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Water recycling — forwards or backwards for public health?

Karin S Leder, Joanne E O’Toole and Martha I Sinclair
Med J Aust 2009; 190 (6): . || doi: 10.5694/j.1326-5377.2009.tb02414.x
Published online: 16 March 2009

A stringent, preventive risk-management approach could ensure potable reuse is a safe option

As a result of prolonged drought, Australians are increasingly relying on alternative water sources — including rainwater, greywater, and water recycled from stormwater or sewage — for many community and household uses. Health professionals therefore need to be aware of the likelihood, if any, of illness related to water usage. In particular, careful consideration should be given to the safety of water recycling, especially as, at face value, it seems to represent a backward step from John Snow’s mid 19th century discovery of the importance of keeping drinking water and sewage separate.1 The obvious question is: is water recycling safe?


  • 1 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC.
  • 2 Royal Melbourne Hospital, Melbourne, VIC.



  • 1. Snow J. On the mode of communication of cholera. London: John Churchill, 1855.
  • 2. National Water Quality Management Strategy. Australian guidelines for water recycling: managing health and environmental risks (Phase 1). Canberra: Natural Resource Management Ministerial Council, Environment Protection and Heritage Council, and Australian Health Ministers’ Conference, 2006. http://www.ephc.gov.au/sites/default/files/WQ_AGWR_GL__Managing_Health_Environmental_Risks_Phase1_Final_200611.pdf (accessed Feb 2009).
  • 3. National Water Quality Management Strategy. Australian guidelines for water recycling: managing health and environmental risks (Phase 2). Augmentation of drinking water supplies. Canberra: Environment Protection and Heritage Council, Natural Resource Management Ministerial Council, and National Health and Medical Research Council, 2008. http://www.ephc.gov.au/sites/default/files/WQ_AGWR_GL__Augmentation_of_Drinking_Water_Supplies_Final_2008_05.pdf (accessed Feb 2009).
  • 4. Hellard ME, Sinclair MI, Forbes AB, Fairley CK. A randomized, blinded, controlled trial investigating the gastrointestinal health effects of drinking water quality. Environ Health Perspect 2001; 109: 773-778.
  • 5. Robertson B, Sinclair MI, Forbes AB, et al. Case-control studies of sporadic cryptosporidiosis in Melbourne and Adelaide, Australia. Epidemiol Infect 2002; 128: 419-431.
  • 6. Khan S, Roser D. Risk assessment and health effects studies of indirect potable reuse schemes: final report. Sydney: Centre for Water and Waste Technology, School of Civil and Environmental Engineering, University of New South Wales, 2007.
  • 7. Natural Water Quality Management Strategy. Australian drinking water guidelines 6. Canberra: National Health and Medical Research Council, and National Resource Management Ministerial Council, 2004. http://www.nhmrc.gov.au/publications/synopses/eh19syn.htm (accessed Feb 2009).

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