\ \
 United States
 Environmental Protection
 Agency
 Health Effects
 Research Laboratory
 Research Triangle Park NC 27711
Research and Development
 EPA/600/S1-85/015   Aug. 1986
Project  Summary
Health  Effects  of  Land
Application  of Municipal
Sludge
Norman E. Kowal
  The potential health effects arising
from the land application of munici-
pal sludge are examined, and an ap-
praisal of these effects made. The
agents, or pollutants, of concern from a
health  effects viewpoint are divided
into the categories of pathogens and
toxic substances. The pathogens in-
clude bacteria, viruses, protozoa, and
helminths; the toxic substances include
organics, trace elements, and nitrates.
  For each agent of concern the types
and levels commonly found in munici-
pal wastewater and sludge are briefly
reviewed. A discussion of the levels, be-
havior, and survival of the agent in the
medium or route of potential human
exposure, i.e., aerosols, surface soil and
plants, subsurface soil and ground-
water, and animals, follows as appro-
priate. Infective dose, risk of infection,
and epidemiology are then briefly re-
viewed. Finally, some general conclu-
sions are presented.
  This Project Summary was devel-
oped by EPA's Health Effects Research
Laboratory, Research Triangle Park, NC,
to announce key findings of the re-
search project that is fully documented
in a separate report of the same title
(see Project Report ordering informa-
tion at back).

Introduction
  For centuries Western man has been
conscious of the potential value of the
application of human wastes to the
land. Thus, von Liebig, in his 1863 work,
"The  Natural Laws of  Husbandry"
wrote:
    "Even the most ignorant peasant is
  quite aware that the rain falling upon
  his dung-heap washes away a great
  many silver dollars, and that it would
  be much  more profitable to him to
  have on his fields what now poisons
  the air of his house and the streets of
  the village; but he looks on uncon-
  cerned and leaves matters to take
  their course, because they have
  always gone on in the same way."
  In spite of von Liebig's pessimism,
farmers in many areas of the world have
been applying sewage sludge to agri-
cultural land for centuries. The practice
has continued for millennia in the Far
East. Sewage sludge (or "municipal
sludge") has characteristics that make it
valuable as a fertilizer and a soil condi-
tioner: it contains fair amounts of nitro-
gen, phosphorus, and micronutrients,
and it increases soil friability, tilth, pore
space, and water-holding capacity.
  In the United States a mandate for the
greater use of land application of both
municipal wastewater and sludge  has
been provided by the Clean Water Act of
1977 (PL 95-217), Title II (Grants for Con-
struction of Treatment Works), Section
201, which states that the:
    "Administrator shall encourage
  waste treatment management which
  results in the construction of revenue
  producing facilities providing  for
  (1)the recycling of potential sewage
  pollutants  through the production of
  agriculture, silviculture, or aquacul-
  ture products, or any combination
  thereof. . ."
  The land application of wastewater
(or "land treatment") has been dis-
cussed  in previous reports;  the land
application of sludge is the subject of the
present report.

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  Land application of sludge consists of
the low-rate application (compared with
a purely disposal operation) to agricul-
tural, forest, or reclaimed land of munic-
ipal wastewater sludge which has been
"stabilized" in some way, e.g., anaero-
bic digestion or composting. That land
application of sludge is an important
and probably growing  practice  in the
U.S. is indicated by the results of a re-
cent survey of 1008 publicly  owned
treatment works,  accounting for over
2 million dry metric tons per  day of
sludge. The survey  found 17%  of the
total sludge to be utilized in large scale
food-chain landspreading, 12% in large
scale nonfood-chain landspreading, and
21% in distribution and marketing sys-
tems (much of which probably ends up
in gardens and lawns).
   With the application to land of large
volumes of wastewater and sludge, it is
evident that considerable potential for
adverse health effects exists. The major
health concerns with land treatment of
wastewater and  land  application of
sludge are somewhat different. Thus,
the potential  exposure  of humans
through the routes of aerosols and
groundwater is frequently emphasized
with wastewater, and through the food
chain with sludge.  Nevertheless, the
agents, or pollutants, of concern from a
health effects viewpoint are almost the
same in wastewater and sludge. These
agents can be divided into the two
broad categories of pathogens and
toxic  substances. The pathogens  in-
clude  bacteria  (e.g., Salmonella and
Shigella), viruses (i.e., enteroviruses,
hepatitis virus, adenoviruses, ro-
taviruses, and Norwalk-like agents),
protozoa (e.g., Entamoebaand Giardia),
and the helminths (or worms, e.g., As-
caris,  Trichuris,  and Toxocara). The
protozoa and helminths are often
grouped together under the term,
"parasites," although in reality all the
pathogens are parasites. The toxic sub-
stances  include  organics, trace ele-
ments (or heavy metals, e.g., cadmium
and lead), and nitrates. Nitrates are
usually  not viewed as "toxic" sub-
stances,  but are here so considered be-
cause  of their potential hematological
effects when present in water supplies
at high levels.  These agents form the
basis of the main sections of this report.
The major health effects of these agents
are listed in Figure 1.
   For each agent of concern the types
and levels commonly found in  munici-
pal sludge are  briefly reviewed. A dis-
cussion of the levels, behavior, and sur-
                                   2
vival of the agent in the medium or
route of potential human exposure, i.e.,
aerosols, surface soil and plants, sub-
surface soil and groundwater, and ani-
mals, follows as appropriate. (Runoff to
surface water is not considered, since it
is assumed that this will be prevented in
a well-managed sludge land application
operation.) For the pathogens, infective
dose,  risk of infection, and epidemiol-
ogy are then briefly reviewed.

General  Conclusions

Types and Levels of Agents in
Wastewater and Sludge
  The types of  levels in wastewater and
sludge of most pathogens are fairly well
understood, with the exception of
viruses. Since only a fraction of the total
viruses in wastewater and other envi-
ronmental samples may actually  be de-
tected, the development of methods to
recover and  detect viruses needs to be
continued. The occurrence of viruses in
an environmental setting should proba-
bly be based on viral tests rather than
bacterial indicators since failures  in this
indicator system have been reported.
  The tremendous number of organic
chemicals possibly present in sludge,
together with their myriad health effects
and poorly understood behavior in the
environment, represent a potential for
public health risk when the sludge is ap-
plied  to agricultural land. Among the
trace  elements, probably only cad-
mium, under ordinary circumstances, is

              Agent (Pollutant)
likely to be of health concern to human
as a result of the land  application <
sludge, with  the exposure  bein
through food plants or organ meat!
Minimizing of health risks can probabl
be accomplished by the monitoring c
sludge composition, and the  regulatio
of maximum concentrations  and curr
ulative application of toxic substances!
land-applied sludge. The complexity c
the organics composition of sludge;
however, might require the developmer
and use of biological assays to screen fc
toxicity.
Aerosols
  Because of the potential exposure t<
aerosolized bacteria, and  possibh
viruses, at land application sites,  i
would be prudent to limit public acces:
to a sludge spray source,  such as ai
active spray gun or tank truck. Humai
exposure  to pathogenic protozoa o
helminth eggs through aerosols is un
likely.

Surface Soil and Plants
  The survival times of pathogens or
soil and plants are summarized ir
Table 1. Since pathogens survive for •<
much longer time on soil than on plants
recommended waiting periods befon
harvest are based upon probable con
tamination with soil. However, what is i
safe waiting period before crop harves
for human consumption is  really ar
unsettled issue.

          Health Effect

Toxic
Substances
Bacteria
Viruses
Protozoa
Helminths
Organics
Trace Eleme
Nitrates


nts





-i

Carcinogenesis

(cardiovascular, immunological
hematological, neurological, etc.
Figure 1.   Health effects of pathogens and toxic substances.

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 Table 1.   Survival Times of Pathogens on Soil and Plants

                            Soil
                     Plants
Pathogen
Bacteria
Viruses
Protozoa
Helminths
Absolute
Maximum
t year
6 months
10 days
7 years
Common
Maximum
2 months
3 months
2 days
2 years
Absolute
Maximum
6 months
2 months
5 days
5 months
Common
Maximum
1 month
1 month
2 days
1 month
  Aerial crops with little chance for con-
tact with  soil should probably not be
harvested for human consumption for
at least one month after the last sludge
application; subsurface and low-
growing crops for human consumption
would probably require a six-month
waiting period after last application.
These waiting periods need not apply to
the growth of crops for animal feed,
however.
  The levels of toxic organics likely to
be present in soils at land application
sites  will  probably  result in  very low
levels in  above-ground  portions of
plants, but levels in  roots, tubers, and
bulbs may present a  health hazard.
  The potential increase in cadmium
levels in human food due to land appli-
cation of  sludge  is  still  an unsettled
question. Present levels of total dietary
intake of cadmium for most people ap-
pear to be fairly safe. However, in view
of human variability in sensitivity and
the variability in food supply, these
levels probably should not be allowed
to rise greatly.

Movement in Soil and Ground-
water
  Properly designed sludge application
sites may  pose little threat of bacterial
or viral contamination of groundwater.
Human exposure to pathogenic proto-
zoa or helminths through groundwater
is unlikely. Groundwater is unlikely to
represent a significant organic or trace
element threat.
  There is a possibility that land appli-
cation of sludge may raise the nitrate
concentration of groundwater above
the drinking water standard of 10 mg/C
as N. This can be prevented, however,
by proper siting and management prac-
tice, e.g., matching loading rate to crop
uptake.

Animals
  The literature to  date suggests little
danger of bacterial, viral,  or protozoan
disease to animals grazing at land appli-
cation sites if grazing does not resume
until four weeks after last application
but the need for complete inactivation of
helminths in  sludge before land appli-
cation is still  unsettled. The feeding of
land-application-site-grown  plants  to
animals  is unlikely to pose  a health
problem, but  grazing animals may ac-
cumulate significant levels of toxic or-
ganics. The issue  of accumulation of
organics  from the soil by plants and
animals (particularly into milk), and into
the human food supply, is poorly under-
stood.

Infective Dose, Risk of Infec-
tion, Epidemiology
  Because of the possibility of contract-
ing an infection, it would  be wise for
humans to  maintain a minimum
amount of contact with an active  land
application site.
  Epidemiological studies to date sug-
gest little effect of land application on
disease  incidence. However, many
questions on  the public health conse-
quences  of land application  of waste-
water and sludge remain.
  The EPA author Norman £. Kowal is with the Toxicology and Microbiology
    Division of the Health  Effects Research Laboratory—RTP,  Cincinnati, OH
    45268.
  The complete report, entitled "Health Effects of Land Application of Municipal
    Sludge," (Order No. PB 86-197 456/AS; Cost: $11.95. subject to change) will
    be available only from:
          National Technical Information Service
          5285 Port Royal Road
          Springfield. VA 22161
          Telephone: 703-487-4650
  The EPA author can be contacted at:
          Health Effects Research Laboratory
          U.S. Environmental Protection Agency
          Research Triangle Park, NC 27711

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United States
Environmental Protection
Agency
Center for Environmental Research
Information
Cincinnati OH 45268
Official Business
Penalty for Private Use $300


EPA/600/S1-85/015
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