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Keywords Greywater, microbial risk assessment, pathogens, reuse, treatment Abstract The aim of this study was to investigate and evaluate health risks from infectious diseases related to the reuse of source-separated greywater. Prevalence of pathogens in the population and the faecal load based on coprostanol concentrations were used to form the basis of a screening-level quantitative microbial risk assessment QMRA ; that was undertaken for rotav irus, Salmonella, Campylobacter, Giardia and Cryptosporidium, looking at the treatment required to be below an acceptable level of risk 10 -3 ; for reuse or discharge of the greywater. The different exposure scenarios simulated groundwater recharge, direct contact, irrigation and recreational water showed that a mean reduction of 0.7 3.7 log was needed for rotavirus, with the measured level of faecal load in Vibysen Sweden ; . The other pathogen of concern was Campylobacter, where a mean 2.2 log reduction was needed for groundwater recharge. The infe ctious dose of Salmonella is high and the excretion numbers of Giardia cysts and Cryptosporidium ocysts low, resulting in low or no treatment requirements for these organisms for the inve stigated exposure scenarios. The use of QMRA can serve as a basis for integration of hygiene issues with other parameters as economy and environment. Introduction Greywater constitute the major part of household wastewater. The interest of separation and reuse of greywater, e.g. wastewater from bath shower, the kitchen and laundry but without input from toilets, has increased due to economical, structural and ecological considerations Asano & Levine, 1996; Gunther, 2000 ; . Based on repeatedly high counts of faecal indicator bacteria, regulatory agencies prior were enforcing combined treatment, or stric t separate treatment of the greywater. The risk of introducing pathogens into greywater are mainly from faecal contaminated laundry, diapers, childcare and showering and will most often be much lower than the i ndicator bacterial counts signal. The faecal input in greywater measured by the chemical bi omarker coprostanol was only 0.04 g person-1 day-1 in a community north of Stockholm, Sweden Ottosson & Stenstrm, 2002 ; . To measure the impact on public health quantitative microbial risk assessment, QMRA, was used. Traditionally in QMRAs the probability of infection is calc ulated. However, the poor data on greywater treatment efficiency, especially virus reduction, has prompted us to simulate the treatment required to be inside the 10 -3 risk addressed by Haas, 1996 ; . This has been done for different exposure scenarios groundwater recharge, accidental ingestion, irrigation of sports fields and gardens ; to reused or discharged greywater for rotav irus, Campylobacter, Salmonella, Giardia and Cryptosporidium under Swedish conditions. Session D and allopurinol.
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Acknowledgements The authors gratefully appreciate the assistance of S. Alexander, Enteric Reference Laboratory and the staff of the Susceptibility Testing Laboratory. References 1. Lior H. New, extended biotyping scheme for Campylobacter jejuni, Campylobacter coli, and "Campylobacter laridis". J Clin Microbiol 1984; 20: 636-40. Hodge DS, Borczyk A, Wat L-L. Evaluation of the indoxyl acetate hydrolysis test for the differentiation of campylobacters. J Clin Microbiol 1990; 28: 1482-83. Endtz HP, Ruijs GJ, van Klingeren B et al. Quinolone resistance in campylobacter isolated from man and poultry following the introduction of fluoroquinolones in veterinary medicine. J Antimicrob Chemother 1991; 27: 199-208. Rautelin H, Renkonen O-V, Kosunen TU. Emergence of fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli in subjects from Finland. Antimicrob Agents Chemother 1991; 35: 2065-69. Chatzipanagiotou S, Papvasiliou E, Malamou-Lada E. Isolation of Campylobacter jejuni strains resistant to nalidixic acid and fluoroquinolones from children with diarrhea in Athens, Greece. Eur J Clin Microbiol Infect Dis 1993; 12: 566-68. Sanchez R, Fernandez-Baca V, Diaz MD et al. Evolution of susceptibilities of Campylobacter spp. to quinolones and macrolides. Antimicrob Agents Chemother 1994; 38: 1879-82. Morris GK, Patton CM. Campylobacter. In: Lennette EH, Balows A, Hausler WJ, Shadomy HT, eds. Manual of clinical, for example, allegra medication.

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