The presence of pathogenic bacteria, viruses, protozoa and helminth eggs in fecal wastewater poses significant public health risks. Untreated or inadequately treated effluent can contaminate drinking water sources, leading to outbreaks of cholera, dysentery and other enteric diseases. Moreover, the organic load can deplete dissolved oxygen in receiving waters, harming aquatic life, and the nutrients can cause eutrophication, promoting algal blooms and depleting oxygen further.
Wastewater treatment facilities mitigate these risks through a sequence of physical, chemical and biological processes. Primary treatment removes solids by sedimentation; secondary treatment uses aerobic or anaerobic biology to decompose organic matter; tertiary processes such as filtration, disinfection (chlorination, UV), or nutrient removal reduce pathogens and residual nutrients to levels acceptable for discharge or reuse. In many European countries, treated effluent may be reused for irrigation, industrial cooling or even surface water replenishment, whereas in poorer regions primary treatment may be absent and untreated wastewater is discharged directly into the environment.
Regulations in the European Union, guided by the Water Framework Directive and the Urban Waste Water Treatment Directive, set limits on biochemical oxygen demand, suspended solids and pathogen counts. Compliance monitoring is required for all sewers and treatment plants. The main challenges for many developing regions remain inadequate sewer infrastructure, limited financial resources for upgrades and the need to integrate sanitation with public health education.