The reuse of treated wastewater, whether direct or indirect, can raise public concerns as a result of the overall risk perception. As such, community acceptance plays a significant role in the implementation of alternative water systems. Public attitudes towards water reuse are highly influenced by perceived health risk, religious prohibition, political issues, and the degree of human contact with recycled water. In most of the Mediterranean countries, wastewater is reused to different extents either within planned or unplanned schemes. Unfortunately, there are few in-depth studies of the socio-cultural aspects of reuse projects in developing countries, and Lebanon is no exception. Accordingly, this research will comprehensively tackle the issue of public knowledge, perceptions, and acceptance from different perspectives in an effort to provide national baseline information on wastewater reuse that is needed for future regulatory and developmental projects. As such, a survey was developed, tested, and administered. Results showed an inverse relation between the degree of human contact with the treated wastewater and public acceptance. People were found to be more inclined towards reuse for purposes with minimal human contact such as landscaping and agriculture with opposition when it came to use for personal use. Moreover, the results showed a general lack of trust in governing institutions and authorities, which could explain perceived health risks and perceptions of risk resulting from system failure. Overall, the willingness to use treated wastewater was found to vary as a function of the "disgust factor," religious beliefs, and perceptions of a high risk towards contracting waterborne diseases. The disgust towards reuse of treated wastewater was found to be a strong predictor affecting willingness to reuse whereby those who believed it is disgusting to reuse treated wastewater were found to be on average, three times less likely to reuse treated wastewater as compared to those who did not declare disgust. Similarly, a significant association was found between religious beliefs and respondents' willingness to use treated wastewater. Interviewees who thought treated wastewater reuse is not religiously accepted were, on average, twice less likely to use treated wastewater as compared to those who did not believe that reuse contradicts with their religious beliefs. Additionally, people's perceptions on associating the spread of water-borne diseases with reuse were found to be significant. Those who perceived that reusing treated wastewater would lead to diseases and affect the human health, were on average, twice less likely to accept reuse. Developing a comprehensive strategy that integrates increasing awareness and knowledge, setting policies related to water reuse, building public trust and communication channels, increasing public participation/engagement in decision making, and developing a sustainable management framework is thus crucial before any investments are made in reclaimed water-reuse projects.
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