title: Health status of residents of an urban dual reticulation system.
abstract: BACKGROUND
  Households in dual reticulation developments are supplied with recycled water from sewage effluent for some non-potable purposes, and conventional tap water for other uses. Adverse health effects from recycled water exposure are considered unlikely; however, no epidemiological studies have been undertaken to assess the public health impact of such exposures.
  
  
  METHODS
  We compared the health status of residents of a dual reticulation housing development with residents of an adjacent conventional water supply area by assessing consultation rates with primary-care physicians for three conditions considered plausibly related to recycled water exposure (gastroenteritis, respiratory complaints and dermal complaints), and two conditions considered unrelated to water exposures (urinary tract infections and musculoskeletal complaints).
  
  
  RESULTS
  We found little difference in the overall number of medical consultations per person, or in consultation rates for specific disease conditions between residents of the two water supply areas, after adjustment for demographic differences. Slight elevations in odds ratios (ORs) for dermal and respiratory consultations were observed, but seasonal patterns were not consistent with recycled water exposures.
  
  
  CONCLUSIONS
  This retrospective assessment of medical records indicates that residents of the dual reticulation water supply area are not likely to be experiencing elevated rates of adverse health outcomes as a result of their exposure to recycled water. This finding provides added assurance that appropriately operated and managed dual reticulation residential developments are a safe option for future urban water supplies.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. martha.sinclair@monash.edu
authors.forename: Martha
authors.initials: M
authors.lastname: Sinclair
authors.forename: Joanne
authors.initials: J
authors.lastname: O'Toole
authors.forename: Andrew
authors.initials: A
authors.lastname: Forbes
authors.forename: Darren
authors.initials: D
authors.lastname: Carr
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
mesh_terms: D000293:Adolescent; D000328:Adult; D003141:Communicable Diseases / Q000453:epidemiology* / Q000382:microbiology; D003247:Conservation of Natural Resources / Q000379:methods; D058005:General Practitioners / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008499:Medical Records; D015201:Meta-Analysis as Topic; D009517:New South Wales / Q000453:epidemiology; D059027:Recycling; D014505:Urban Population; D014871:Water Microbiology / Q000592:standards; D014881:Water Supply; D055815:Young Adult