RESUMO
Urban sewage production is increasing and its agronomical use as a fertiliser has been advocated. Considerable defiance is prevalent in consumers and among farmers on the use of such fertilisers due to unknown pathological or environmental risks. The aim of the present review was to consider which pathological risk is major. Cysticercosis due to Taenia saginata appears to be one of the major pathological threats when sewage sludge is used to fertilise cattle pastures in temperate areas. The situation is different in Africa (Taenia solium and T. saginata are both highly prevalent) and Asia (Taeniasaginata-like are prevalent). The processing of sludge and the delay between its application onto a pasture and grazing are probably major risk factors. Little data are available on the influence of processing, delay between processing and the use of sludge on the pathogenic risk. Producers and consumers will be more confident on the use of sludge if objective data are gained on risk. Most of the cases of cysticercosis (North America, United-Kingdom, Germany or Denmark) are related to poor human hygiene or accidental overflooding of sewage plants onto pastures. The standard application of sludge on pastures is apparently at low risk. This low risk does not mean that surveillance should cease since outbreaks of cysticercosis have been reported. Future investigations should concentrate on the most sustainable means of reducing risk (length of storage before use, composting, other treatments).