外文翻译--废水回收与在使用 中文版.pdf
EDITORIALSWastewaterRecyclingandReuseAsiswellknown,wastewatershavebeenreclaimedforagriculturaluseforcenturies.ThearticlebyFattal,etal,inthisissueoftheJournalreportsresultsofanepidemiologicalstudyoftheimpactofpoorqualitywastewatereffluentusedforirrigationofnonfoodcropsonthehealthofpeopleresidinginnearbykibbutziminIsrael.Thepracticeofusingwastewatersforirrigationiscommoninmanyaridandsemiaridareasoftheworld,includingtheUnitedStates.Currently,thereisconsiderableinterestinthepotentialhealtheffectsassociatedwiththedirectandindirecthumanconsumptionofreclaimedwastewaters.Indirecthumancon-sumptionofwastewatersoccurswhensurfacewaters,par-ticularlyriversreceivingwastewaterdischarges,areusedforwatersupply.Thesesurfacesources,alongwithanincreas-ingnumberofgroundwaterresources,arecontaminatedbythewastedischargesfromcommunities,industrialactivities,agriculturalandurbanrunoff,andstormwater.Usingthesesourcesofsupply,watertreatmentplantshaveproducedwaterthatisconsideredsafeforhumanuse,althoughthesefinishedwatersmaycontainlowlevelsoforganicchemicalswhichmaybepotentiallyharmfulfollowinglong-terminges-tion.AnearlyexampleofthedirectreuseofwastewaterforpotablepurposesoccurredinChanute,Kansasfollowingthedroughtof1952-57.2DuringtheperiodfromOctober14,1956throughMarch14,1957,becauseofthecriticalshortageofwater,municipalwastewatertreatmentplanteffluentwasrecycledthroughthewatertreatmentplantandintroducedintothewaterdistributionsystem.Althoughthewatermetexistingmicrobialstandards,withcontinuedrecyclingpublicacceptancedecreasedand"bottled-watersalesflourished."Currently,theonlyknownsourceofdirectreuseofreclaimedwastewateristhatatWindhoek,NamibiainsouthwestAfrica,wherewastewaters,devoidoftoxicindustrialwastes,aredischargedafterextensivetreatmenttomaturationpondsbeforeadmixturewithuncontaminatedsourcewaters.Withthedevelopmentofnewtechnologiesforthetreatmentofwastewater(advancedortertiarytreatment),fosteredinpartbytheFederalWaterPollutionActof1972andSection1444oftheSafeDrinkingWaterActof1974,34extensivestudieshaveshownthattreatedwastewaterscouldbeproducedwhichmeetallofthemaximumconcentrationlimitsstipulatedinthedrinkingwaterstandards.56Thedrinkingwaterstandardsstate".priorityshouldbegiventotheselectionofthepurestsource.Pollutedsourcesshouldnotbeused."and"Abate-mentandcontrolofpollutionwillsignificantlyaidinproducingdrinkingwater.infullcompliancewith.thesestandardsandwillbeaestheticallyacceptabletotheconsumer.IEventhoughthestandardscallforobtainingthewatersupplyfromtheleastpollutedsource,thereareareas,particularlyinthesunbelt,whicharealreadyusingwaterbeyondthecapacityoftheavailablenaturalsupplies,3andwhereitmaynotbeeconomicallyfeasibletoimportwatersofpotablequality.Intheinterestofconservingexistingwatersupplysources,reclaimedwastewatersarebeingusedforindustrialpurposes,78agriculturalcropirrigation,79urbanirrigation,79recreationalpurposes,7andgroundwaterre-charge.4"105Dependingontheextentoftreatmentreceivedbeforereuse,therearepublichealthconcernsrelatedtoeachofthesereusepractices.Theseinclude:*microbialpathogensandindicators;7"22*traceorganicconstituentsandtheireffects;7"15"1923*traceinorganiccontaminantsandtheireffects;7"5"1922and*physicalconstituents,suchassuspendedsolidsandturbidity.7InthemostcomprehensivestudytodatetoevaluatetheeffectsonhealthofusingtreatedwastewaterforgroundwaterreplenishmentattheWhittierNarrowsGroundwaterReplen-ishmentPlant,theauthors24concludedthattherewerenodemonstrableormeasurableadverseeffectsoneithertheareasgroundwateroronthehealthofthepeopleingestingthewater.Roberts5indicatedthatthoseresponsibleforpossiblehealthdecisionsintheuseofreclaimedwastewaterstakeanunderstandablycautiousattitudetowardtheyetunquantifiedriskofchronichealtheffectscausedbytraceorganics.Althoughmaximumconcentrationlimitshavebeenes-tablishedforseveralinorganicandafeworganicpesticidesinpotablewatersupplies,56limitsformanycompounds,par-ticularlyorganic,havenotbeenestablished.However,limitshavebeenproposedforadditionalorganiccompoundsinwater.25Maximumconcentrationlimitsareforsingleentitiesanddonotrelatetothepossibleadditive,synergistic,orantagonisticbehaviorofmanycontaminants.Californiahasbeenaleaderindevelopingstandardsforreclaimedwastewatersusedinagricultureandfortherechargeofgroundwaters.40"926Inlieuofstandardsforassessingthequalityofreclaimedwastewater,Work,etal,27proposedthattreatmentatDenverbecapableofremovingtheincrementaddedtothewastethroughuse,thusreturningthewatertothequalityinitiallypresentinthewatersupplysource.This,ofcourse,wouldentailmeasurementofallknownparame-ters,butnotunknownsubstancescapableofinducinghealtheffectsafterlong-termconsumption.Asindicatedearlier,processesareavailabletotreatwastewaterstomeetcurrentdrinkingwaterstandards;6however,theextentoftreatmentisafunctionofcost.Removaloftheresidualrefractorymaterialsbecomesin-creasinglyexpensive,andthepublicisnotconditionedtopayahigherpriceforitsmunicipalwatersupply.Therefractorysubstancesofmostconcernaretheorganiccompounds.Specificstudieshavebeencarriedouttoevaluate2829anddevelop8additionalmethodsfortheirremoval.Themajorunresolvedproblemisthehandlinganddisposalofthetoxicinorganicandorganicsubstancesthatarepresentinthesludges,slurries,and/orresidualconcentratesproducedduringtreatment.Analternativetoextensivetreatmentforurbanuseofnonpotablereclaimedwastewatershasbeentoprovidedualdistributionsystems-oneforthepotablesupplyandaseparateoneforthenonpotablesupply.Althoughfeasibleandinuseinseveralcommunities,8926theAmericanWaterWorksAssociation(AWWA),intheforewordtoitsManualonDualSystems,statesthattheuseofadualdistributionsystemis".notarecommendedstandardofpracticebutAJPHAugust1986,Vol.76,No.8960areportofthestate-of-the-art."8Sincethepublicdrinksonlyabout1percentofthewatersuppliedtothecommunity,andif,asstatedbyLynch,30.whatamountstozeroriskeverbecomesthewillofthepeople,itmightbenecessarytoexchangeourtraditionalone-systemapproachtowaterdistributionforadualsysteminwhichthewaterintendedforhumanconsumptionwouldundergoextremesofmonitoring,testing,andtreatmentandtherestwouldbekeptatlevelsofqualityorsafetythatuntilnowhavebeendeemedtobesatisfactory."Inthetreatmentofreclaimedwastewatersforindirectreuse,acriticalissueisthereliabilityofthetreatmentprocess.Roberts"5reportsthatWaterFactory21hasdem-onstratedthatpotablewaterqualitystandardscanbesatis-fied,forthemostpart,withbetterthan95percentreliabilitybasedonCaliforniacontaminationlevelstandards.Withproperdesignoffacilities,carefuloperation,adequatelytrainedpersonnel,andpossibilityofoccasionalbypassing,mostplantsshouldbeabletoperformaswell.Scientifically,ourabilitytoidentifyandtoquantifythelowlevelsofcontaminantspresentinwaterhasfarout-strippedourcapabilitiestoevaluateandinterpretthesignif-icanceofthelevelsmeasuredinassessingpotentialchronichealtheffects.Thereisaneedtodevelopappropriatetestprocedurestodeterminethehealthsignificanceofthemanysubstancescurrentlyidentifiableinwater.Beforereuseofreclaimedwastewatercanbecomeareality,thepublicmustaccepttheproduct.Publicattitudesurveyshaveshownthatalargesegmentofthepublicendorseswastewaterreuseforagriculturalandurbanirriga-tion,industrialuse,toiletflushing,andsceniclakeswhereasalesserfractionsupportsitsuseforboating/fishing,laundry,andbeachesandbathing,andastillsmallerfractionforfoodcanning,cooking,anddrinking.273133Generalacceptancefordrinkingreclaimedwaterrangedfrom40tomorethan80percent.Ifthereclaimedwaterwastobeofthesameorbetterqualitythanthecurrentsupply,resultsofaDenversurveyshowedthat84.1percentofthepublicagreedtosomedegree.2732Some63percentofDenverresidentsfavoredeventualpotablewaterreuse.27Bruvold33characterizedthemembersofthepublicandtheindividualshavingthemostfavorableattitudetowardreusingreclaimedwastewaterfordrinkingaswellasthosethatdidnothaveafavorableattitude.Inarecentarticle,Wolman34indicatedthatpeopleweremilitant,concerned,fearful,andevenhystericalintheirsearchforguaranteedsafetyandzerorisk.Heidentifiedasaparameterpublicconfrontation,andnotedthatthiscomplexhumanbehavior".compoundedbyconcern,ignorance,misconception,hysteria,andfearoftheunknown.hasitsorigininpressuregroups,officialdom,andthecommunica-tionsmedia.Thesephenomenaareofhighimport,however,inanyassessmentofthesignificanceofwaterborneillnessesfromwastewaterdischarges."Hasthiscomplexhumanbehaviorrelativetothesafetyofourwatersuppliesbeenthemotivatingfactorforthetremendoussurgeintheuseofbottledwaterandbeverages?Inconclusion,thedirectreuseofreclaimedwastewatersforpotablepurposesshouldbedeferreduntilenoughscien-tificevidenceisavailabletoadequatelyassessthepotentiallyadversehealtheffects,bothacuteandchronic.9ThereisaneedforadditionalcomprehensivehealtheffectsstudiesofthetypereportedbyNellor,etal.24Wealsoanticipatetheresultsofthelong-termhealtheffectsstudiesplannedbytheCityofDenverasapartofitsdemonstrationprojecttoEDITORIALSevaluatethefeasibilityofreclaimingwastewaterfordirectreuse.35REFERENCES1.FattalB,WaxY,DaviesM,ShuvalHI:Healthrisksassociatedwithwastewaterirrigation-Anepidemiologicalstudy.AmJPublicHealth1986;76:977-979.2.MetzlerDF,CulpRL,StoltenbergHA,WoodwardRL,WaltonG,ChangSL,ClarkeNA,PalmerCM,MiddletonFM:EmergencyuseofreclaimedwaterforpotablesupplyatChanute,Kansas.JAmWaterWorksAssoc1958;50:1021-1057.3.EnglishJN,BennettER,LindstedtKD:Researchrequiredtoestablishconfidenceinthepotablereuseofwastewater.JAmWaterWorksAssoc1977;69:131-136.4.RobertsPV,McCartyPL,RomanWH:Directinjectionofreclaimedwaterintoanaquifer.JEnvironEngrDiv,AmSocCivilEngrs1978;104:933-949.5.NationalInterimPrimaryDrinkingWaterRegulations1977;EPA-570/9-76-003.Washington,DC:OfficeofWaterSupply,EnvironmentalProtec-tionAgency.6.FederalRegister1979;44(140):42918(July18).7.GarrisonWE,MieleRP:Currenttrendsinwaterreclamationtechnology.JAmWaterWorksAssoc1977;69:364-369.8.DeBoerJG:Wastewaterreuse:Aresourceoranuisance?JAmWaterWorksAssoc1983;75:348-356.9.OkunDA:Reuse:Panaceaorpieinthesky?JAmWaterWorksAssoc1985;77:26.10.AsanoT,WassermanKL:GroundwaterrechargeoperationsinCalifornia.JAmWaterWorksAssoc1980;72:380-385.11.SontheimerH:ExperiencewithriverbankfiltrationalongtheRhineRiver.JAmWaterWorksAssoc1980;72:386-390.12.PietGJ,ZoetemanBCJ:OrganicwaterqualitychangesduringsandbankanddunefiltrationofsurfacewatersinTheNetherlands.JAmWaterWorksAssoc1980;72:400-404.13.IdelovitchE:Environmentaleffectsofwaterreusescheme.JEnvironEngrDiv,AmSocCivilEngrs1980;106:561-570.14.IdelovitchE,TerkeltoubR,MichailM:Theroleofgroundwaterrechargeinwastewaterreuse:IsraelsDanRegionProject,JAmWaterWorksAssoc1980;72:391-400.15.Roberts,PV:Waterreuseforgroundwaterrecharge:Anoverview.JAmWaterWorksAssoc1980;72:375-379.16.LarkinEP,TierneyJT,SullivanR:Persistenceofvirusonsewage-irrigatedvegetables.JEnvironEngrDiv,AmSocCivilEngrs1976;102:29-35.17.LarkinEP,TierneyJT,SullivanR:Persistenceofvirusonsewage-irrigatedvegetables.JEnvironEngrDiv,AmSocCivilEngrs1977;103:742-743.18.CooperRC:Healthconsiderationsinuseoftertiaryeffluents.JEnvironEngrDiv,AmSocCivilEngrs1977;103:37-47.19.CrookJ:HealthaspectsofwaterreuseinCalifornia.JEnvironEngrDiv,AmSocCivilEngrs1978;104:601-610.20.ScheuermanPR,BittonG,OvermanAR,GiffordGE:Transportofvirusesthroughorganicsoilsandsediments.JEnvironEngrDiv,AmSocCivilEngrs1979;105:629-640.21.BixbyRL:Transportofvirusesthroughorganicsoilsandsediments.JEnvironEngrDiv,AmSocCivilEngrs1980;106:654-675.22.NealRA:Evaluatingpotentialhealthrisksofconsumingreusedwater.JAmWaterWorksAssoc1982;74:638-641.23.CrookJ:WaterreuseinCalifornia.JAmWaterWorksAssoc1985;77:60-71.24.NellorMH,BairdRB,SmythJR:Healtheffectsofindirectpotablewaterreuse.JAmWaterWorksAssoc1985;77:88-96.25.Update.JAmWaterWorksAssoc1985;77(12).26.GallierWT:Planningandimplementingadualdistributionsystem.JAmWaterWorksAssoc1985;77:40-44.27.WorkSW,RothbergMR,MillerKJ:Denverspotablereuseprojects:Pathwaystopublicacceptance.JAmWaterWorksAssoc1980;72:435-440.28.ReinhardM,DolceCJ,McCartyPL,ArgoDG:Traceorganicsremovalbyadvancedwastetreatment.JEnvironEngrDiv,AmSocCivilEngrs1979;105:675-693.29.RandtkeSJ,McCartyPL:Removalofsolublesecondary-effluentorganics.JEnvironEngrDiv,AmSocCivilEngrs1979;105:727-743.30.LynchWO:Aperspectiveonthecontroloftoxics.JAmWaterWorksAssoc1984;76:12,14.31.StoneR:Waterreclamation:Technologyandpublicacceptance.JEnvironEngrDiv,AmSocCivilEngrs1976;102:581-594.32.MillikenJG,TrumblyAS:Municipalrecyclingofwastewater.JAmWaterWorksAssoc1979;71:548-555.33.BruvoldWH:Obtainingpublicsupportforreusewater.3AmWaterWorksAJPHAugust1986,Vol.76,No.8961EDITORIALSAssoc1985;77:72-77.34.WolmanA:Reflections,perceptions,andprojections.JWaterPollControlFed1983;55:1412-1416.35.LauerWC,RogersSE,RayJM:ThecurrentstatusofDenverspotablewaterreuseproject.JAmWaterWorksAssoc1985;77:52-59.CONRADP.STRAUB,MCE,PHDDr.StraubisnowretiredfromhispostasProfessor,EnvironmentalHealth,UniversityofMinnesotaSchoolofPublicHealth,andiscurrentlyamemberoftheJournalEditorialBoard.AddressreprintrequeststoConradP.Straub,PhD,2330ChaletDrive,ColumbiaHeights,MN55421.C1986AmericanJournalofPublicHealth0090-0036/86$1.50CesareanSectionandBreechPresentationsCesareansectionusageintheUnitedStateshasin-creaseddramaticallyinthepastfewdecadesfromaround3percentto20percentofallbirths.Reasonscitedincludetheuseofelectronicfetalmonitoring,fearofmalpracticesuits,andfinancialincentives.Anotherveryrealreasonistherecognitionbyphysiciansofthehazardsofvaginaldeliveriestocertaingroupsofbabies.FortneyandcolleaguesintheirpaperelsewhereinthisissueoftheJournalfocusononeofthesehigh-riskconditions-breechpresentation-andreportonanextraordinarysampleofover10,000suchcasesfromaroundtheworld.Theyfoundthatinhospitalswithlowmortalityrates(presumablymoresophisticatedandwithlowerriskpopula-tions),cesareansectionwasusedforbreechdeliverymuchmorefrequentlythaninhospitalswithhighmortalityrates.Thismightleadsometoconcludethat"cesareanisbetterforthesecases,"but,astheauthorscorrectlypointout,itisnotthatsimple.Iftheperinatalmortalityishigh,itmaywellmeanahighincidenceoflowbirthweightandverylowbirthweight(1000grams)babies.Theseinfants,inturn,aremorelikelytobe"writtenoff,"especiallywheregoodintensivecarefornewbornsislacking,andthemothersallowedtodelivervaginallyratherthansquanderpreciousresourcesoncesar-eansectioninalostcause.Thissinglefactcangofartoexplainthevarianceamongratesandrelativerisksinthethreestrataofhospitals.Obviously,ifcesareansectionisreservedforthebabieswithabettersurvivalchance,itwillmakeforahigherrelativeriskforvaginaldelivery.Evenso,therearesomepointstolearnfromthepaperbyFortney,etal.First,evenwithbreechdeliveries,theworldisfullof"haves"and"havenots"i.e.,thetrickledowntheoryinpractice!Second,given36weeksofgesta-tionalage,particularlyinfootlingpresentationsandinprimiparas,cesareansectionisprobablythesafestrouteofdeliveryforabreech.Fortheverylowbirthweightinfant,thisisnotdemonstrated.Third,thelargebreech(>3500grams)shouldbedeliveredbycesareansectionwheneverpossible.Fourth,wemustnotforgettheimpactoftheincreasingnumbersofcesareansectionsonmaternalmor-bidityandmortality.Andfinally,thephysiciancaringforthesepatientsmustcontinuetoexerciseindividualizedclin-icaljudgmentinmakingadecision.Inagivensituation,toparaphrasetheauthors,cesareandeliverydoesnotguaranteeahealthybaby,althoughitenhancestheprobabilityofone.REFERENCE1.FortneyJA,HigginsJE,KennedyKI,LaufeLE,WilkensL:Deliverytypeandneonatalmortalityamong10,749breeches.AmJPublicHealth1986;76:980-985.GEORGEM.RYAN,JR.,MDAddressreprintrequeststoGeorgeM.Ryan,Jr.,MD,ProfessorofObstetricsandGynecology,UniversityofTennessee,CenterfortheHealthSciences,800MadisonAvenue,Memphis,TN38163.C1986AmericanJournalofPublicHealth0090-0036/86$1.50962AJPHAugust1986,Vol.76,No.8