Travel back to Ancient Rome and you’ll find the use of privy vaults and cesspools to contain waste. Water closets, known as toilets, were installed in the 19th century, but were not connected to any sewer system at that time. It soon became apparent, with the growing population, that cesspools were not equipped to handle such quantities of waste. Further, outbreaks of cholera in England claimed upwards of tens of thousands of lives due to contaminated water supply. Hence the birth of sewage systems to relieve cesspools and transfer waste to nearby bodies of water, but that led to a new problem: surface water pollution.
“The solution to pollution is dilution” was once the belief, but in densely populated areas dilution does not prevent pollution. In the late 19th and early 20th centuries, the construction of centralized sewage treatment plants began. This required all waste to pass through a combination of physical, biological and chemical processes before being released. Towards mid-20th century, broader and more stringent regulation of wastewater discharge was enforced, and wastewater treatment plants became large, complex facilities.
Today, wastewater treatment plants are available via package plants that expand with population demands and can be decentralized from city sewer systems. Wastewater treatment technology is so advanced that it is possible to remove virtually all pollutants from sewage to the point of reuse, even as drinking water!
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Reference: Nathanson, Jerry & Ambulkar, Archis. (The Encyclopedia Britannica). Wastewater Treatment. Retrieved from https://www.britannica.com/technology/wastewater-treatment