The use of wastewater and excreta in agriculture is a common practice in Southeast Asia; however, concerns remain about the potential public health risks of this practice. We undertook a scoping review to examine the extent, range, and nature of literature, as well as synthesize the evidence for associations between wastewater and excreta management practices and public health risks in Southeast Asia. Three electronic databases (PubMed, CAB Direct, and Web of Science) were searched and a total of 27 relevant studies were included and evaluated. The available evidence suggested that possible occupational health risks of wastewater and excreta management practices include diarrhea, skin infection, parasitic infection, bacterial infection, and epilepsy. Community members can be at risk for adverse health outcomes through consuming contaminated fish, vegetables, or fruits. Results suggested that practices including handling, treatment, and use of waste may be harmful to human health, particularly farmer’s health. Many studies in this review, however, had limitations including lack of gender analyses, exposure assessment, and longitudinal study designs. These findings suggest that more studies on identifying, quantitatively assessing, and mitigating health risks are needed if sustainable benefits are to be obtained from wastewater and excreta reuse in agriculture in Southeast Asia.

This article characterizes the health risk perceptions toward excreta and wastewater management practices among waste management stakeholders in Vietnam and explores the implications of such perceptions on hygiene behaviors and preventative actions. Key informant interviews (n = 19; 12 women and 7 men) were conducted with farmers, community leaders, researchers, and government representatives in Hanoi and Ha Nam Province. Interviews were audio-recorded with permission, transcribed, and analyzed using a constant comparative method and qualitative thematic analysis. Researchers and government representatives perceived that the lack of knowledge of safe waste management practices among farmers was responsible for the use of “outdated” and often “unsafe” waste management practices. However, many farmers were aware of the health risks and safe hygienic practices but felt that safety measures were impractical and viewed susceptibility to diseases as low risk. Farmers also identified unfavorable climate and working conditions, limited financial capacity, and limited farm space as barriers to adopting safe management practices. At the broader level, inadequate communication between ministries often led to the creation of inconsistent waste management regulations. These barriers create constraints on efforts to improve sustainable waste management practices. Promoting collaboration between sectors, encouraging farmer-to-farmer knowledge sharing, and designing and implementing risk communication strategies that account for risk perceptions of stakeholders are recommended.