The risk factors and threshold level of subchronic inhalation exposure of reclaimed water.

Inhalation of reclaimed water is known to cause lung inflammation, and free endotoxins have been shown to be a major risk factor for acute exposure. Subchronic exposure has also been shown to induce inflammatory responses with visible tissue damage. However, subchronic risk factors have yet to be identified, and a threshold for the protection of occupational populations during urban reuse is necessary. In this study, potential risk factors in reclaimed water were examined by subchronic exposure with fractionated reclaimed water, and the health risk threshold was tested with a series of diluted reclaimed water. Accordingly, following a 12-week exposure, macromolecules and microorganisms were found to be two major risk factors in reclaimed water that could cause pulmonary inflammation, including increased proportion of polymorphonuclear leukocytes in bronchoalveolar fluid, formation of inducible bronchus-associated lymphoid tissue, and elevation of Immunoglobulin A levels. Moreover, inflammation persisted after a 4-week recovery period. The calculated threshold of reclaimed water exposure for mice was 31.8 Endotoxin Unit (EU)/(kg·day) under when exposed to 50% additional relative humidity from reclaimed water at 25°C for 2 hr/day. Meanwhile, the subchronic threshold estimate for humans under the same exposure conditions was found to be 12.2 EU/(kg·day), corresponding to endotoxin levels of 61.7 EU/mL in reclaimed water. The threshold level of endotoxin was lower than that in most non-potable reclaimed water. The findings of this study suggest that occupational exposure of reclaimed water can serve as a potential risk to workers.