Volume 8, Issue 4 (December 2023)
J Environ Health Sustain Dev 2023, 8(4): 2139-2148 |
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Ethics code: IR.SSU.SPH.REC.1399.156
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Rahaei Z, Ghaneian M T, Hasanzadeh Mohammadi F, Ehrampoush M H, Jambarsang S, Ghelmani S V. Public Acceptance of Water Reuse: Barriers and Facilitators in Yazd, Iran, in 2020. J Environ Health Sustain Dev 2023; 8 (4) :2139-2148
URL: http://jehsd.ssu.ac.ir/article-1-626-en.html
URL: http://jehsd.ssu.ac.ir/article-1-626-en.html
Zohreh Rahaei 
, Mohammad Taghi Ghaneian , Fatemeh Hasanzadeh Mohammadi * , Mohammad Hassan Ehrampoush , Sara Jambarsang , Seyyed Vahid Ghelmani
, Mohammad Taghi Ghaneian , Fatemeh Hasanzadeh Mohammadi * , Mohammad Hassan Ehrampoush , Sara Jambarsang , Seyyed Vahid Ghelmani
Environmental Sciences and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Table 1: Absolute and relative frequency distribution of demographic information
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Figure 2: Relative frequency distribution of answers to acceptance of water reuse questions.
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Figure 3: Relative frequency distribution of answers to facilitators of water reuse questions.
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Figure 4: Relative frequency distribution of answers to barriers of water reuse questions.
Table 2: The mean and standard deviation of knowledge, acceptance, facilitators, and barriers of water reuse
Table 3: Correlation coefficient of awareness score, acceptance, facilitators, and barriers of water reuse
Full-Text: (55 Views)
Public Acceptance of Water Reuse: Barriers and Facilitators in Yazd, Iran, in 2020
Zohreh Rahaei 1, Mohammad Taghi Ghaneian 2, Fatemeh Hasanzadeh Mohammadi 2*, Mohammad Hassan Ehrampoush 2, Sara Jambarsang 3, Seyyed Vahid Ghelmani 4
1 Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2 Environmental Sciences and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
3 Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4 Director of Water and Sewerage Affairs of Region One, Yazd, Iran.
Zohreh Rahaei 1, Mohammad Taghi Ghaneian 2, Fatemeh Hasanzadeh Mohammadi 2*, Mohammad Hassan Ehrampoush 2, Sara Jambarsang 3, Seyyed Vahid Ghelmani 4
1 Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2 Environmental Sciences and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
3 Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4 Director of Water and Sewerage Affairs of Region One, Yazd, Iran.
| A R T I C L E I N F O | ABSTRACT | |
| ORIGINAL ARTICLE | Introduction: Droughts and precipitation imbalances in various parts of the world have underscored the significance of alternative water resources. In recent years, recycled water has emerged as a viable alternative, with wastewater being treated to a safe level for diverse purposes. However, the public acceptance of water reuse plays a pivotal role in determining the success of recycling initiatives. This study aims to identify the barriers and facilitators influencing public acceptance of water reuse in Yazd, Iran, during 2020. Material and Methods: A cross-sectional study involving 384 individuals in Yazd city during 2020 was conducted. Participants were selected using the stratified sampling method. The data collection tool was a researcher-made questionnaire. Data were analyzed using descriptive statistics and the Pearson correlation test in SPSS software version 23. Results: The most crucial facilitator for acceptance was the concept of segregating drinking water and recycled water networks. The primary barrier to acceptance was the perceived risk of recycled water contamination and potential health hazards. Water reuse was most widely accepted for construction purposes, followed by toilet flush tanks and irrigation of green spaces in parks and sports fields. A positive correlation (r = 0.416) existed between facilitators and acceptance of water reuse, indicating that enhancing facilitators positively affected acceptance. Conclusion: To successfully implement water reuse projects, it is essential to consider key facilitators such as segregated water systems for different household uses, raising public awareness about the benefits of water reuse, and building public trust in recycled water safety. |
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Article History: Received: 05 August 2023 Accepted: 20 October 2023 |
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*Corresponding Author: Fatemeh Hasanzadeh Mohammadi Email: hasanzadeh.fajr313@gmail.com Tel: +98 910 3242661 |
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Keywords: Attitude, Public Health, Wastewater, Yazd City. |
Citation: Rahaei Z, Ghaneian MT, Hasanzadeh Mohammadi F, et al. Public Acceptance of Water Reuse: Barriers and Facilitators in Yazd, Iran, in 2020. J Environ Health Sustain Dev. 2023; 8(4): 2139-48.
Introduction
In recent decades, increasing water demand, drought, and precipitation imbalances in different parts of the world have highlighted the importance of alternative water sources 1. Recycled water is potential source of water and research studies have demonstrated that wastewater can be treated to a level that is safe even for human consumption 2. However, in many jurisdictions public acceptance represents an obstacle to the introduction of these schemes 3.
Today, water shortage in Iran is considered a significant problem. According to the Falcon Mark classification, 1700 cubic meters per year per person is the limit of water stress, and levels less than 1000 cubic meters are contemplated as a critical condition; however, many of the central and eastern catchments of Iran are observed to be in this condition. Falcon Mark has presented another index called Water Crowding Index (WCI), which represents the number of inhabitants per million cubic meters of renewable water resources 4. The index values between 600 and 1000 indicate water stress, between 1000 and 2000 show absolute water scarcity, and above 2000 indicate water as a barrier to growth and development. Considering the average renewable water resources (89 billion cubic meters per year) of the country in the last 15 years and the population of the census in 2016 (80 million people), the WCI index was about 900 for Iran in 2016, which is at the limit of water stress. Considering the population projection of 148 million people by 2041 (Ministry of Energy, 2015) and assuming no reduction in renewable water resources in the future, despite the negative effects of climate change on water resources, this index would reach 1200 by that year, which is considered an absolute water scarcity. Also, the values are higher than the average in the arid regions of the country 5.
Yazd province is one of the arid, semi-arid, and desert regions of the country, in terms of water resources; therefore, this region is facing water quality and quantity limitations and critical conditions. The annual precipitation in this province is reported to be 50 to 60 mm, which is almost a quarter of the average levels in the country. Therefore, providing water resources is vital for this province, and in such circumstances, water reuse is one of the helpful methods to overcome the problem of water scarcity 6. Previous studies have shown that public acceptance of water reuse is a key factor in determining the success of water reuse projects, and regardless of the scientific and engineering considerations, public opposition has the potential of failing water reuse projects, before, during, or after their implementation 7, 8. Public acceptance of recycled water is currently the most important success factor for any water reuse project. In fact, water reuse projects usually require the cooperation of engineers and sociologists in order to analyze the social aspects and possible cultural barriers to project implementation, and to propose solutions while studying technical parameters 9. Water reuse projects may face public opposition due to various reasons, including prejudice, fear, attitudes, lack of knowledge, and public distrust 1,8,10. Understanding the benefits of reuse, satisfaction with the physical quality of the effluent, knowledge regarding the system, perceived trust and control, knowledge of water scarcity, and previous experiences in using alternative water resources are among the important criteria in accepting water reuse 11, 12. Different studies have shown that promoting public understanding is critical to improve the success of water reuse projects 13.
Yazd province is one of the desert regions of Iran with limited water resources, and water reuse is one of the methods to overcome the problem of water scarcity. Moreover, public acceptance of water reuse in different regions, with distinct cultural and climatic differences, is of great importance, and limited studies have been conducted on the barriers and facilitators of public acceptance of water reuse in Yazd.
Accepting water reuse projects is associated with many barriers and facilitators, and recognizing them and planning to strengthen the facilitators or remove the barriers can lead to an increment of public acceptance. During the past few years, due to the limitation of water resources, various reuse projects have been started in the field of agriculture and industry, such as Karizboom project of Kausar Yazd Institute in the city of Yazd.
Therefore, considering the importance of water reuse projects, this study was conducted with the aim of identifying the barriers and facilitators of public acceptance of water reuse in Yazd city in 2020.
Materials and Methods
This cross-sectional study was carried out on 384 people in Yazd city in 2020, which were selected using the stratified sampling method (Figure 1). The sample size was determined based on the assumption of 50% acceptance with water reuse (p = 0.5), (d = 0.1), (α = 0.05), and test power at the level of 20%.
Due to the prevalence of COVID-19 in the community, an online questionnaire was prepared. Then, the contact numbers of some water network consumers were randomly selected and the questionnaires were distributed among people of Yazd city through WhatsApp social network. The inclusion criteria were people aged over 18 years with a smartphone. Data collection tool was a five-part researcher-made questionnaire, including demographic information, knowledge regarding water and wastewater, acceptance, barriers, and facilitators of public acceptance of water reuse. The validity of the questionnaire was confirmed by the panel of experts and the reliability was confirmed by retesting and calculating Cronbach's alpha. Data were analyzed using descriptive statistics and the Pearson correlation test in SPSS software version 23.
In recent decades, increasing water demand, drought, and precipitation imbalances in different parts of the world have highlighted the importance of alternative water sources 1. Recycled water is potential source of water and research studies have demonstrated that wastewater can be treated to a level that is safe even for human consumption 2. However, in many jurisdictions public acceptance represents an obstacle to the introduction of these schemes 3.
Today, water shortage in Iran is considered a significant problem. According to the Falcon Mark classification, 1700 cubic meters per year per person is the limit of water stress, and levels less than 1000 cubic meters are contemplated as a critical condition; however, many of the central and eastern catchments of Iran are observed to be in this condition. Falcon Mark has presented another index called Water Crowding Index (WCI), which represents the number of inhabitants per million cubic meters of renewable water resources 4. The index values between 600 and 1000 indicate water stress, between 1000 and 2000 show absolute water scarcity, and above 2000 indicate water as a barrier to growth and development. Considering the average renewable water resources (89 billion cubic meters per year) of the country in the last 15 years and the population of the census in 2016 (80 million people), the WCI index was about 900 for Iran in 2016, which is at the limit of water stress. Considering the population projection of 148 million people by 2041 (Ministry of Energy, 2015) and assuming no reduction in renewable water resources in the future, despite the negative effects of climate change on water resources, this index would reach 1200 by that year, which is considered an absolute water scarcity. Also, the values are higher than the average in the arid regions of the country 5.
Yazd province is one of the arid, semi-arid, and desert regions of the country, in terms of water resources; therefore, this region is facing water quality and quantity limitations and critical conditions. The annual precipitation in this province is reported to be 50 to 60 mm, which is almost a quarter of the average levels in the country. Therefore, providing water resources is vital for this province, and in such circumstances, water reuse is one of the helpful methods to overcome the problem of water scarcity 6. Previous studies have shown that public acceptance of water reuse is a key factor in determining the success of water reuse projects, and regardless of the scientific and engineering considerations, public opposition has the potential of failing water reuse projects, before, during, or after their implementation 7, 8. Public acceptance of recycled water is currently the most important success factor for any water reuse project. In fact, water reuse projects usually require the cooperation of engineers and sociologists in order to analyze the social aspects and possible cultural barriers to project implementation, and to propose solutions while studying technical parameters 9. Water reuse projects may face public opposition due to various reasons, including prejudice, fear, attitudes, lack of knowledge, and public distrust 1,8,10. Understanding the benefits of reuse, satisfaction with the physical quality of the effluent, knowledge regarding the system, perceived trust and control, knowledge of water scarcity, and previous experiences in using alternative water resources are among the important criteria in accepting water reuse 11, 12. Different studies have shown that promoting public understanding is critical to improve the success of water reuse projects 13.
Yazd province is one of the desert regions of Iran with limited water resources, and water reuse is one of the methods to overcome the problem of water scarcity. Moreover, public acceptance of water reuse in different regions, with distinct cultural and climatic differences, is of great importance, and limited studies have been conducted on the barriers and facilitators of public acceptance of water reuse in Yazd.
Accepting water reuse projects is associated with many barriers and facilitators, and recognizing them and planning to strengthen the facilitators or remove the barriers can lead to an increment of public acceptance. During the past few years, due to the limitation of water resources, various reuse projects have been started in the field of agriculture and industry, such as Karizboom project of Kausar Yazd Institute in the city of Yazd.
Therefore, considering the importance of water reuse projects, this study was conducted with the aim of identifying the barriers and facilitators of public acceptance of water reuse in Yazd city in 2020.
Materials and Methods
This cross-sectional study was carried out on 384 people in Yazd city in 2020, which were selected using the stratified sampling method (Figure 1). The sample size was determined based on the assumption of 50% acceptance with water reuse (p = 0.5), (d = 0.1), (α = 0.05), and test power at the level of 20%.
Due to the prevalence of COVID-19 in the community, an online questionnaire was prepared. Then, the contact numbers of some water network consumers were randomly selected and the questionnaires were distributed among people of Yazd city through WhatsApp social network. The inclusion criteria were people aged over 18 years with a smartphone. Data collection tool was a five-part researcher-made questionnaire, including demographic information, knowledge regarding water and wastewater, acceptance, barriers, and facilitators of public acceptance of water reuse. The validity of the questionnaire was confirmed by the panel of experts and the reliability was confirmed by retesting and calculating Cronbach's alpha. Data were analyzed using descriptive statistics and the Pearson correlation test in SPSS software version 23.
.PNG)
Results
In this study, 52.6% of the participants were male, 71.4% were married, and 37% were office workers. Moreover, 59.9% of the participants had no information about recycled water, and radio and television, with 24.2% frequency, were the most important sources of information about recycled water (Table 1).
Figure 2 reveals that the highest acceptance of water reuse is related to construction (72.4%), toilet flash tanks (71.9%), and irrigation of green spaces of parks and sports fields (66.7%).
Regarding the facilitators, the most important facilitator (74%) was “segregation of drinking water and recycled water networks" at home (Figure 3).
In this study, 52.6% of the participants were male, 71.4% were married, and 37% were office workers. Moreover, 59.9% of the participants had no information about recycled water, and radio and television, with 24.2% frequency, were the most important sources of information about recycled water (Table 1).
Figure 2 reveals that the highest acceptance of water reuse is related to construction (72.4%), toilet flash tanks (71.9%), and irrigation of green spaces of parks and sports fields (66.7%).
Regarding the facilitators, the most important facilitator (74%) was “segregation of drinking water and recycled water networks" at home (Figure 3).
Table 1: Absolute and relative frequency distribution of demographic information
| Variable Options | Frequency (n=384) | Percentage | |
| Gender | Male | 202 | 52.6 |
| Female | 182 | 47.4 | |
| Marital status | Single | 110 | 28.6 |
| Married | 274 | 71.4 | |
| Level of education | High school | 35 | 9.1 |
| Diploma | 89 | 23.2 | |
| Bachelor | 169 | 44 | |
| M.A | 73 | 19 | |
| Ph.D. | 18 | 4.7 | |
| Occupation | Worker | 42 | 10.9 |
| Office worker | 142 | 37 | |
| Self-employed | 73 | 19 | |
| Housewife/househusband | 71 | 18.5 | |
| Unemployed | 56 | 14.6 | |
| Residence status | Apartment | 101 | 26.3 |
| Freestanding house | 283 | 73.7 | |
| Have you ever received information about the use of recycled water? | Yes | 154 | 40.1 |
| No | 230 | 59.9 | |
| If yes, from what source? (You can choose up to 4 options) | Book | 44 | 11.5 |
| Internet | 88 | 22.9 | |
| Radio/television | 93 | 24.2 | |
| Friends | 50 | 13 | |
| Other | 79 | 20.6 | |
| Which wastewater subscriber are you? | Having a branch | 130 | 33.9 |
| Pre-purchase | 36 | 9.4 | |
| No branch | 218 | 56.8 | |
Figure 2: Relative frequency distribution of answers to acceptance of water reuse questions.
Figure 3: Relative frequency distribution of answers to facilitators of water reuse questions.
The most important barrier (65.9%) was related to "the possibility of recycled water contamination and endangering health" (Figure 4).
The status of range, mean, and standard deviation of the studied components are shown in Table 2.
The highest and lowest mean percentages of the maximum scores were related to facilitators and awareness, respectively.
The status of range, mean, and standard deviation of the studied components are shown in Table 2.
The highest and lowest mean percentages of the maximum scores were related to facilitators and awareness, respectively.
Figure 4: Relative frequency distribution of answers to barriers of water reuse questions.
Table 2: The mean and standard deviation of knowledge, acceptance, facilitators, and barriers of water reuse
| Variable | Mean ± standard deviation | Score range | Mean percentage of the maximum score | Maximum | Minimum |
| Knowledge | 3.26 ± 1.59 | 0-6 | 54.33 | 6 | 0 |
| Acceptance | 33.85 ± 5.98 | 17-51 | 66.37 | 49 | 17 |
| Facilitators | 29.06 ± 4.57 | 12-36 | 80.72 | 36 | 14 |
| Barriers | 21.78 ± 4.74 | 10-30 | 72.6 | 30 | 10 |
Among the studied variables, the acceptance correlation was only significantly positive with water reuse facilitators, so that by increasing facilitators, water reuse acceptance increased (Table 3).
Table 3: Correlation coefficient of awareness score, acceptance, facilitators, and barriers of water reuse
| Awareness | Acceptance | Facilitators | Barriers | ||
| Awareness | The correlation coefficient | 1 | -0.038 | 0.027 | 0. 244* |
| P-value | 0.461 | 0.602 | 0.000 | ||
| Acceptance | The correlation coefficient | -0.038 | 1 | 0.416* | -0.067 |
| P-value | 0.461 | 0.000 | 0.188 | ||
| Facilitators | The correlation coefficient | 0.027 | 0.416* | 1 | -0.143* |
| P-value | 0.602 | 0.000 | 0.005 | ||
| Barriers | The correlation coefficient | 0.244* | -0.067 | -0.143* | 1 |
| P-value | 0.000 | 0.188 | 0.005 | ||
• Significant at the level of 0.01.
Discussion
New policies to provide water resources that meet the growing needs of the population include recycling and reusing non-conventional water resources. Given that the end product of these processes is directly related to the consumer, its social acceptance plays an important role in the success of water reuse projects 14. Thus, the present study aimed to investigate the barriers and facilitators of public acceptance of water reuse in Yazd, Iran, in 2020.
The acceptance rate of water reuse was reported to be at a moderate level (66.37%), which is consistent with the study by Baghapour et al. which demonstrated a 60% acceptance rate 1. Most of the participants agreed to use recycled water for construction, toilet flush tanks, and irrigation of green spaces in parks, and sports fields. Given the high acceptance of the participants regarding the use of recycled water for construction and irrigation purposes, it is recommended to declare that the use of public drinking water systems for construction and irrigation of green spaces is illegal, and citizens should be informed that they must purchase recycled water for such purposes.
In the study by Baghapour et al. 1, the maximum acceptance rate was related to the use of treated wastewater for general consumption, car washing, and toilet flash tanks. In the study by Buyukkamaci and Alkan 15, the maximum acceptance was related to water reuse for toilet washing, road cleaning, construction, and firefighting systems. In the study by Gu et al. 12, most people tended to use recycled water for toilet flush tanks, road cleaning, environmental purposes, firefighting, and car washing. In the study by Msaki et al. 16, the maximum acceptance rate was related to the use of treated wastewater for irrigation of sports fields, urban gardens, forests, and farms. In the study by Akpan et al. 17, citizens preferred to use treated wastewater for purposes that are less in contact with humans, such as toilet flush tanks, power generation, construction, and car washing.
In the present study, the acceptance rate of recycled water was lower for drinking and purposes that are in contact with humans, which is consistent with other studies 16-20.
The mean acceptance score of people living in apartments was significantly higher than people living in freestanding houses, which could be due to low water pressure in apartments and higher understanding regarding the importance of water.
The most important facilitators were observed to be the segregation of drinking water and recycled water networks, compensation of water shortages in Yazd, reduction of drought, and lower price of recycled water compared to drinking water.
By creating separate piping systems for drinking and recycled water, and increasing public knowledge regarding the benefits of water reuse, such as managing water scarcity and its impact on reducing drought, the acceptance rate increases. It is noteworthy that people want different water prices based on water quality. Among the facilitators, knowledge of wastewater treatment technology and methods was more important than an expert's explanation about the safety of using recycled water. This indicates that people want to increase their knowledge about water and wastewater issues. Therefore, the first step in increasing people's acceptance of the use of recycled water is to clarify the trends and express the related issues in a simple and understandable manner, since many people do not accept the opinions of experts and officials without appropriate reasoning.
In the study by Scruggs et al. 21, managing water scarcity was the most important factor affecting the general acceptance of using treated wastewater. In the study by Nkhoma et al. 22, public trust in delivery agents was the most important factor affecting the general acceptance of using treated wastewater. Also, Jeuland 23 examined the challenges of wastewater reuse in the Middle East and North Africa, and their results showed that mixing recycled water with drinking water resources, reusing water with the condition of segregating recycled water for specific purposes, and knowledge about the effectiveness of successful water reuse policies, are among the facilitators of water reuse. In the study by Verhoest et al. 24, water conservation behavior and a sense of environmental group-efficacy positively affect public acceptance.
The most important barriers included the possibility of contamination of recycled water and the inducement of health problems, the possibility of food poisoning irrigated with recycled water, and having concerns about the color and smell of recycled water, which are in line with other studies in this field 22, 25-27. These results indicated that for increasing the success rate of water reuse projects, honest transparency from experts and officials is required, and the quality of recycled water and the health of the community must be guaranteed.
In the study by Verhoest et al. 24, feelings of disgust and fear of contamination are key drivers of consumer resistance to water reuse. In the study by Rossum 18, the most important barrier to water reuse was having concerns about the presence of chemicals, such as drugs, in the effluent. In the study by Akpan et al. 17, citizens accepted water reuse, subject to the approval of doctors, experts, and university professors.
Out of the total participants, 54.33% had appropriate knowledge regarding the issue; however, Glick et al. 26 reported the lack of public knowledge about water reuse, which is not in line with the results of the present study. According to the results, the level of knowledge increases by increasing the level of education, which indicates the importance of education and increasing the level of knowledge of individuals through educational programs. Also, there was a significant relationship between age and mean knowledge score, thus the age group of 40-51 years had a comparably high level of knowledge, since they were educated and experienced.
Conclusion
One of the basic solutions to solve the issue of water stress and to meet the water needs of the growing population of the world, especially in arid areas, is water reuse. Public acceptance of water reuse is a key factor in the success of water reuse projects. In water reuse projects, failure to meet the people's demands can lead to the rejection of the project, and re-designing the project requires spending more time and money.
Acceptance of water recycling faces many barriers and facilitators, and proper identification and planning can lead to the strengthening of facilitators, removing barriers, and consecutively, increasing the acceptance of people. Knowledge level and acceptance of citizens regarding water reuse were moderate. The most important facilitator for water reuse was the segregation of drinking and recycled water networks, and the most important barrier was the possibility of contamination of recycled water and the inducement of health problems. Most of the subjects accepted to implement recycled water in construction, toilet flash tanks, and irrigation of green spaces in parks and sports fields. Given the high acceptance of the subjects regarding water reuse for construction and irrigation of green spaces, it is recommended to declare that the use of public drinking water systems for construction and irrigation of green spaces is illegal, and citizens should be informed that they must purchase recycled water for such purposes.
Facilitators, such as water segregation for different household purposes, public knowledge of the benefits of water reuse, and building public trust must be considered to successfully implement water reuse projects. Globally, the public acceptance of water reuse can be increased by strengthening facilitators. The most important barrier to water reuse was health concerns and problems caused by water reuse, which are related to the economic and technical aspects of wastewater recycling. The cost of processing and distributing technologies and systems required for this purpose should be reasonable and people should be assured that the quality of the recycled water, for each specific purpose, is in accordance with the standards, and their health is not threatened.
Acknowledgment
The authors would like to thank Shahid Sadoughi University of Medical Sciences and Yazd Water and Wastewater Company.
Funding
This study was supported by the School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran and Yazd Water and Wastewater Company.
Conflict of interests
The authors declare that there is no conflict of interest.
Ethical Considerations
In order to comply with ethical considerations, the purpose of the study and the nature of the investigation were explained to the subjects, and the necessary coordination was made with the relevant authorities, and the subjects were assured of the confidentiality of the information.
Code of Ethics
This study was authorized by Shahid Sadoughi University of Medical Sciences Ethics Committee IR.SSU.SPH.REC.1399.156.
Authors' Contributions
All authors contributed to the study conception and design. Data collection and analysis were performed by Fatemeh Hasanzadeh Mohammadi, Zohreh Rahaei and Sara Jambarsang. The first draft of the manuscript was written by Fatemeh Hasanzadeh Mohammadi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
This is an Open-Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work for commercial use.
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25. Li L, Liu X, Zhang X. Public attention and sentiment of recycled water: Evidence from social media text mining in China. J Clean Prod. 2021;303:126814.
26. Glick D, Goldfarb J, Heiger-Bernays W, et al. Public knowledge, contaminant concerns, and support for recycled Water in the United States. Resour Conserv Recycl. 2019;150:104419.
27. Alhumoud J, Madzikanda D. Public perceptions on water reuse options: the case of sulaibiya wastewater treatment plant in Kuwait. International Business & Economics Research Journal. 2010;9(1):141-58.
New policies to provide water resources that meet the growing needs of the population include recycling and reusing non-conventional water resources. Given that the end product of these processes is directly related to the consumer, its social acceptance plays an important role in the success of water reuse projects 14. Thus, the present study aimed to investigate the barriers and facilitators of public acceptance of water reuse in Yazd, Iran, in 2020.
The acceptance rate of water reuse was reported to be at a moderate level (66.37%), which is consistent with the study by Baghapour et al. which demonstrated a 60% acceptance rate 1. Most of the participants agreed to use recycled water for construction, toilet flush tanks, and irrigation of green spaces in parks, and sports fields. Given the high acceptance of the participants regarding the use of recycled water for construction and irrigation purposes, it is recommended to declare that the use of public drinking water systems for construction and irrigation of green spaces is illegal, and citizens should be informed that they must purchase recycled water for such purposes.
In the study by Baghapour et al. 1, the maximum acceptance rate was related to the use of treated wastewater for general consumption, car washing, and toilet flash tanks. In the study by Buyukkamaci and Alkan 15, the maximum acceptance was related to water reuse for toilet washing, road cleaning, construction, and firefighting systems. In the study by Gu et al. 12, most people tended to use recycled water for toilet flush tanks, road cleaning, environmental purposes, firefighting, and car washing. In the study by Msaki et al. 16, the maximum acceptance rate was related to the use of treated wastewater for irrigation of sports fields, urban gardens, forests, and farms. In the study by Akpan et al. 17, citizens preferred to use treated wastewater for purposes that are less in contact with humans, such as toilet flush tanks, power generation, construction, and car washing.
In the present study, the acceptance rate of recycled water was lower for drinking and purposes that are in contact with humans, which is consistent with other studies 16-20.
The mean acceptance score of people living in apartments was significantly higher than people living in freestanding houses, which could be due to low water pressure in apartments and higher understanding regarding the importance of water.
The most important facilitators were observed to be the segregation of drinking water and recycled water networks, compensation of water shortages in Yazd, reduction of drought, and lower price of recycled water compared to drinking water.
By creating separate piping systems for drinking and recycled water, and increasing public knowledge regarding the benefits of water reuse, such as managing water scarcity and its impact on reducing drought, the acceptance rate increases. It is noteworthy that people want different water prices based on water quality. Among the facilitators, knowledge of wastewater treatment technology and methods was more important than an expert's explanation about the safety of using recycled water. This indicates that people want to increase their knowledge about water and wastewater issues. Therefore, the first step in increasing people's acceptance of the use of recycled water is to clarify the trends and express the related issues in a simple and understandable manner, since many people do not accept the opinions of experts and officials without appropriate reasoning.
In the study by Scruggs et al. 21, managing water scarcity was the most important factor affecting the general acceptance of using treated wastewater. In the study by Nkhoma et al. 22, public trust in delivery agents was the most important factor affecting the general acceptance of using treated wastewater. Also, Jeuland 23 examined the challenges of wastewater reuse in the Middle East and North Africa, and their results showed that mixing recycled water with drinking water resources, reusing water with the condition of segregating recycled water for specific purposes, and knowledge about the effectiveness of successful water reuse policies, are among the facilitators of water reuse. In the study by Verhoest et al. 24, water conservation behavior and a sense of environmental group-efficacy positively affect public acceptance.
The most important barriers included the possibility of contamination of recycled water and the inducement of health problems, the possibility of food poisoning irrigated with recycled water, and having concerns about the color and smell of recycled water, which are in line with other studies in this field 22, 25-27. These results indicated that for increasing the success rate of water reuse projects, honest transparency from experts and officials is required, and the quality of recycled water and the health of the community must be guaranteed.
In the study by Verhoest et al. 24, feelings of disgust and fear of contamination are key drivers of consumer resistance to water reuse. In the study by Rossum 18, the most important barrier to water reuse was having concerns about the presence of chemicals, such as drugs, in the effluent. In the study by Akpan et al. 17, citizens accepted water reuse, subject to the approval of doctors, experts, and university professors.
Out of the total participants, 54.33% had appropriate knowledge regarding the issue; however, Glick et al. 26 reported the lack of public knowledge about water reuse, which is not in line with the results of the present study. According to the results, the level of knowledge increases by increasing the level of education, which indicates the importance of education and increasing the level of knowledge of individuals through educational programs. Also, there was a significant relationship between age and mean knowledge score, thus the age group of 40-51 years had a comparably high level of knowledge, since they were educated and experienced.
Conclusion
One of the basic solutions to solve the issue of water stress and to meet the water needs of the growing population of the world, especially in arid areas, is water reuse. Public acceptance of water reuse is a key factor in the success of water reuse projects. In water reuse projects, failure to meet the people's demands can lead to the rejection of the project, and re-designing the project requires spending more time and money.
Acceptance of water recycling faces many barriers and facilitators, and proper identification and planning can lead to the strengthening of facilitators, removing barriers, and consecutively, increasing the acceptance of people. Knowledge level and acceptance of citizens regarding water reuse were moderate. The most important facilitator for water reuse was the segregation of drinking and recycled water networks, and the most important barrier was the possibility of contamination of recycled water and the inducement of health problems. Most of the subjects accepted to implement recycled water in construction, toilet flash tanks, and irrigation of green spaces in parks and sports fields. Given the high acceptance of the subjects regarding water reuse for construction and irrigation of green spaces, it is recommended to declare that the use of public drinking water systems for construction and irrigation of green spaces is illegal, and citizens should be informed that they must purchase recycled water for such purposes.
Facilitators, such as water segregation for different household purposes, public knowledge of the benefits of water reuse, and building public trust must be considered to successfully implement water reuse projects. Globally, the public acceptance of water reuse can be increased by strengthening facilitators. The most important barrier to water reuse was health concerns and problems caused by water reuse, which are related to the economic and technical aspects of wastewater recycling. The cost of processing and distributing technologies and systems required for this purpose should be reasonable and people should be assured that the quality of the recycled water, for each specific purpose, is in accordance with the standards, and their health is not threatened.
Acknowledgment
The authors would like to thank Shahid Sadoughi University of Medical Sciences and Yazd Water and Wastewater Company.
Funding
This study was supported by the School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran and Yazd Water and Wastewater Company.
Conflict of interests
The authors declare that there is no conflict of interest.
Ethical Considerations
In order to comply with ethical considerations, the purpose of the study and the nature of the investigation were explained to the subjects, and the necessary coordination was made with the relevant authorities, and the subjects were assured of the confidentiality of the information.
Code of Ethics
This study was authorized by Shahid Sadoughi University of Medical Sciences Ethics Committee IR.SSU.SPH.REC.1399.156.
Authors' Contributions
All authors contributed to the study conception and design. Data collection and analysis were performed by Fatemeh Hasanzadeh Mohammadi, Zohreh Rahaei and Sara Jambarsang. The first draft of the manuscript was written by Fatemeh Hasanzadeh Mohammadi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
This is an Open-Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work for commercial use.
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Questionnaire
Demographic information
Gender: Male☐ Female☐
Age:
Number of household members: 1-3☐ 3-5☐ 5-8☐
Marital status: Single☐ Married☐
Level of education: High school☐ Diploma☐ Bachelor ☐ M.A☐ Ph.D ☐
Occupation:
Worker☐ Office worker☐ Self-employed☐ Housewife/househusband☐ Unemployed☐
Residence status: Apartment☐ Freestanding house ☐
Have you ever received information about the use of recycled water? Yes☐ No☐
If yes, from what source? (You can choose up to 4 options)
Book☐ Internet☐ Radio/television☐ Friends☐ Other☐
Which wastewater subscriber are you?
Having a branch☐ Pre-purchase☐ No branch☐
Demographic information
Gender: Male
Age:
Number of household members: 1-3
Marital status: Single
Level of education: High school
Occupation:
Worker
Residence status: Apartment
Have you ever received information about the use of recycled water? Yes
If yes, from what source? (You can choose up to 4 options)
Book
Which wastewater subscriber are you?
Having a branch
| Knowledge | |||
| Questions | Correct | Incorrect | I do not know |
| Yazd city water is supplied from well water and transfer water. | |||
| The majority of water consumption in Yazd belongs to industry and agriculture sector. | |||
| The city of Yazd does not have a municipal wastewater treatment plant. | |||
| From a scientific point of view, recycled water (purified sewage) can be used for various purposes. | |||
| Currently, in Yazd city, treated wastewater is not used to irrigate green spaces, etc. | |||
| In order to use recycled water (purified sewage) for different purposes, there are strict environmental and health standards. | |||
| Acceptance of water reuse | |||
| To what extent do you accept water reuse (treated wastewater) for the following? | Not at all | To some extent | A lot |
| Irrigation of agricultural products that are consumed raw | |||
| Irrigation of agricultural products that are consumed after cooking | |||
| Creating an artificial lake for sailing | |||
| Creating an artificial lake for swimming | |||
| Irrigation of green spaces of parks and sports fields | |||
| Fish farming pool | |||
| Firefighting | |||
| Car washing | |||
| Washing clothes | |||
| Toilet flash tank | |||
| Air conditioner and radiator | |||
| Cleaning street and yard | |||
| Cooking | |||
| Bathing | |||
| Drinking | |||
| For livestock and poultry consumption | |||
| Construction | |||
| Facilitators | |||
| Please specify to what extent each of the following makes it easier for you to use recycled water? | Not at all | To some extent | A lot |
| Water conservation | |||
| Reduction of drought | |||
| Management of water scarcity in Yazd | |||
| Reduction of dependence on transition water from other areas | |||
| Reduction of consumer fertilizer in agriculture using recycled water | |||
| Mixing recycled water with ordinary water | |||
| People in other cities and countries use recycled water | |||
| Ensure regular quality control of recycled water | |||
| Knowledge of wastewater treatment technology and methods | |||
| An expert explains that the use of recycled water is safe | |||
| Segregation of drinking water and recycled water at home | |||
| Lower price of recycled water than ordinary water | |||
| Barriers | |||
| Please specify to what extent any of the following can be an obstacle for you to reuse water? | Not at all | To some extent | A lot |
| Possibility of recycled water contamination and endangering health | |||
| Belief in the impurity of recycled water | |||
| Possibility of poisoning with food irrigated with recycled water | |||
| To be blamed | |||
| Lack of trust in the skills of wastewater treatment plant employees | |||
| Lack of trust in wastewater treatment technologies and systems | |||
| Uncertainty about recycled water quality | |||
| Concern about the color and smell of recycled water | |||
| Unpleasant water reuse | |||
| Difficult and costly separation of branch and piping |
Type of Study: Original articles |
Subject:
Water quality and wastewater treatment and reuse
Received: 2023/08/5 | Accepted: 2023/10/20 | Published: 2023/12/24
Received: 2023/08/5 | Accepted: 2023/10/20 | Published: 2023/12/24
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
