The Prevalence of Viral Hepatitis and Other Enteric Disease in Communities Utilizing Wastewater in Agriculture*

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Abstract
A retrospective epidemiological study was carried out on the association between enteric disease incidence and wastewater utilization in agriculture in 79 kibbutzim (cooperative agricultural settlements) in Israel. Medical records on disease incidence were collected directly from the patient files at the clinic of each kibbutz while environmental data was obtained from a detailed questionnaire. The kibbutzim included in the study were divided into four categories: I. thirty irrigating with wastewater effluent (population: 13,531), II. twenty-eight not utilizing effluent for any purpose (population: 11,096), III. ten using wastewater effluent as feed-water for fish ponds (population: 5,005), and IV. eleven which practiced two consecutive years of effluent utilization and another two consecutive years in which no effluent was utilized for any purpose or vice versa (population: 3,040). The findings reported herein are part of a major research project to be published elsewhere.** The project is designed to determine the association between enteric disease and wastewater utilization in agriculture. The full study utilizes a regression type of analysis based on logistic and log linear models designed to control for the numerous confounding factors. In this portion of the study, no excess in crude rates of viral hepatitis was found in effluent utilizing kibbutzim (categories I and III) when compared to non-effluent utilizing kibbutzim (category II). A significant (P*Although the research described in this article has been funded by the United States Environmental Protection Agency under Grant R-805174 to the Hebrew University of Jerusalem, it has not been subjected to the Agency's Peer and Policy Review and it does not necessarily reflect the views of the Agency and no official endorsement should be inferred. **Forthcoming E.P.A. reports.

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