Health Services Utilisation and Urban Dual Reticulation Systems

K Leder
M Sinclair
J O'Toole

Funded by: CRC for Water Quality and Treatment

This study examined selected health outcomes of residents of an area supplied by a dual water reticulation system, and compared them to an otherwise similar area with a conventional reticulation system. The study was carried out in the Rouse Hill area of Sydney, which is the largest existing dual reticulation system in Australia with about 15,000 households occupied as of late 2004.

This project provided additional assurance of the safety of supplying recycled water for non-potable purposes. Output from this study is important given the proposed future scale of implementation of dual reticulation system in Australia whereby larger numbers of people hitherto unexposed, will be exposed to recycled water in the domestic and urban context. Recycled water is supplied to these homes for flushing toilets, watering gardens, washing cars and other outdoor uses.

The study was carried out in partnership with the Hawkesbury-Hills Division of General Practice which covers General Practitioners in the recycled water area and adjacent suburbs. Almost 36,000 patient records covering a two year period from eleven General Practices were examined to measure how commonly patients presented to their GP with acute gastroenteritis, acute skin complaints or acute respiratory conditions. All three medical conditions are plausibly related to exposure to pathogens or bacterial toxins in recycled water, if the water is not adequately treated. No significant difference in presentation rates for the three conditions was found between residents living in houses connected to the Rouse Hill Recycled Water Scheme, compared to residents from surrounding suburbs connected to the conventional water supply.


Health status of residents of an urban dual reticulation system
Sinclair, M., O'Toole, J., Forbes, A., Carr, D. and Leder, K. (2010) International Journal of Epidemiology, 39(6); 1667-1675.

Health Services Utilisation and Urban Dual Reticulation Systems. Research Report 81
Sinclair, M. O'Toole, J. Leder, K. Forbes, A. Carr, D. CRC for Water Quality and Treatment & Water Quality Research Australia