Determination of murine norovirus aerosol concentration during toilet flushing

Murine norovirus (MNV) was used as a surrogate for human viral pathogens (e.g., norovirus) to determine if toilet flushing resulted in the aerosolization of virus. A flushometer type toilet was seeded with a viral solution of 105 and 106 PFU mL-1 of MNV and then flushed. Upon flushing, two bioaerosol samplers were activated to collect aerosolized MNV. Prior to the experiment, two optical particle counters monitored particle size and number distribution of aerosol produced from flushing a toilet across height, position, and side. The location with the highest mean particle concentration, was behind the toilet and 0.15 m above the toilet bowl rim, which is where bioaerosol sampling occurred. Bioaerosol and toilet water samples were collected, extracted and then quantified using RT-ddPCR. The concentration of MNV collected after seeding the toilet water ranged from 2.18 × 105 to 9.65 × 106 total copies of MNV. Positive samples of airborne MNV were detected with collected concentrations ranging from 383 to 684 RNA copies/m3 of air. This study provides evidence that viral pathogens may be aerosolized when a toilet is flushed. Furthermore, the MNV used in this study is a model organism for human norovirus and may be generalizable to other viral pathogens (e.g., coronavirus). This study suggests that virus is aerosolized from toilet flushing and may contribute to human exposure to viral pathogens.

Review of Evidence of Aerosol Transmission of SARS-CoV-2 Particles

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes Coronavirus disease (COVID-19) through multiple transmission routes and understanding the mode of transmission is very important for its containment and prevention. Consequently, inadequate attention has been given to the spread of respiratory droplets in indoor conditions under microclimatologic turbulent wind promoted by aerosol from talking (loud), coughing, sneezing, toilet flushing of an isolation room, and resuspension of the settled virus from the surfaces. To this end, this study is presenting an early review of the process and evidence of aerosol transmission of SARS-CoV-2 particles. There are significant results of many studies including those under peer review that support aerosol and airborne transmission which government agencies should consider for reducing the transmission rate.

Human Fecal Pollution Monitoring and Microbial Risk Assessment for Water Reuse Potential in a Coastal Industrial–Residential Mixed-Use Watershed

Rapid economic development has caused industrial expansion into residential communities, leading to higher fecal pollution loads that could be discharged into aquatic environments. However, little is known regarding the potential microbial impact on human health. This study investigated microbial contamination from coastal industrial–residential community areas in nine sampling sites in waterways during three dry events. A general microbial source tracking (MST) marker, GenBac3, was detected in all samples from all three events, indicating continuing fecal pollution in the area, mostly from human sewage contamination. This was shown by the human-specific genetic marker crAssphage (88.9%) and human polyomavirus (HPyVs; 92.6%) detection. Enteric human adenovirus (HAdV40/41) showed three positive results only from residential sites in the first event. No spatial difference was observed for MST markers and traditional fecal indicators (total coliforms and Escherichia coli) in each event. Still, a significantly lower abundance of GenBac3, HPyVs, and total coliforms in the first sampling event was detected. Spearman’s rho analysis indicated a strong correlation among certain pairs of microbial parameters. Multivariate analysis revealed two clusters of samples separated by land use type (industrial vs. residential). According to factor analysis of mixed data, the land use parameter was more associated with physicochemical parameters (i.e., salinity, conductivity, water temperature, and dissolved oxygen). A Quantitative Microbial Risk Assessment (QMRA) was then conducted to estimate the annual infection risks of HAdV40/41 for non-potable water reuse purposes using predicted concentrations from crAssphage and HPyVs. The highest risks (95th percentiles) were ranked by food crop irrigation, aquaculture, and toilet flushing, at 10–1, 10–2, and 10–3 per person per year (pppy). Required treatment levels to achieve a 10–4 pppy annual infection risk were estimated. QMRA-based water treatment scenarios were suggested, including chlorination for toilet flushing reuse and depth filtration prior to chlorination for aquaculture and food crop irrigation. Microbial monitoring combined with a QMRA could provide better insights into fecal pollution patterns and the associated risks, facilitating effective water quality management and appropriate prior treatments for water reuse.

Microbiological Health Risk Assessment of Water Conservation Strategies: A Case Study in Amsterdam

The aim of this study was to assess the health risks that may arise from the implementation of greywater reuse and rainwater harvesting for household use, especially for toilet flushing. In addition, the risk of cross connections between these systems and the drinking water system was considered. Quantitative microbial risk assessment (QMRA) is a method that uses mathematical modelling to estimate the risk of infection when exposure to pathogens happens and was used in this study to assess the health risks. The results showed that using rainwater without prior treatment for toilet flushing poses an annual infection risk from L. pneumophila at 0.64 per-person-per-year (pppy) which exceeds the Dutch standard of 10−4 pppy. The use of untreated greywater showed a risk that is below the standard. However, treatment is recommended due to the ability of P. aeruginosa to grow in the reuse system. Moreover, showering and drinking with cross-connected water has a high annual infection risk that exceeds the standard due to contact with Staphylococcus aureus and E. coli O157:H7. Several measures can be implemented to mitigate the risks such as treating the greywater and rainwater with a minimum of 5-log removal, closing the toilet lid while flushing, good design of greywater and rainwater collection systems, and rigorous plumbing installation procedures.

Exposure to SARS-CoV-2 in Aerosolized Wastewater: Toilet Flushing, Wastewater Treatment, and Sprinkler Irrigation

The existence of SARS-CoV-2, the etiologic agent of coronavirus disease 2019 (COVID-19), in wastewater raises the opportunity of tracking wastewater for epidemiological monitoring of this disease. However, the existence of this virus in wastewater has raised health concerns regarding the fecal–oral transmission of COVID-19. This short review is intended to highlight the potential implications of aerosolized wastewater in transmitting this virus. As aerosolized SARS-CoV-2 could offer a more direct respiratory pathway for human exposure, the transmission of this virus remains a significant possibility in the prominent wastewater-associated bioaerosols formed during toilet flushing, wastewater treatment, and sprinkler irrigation. Implementing wastewater disinfection, exercising precautions, and raising public awareness would be essential. Additional research is needed to evaluate the survival, fate, and dissemination of SARS-CoV-2 in wastewater and the environment and rapid characterization of aerosols and their risk assessment.

Water and energy savings from greywater reuse: a modelling scheme using disaggregated consumption data

Municipal drinking water supplies are under great stress globally, and one way to mitigate the problems is the reutilization of wastewater in various settings. In this paper, a greywater reuse scheme and the impact of system design and configuration on water and energy savings are investigated. The objective of the paper was to investigate the impact of hydraulic design and performance of a greywater treatment and reuse system on water and energy savings. A simulation model was created based on real, disaggregated water consumption data that predicts the reuse potential. Three scenarios were investigated; (1) greywater collection from the bathroom and reuse for toilet flushing, (2) greywater collection from bathroom sinks and showers, and reuse as hot water for sinks and showers, and (3) a combination of (1) and (2) where greywater collection from bathroom sinks and showers is used for toilet flushing, sinks and shower. The results indicate hot water reductions between 55.6 and 58.2%, while cold water reductions ranged from 5.8 to 30.6%. Reductions in energy for producing hot water between 43.5 and 46.8% were observed. Recommendations per connected user for hydraulic design ranged from 0.033 to 0.1 dm3 min−1, 3 dm3, and 0.7–10 dm3 for treatment capacity, collection and holding tank volume.

Quantifying the Risk of Indoor Drainage System in Multi-unit Apartment Building as a Transmission Route of SARS-CoV-2

The COVID-19 pandemic has had a profound impact on human society. The isolation of SARS-CoV-2 from patients feces on human cell line raised concerns of possible transmission through human feces including exposure to aerosols generated by toilet flushing and through the indoor drainage system. Currently, routes of transmission, other than the close contact droplet transmission, are still not well understood. A quantitative microbial risk assessment was conducted to estimate the health risks associated with two aerosol exposure scenarios: 1) toilet flushing, and 2) faulty connection of a floor drain with the building main sewer pipe. SARS-CoV-2 data were collected from the emerging literature. The infectivity of the virus in feces was estimated based on a range of assumption between viral genome equivalence and infectious unit. The human exposure dose was calculated using Monte Carlo simulation of viral concentrations in aerosols under each scenario and human breathing rates. The probability of COVID-19 illness was generated using the dose-response model for SARS-CoV-1, a close relative of SARS-CoV-2, that was responsible for the SARS outbreak in 2003. The results indicate the median risks of developing COVID-19 for a single day exposure is 1.11 x 10-10 and 3.52 x 10-11 for toilet flushing and faulty drain scenario, respectively. The worst case scenario predicted the high end of COVID-19 risk for the toilet flushing scenario was 5.78 x 10-4 (at 95th percentile). The infectious viral loads in human feces are the most sensitive input parameter and contribute significantly to model uncertainty.