Guidelines 18/04/06 16:37 Page 1

WHO

WASTEWATER AND EXCRETA USE IN AQUACULTURE

The third edition of the WHO Guidelines for the safe use of wastewater,
excreta and greywater has been extensively updated to take account of WHO GUIDELINES FOR THE
new scientific evidence and contemporary approaches to risk management.
The revised Guidelines reflect a strong focus on disease prevention and
public health principles.
SAFE USE OF WASTEWATER ,
This new edition responds to a growing demand from WHO Member
EXCRETA AND GREYWATER
States for guidance on the safe use of wastewater, excreta and greywater
in agriculture and aquaculture. Its target audience includes environmental
and public health scientists, researchers, engineers, policy-makers and
those responsible for developing standards and regulations.

VOLUME III
VOLUME III
The Guidelines are presented in four separate volumes: Volume 1: Policy WASTEWATER AND EXCRETA USE IN AQUACULTURE
and regulatory aspects; Volume 2:Wastewater use in agriculture; Volume 3:
Wastewater and excreta use in aquaculture; and Volume 4: Excreta and

WHO GUIDELINES FOR THE SAFE USE OF WASTEWATER , EXCRETA AND GREYWATER
greywater use in agriculture.

Volume 3 of the Guidelines informs readers on the assessment of microbial

hazards and toxic chemicals and the management of the associated risks
when using wastewater and excreta in aquaculture. It explains requirements
to promote safe use practices, including minimum procedures and specific
health-based targets. It puts trade-offs between potential risks and nutritional
benefits in a wider development context.

ISBN 92 4 154684 0
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GUIDELINES FOR THE SAFE USE OF

WASTEWATER, EXCRETA AND GREYWATER

Volume 3
Wastewater and excreta use in aquaculture
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CONTENTS

List of acronyms and abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix

Executive summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
1.1 Objectives and general considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
1.2 Target audience, definitions and scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
1.3 Organization of this Guidelines document . . . . . . . . . . . . . . . . . . . . . . . . . .3
1.4 Driving forces affecting wastewater and excreta use in aquaculture . . . . . .3
1.5 Historical overview of waste-fed aquaculture . . . . . . . . . . . . . . . . . . . . . . . .5
1.6 Current waste-fed aquacultural practice . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
1.6.1 Bangladesh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
1.6.2 China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
1.6.3 India . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
1.6.4 Indonesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
1.6.5 Viet Nam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
1.6.6 Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
1.6.7 Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
1.6.8 The Americas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
1.6.9 Western Pacific . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

2. The Stockholm Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

2.1 A harmonized approach to risk assessment/management . . . . . . . . . . . . . .13
2.2 Assessment of environmental exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
2.3 Assessment of health risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
2.4 Tolerable risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
2.5 Health-based targets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
2.6 Risk management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
2.7 Public health status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
2.7.1 Excreta-related diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
2.7.2 Foodborne trematodes and schistosomiasis . . . . . . . . . . . . . . . . . . . .25
2.7.3 Vector-borne diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
2.7.4 Measuring public health status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

3. Assessment of health risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

3.1 Microbial evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
3.1.1 Microbial pond water quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
3.1.2 Evidence of product contamination: Fish . . . . . . . . . . . . . . . . . . . . .31
3.1.3 Evidence of product contamination: Plants . . . . . . . . . . . . . . . . . . . .32
3.2 Epidemiological evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
3.2.1 Skin diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
3.2.2 Product consumption and other exposures . . . . . . . . . . . . . . . . . . . .33
3.3 Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
3.4 Health benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

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4. Health-based targets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

4.1 Protection of product consumers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
4.1.1 Trematodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
4.1.2 Other pathogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
4.1.3 Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
4.2 Protection of aquacultural workers and local communities . . . . . . . . . . . .43
4.2.1 Pathogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
4.2.2 Skin irritants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
4.2.3 Vector-borne diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
4.3 International guidelines and national standards . . . . . . . . . . . . . . . . . . . . .45
4.3.1 Food exports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
4.3.2 National standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46

5. Health protection measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

5.1 Health protection measures for different exposed groups . . . . . . . . . . . . .47
5.1.1 Product consumers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
5.1.2 Workers (and their families) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
5.1.3 Local communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
5.2 Effectiveness of health protection measures . . . . . . . . . . . . . . . . . . . . . . . .49
5.2.1 Excreta treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
5.2.2 Wastewater treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
5.2.3 Produce restriction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
5.2.4 Waste application withholding period . . . . . . . . . . . . . . . . . . . . . . . .57
5.2.5 Depuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
5.2.6 Food handling and preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
5.2.7 Produce washing/disinfection and cooking of food . . . . . . . . . . . . . .58
5.2.8 Health and hygiene promotion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
5.2.9 Immunization and chemotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . .60
5.2.10 Exposure control measures for workers, product
handlers and local communities . . . . . . . . . . . . . . . . . . . . . . . . . . . .60
5.2.11 Control of vector-borne diseases . . . . . . . . . . . . . . . . . . . . . . . . . . .62
5.3 Trematodes: Special considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
5.3.1 Reducing trematode contamination of ponds and interrupting
trematode life cycles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
5.3.2 Control of intermediate hosts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
5.3.3 Post-harvest health protection measures . . . . . . . . . . . . . . . . . . . . . .65
5.3.4 Chemotherapy of humans and animals . . . . . . . . . . . . . . . . . . . . . . .66
5.3.5 Schistosomiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67

6. Monitoring and system assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69

6.1 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
6.2 Monitoring functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
6.3 System assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
6.4 Validation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72
6.5 Operational monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
6.6 Verification monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
6.7 Small systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
6.8 Other types of monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
6.8.1 Food inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
6.8.2 Public health surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
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7. Sociocultural, environmental and economic aspects . . . . . . . . . . . . . . . . . . .79

7.1 Sociocultural aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
7.1.1 Public perception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
7.1.2 Excreta use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
7.1.3 Wastewater use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
7.1.4 Food-related determinants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
7.2 Environmental concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
7.3 Economic and financial feasibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
7.3.1 Economic appraisal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
7.3.2 Financial feasibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86

8. Policy aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89

8.1 Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
8.1.1 International policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90
8.1.2 National wastewater and excreta use policies . . . . . . . . . . . . . . . . . .90
8.1.3 Wastewater and excreta in integrated water resources management . . .91
8.2 Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
8.2.1 Institutional roles and responsibilities . . . . . . . . . . . . . . . . . . . . . . . .91
8.2.2 Rights of access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
8.2.3 Land tenure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
8.2.4 Public health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
8.3 Regulations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
8.4 Developing a national policy framework . . . . . . . . . . . . . . . . . . . . . . . . . .95
8.4.1 Defining objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
8.4.2 Assessment of the policy environment . . . . . . . . . . . . . . . . . . . . . . . .96
8.4.3 Developing national approaches based on the WHO Guidelines . . .97
8.4.4 Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97

9. Planning and implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101

9.1 Reporting and communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
9.2 Interaction with community and consumers . . . . . . . . . . . . . . . . . . . . . . .103
9.3 Use of data and information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
9.4 Project planning criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
9.4.1 Support services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107
9.4.2 Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109

Annex 1: Wastewater-fed fish pond design . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Annex 2: FAO Code of Conduct for Responsible Fisheries:
Aquaculture and environmental impact . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
Annex 3: Health impact assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
Annex 4: Glossary of terms used in the Guidelines . . . . . . . . . . . . . . . . . . . .135

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LIST OF ACRONYMS AND

ABBREVIATIONS

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PREFACE

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ACKNOWLEDGEMENTS

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EXECUTIVE SUMMARY

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1
INTRODUCTION

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1. Introduction

Guidelines

4. Health-based
targets
2. Stockholm
Framework 5. Health protection 7. Sociocultural,
measures environmental and
3. Assessment of economic aspects
health risk 6. Monitoring
and system
assessment

Supporting Other
evidence information

8. Policy aspects

9. Planning and
implementation

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Wastewater/excreta

Fingerlings

Fish Aquatic plants

Feed

Fish Livestock

Human consumption

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2
THE STOCKHOLM FRAMEWORK

Health-based
targets

Basic control
approaches
Tolerable
health risk

Water/waste Other management

quality objectives objectives

Define measures and interventions Assess

(requirements, specifications) based environmental Assessment of
exposure health risk
Health risk management

on objectives

Define key risk points and audit

procedures for overall system
effectiveness

Define analytical verifications Public health

(process, public health) status

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Table 2.1 (continued)

(continued)

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Table 2.2 (continued)

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Hazard Hazard Hazard

Treatment Treatment Treatment

Application of wastes Personal protective Access to safe

- allowing die-off equipment
periods
Access to safe
Produce restriction drinking-water and
sanitation near
Control of trematode facilities
intermediate hosts
Control of vectors
Prevention of cross- and intermediate
contamination hosts
drinking-water and
sanitation for local
communities
Restrict public
access to ponds
Control of vectors
and intermediate
hosts

Post-harvest Personal hygiene Vector barriers,

processing repellents,
prophylactics
Food hygiene

Cooking food

Consumer Workers and Local

families communities

Barrier

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3
ASSESSMENT OF HEALTH RISK

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4
HEALTH-BASED TARGETS

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5
HEALTH PROTECTION MEASURES

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Barrier E
Vectors

D Workers,
local communities
G
Water body C
Wastewater,
excreta, plants, fish, F Infection/
animal wastes disease
A intermediate hosts

Consumers G
B

A = Wastewater/excreta treatment E = Prevent vector contact (mosquito nets,

B = Crop restriction, waste application/timing, window screens, chemical repellents)
depuration, food handling/preparation, F = Immunization (typhoid, hepatitis A virus,
produce washing/disinfection, food Japanese encephalitis)
processing, cooking G = Chemoprophylaxis (malaria)
C = Personal protective equipment, access
control, access to safe drinking-water and
adequate sanitation, personal hygiene
D = Vector control (physical, biological and
chemical methods)

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Infected Human/animal
fingerlings excreta

9 1, 2, 3, 4
Contaminated
feed
Post-harvest risk reduction
10,11 12, 13, 14

Pond Market Human

5 15, 16, 17

Wastewater
7, 8
3, 4, 6
Animal Intermediate Health protection
reservoirs hosts (snails) measure

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6
MONITORING AND SYSTEM
ASSESSMENT

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Assemble the team to prepare the risk management plan

Document and describe the system

Undertake a hazard assessment and risk

characterization to identify and understand how risks
can be managed in the system

Assess the existing or proposed system (including a

description of the system and a flow diagram)

Identify control measures —

the means by which risks can be controlled

Define monitoring of control measures —

what limits define acceptable performance and how
these are monitored

Establish procedures to verify that the risk

management plan is working effectively and will meet
the health-based targets

Develop supporting programmes (e.g. training, hygienic

practices, standard operating procedures, upgrade and
improvement, research and development, etc.)

Prepare management procedures (including corrective

actions) for normal and incident conditions

Establish documentation and communication

procedures

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Table 6.3 (continued)

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7
SOCIOCULTURAL, ENVIRONMENTAL
AND ECONOMIC ASPECTS

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8
POLICY ASPECTS

International National Local

Policy Legislation Institutional Regulation

framework application

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9
PLANNING AND IMPLEMENTATION

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Health

Technical Economic
feasibility feasibility

Sustainable Social impact

Institutional and public
feasibility project
planning perception

Market Financial
feasibility feasibility

Environmental
impact

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REFERENCES

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Annex 1
Wastewater-fed fish pond design

Light

New cells

Algae

O2 CO2

Bacteria

Wastewater BOD New cells

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Box A1.1 (continued)

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Box A1.1 (continued)

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Annex 2
FAO Code of Conduct for
Responsible Fisheries: aquaculture
and environmental impact

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Annex 3
Health impact assessment

Procedures Methods

Apply screening criteria to Profiling of communities

select project or policy
Collect evidence
Interview stakeholders and
from previous
Establish steering group key informants reports

Agree scope and terms of Identify health determinants

reference for assessment affected

Select assessor Assess evidence

Conduct assessment Establish priority impacts

Appraise the assessment Recommend and justify

options for action
Negotiate favoured options

Implement and monitor

Evaluate and document

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Annex 4
Glossary of terms used in
Guidelines 1

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Guidelines 18/04/06 16:37 Page 1

WHO

WASTEWATER AND EXCRETA USE IN AQUACULTURE

The third edition of the WHO Guidelines for the safe use of wastewater,
excreta and greywater has been extensively updated to take account of WHO GUIDELINES FOR THE
new scientific evidence and contemporary approaches to risk management.
The revised Guidelines reflect a strong focus on disease prevention and
public health principles.
SAFE USE OF WASTEWATER ,
This new edition responds to a growing demand from WHO Member
EXCRETA AND GREYWATER
States for guidance on the safe use of wastewater, excreta and greywater
in agriculture and aquaculture. Its target audience includes environmental
and public health scientists, researchers, engineers, policy-makers and
those responsible for developing standards and regulations.

VOLUME III
VOLUME III
The Guidelines are presented in four separate volumes: Volume 1: Policy WASTEWATER AND EXCRETA USE IN AQUACULTURE
and regulatory aspects; Volume 2:Wastewater use in agriculture; Volume 3:
Wastewater and excreta use in aquaculture; and Volume 4: Excreta and

WHO GUIDELINES FOR THE SAFE USE OF WASTEWATER , EXCRETA AND GREYWATER
greywater use in agriculture.

Volume 3 of the Guidelines informs readers on the assessment of microbial

hazards and toxic chemicals and the management of the associated risks
when using wastewater and excreta in aquaculture. It explains requirements
to promote safe use practices, including minimum procedures and specific
health-based targets. It puts trade-offs between potential risks and nutritional
benefits in a wider development context.

ISBN 92 4 154684 0