In any wastewater recycling scheme, the protection of public health is of primary importance. In Australia, the public health requirements applying to the treatment of recycled water are stringent. They use the Disability-Adjusted Life Year (DALY) metric to set a level of negligible public health risk. The target maximum risk of 10–6 DALY per person per year has been adopted in Australian water recycling guidelines since 2006. A key benefit of the DALY approach is its ability to standardise the understanding of risk across disparate areas of public health. To address the key challenge of translating the results of monitoring of microorganisms in the recycled water into this quantitative public health metric, we have developed a novel method. This paper summarises an approach where microbial surrogate organisms indigenous to wastewater are used to measure the efficiency of water recycling treatment processes and estimate public health risk. An example of recent implementation in the Greater Sydney region of Australia is provided.

In the more than 15 years since its introduction, quantitative microbial risk assessment (QMRA) has become a widely used technique for assessing population health risk posed by waterborne pathogens. However, the variation in approaches taken for QMRA in relation to drinking water supply is not well understood. This systematic review identifies, categorises, and critically synthesises peer-reviewed and academic case studies of QMRA implementation for existing distributed public drinking water supplies. Thirty-nine English-language, peer-reviewed and academic studies published from 2003 to 2019 were identified. Key findings were synthesised in narrative form. The overall designs of the included studies varied widely, as did the assumptions used in risk calculation, especially in relation to pathogen dose. There was also substantial variation in the degree to which the use of location-specific data weighed with the use of assumptions when performing risk calculation. In general, the included studies' complexity did not appear to be associated with greater result certainty. Factors relating to pathogen dose were commonly influential on risk estimates whereas dose-response parameters tended to be of low relative influence. In two of the included studies, use of the 'susceptible fraction' factor was inconsistent with recognised guidance and potentially led to the underestimation of risk. While approaches and assumptions used in QMRA need not be standardised, improvement in the reporting of QMRA results and uncertainties would be beneficial. It is recommended that future authors consider the water supply QMRA reporting checklist developed for the current review. Consideration of the broad types of uncertainty relevant to QMRA is also recommended. Policy-makers should consider emergent discussion on acute microbial health-based targets when setting normative guidelines. The continued representation of QMRA case studies within peer-reviewed and academic literature would also enhance future implementation. Further research is needed on the optimisation of QMRA resourcing given the application context. (C) 2020 Elsevier Ltd. All rights reserved.

To identify the animal sources for Cryptosporidium and Giardia contamination, we genotyped Cryptosporidium and Giardia spp. in wildlife from Sydney’s water catchments using sequence analysis at the 18S rRNA locus for Cryptosporidium and 18S rRNA and glutamate dehydrogenase (gdh) for Giardia. A total of 564 faecal samples from 16 different host species were analysed. Cryptosporidium was identified in 8.5% (48/564) samples from eight host species and Giardia was identified in 13.8% (78/564) from seven host species. Eight species/genotypes of Cryptosporidium were identified. Five G. duodenalis assemblages were detected including the zoonotic assemblages A and B.

Waterborne Cryptosporidium has been responsible for drinking water-associated disease outbreaks in a number of developed countries. As a result of the resistance of Cryptosporidium to chlorine, which is typically applied as a final barrier to protect the quality of distributed drinking water, current management practices are focused on source-water management and water treatment as ways of preventing Cryptosporidium from entering drinking-water supplies. In the event that treatment barriers fail, surprisingly little is known of the fate of oocysts once they enter a distribution system. To assess properly the risks of waterborne Cryptosporidium, a more thorough understanding of the fate of oocysts in water distribution systems, with emphasis on Cryptosporidium-biofilm interactions, is required.

To protect the quality of drinking water in Sydney, the Sydney Water Corporation (SWC) and the recently created Sydney Catchment Authority (SCA) have adopted a catchment to customer risk management approach after the Cryptosporidium water crisis in 1998. In Sydney such an approach involves close collaboration with the New South Wales Department of Health (NSW Health), as well as the consortia managing several of Sydney's large water filtration plants (WFPs) under Build-Own-Operate (BOO) contracts. This chapter presents a paper, which aims to provide an update of the main actions that have been taken since the water crisis in Sydney in 1998. These updates need to be in: the catchments, water treatment plants, distribution system, and analytical laboratories for Cryptosporidium analysis.