Safe Use of Wastewater Excreta and Greywater: Who Guidelines For The

WHO GUIDELINES FOR THE
SAFE USE OF WASTEWATER ,

EXCRETA AND GREYWATER
VOLUME IV
EXCRETA AND GREYWATER USE IN AGRICULTURE
GUIDELINES FOR THE SAFE USE OF
WASTEWATER, EXCRETA AND GREYWATER
Volume 4
Excreta and greywater use in agriculture
WHO Library Cataloguing-in-Publication Data
WHO guidelines for the safe use of wastewater, excreta and greywater / World
Health Organization.
v. 1. Policy and regulatory aspects — v. 2. Wastewater use in agriculture

— v. 3. Wastewater and excreta use in aquaculture — v. 4. Excreta and
greywater use in agriculture.
1. Water supply. 2. Water supply - legislation. 3. Agriculture. 4. Aquaculture.

5. Sewage. 6. Wastewater treatment plants. 7. Guidelines. I. World Health
Organization. II. Title: Safe use of wastewater, excreta and greywater. III.
Title: Policy and regulatory aspects. IV. Title: Wastewater use in agriculture.
V. Title: Wastewater and excreta use in aquaculture. VI. Title: Excreta and
ISBN 92 4 154686 7 (set) (NLM classification: WA 675)

ISBN 92 4 154682 4 (v. 1)
ISBN 92 4 154683 2 (v. 2)
ISBN 92 4 154684 0 (v. 3)
ISBN 92 4 154685 9 (v. 4)
© World Health Organization 2006
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Printed in France.
ii
CONTENTS
List of acronyms and abbreviations .....................................................................vi

Preface ....................................................................................................................vii
Acknowledgements ................................................................................................ix
Executive summary............................................................................................. xiii
1. Introduction .........................................................................................................1
1.1 Objectives and general considerations ...........................................................2
1.2 Target audience and definitions ......................................................................3
1.3 International guidelines and national standards .............................................3
1.3.1 National standards .................................................................................3
1.3.2 Food exports ..........................................................................................4
1.4 Factors that affect sustainability in sanitation ................................................4
1.4.1 Health and hygiene ................................................................................4
1.4.2 Environment and resource use ...............................................................5
1.4.3 Economy ................................................................................................5
1.4.4 Sociocultural aspects and use ................................................................5
1.4.5 Technology function ..............................................................................5
1.5 Driving forces .................................................................................................6
1.5.1 Water scarcity, stress and degradation ...................................................6
1.5.2 Population growth and food production ................................................7
1.5.3 Excreta and greywater as resources .......................................................8
1.5.4 Millennium Development Goals..........................................................15
2. The Stockholm Framework..............................................................................19

2.1 A harmonized approach to risk assessment/management.............................19
2.2 Elements of the Stockholm Framework .......................................................20
2.3 Assessment of environmental exposure .......................................................21
2.4 Assessment of health risk .............................................................................22
2.5 Tolerable risk and health-based targets ........................................................24
2.5.1 Tolerable risk .......................................................................................25
2.5.2 Health-based targets.............................................................................25
2.6 Risk management .........................................................................................26
2.7 Public health status .......................................................................................27
3. Assessment of health risk..................................................................................29

3.1 Health benefits ..............................................................................................29
3.2 Excreta-related infections .............................................................................30
3.2.1 Pathogens in faeces. .............................................................................31
3.2.2 Pathogens in urine................................................................................34
3.2.3 Pathogens in greywater ........................................................................36
3.3 Pathogen survival in faeces, urine and greywater ........................................37
3.3.1 Survival in faeces .................................................................................37
3.3.2 Survival in urine ..................................................................................39
3.3.3 Faecal load and survival of faecal pathogens in greywater .................41
3.4 Survival in soils and on crops.......................................................................42
3.5 Epidemiological and risk-based evidence ....................................................44
3.6 Quantitative microbial risk analysis .............................................................49
3.6.1 Example of risk calculation for a greywater scenario .........................49
3.6.2 Example of risk calculation for collection and use of diverted
human urine ..................................................................................................51
3.6.3 Example of risk calculation for stored but otherwise untreated excreta...... 55
iii
Guidelines for the safe use of wastewater, excreta and greywater
4. Health-based targets .........................................................................................59

4.1 Type of targets applied .................................................................................60
4.2 Tolerable burden of disease and health-based targets ..................................60
4.3 Microbial reduction targets...........................................................................64
4.4 Verification monitoring.................................................................................66
4.4.1 Treatment of excreta and greywater ....................................................67
4.4.2 Other health protection measures ........................................................67
4.4.3 Excreta in small systems ......................................................................68
4.4.4 Operational monitoring for urine in large- and small-scale systems ...70
5. Health protection measures..............................................................................73

5.1 Specific considerations for exposure control in the use of urine, faeces
and greywater ...............................................................................................74
5.1.1 Exposure control: general principles ...................................................75
5.1.2 Exposure control at agricultural sites or site of use. ............................75
5.1.3 Post-harvest exposure control. .............................................................78
5.2 Technical measures .......................................................................................79
5.2.1 On-site sanitation systems ...................................................................79
5.2.2 Handling and transport of excreta and sludge .....................................88
5.2.3 Treatment of blackwater and septic tank/faecal sludge .......................90
5.2.4 Greywater ............................................................................................93
6. Monitoring and system assessment ...............................................................101

6.1 Monitoring functions ..................................................................................101
6.2 System assessment .....................................................................................102
6.3 Validation....................................................................................................102
6.4 Operational monitoring ..............................................................................104
6.5 Verification .................................................................................................106
6.6 Small systems .............................................................................................107
6.7 Other types of monitoring ..........................................................................107
7. Sociocultural aspects.......................................................................................109
7.1 Perceptions of excreta and greywater use ..................................................109
7.2 Food-related determinants .......................................................................... 111
7.3 Behavioural change and cultural factors .................................................... 111
7.4 Convenience factors and dignity issues......................................................113
7.5 Gender aspects on use of excreta and greywater ........................................114
8. Environmental aspects.................................................................................... 117

8.1 Impacts on soil............................................................................................117
8.1.1 Metals ................................................................................................118
8.1.2 Persistent organic compounds ...........................................................119
8.1.3 Salinization ........................................................................................120
8.2 Impacts on water bodies .............................................................................121
9. Economic and financial considerations .........................................................123

9.1 Economic feasibility ...................................................................................123
9.1.1 Cost–benefit analysis .........................................................................123
9.1.2 Costs and benefits ..............................................................................124
9.1.3 Multiple-objective decision-making processes..................................125
9.1.4 Empirical examples of cost analyses for reuse systems ....................125
9.2 Financial feasibility ....................................................................................127
9.3 Market feasibility .......................................................................................132
iv
Volume 4: Excreta and greywater use in agriculture
10. Policy aspects .................................................................................................133

10.1 Policy ............................................................................................................133
10.1.1 International policy ..........................................................................134
10.1.2 National greywater and excreta use policies ...................................134
10.1.3 Greywater and excreta in integrated water resources management.135
10.2 Legislation ................................................................................................135
10.2.1 Institutional roles and responsibilities .............................................136
10.2.2 Other roles and responsibilities .......................................................139
10.2.3 Rights of access ...............................................................................142
10.2.4 Land tenure ......................................................................................142
10.2.5 Public health ....................................................................................142
10.3 Regulation ................................................................................................142
10.4 Development of a national policy framework ..........................................143
10.4.1 Defining objectives ..........................................................................144
10.4.2 Analysis of the existing policy framework ......................................144
10.4.3 Development of action plans ...........................................................146
10.4.4 Research ...........................................................................................148
11. Planning and implementation ......................................................................149

11.1 Adopting an appropriate planning approach.............................................149
11.2 Local project planning: specific considerations........................................151
11.2.1 Participatory approaches ..................................................................151
11.2.2 Treatment .........................................................................................152
11.2.3 Crop restriction ................................................................................153
11.2.4 Application .......................................................................................153
11.2.5 Human exposure control ..................................................................153
11.2.6 Costs.................................................................................................154
11.2.7 Technical aspects..............................................................................155
11.2.8 Support services ...............................................................................156
11.2.9 Training ............................................................................................156
References. ...........................................................................................................157
Annex 1: Glossary of terms used in Guidelines................................................177
v
LIST OF ACRONYMS AND
ABBREVIATIONS
vi
PREFACE
vii
viii
ACKNOWLEDGEMENTS
ix
x
xi
EXECUTIVE SUMMARY
xiii
xiv
xv
xvi
xvii
xviii
xix
xx
1
INTRODUCTION
1. Introduction
Guidelines
4. Health-based 7. Sociocultural
targets aspects
2. Stockholm
Framework 5. Health protection 8. Environmental
measures aspects
3. Assessment of
health risk 6. Monitoring 9. Economic and
and system financial
assessment considerations
Supporting Other
evidence information
10. Policy aspects

11. Planning and
implementation
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Volume 4:
2 Excreta and greywater use in agriculture
THE STOCKHOLM FRAMEWORK
19
Health-based
targets
Basic control
approaches
Tolerable
health risk
Water/waste Other management

quality objectives objectives
Define measures and interventions Assess

(requirements, specifications) based environmental Assessment of
health risk
Health risk management
on objectives exposure
Define key risk points and audit

procedures for overall system
effectiveness
Define analytical verifications (proc- Public health

ess, public health) status
20
Table 2.1 (continued)
21
22
23
24
25
26
27
28
Volume 4:3Excreta and greywater use in agriculture
ASSESSMENT OF HEALTH RISK
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
HEALTH-BASED TARGETS
59
60
61
62
63
64
65
66
67
68
69
70
71
72
Volume 4:
HEALTH PROTECTION MEASURES
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
Volume 4:
MONITORING AND SYSTEM
ASSESSMENT
101
102
Assemble the team to prepare the risk management plan
Document and describe the system
Undertake a hazard assessment and risk

characterization to identify and understand how risks
can be managed in the system
Assess the existing or proposed system (including a

description of the system and a flow diagram)
Identify control measures —

the means by which risks can be controlled
Define monitoring of control measures —

what limits define acceptable performance and how
these are monitored
Establish procedures to verify that the risk

management plan is working effectively and will meet
the health-based targets
Develop supporting programmes (e.g. training, hygienic

practices, standard operating procedures, upgrade and
improvement, research and development, etc.)
Prepare management procedures (including corrective

actions) for normal and incident conditions
Establish documentation and communication

procedures
103
104
105
106
107
108
Volume 4:
SOCIOCULTURAL ASPECTS
109
110
111
112
113
114
115
116
ENVIRONMENTAL ASPECTS
117
118
119
120
121
122
ECONOMIC AND FINANCIAL
CONSIDERATIONS
123
124
125
126
Box 9.1 (continued)
127
128
129
130
131
132
Volume 10
4: Excreta and greywater use in agriculture
POLICY ASPECTS
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
11Excreta and greywater use in agriculture
Volume 4:
PLANNING AND IMPLEMENTATION
149
150
151
152
153
154
155
156
REFERENCES
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
Volume 4: Excreta
Annex 1 and greywater use in agriculture
Glossary of terms used in Guidelines
177
178
179
180
181
182
The third edition of the WHO Guidelines for the safe use of wastewater,
excreta and greywater has been extensively updated to take account of
new scientific evidence and contemporary approaches to risk management.
The revised Guidelines reflect a strong focus on disease prevention and
public health principles.
This new edition responds to a growing demand from WHO Member

States for guidance on the safe use of wastewater, excreta and greywater
in agriculture and aquaculture. Its target audience includes environmental
and public health scientists, researchers, engineers, policy-makers and
those responsible for developing standards and regulations.
The Guidelines are presented in four separate volumes: Volume 1: Policy

and regulatory aspects; Volume 2:Wastewater use in agriculture; Volume 3:
Wastewater and excreta use in aquaculture; and Volume 4: Excreta and
Volume 4 of the Guidelines focuses exclusively on the safe use of excreta

and greywater in agriculture. Recent trends in sanitation, including ecological
sanitation, are driven by rapid urbanization. The momentum created by the
Millennium Development Goals is resulting in dramatic changes in human
waste handling and processing. New opportunities enable the use of human
waste as a resource for pro-poor agricultural development, particularly in
periurban areas. Best practice to minimize associated health risks is at the
heart of this volume.
ISBN 92 4 154685 9

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WHO GUIDELINES FOR THE

SAFE USE OF WASTEWATER ,

v. 1. Policy and regulatory aspects — v. 2. Wastewater use in agriculture

1. Water supply. 2. Water supply - legislation. 3. Agriculture. 4. Aquaculture.

ISBN 92 4 154686 7 (set) (NLM classification: WA 675)

© World Health Organization 2006

List of acronyms and abbreviations .....................................................................vi

Executive summary............................................................................................. xiii

2. The Stockholm Framework..............................................................................19

3. Assessment of health risk..................................................................................29

4. Health-based targets .........................................................................................59

5. Health protection measures..............................................................................73

6. Monitoring and system assessment ...............................................................101

8. Environmental aspects.................................................................................... 117

9. Economic and financial considerations .........................................................123

10. Policy aspects .................................................................................................133

11. Planning and implementation ......................................................................149

Annex 1: Glossary of terms used in Guidelines................................................177

10. Policy aspects

Water/waste Other management

Define measures and interventions Assess

Define key risk points and audit

Define analytical verifications (proc- Public health

Table 2.1 (continued)

Table 3.11 (continued)

Table 5.2 (continued)

Assemble the team to prepare the risk management plan

Document and describe the system

Undertake a hazard assessment and risk

Assess the existing or proposed system (including a

Identify control measures —

Define monitoring of control measures —

Establish procedures to verify that the risk

Develop supporting programmes (e.g. training, hygienic

Prepare management procedures (including corrective

Establish documentation and communication

Table 6.2 (continued)

Box 9.1 (continued)

Table 10.1 (continued)

Table 10.3 (continued)

This new edition responds to a growing demand from WHO Member

The Guidelines are presented in four separate volumes: Volume 1: Policy

Volume 4 of the Guidelines focuses exclusively on the safe use of excreta

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