium spp. e Giardia spp / Research on bioagents in the Pardo river water, Brazil, and estimated risk of infection and disease by Cryptosporidium spp. and Giardia spp

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

Detection and risk assessment of diarrheagenic E. coli in recreational beaches of Brazil.

Marine beaches are important recreational and economic resources in Brazil, but the beaches' water quality is negatively impacted by the discharge of domestic sewage effluent. The occurrence of diarrheagenic Escherichiacoli among the E. coli isolated from three Brazilian marine beaches was investigated. Multiplex and single step PCR were used to screen 99 E. coli isolates for ten target toxin genes. Six toxin genes, stx1, eae, estp, esth, astA, and bfpA, were identified in 1% to 35% of the isolates. A quantitative microbial risk assessment (QMRA) of human exposure to diarrheagenic E. coli during marine recreation was carried out. The results indicated that the diarrheagenic E. coli risk is well below the U.S. EPA's recommended daily recreational risk benchmark. However, the overall recreational health risk due to all pathogens in the water could be much higher and exceeded the U.S. EPA's benchmark.

Vegetais minimamente processados prontos para o consumo: influência da etapa de desinfecção na inativação de Salmonella Typhimurium, na ocorrência da contaminação cruzada e na avaliação quantitativa de risco microbiológico em relação a este patógeno / Minimally processed ready-to-eat vegetables: influence of washing-disinfection step on Salmonella Typhimurium inactivation, on occurrence of cross-contamination and on quantitative microbiological risk assessment regarding this pathogen

Dados mundiais apontam haver uma associação entre o aumento do comércio de vegetais minimamente processados prontos para o consumo (VPC) e o aumento da ocorrência de surtos de enfermidades transmitidas por alimentos. Durante o processamento industrial de VPC, a desinfecção é a principal etapa de inativação de micro-organismos patogênicos presentes, mas nessa etapa também pode ocorrer contaminação cruzada, com transferência de contaminantes de produtos contaminados para não-contaminados. Neste trabalho, foram coletadas informações sobre as práticas empregadas na etapa de desinfecção em dez importantes indústrias produtoras de VPC no Estado de São Paulo, avaliando-se, em seguida, a influência dessas práticas na qualidade microbiológica dos produtos e na inativação de Salmonella Typhimurium, bem como na ocorrência de contaminação cruzada por este patógeno. Um modelo de avaliação quantitativa de risco microbiológico foi elaborado para estimar o impacto da contaminação cruzada durante a etapa de desinfecção no risco de infecção por Salmonella devido ao consumo de VPC. Observou-se que, em todas as indústrias visitadas, a desinfecção dos vegetais era feita com produtos à base de cloro em concentrações de 50 a 240 mg/L, que resultava em redução de até 1,2 log na carga microbiana dos vegetais que entravam na linha de processamento. Ao avaliar a influência das características da água de processamento (pH, temperatura, concentração de matéria orgânica e concentração de dicloroisocianurato de sódio) e do tempo de contato entre a água clorada e os vegetais na redução de Salmonella, observou-se que a concentração do produto à base de cloro foi o parâmetro que apresentou maior influência (p<0.05). Concentrações de dicloroisocianurato de sódio acima de 10 mg/L foram necessárias para controle da contaminação cruzada durante a etapa de lavagem. O modelo de avaliação de risco construído indicou quantitativamente haver uma relação entre a concentração de dicloroisocianurato de sódio na água de desinfecção e o risco de ocorrência de surtos causados por Salmonella em VPC. Cenários simulando uso de dicloroisocianurato de sódio em concentrações abaixo de 5 mg/L indicaram que mais de 96% dos casos preditos de infecção por Salmonella poderiam ser atribuídos à ocorrência de contaminação cruzada, enquanto que em cenários com concentrações acima de 50 mg/L, casos de infecção devidos à contaminação cruzada não foram preditos. Estes resultados mostram que o controle da qualidade da água e o monitoramento da concentração de sanitizante na etapa de desinfecção são essenciais para evitar a ocorrência de contaminação cruzada e garantir a produção de VPC seguros para o consumo

Surveillance data in several countries show an association between consumption of minimally processed ready-to-eat (RTE) vegetables and increased occurrence of foodborne diseases outbreaks. During RTE vegetables processing, washing-disinfection is the main step aiming to ensure inactivation of pathogenic microorganisms, but also is the step in which cross-contamination may occur, with transfer of contaminants from contaminated to non-contaminated products. In this study, we collected information on the practices employed during the washing-disinfection step in ten RTE vegetables processing plants located in the State of Sao Paulo, Brazil, and evaluated the influence of these washing practices on the microbial quality of the products and inactivation of Salmonella Typhimurium, as well as on the occurrence of cross-contamination by this pathogen. A quantitative microbial risk assessment model was built in order to estimate the impact of cross-contamination during the washing step on the risk of infection by Salmonella due to the consumption of RTE vegetables. In all visited processing plants, the disinfection step was done using chlorine-based products, in concentrations ranging from 50 to 240 mg/L, achieving a reduction of up to 1.2 log in the microbial load of vegetables entering the processing line. When the influence of washing water parameters (pH, temperature, organic load and sodium dichloroisocyanurate concentration) and time of contact between chlorinated water and vegetables on reduction of Salmonella were evaluated, sodium dichloroisocyanurate concentration influenced the most (p<0.05). Concentrations above 10 mg/L were necessary for avoiding cross-contamination during washing step. The risk assessment model indicated quantitatively a relationship between sodium dichloroisocyanurate concentration and the risk of illness caused by Salmonella in RTE vegetables. When simulation was done with less than 5 mg/L of sodium dichloroisocyanurate, most (>96%) of the illnesses arose from cross-contamination. However, when the concentration was 50 mg/L or higher, no illnesses arising from cross-contamination were predicted. These results show that controlling the quality of the water and monitoring the concentration of the sanitizer in the disinfection step are essential to avoid occurrence of cross contamination and ensure production of RTE vegetables that are safe for consumption

Quantification of human infection risk caused by rotavirus in surface waters from Córdoba, Argentina.

Fecal contamination of water is a worrying problem because it is associated with the transmission of enteric pathogenic microorganisms that can cause many infectious diseases. In this study, an environmental survey was conducted to assess the level of viral contamination by viable enterovirus and rotavirus genome in two recreational rivers (Suquía and Xanaes) of Córdoba, Argentina. Quantitative microbial risk assessment (QMRA) was calculated to estimate the risk of rotavirus infection. Water sampling was carried out during a one-year period, the presence of total and fecal coliforms was determined and water samples were then concentrated for viral determination. Cell culture and indirect immunofluorescence were applied for enterovirus detection and RT-qPCR for rotavirus quantification. Coliform bacteria levels found in Suquía River often far exceeded the guideline limits for recreational waters. The Xanaes exhibited a lower level of bacterial contamination, frequently within the guideline limits. Enterovirus and rotavirus were frequently detected in the monitoring rivers (percentage of positive samples in Suquía: 78.6% enterovirus, 100% rotavirus; in Xanaes: 87.5% enterovirus, 18.7% rotavirus). Rotavirus was detected at a media concentration of 5.7×10(5) genome copies/L (gc/L) in the Suquía and 8.5×10(0)gc/L in the Xanaes. QMRA revealed high risk of rotavirus infection in the Suquía, at sampling points with acceptable and non-acceptable bacteria numbers. The Xanaes showed significantly lower health risk of rotavirus infection but it proved to be a public health hazard. The viral occurrence was not readily explained by the levels of bacteria indicators, thus viral monitoring should be included to determine microbiological water quality. These findings provide the first data of QMRA for recreational waters in Argentina and reveal the need for public awareness of the health implications of the use of the river waters.

Avaliação quantitativa do risco microbiológico em águas e biossólidos: estado da arte / Quantitative microbial risk assessment: state of the art in water and biosolids

A avaliação quantitativa de risco microbiológico é o processo utilizado para estimar a probabilidade de infecção, doença ou morte após exposição a microrganismos patogênicos presente em águas, biossólidos, alimentos e ar. Essa pesquisa tem como objetivo descrever o estado da arte da avaliação qualitativa de risco microbiológico associadas a águas e biossólidos, bem como descrever as abordagens e etapas utilizadas na condução do processo, relatar a aplicabilidade e discutir as dificuldades e necessidades na condução da AQRM. Sendo uma pesquisa de caráter descritivo-explicativo, realizou-se revisão de literatura sobre a temática nas seguintes bases de dados: Scielo, LILACS, DEDALUS, MEDLINE e PUBMED e nos documentos produzidos pela Organização Mundial de Saúde e U.S. Environmental Protect Agency. Na literatura consultada verificou-se que a AQRM vem sendo utilizada desde o início da década de 1980 para estimar os riscos à saúde humana. Existem diferentes abordagens utilizadas na condução da ferramenta, diferem na forma de organizar e sistematizar as informações, porém são similares. A abordagem mais utilizada é a proposta pela NRC e consta de quatro etapas: identificação do perigo, avaliação de exposição, avaliação de dose-resposta e caracterização do risco. Constatou-se que a avaliação de exposição apresentase como a etapa mais complexa da AQRM, devido a: i) limitações metodológicas na determinação da concentração e viabilidade dos patógenos em águas e biossólidos e ii) escassez de dados de exposição e de consumo. Verificou-se que a utilização da ferramenta é proeminente na avaliação dos riscos decorrentes da exposição à patógenos presentes em águas de consumo, recreacionais e residuárias, bem como os decorrentes da exposição a solos e cultivos agrícolas fertilizados com biossólidos...

The quantitative microbial risk assessment is the process used to estimate the probability of infection, disease or death after exposure to pathogenic microorganisms present in water, biosolids, food and air. This research aims to describe the state of the art of quantitative microbial risk assessment associated with water and biosolids, and to describe the approaches and steps used in conducting the proceedings, report the applicability and discuss the difficulties and needs in the conduct of QMRA. As a search with a descriptive-explanatory character, there was a literature review on the subject on the following databases: SciELO, LILACS, DEDALUS, MEDLINE, PUBMED and in documents produced by the World Health Organization and the U.S. Environmental Protection Agency. In literature it was found that the QMRA has been used since the early 1980s to estimate the risk to human health. There are different approaches used in the conduct of the tool, they differ in the way of organizing and systematizing the information, but they are similar. The most used approach is the one proposed by the NRC and consists of four steps: hazard identification, exposure assessment, dose response assessment and risk characterization. It was found that the exposure assessment is presented as the most complex steps of QMRA due to: i) methodological limitations in determining the concentration and viability of pathogens in water and biosolids, and ii) lack of exposure data and consumption. It was verified that the use of the tool is prominent in assessing the risks from exposure to pathogens in drinking water, recreational water and waste water, as well as from exposure to soils and crops fertilized with biosolids...