Review of occupational exposure to severe acute respiratory syndrome coronavirus-2 in wastewater and its implications in the gulf region

Coronavirus disease-19 (COVID-19) is a viral disease caused by severe acute respiratory syndrome corona virus-2(SARS-CoV-2) that affects the respiratory system and causes varying symptoms including fever and cough. Throughout the current COVID-19 pandemic, several studies have confirmed that raw wastewater may contain the SARS-CoV-2 genome as the virus is shed from excreta of infected individuals. This review examined the literature from 2020 to 2023 on occupational health, safety, wastewater, and SARS-CoV-2, excluding clinical aspects. Relevant publications from previous epidemics (SARS-CoV-1 and Middle East respiratory syndrome coronavirus) were also considered. Quantitative microbial risk assessments have been used previously and in the current pandemic to assess the risk of inhaling aerosolized SARS-CoV-2 generated during the wastewater treatment processes. Meanwhile, water-based epidemiology (WBE) has been effective in identifying and tracking high incidence hotspots as well as mitigating the spread of the disease. Inefficient processes in wastewater treatment plants may be a source of SARS-CoV-2 transmission to workers employed at such plants as well as to personnel handling treated wastewater for reuse purposes such as irrigation and recreation, more so in the gulf countries owing to the extreme limitation of freshwater in this region; thus, exploring the implications of SARS-CoV-2 genome in wastewater to safeguard occupational and public health is crucial. WBE can assist in the pandemic prevention and control measures by investigating SARS-CoV-2 virus survival and transmission through the wastewater treatment and effective control measures. This review presents an overview of occupational exposure to SARS-CoV-2 from wastewater aerosols and elucidates its implications, while recommending preventive and mitigation measures.