title: Pathogens and pharmaceuticals in source-separated urine in eThekwini, South Africa.
abstract: In eThekwini, South Africa, the production of agricultural fertilizers from human urine collected from urine-diverting dry toilets is being evaluated at a municipality scale as a way to help finance a decentralized, dry sanitation system. The present study aimed to assess a range of human and environmental health hazards in source-separated urine, which was presumed to be contaminated with feces, by evaluating the presence of human pathogens, pharmaceuticals, and an antibiotic resistance gene. Composite urine samples from households enrolled in a urine collection trial were obtained from urine storage tanks installed in three regions of eThekwini. Polymerase chain reaction (PCR) assays targeted 9 viral and 10 bacterial human pathogens transmitted by the fecal-oral route. The most frequently detected viral pathogens were JC polyomavirus, rotavirus, and human adenovirus in 100%, 34% and 31% of samples, respectively. Aeromonas spp. and Shigella spp. were frequently detected gram negative bacteria, in 94% and 61% of samples, respectively. The gram positive bacterium, Clostridium perfringens, which is known to survive for extended times in urine, was found in 72% of samples. A screening of 41 trace organic compounds in the urine facilitated selection of 12 priority pharmaceuticals for further evaluation. The antibiotics sulfamethoxazole and trimethoprim, which are frequently prescribed as prophylaxis for HIV-positive patients, were detected in 95% and 85% of samples, reaching maximum concentrations of 6800 μg/L and 1280 μg/L, respectively. The antiretroviral drug emtricitabine was also detected in 40% of urine samples. A sulfonamide antibiotic resistance gene (sul1) was detected in 100% of urine samples. By coupling analysis of pathogens and pharmaceuticals in geographically dispersed samples in eThekwini, this study reveals a range of human and environmental health hazards in urine intended for fertilizer production. Collection of urine offers the benefit of sequestering contaminants from environmental release and allows for targeted treatment of potential health hazards prior to agricultural application. The efficacy of pathogen and pharmaceutical inactivation, transformation or removal during urine nutrient recovery processes is thus briefly reviewed.
authors: Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland. Electronic address: heather.bischel@epfl.ch.
authors: Heather N
authors: HN
authors: Bischel
authors: Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH-8600 Dübendorf, Switzerland.
authors: Birge D
authors: BD
authors: Özel Duygan
authors: Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH-8600 Dübendorf, Switzerland.
authors: Linda
authors: L
authors: Strande
authors: Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH-8600 Dübendorf, Switzerland.
authors: Christa S
authors: CS
authors: McArdell
authors: Eawag, Swiss Federal Institute of Aquatic Science and Technology, CH-8600 Dübendorf, Switzerland.
authors: Kai M
authors: KM
authors: Udert
authors: Laboratory of Environmental Chemistry, School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland.
authors: Tamar
authors: T
authors: Kohn
mesh_terms: D000900:Anti-Bacterial Agents / Q000302:isolation & purification / Q000652:urine*; D000998:Antiviral Agents / Q000302:isolation & purification / Q000652:urine*; D004352:Drug Resistance, Microbial / Q000235:genetics; D000068679:Emtricitabine / Q000302:isolation & purification / Q000652:urine; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D062489:Health Impact Assessment; D006801:Humans; D013019:South Africa; D013420:Sulfamethoxazole / Q000302:isolation & purification / Q000652:urine; D014295:Trimethoprim / Q000302:isolation & purification / Q000652:urine; D014556:Urine / Q000382:microbiology* / Q000821:virology*
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D014295:Trimethoprim; D000068679:Emtricitabine; D013420:Sulfamethoxazole
keywords: Health hazards; Risk; Sustainable sanitation; Urine nutrient recovery