An Investigation into the Societal Attitudes and Acceptance of Treated Wastewater Reuse in an Area Experiencing Water Scarcity  

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AL-Rikabi, Salah L. Zubaidi, Sandra Ortega-Martorell, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5780361/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 18 Nov, 2025 Read the published version in Scientific Reports → Version 1 posted 8 You are reading this latest preprint version Abstract This study aimed to evaluate the public's perspective on the utilisation of reclaimed water in Al-Kut, Iraq. Accordingly, a survey consisting of multiple-choice questions was designed to gather demographic information and assess the participants' views and knowledge about water resources and wastewater reuse. The replies of 507 Iraqis, consisting of 326 males and 181 females, were analysed using a T, one-way analysis of variance (ANOVA), and Chi-square tests. The study's findings indicate that 90.6% of the people are conscious of the issue of water crisis problem, whereas the others 9.4% either deny its existence (6.6%) or are uncertain about it (2.8%). Based on the survey questions, a high percentage (about 41%) of respondents have no idea that there is a water crisis. Nevertheless, the majority (88%) of individuals are implementing strategies to preserve water and are open to incurring additional charges for the installation of centralised wastewater treatment plants in the area. Many individuals support the utilisation of reclaimed water for agricultural and industrial applications. The findings also indicated a statistically significant relationship between sex, income, and acceptance of wastewater reuse. Incentives for reusing treated wastewater and opposition against it were ranked by the respondents. Earth and environmental sciences/Environmental sciences Earth and environmental sciences/Environmental social sciences wastewater reuse public perception SDGs survey sustainability Iraq Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 1. Introduction The World Health Organisation and the United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation have determined that 1.8 billion people around the world are likely to consume water that is contaminated with human waste [ 1 ]. As suggested by Roson and Damania [ 2 ], the global accessibility of freshwater suitable for direct human consumption comprises a mere fraction, amounting to only 1/100th of the world's total freshwater reserves, which represent just 3% of the total water supply. This stark reality underscores the significant mismatch between available resources and the burgeoning demand from human populations. By 2030, it is projected that the number of individuals experiencing serious shortages of water will increase twofold, reaching around 1.6 billion people, which accounts for over a quarter of the global population. Multiple investigations, for example, Smith, et al. [ 3 ], Michetti, et al. [ 4 ], and Mu’azu, et al. [ 5 ], have indicated that urbanisation, industrialisation, water pollution caused by people, rapid population increase, and overuse of freshwater resources are all factors that contribute to the increase of water stress. Hence, effective and sustainable strategies to address the increasing demand for freshwater necessitate the implementation of appropriate methodologies and proactive measures by the relevant parties. Water scarcity is a real problem, and one way to fix it is to supplement existing supplies with water from unconventional sources [ 6 ]. Wastewater recycling emerges as a promising solution to global freshwater challenges, as evidenced by its adoption by numerous nations [ 7 – 9 ]. By reducing sewage disposal, recovering freshwater from wastewater, and reusing it for municipal applications, this sustainable waste management strategy significantly contributes to the circular economy (CE) goals of resource recovery, zero waste, and reducing environmental pollution [ 10 – 12 ]. Recycled water is regarded as a viable alternative because research studies have demonstrated that wastewater may be sufficiently treated to ensure its safety for consumption [13–15]. Governments' consideration of wastewater reuse reflects a strategic approach to bolstering freshwater resources [16]. Yue, et al. [ 17 ] stated that wastewater reuse (WWR) is currently recognised as an essential element of Integrated Water Resources Management (IWRM). WWR is of utmost importance for several areas, including agriculture, industry, urban development, domestic reuse, potable water supply, and others, as it has been emphasised by several studies [16]. Insufficient freshwater is a prevalent issue in nine Middle Eastern countries, including Iraq [ 18 ]. Furthermore, Iraq, a developing nation located in a semi-arid to dry region, is one of the Middle Eastern countries most vulnerable to the impacts of climate change [ 19 ]. Several causes, including global warming, the oil sector growth, increasing urbanisation, and the region's already rapid population expansion, contribute to the region's existing water scarcity [ 20 ]. The majority of Iraq's freshwater is provided by the Euphrates and Tigris Rivers, where many storage dams have been constructed [21]. From 2009 to 2014, there was a severe water shortage in both rivers. The issue at hand will get worse due to climate change and the escalating water requirements from upstream nations such as Syria, Iran, and Turkey [ 22 ]. Salman, et al. [ 23 ] projected multiple methods and scenarios indicating a probable rise in temperatures across Iraq, alongside a negative impact on future rainfall in terms of both pattern and quantity [ 24 ]. Furthermore, Ewaid, et al. [ 25 ] highlighted that several studies have examined the quality of freshwater in Iraq, revealing an increase in various contaminants [26–28]. In addition, the water management of the rivers had adverse consequences following the terrorist attacks on many barrages and dams in Iraq after 2003 [29]. The research will be focused on Al-Kut City, which is the capital of Wasit Governorate. For the most part, the freshwater supply is provided by the Tigris River and its branches. One of the governorates' claims to fame is its pioneering work in growing strategic crops. The high rate of agricultural use depletes water resources. There is a severe water crisis due to its dependence on the Tigris River, which suffers from water scarcity. Also, Wasit is feeling the pinch of climate change in the form of rising temperatures and less precipitation. As per the data provided by the Ministry of Municipalities' Department of Sewerage, the City of Kut generates around 65,000 cubic metres of wastewater every day. Moreover, the government plans to establish central wastewater treatment plants in the region. Worldwide, the topic of wastewater reuse has been extensively discussed [ 30 , 31 ], and the degree of its acceptance varies widely. As an example, Al-Khatib, et al. [ 32 ] noted that there is a correlation between factors such as education, age, income, and sex, and the level of acceptance for using recycled water. Accordingly, Abdelrahman, et al. [33] studied the attitudes toward water reuse, and argued that emotions could facilitate the evaluation of complicated situations, significantly impacting both, attitude and behaviour. Attitudes can be evaluated via a model consisting of cognitive, behavioural, and emotional components. Cottrell [ 34 ] utilised the three-component attitude model to gain a deeper understanding of how emotions influence attitudes and behaviours. One potential barrier to the acceptance of wastewater reuse may be the deep-seated emotions that elicit negative attitudes toward water reuse [ 35 ]. Hence, it is crucial to get knowledge regarding the public's attitudes toward the concept of recycling treated wastewater to understand the emotional responses and individual differences associated with this subject. Utilising this data, campaigns promoting wastewater recycling should employ more precise targeting strategies to effectively reach the general community. The success of wastewater reuse facility development, building, and operation relies heavily on the public's attitudes, approval, and support. Various studies have investigated the contributing factor of public attitudes, encompassing variables such as sex, educational attainment, income level, cultural background, religious affiliation, health status, sources of information, and level of knowledge [36–38]. Studies like [ 39 – 41 ] indicate that both sexes find it acceptable to use treated wastewater for non-skin contact activities, such as flushing toilets, washing cars, and watering plants. Furthermore, according to Abdelrahman, et al. [33], regardless of the level of treatment, a large number of people are opposed to using recycled wastewater. However, as the application shifts from direct physical touch to indirect nonphysical contact, the resistance decreases. Several prior studies conducted on nations neighbouring Iraq yielded varying results regarding the acceptance of treated water reuse. In two investigations from Oman, respondents opposed using treated wastewater for direct contact. The first survey found that 64.5% of respondents would reuse treated wastewater for gardening and 42.7% for car cleaning [ 42 ]. The second study found that 64.2–78.7% of attendees were optimistic about using treated wastewater to irrigate non-edible crops, business landscapes, fire hydrants, cool buildings, golf courses, public parks, school grounds, toilet flushing, and car washing [ 43 ]. Moreover, another study from Palestine Al-Khatib, et al. [ 44 ] found that most respondents opposed using treated wastewater for direct contact. However, aquifer recharge and aquaculture were more accepted—38% and 42%, respectively. In a study conducted in the United Arab Emirates, Abdelrahman, et al. [33] found that a majority of the public (55%) expressed a preference for utilising treated wastewater for irrigating non-food crops. However, they tended to use it for irrigating food crops, with a rejection rate of 66%. According to another study, 76% of the public in the Muscat Governorate of Oman accepted the use of recycled wastewater for gardening, while 66% approved its use for toilet flushing and 53% approved its use for car washing [ 45 ]. A state-wide survey revealed that there was widespread concern among the population in Turkey regarding the possible health risks associated with the reuse of wastewater. Nevertheless, they consented to repurpose it for activities like flushing toilets and cleaning roads and buildings, which do not require direct interaction with humans [ 32 ]. Additional global investigations, such as Brazilian respondents Faria and Naval [ 46 ], use treated wastewater for indirect applications (watering plants and gardens, washing clothing, and cleaning), 98% and 74% for complete and incomplete higher education, respectively. Also, Over 50% of Tanzanian respondents approved of using treated wastewater in diverse applications, while 93% were opposed if it included direct water contact [ 47 ]. Furthermore, Li and Roy [ 48 ] mentioned that although conservation efforts and informational campaigns can help change people's minds about recycled water, many individuals are still unsure about how they feel about using it. Leong and Lebel [ 49 ] reported that numerous research have revealed that a multitude of factors contribute to this mistrust. These aspects encompass sociodemographic variables, community involvement, awareness levels, water availability and access, health concerns, and the water's intended usage. However, customers' attitudes and intentions to buy potable reuse water should improve as their perceived knowledge or experience with water reuse increases [ 50 ]. Mu’azu, et al. [ 5 ]stated that previous studies did not confirm the relationship between higher education levels and acceptance of treated wastewater. Some large-scale research in wealthy countries found no statistically significant association. In poorer countries, reuse acceptance decreases with education. In contrast, different studies on treated wastewater reuse show that better education increases acceptance. This research falls within the context of global efforts to achieve sustainable development, contributing to the Sustainable Development Goals (SDGs) adopted by the United Nations, particularly in the field of water resource management. The research examines the community's acceptance of reused water, which is closely linked to SDG 6, "Clean Water and Sanitation," which seeks to improve water management and reduce pollution through recycling and safe use of reused water. This research also supports SDG 11, "Sustainable Cities and Communities," by providing solutions that enhance the sustainability of urban water resources, reducing pressure on freshwater and contributing to improved sanitation infrastructure. Furthermore, the research aligns with SDG 13, "Climate Action," as reducing the consumption of freshwater resources through reuse can contribute to mitigating the effects of climate change and reducing the risk of drought. The research also supports the achievement of SDG 12, "Responsible Consumption and Production," by encouraging recycling policies and sustainable resource use, reducing water waste, and promoting responsible environmental practices. Accordingly, the findings of this research can provide a scientific framework that helps decision-makers develop more sustainable water management strategies, in line with the global Sustainable Development Goals. The primary aim of this study is to evaluate public acceptance and attitudes regarding using treated wastewater for different usages in Al-Kut City. So, the major objectives of this study were to: (1) Determine how well people understand the water scarcity issue. (2) Investigate how people of different ages, sexes, educational backgrounds, and income levels feel about using recycling wastewater for agricultural, commercial, and industrial purposes; and (3) Examine what motivates people to take advantage of wastewater reuse incentives and what stops them from expanding reclaimed water reuse. 2. Research Methodology 2.1. Collection of data A stated preference survey was developed and distributed to people in Al-Kut City, Iraq, to examine their attitudes and acceptance regarding the reuse of reclaimed water. This survey consists of 32 questions divided into five categories. The potential participants were randomly selected and they were initially asked about their willingness to be part of this study and answer the questions to ensure higher response accuracy. As such, the survey was only distributed to individuals who agreed to participate in this study. For the current study, we revised the questionnaire used by Abdelrahman, et al. [33]., incorporating new questions and removing the ones that are not relevant to Iraq (please see supplementary material). Between December 15, 2023, and March 14, 2024, a continuous period of three months was dedicated to conducting a survey. The survey was conducted using both Google Forms and printed copies to target seniors and retirees who were not familiar with digital platforms. Mechanism for randomly selecting participants, and distributing paper copies in different areas of the city to ensure choosing both Arab and Kurdish people. The representative sample consisted of 507 participants out of 1,000 participants, yielding a response rate of 50.7%. To ensure that the participants in the study accurately represented the study area, a minimum sample size was utilised. In their 2014 study, Dillman, et al. [ 51 ] formulated an equation to determine the most favourable sample size, as shown in Eq. ( 1 ): $$\:n=\frac{{z}^{2}\times\:p\times\:(1-p)}{{MoE}^{2}}$$ 1 Where: n = full sample size required to achieve target precision, p = the percentage under examination, MoE = the target margin of error for the sample, z = critical value for the desired confidence level. As the margin of error increases, the confidence level in the survey results decreases. Research that analyses survey data frequently uses a confidence level of 95%. Therefore, with a confidence level of 95%, the 𝑧-value is 1.96. Furthermore, the current investigation employs a conservative value of p that is evenly split 50/50. The margin of sampling error was ultimately established at 4.5. By substituting these numbers into Eq. ( 1 ), we find that a size of 475 is necessary for this inquiry. Therefore, the number of survey responses gathered for this inquiry, which was 507, surpassed the minimum requirement for a 95% confidence level. 2.2. Steady of area Al-Kut is located on the banks of the Tigris River in southern Iraq and is the capital of the Wasit Governorate [ 52 ] (Fig. 1 ). The metropolis is vast, covering an area of 17,153 square kilometers. Conversely, the urban area of Al-Kut spans approximately 40 square kilometers. Forecasts suggest that the population of the city will increase significantly to more than 750,000 by 2035, compared to 400,000 in 2003. Al-Kut is renowned for its agricultural prowess in wheat production [ 53 , 54 ]. The mean altitude between two longitudes (45° 54 / and 45 o 45 / ) east and two latitudes (32 o 21 / and 32 o 34 / ) north is approximately 20 meters [ 55 ]. The climate in Al-Kut City is characterised by agreeable seasons, with nice spring and autumn, frigid winters, and dry, hot summers. As per the Iraqi Meteorological Department, the winter season commences in November and lasts until March. The summer season spans the following seven months, often with June, July, and August experiencing their highest temperatures [54,56]. 2.3. Study instrument This study utilised a stated preference survey, as described in section 2.1 and supplementary material. The first section of the survey (questions 1–14) asked participants to provide details about themselves, including their demographic and other personal details. It is mainly based on multiple-choice and binary (Yes/No) or closed-category (multiple-choice) questions. Moreover, the 2nd section, encompassing questions 15–21, evaluated the respondents' attitudes and levels of knowledge of water resources and the recycling of wastewater. Except for question 18, it includes binary questions (Yes/No), and optional questions (such as the source of knowledge). Question 18, uses the Likert scale, where responders need to select from a range of multiple-choice options. Through the analysis of the data derived from these questions, we can evaluate its validity and dependability. Question 18 is designed to measure the extent to which individuals engage in water conservation practices in their households. On a three-point scale, you can choose between "always," "sometimes," and "never" to answer this question. Section three (questions 22–26) assessed individuals' attitudes towards the reuse of treated wastewater, the establishment of centralised wastewater treatment systems, and their confidence in the safety regulations for treated wastewater. It includes binary questions (Yes/No) like questions 23 and 26., and two Likert Scale types (5 points). Question 22 is designed on a five-point Likert Scale (from “I strongly agree” to “I strongly refuse”) to measure the extent to which individuals engage in using recycled wastewater for some purposes. Question 25 is designed on a five-point Likert Scale (from “Fully trust” to “Have no knowledge of it”) to measure the extent to which individuals trust the safety criteria of treated wastewater that you can use. Questions 27–30 (fourth section) required participants to assess their level of confidence in different applications of treated wastewater, as well as their justifications for accepting this usage. It measures respondents' confidence in the different applications of treated wastewater based on a four-point Likert Scale. Answers to these questions can be categorised as either "strongly support", "support", "do not support", or "do not know" on a four-point scale. The fifth section, questions 31 and 32, assessed the participants' views on the public's perceptions of the benefits and obstacles of reusing treated wastewater. These questions are based on ranking questions, which differ from the Likert scale. The “First” option goes to the most important followed by other options for the least important. Cronbach's alpha, which can be expressed as a value between 0 and 1, was used to determine the questionnaire's internal consistency. A test's reliability might be defined as the degree to which it consistently yields the expected results. A test's reliability can be expressed as a function of its item count and average inter-item correlation, which is known as Cronbach's Alpha[16]. The reliability of the questionnaire was evaluated using the Statistical Package for Social Science SPSS, Version 29, software. As the reliability value approaches 1, it indicates a lower level of error. For instance, when the reliability is 0.9, it means that, on average, the variables are 90% accurate with a 10% margin of error. The formula for Cronbach's alpha can be found in Eq. ( 2 ). A survey was given out to a sample of forty individuals to establish its reliability and validity. The questionnaire items 18, 27, 28, 29, and 30 were found to have reliability values of (α = 0.928) and validity of 0.963. $$\:\propto\:=\frac{N\stackrel{-}{c}}{\stackrel{-}{\upsilon\:}+\left(N-1\right)\stackrel{-}{c}}$$ 2 Where: α = Cronbach's alpha, N = number of items, \(\:\stackrel{-}{c}\) = the average interitem covariance, and υ = average variance 2.4. Analysis of data A statistical analysis was conducted to define the frequency distribution of the data and to test the study hypotheses. The SPSS, Version 29, was utilised for the preparation and testing process. The analysis of the participants' characteristics was conducted using frequency analysis. This analysis included their sex, ages, incomes, and educational levels. The relationship between sex and the utilisation of treated wastewater for various purposes was analysed using the T-test. An analysis was conducted to examine the correlation between confidence in wastewater reuse for various purposes and factors such as age, level of education, and income. The analysis employed the ANOVA test. The Chi-square technique was applied to analyse participants' viewpoints on the relative significance of several incentives for the public utilisation of reclaimed water, based on factors such as sex, age, education level, and income. An additional analysis was performed utilising the Chi-square technique to figure out the correlation between sex, age, education level, income, and the public's assessment of the obstacles to reusing treated wastewater. Table 1 presents the demographic characteristics of the 507 respondents. 2.5 Ethics Statement: Before asking the participants in this study about their opinions, the purpose of the questionnaire was clearly explained, and they were asked about their willingness to participate in the survey. Accordingly, this study only asked participants who were willing to participate in the questionnaire. Plus, they were informed that written informed consent is required, and the anonymity of their responses is assured. As such, the study is completed only after receiving the assent from the participants. It is crucial to note that this study adhered to the ethical principles outlined in the Declaration of Helsinki, and all procedures for conducting the questionnaire that involved human participants were approved by the Institutional Review Board of the University of Wasit, Iraq. 3. Results and discussion Understanding public attitudes and acceptance of recycled water is crucial for the successful implementation of wastewater reuse initiatives [ 57 ]. Research studies have also linked general water or water treatment process knowledge to a higher rate of recycled water adoption, such as water for close-contact uses [ 58 ]. Extensive research suggested that individuals tend to be more receptive to using recycled water for drinking purposes when they exhibit a greater level of self-reported knowledge or awareness regarding the subject [59–61]. To identify subsets of the population displaying heightened enthusiasm for the reuse of treated wastewater compared to the general populace, Baghapour, et al. [ 38 ] and Dolnicar and Schäfer [ 62 ] conducted comparative research on public awareness, attitudes, and acceptance of the topic. According to their findings, treated wastewater is acceptable for nondirect contact usage, including industrial processes, irrigation of crops that are not food crops, and others. 3.1. Knowledge The response to question 15, querying, "Do you have any knowledge about the water available in your country?" emerges as the pivotal discovery of this study. As illustrated in Fig. 2, approximately 65.3% of respondents indicated awareness of water availability in Iraq, while 34.7% either expressed uncertainty (16%) or claimed no knowledge (18.7%). Notably, regarding question 15.1 ("If your response to question 15 is 'yes', In your opinion, does Iraq have an inadequate supply of natural water resources?"), further insights are warranted. The data depicted in the figure indicates that 90.6% of respondents selected "yes," while the remaining 9.4% either answered "no" (6.6%) or expressed uncertainty (2.8%). Drawing from the preceding questions, it is notable that a considerable proportion (approximately 41%) of survey participants lack awareness of the water crisis and governmental efforts to ensure adequate water supply. This underscores a significant area of concern. Regarding their answer to question 16, which inquired, " Is it necessary to reduce water consumption in Iraq, in your opinion?" a substantial majority (93.3%) of survey participants expressed support for water rationalisation. Furthermore, nearly nine out of ten respondents affirmed their commitment to conserving water consumption in their households in response to question 17. Question 18 subsequently prompted participants who responded affirmatively to question 17 to delineate the specific measures undertaken to conserve water in household applications. Figure 3 illustrates that respondents implemented water-saving practices such as reducing water usage during cleaning or bathing, transitioning to toilets with lower water consumption, and upgrading to water-saving taps. However, their responses varied, with percentages indicating "sometimes" ranging from 43–61%, while "never" responses ranged from 3–30%. Additionally, a notable finding is that participants expressed a need to know more about the country's water conservation efforts and how they benefit people, the environment, and society as a whole. Concerning question 19 ("Do you have any background knowledge on treated wastewater?"), the findings revealed that approximately 30% of survey participants had never encountered the concept of wastewater recycling. This underscores the importance of public education initiatives aimed at this demographic, emphasising the economic and ecological advantages associated with wastewater reuse. Regarding question 20 ("What sources have you used to learn about treated wastewater reuse?"), the primary sources cited were the Internet, followed by environmental groups as a distant second, as indicated in Fig. 2. Contributions from friends, television, family, and journals were comparatively less substantial. Likewise, Chfadi, et al. [63] observed that the Internet serves as the predominant avenue for public information dissemination. As for question 21 ("From your different backgrounds, how would you suggest communication with the public be when implementing this type of project?"), respondents were afforded free choice. In efforts to enhance public attitudes toward wastewater recycling, they proposed various methods outlined in Table 2 . The results in this section align with the study's first objective, which aimed to assess the population's awareness of water resources and their reuse. The limited awareness of water resource sustainability may be a significant obstacle to implementing water reuse policies. Therefore, increasing awareness campaigns, mainly through the media and social media platforms, may improve the population's acceptance of these technologies and raise awareness of the importance of reuse. According to earlier research studies, the level of public awareness and knowledge is a key factor in the success of any recycling initiative [ 64 , 65 ]. 3.2. Attitude Baghapour, et al. [ 38 ], Raman [ 66 ], Buyukkamaci and Alkan [ 67 ], Domènech and Saurí [ 68 ], Kantanoleon, et al. [69], DuBose [ 70 ], Dolnicar, et al. [ 71 ] and Maraqa and Ghoudi [ 72 ], pointed out the public's conditional approval of using reclaimed water. In question 22 ("Are you in favour of using recycled wastewater for some purposes?"), Fig. 4 distinctly delineates two groups, representing those in agreement and those in disagreement. The studies conducted by DuBose [ 70 ], Aitken, et al. [ 73 ], Browning-Aiken, et al. [ 74 ], and Leviston, et al. [ 75 ] forecasted substantial support for water-treated initiatives when crafted with sustainability as a central focus. Contrary to previous studies, Chfadi, et al. [63] and Baghapour, et al. [ 38 ], found that the reclaimed water acceptance was highest when there was minimal skin contact and lowest when it was linked to activities such as drinking, cooking, washing, and bathing. Domènech and Saurí [ 68 ] underscored that the public's tendency to establish centralised wastewater treatment facilities in their homes is significantly shaped by considerations such as health risks, operational procedures, pricing, and environmental awareness, particularly in Spain. In our study, concerning question 23 ("Would you be open to having a central system installed in your home?"), approximately 75% of participants responded with either "yes" or "maybe." Subsequently, question 24 inquired, "If your answer to question 23 is yes or maybe, how much extra monthly fees are you willing to pay?". Approximately 60% of respondents indicated they would be willing to pay between 5,000 and 15,000 IQ, equivalent to around 4 to 12 US dollars, each month for the installation of a central wastewater treatment system, as depicted in Fig. 4 . Conversely, in answer to the 25th question ("How much do you trust the safety standards for treated wastewater that you can use?"), Fig. 4 shows that more than 62% of Iraqis have faith in the safety rules put in place by the government. Table 3 presents a summary of responses to questions 27 through 30. While 16.4% of respondents expressed opposition to using treated wastewater for watering food crops, a significant majority (70.4%) supported its use for non-food crops. On average, 16% of survey participants objected to using treated wastewater for irrigation, while 14.1% remained uncertain, as outlined in Table 3. The study conducted in Canada by Velasquez and Yanful [ 58 ] found that 76% of participants endorsed using treated wastewater for irrigating food crops, while 86% supported its use for non-food crops. The adoption rate was relatively higher for low-contact applications such as the irrigation of public parks and animal crops compared to high-contact applications such as food crops irrigation. Menegaki, et al. [76] emphasised the significance of attitudes in exploring both the usage and payment intentions for using reclaimed water in agriculture. According to Table 3, on average, a significant majority (66.2%) of respondents express support for treating wastewater for commercial and industrial purposes. This support extends to various applications, including power plants (69%), cooling, cleaning, and car wash averages (70%), construction operations (69%), firefighting (75%), and laundry services (43%). According to Table 3, a majority of respondents express support for recycling wastewater into storage for emergencies (61.5%) and artificial lakes (60.8%). However, they are against its usage in the following areas: cooking (59.6% ), cleaning produce (i.e., vegetables and fruits) (55%), watering pets and birds (24.5%), domestic usage (51.9%), swimming pools (48.7%), and fish farms (32.9%). The level of physical contact appears to be inversely correlated with favourable perceptions of using treated wastewater. The most popular uses were washing cars and flushing toilets, while the least popular was washing clothes and taking baths. [ 72 ]. According to Table 3, a majority of respondents express support for reusing treated wastewater for several beneficial purposes, including decreasing the application of toxic chemical fertilisers (88.9%), dropping pollution (87.9%), environmental preservation (85.8%), and alleviating the strain on dwindling aquifer networks and costly seawater desalination unit (86.6%). In question 31 (Arrange these incentives, in your view, to promote the use of treated wastewater by the general population; the range from 1 to 4 is from highest to lowest). Here is the overall rating, as shown in Fig. 5 : reducing cost (53.8%, 1), reducing environmental damage (54%, 1), relieving stress on alternative water supplies (43.2%, 1), and wastewater representing an additional water source (40.4%, 2). In question 32 (From your point of view, what is the single most significant obstacle to the general public's willingness to utilise treated wastewater? with 1 being the highest and 3 the lowest). As shown in Fig. 6 , the following is the overall ranking of barriers: the fear of transmission of infectious diseases (62.5%, 1), ethical considerations or cultural issues (46.9%, 1), and quality and performance standards (41.4%, 1). Similarly, Buyukkamaci and Alkan [ 67 ] demonstrated that the public is primarily concerned about potential health risks associated with reclaimed water usage, regardless of the treatment level. 3.2.1.T-test The study employed a T-test of independent samples to investigate potential variations between sexes concerning confidence in the diverse applications of treated wastewater, such as irrigation, commercial, and industrial use, and attaining multiple objectives. The outcomes of the T-test indicate sex differences in the trust levels regarding the utilisation of reclaimed water for irrigation, commercial and industrial purposes, and various objectives (refer to Table 4 ). Specifically, a statistically significant difference was observed between males and females, with females exhibiting greater trust in utilising reclaimed water for industrial and commercial purposes (t = -3.67 and p = 0.000), achieving different goals (t = -4.03 and p = 0.000), and irrigation (t = -4.62 and p = 0.000). Based on the authors' knowledge, the findings agree with the Abdelrahman, et al. [33] in some items. However, our outcomes contrast with previous studies indicating that men typically exhibit greater acceptance of risky technologies [ 5 , 37 , 77 ]. Therefore, when examining individuals' responses to recycled water, it is imperative to account for sex variations. Data from Table 1 was regrouped into three categories—age, education level, and income—to examine how these factors affected respondents' opinions about increasing recycled wastewater utilisation for other usages (Table 5 ). 3.2.2. One-way analysis of variance (ANOVA) test. This technique was employed to analyse the impact of age, income, and educational level on a participant's tendency towards using reclaimed water for industry, irrigation, commerce, different purposes, and multiple goals, aiming to achieve the fields outlined in Table 6 . For the fields examined (industrial and commercial uses, irrigation, and other purposes), the results revealed that some variables were statistically significant (p 0.05). For example, no statistically significant difference was found between them and income, except for the "other purposes" category. There was a significant difference (p = 0.01*) between groups, indicating that the differences between groups were not random. Specifically, there was a significant difference (p = 0.73) between G1i and G3i for G3i and a significant difference (p = 1.05) between G2i and G3i for G3i. This indicates that individuals with higher incomes are more receptive to the idea. These findings are consistent with those of previous studies [ 78 – 80 ], which concluded that higher income is associated with higher levels of agreeableness. In contrast, other factors did not show any statistically significant effect (p > 0.05), meaning the differences between groups were insignificant. For instance, regarding the utilisation of treated wastewater for irrigation, there is no statistically significant relationship between age-groups (0.17) or educational levels (0.36). Interestingly, these results contradict previous studies Bennett, et al. [ 81 ], Chen, et al. [ 82 ] and Buyukkamaci and Alkan [ 67 ] which suggest that younger participants tend to be more agreeable. In contrast, Probe Smith, et al. [ 83 ] and Bruvold and Cook [ 84 ] found that older participants were more agreeable. Additionally, there was no statistically significant difference between educational levels across all fields examined, a finding consistent with two large-scale studies conducted in Australia by Dolnicar, et al. [ 71 ] and the United States of America by Haddad, et al. [ 85 ]. These results (i.e., Sections 3.2.1 and 3.2.2 ) are in line with the second objective of the research, as they provide a detailed understanding of how demographic backgrounds influence attitudes toward reused water. Previous studies by Lahlou, et al. [ 86 ], Dolnicar, et al. [ 71 ], and Fielding, et al. [ 15 ] indicate that higher education levels are often associated with greater acceptance of sustainable technologies, which is supported by the results of this study. Therefore, developing awareness programs specifically targeted at less receptive groups, such as the elderly, may help enhance confidence in the effectiveness and safety of reused water. 3.2.3. Chi‑square test A chi-square test was employed to analyse the respondents' attitudes regarding the ranking of attitudes for treated wastewater reuse, based on demographic variables such as sex, age, education level, and income. Figure 7 illustrates that the top-ranked incentive for treated wastewater reuse is the provision of dropping environmental damage, which ranks first, with the primary drivers being middle-aged males with high educational levels and high income. Also, additional water resources rank 2nd, and it indicates that individuals who are old females, possess undergraduate education levels, and have a high income are the primary drivers of this preference. Additionally, reduced pressure on other water resources ranks three, and the drivers are old females with (a diploma or less to an undergraduate) education level and high income. Moreover, reducing cost ranks fourth, with the primary drivers, being younger to middle-aged females and males (i.e., females and males have the same percentage) with undergraduate educational levels and middle-income. Using a chi-square test, the study examined how respondents' sex, age, education level, and income influenced the ranking of barriers to using treated wastewater. This analysis allowed us to understand how respondents rated these obstacles based on demographic variables such as sex, age, education level, and income. Figure 8 displays that transmission of infectious diseases ranks first, and the drivers are old females with a diploma or less educational level and high income. Quality and performance standards rank second, with the primary drivers being young females, with undergraduate educational levels and middle income. Ethical considerations or cultural issues rank third, with young females of undergraduate educational levels and middle income as the primary drivers. These findings of this section align with the third objective of the research, as they provide an analysis of the factors that promote or hinder treated water reuse. Previous studies by Shafiquzzaman, et al. [ 42 ], Ablo and Etale [ 87 ], and Lahlou, et al. [88] confirm that health concerns are one of the most significant barriers to treated water reuse in Middle Eastern countries. Based on these findings, health awareness campaigns that explain water treatment processes and ensure their quality can increase population acceptance and reduce associated concerns. The attitudes of inhabitants towards reusing treated wastewater can be better understood by combining the findings of the chi-square test with ANOVA. While chi-square finds the correlation between demographics and categorical orientations, ANOVA checks for statistical significance to make the findings more trustworthy. For instance, the ANOVA results showed that there was a statistical difference in confidence levels between the sexes, while the chi-square results showed that women were more likely to rate "reducing environmental damage" as the most important reason for reusing treated wastewater. 4. Conclusion The primary conclusion of this research is that about 65.3% of individuals are aware of the availability of water in Iraq. However, a significant portion (approximately 41%) do not know about the water crisis and the government's initiatives to fix it. This lack of awareness is a major concern. The primary sources of information are the Internet and environmental groups. To highlight the possible economic advantages of reclaimed water reuse for Iraq, people, and the environment, campaigns should concentrate on these two types of media. These campaigns ought to incorporate the expertise of water science and psychology specialists in reusing wastewater. The majority of respondents (93.3%) demonstrate social responsibility through their belief in water rationalisation efforts. Additionally, 88% recognise the importance of conserving water in their households, and 41% would pay more to have a centralised reclaimed water system built where they reside. Most individuals agree on the utilisation of reclaimed water for irrigation purposes. The highest acceptance rate was observed for the irrigation of public gardens (78.3%), followed by irrigation of animal crops (75%), non-food crops (70.4%), and food crops (68.2%), as indicated in Table 3. Furthermore, for industry and commerce usage, most individuals prefer using treated wastewater for purposes such as refrigeration, car washing, cleaning, and construction. While using treated wastewater for purposes such as flushing toilets garners the most votes, followed by drinking among animals and birds, storage for emergencies, creating artificial lakes, and fish farms, it is not favoured for domestic use, swimming pools, washing vegetables, or cooking. Respondents indicated that the primary reasons they favour using reclaimed water are to reduce the utilisation of harmful chemical fertilisers, reduce pollution, alleviate pressure on groundwater and desalinate water, and preserve the environment. The results of a T-test indicated sex variance in confidence regarding the reuse of reclaimed water for all purposes, including industrial and commercial uses, irrigation, and various goals. Females were found to be more likely to trust the use of treated wastewater than men across all mentioned uses. Furthermore, a one-way ANOVA revealed no significant differences between groups, regardless of age, education level, and income, regarding using reclaimed water for industrial and commercial uses, irrigation, and other specified purposes. However, concerning achieving specific goals, individuals with higher income levels were found to be more accepting than others. Additionally, the results of the chi-square test highlighted that the primary motivations for reusing treated wastewater were considering it to reduce environmental damage and additional water resources on other water resources. Conversely, the main hurdles identified were the fear of infectious disease transmission and concerns related to quality and performance standards. Regarding achieving the three research objectives: 1) Measuring public awareness of the water crisis: While most people in the study were aware that there was a water resource problem, they were unaware that the government was making any attempts to solve it. This highlights a significant knowledge gap on the water crisis. 2) Analysis of population attitudes towards water reuse: Results showed that confidence in treated water was higher among females than males, and that acceptability of treated water reuse varied by age, gender, and economic level. 3) Identifying the factors that encourage and hinder the use of treated wastewater: Reducing pollution was seen as the primary incentive for water reuse, while health and cultural issues were identified as the primary hurdles. This study provides valuable insight into the public's perspective on treated wastewater reuse in Iraq. It finds that although many are in favour of its use in agriculture and industry, there are still others who are resistant due to health and cultural concerns. Generalisability may be affected by several methodological restrictions, such as the limited response rate and the study's narrow geographic emphasis, even though the results are robust. The study's findings show that neighbouring nations are comparable in terms of popular acceptance, but that the driving and barrier factors are different. In light of these results, the study suggests reaching out to psychological and technological specialists to help create awareness campaigns, increasing the scope of the research to cover more of Iraq for a more complete picture, and raising community awareness overall. 5. Limitations and future directions The sample size is one of the methodological limitations of this study. Data was obtained from 507 participants in Kut city, meaning that not all Iraq perspectives may have been accurately represented. Additionally, response biases could have impacted the results; for example, certain participants might have had a greater familiarity with or interest in treated water reuse than others. Furthermore, while many statistical checks were conducted to guarantee the reliability of the analysis, additional research is needed to fully comprehend the significant influence of certain socioeconomic variables on the adoption of treated water reuse. Considering the study's regional context, it can be compared to others that have looked at acceptance levels in Middle Eastern nations, including Turkey, Oman, and the United Arab Emirates. In those countries, acceptance levels vary according to cultural, religious, and economic reasons. Future research should take into consideration the fact that direct comparisons are complicated due to variations in infrastructure and government policy. Based on these limitations, this research recommends future studies that include a broader geographic scope and use qualitative research methods such as in-depth interviews to gain a deeper understanding of audience motivations. Also, the study made other recommendations to maximise water reuse's societal acceptability: raising awareness of the water scarcity crisis in Iraq and promoting wastewater reuse initiatives. Recruit the help of psychology and water science specialists to spread the benefits of wastewater reuse that could have a positive financial impact on the country, its citizens, and the environment through online platforms, social media, and television. This study can be used as a springboard for further research in other Iraqi Governorates. 6. Policy implications In order to achieve water sustainability in Iraq, this study's empirical findings can be used to propose a set of policy recommendations that will increase the acceptance and reuse of treated wastewater. Public Awareness and Education Campaigns: Our findings indicate that 41% of respondents were unaware of Iraq’s water crisis, and 30% had never encountered the concept of wastewater recycling. This highlights the urgent need for targeted public education programs to increase awareness and acceptance of treated wastewater reuse. Accordingly, government agencies should collaborate with educational institutions, environmental NGOs, and social media platforms to develop campaigns that highlight the benefits of wastewater reuse while addressing common misconceptions (e.g., health risks and cultural concerns). This recommendation aligns with global success stories, such as Singapore’s “NEWater” initiative, which improved public confidence in water reuse through strategic communication and engagement. Regulatory and Safety Standards Enforcement: While 62% of Iraqis trust existing wastewater treatment safety standards, concerns about quality and performance standards ranked as the second-largest barrier to adoption. Establishing stricter quality assurance frameworks, increasing transparency in water treatment processes, and conducting regular independent audits can enhance public trust in reclaimed water. Lessons from Australia and California show that public confidence improves when governments publish real-time water quality data and enforce clear safety benchmarks. Financial Incentives to Drive Adoption: Our study revealed that cost reduction (53.8%) and environmental benefits (54%) were the top motivations for wastewater reuse. Furthermore, 41% of participants were willing to pay extra fees for centralised treatment systems, suggesting an opportunity for incentive-based policy interventions. Implement tiered pricing models that offer reduced water tariffs for households using reclaimed water. Introduce subsidies or tax incentives for industries and farms that integrate treated wastewater into their operations. Similar policies in the UAE have successfully encouraged wastewater reuse by providing economic benefits to early adopters. Infrastructure Investment and Decentralised Treatment Options: Our results show that 75% of respondents support installing centralised wastewater treatment systems but highlighted concerns about implementation costs and accessibility. Expand public-private partnerships (PPPs) to fund the development of wastewater treatment plants. Encourage localised, decentralised treatment systems in rural or underserved areas to reduce infrastructure costs and improve water security. Decentralised treatment models have been successfully implemented in Germany and India, reducing dependency on large-scale infrastructure while ensuring equitable water access. Addressing Cultural and Ethical Concerns: Cultural and ethical concerns ranked as the third-highest barrier to wastewater reuse in our study. Collaborate with religious and community leaders to frame wastewater reuse within an ethical and environmental stewardship narrative. Countries like Jordan and Saudi Arabia have successfully incorporated religious perspectives to encourage water conservation and wastewater reuse. Declarations Acknowledgments The authors appreciate the respondents who gave their time to contribute to the survey in this study. Supplemental material Survey CRediT authorship contribution statement Hamza T. AL-Rikabi : Validation; Formal analysis; Writing—original draft; Writing—review & editing; Visualization. Salah L. Zubaidi : Conceptualization; Methodology; Software; Investigation; Writing—review & editing; Supervision; Project administration. Sandra Ortega-Martorell : Methodology; Resources; Writing—review & editing. Nadhir Al-Ansari: Conceptualization; Methodology; Writing—review & editing; Visualization. Nabeel Saleem Saad Al-Bdairi : Methodology; Software; Investigation; Writing—review & editing; Visualization. Yousif Raad Muhsen : Methodology; Software; Writing—review & editing; Visualization. Khalid S. Hashim : Methodology; Resources. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflicts of interest. Data Availability: The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request. References Ravishankar, C.; Nautiyal, S.; Seshaiah, M. Social Acceptance for Reclaimed Water Use: A Case Study in Bengaluru. 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Testing the climate for non-potable water reuse: opportunities and challenges in water-scarce urban growth corridors. Journal of Environmental Policy Planning 2011 , 13 , 253-275, doi:https://doi.org/10.1080/1523908X.2011.594597. Leviston, Z.; Nancarrow, B.E.; Tucker, D.I.; Porter, N.B. Predicting community behaviour: Indirect potable reuse of wastewater through Managed Aquifer Recharge. Land Water Science Report 2006 , 2906 , 06. Menegaki, A.N.; Hanley, N.; Tsagarakis, K.P. The social acceptability and valuation of recycled water in Crete: A study of consumers' and farmers' attitudes. Ecological Economics 2007 , 62 , 7-18, doi:https://doi.org/10.1016/j.ecolecon.2007.01.008. Finucane, M.L.; Slovic, P.; Mertz, C.K.; Flynn, J.; Satterfield, T. Gender, Race and Perceived Risk: The ‘White-Male'Effect. In The Feeling of Risk , Routledge: 2013; https://doi.org/10.4324/9781849776677pp. 125-139. Garcia-Cuerva, L.; Berglund, E.Z.; Binder, A.R.J.R., Conservation. Public perceptions of water shortages, conservation behaviors, and support for water reuse in the US. Resources, Conservation Recycling 2016 , 113 , 106-115, doi:https://doi.org/10.1016/j.resconrec.2016.06.006. Hills, S.; Birks, R.; McKenzie, B. The Millennium Dome “Watercycle” experiment: to evaluate water efficiency and customer perception at a recycling scheme for 6 million visitors. Water Science Technology 2002 , 46 , 233-240, doi:https://doi.org/10.2166/wst.2002.0684. Pickering, P. Community values for recycled water in Sydney: Economic viability of recycled water schemes—Technical Report 2. 2014 . Bennett, J.; McNair, B.; Cheesman. Community preferences for recycled water in Sydney. Australasian Journal of Environmental Management 2016 , 23 , 51-66, doi:https://doi.org/10.1080/14486563.2015.1129364. Chen, W.; Bai, Y.; Zhang, W.; Lyu, S.; Jiao, W. Perceptions of different stakeholders on reclaimed water reuse: the case of Beijing, China. Sustainability 2015 , 7 , 9696-9710, doi:https://doi.org/10.3390/su7079696. Smith, H.M.; Rutter, P.; Jeffrey, P. Public perceptions of recycled water: a survey of visitors to the London 2012 Olympic Park. Journal of Water Reuse Desalination 2015 , 5 , 189-195, doi:https://doi.org/10.2166/wrd.2014.146. Bruvold, W.H.; Cook, J. Reclaiming and reusing wastewater. Water/Engineering Management 1981 , 128 . Haddad, B.M.; Rozin, P.; Nemeroff, C.; Slovic, P. The psychology of water reclamation and reuse: survey findings and research roadmap ; WateReuse Foundation Alexandria, VA: 2009. Lahlou, F.; Mackey, H.; McKay, G.; Al-Ansari, T. Reuse of treated industrial wastewater and bio-solids from oil and gas industries: Exploring new factors of public acceptance. Water Resources Industry 2021 , 26 , 100159, doi:doi.org/10.1016/j.wri.2021.100159. Ablo, A.D.; Etale, A. Beyond technical: delineating factors influencing recycled water acceptability. Urban Water Journal 2022 , 21 , 1014-1021, doi:DOI:10.1080/1573062X.2022.2155847. Lahlou, F.; Mackey, H.; McKay, G.; Al-Ansari, T.; Industry. Reuse of treated industrial wastewater and bio-solids from oil and gas industries: Exploring new factors of public acceptance. Water Resources Industry 2021 , 26 , 100159, doi:https://doi.org/10.1016/j.wri.2021.100159. Tables Tables 1 to 6 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.pdf QuestionnaireForm.pdf Cite Share Download PDF Status: Published Journal Publication published 18 Nov, 2025 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 23 Apr, 2025 Reviews received at journal 19 Apr, 2025 Reviewers agreed at journal 17 Apr, 2025 Reviews received at journal 16 Apr, 2025 Reviewers agreed at journal 16 Apr, 2025 Reviewers invited by journal 16 Apr, 2025 Submission checks completed at journal 07 Apr, 2025 First submitted to journal 26 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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AL-Rikabi","email":"","orcid":"","institution":"Wasit University","correspondingAuthor":false,"prefix":"","firstName":"Hamza","middleName":"T.","lastName":"AL-Rikabi","suffix":""},{"id":443743700,"identity":"9b511028-81a0-4214-9e3a-6a96e0cc75a9","order_by":1,"name":"Salah L. Zubaidi","email":"","orcid":"","institution":"Wasit University","correspondingAuthor":false,"prefix":"","firstName":"Salah","middleName":"L.","lastName":"Zubaidi","suffix":""},{"id":443743701,"identity":"a349ac83-7c62-4ad6-bd71-126e0dc588fa","order_by":2,"name":"Sandra Ortega-Martorell","email":"","orcid":"","institution":"Liverpool John Moores University","correspondingAuthor":false,"prefix":"","firstName":"Sandra","middleName":"","lastName":"Ortega-Martorell","suffix":""},{"id":443743703,"identity":"70348855-4b46-46c8-a371-1f2f501c0373","order_by":3,"name":"Nadhir Al-Ansari","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA60lEQVRIiWNgGAWjYHACM4YEIMkH4UjI8RGthQ2qxZiNjRgtDAgtDIlthLSYsx/e9uDhHgZ5Nvazhz/83GOR3ibfY8D4owK3FsuetHKDhGcMhm08eWmSPc8kctvYeAyYec7g1mJwIMdMIuEAA2MbQ44ZA88BqBYgF7eW82/AWuzb+N8Yf/xzQCKdDaiF8ec/PFpuQGxJbJPIMZAG2pIA0sLA24BPy7MyoBaJ5DaJN2bSMgckDNvY0goO8xzD57DkbZI/DtjY9vPnGH98c6BOnp/58MaHP2pwa4ECCVTuAYIaRsEoGAWjYBTgBQAoQ0cG7dpQOgAAAABJRU5ErkJggg==","orcid":"","institution":"Lulea University of Technology","correspondingAuthor":true,"prefix":"","firstName":"Nadhir","middleName":"","lastName":"Al-Ansari","suffix":""},{"id":443743704,"identity":"5f3cdcac-58bc-40db-921a-a21aec19aa89","order_by":4,"name":"Nabeel Salem Saad Al-Bdairi","email":"","orcid":"","institution":"Wasit University","correspondingAuthor":false,"prefix":"","firstName":"Nabeel","middleName":"Salem Saad","lastName":"Al-Bdairi","suffix":""},{"id":443743705,"identity":"7c31f410-05ef-441d-9270-2bfbce6e99e5","order_by":5,"name":"Yousif Raad Muhsen","email":"","orcid":"","institution":"Wasit University","correspondingAuthor":false,"prefix":"","firstName":"Yousif","middleName":"Raad","lastName":"Muhsen","suffix":""},{"id":443743706,"identity":"c314ebe8-066c-44d7-9937-c9cee38c0235","order_by":6,"name":"Khalid S. Hashim","email":"","orcid":"","institution":"Liverpool John Moores University","correspondingAuthor":false,"prefix":"","firstName":"Khalid","middleName":"S.","lastName":"Hashim","suffix":""}],"badges":[],"createdAt":"2025-01-07 10:23:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5780361/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5780361/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-025-24308-w","type":"published","date":"2025-11-18T15:57:50+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":81003494,"identity":"4ece534c-fa6a-46bd-842d-3efda34e72f2","added_by":"auto","created_at":"2025-04-21 06:38:50","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":461647,"visible":true,"origin":"","legend":"\u003cp\u003eLocation map of the research area (Wasit Governorate).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/ea8c134cf46224536b86e705.png"},{"id":81004263,"identity":"07428556-93d3-4af7-b847-578dd5a8fc94","added_by":"auto","created_at":"2025-04-21 06:46:50","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":35657,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ responses to questions 15, 15-1, 16, 17, 19 and 20.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/dbdd807f3299fbfd34d35df5.png"},{"id":81001747,"identity":"733960d1-3938-4e0c-a543-3a936eaa6222","added_by":"auto","created_at":"2025-04-21 06:30:50","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":24384,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ response to question 18.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/2de99fea61783aee4a3eea31.png"},{"id":81001761,"identity":"beea2735-929a-496f-bb8e-ead072faaf3a","added_by":"auto","created_at":"2025-04-21 06:30:51","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":35965,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ responses to questions 22–26\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/c2a38dd3f99dea7d33ca271b.png"},{"id":81001772,"identity":"94f0cede-bf20-4c5f-8509-f3e33b15cbd0","added_by":"auto","created_at":"2025-04-21 06:30:51","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":27625,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ response to question 31.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/9542b39cbabc2f0edc22c9d9.png"},{"id":81001764,"identity":"2026cbed-f52a-468d-b4f9-114a0e7ea43b","added_by":"auto","created_at":"2025-04-21 06:30:51","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":20338,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants’ response to question 32.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/36f1c0ffc34c819afe36ccdc.png"},{"id":81003506,"identity":"9c030f77-2bb0-46ac-9001-bd48a706c464","added_by":"auto","created_at":"2025-04-21 06:38:52","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":46556,"visible":true,"origin":"","legend":"\u003cp\u003eChi-square analysis outcomes of the factors influencing the ranking of incentives to increase the reuse of recovered water.\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/a35218a11849414117b42b83.png"},{"id":81001775,"identity":"6a4275a6-a1c3-4f0f-b3d6-14dd3f782e7e","added_by":"auto","created_at":"2025-04-21 06:30:51","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":43377,"visible":true,"origin":"","legend":"\u003cp\u003eChi-square analysis outcomes of the factors influencing the ranking barriers against expansion of recovered water.\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/f164cbe9d4f136199a3898ff.png"},{"id":96650133,"identity":"400b50c8-8193-45c9-a3f1-1f8de06b5126","added_by":"auto","created_at":"2025-11-24 16:08:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1618120,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/2d92e4bd-7794-46fa-a12c-7d8f08528138.pdf"},{"id":81003495,"identity":"1554d5bd-2943-4643-ac95-25ede060026b","added_by":"auto","created_at":"2025-04-21 06:38:50","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":225287,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/2eb4244a7fd554551ea854ae.pdf"},{"id":81001746,"identity":"ab2d03d5-ab3d-453d-8945-bf02846f7157","added_by":"auto","created_at":"2025-04-21 06:30:50","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":206292,"visible":true,"origin":"","legend":"","description":"","filename":"QuestionnaireForm.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5780361/v1/a0a9595752cf0e666c310554.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"An Investigation into the Societal Attitudes and Acceptance of Treated Wastewater Reuse in an Area Experiencing Water Scarcity ","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe World Health Organisation and the United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation have determined that 1.8\u0026nbsp;billion people around the world are likely to consume water that is contaminated with human waste [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. As suggested by Roson and Damania [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], the global accessibility of freshwater suitable for direct human consumption comprises a mere fraction, amounting to only 1/100th of the world's total freshwater reserves, which represent just 3% of the total water supply. This stark reality underscores the significant mismatch between available resources and the burgeoning demand from human populations. By 2030, it is projected that the number of individuals experiencing serious shortages of water will increase twofold, reaching around 1.6\u0026nbsp;billion people, which accounts for over a quarter of the global population. Multiple investigations, for example, Smith, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], Michetti, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], and Mu\u0026rsquo;azu, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], have indicated that urbanisation, industrialisation, water pollution caused by people, rapid population increase, and overuse of freshwater resources are all factors that contribute to the increase of water stress. Hence, effective and sustainable strategies to address the increasing demand for freshwater necessitate the implementation of appropriate methodologies and proactive measures by the relevant parties.\u003c/p\u003e \u003cp\u003eWater scarcity is a real problem, and one way to fix it is to supplement existing supplies with water from unconventional sources [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Wastewater recycling emerges as a promising solution to global freshwater challenges, as evidenced by its adoption by numerous nations [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. By reducing sewage disposal, recovering freshwater from wastewater, and reusing it for municipal applications, this sustainable waste management strategy significantly contributes to the circular economy (CE) goals of resource recovery, zero waste, and reducing environmental pollution [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Recycled water is regarded as a viable alternative because research studies have demonstrated that wastewater may be sufficiently treated to ensure its safety for consumption [13\u0026ndash;15]. Governments' consideration of wastewater reuse reflects a strategic approach to bolstering freshwater resources [16]. Yue, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e17\u003c/span\u003e] stated that wastewater reuse (WWR) is currently recognised as an essential element of Integrated Water Resources Management (IWRM). WWR is of utmost importance for several areas, including agriculture, industry, urban development, domestic reuse, potable water supply, and others, as it has been emphasised by several studies [16].\u003c/p\u003e \u003cp\u003eInsufficient freshwater is a prevalent issue in nine Middle Eastern countries, including Iraq [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Furthermore, Iraq, a developing nation located in a semi-arid to dry region, is one of the Middle Eastern countries most vulnerable to the impacts of climate change [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Several causes, including global warming, the oil sector growth, increasing urbanisation, and the region's already rapid population expansion, contribute to the region's existing water scarcity [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The majority of Iraq's freshwater is provided by the Euphrates and Tigris Rivers, where many storage dams have been constructed [21]. From 2009 to 2014, there was a severe water shortage in both rivers. The issue at hand will get worse due to climate change and the escalating water requirements from upstream nations such as Syria, Iran, and Turkey [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Salman, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] projected multiple methods and scenarios indicating a probable rise in temperatures across Iraq, alongside a negative impact on future rainfall in terms of both pattern and quantity [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Furthermore, Ewaid, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] highlighted that several studies have examined the quality of freshwater in Iraq, revealing an increase in various contaminants [26\u0026ndash;28]. In addition, the water management of the rivers had adverse consequences following the terrorist attacks on many barrages and dams in Iraq after 2003 [29].\u003c/p\u003e \u003cp\u003eThe research will be focused on Al-Kut City, which is the capital of Wasit Governorate. For the most part, the freshwater supply is provided by the Tigris River and its branches. One of the governorates' claims to fame is its pioneering work in growing strategic crops. The high rate of agricultural use depletes water resources. There is a severe water crisis due to its dependence on the Tigris River, which suffers from water scarcity. Also, Wasit is feeling the pinch of climate change in the form of rising temperatures and less precipitation. As per the data provided by the Ministry of Municipalities' Department of Sewerage, the City of Kut generates around 65,000 cubic metres of wastewater every day. Moreover, the government plans to establish central wastewater treatment plants in the region.\u003c/p\u003e \u003cp\u003eWorldwide, the topic of wastewater reuse has been extensively discussed [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], and the degree of its acceptance varies widely. As an example, Al-Khatib, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] noted that there is a correlation between factors such as education, age, income, and sex, and the level of acceptance for using recycled water. Accordingly, Abdelrahman, \u003cem\u003eet al.\u003c/em\u003e [33] studied the attitudes toward water reuse, and argued that emotions could facilitate the evaluation of complicated situations, significantly impacting both, attitude and behaviour. Attitudes can be evaluated via a model consisting of cognitive, behavioural, and emotional components. Cottrell [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] utilised the three-component attitude model to gain a deeper understanding of how emotions influence attitudes and behaviours.\u003c/p\u003e \u003cp\u003eOne potential barrier to the acceptance of wastewater reuse may be the deep-seated emotions that elicit negative attitudes toward water reuse [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Hence, it is crucial to get knowledge regarding the public's attitudes toward the concept of recycling treated wastewater to understand the emotional responses and individual differences associated with this subject. Utilising this data, campaigns promoting wastewater recycling should employ more precise targeting strategies to effectively reach the general community. The success of wastewater reuse facility development, building, and operation relies heavily on the public's attitudes, approval, and support. Various studies have investigated the contributing factor of public attitudes, encompassing variables such as sex, educational attainment, income level, cultural background, religious affiliation, health status, sources of information, and level of knowledge [36\u0026ndash;38].\u003c/p\u003e \u003cp\u003eStudies like [\u003cspan additionalcitationids=\"CR40\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] indicate that both sexes find it acceptable to use treated wastewater for non-skin contact activities, such as flushing toilets, washing cars, and watering plants. Furthermore, according to Abdelrahman, et al. [33], regardless of the level of treatment, a large number of people are opposed to using recycled wastewater. However, as the application shifts from direct physical touch to indirect nonphysical contact, the resistance decreases. Several prior studies conducted on nations neighbouring Iraq yielded varying results regarding the acceptance of treated water reuse. In two investigations from Oman, respondents opposed using treated wastewater for direct contact. The first survey found that 64.5% of respondents would reuse treated wastewater for gardening and 42.7% for car cleaning [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. The second study found that 64.2\u0026ndash;78.7% of attendees were optimistic about using treated wastewater to irrigate non-edible crops, business landscapes, fire hydrants, cool buildings, golf courses, public parks, school grounds, toilet flushing, and car washing [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, another study from Palestine Al-Khatib, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] found that most respondents opposed using treated wastewater for direct contact. However, aquifer recharge and aquaculture were more accepted\u0026mdash;38% and 42%, respectively. In a study conducted in the United Arab Emirates, Abdelrahman, et al. [33] found that a majority of the public (55%) expressed a preference for utilising treated wastewater for irrigating non-food crops. However, they tended to use it for irrigating food crops, with a rejection rate of 66%. According to another study, 76% of the public in the Muscat Governorate of Oman accepted the use of recycled wastewater for gardening, while 66% approved its use for toilet flushing and 53% approved its use for car washing [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. A state-wide survey revealed that there was widespread concern among the population in Turkey regarding the possible health risks associated with the reuse of wastewater. Nevertheless, they consented to repurpose it for activities like flushing toilets and cleaning roads and buildings, which do not require direct interaction with humans [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Additional global investigations, such as Brazilian respondents Faria and Naval [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], use treated wastewater for indirect applications (watering plants and gardens, washing clothing, and cleaning), 98% and 74% for complete and incomplete higher education, respectively. Also, Over 50% of Tanzanian respondents approved of using treated wastewater in diverse applications, while 93% were opposed if it included direct water contact [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFurthermore, Li and Roy [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] mentioned that although conservation efforts and informational campaigns can help change people's minds about recycled water, many individuals are still unsure about how they feel about using it. Leong and Lebel [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] reported that numerous research have revealed that a multitude of factors contribute to this mistrust. These aspects encompass sociodemographic variables, community involvement, awareness levels, water availability and access, health concerns, and the water's intended usage. However, customers' attitudes and intentions to buy potable reuse water should improve as their perceived knowledge or experience with water reuse increases [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Mu\u0026rsquo;azu, et al. [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]stated that previous studies did not confirm the relationship between higher education levels and acceptance of treated wastewater. Some large-scale research in wealthy countries found no statistically significant association. In poorer countries, reuse acceptance decreases with education. In contrast, different studies on treated wastewater reuse show that better education increases acceptance.\u003c/p\u003e \u003cp\u003eThis research falls within the context of global efforts to achieve sustainable development, contributing to the Sustainable Development Goals (SDGs) adopted by the United Nations, particularly in the field of water resource management. The research examines the community's acceptance of reused water, which is closely linked to SDG 6, \"Clean Water and Sanitation,\" which seeks to improve water management and reduce pollution through recycling and safe use of reused water. This research also supports SDG 11, \"Sustainable Cities and Communities,\" by providing solutions that enhance the sustainability of urban water resources, reducing pressure on freshwater and contributing to improved sanitation infrastructure. Furthermore, the research aligns with SDG 13, \"Climate Action,\" as reducing the consumption of freshwater resources through reuse can contribute to mitigating the effects of climate change and reducing the risk of drought. The research also supports the achievement of SDG 12, \"Responsible Consumption and Production,\" by encouraging recycling policies and sustainable resource use, reducing water waste, and promoting responsible environmental practices. Accordingly, the findings of this research can provide a scientific framework that helps decision-makers develop more sustainable water management strategies, in line with the global Sustainable Development Goals.\u003c/p\u003e \u003cp\u003eThe primary aim of this study is to evaluate public acceptance and attitudes regarding using treated wastewater for different usages in Al-Kut City. So, the major objectives of this study were to: (1) Determine how well people understand the water scarcity issue. (2) Investigate how people of different ages, sexes, educational backgrounds, and income levels feel about using recycling wastewater for agricultural, commercial, and industrial purposes; and (3) Examine what motivates people to take advantage of wastewater reuse incentives and what stops them from expanding reclaimed water reuse.\u003c/p\u003e"},{"header":"2. Research Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Collection of data\u003c/h2\u003e \u003cp\u003eA stated preference survey was developed and distributed to people in Al-Kut City, Iraq, to examine their attitudes and acceptance regarding the reuse of reclaimed water. This survey consists of 32 questions divided into five categories. The potential participants were randomly selected and they were initially asked about their willingness to be part of this study and answer the questions to ensure higher response accuracy. As such, the survey was only distributed to individuals who agreed to participate in this study. For the current study, we revised the questionnaire used by Abdelrahman, et al. [33]., incorporating new questions and removing the ones that are not relevant to Iraq (please see supplementary material).\u003c/p\u003e \u003cp\u003eBetween December 15, 2023, and March 14, 2024, a continuous period of three months was dedicated to conducting a survey. The survey was conducted using both Google Forms and printed copies to target seniors and retirees who were not familiar with digital platforms. Mechanism for randomly selecting participants, and distributing paper copies in different areas of the city to ensure choosing both Arab and Kurdish people. The representative sample consisted of 507 participants out of 1,000 participants, yielding a response rate of 50.7%. To ensure that the participants in the study accurately represented the study area, a minimum sample size was utilised. In their 2014 study, Dillman, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] formulated an equation to determine the most favourable sample size, as shown in Eq.\u0026nbsp;(\u003cspan refid=\"Equ1\" class=\"InternalRef\"\u003e1\u003c/span\u003e):\u003cdiv id=\"Equ1\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equ1\" name=\"EquationSource\"\u003e\n$$\\:n=\\frac{{z}^{2}\\times\\:p\\times\\:(1-p)}{{MoE}^{2}}$$\u003c/div\u003e\u003cdiv class=\"EquationNumber\"\u003e1\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWhere: n\u0026thinsp;=\u0026thinsp;full sample size required to achieve target precision, p\u0026thinsp;=\u0026thinsp;the percentage under examination, MoE\u0026thinsp;=\u0026thinsp;the target margin of error for the sample, z\u0026thinsp;=\u0026thinsp;critical value for the desired confidence level.\u003c/p\u003e \u003cp\u003eAs the margin of error increases, the confidence level in the survey results decreases. Research that analyses survey data frequently uses a confidence level of 95%. Therefore, with a confidence level of 95%, the \u0026#119911;-value is 1.96. Furthermore, the current investigation employs a conservative value of p that is evenly split 50/50. The margin of sampling error was ultimately established at 4.5. By substituting these numbers into Eq.\u0026nbsp;(\u003cspan refid=\"Equ1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), we find that a size of 475 is necessary for this inquiry. Therefore, the number of survey responses gathered for this inquiry, which was 507, surpassed the minimum requirement for a 95% confidence level.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Steady of area\u003c/h2\u003e \u003cp\u003eAl-Kut is located on the banks of the Tigris River in southern Iraq and is the capital of the Wasit Governorate [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e] (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The metropolis is vast, covering an area of 17,153 square kilometers. Conversely, the urban area of Al-Kut spans approximately 40 square kilometers. Forecasts suggest that the population of the city will increase significantly to more than 750,000 by 2035, compared to 400,000 in 2003. Al-Kut is renowned for its agricultural prowess in wheat production [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. The mean altitude between two longitudes (45\u0026deg; 54\u003csup\u003e/\u003c/sup\u003e and 45\u003csup\u003eo\u003c/sup\u003e 45\u003csup\u003e/\u003c/sup\u003e) east and two latitudes (32\u003csup\u003eo\u003c/sup\u003e 21\u003csup\u003e/\u003c/sup\u003e and 32\u003csup\u003eo\u003c/sup\u003e 34\u003csup\u003e/\u003c/sup\u003e) north is approximately 20 meters [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. The climate in Al-Kut City is characterised by agreeable seasons, with nice spring and autumn, frigid winters, and dry, hot summers. As per the Iraqi Meteorological Department, the winter season commences in November and lasts until March. The summer season spans the following seven months, often with June, July, and August experiencing their highest temperatures [54,56].\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Study instrument\u003c/h2\u003e \u003cp\u003eThis study utilised a stated preference survey, as described in section \u003cspan refid=\"Sec3\" class=\"InternalRef\"\u003e2.1\u003c/span\u003e and supplementary material. The first section of the survey (questions 1\u0026ndash;14) asked participants to provide details about themselves, including their demographic and other personal details. It is mainly based on multiple-choice and binary (Yes/No) or closed-category (multiple-choice) questions. Moreover, the 2nd section, encompassing questions 15\u0026ndash;21, evaluated the respondents' attitudes and levels of knowledge of water resources and the recycling of wastewater. Except for question 18, it includes binary questions (Yes/No), and optional questions (such as the source of knowledge). Question 18, uses the Likert scale, where responders need to select from a range of multiple-choice options. Through the analysis of the data derived from these questions, we can evaluate its validity and dependability. Question 18 is designed to measure the extent to which individuals engage in water conservation practices in their households. On a three-point scale, you can choose between \"always,\" \"sometimes,\" and \"never\" to answer this question.\u003c/p\u003e \u003cp\u003eSection three (questions 22\u0026ndash;26) assessed individuals' attitudes towards the reuse of treated wastewater, the establishment of centralised wastewater treatment systems, and their confidence in the safety regulations for treated wastewater. It includes binary questions (Yes/No) like questions 23 and 26., and two Likert Scale types (5 points). Question 22 is designed on a five-point Likert Scale (from \u0026ldquo;I strongly agree\u0026rdquo; to \u0026ldquo;I strongly refuse\u0026rdquo;) to measure the extent to which individuals engage in using recycled wastewater for some purposes. Question 25 is designed on a five-point Likert Scale (from \u0026ldquo;Fully trust\u0026rdquo; to \u0026ldquo;Have no knowledge of it\u0026rdquo;) to measure the extent to which individuals trust the safety criteria of treated wastewater that you can use.\u003c/p\u003e \u003cp\u003eQuestions 27\u0026ndash;30 (fourth section) required participants to assess their level of confidence in different applications of treated wastewater, as well as their justifications for accepting this usage. It measures respondents' confidence in the different applications of treated wastewater based on a four-point Likert Scale. Answers to these questions can be categorised as either \"strongly support\", \"support\", \"do not support\", or \"do not know\" on a four-point scale. The fifth section, questions 31 and 32, assessed the participants' views on the public's perceptions of the benefits and obstacles of reusing treated wastewater. These questions are based on ranking questions, which differ from the Likert scale. The \u0026ldquo;First\u0026rdquo; option goes to the most important followed by other options for the least important.\u003c/p\u003e \u003cp\u003eCronbach's alpha, which can be expressed as a value between 0 and 1, was used to determine the questionnaire's internal consistency. A test's reliability might be defined as the degree to which it consistently yields the expected results. A test's reliability can be expressed as a function of its item count and average inter-item correlation, which is known as Cronbach's Alpha[16]. The reliability of the questionnaire was evaluated using the Statistical Package for Social Science SPSS, Version 29, software. As the reliability value approaches 1, it indicates a lower level of error. For instance, when the reliability is 0.9, it means that, on average, the variables are 90% accurate with a 10% margin of error. The formula for Cronbach's alpha can be found in Eq.\u0026nbsp;(\u003cspan refid=\"Equ2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). A survey was given out to a sample of forty individuals to establish its reliability and validity. The questionnaire items 18, 27, 28, 29, and 30 were found to have reliability values of (α\u0026thinsp;=\u0026thinsp;0.928) and validity of 0.963.\u003cdiv id=\"Equ2\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equ2\" name=\"EquationSource\"\u003e\n$$\\:\\propto\\:=\\frac{N\\stackrel{-}{c}}{\\stackrel{-}{\\upsilon\\:}+\\left(N-1\\right)\\stackrel{-}{c}}$$\u003c/div\u003e\u003cdiv class=\"EquationNumber\"\u003e2\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWhere: α\u0026thinsp;=\u0026thinsp;Cronbach's alpha, N\u0026thinsp;=\u0026thinsp;number of items, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{c}\\)\u003c/span\u003e\u003c/span\u003e= the average interitem\u003c/p\u003e \u003cp\u003ecovariance, and υ\u0026thinsp;=\u0026thinsp;average variance\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4. Analysis of data\u003c/h2\u003e \u003cp\u003eA statistical analysis was conducted to define the frequency distribution of the data and to test the study hypotheses. The SPSS, Version 29, was utilised for the preparation and testing process. The analysis of the participants' characteristics was conducted using frequency analysis. This analysis included their sex, ages, incomes, and educational levels. The relationship between sex and the utilisation of treated wastewater for various purposes was analysed using the T-test. An analysis was conducted to examine the correlation between confidence in wastewater reuse for various purposes and factors such as age, level of education, and income. The analysis employed the ANOVA test. The Chi-square technique was applied to analyse participants' viewpoints on the relative significance of several incentives for the public utilisation of reclaimed water, based on factors such as sex, age, education level, and income. An additional analysis was performed utilising the Chi-square technique to figure out the correlation between sex, age, education level, income, and the public's assessment of the obstacles to reusing treated wastewater. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the demographic characteristics of the 507 respondents.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Ethics Statement:\u003c/h2\u003e \u003cp\u003eBefore asking the participants in this study about their opinions, the purpose of the questionnaire was clearly explained, and they were asked about their willingness to participate in the survey. Accordingly, this study only asked participants who were willing to participate in the questionnaire. Plus, they were informed that written informed consent is required, and the anonymity of their responses is assured. As such, the study is completed only after receiving the assent from the participants. It is crucial to note that this study adhered to the ethical principles outlined in the Declaration of Helsinki, and all procedures for conducting the questionnaire that involved human participants were approved by the Institutional Review Board of the University of Wasit, Iraq.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results and discussion","content":"\u003cp\u003eUnderstanding public attitudes and acceptance of recycled water is crucial for the successful implementation of wastewater reuse initiatives [\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e]. Research studies have also linked general water or water treatment process knowledge to a higher rate of recycled water adoption, such as water for close-contact uses [\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e]. Extensive research suggested that individuals tend to be more receptive to using recycled water for drinking purposes when they exhibit a greater level of self-reported knowledge or awareness regarding the subject [59\u0026ndash;61]. To identify subsets of the population displaying heightened enthusiasm for the reuse of treated wastewater compared to the general populace, Baghapour, et al. [\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e] and Dolnicar and Sch\u0026auml;fer [\u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e] conducted comparative research on public awareness, attitudes, and acceptance of the topic. According to their findings, treated wastewater is acceptable for nondirect contact usage, including industrial processes, irrigation of crops that are not food crops, and others.\u003c/p\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003e3.1. Knowledge\u003c/h2\u003e\n \u003cp\u003eThe response to question 15, querying, \u0026quot;Do you have any knowledge about the water available in your country?\u0026quot; emerges as the pivotal discovery of this study. As illustrated in Fig.\u0026nbsp;2, approximately 65.3% of respondents indicated awareness of water availability in Iraq, while 34.7% either expressed uncertainty (16%) or claimed no knowledge (18.7%). Notably, regarding question 15.1 (\u0026quot;If your response to question 15 is \u0026apos;yes\u0026apos;, In your opinion, does Iraq have an inadequate supply of natural water resources?\u0026quot;), further insights are warranted. The data depicted in the figure indicates that 90.6% of respondents selected \u0026quot;yes,\u0026quot; while the remaining 9.4% either answered \u0026quot;no\u0026quot; (6.6%) or expressed uncertainty (2.8%). Drawing from the preceding questions, it is notable that a considerable proportion (approximately 41%) of survey participants lack awareness of the water crisis and governmental efforts to ensure adequate water supply. This underscores a significant area of concern.\u003c/p\u003e\n \u003cp\u003eRegarding their answer to question 16, which inquired, \u0026quot; Is it necessary to reduce water consumption in Iraq, in your opinion?\u0026quot; a substantial majority (93.3%) of survey participants expressed support for water rationalisation. Furthermore, nearly nine out of ten respondents affirmed their commitment to conserving water consumption in their households in response to question 17. Question 18 subsequently prompted participants who responded affirmatively to question 17 to delineate the specific measures undertaken to conserve water in household applications. Figure \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates that respondents implemented water-saving practices such as reducing water usage during cleaning or bathing, transitioning to toilets with lower water consumption, and upgrading to water-saving taps. However, their responses varied, with percentages indicating \u0026quot;sometimes\u0026quot; ranging from 43\u0026ndash;61%, while \u0026quot;never\u0026quot; responses ranged from 3\u0026ndash;30%. Additionally, a notable finding is that participants expressed a need to know more about the country\u0026apos;s water conservation efforts and how they benefit people, the environment, and society as a whole.\u003c/p\u003e\n \u003cp\u003eConcerning question 19 (\u0026quot;Do you have any background knowledge on treated wastewater?\u0026quot;), the findings revealed that approximately 30% of survey participants had never encountered the concept of wastewater recycling. This underscores the importance of public education initiatives aimed at this demographic, emphasising the economic and ecological advantages associated with wastewater reuse. Regarding question 20 (\u0026quot;What sources have you used to learn about treated wastewater reuse?\u0026quot;), the primary sources cited were the Internet, followed by environmental groups as a distant second, as indicated in Fig. 2. Contributions from friends, television, family, and journals were comparatively less substantial. Likewise, Chfadi, \u003cem\u003eet al.\u003c/em\u003e [63] observed that the Internet serves as the predominant avenue for public information dissemination. As for question 21 (\u0026quot;From your different backgrounds, how would you suggest communication with the public be when implementing this type of project?\u0026quot;), respondents were afforded free choice. In efforts to enhance public attitudes toward wastewater recycling, they proposed various methods outlined in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eThe results in this section align with the study\u0026apos;s first objective, which aimed to assess the population\u0026apos;s awareness of water resources and their reuse. The limited awareness of water resource sustainability may be a significant obstacle to implementing water reuse policies. Therefore, increasing awareness campaigns, mainly through the media and social media platforms, may improve the population\u0026apos;s acceptance of these technologies and raise awareness of the importance of reuse. According to earlier research studies, the level of public awareness and knowledge is a key factor in the success of any recycling initiative [\u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003e3.2. Attitude\u003c/h2\u003e\n \u003cp\u003eBaghapour, et al. [\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e], Raman [\u003cspan class=\"CitationRef\"\u003e66\u003c/span\u003e], Buyukkamaci and Alkan [\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e], Dom\u0026egrave;nech and Saur\u0026iacute; [\u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e], Kantanoleon, \u003cem\u003eet al.\u003c/em\u003e [69], DuBose [\u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e], Dolnicar, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e] and Maraqa and Ghoudi [\u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e], pointed out the public\u0026apos;s conditional approval of using reclaimed water. In question 22 (\u0026quot;Are you in favour of using recycled wastewater for some purposes?\u0026quot;), Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e distinctly delineates two groups, representing those in agreement and those in disagreement. The studies conducted by DuBose [\u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e], Aitken, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e73\u003c/span\u003e], Browning-Aiken, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e74\u003c/span\u003e], and Leviston, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e75\u003c/span\u003e] forecasted substantial support for water-treated initiatives when crafted with sustainability as a central focus.\u003c/p\u003e\n \u003cp\u003eContrary to previous studies, Chfadi, et al. [63] and Baghapour, et al. [\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e], found that the reclaimed water acceptance was highest when there was minimal skin contact and lowest when it was linked to activities such as drinking, cooking, washing, and bathing. Dom\u0026egrave;nech and Saur\u0026iacute; [\u003cspan class=\"CitationRef\"\u003e68\u003c/span\u003e] underscored that the public\u0026apos;s tendency to establish centralised wastewater treatment facilities in their homes is significantly shaped by considerations such as health risks, operational procedures, pricing, and environmental awareness, particularly in Spain. In our study, concerning question 23 (\u0026quot;Would you be open to having a central system installed in your home?\u0026quot;), approximately 75% of participants responded with either \u0026quot;yes\u0026quot; or \u0026quot;maybe.\u0026quot; Subsequently, question 24 inquired, \u0026quot;If your answer to question 23 is yes or maybe, how much extra monthly fees are you willing to pay?\u0026quot;. Approximately 60% of respondents indicated they would be willing to pay between 5,000 and 15,000 IQ, equivalent to around 4 to 12 US dollars, each month for the installation of a central wastewater treatment system, as depicted in Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e. Conversely, in answer to the 25th question (\u0026quot;How much do you trust the safety standards for treated wastewater that you can use?\u0026quot;), Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e shows that more than 62% of Iraqis have faith in the safety rules put in place by the government.\u003c/p\u003e\n \u003cp\u003eTable\u0026nbsp;3 presents a summary of responses to questions 27 through 30. While 16.4% of respondents expressed opposition to using treated wastewater for watering food crops, a significant majority (70.4%) supported its use for non-food crops. On average, 16% of survey participants objected to using treated wastewater for irrigation, while 14.1% remained uncertain, as outlined in Table\u0026nbsp;3. The study conducted in Canada by Velasquez and Yanful [\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e] found that 76% of participants endorsed using treated wastewater for irrigating food crops, while 86% supported its use for non-food crops. The adoption rate was relatively higher for low-contact applications such as the irrigation of public parks and animal crops compared to high-contact applications such as food crops irrigation. Menegaki, \u003cem\u003eet al.\u003c/em\u003e [76] emphasised the significance of attitudes in exploring both the usage and payment intentions for using reclaimed water in agriculture. According to Table 3, on average, a significant majority (66.2%) of respondents express support for treating wastewater for commercial and industrial purposes. This support extends to various applications, including power plants (69%), cooling, cleaning, and car wash averages (70%), construction operations (69%), firefighting (75%), and laundry services (43%). According to Table 3, a majority of respondents express support for recycling wastewater into storage for emergencies (61.5%) and artificial lakes (60.8%). However, they are against its usage in the following areas: cooking (59.6% ), cleaning produce (i.e., vegetables and fruits) (55%), watering pets and birds (24.5%), domestic usage (51.9%), swimming pools (48.7%), and fish farms (32.9%).\u003c/p\u003e\n \u003cp\u003eThe level of physical contact appears to be inversely correlated with favourable perceptions of using treated wastewater. The most popular uses were washing cars and flushing toilets, while the least popular was washing clothes and taking baths. [\u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e]. According to Table 3, a majority of respondents express support for reusing treated wastewater for several beneficial purposes, including decreasing the application of toxic chemical fertilisers (88.9%), dropping pollution (87.9%), environmental preservation (85.8%), and alleviating the strain on dwindling aquifer networks and costly seawater desalination unit (86.6%). In question 31 (Arrange these incentives, in your view, to promote the use of treated wastewater by the general population; the range from 1 to 4 is from highest to lowest). Here is the overall rating, as shown in Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e: reducing cost (53.8%, 1), reducing environmental damage (54%, 1), relieving stress on alternative water supplies (43.2%, 1), and wastewater representing an additional water source (40.4%, 2). In question 32 (From your point of view, what is the single most significant obstacle to the general public\u0026apos;s willingness to utilise treated wastewater? with 1 being the highest and 3 the lowest). As shown in Fig. \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e, the following is the overall ranking of barriers: the fear of transmission of infectious diseases (62.5%, 1), ethical considerations or cultural issues (46.9%, 1), and quality and performance standards (41.4%, 1). Similarly, Buyukkamaci and Alkan [\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e] demonstrated that the public is primarily concerned about potential health risks associated with reclaimed water usage, regardless of the treatment level.\u003c/p\u003e\n \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e\n \u003ch2\u003e3.2.1.T-test\u003c/h2\u003e\n \u003cp\u003eThe study employed a T-test of independent samples to investigate potential variations between sexes concerning confidence in the diverse applications of treated wastewater, such as irrigation, commercial, and industrial use, and attaining multiple objectives. The outcomes of the T-test indicate sex differences in the trust levels regarding the utilisation of reclaimed water for irrigation, commercial and industrial purposes, and various objectives (refer to Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Specifically, a statistically significant difference was observed between males and females, with females exhibiting greater trust in utilising reclaimed water for industrial and commercial purposes (t = -3.67 and p\u0026thinsp;=\u0026thinsp;0.000), achieving different goals (t = -4.03 and p\u0026thinsp;=\u0026thinsp;0.000), and irrigation (t = -4.62 and p\u0026thinsp;=\u0026thinsp;0.000). Based on the authors\u0026apos; knowledge, the findings agree with the Abdelrahman, et al. [33] in some items. However, our outcomes contrast with previous studies indicating that men typically exhibit greater acceptance of risky technologies [\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e77\u003c/span\u003e]. Therefore, when examining individuals\u0026apos; responses to recycled water, it is imperative to account for sex variations.\u003c/p\u003e\n \u003cp\u003eData from Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e was regrouped into three categories\u0026mdash;age, education level, and income\u0026mdash;to examine how these factors affected respondents\u0026apos; opinions about increasing recycled wastewater utilisation for other usages (Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e\n \u003ch2\u003e3.2.2. One-way analysis of variance (ANOVA) test.\u003c/h2\u003e\n \u003cp\u003eThis technique was employed to analyse the impact of age, income, and educational level on a participant\u0026apos;s tendency towards using reclaimed water for industry, irrigation, commerce, different purposes, and multiple goals, aiming to achieve the fields outlined in Table \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e. For the fields examined (industrial and commercial uses, irrigation, and other purposes), the results revealed that some variables were statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), while others had no statistically significant effect (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). For example, no statistically significant difference was found between them and income, except for the \u0026quot;other purposes\u0026quot; category. There was a significant difference (p\u0026thinsp;=\u0026thinsp;0.01*) between groups, indicating that the differences between groups were not random. Specifically, there was a significant difference (p\u0026thinsp;=\u0026thinsp;0.73) between G1i and G3i for G3i and a significant difference (p\u0026thinsp;=\u0026thinsp;1.05) between G2i and G3i for G3i. This indicates that individuals with higher incomes are more receptive to the idea. These findings are consistent with those of previous studies [\u003cspan class=\"CitationRef\"\u003e78\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e80\u003c/span\u003e], which concluded that higher income is associated with higher levels of agreeableness. In contrast, other factors did not show any statistically significant effect (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), meaning the differences between groups were insignificant. For instance, regarding the utilisation of treated wastewater for irrigation, there is no statistically significant relationship between age-groups (0.17) or educational levels (0.36).\u003c/p\u003e\n \u003cp\u003eInterestingly, these results contradict previous studies Bennett, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e81\u003c/span\u003e], Chen, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e82\u003c/span\u003e] and Buyukkamaci and Alkan [\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e] which suggest that younger participants tend to be more agreeable. In contrast, Probe Smith, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e83\u003c/span\u003e] and Bruvold and Cook [\u003cspan class=\"CitationRef\"\u003e84\u003c/span\u003e] found that older participants were more agreeable. Additionally, there was no statistically significant difference between educational levels across all fields examined, a finding consistent with two large-scale studies conducted in Australia by Dolnicar, et al. [\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e] and the United States of America by Haddad, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e85\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eThese results (i.e., Sections \u003cspan class=\"InternalRef\"\u003e3.2.1\u003c/span\u003e and \u003cspan class=\"InternalRef\"\u003e3.2.2\u003c/span\u003e) are in line with the second objective of the research, as they provide a detailed understanding of how demographic backgrounds influence attitudes toward reused water. Previous studies by Lahlou, \u003cem\u003eet al.\u003c/em\u003e [\u003cspan class=\"CitationRef\"\u003e86\u003c/span\u003e], Dolnicar, et al. [\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e], and Fielding, et al. [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e] indicate that higher education levels are often associated with greater acceptance of sustainable technologies, which is supported by the results of this study. Therefore, developing awareness programs specifically targeted at less receptive groups, such as the elderly, may help enhance confidence in the effectiveness and safety of reused water.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\n \u003ch2\u003e3.2.3. Chi‑square test\u003c/h2\u003e\n \u003cp\u003eA chi-square test was employed to analyse the respondents\u0026apos; attitudes regarding the ranking of attitudes for treated wastewater reuse, based on demographic variables such as sex, age, education level, and income. Figure \u003cspan class=\"InternalRef\"\u003e7\u003c/span\u003e illustrates that the top-ranked incentive for treated wastewater reuse is the provision of dropping environmental damage, which ranks first, with the primary drivers being middle-aged males with high educational levels and high income. Also, additional water resources rank 2nd, and it indicates that individuals who are old females, possess undergraduate education levels, and have a high income are the primary drivers of this preference. Additionally, reduced pressure on other water resources ranks three, and the drivers are old females with (a diploma or less to an undergraduate) education level and high income. Moreover, reducing cost ranks fourth, with the primary drivers, being younger to middle-aged females and males (i.e., females and males have the same percentage) with undergraduate educational levels and middle-income. Using a chi-square test, the study examined how respondents\u0026apos; sex, age, education level, and income influenced the ranking of barriers to using treated wastewater. This analysis allowed us to understand how respondents rated these obstacles based on demographic variables such as sex, age, education level, and income. Figure \u003cspan class=\"InternalRef\"\u003e8\u003c/span\u003e displays that transmission of infectious diseases ranks first, and the drivers are old females with a diploma or less educational level and high income. Quality and performance standards rank second, with the primary drivers being young females, with undergraduate educational levels and middle income. Ethical considerations or cultural issues rank third, with young females of undergraduate educational levels and middle income as the primary drivers. These findings of this section align with the third objective of the research, as they provide an analysis of the factors that promote or hinder treated water reuse. Previous studies by Shafiquzzaman, et al. [\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e], Ablo and Etale [\u003cspan class=\"CitationRef\"\u003e87\u003c/span\u003e], and Lahlou, \u003cem\u003eet al.\u003c/em\u003e [88] confirm that health concerns are one of the most significant barriers to treated water reuse in Middle Eastern countries. Based on these findings, health awareness campaigns that explain water treatment processes and ensure their quality can increase population acceptance and reduce associated concerns.\u003c/p\u003e\n \u003cp\u003eThe attitudes of inhabitants towards reusing treated wastewater can be better understood by combining the findings of the chi-square test with ANOVA. While chi-square finds the correlation between demographics and categorical orientations, ANOVA checks for statistical significance to make the findings more trustworthy. For instance, the ANOVA results showed that there was a statistical difference in confidence levels between the sexes, while the chi-square results showed that women were more likely to rate \u0026quot;reducing environmental damage\u0026quot; as the most important reason for reusing treated wastewater.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"4. Conclusion","content":"\u003cp\u003eThe primary conclusion of this research is that about 65.3% of individuals are aware of the availability of water in Iraq. However, a significant portion (approximately 41%) do not know about the water crisis and the government's initiatives to fix it. This lack of awareness is a major concern. The primary sources of information are the Internet and environmental groups. To highlight the possible economic advantages of reclaimed water reuse for Iraq, people, and the environment, campaigns should concentrate on these two types of media. These campaigns ought to incorporate the expertise of water science and psychology specialists in reusing wastewater. The majority of respondents (93.3%) demonstrate social responsibility through their belief in water rationalisation efforts. Additionally, 88% recognise the importance of conserving water in their households, and 41% would pay more to have a centralised reclaimed water system built where they reside.\u003c/p\u003e \u003cp\u003eMost individuals agree on the utilisation of reclaimed water for irrigation purposes. The highest acceptance rate was observed for the irrigation of public gardens (78.3%), followed by irrigation of animal crops (75%), non-food crops (70.4%), and food crops (68.2%), as indicated in Table\u0026nbsp;3. Furthermore, for industry and commerce usage, most individuals prefer using treated wastewater for purposes such as refrigeration, car washing, cleaning, and construction. While using treated wastewater for purposes such as flushing toilets garners the most votes, followed by drinking among animals and birds, storage for emergencies, creating artificial lakes, and fish farms, it is not favoured for domestic use, swimming pools, washing vegetables, or cooking. Respondents indicated that the primary reasons they favour using reclaimed water are to reduce the utilisation of harmful chemical fertilisers, reduce pollution, alleviate pressure on groundwater and desalinate water, and preserve the environment.\u003c/p\u003e \u003cp\u003eThe results of a T-test indicated sex variance in confidence regarding the reuse of reclaimed water for all purposes, including industrial and commercial uses, irrigation, and various goals. Females were found to be more likely to trust the use of treated wastewater than men across all mentioned uses. Furthermore, a one-way ANOVA revealed no significant differences between groups, regardless of age, education level, and income, regarding using reclaimed water for industrial and commercial uses, irrigation, and other specified purposes. However, concerning achieving specific goals, individuals with higher income levels were found to be more accepting than others. Additionally, the results of the chi-square test highlighted that the primary motivations for reusing treated wastewater were considering it to reduce environmental damage and additional water resources on other water resources. Conversely, the main hurdles identified were the fear of infectious disease transmission and concerns related to quality and performance standards.\u003c/p\u003e \u003cp\u003eRegarding achieving the three research objectives: 1) Measuring public awareness of the water crisis: While most people in the study were aware that there was a water resource problem, they were unaware that the government was making any attempts to solve it. This highlights a significant knowledge gap on the water crisis. 2) Analysis of population attitudes towards water reuse: Results showed that confidence in treated water was higher among females than males, and that acceptability of treated water reuse varied by age, gender, and economic level. 3) Identifying the factors that encourage and hinder the use of treated wastewater: Reducing pollution was seen as the primary incentive for water reuse, while health and cultural issues were identified as the primary hurdles.\u003c/p\u003e \u003cp\u003eThis study provides valuable insight into the public's perspective on treated wastewater reuse in Iraq. It finds that although many are in favour of its use in agriculture and industry, there are still others who are resistant due to health and cultural concerns. Generalisability may be affected by several methodological restrictions, such as the limited response rate and the study's narrow geographic emphasis, even though the results are robust. The study's findings show that neighbouring nations are comparable in terms of popular acceptance, but that the driving and barrier factors are different. In light of these results, the study suggests reaching out to psychological and technological specialists to help create awareness campaigns, increasing the scope of the research to cover more of Iraq for a more complete picture, and raising community awareness overall.\u003c/p\u003e"},{"header":"5. Limitations and future directions","content":"\u003cp\u003eThe sample size is one of the methodological limitations of this study. Data was obtained from 507 participants in Kut city, meaning that not all Iraq perspectives may have been accurately represented. Additionally, response biases could have impacted the results; for example, certain participants might have had a greater familiarity with or interest in treated water reuse than others. Furthermore, while many statistical checks were conducted to guarantee the reliability of the analysis, additional research is needed to fully comprehend the significant influence of certain socioeconomic variables on the adoption of treated water reuse. Considering the study's regional context, it can be compared to others that have looked at acceptance levels in Middle Eastern nations, including Turkey, Oman, and the United Arab Emirates. In those countries, acceptance levels vary according to cultural, religious, and economic reasons. Future research should take into consideration the fact that direct comparisons are complicated due to variations in infrastructure and government policy.\u003c/p\u003e \u003cp\u003eBased on these limitations, this research recommends future studies that include a broader geographic scope and use qualitative research methods such as in-depth interviews to gain a deeper understanding of audience motivations. Also, the study made other recommendations to maximise water reuse's societal acceptability: raising awareness of the water scarcity crisis in Iraq and promoting wastewater reuse initiatives. Recruit the help of psychology and water science specialists to spread the benefits of wastewater reuse that could have a positive financial impact on the country, its citizens, and the environment through online platforms, social media, and television. This study can be used as a springboard for further research in other Iraqi Governorates.\u003c/p\u003e"},{"header":"6. Policy implications","content":"\u003cp\u003eIn order to achieve water sustainability in Iraq, this study's empirical findings can be used to propose a set of policy recommendations that will increase the acceptance and reuse of treated wastewater.\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePublic Awareness and Education Campaigns: Our findings indicate that 41% of respondents were unaware of Iraq\u0026rsquo;s water crisis, and 30% had never encountered the concept of wastewater recycling. This highlights the urgent need for targeted public education programs to increase awareness and acceptance of treated wastewater reuse. Accordingly, government agencies should collaborate with educational institutions, environmental NGOs, and social media platforms to develop campaigns that highlight the benefits of wastewater reuse while addressing common misconceptions (e.g., health risks and cultural concerns). This recommendation aligns with global success stories, such as Singapore\u0026rsquo;s \u0026ldquo;NEWater\u0026rdquo; initiative, which improved public confidence in water reuse through strategic communication and engagement.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eRegulatory and Safety Standards Enforcement: While 62% of Iraqis trust existing wastewater treatment safety standards, concerns about quality and performance standards ranked as the second-largest barrier to adoption. Establishing stricter quality assurance frameworks, increasing transparency in water treatment processes, and conducting regular independent audits can enhance public trust in reclaimed water. Lessons from Australia and California show that public confidence improves when governments publish real-time water quality data and enforce clear safety benchmarks.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eFinancial Incentives to Drive Adoption: Our study revealed that cost reduction (53.8%) and environmental benefits (54%) were the top motivations for wastewater reuse. Furthermore, 41% of participants were willing to pay extra fees for centralised treatment systems, suggesting an opportunity for incentive-based policy interventions. Implement tiered pricing models that offer reduced water tariffs for households using reclaimed water. Introduce subsidies or tax incentives for industries and farms that integrate treated wastewater into their operations. Similar policies in the UAE have successfully encouraged wastewater reuse by providing economic benefits to early adopters.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eInfrastructure Investment and Decentralised Treatment Options: Our results show that 75% of respondents support installing centralised wastewater treatment systems but highlighted concerns about implementation costs and accessibility. Expand public-private partnerships (PPPs) to fund the development of wastewater treatment plants. Encourage localised, decentralised treatment systems in rural or underserved areas to reduce infrastructure costs and improve water security. Decentralised treatment models have been successfully implemented in Germany and India, reducing dependency on large-scale infrastructure while ensuring equitable water access.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAddressing Cultural and Ethical Concerns: Cultural and ethical concerns ranked as the third-highest barrier to wastewater reuse in our study. Collaborate with religious and community leaders to frame wastewater reuse within an ethical and environmental stewardship narrative. Countries like Jordan and Saudi Arabia have successfully incorporated religious perspectives to encourage water conservation and wastewater reuse.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors appreciate the respondents who gave their time to contribute to the survey in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupplemental material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSurvey\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCRediT authorship contribution statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHamza T. AL-Rikabi\u003c/strong\u003e: Validation; Formal analysis; Writing—original draft; Writing—review \u0026amp; editing; Visualization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSalah L. Zubaidi\u003c/strong\u003e: Conceptualization; Methodology; Software; Investigation; Writing—review \u0026amp; editing; Supervision; Project administration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSandra Ortega-Martorell\u003c/strong\u003e: Methodology; Resources; Writing—review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNadhir Al-Ansari:\u0026nbsp;\u003c/strong\u003eConceptualization; Methodology; Writing—review \u0026amp; editing; Visualization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNabeel Saleem Saad Al-Bdairi\u003c/strong\u003e: Methodology; Software; Investigation; Writing—review \u0026amp; editing; Visualization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eYousif Raad Muhsen\u003c/strong\u003e: Methodology; Software; Writing—review \u0026amp; editing; Visualization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKhalid S. Hashim\u003c/strong\u003e: Methodology; Resources.\u003c/p\u003e\n\u003cp\u003eAll authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e\u0026nbsp;The authors declare no conflicts of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eData Availability:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eRavishankar, C.; Nautiyal, S.; Seshaiah, M. Social Acceptance for Reclaimed Water Use: A Case Study in Bengaluru. \u003cem\u003eRecycling \u003c/em\u003e\u003cstrong\u003e2018\u003c/strong\u003e, \u003cem\u003e3\u003c/em\u003e, doi:10.3390/recycling3010004.\u003c/li\u003e\n\u003cli\u003eRoson, R.; Damania, R. 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Public perceptions of recycled water: a survey of visitors to the London 2012 Olympic Park.\u003cem\u003e Journal of Water Reuse Desalination \u003c/em\u003e\u003cstrong\u003e2015\u003c/strong\u003e, \u003cem\u003e5\u003c/em\u003e, 189-195, doi:https://doi.org/10.2166/wrd.2014.146.\u003c/li\u003e\n\u003cli\u003eBruvold, W.H.; Cook, J. Reclaiming and reusing wastewater. \u003cem\u003eWater/Engineering Management \u003c/em\u003e\u003cstrong\u003e1981\u003c/strong\u003e, \u003cem\u003e128\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eHaddad, B.M.; Rozin, P.; Nemeroff, C.; Slovic, P. \u003cem\u003eThe psychology of water reclamation and reuse: survey findings and research roadmap\u003c/em\u003e; WateReuse Foundation Alexandria, VA: 2009.\u003c/li\u003e\n\u003cli\u003eLahlou, F.; Mackey, H.; McKay, G.; Al-Ansari, T. Reuse of treated industrial wastewater and bio-solids from oil and gas industries: Exploring new factors of public acceptance. \u003cem\u003eWater Resources Industry \u003c/em\u003e\u003cstrong\u003e2021\u003c/strong\u003e, \u003cem\u003e26\u003c/em\u003e, 100159, doi:doi.org/10.1016/j.wri.2021.100159.\u003c/li\u003e\n\u003cli\u003eAblo, A.D.; Etale, A. Beyond technical: delineating factors influencing recycled water acceptability. \u003cem\u003eUrban Water Journal \u003c/em\u003e\u003cstrong\u003e2022\u003c/strong\u003e, \u003cem\u003e21\u003c/em\u003e, 1014-1021, doi:DOI:10.1080/1573062X.2022.2155847.\u003c/li\u003e\n\u003cli\u003eLahlou, F.; Mackey, H.; McKay, G.; Al-Ansari, T.; Industry. Reuse of treated industrial wastewater and bio-solids from oil and gas industries: Exploring new factors of public acceptance. \u003cem\u003eWater Resources Industry \u003c/em\u003e\u003cstrong\u003e2021\u003c/strong\u003e, \u003cem\u003e26\u003c/em\u003e, 100159, doi:https://doi.org/10.1016/j.wri.2021.100159.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 6 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"wastewater reuse, public perception, SDGs, survey, sustainability, Iraq","lastPublishedDoi":"10.21203/rs.3.rs-5780361/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5780361/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"This study aimed to evaluate the public's perspective on the utilisation of reclaimed water in Al-Kut, Iraq. Accordingly, a survey consisting of multiple-choice questions was designed to gather demographic information and assess the participants' views and knowledge about water resources and wastewater reuse. The replies of 507 Iraqis, consisting of 326 males and 181 females, were analysed using a T, one-way analysis of variance (ANOVA), and Chi-square tests. The study's findings indicate that 90.6% of the people are conscious of the issue of water crisis problem, whereas the others 9.4% either deny its existence (6.6%) or are uncertain about it (2.8%). Based on the survey questions, a high percentage (about 41%) of respondents have no idea that there is a water crisis. Nevertheless, the majority (88%) of individuals are implementing strategies to preserve water and are open to incurring additional charges for the installation of centralised wastewater treatment plants in the area. Many individuals support the utilisation of reclaimed water for agricultural and industrial applications. The findings also indicated a statistically significant relationship between sex, income, and acceptance of wastewater reuse. Incentives for reusing treated wastewater and opposition against it were ranked by the respondents.","manuscriptTitle":"An Investigation into the Societal Attitudes and Acceptance of Treated Wastewater Reuse in an Area Experiencing Water Scarcity ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-21 06:30:45","doi":"10.21203/rs.3.rs-5780361/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-23T08:09:12+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-19T21:45:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"265382238302339484250450681110171203513","date":"2025-04-17T12:01:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-16T09:34:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"153780539387153807405072244077570128453","date":"2025-04-16T09:20:39+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-16T05:27:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-07T08:47:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-03-26T12:16:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"acabc1ff-90c5-4654-b16f-2f22b7afd133","owner":[],"postedDate":"April 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":47244063,"name":"Earth and environmental sciences/Environmental sciences"},{"id":47244064,"name":"Earth and environmental sciences/Environmental social sciences"}],"tags":[],"updatedAt":"2025-11-24T16:01:54+00:00","versionOfRecord":{"articleIdentity":"rs-5780361","link":"https://doi.org/10.1038/s41598-025-24308-w","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2025-11-18 15:57:50","publishedOnDateReadable":"November 18th, 2025"},"versionCreatedAt":"2025-04-21 06:30:45","video":"","vorDoi":"10.1038/s41598-025-24308-w","vorDoiUrl":"https://doi.org/10.1038/s41598-025-24308-w","workflowStages":[]},"version":"v1","identity":"rs-5780361","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5780361","identity":"rs-5780361","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}