A

Water Research X 21 (2023) 100203
Contents lists available at ScienceDirect
Water Research X
journal homepage: www.sciencedirect.com/journal/water-research-x
Mitigating risks and maximizing sustainability of treated wastewater reuse

for irrigation
David Yalin a, #, Hillary A. Craddock b, #, Shmuel Assouline c, Evyatar Ben Mordechay d,
Alon Ben-Gal e, Nirit Bernstein c, Rabia M. Chaudhry f, †, Benny Chefetz d, Despo Fatta-Kassinos g,
Bernd M. Gawlik h, Kerry A. Hamilton i, Leron Khalifa c, Isaya Kisekka j, Iftach Klapp k,
Hila Korach-Rechtman l, Daniel Kurtzman c, Guy J. Levy c, Roberta Maffettone h, Sixto Malato m,
Célia M. Manaia n, Kyriakos Manoli o, Orah F. Moshe p, Andrew Rimelman q, Luigi Rizzo r,
David L. Sedlak s, Maya Shnit-Orland t, Eliav Shtull-Trauring c, Jorge Tarchitzky d,
Venus Welch-White f, †, Clinton Williams u, †, Jean McLain v, #, Eddie Cytryn c, #, *
a
A Department of Earth and Planetary Sciences, The Weizmann Institute of Science, Rehovot, Israel
b
Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
c
Institute of Soil, Water and Environmental Sciences, Agriculture Research Organization (ARO) – The Volcani Institute, Rishon LeZion, Israel
d
The Robert H Smith Faculty of Agriculture, Food and Environment, Hebrew University of Jerusalem, Rehovot, Israel
e
Institute of Soil, Water and Environmental Sciences, Agricultural Research Organization (ARO) – The Volcani Institute, Gilat Reseach Center, Israel
f
U.S. Environmental Protection Agency, District of Columbia, USA
g
Department of Civil and Environmental Engineering, NIREAS-International Water Research Center, University of Cyprus, Nicosia, Cyprus
h
Ocean and Water Unit, Joint Research Centre, European Commission, Ispra, Italy
i
The School of Sustainable Engineering and the Built Environment and The Biodesign Institute Center for Environmental Health Engineering, Arizona State University,
Tempe, AZ, USA
j
Department of Land Air and Water Resources, University of California, Davis, California, USA
k
Institute of Agricultural engineering, Agriculture Research Organization (ARO) – The Volcani Institute, Rishon LeZion, Israel
l
Kando Environmental services LTD., Tsur 8, Tsur Yigal 44862, Israel
m
CIEMAT-Plataforma Solar de Almería, Ctra. Sen´es km 4, 04200 Tabernas, Almería, Spain
n
Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
o
NIREAS-International Water Research Center, University of Cyprus, Nicosia, Cyprus
p
Department of Soil Conservation, Soil Erosion Research Center, Ministry of Agriculture, Rishon LeZion, Israel
q
PG Environmental. 1113 Washington Avenue, Suite 200. Golden, CO 80401, USA
r
Water Science and Technology (WaSTe) Group, Department of Civil Engineering, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, SA, Italy
s
Department of Civil & Environmental Engineering, University of California, Berkeley, Berkeley, CA 94720 USA
t
Extension Service, Ministry of Agriculture and Rural Development, Israel
u
US Arid-Land Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, Maricopa, AZ, USA
v
Department of Environmental Science, University of Arizona, Tucson, Arizona, USA
A R T I C L E I N F O A B S T R A C T
Scarcity of freshwater for agriculture has led to increased utilization of treated wastewater (TWW), establishing it
Keywords:
Treated wastewater irrigation
as a significant and reliable source of irrigation water. However, years of research indicate that if not managed
Agronomic and environmental risks adequately, TWW may deleteriously affect soil functioning and plant productivity, and pose a hazard to human
Abbreviations: TWW, treated wastewater; TDS, total dissolved solids; EC, electrical conductivity; SAR, sodium adsorption ratio; OM, organic matter; DOM, dis
solved organic matter; WWTP, wastewater treatment plant; CEC, contaminants of emerging concern; PPCP, pharmaceuticals and personal care products; PFAS, poly-
and perfluoroalkyl substances; MP, microplastics; AMR, antimicrobial resistance; ADI, acceptable daily intake; TTC, threshold of toxicological concern; ARB, anti
biotic resistant bacteria; ARG, antimicrobial resistant genes; QMRA, quantitative microbial risk assessment; DBP, disinfection by-products; NDMA, nitro
sodimethylamine; NF, Nano filtration; RO, Reverse Osmosis; GHG, Greenhouse gasses.
* Corresponding author.
E-mail address: eddie@volcani.agri.gov.il (E. Cytryn).
#
These authors contributed equally: David Yalin, Hillary A. Craddock, Jean McLain, and Eddie Cytryn.
†
Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views or policies of the U.S. Environmental Protection
Agency or the U.S. Department of Agriculture
https://doi.org/10.1016/j.wroa.2023.100203
Received 20 July 2023; Received in revised form 8 September 2023; Accepted 19 September 2023
Available online 22 September 2023
2589-9147/© 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
D. Yalin et al. Water Research X 21 (2023) 100203
Contaminants of emerging concern and environmental health. This review leverages the experience of researchers, stakeholders, and policymakers
Wastewater treatment processes from Israel, the United-States, and Europe to present a holistic, multidisciplinary perspective on maximizing the
Policy and outreach benefits from municipal TWW use for irrigation. We specifically draw on the extensive knowledge gained in
Israel, a world leader in agricultural TWW implementation. The first two sections of the work set the foundation
for understanding current challenges involved with the use of TWW, detailing known and emerging agronomic
and environmental issues (such as salinity and phytotoxicity) and public health risks (such as contaminants of
emerging concern and pathogens). The work then presents solutions to address these challenges, including
technological and agronomic management-based solutions as well as source control policies. The concluding
section presents suggestions for the path forward, emphasizing the importance of improving links between
research and policy, and better outreach to the public and agricultural practitioners. We use this platform as a
call for action, to form a global harmonized data system that will centralize scientific findings on agronomic,
environmental and public health effects of TWW irrigation. Insights from such global collaboration will help to
mitigate risks, and facilitate more sustainable use of TWW for food production in the future.
1. Introduction TWW quality is highly variable because of the different sources

contributing to the wastewater (e.g., industrial sources vs municipal)
Agriculture accounts for ~70 % of global freshwater consumption and the types of treatments employed. Here, we focus on municipal
annually, with irrigated crops composing ~40 % of the cultivated lands TWW, because urban areas are the largest potential source of waste
globally (Pastor et al., 2019). The climate crisis and growing demand for water for agricultural irrigation (Jones et al., 2021). The majority of
food due to population growth have impacted freshwater availability, studies covered in this work come from Israel, Europe and the US,
motivating the search for alternative water sources for agriculture, referring to irrigation with secondary and tertiary TWW. Throughout
especially in arid and semi-arid regions (Assouline et al., 2015; Euro the manuscript, the term freshwater refers to irrigation water sources
pean Commission 2020; Pastor et al., 2019). Reusing wastewater is that are not primarily composed of wastewater (i.e. groundwater or
emerging as a credible alternative to supply irrigation water, however surface water).
only ~50 % of current wastewater production goes through treatment
(Jones et al., 2021). In developing regions of the world, water stress 2. Agronomic and environmental challenges of TWW reuse
leads to use of crude wastewater (i.e. raw sewage or lightly treated
wastewater) for irrigation, resulting in detrimental public health and While the quality of TWW can vary significantly depending on the
environmental consequences (Contreras et al., 2017; Qadir et al., 2010). level of treatment, it is typically characterized by elevated levels of
Wastewater treatment circumvents many of these effects, and so irri inorganic and organic constituents as compared to freshwater (Table 1),
gation with treated wastewater (TWW) can provide agriculture with which if not managed adequately may lead to unintended environ
multiple economic, environmental, and social advantages (Mannina mental and agronomic outcomes, detailed below.
et al., 2022; Tal, 2006; Thebo et al., 2021).
Currently, only ~20 % of the global treated wastewater produced is 2.1. Salinization and phytotoxicity
reused (Jones et al., 2021), with the rest being discharged into the
environment. The long term experience of countries such as Israel, Total dissolved solids (TDS) in municipal sewage are typically
where ~85 % of the generated TWW is reused for agricultural irrigation 250–850 mg L− 1 (0.4–1.3 dS m − 1) higher than corresponding fresh
(Cohen et al., 2020), can promote widespread use of this untapped water supplies (Muttamara, 1996), and may be higher in areas with
resource. Despite its advantages, it bears noting that widespread TWW elevated domestic water use-efficiency (Schwabe et al., 2020). These
irrigation poses challenges to agricultural production, the environment, salts can pose a potential hazard to crops (Ayoub et al., 2016; Bernstein,
and public health that need to be addressed (Levy et al., 2011; Ofori 2013; Jahany and Rezapour, 2020; Lado et al., 2012) even when irri
et al., 2021; Tal, 2016). The primary objective of this manuscript is to gation water contains moderate salinity levels (Aragüés et al., 2015).
provide a roadmap for researchers, stakeholders, and policymakers to Furthermore, these salts can be transported to groundwater below irri
understand current and emerging challenges associated with agricul gation sites (Kurtzman et al., 2021; Mohanavelu et al., 2021). In
tural TWW use, drawing upon the vast experience gained in Israel, developing contexts, it should be noted that freshwater sources may
Europe and the US. By contextualizing present-day research, policy and already be saline (e.g., Da’as and Walraevens, 2010), therefore TWW
practical experience, this publication aims to inspire the expansion of reuse requires careful planning as it could either compound the problem
agricultural TWW reuse. This work was the product of a four day in or provide a less-saline irrigation water source.
ternational symposium (TreWAg 2022), supported by the United When exposed to saline conditions, crops may experience both rapid
States-Israel Binational Agricultural Research and Development Fund, (hours to days) osmotic stress, and slower (days to weeks) phytotoxic
the European Union’s Horizon 2020 PRIMA program, and the US EPA damage. Osmotic stress hinders plant water uptake, which harms seed
Water Reuse Action Plan (WRAP Action 1.6), which brought together a germination and plant development, potentially resulting in yield loss
multidisciplinary group of scientists, stakeholders and policymakers. and lower produce quality (Hopmans et al., 2021). The osmotic sensi
The first two sections of this work highlight the potential detrimental tivity of plants significantly differs between species (Hanin et al., 2016;
agronomic and environmental impacts of TWW irrigation (Section 2), as Zörb et al., 2019), with sensitive crops (such as beans, turnips, carrots,
well as potential public health risks arising from the transfer of chemical and strawberries) exhibiting yield losses at EC values of irrigation water
and microbial contaminants from TWW to irrigated produce (Section 3). exceeding 1.0 dS m − 1 (Maas, 1987).
Section 4 provides well established technological and management so Particular TWW-derived elements, can accumulate in soils and
lutions that can help circumvent these hazards. Section 5 discusses plants, eventually leading to phytotoxic damage (Ayoub et al., 2016;
policy, outreach, education, and regulatory actions that can promote Bedbabis et al., 2015; Bernstein, 2019; Kalavrouziotis et al., 2008;
beneficial reuse of TWW as well as recommendations for future research. Pedrero and Alarcón, 2009; Raveh and Ben-Gal, 2016; Ravindran et al.,
By integrating these topics, this paper provides a holistic perspective, 2016). The primary elements of concern are Na and Cl, whose concen
which is essential for the sustainable use of TWW, especially in view of trations in treated effluents are typically 40 - 70 mg L− 1, and 20 - 50 mg
the complex interactions among the multiple stakeholders along the L‑1, respectively higher in TWW than in local freshwater supplies (Fei
TWW use and supply chain. gin et al., 1991), but can be almost twice as high (Muttamara, 1996).
2
Other elements of concern include B, Cu, Zn, Cd, Pb, Ni, and Co. et al., 2019).
Phytotoxic damage occurs primarily in woody perennials, such as trees Despite decades of widespread TWW use in agriculture, only a few
and vines (Maas et al., 1982). Typical symptoms include growth inhi field studies have examined the long-term effects of irrigation with
bition and necrosis, with frequent reduction in yield and produce quality TWW on soil physical properties. These have revealed reduced soil
(Grattan et al., 2015; Kisekka et al., 2023; Maas, 1987; Poustie et al., infiltrability and aeration (Assouline and Narkis, 2013; Erel et al., 2019;
2020; Xu et al., 1999). Mechanistically, phytotoxic elements either Yalin et al., 2021), and non-uniform wetting of the soil at the field scale
directly interfere with essential physiological processes or indirectly (Rahav et al., 2017). The capacity to remediate hydraulic properties of
affect plant-nutrient homeostasis through mechanisms such as compe damaged soil at the field scale has only begun to be investigated
tition between Na and K uptake (Arif et al., 2020; Kronzucker et al., (Assouline et al., 2020; Kramer et al., 2022; Ogunmokun and Wallach,
2013). Although most phytotoxic damage is observed in plant leaves, 2021).
there is evidence that accumulation of Na in trunk and root tissues can
also have detrimental effects (Netzer et al., 2014; Yalin et al., 2017).
2.3. Nutrient availability
Soil conditions, including oxygen availability, pH, redox potential,
and organic matter (OM) content can drastically affect the potential for
Municipal effluents typically contain significant concentrations of
phytotoxicity (Barbieri, 2016; Barrett-Lennard and Shabala, 2013; Rai
essential inorganic plant nutrients (Elgallal et al., 2016; Shtull-Trauring
et al., 2019). For instance, Yermiyahu et al. (2001) reported that
et al., 2020). Treatment regulations in many countries require removal
compost amendments reduced availability and uptake of B in bell pep
of a large portion of N (nitrogen) and P (phosphorus) from the effluents
per, due to adsorption to soil OM. Another study reported that enhanced
(e.g., Inbar, 2007), to prevent these elements from reaching ground and
soil aeration decreased citrus root Na concentrations, presumably due to
surface waters, where they can have detrimental environmental and
improved root resistance to Na induced by elevated oxygen availability
public health ramifications (Shoushtarian and Negahban-Azar, 2020).
(Paudel et al., 2019).
Conversely, if considered and managed according to crop requirements,
the presence of these elements in TWW can reduce fertilizer application
rates, reducing the costs and environmental impacts of fertilizer pro
2.2. Deterioration of soil physical and hydraulic properties
duction. Recent research in Israel has shown that in most of the exam
ined cases, TWW could provide at least 50 % of the required N, and all of
The presence of typically elevated sodium adsorption ratio (SAR)
the required P and K for low-demand crops such as citrus and avocado
coupled with distinct forms of dissolved organic matter (DOM) in TWW,
(Shtull-Trauring et al., 2022). The authors proposed that in watersheds
can deteriorate soil structure. Clay swelling and dispersion are the main
with low eco-hydrological sensitivity, less stringent wastewater treat
cause of damage (Levy and Nachshon, 2022), but pore clogging (Vinten
ment processes can be promoted to supply more of the crop N
et al., 1983) and water repellency (Leuther et al., 2018) have also been
requirements.
reported following irrigation with TWW. These effects lead to unfavor
The phyto-availability of nutrients from TWW is generally equivalent
able soil physical and hydraulic properties (Assouline and Narkis, 2011),
to common mineral and organic fertilizers (Bar-Tal et al., 2010). How
reducing water and oxygen availability to plants, and ultimately
ever, supplying nutrients with TWW is challenging because TWW irri
harming crop performance.
gation loads and scheduling regimes are principally dictated by crop
Degradation of soil structure is mainly driven by elevated SAR.
water requirements rather than nutrient requirements. This may result
However, the SAR threshold, above which degradation occurs, is also
in temporal imbalances between nutrient supply and plant requirements
dictated by the soil ionic strength, texture, mineralogy, and DOM con
(Fig. 1), which can fluctuate between excess nutrient supply and defi
tent (Assouline and Narkis, 2013; Lado and Ben-Hur, 2009). The effect of
ciency (necessitating fertilizer supplementation).
TWW-borne DOM on subsurface water flow has been estimated to be
equivalent to an increase in SAR of two to three units (Assouline et al.,
2016; Suarez and Gonzalez-Rubio, 2017). Pore clogging can result from 2.4. Impact on soil microbial community structure and activity
suspended solids in TWW (Vinten et al., 1983), increased microbial
growth due to the presence of labile organic carbon (Vandevivere et al., The physiochemical changes in the soil environment (i.e., soil pH,
1995), and accumulation of dispersed clay material (Shainberg and salinity, humidity, and carbon- and nutrient- availability) and intro
Letey, 1984). Alteration of the soil wetting properties and subsequent duction of exogenous microbiota, may alter the soil microbiome
development of hydrophobicity has been associated with the coating of (Becerra-Castro et al., 2015; Dang et al., 2019; Zolti et al., 2019). This
soil particles with TWW-derived DOM, which impedes hydraulic con facilitates complex interactions that affect soil microbial activity, di
ductivity and can lead to preferential flow (Adabembe et al., 2022; Liu versity, and biomass, which can be crudely divided into positive
Table 1
Characteristics of treated municipal wastewater (TWW) used for irrigation in Israel. Range and median values of TWW quality includes reported data from 56
wastewater treatment plants (WWTP), and the Dan region, “Shafdan” WWTP. Data is for the years 2017–2018 and includes only WWTP producing more than 106 m3
effluent yr− 1 (overall with the Shafdan covering 97 % of the TWW produced in those years in Israel). “Range” describes the 2.5 - 97.5 percentiles. Data retrieved from
Cohen et al. (2020).
Parameter Supply BOD5* pH N** P K Na Ca Mg Cl SAR*** EC****
volume
Units 106 x m3 mg L− 1
mg L − 1
meq L −
dS m − 1
yr− 1 0.5
WWTP excluding Range 1.2 – 31.4 1 – 78 6.1 – 2 - 79 1 - 17 10 - 70 - 37 - 5 - 58 111 - 1.9 - 5.4 0.6 - 1.6
Shafdan 8.0 83 200 103 364
Median 3.1 (56) 8 (56) 7.5 19 4 32 112 62 (56) 16 168 3.5 (55) 0.9 (56)
(n) (30) (45) (52) (41) (55) (56) (55)
Shafdan WWTP – 145 5 7.4 6 1 22 146 58 20 205 4.2 1.1
*
- Biological oxygen demand after 5 days incubation at 20 C. ◦
**
- Kjeldahl total nitrogen.
***
- Sodium adsorption ratio.
**** 1
- Calculated from the sum of major cations according to: EC [dS m − ] x 10 = sum of cations [meq L− 1].
3
Fig. 1. Cumulative amount of nutrients and water in a TWW-irrigated orchard, showing irrigation water volume (grey bars). Actual nutrients supplied with TWW
(solid line), as compared to the agronomic recommended nutrient requirements (broken lines). Study site: Avocado orchard in Acre, Israel. Data from the 2013
irrigation season (courtesy of Anat Lowengart-Aycicegi).
(Bastida et al., 2017; Garcia and Hernandez, 1996); neutral (Frenk et al., concentrations, plant uptake, and viability (microbes) in both the soil
2014; Ibekwe et al., 2018; Li et al., 2019), and mixed (Cui et al., 2018; and crops irrigated with TWW, which is essential for risk assessment and
García-Orenes et al., 2015; Guo et al., 2017) effects. Unraveling these recommended mitigation measures. Research is ongoing to assess risks
complex interactions has begun recently through studies examining of these contaminants.
changes in specific microbial groups.
Collectively, research has indicated that irrigating with TWW: (a)
increases bacterial diversity and reduces fungal diversity in soil (Dang 3.1. Contaminants of emerging concern
et al., 2019); (b) lowers the relative abundance of Actinomycetota
(formerly Actinobacteria) and increases the relative abundance of Gam Contaminants of emerging concern (CECs) are a constantly evolving
maproteobacteria and Bacteroidota (formerly Bacteroidetes) in root bac category of anthropogenically derived constituents that includes
terial communities (Frenk et al., 2014; Wafula et al., 2015; Zolti et al., amongst others, a diverse range of pharmaceutical compounds, personal
2019); (c) increases relative abundance of Gemmatimonadota (formely care products, flame-retardants, microplastics (MP), and disinfectants
Gemmatimonadetes), Bacteroidota (formerly Bacteroidetes), and Pseudo (Sauvé and Desrosiers, 2014).
monadota (formerly Proteobacteria) (Guo et al., 2018; Obayomi et al., Many studies have evaluated pharmaceuticals in TWW (Alygizakis
2020); (d) facilitates shifts in the composition of ammonia-oxidizing et al., 2020; Beretsou et al., 2022; Moslah et al., 2018; Panthi et al.,
bacteria, with Nitrosomonas detected in TWW-irrigated soils, but not in 2019; Rapp-Wright et al., 2023; Rordriguez-Mozaz et al., 2020;);
freshwater-irrigated soils (Frenk et al., 2014; Oved et al., 2001); and (e) including those noting that TWW has higher prevalence and concen
increases Cyanobacteriota (formerly Cyanobacteria) abundance (Liu tration of antimicrobials than other irrigation water sources (Panthi
et al., 2018). These changes potentially have weighty implications on et al., 2019). The uptake of pharmaceuticals and other CECs by plants
the ecology of microbial communities, for example, due to cyanobac results from passive diffusion through the cell membrane. The magni
teria’s ability to fix atmospheric nitrogen (Martins et al., 2011). Notably, tude of this process, and the distribution of accumulated pharmaceuti
some studies suggest that observed shifts in TWW-irrigated microbial cals within the plant depends on the soil properties and root lipid
communities are transient, with soil bacterial populations of content (Ben Mordechay et al., 2022a; Filipović et al., 2020), the lip
TWW-irrigated soils indistinguishable from those under freshwater ophilicity and charge of the molecule (Briggs et al., 1982; Trapp, 2000),
irrigation within one growing season following the rainy season when the transpiration rate and in-plant metabolism (Malchi et al., 2022;
irrigation is not applied (Frenk et al., 2014). The revelation that TWW Miller et al., 2015). When considering irrigation with TWW, it is vital to
irrigation significantly stimulated root-associated bacterial genes asso identify and target the most recalcitrant CECs that can potentially persist
ciated with salinity, pH, and oxygen stress, suggests that the in soil and accumulate in crops. Frequently, accumulation occurs in
root-associated microbiome can serve as a “barometer” for plant stress roots and leaves, which are the edible portion of many crops (Ben
(Zolti et al., 2019). If further developed, the microbiome analysis could Mordechay et. al. 2022b; Garcia et. al. 2018).
be utilized as a proxy in future research on TWW. Highly recalcitrant CECs of interest in TWW include carbamazepine
(anticonvulsant), diclofenac (non-steroidal anti-inflammatory drug)
3. Chemical and microbial hazards (Fatta-Kassinos et al., 2011b; Zhang et al., 2008), poly-and per
fluoroalkyl substances (PFAS; Lenka et al., 2021), and microplastics
TWW may contain potentially harmful pathogens, chemical con (MPs) (Hu et al., 2022). In Israel, carbamazepine has been found more
taminants, and related issues of concern (e.g., antimicrobial resistance frequently and in higher concentrations in the urine of consumers of
genes), with concentrations dependent on numerous factors, including produce irrigated with secondary TWW, relative to consumers of
upstream industrial waste discharges and treatment types employed by freshwater-irrigated produce (Paltiel et al., 2016; Schapira et al., 2020).
individual wastewater treatment plants. These contaminants can accu Ben Mordechay et al. (2022b) estimated that in extreme cases, human
mulate in soils and edible crops, and be transferred to groundwater and exposure to carbamazepine and epoxide-carbamazepine via consump
surface water following irrigation (Christou et al., 2017; Fatta-Kassinos tion of TWW irrigated produce in Israel may exceed the acceptable daily
et al., 2011a). However, there is limited data regarding their presence, intake (ADI) for adults. MPs have been shown to accumulate in some
edible plants, such as lettuce, wheat, rice, and carrots (Jiang et al., 2019;
4
Naziri et al., 2023). However, the effects of consuming MP-containing thermotolerant coliforms, or Escherichia coli (Blumenthal et al., 2000).
produce on human health are currently unknown and require further However, numerous studies have established that E. coli levels are not
research (De-la-Torre, 2020; Smith et al., 2018) utilizing standardized consistently associated with the presence of other pathogen groups
methods to comprehensively understand the effect of plastic waste (Weller et al., 2020), particularly enteric parasites and viruses.
(Campanale et al., 2020). PFAS includes thousands of highly persistent, Furthermore, pathogen levels are highly dependent on the level of
bio-accumulative, and potentially toxic substances (Cousins et al., wastewater treatment and the pathogen concentrations in the influent
2020). PFAS concentrations in TWW vary by location, and data on their (Table 2). Thus, additional surveillance targets are required to establish
levels in irrigated soils and crops are limited and conflicting (Mroczko health risks (Ofori et al., 2021).
et al., 2022; Shigei et al., 2020; Table 2), highlighting the need for
further research and comprehensive evaluation on local scales. 3.3. Antimicrobial resistance
Antimicrobial resistance (AMR) poses a specific challenge when

3.2. Pathogens in TWW relating to microbial contamination. For routine monitoring of effluents
and receiving environments, it is crucial to select antibiotic resistant
Contamination of produce by pathogens in the TWW is a public gene (ARG) markers that are clinically relevant, common in TWW, occur
health concern (Gurtler and Gibson, 2022); however, data are incon in association with mobile genetic elements, are persistent in receiving
sistent. Predominantly, public health regulations rely on the enumera environments, and for which testing equipment is market available
tion of standardized indicator microbes such as fecal coliforms, (Manaia, 2023). Recent reviews have proposed ARG and antibiotic
resistant bacterial (ARB) indicators that can be targeted for monitoring
Table 2 and regulation (Liguori et al., 2022; Manaia, 2023); however, bench
A selection of literature regarding the presence, concentration, and/or persis mark levels for these indicators have not yet been established. The
tence of chemical contaminants of emerging concern (CECs) and pathogenic recent proposal for a directive of the European Union (EU) Parliament
contaminants in treated municipal wastewater (TWW) intended for irrigation. and Council concerning urban wastewater treatment (COM/2022/541
Contaminant Country Did the contaminant Reference final) dictates that by 2025 large WWTPs need to periodically monitor
persist in soil/crops AMR indicators. It is therefore conceivable that future criteria for irri
after irrigation OR
were levels higher in
gation with TWW could require monitoring for target levels of specific
TWW than other AMR indicators in the EU and beyond. However, there are currently no
sources? standardized methods or regulatory guidelines for AMR in TWW or
Chemical contaminants irrigated produce.
PFAS * USA Yes - Persistence after Mroczko et al., 2022
irrigation 3.4. Risk assessment
PFAS Jordan No - No persistence Shigei et al., 2020
Carbamazepine, Israel Yes - Persistence after Ben Mordechay
other epilepsy irrigation et al., 2022a; Paltiel
Risk assessment is applied to quantify human health risks for both
drugs et al., 2016; hazardous chemicals and pathogens in situations where effect sizes are
Schapira et al., 2020 small and logistically challenging to measure using epidemiological
Antimicrobials USA Yes - TWW higher Panthi et al., 2019 studies (Ofori et al., 2021). It utilizes a range of assessments, modeling,
than other irrigation
and statistical analyses to make inferences regarding risk (Haas et al.,
sources, with
exception of 2014; WHO, 2016; National Research Council (US) Committee on the
ciprofloxacin Institutional Means for Assessment of Risks to Public Health, 1983).
Antimicrobials Germany Yes - Persistence after Kampouris et al., Chemical risk assessment can potentially rely on sentinel chemicals
irrigation 2022 (Revitt et al., 2021). However, CEC persistence, as well as accumulation
Bacterial and viral contaminants
Enteric viruses Spain Yes - TWW higher López-Gálvez et al.,
in edible portions, is highly variable, requiring routine monitoring (Ben
than other irrigation 2016 Mordechay et al., 2022B; Delli Compagni et al., 2020; Shi et al., 2022).
sources Some notable challenges in chemical risk assessments are the breadth of
E. coli Palestine TWW not consistently Craddock et al., 2020 chemicals (studies often range from dozens to hundreds of chemical
different than other
targets), plant-specific risks, the occurrence of metabolites (which can
irrigation water
sources potentially be more hazardous than parent materials), the impact of
Vibrio spp. USA TWW not consistently Malayil et al., 2021 mixtures, and the impact of long-term sub-clinical exposure (Egli et al.,
higher than other 2021; Goldstein et al., 2018; Malchi et al., 2014; Paz et al., 2016).
irrigation water Quantitative microbial risk assessment (QMRA) of TWW has typi
sources
Salmonella enterica USA No - Surface water had Acheamfour et al.,
cally focused on risk-based monitoring targets, specific risk benchmarks
and Listeria higher levels than 2021 that have been defined through multiple research studies (e.g., 36
monocytogenes TWW gastrointestinal illnesses per 1000 recreators for swimming), and
ARGs ** USA Yes - TWW higher Malayil et al., 2022 ranking risks and associated tradeoffs (Foster et al., 2021; Hamilton
than other irrigation
et al., 2019; Hultquist, 2016; NRMMC et al., 2006; Petterson et al., 2021;
sources
Resistant USA No - TWW had no McLain and SWRCB, 2016; USEPA, 2012; WHO, 2013; Zhang et al., 2019).
Enterococcus impact on ARB in Williams, 2014 Numerous QMRA models have focused on TWW for irrigation, often
sludge using lettuce as an index crop due to its uptake and raw consumption
ARGs Israel No - TWW had no Seyoum et al., 2022 practices (Beaudequin et al., 2016; Amha et al., 2015; Kouamé et al.,
impact on food surface
ARBs *** /ARGs Israel Mixed effects, Marano et al., 2021,
2017; Silverman et al., 2013; Hamadieh et al., 2021; Mara et al., 2007).
dependent on soil 2019 While historically QMRA has focused on fecal-associated pathogens,
factors, enrichment monitoring approaches are expanding to incorporate opportunistic res
capability piratory pathogens (i.e., Legionella pneumophila), ARBs, and ARGs
*
- poly-and perfluoroalkyl substances. (Schoen et al., 2021; Hamilton et al., 2018). However, this expansion is
**
- Antimicrobial Resistance Genes. limited by a relative lack of research providing direct comparisons of
***
- Antibiotic Resistant Bacteria. TWW with freshwater and other irrigation water sources. Holistic QMRA
5
that includes CECs is critical for decision-making for TWW reuse, as it used to detect OM in different water sources (Yu et al., al.,2015; Carstea
can inform regulations and guidance (Rock et al., 2019), the utility of et al., 2019), or organic contaminants in irrigation water (Sinitsa et al.,
"barrier criteria" interventions (Ofori et al., 2021), or inform which crops al.,2022). Such spectroscopic methods are increasingly supported by
are irrigated with TWW. Looking forward, expansion of the QMRA machine learning tools to enhance on-line monitoring platforms for
paradigm to integrate findings more holistically with chemical risk as detection of various organic contaminants (Khamis et al., 2015, Hansen
sessments and to expand pathogens of focus will be beneficial for et al., 2020, Sinitsa et al., at.,2023).
informing decision-making around TWW use for irrigation purposes.
4. Technological and management solutions for safe and 4.2. Engineered treatment processes
sustainable irrigation with treated wastewater
Two primary non-potable wastewater reuse models exist: centralized
Sections 2 and 3 underline the need to eliminate organic and inor systems that transport treated effluents from municipal wastewater
ganic constituents, and specifically recalcitrant chemical and microbial treatment plants to agricultural hubs for irrigation, and decentralized
pollutants when considering the reuse of municipal wastewater for systems, where effluents are treated and applied locally for irrigation
irrigation. Designing processes and policies to improve water quality for (Angelakis and Snyder, 2015). Decentralized systems substantially
irrigation can be complicated by local regulatory disparities, differences reduce storage and transport infrastructure costs and are considered
in exposure pathways between crops (e.g., use as animal feed, peeling or more environmentally sustainable, but operating and monitoring these
cooking before eating), and public acceptance. Furthermore, concerns systems to meet regulatory criteria can be logistically challenging.
about emerging (i.e., CECs and ARGs) and yet-to-be-discovered con Implementation of advanced treatment and specific technologies,
taminants of health concern necessitate flexible technological and reg beyond traditional secondary treatment, strongly depends on the local
ulatory solutions. infrastructure, regulatory requirements, irrigation method, available
resources, the TWW quality and the type of crops (i.e.,
4.1. Source control edible/non-edible). We summarize the capabilities and limitations of
such technologies in Table 3.
Two strategies can be employed by stakeholders and policymakers to Disinfection processes are frequently applied following secondary
reduce the transfer of undesired constituents from TWW to soil and wastewater treatment to remove microbial pathogens (viruses, bacteria,
crops: (1) regulatory policies that restrict the use of specific materials, or and protozoa). Chlorination, the most prevalent disinfection process,
(2) implementation of more stringent treatment processes when indus involves adding chlorine gas or hypochlorite to TWW, and normally
trial or high-risk (e.g., hospital) effluents are released to the sewer shed results in the formation of combined chlorine in the water. However,
(Harris-Lovett and Sedlak, 2020). chlorination can produce disinfection by-products (DBPs) such as tri
halomethanes that are potentially carcinogenic (Mezzanotte et al.,
4.1.1. Policy-based source control
Most, but not all, CECs enter municipal wastewater facilities through Table 3
consumer use. The majority of these compounds degrade during sec Capacity of technologies for removing salts, pathogens and contaminants of
ondary and advanced wastewater treatment, but as described in Section emerging concern (CECs) from secondary wastewater effluents intended for
irrigation.
3, certain CECs are highly recalcitrant and can potentially accumulate in
TWW-irrigated produce. Stewardship programs aimed at reducing the Treatment type Removal capacity Comments
use and disposal of these CECs are impetrative (Daughton, 2003), Salinity Pathogens CECs
especially in cases where alternatives that do not pose risks to the food Nanofiltration 1 + +++++ +++ 1
Requires solutions for
supply are available. Additionally, biodegradability and cytotoxicity Reverse osmosis +++++ +++++ +++++ treating brine; 2
should be considered during the registration and introduction of new 1, 2
Energetically expensive;
3
products (Kümmerer et al., 2018). For example, the risk of boron Forward osmosis +++++ +++++ +++++ Needs draw solution &
1, 3
correlation between
phytotoxicity (see Section 2.1) can be evaded by replacing boron based
irrigation volume and
detergents with appropriate substitutes (Tal, 2006). Likewise, policies fertilization quantity
that discourage the use of Na-based ion exchange water softening de Chlorination No ++++ No Relatively cheap;
vices can lower salinity in TWW. potentially creates toxic
byproducts
Peracetic Acid No No No disinfection
4.1.2. Industrial/commercial source control
+++
products; more
Water reuse schemes that implement risk-averse strategies to expensive/less available
monitor contaminants may target specific compounds relevant to agri than chlorine
cultural wastewater reuse. Because the illegal discharge of pollutants is UV-C radiation No ++++ No No byproducts;
relatively easily
unpredictable, "real-time" monitoring approaches that apply remote
implemented; requires
sensing or on-line monitoring of indicator parameters such as electrical pre-treatment
conductivity (EC), pH, redox potential, organic matter (OM), tempera Ozonation No +++++ +++++ Can be expensive to
ture, and turbidity, enable the detection of anomalies caused by key implement and operate;
pollutants such as salts, acids, and selected nutrients. In contrast, anal potentially forms toxic
byproducts and
ysis for hazardous pollutants such as heavy metals, persistent organic therefore requires post-
compounds, and pharmaceutical contaminants currently require treatment
analytical laboratories (Bertanza et al., 2022). Integrating continuous Homogeneous No ++++ ++++ Technology not fully
data acquisition platforms from sewage collection systems with accurate solar-based mature; more suitable
for small-scale systems
and reliable data management and predictive analytics can ensure
UV-C/H2O2 No +++++ +++ Energetically expensive
high-quality TWW for irrigation, significantly reducing post-treatment Activated carbon No No +++
costs. These networks can be enhanced with application of novel (AC)
online-monitoring technologies, including sensors that detect and Effluent No +++ No Very low operational
quantify hazardous metals, CECs, bacterial pathogens, and ARGs stabilization costs; enables better
reservoirs effluent management
(Manny, 2023). Fluorescence spectroscopy is one technology currently
6
2007). If supported by risk assessment outcomes, DBPs might be water. An obstacle for the use of membrane technologies is the need to
restricted according to the EU regulation (EU, 2020), and therefore find a solution for the concentrate or brine produced (Capocelli et al.,
chlorination is increasingly replaced by alternative disinfection pro 2019), which can be a significant issue in inland systems. Additionally,
cesses such as UV-C radiation and Peracetic Acid (PAA, Rizzo, 2022). membrane processes are more energy intensive than conventional
While slightly less effective than chlorination, PAA does not generate wastewater treatment (Bailey et al., 2020).
DBPs when low doses are used (<5–10 mg L − 1). It therefore may be Effluent storage reservoirs (alternatively known as stabilization
advantageous in decentralized systems (Freitas et al., 2021; Mezzanotte reservoirs) modulate between relatively constant sewage production
et al., 2007), as previously shown (Bell and Wylie, 2016; Di Cesare et al., and generally irregular (seasonal) irrigation water demand. They are
2016; Formisano et al., 2016; Manoli et al., 2019; Santoro et al., 2007; unique relative to sewage stabilization ponds in their non-steady-state
Stewart et al., 2018). UV-C radiation has been shown to be more efficient hydraulic regimes, and higher depth (up to 20 m) and volume
in removal of viruses, protozoa, and bacterial pathogens than chlori (Juanicó and Dor, 2011). Retention times of at least three months,
nation, ozonation and PAA treatment (Mezzanotte et al., 2007), pro coupled with disinfection, ensures water quality that meets Israeli mi
ducing effluents suitable for unrestricted irrigation of food crops (Nasser crobial standards for unlimited TWW reuse (Inbar, 2007) and decreases
et al., 2006). Since turbidity and suspended solids drastically reduce certain metals and recalcitrant organic compounds (Juanicó and Dor,
inactivation efficiency, conventional activated sludge effluents used for 2011; Marano et al., 2019; Friedler et al., 2003; Kfir et al., 2012). Dual
irrigation typically require pre-treatment using sand filtration to enable reservoir configurations (where one basin is constantly being filled and
effective UV disinfection (Ghernaout and Elboughdiri, 2020). Addi the other emptied) enable balancing between influent and effluent flows
tionally, UV disinfection can be energy intensive (Bailey et al., 2020). while maintaining the required retention times. The capacity of stabi
Ozonation has been widely applied for TWW disinfection and, more lization reservoirs is attributed to their robust biota, which along with
recently, for quaternary treatment because unlike other disinfection abiotic processes facilitates "ecosystem functioning" (Shuval and Fattal,
processes (e.g., chlorination) it also effectively degrades CECs (von 1999). However, these microorganisms (especially photosynthetic mi
Gunten, 2018; Rizzo et al., 2020). Moreover, ozonation is efficient croorganisms) produce extra-polymeric substances that can clog distri
against a broad array of pathogens including chlorine-resistant Crypto bution and irrigation pipes (Katz et al., 2014).
sporidium parvum oocysts and Giardia cysts (Morrison et al., 2022; Rizzo
et al., 2020). A pitfall of ozonation is the potential formation of toxic 4.3. Agronomic management mitigation and remediation strategies
DBPs such as bromate and NDMA (Lim et al., 2016), which can accu
mulate in irrigated crops (Calderón-Preciado et al., 2011). These can be Preventing the buildup of salinity in the root-zone soil can be ach
removed by post-treatments such as biofiltration and activated carbon ieved by leaching practices (Ben-Gal et al., 2008; Minhas et al., 2020),
(Rizzo et al., 2020). Specific ozone doses in the range of 0.4–0.6 g O3 which need to consider crop sensitivity to salt, soil properties, chemical
1
g−DOC (DOC, dissolved organic carbon) can ensure high-quality TWW for composition and salinity of irrigation water, climate, and evapotrans
irrigation (Rizzo et al., 2020). piration (Dudley et al., 2008; Letey et al., 2011; Shani et al., 2007).
Activated carbon (AC) adsorbs a broad spectrum of organics due to Decision support systems (e.g., https://app.agri.gov.il/AnswerApp/)
its large surface area and high degree of surface interactions. Conse can aid in developing irrigation-leaching strategies, crop selection, and
quently, powdered and granular activated carbon (PAC and GAC, evaluating the sensitivity of various parameters that affect the
respectively) are applied to remove recalcitrant CECs in WWTP effluents water-soil-crop system (Kaner et al., 2019). To divert salts and nitrates
(Mestre et al., 2022). PAC is generally more efficient than GAC, because leached from the root-zone from reaching groundwater, drainage solu
its smaller size enables dosing it (10–20 mg L − 1) into biological tions such as tile drains and capillary barriers may be employed (Russo,
treatment processes (Gutiérrez et al., 2021). However, post-treatment is 2017; Singh, 2019).
required for separation of residual PAC (Kosek et al., 2020). The low cost Various agro-technical measures have been suggested to mitigate
and wide availability of materials required for AC treatment (e.g., and remediate TWW-induced damage to soil hydraulic properties,
Steigerwald and Ray, 2021) mark it as a possible solution for including: alternating between TWW and fresh-water, diluting TWW
low-resource environments. with freshwater (Assouline et al., 2020; Nemera et al., 2020), applying
Photo Homogeneous Advanced Oxidation Processes (AOPs, e.g., gypsum (Ghafoor et al., 2012; Mamedov et al., 2009), and using sur
UVC/H2O2, photo-Fenton) are increasingly investigated for the simul factants (Ogunmokun and Wallach, 2021). However, these treatments
taneous removal of CECs and microbial contaminants in TWW (Rizzo, have not yet been tested on a commercial scale and there is uncertainty
2022). UVC/H2O2 is a consolidated technology with a cost dependent on as to whether full remediation is possible (Kramer et al., 2022).
the UV lamp intensity and replacement frequency, but the recent Optimizing plant nutrient utilization, while reducing the risk of
development of UV-LED lamps shows promise (Soro et al., 2023). The groundwater contamination from TWW-borne nitrogen and phosphorus,
application of this technology is especially of interest as a tail-end can be achieved by defining site-specific treatment regulations
technology for TWW (applying 5–10 mg H2O2 L − 1). Photo-Fenton is (Shtull-Trauring et al., 2022) that allow for more lenient removal levels
a promising process in view of its technological readiness (Rodri in basins with low eco-hydrological risk. As a result, TWW nutrient use
guez-Mozaz et al., 2020), especially when applied at neutral pH thanks efficiency can be optimized through continuous monitoring systems that
to the use of iron complexing agents for maintaining iron in solution, as inform farmers of real-time nutrient conditions, allowing them to sup
well as the possibility of being powered by solar irradiation (Zhan and plement TWW with fertilizers only when needed (Erel et al., 2019;
Zhou, 2019). Amortization costs of photoreactors can be high, but these Vazquez-Montiel et al., 1996; Vivaldi et al., 2022).
can be significantly reduced when using raceway pond open solar
photoreactors that are simple to manufacture (Malato et al., 2020). 5. Looking to the future
Membrane processes that remove organic contaminants, pathogens
and salts are increasingly applied in different wastewater treatment 5.1. From policy to practice
scenarios (Ezugbe and Rathilal, 2020). Nanofiltration (NF; membrane
pore size of 0.01–0.001 µm) removes organics, a selection of inorganic Recurring drought in Israel during the 1980s facilitated adminis
ions, and most pathogens. In contrast, under optimal transmembrane tration of major freshwater restrictions for agriculture. This was a major
pressure, reverse osmosis (RO, pore size of 0.001–0.0001 µm) removes driver for farmers to transition to TWW, which was unrestricted and
almost all constituents except water molecules (Naimah et al., 2021). relatively cheap (Marin et al., 2017). The wide adoption of TWW irri
Currently, the high-energy consumption and the susceptibility of gation in Israel is further attributed to comprehensive research, coupled
membranes to fouling make RO unsuitable for treatment of irrigation to feedback networks between farmers, scientists, regulators, and
7
centralized water suppliers that translate insights into practice and frameworks involving extensive bi-directional communication between
policy. These feedback networks need to be dynamic to adapt to researchers and farmers are another important tool, which can uncover
emerging challenges and changing conditions. For example, Israeli re regionally-specific quality issues, challenges with TWW use, and farmer
gions supplied with relatively saline TWW generally refrain from concerns and knowledge gaps (Konradsen et al., 2009). Establishing and
growing crops sensitive to salinity stress, especially in clay soils where developing trust from the source of information as well as the data is
oxygen limitation makes plants more prone to salt damage. critical to adoption. Recent studies have reflected the importance of
Expanding agricultural water shortages in the US, especially in re presenting the consumers of recycled water with more information
gions supplied by the Colorado River, present the need for wider inte rather than less, stating that detailed and credible information is capable
gration of TWW in agriculture. U.S. farmers have expressed interest in of changing perceptions (Tennyson et al., 2015) and informed, accepting
supplementing traditional irrigation water (typically freshwater) sour consumers allay the fears and concerns of many farmers globally (Dare
ces with TWW for on-farm water applications (Dery et al., 2019). and Mohtar, 2018; Gerdes et al., 2020). In the EU, Member States are
However, only two percent of farms report using TWW, representing an required to develop information and awareness-raising campaigns (EU,
opportunity to expand TWW for agricultural purposes (USDA NASS, 2020), to encourage TWW reuse and ensure that stakeholders and the
2019; Sheikh, B. 2019). The twenty-eight U.S. states that have regula public are aware of the benefits of such practices. Surprisingly, studies in
tions for the reuse of TWW in agriculture (food crops) generally have Israel have found low levels of support and awareness regarding
stricter treatment requirements than those required by Israel (US EPA TWW-irrigated agriculture, despite this practice being in regular use for
REUSExplorer, 2023; US Food and Drug Administration, 2023), how decades (Craddock et al., 2021; Friedler et al., 2006). Overall, when
ever these regulations generally do not address agronomic, environ designing consumer and farmer outreach, an understanding of what a
mental and emerging public health parameters discussed in this review. community knows and thinks about TWW and which factors are influ
Within the EU, about one billion cubic meters of TWW are reused encing acceptance is critical for its success and utilization (Hartley,
annually for irrigation and there is an estimated potential to expand 2006; Miller and Buys, 2008; Morgan and Grant-Smith, 2015; Rozin
reuse by six times (European Comission, 2023). In 2020, the EU adopted et al., 2015).
Regulation (EU) 2020/741 on minimum requirements for water reuse,
implemented in June 2023, which harmonized minimum water quality, 5.3. Knowledge gaps
monitoring, and permitting requirements for the reuse of TWW in
agricultural irrigation within all EU Member States (EU, 2020). Prior to Approximately 50 % of globally produced wastewater is untreated
this, TWW was reused for agricultural irrigation in several EU Member (Jones et al., 2021), and there is an urgent need for development and
States (e.g., Cyprus, Italy and Spain), following different water quality implementation of cheap, simple, and attainable collection and treat
criteria set in national legislations that complied with Regulation (EC) ment solutions (e.g., Brix et al., 2007) to increase safe water availability
852/2004 on hygiene of foodstuffs (EU, 2004). The new regulation for irrigation in diverse circumstance (i.e., decentralized agriculture,
stipulates a water reuse risk management plan to ensure protection of low capacity regions). In developed regions, despite cumulative scien
human and animal health and the environment (EU, 2020). In the tific understanding there are still several knowledge gaps that need to be
future, minimum water quality and monitoring requirements may be addressed to ensure long-term sustainability of TWW-irrigation. Agro
expanded to include DBPs, CECs, MPs and AMR, depending on the nomic research should transition from studying the impact of specific
outcome of site-specific risk assessment related to the use of TWW (EU, TWW constituents to investigating the complex interactions between
2020). Technical guidance on developing risk management plans for different constituents (such as the effects of joint effect of DOM and SAR
wastewater reuse, including methodologies for evaluating environ on hydraulic properties), and focus more on developing mitigation and
mental and emerging public health parameters, was recently published remediation approaches for agriculturally-sustainable TWW irrigation
to support the implementation of the regulation (Maffettone and Gaw (Assouline et al., 2020; Kramer et al., 2022; Nemera et al., 2020;
lik, 2022). The guidance’s approach on risk management has been Ogunmokun and Wallach, 2021). Furthermore, it is essential to establish
developed on globally established recommendations and criteria (ISO, long-term research and monitoring programs because detrimental
2018; ISO, 2020; NRMMC-EPHC-AHMC, 2006; WHO, 2015). Although agronomic and environmental effects often manifest after several years
the EU uses a wider risk management framework for water reuse in of consecutive TWW irrigation (Assouline et al., 2015; Tal, 2016). The
agriculture, landscape irrigation and other application, it does not influence of TWW on public health is still not consolidated, with many
possess an analogue setting on general requirements regarding irrigation gaps in knowledge, including the fate of CECs and ARGs along the
water quality. This constitutes a significant obstacle to promote a sys soil-plant-consumer continuum, and their possible effects on public
tematic direct reuse approach. health. To assess and understand public health risks, standardized
methods of detecting and quantifying monitoring targets (i.e. ARGs,
5.2. Outreach and education CECs) in water, soil, and crops need to be agreed upon within the sci
entific community.
Though it is clear that the utilization of TWW for crop irrigation is There is a great need to address the current challenges of TWW
growing worldwide, the potential for opposition remains. This is not irrigation on a global level, and subsequently, we propose to establish a
necessarily due to issues with technology; instead, the principal barriers harmonized data sharing system that will promote integration of find
can be farmer hesitancy, which can stem from concerns with safety and ings from global research on known and emerging contaminants. This
quality (Dare and Mohtar, 2018; Dery et al., 2019; Ghanem et al., 2010), data management platform can be accompanied by more accurate risk
concerns regarding lack of public acceptance and perception that crops assessment models to estimate short- and long-term public health,
could be considered unsafe or inferior in quality (Craddock et al., 2021), environmental and agronomic effects, as well as synergistic impacts,
or concerns regarding cost of implementation (Deh-Haghi et al., 2020). which can be translated into regulatory criteria. Another topic of pri
Farmers’ individual characteristics such as production types, moti ority is the development of real-time monitoring systems in effluents
vations and trust levels impact their behaviors, and therefore different used for irrigation that can provide stakeholders with on-line notifica
strategies and policy interventions for promoting TWW irrigation may tion of risk factors (i.e. pathogens), and potentially be combined with
appeal to different farmer types (Upadhaya et al., 2021). While optimal treatment systems to improve water quality (i.e. dilution to reduce
outreach strategies for farmers must account for this considerable di salinity below critical levels). Finally, it is important to consistently and
versity, information and dedicated workshops addressing environ broadly evaluate indirect environmental impacts, such as greenhouse
mental and public health concerns are generally key to farmer outreach gas (GHG) emissions from WWTP and TWW irrigation (Gómez-Llanos
(Gerdes et al., 2020; Suri et al., 2019). Participatory research et al., 2020), as well as the indirect leaching of contaminants from
8
TWW-irrigated lands into natural habitats such as estuaries (e.g., Topaz under the PRIMA program under grant agreement 1822. Further support
et al., 2020). By addressing these research areas in a unified manner, we was provided by the US EPA Water Reuse Action Plan (WRAP Action
can enhance our understanding of TWW irrigation and facilitate the 1.6). We especially thank Dr. Sharon Nappier, the National Program
development of effective strategies and policies for its sustainable use. Leader for Water Reuse at the US Environmental Protection Agency
(EPA), for critical review and important comments that enabled us to
5.4. Key messages improve the manuscript.
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Water Research X 21 (2023) 100203

Contents lists available at ScienceDirect

Mitigating risks and maximizing sustainability of treated wastewater reuse

1. Introduction TWW quality is highly variable because of the different sources

Antimicrobial resistance (AMR) poses a specific challenge when

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