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Boogaerts T, Van Wichelen N, Quireyns M, Burgard D, Bijlsma L, Delputte P, Gys C, Covaci A, van Nuijs ALN. Current state and future perspectives on de facto population markers for normalization in wastewater-based epidemiology: A systematic literature review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 935:173223. [PMID: 38761943 DOI: 10.1016/j.scitotenv.2024.173223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 05/20/2024]
Abstract
Wastewater-based epidemiology (WBE) and wastewater surveillance have become a valuable complementary data source to collect information on community-wide exposure through the measurement of human biomarkers in influent wastewater (IWW). In WBE, normalization of data with the de facto population that corresponds to a wastewater sample is crucial for a correct interpretation of spatio-temporal trends in exposure and consumption patterns. However, knowledge gaps remain in identifying and validating suitable de facto population biomarkers (PBs) for refinement of WBE back-estimations. WBE studies that apply de facto PBs (including hydrochemical parameters, utility consumption data sources, endo- and exogenous chemicals, biological biomarkers and signalling records) for relative trend analysis and absolute population size estimation were systematically reviewed from three databases (PubMed, Web of Science, SCOPUS) according to the PRISMA guidelines. We included in this review 81 publications that accounted for daily variations in population sizes by applying de facto population normalization. To date, a wide range of PBs have been proposed for de facto population normalization, complicating the comparability of normalized measurements across WBE studies. Additionally, the validation of potential PBs is complicated by the absence of an ideal external validator, magnifying the overall uncertainty for population normalization in WBE. Therefore, this review proposes a conceptual tier-based cross-validation approach for identifying and validating de facto PBs to guide their integration for i) relative trend analysis, and ii) absolute population size estimation. Furthermore, this review also provides a detailed evaluation of the uncertainty observed when comparing different de jure and de facto population estimation approaches. This study shows that their percentual differences can range up to ±200 %, with some exceptions showing even larger variations. This review underscores the need for collaboration among WBE researchers to further streamline the application of de facto population normalization and to evaluate the robustness of different PBs in different socio-demographic communities.
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Affiliation(s)
- Tim Boogaerts
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Exposome Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Natan Van Wichelen
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Exposome Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Maarten Quireyns
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Exposome Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Dan Burgard
- Department of Chemistry and Biochemistry, University of Puget Sound, Tacoma, WA, USA
| | - Lubertus Bijlsma
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Infla-Med Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Celine Gys
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Exposome Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Exposome Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Alexander L N van Nuijs
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Exposome Center of Excellence, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
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Wang Z, Zheng Q, O'Brien JW, Tscharke BJ, Chan G, Thomas KV, Mueller JF, Thai PK. Analysis of wastewater from 2013 to 2021 detected a recent increase in nicotine use in Queensland, Australia. WATER RESEARCH 2024; 250:121040. [PMID: 38154341 DOI: 10.1016/j.watres.2023.121040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
Previous wastewater-based epidemiology (WBE) studies have reported decreasing trends of nicotine and tobacco use in Australia before 2017, but there is concern that increasing illicit use of nicotine in vaping products and illicit tobacco could reverse this progress. This study aimed to assess temporal trends of nicotine consumption and specifically tobacco consumption via wastewater analysis in a population in Australia between 2013 and 2021. One week of daily wastewater samples were analyzed every two months from February 2013 to December 2021 in a regional city serving ∼100,000 people. A total of 340 daily samples were analyzed for anabasine (tobacco specific biomarker) and nicotine metabolites, cotinine and hydroxycotinine, using direct injection method by liquid chromatography with tandem mass spectrometry. Daily consumption estimates were calculated from daily flow data, population estimates and previously reported excretion factors. Linear spline regression was performed to identify periods when significant change of slopes occurred and to evaluate the temporal trends. Tobacco use monitored using anabasine as a biomarker, showed a decreasing trend over the whole period with a higher rate of decrease during the first two years (2013-2014, 21 % decrease) compared to the later 7 years (2015-2021, 10 % decrease). Nicotine use, monitored using cotinine and hydroxycotinine, showed a downward trend between 2013 and 2018 (2013-2014: 18 % decrease, p < 0.05; 2015-2016: 6 % increase, p = 0.48; Feb-Dec 2017: 15 % decrease, p = 0.39) followed by a significant increase from 2018 to 2021 (40 % increase, p < 0.001). This finding suggests the increasing use of non-tobacco nicotine-based products. Additionally, the tobacco use estimate by wastewater analysis was higher than the tobacco sales data, which suggests the use of illicit tobacco in the catchment.
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Affiliation(s)
- Zhe Wang
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Qiuda Zheng
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia.
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Benjamin J Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Gary Chan
- Center for Youth Substance Abuse Research, The university of Queensland, Brisbane, QLD 4102, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
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Yavuz Guzel E, Atasoy Aydin A, Gören İE, Unuvar N, Daglioglu N. Estimation of anti-diabetes drug metformin in Turkiye using wastewater-based epidemiology. Drug Test Anal 2024. [PMID: 38296259 DOI: 10.1002/dta.3646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/23/2023] [Accepted: 01/03/2024] [Indexed: 02/23/2024]
Abstract
Metformin is the most commonly used drug for the treatment of type 2 diabetes (T2D), which is dramatically increasing due to factors such as increasing obesity, physical inactivity, and aging of the population. Metformin analysis was carried out in composite wastewater samples seasonally collected from wastewater treatment plants in 10 cities in 2019 and 2020 30 cities in 2021 in Turkiye. Metformin was measured in all wastewater samples, with an average concentration of 97.81 μg/l in 2019, 75.19 μg/l in 2020, and 69.13 μg/l in 2021. This study was utilized to predict metformin usage in different sociodemographic regions in Turkiye using a wastewater-based epidemiology (WBE) approach. As a result of the analysis, the average metformin consumption in Turkiye was estimated to be 22.2 ± 9.6 [1.9-63.8] g/d/1,000 persons (mean ± SD [range]). Furthermore, these estimates were compared with data for time, sociodemographic characteristics, and patient numbers. Assessing the correlation with estimates and the socioeconomic classes of the cities in question revealed that cities with high-income levels had the lowest metformin use rate. Finally, the study provides supporting data aiding the development of public health strategies for decreasing the overall load of T2D across Turkiye.
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Affiliation(s)
- Evsen Yavuz Guzel
- Faculty of Fisheries, Department of Basic Science, Cukurova University, Adana, Türkiye
| | - Aslı Atasoy Aydin
- Institute of Forensic Sciences, Department of Forensic Toxicology, Ankara University, Ankara, Türkiye
| | - İsmail Ethem Gören
- Institute of Forensic Sciences, Department of Forensic Toxicology, Ankara University, Ankara, Türkiye
| | | | - Nebile Daglioglu
- Institute of Forensic Sciences, Department of Forensic Toxicology, Ankara University, Ankara, Türkiye
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Sharfudeen YA, Cha HJ, Oh JE. Tracking methamphetamine and amphetamine consumption patterns in South Korea via enantiomeric analysis of wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:166910. [PMID: 37689196 DOI: 10.1016/j.scitotenv.2023.166910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
Wastewater-based epidemiology (WBE) has emerged as an effective method for monitoring a community's health status and lifestyle. In recent years, enantiomeric profiling has shown promise as a tool for tracing the sources of abused drugs through WBE. This study investigated amphetamine (AMP) and methamphetamine (METH) consumption in South Korea using enantiomeric analysis of untreated wastewater samples collected from 27 wastewater-treatment plants (WWTPs). Both AMP and METH were detected, with the predominant detection of S-(+)-METH indicating widespread illegal use of METH, which is primarily produced by a clandestine synthesis procedure that involves the reduction of ephedrine/pseudoephedrine. Most AMP/METH ratios in the samples were consistent with the expected METH excretion profile, indicating that the presence of AMP was primarily due to METH metabolism. However, R-(-) AMP was detected in 18.5 % and 25.9 % of wastewater samples in winter and spring, respectively, and the high AMP/METH ratio (>0.27) indicated potential AMP abuse. By differentiating between the sources of AMP and METH in wastewater, enantiomeric analysis could help authorities to target and address specific drug-abuse issues affecting the population more effectively.
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Affiliation(s)
- Yasar Arafath Sharfudeen
- Department of Civil and Environmental Engineering, Pusan National University, Busan 46241, Republic of Korea
| | - Hye Jin Cha
- College of Veterinary Medicine, Gyeongsang National University, Jinju-si, Gyeongsangnam-do 52828, Republic of Korea
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Busan 46241, Republic of Korea; Institute for Environment and Energy, Pusan National University, Busan 46241, Republic of Korea.
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Rousis N, Bade R, Romero-Sánchez I, Mueller JF, Thomaidis NS, Thomas KV, Gracia-Lor E. Festivals following the easing of COVID-19 restrictions: Prevalence of new psychoactive substances and illicit drugs. ENVIRONMENT INTERNATIONAL 2023; 178:108075. [PMID: 37399770 DOI: 10.1016/j.envint.2023.108075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/15/2023] [Accepted: 06/29/2023] [Indexed: 07/05/2023]
Abstract
The market for illicit drugs and new psychoactive substances (NPS) has grown significantly and people attending festivals have been identified as being at high risk (high extent and frequency of substance use). Traditional public health surveillance data sources have limitations (high costs, long implementation times, and ethical issues) and wastewater-based epidemiology (WBE) can cost-effectively support surveillance efforts. Influent wastewater samples were analyzed for NPS and illicit drug consumption collected during New Year period (from 29-Dec-2021 to 4-Jan-2022) and a summer Festival (from 29-June-2022 to 12-July-2022) in a large city in Spain. Samples were analyzed for phenethylamines, cathinones, opioids, benzodiazepines, plant-based NPS, dissociatives, and the illicit drugs methamphetamine, MDA, MDMA, ketamine, heroin, cocaine, and pseudoephedrine by liquid chromatography mass spectrometry. High consumption rates of specific NPS and established illicit drugs were identified at the peak of each event. Furthermore, a dynamic change in NPS use (presence and absence of substances) was detected over a period of six months. Eleven NPS, including synthetic cathinones, benzodiazepines, plant-based NPS and dissociatives, and seven illicit drugs were found across both the New Year and summer Festival. Statistically significant differences (p < 0.05) were seen for 3-MMC (New Year vs summer Festival), eutylone (New Year vs summer Festival), cocaine (summer Festival vs normal week and summer Festival vs New Year), MDMA (New Year vs normal week and summer Festival vs normal week), heroin (summer Festival vs New Year) and pseudoephedrine (summer Festival vs New Year). This WBE study assessed the prevalence of NPS and illicit drugs at festivals following the reduction of the COVID-19 pandemic restrictions highlighting the high use of specific substances at the peak of each event. This approach identified in a cost-effective and timely manner without any ethical issues the most used drugs and changes in use patterns and, thus, can complement public health information.
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Affiliation(s)
- Nikolaos Rousis
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | - Richard Bade
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia.
| | - Iván Romero-Sánchez
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Nikolaos S Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Emma Gracia-Lor
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain.
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Chiappini S, Vickers-Smith R, Harris D, Papanti Pelletier GD, Corkery JM, Guirguis A, Martinotti G, Sensi SL, Schifano F. Is There a Risk for Semaglutide Misuse? Focus on the Food and Drug Administration's FDA Adverse Events Reporting System (FAERS) Pharmacovigilance Dataset. Pharmaceuticals (Basel) 2023; 16:994. [PMID: 37513906 PMCID: PMC10384093 DOI: 10.3390/ph16070994] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/04/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Recent media reports commented about a possible issue of the misuse of antidiabetics related to molecules promoted as a weight-loss treatment in non-obese people. We evaluated here available pharmacovigilance misuse/abuse signals related to semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, in comparison to other GLP-1 receptor agonists (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, and tirzepatide) and the phentermine-topiramate combination. To acheieve that aim, we analyzed the Food and Drug Administration's FDA Adverse Events Reporting System (FAERS) dataset, performing a descriptive analysis of adverse event reports (AERs) and calculating related pharmacovigilance measures, including the reporting odds ratio (ROR) and the proportional reporting ratio (PRR). During January 2018-December 2022, a total of 31,542 AERs involving the selected molecules were submitted to FAERS; most involved dulaglutide (n = 11,858; 37.6%) and semaglutide (n = 8249; 26.1%). In comparing semaglutide vs. the remaining molecules, the respective PRR values of the AERs 'drug abuse', 'drug withdrawal syndrome', 'prescription drug used without a prescription', and 'intentional product use issue' were 4.05, 4.05, 3.60, and 1.80 (all < 0.01). The same comparisons of semaglutide vs. the phentermine-topiramate combination were not associated with any significant differences. To the best of our knowledge, this is the first study documenting the misuse/abuse potential of semaglutide in comparison with other GLP1 analogues and the phentermine-topiramate combination. The current findings will need to be confirmed by further empirical investigations to fully understand the safety profile of those molecules.
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Affiliation(s)
- Stefania Chiappini
- UniCamillus University, Via di S. Alessandro 8, 00131 Rome, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Rachel Vickers-Smith
- Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, 111 Washington Avenue, Lexington, KY 40536, USA
| | - Daniel Harris
- Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, 289 South Limestone Street, Lexington, KY 40536, USA
- Center for Clinical and Translational Sciences, University of Kentucky, 800 Rose Street, Lexington, KY 40506, USA
| | - G Duccio Papanti Pelletier
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Cividale Community Mental Health Centre, ASUFC Mental Health Department, Via Carraria 29, 33043 Cividale del Friuli, Italy
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Amira Guirguis
- Department of Pharmacy, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Giovanni Martinotti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Department of Neurosciences, Imaging, and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Stefano L Sensi
- Department of Neurosciences, Imaging, and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology (CAST), Institute of Advanced Biomedical Technology (ITAB), University of Chieti-Pescara, Via dei Vestini 21, 66100 Chieti, Italy
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Department of Neurosciences, Imaging, and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
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Xu H, Cao L, Li J, Zhang F, Wang W, Liang T, Liu X, Fu C. Is Chinese Spring Festival a key point for glycemic control of patients with type 2 diabetes mellitus in China? Front Public Health 2022; 10:975544. [PMID: 36620247 PMCID: PMC9813744 DOI: 10.3389/fpubh.2022.975544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives This study aims to explore the long-term trend of fasting blood glucose (FBG) among urban patients with type 2 diabetes mellitus (T2DM) and the impacts of the Chinese Spring Festival on their glycemic control in urban China. Methods The general information and longitudinal monitoring data of patients with T2DM in Minhang District, Shanghai China from 15 December 2006 to 31 December 2015 were collected. The FBG records were grouped into three periods, namely, the preholiday period (2 months right before the Chinese Spring Festival), the holiday period (from 28 December to 7 January of the lunar calendar year), and the postholiday period (2 months after the Chinese Spring Festival). The Mann-Kendall trend test and Cochran-Armitage trend test were occupied to explore the long-term trend, and paired t-test and chi-square (χ2) test were used to determine the differences in glycemic level and control rate between the preholiday and postholiday periods, respectively. Results From 2007 to 2015, the glycemic control rate in patients with T2DM showed an upward trend (P < 0.001), and the FBG level showed a decreasing trend (P = 0.048). After the Chinese Spring Festival, the glycemic control rate decreased significantly (P < 0.001), and the FBG level increased significantly (P < 0.001) compared to those during the preholiday period. The incidence of hypoglycemia increased during holidays. Patients who were aged 60-69 years, overweight or obese, with hypertension, with a disease duration of <3 years, or with poor glycemic control in one previous year were more likely to be affected by the holiday. Conclusion Chinese Spring Festival is a key point for glycemic control of patients with T2DM in China. Intensive holiday-specific diabetic healthcare needs to be further improved, and community-based interventions should be developed and implemented to control the possible holiday effects.
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Affiliation(s)
- Huilin Xu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Li Cao
- School of Public Health, Fudan University, Shanghai, China,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Jun Li
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Fen Zhang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Weijie Wang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Tongtong Liang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Xiaohua Liu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China,*Correspondence: Xiaohua Liu ✉
| | - Chaowei Fu
- School of Public Health, Fudan University, Shanghai, China,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,Key Laboratory of Public Health Safety, Fudan University, Shanghai, China,Chaowei Fu ✉
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Zhao J, Lu J, Zhao H, Yan Y, Dong H, Li W. Illicit drugs and their metabolites in urban wastewater: Analysis, occurrence and consumption in Xinjiang, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 852:158457. [PMID: 36063955 DOI: 10.1016/j.scitotenv.2022.158457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/15/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
The use of illicit drugs has increased considerably across the world. Wastewater-based epidemiology (WBE) of illicit drugs might help determine the types and quantity of illicit drugs consumed in a region. In this study, WBE was applied to analyze illicit drugs in five representative urban wastewater treatment plants (WWTPs) in Xinjiang, China. The collected samples were pretreated under optimized solid-phase extraction conditions and then analyzed using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The results revealed the presence of 9 of the 11 evaluated drugs; among them, the concentrations of these substances ranged as follows: METH (2.60-10.02 ng/L), MDMA (0.49-6.87 ng/L), MOR (4.53-44.75 ng/L), COD (2.24-8.30 ng/L), MTD (1.36-3.75 ng/L), COC (0.48 ng/L), THC (5.98-18.89 ng/L), BE (1.12-2.45 ng/L) and KET (1.50 ng/L). And an estimate of the per capita consumption revealed morphine (10.2 mg/d/1000inhabitants), cannabis (3.9 mg/d/1000inhabitants), 3,4-methylenedioxymethamphetamine (3.9 mg/d/1000 inhabitants), and methamphetamine (2.2 mg/d/1000 inhabitants) as the main substances of abuse in Xinjiang, China. The results of this study might be taken as a reference for future studies on the continuous monitoring of such drugs.
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Affiliation(s)
- Jie Zhao
- School of Chemistry and Chemical Engineering/Key Laboratory of Environmental Monitoring and Pollutant Control of Xinjiang Bingtuan, Shihezi University, Shihezi 832003, China
| | - Jianjiang Lu
- School of Chemistry and Chemical Engineering/Key Laboratory of Environmental Monitoring and Pollutant Control of Xinjiang Bingtuan, Shihezi University, Shihezi 832003, China.
| | - Haijun Zhao
- The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832003, China
| | - Yujun Yan
- School of Chemistry and Chemical Engineering/Key Laboratory of Environmental Monitoring and Pollutant Control of Xinjiang Bingtuan, Shihezi University, Shihezi 832003, China
| | - Hongyu Dong
- School of Chemistry and Chemical Engineering/Key Laboratory of Environmental Monitoring and Pollutant Control of Xinjiang Bingtuan, Shihezi University, Shihezi 832003, China
| | - Wen Li
- School of Chemistry and Chemical Engineering/Key Laboratory of Environmental Monitoring and Pollutant Control of Xinjiang Bingtuan, Shihezi University, Shihezi 832003, China
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Thanh BX, Vu GT, Hue TTT, Zheng Q, Chan G, Anh NTK, Thai PK. Assessing changes in nicotine consumption over two years in a population of Hanoi by wastewater analysis with benchmarking biomarkers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 846:157310. [PMID: 35839874 DOI: 10.1016/j.scitotenv.2022.157310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/19/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Monitoring the actual change in consumption of nicotine (a proxy for smoking) in the population is essential for formulating tobacco control policies. In recent years, wastewater-based epidemiology (WBE) has been applied as an alternative method to estimate changes in consumption of tobacco and other substances in different communities around the world, with high potential to be used in resource-scarce settings. This study aimed to conduct a WBE analysis in Hanoi, Vietnam, a lower-middle-income-country setting known for high smoking prevalence. Wastewater samples were collected at two sites along a sewage canal in Hanoi during three periods: Period 1 (September 2018), Period 2 (December 2018-January 2019), and Period 3 (December 2019-January 2020). Concentrations of cotinine, 3-hydroxycotinine, and nicotine ranged from 0.73 μg/L to 3.83 μg/L, from 1.09 μg/L to 5.07 μg/L, and from 0.97 μg/L to 9.90 μg/L, respectively. The average mass load of cotinine estimated for our samples was 0.45 ± 0.09 mg/day/person, which corresponds to an estimated daily nicotine consumption of 1.28 ± 0.25 mg/day/person. No weekly trend was detected over the three monitoring periods. We found the amount of nicotine consumption in Period 1 to be significantly lower than in Period 2 and Period 3. Our WBE estimates of smoking prevalence were slightly lower than the survey data. The analysis of benchmarking biomarkers confirmed that cotinine was stable in the samples similar to acesulfame, while paracetamol degraded along the sewer canal. Further refinement of the WBE approach may be required to improve the accuracy of analyzing tobacco consumption in the poor sewage infrastructure setting of Vietnam.
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Affiliation(s)
- Bui Xuan Thanh
- Department of Public Health, University of Medicine and Pharmacy, Ho Chi Minh, Viet Nam
| | - Giang T Vu
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Tran Thi Thanh Hue
- Department of Pharmacology, National Institute of Drug Quality Control, Hanoi, Viet Nam; Department of Analytical Chemistry and Toxicology, Hanoi University of Pharmacy, Viet Nam
| | - Qiuda Zheng
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Nguyen Thi Kieu Anh
- Department of Analytical Chemistry and Toxicology, Hanoi University of Pharmacy, Viet Nam.
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
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10
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Duan L, Zhang Y, Wang B, Yu G, Gao J, Cagnetta G, Huang C, Zhai N. Wastewater surveillance for 168 pharmaceuticals and metabolites in a WWTP: Occurrence, temporal variations and feasibility of metabolic biomarkers for intake estimation. WATER RESEARCH 2022; 216:118321. [PMID: 35339048 DOI: 10.1016/j.watres.2022.118321] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Wastewater-based epidemiology (WBE) is amply used for mining information about public health such as the estimation of consumption/intake of certain substances. Yet, proper biomarker selection is critical to obtain reliable data. This study measured a broad range of pharmaceuticals and metabolites in a wastewater treatment plant in Beijing, China, and evaluated their suitability as consumption estimation biomarkers. Wastewater sampling was conducted during a normal week and two holiday weeks to assess the impact of the holiday on population normalized daily mass loads (PNDLs). One hundred and forty-nine out of 168 pharmaceuticals were detected, with 94 analytes being quantified in all sampling events. Moreover, digestive drug cimetidine (<MDL∼672 ng L - 1) and anabolic steroid trenbolone (<MDL∼53 ng L - 1) were only detected during holiday weeks. PNDLs of some substances showed disparities between weekdays and weekends during the normal week. This study proposed a framework to diagnose whether a parent compound or its metabolite is suitable for intake/prevalence rate estimation. Our results support that not all the metabolites can be employed as biomarkers for back-calculation when the in-sewer stability of these compounds is unclear, such as metoprolol acid and O-desmethyl venlafaxine. Public healthcare data for drug utilization were applied to validate the prevalence of average substance use in this study. As a popular anti-epileptic ranging from hundreds to thousands of ng L - 1 in this study, the parent compound levetiracetam is more appropriate to be used in WBE under our framework, referring to public healthcare data. This WBE study illustrates the changes in pharmaceutical use and population lifestyle that stem from holidays and commutes. In addition, it can provide data support for the selection of more suitable biomarkers in WBE studies.
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Affiliation(s)
- Lei Duan
- Beijing Laboratory of Environmental Frontier Technology, Beijing Key Laboratory of Emerging Organic Contaminants Control, School of Environment, Tsinghua University, Beijing 100084, China; Research Institute for Environmental Innovation (Suzhou), Tsinghua, Suzhou 215163, China
| | - Yizhe Zhang
- Beijing Laboratory of Environmental Frontier Technology, Beijing Key Laboratory of Emerging Organic Contaminants Control, School of Environment, Tsinghua University, Beijing 100084, China; Research Institute for Environmental Innovation (Suzhou), Tsinghua, Suzhou 215163, China
| | - Bin Wang
- Beijing Laboratory of Environmental Frontier Technology, Beijing Key Laboratory of Emerging Organic Contaminants Control, School of Environment, Tsinghua University, Beijing 100084, China; Research Institute for Environmental Innovation (Suzhou), Tsinghua, Suzhou 215163, China.
| | - Gang Yu
- Beijing Laboratory of Environmental Frontier Technology, Beijing Key Laboratory of Emerging Organic Contaminants Control, School of Environment, Tsinghua University, Beijing 100084, China; Research Institute for Environmental Innovation (Suzhou), Tsinghua, Suzhou 215163, China
| | - Jianfa Gao
- College of Chemistry and Environmental Engineering, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, China
| | - Giovanni Cagnetta
- Beijing Laboratory of Environmental Frontier Technology, Beijing Key Laboratory of Emerging Organic Contaminants Control, School of Environment, Tsinghua University, Beijing 100084, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Nannan Zhai
- Shanghai Sciex Analytical Instrument Trading Co., Ltd Beijing Branch Company, Beijing 100015, China
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11
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He G, Cai M, Meng R, Hu J, Peng K, Hou Z, Zhou C, Xu X, Xiao Y, Yu M, Huang B, Lin L, Liu T, Xiao J, Gong W, Hu R, Li J, Jin D, Qin M, Zhao Q, Xu Y, Zeng W, Li X, Huang C, Si L, Yang X, Ma W. The Spring Festival Is Associated With Increased Mortality Risk in China: A Study Based on 285 Chinese Locations. Front Med (Lausanne) 2022; 9:761060. [PMID: 35308488 PMCID: PMC8924482 DOI: 10.3389/fmed.2022.761060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background The Spring Festival is one of the most important traditional festivals in China. This study aimed to estimate the mortality risk attributable to the Spring Festival. Methods Between 2013 and 2017, daily meteorological, air pollution, and mortality data were collected from 285 locations in China. The Spring Festival was divided into three periods: pre-Spring Festival (16 days before Lunar New Year's Eve), mid-Spring Festival (16 days from Lunar New Year's Eve to Lantern Festival), and post-Spring Festival (16 days after Lantern Festival). The mortality risk attributed to the Spring Festival in each location was first evaluated using a distributed lag nonlinear model (DLNM), and then it was pooled using a meta-analysis model. Results We observed a dip/rise mortality pattern during the Spring Festival. Pre-Spring Festival was significantly associated with decreased mortality risk (ER: −1.58%, 95%CI: −3.09% to −0.05%), and mid-Spring Festival was unrelated to mortality risks, while post-Spring Festival was significantly associated with increased mortality risk (ER: 3.63%, 95%CI: 2.15–5.12%). Overall, a 48-day Spring Festival period was associated with a 2.11% (95%CI: 0.91–3.33%) increased mortality. We also found that the elderly aged over 64 years old, women, people with cardiovascular disease (CVD), and people living in urban areas were more vulnerable to the Spring Festival. Conclusion Our study found that the Spring Festival significantly increased the mortality risk in China. These findings suggest that it is necessary to develop clinical and public health policies to alleviate the mortality burden associated with the Spring Festival.
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Affiliation(s)
- Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Min Cai
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Ke Peng
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Junhua Li
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lei Si
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Xingfen Yang
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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12
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Xu L, Wang Y, Wu DF, Sun FM, Di B, Xu H, Song M, Lu YT, Hang TJ. Identification and monitoring of fentanyls-related substances in east China sewage water samples by LC-MS for drug enforcement. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 797:149109. [PMID: 34303241 DOI: 10.1016/j.scitotenv.2021.149109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
Fentanyls abuse is a persistent international concern. New fentanyl derivatives are constantly appearing, circumventing national and international laws. In this study, laboratory degradation experiment with different conditions such as pH, light, temperature and oxygen availability were compared to improve the understanding of the fentanyls degradation pathways. Twelve major degradants of sufentanil and alfentanil were detected and identified together using UHPLC-QTOF-MS. A total of thirty nine fentanyls including twelve typical fentanyl new psychoactive substances, eighteen manufacturing process-related substances and nine key degradants of sufentanil and alfentanil were screened in 120 sewage water samples collected from 20 sewage water treatment plants chosen among 6 urban cities in east China from July to August in 2020 using a validated UHPLC-MS/MS method. Three fentanyls (fentanyl, sufentanil, alfentanil), seven degradants and six manufacturing process-related substances were found in the test samples. The study could provide a useful tool for the monitoring of the abuses, illegal manufacturing or pharmaceuticals related pollutions of fentanyls and their analogs.
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Affiliation(s)
- Lei Xu
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Ye Wang
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Dong-Feng Wu
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Fan-Mei Sun
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Bin Di
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Hui Xu
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Min Song
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Yu-Ting Lu
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China.
| | - Tai-Jun Hang
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China.
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13
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Ding J, Huang J, Xia B, Hu S, Fan H, Dai J, Li Z, Wang J, Le C, Qiu P, Wang Y. Transfer of α-synuclein from neurons to oligodendrocytes triggers myelin sheath destruction in methamphetamine administration mice. Toxicol Lett 2021; 352:34-45. [PMID: 34562559 DOI: 10.1016/j.toxlet.2021.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/12/2021] [Accepted: 09/20/2021] [Indexed: 01/06/2023]
Abstract
Methamphetamine (METH), a widely abused nervous system stimulant, could induce neurotoxicity through α-synuclein (α-syn). Not much is known about the neuronal derived α-syn transmission that underlies oligodendrocyte pathology in METH mice model. In this study, we tested α-syn level, oligodendroglial pathology and autophagy lysosome pathway (ALP) function in corpus callosum in a chronic METH mice model. METH increased α-syn level in neurons and then accumulated in oligodendrocytes. METH increased phosphor-mTOR level, decreased transcription factor EB (TFEB) level and triggered autophagy lysosomal pathway (ALP) impairment, leading to myelin sheath destruction, oligodendroglial proteins loss, mature dendritic spine loss, neuron loss, and astrocyte activation. Deleting endogenous α-syn increased TFEB level, alleviated ALP deficit, and diminished neuropathology induced by METH. TFEB overexpression in oligodendrocytes exerted beneficial effects in METH mice model. These neuroprotective effects were associated with the rescued ALP machinery after oligodendroglial TFEB overexpression. Our study demonstrated, for the first time, that α-syn-TFEB axis might be involve in the METH induced myelin loss, oligodendroglial pathology, and neuropathology. In summary, targeting at the α-syn-TFEB axis might be a promising therapeutic strategy for treating METH induced oligodendroglial pathology, and to a broader view, neurodegenerative diseases.
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Affiliation(s)
- Jiuyang Ding
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Jian Huang
- School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Bing Xia
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Shanshan Hu
- Good Clinical Practice Center, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Haoliang Fan
- School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jialin Dai
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Zhu Li
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Jiawen Wang
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Cuiyun Le
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Pingming Qiu
- School of Forensic Medicine, Southern Medical University, Guangzhou, China.
| | - Yuanhe Wang
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China.
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14
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Boogaerts T, Ahmed F, Choi PM, Tscharke B, O'Brien J, De Loof H, Gao J, Thai P, Thomas K, Mueller JF, Hall W, Covaci A, van Nuijs ALN. Current and future perspectives for wastewater-based epidemiology as a monitoring tool for pharmaceutical use. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 789:148047. [PMID: 34323839 DOI: 10.1016/j.scitotenv.2021.148047] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
The medical and societal consequences of the misuse of pharmaceuticals clearly justify the need for comprehensive drug utilization research (DUR). Wastewater-based epidemiology (WBE) employs the analysis of human metabolic excretion products in wastewater to monitor consumption patterns of xenobiotics at the population level. Recently, WBE has demonstrated its potential to evaluate lifestyle factors such as illicit drug, alcohol and tobacco consumption at the population level, in near real-time and with high spatial and temporal resolution. Up until now there have been fewer WBE studies investigating health biomarkers such as pharmaceuticals. WBE publications monitoring the consumption of pharmaceuticals were systematically reviewed from three databases (PubMed, Web of Science and Google Scholar). 64 publications that reported population-normalised mass loads or defined daily doses of pharmaceuticals were selected. We document that WBE could be employed as a complementary information source for DUR. Interest in using WBE approaches for monitoring pharmaceutical use is growing but more foundation research (e.g. compound-specific uncertainties) is required to link WBE data to routine pharmacoepidemiologic information sources and workflows. WBE offers the possibility of i) estimating consumption of pharmaceuticals through the analysis of human metabolic excretion products in wastewater; ii) monitoring spatial and temporal consumption patterns of pharmaceuticals continuously and in near real-time; and iii) triangulating data with other DUR information sources to assess the impacts of strategies or interventions to reduce inappropriate use of pharmaceuticals.
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Affiliation(s)
- Tim Boogaerts
- Toxicological Centre, University of Antwerp, Belgium, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Fahad Ahmed
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia
| | - Phil M Choi
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia; Water Unit, Health Protection Branch, Prevention Division, Queensland Health, GPO Box 48, Brisbane, QLD 4001, Australia
| | - Benjamin Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia
| | - Jake O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia
| | - Hans De Loof
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Jianfa Gao
- College of Chemistry and Environmental Engineering, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, China
| | - Phong Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia
| | - Kevin Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia
| | - Wayne Hall
- Queensland Alliance for Environmental Health Sciences (QAEHS), University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4102, Australia; Centre for Youth Substance Abuse, University of Queensland, 17 Upland Road, Woolloongabba, QLD 4102, Australia
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Belgium, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Alexander L N van Nuijs
- Toxicological Centre, University of Antwerp, Belgium, Universiteitsplein 1, 2610 Antwerp, Belgium.
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15
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Erickson TB, Endo N, Duvallet C, Ghaeli N, Hess K, Alm EJ, Matus M, Chai PR. "Waste Not, Want Not" - Leveraging Sewer Systems and Wastewater-Based Epidemiology for Drug Use Trends and Pharmaceutical Monitoring. J Med Toxicol 2021; 17:397-410. [PMID: 34402038 PMCID: PMC8366482 DOI: 10.1007/s13181-021-00853-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/28/2021] [Accepted: 07/09/2021] [Indexed: 12/26/2022] Open
Abstract
During the current global COVID-19 pandemic and opioid epidemic, wastewater-based epidemiology (WBE) has emerged as a powerful tool for monitoring public health trends by analysis of biomarkers including drugs, chemicals, and pathogens. Wastewater surveillance downstream at wastewater treatment plants provides large-scale population and regional-scale aggregation while upstream surveillance monitors locations at the neighborhood level with more precise geographic analysis. WBE can provide insights into dynamic drug consumption trends as well as environmental and toxicological contaminants. Applications of WBE include monitoring policy changes with cannabinoid legalization, tracking emerging illicit drugs, and early warning systems for potent fentanyl analogues along with the resurging wave of stimulants (e.g., methamphetamine, cocaine). Beyond drug consumption, WBE can also be used to monitor pharmaceuticals and their metabolites, including antidepressants and antipsychotics. In this manuscript, we describe the basic tenets and techniques of WBE, review its current application among drugs of abuse, and propose methods to scale and develop both monitoring and early warning systems with respect to measurement of illicit drugs and pharmaceuticals. We propose new frontiers in toxicological research with wastewater surveillance including assessment of medication assisted treatment of opioid use disorder (e.g., buprenorphine, methadone) in the context of other social burdens like COVID-19 disease.
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Affiliation(s)
- Timothy B Erickson
- Department of Emergency Medicine / Division of Toxicology, Brigham & Women's Hospital / Harvard Medical School, 10 Vining St, Boston, MA, 02155, USA.
- Division of Medical Toxicology, Department of Emergency Medicine, Mass General Brigham, Boston, USA.
- Harvard Humanitarian Institute, Cambridge, MA, USA.
| | | | | | | | | | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Peter R Chai
- Department of Emergency Medicine / Division of Toxicology, Brigham & Women's Hospital / Harvard Medical School, 10 Vining St, Boston, MA, 02155, USA
- Division of Medical Toxicology, Department of Emergency Medicine, Mass General Brigham, Boston, USA
- The Fenway Institute, Boston, MA, USA
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
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16
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Altered fecal microbiota composition in individuals who abuse methamphetamine. Sci Rep 2021; 11:18178. [PMID: 34518605 PMCID: PMC8437956 DOI: 10.1038/s41598-021-97548-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023] Open
Abstract
As a severe public health problem, methamphetamine (METH) abuse places a heavy burden on families and society. A growing amount of evidence has indicated communication between gut microbiota and the CNS in drug addiction, with associations to neural, endocrine and immune pathways. Thus, we searched for alterations in the gut microbiota and their potential effects in METH users through 16S rRNA gene sequencing. A decreased Shannon index indicated lower bacterial diversity in the METH users than in the age-matched control group. The gut microbial community composition in the METH users was also altered, including reductions in Deltaproteobacteria and Bacteroidaceae abundances and increases in Sphingomonadales, Xanthomonadales, Romboutsia and Lachnospiraceae abundances. Moreover, the Fusobacteria abundance was correlated with the duration of METH use. Enterobacteriaceae, Ruminococcaceae, Bacteroides, and Faecalibacterium had statistically significant correlations with items related to the positive and negative symptoms of schizophrenia and to general psychopathology in the METH users, and all have previously been reported to be altered in individuals with psychotic syndromes, especially depression. Abstraction, one of the items of the cognitive assessment, was positively related to Blautia. These findings revealed alterations in the gut microbiota of METH users, and these alterations may play a role in psychotic syndrome and cognitive impairment. Although the mechanisms behind the links between these disorders and METH abuse are unknown, the relationships may indicate similarities in the pathogenesis of psychosis induced by METH abuse and other causes, providing a new paradigm for addiction and METH use disorder treatment.
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17
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Yan J, Lin W, Gao Z, Ren Y. Use of selected NSAIDs in Guangzhou and other cities in the world as identified by wastewater analysis. CHEMOSPHERE 2021; 279:130529. [PMID: 33878693 DOI: 10.1016/j.chemosphere.2021.130529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/23/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
The mass load of pharmaceuticals in the municipal wastewater based on wastewater-based epidemiology (WBE) is a good indication of population consumption in the catchment. After successful application of illicit drugs' estimation, this method holds the potential to measure the geographical and temporal consumption of prescription medicines. In this study, we investigated the occurrence of four non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen (ACM), diclofenac (DCF), ibuprofen (IBU) and naproxen (NPX), in two wastewater treatment plants in Guangzhou City, China and compared the spatial and temporal consumption variation of them. Over a period of 28 days' sampling, the detection frequency of ACM, DCF, IBU, and NPX in the influent of two wastewater treatment plants (WWTPs) in Guangzhou City were 91%, 66%, 100%, and 95%, and their concentrations were up to 128, 131, 372, and 324 ng/L, respectively. No significant inter-catchment difference was observed regarding the per capita mass load in the two WWTPs investigated. A literature review which covered 160 WWTPs in 18 countries was conducted to compare the population normalized mass load of four commonly used NSAIDs. ACM had the highest population normalized mass loads (29-17,430 mg/d/1000 inhabitants) and DCF had the lowest population normalized mass load (6.5-628 mg/d/1000 inhabitants) in the catchments located in 18 countries. The mass loads of selected NSAIDs in China were lower than those in European and North American. ACM and IBU consumptions were at least 2 times higher in winter than that in summer, in contrast, DCF and NPX consumptions had no significant seasonal variation.
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Affiliation(s)
- Jingna Yan
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, China; Guangdong Zhongzheng Environmental Science and Technology Service Co.,Ltd, 505, 5th Floor, Times-park Building, No.231 Gaotang Road, Tianhe District, Guangzhou, 510630, China.
| | - Wenting Lin
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, China.
| | - Zhihan Gao
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, China.
| | - Yuan Ren
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, China; The Key Laboratory of Pollution Control and Ecosystem Restoration in Industry Clusters, Ministry of Education, Guangzhou, 510006, China; The Key Laboratory of Environmental Protection and Eco-Remediation of Guangdong Regular Higher Education Institutions, Guangzhou, 510006, China.
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18
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Hou C, Chu T, Chen M, Hua Z, Xu P, Xu H, Wang Y, Liao J, Di B. Application of multi-parameter population model based on endogenous population biomarkers and flow volume in wastewater epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 759:143480. [PMID: 33213920 DOI: 10.1016/j.scitotenv.2020.143480] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
The consumption or prevalence of acesulfame, caffeine, paracetamol and amantadine was estimated by wastewater-based epidemiology based on a multi-parameter population model in 20 sewage treatment plants (STPs) in Hebei province, China. To minimize the uncertainties contributed by population estimation in WBE, a multi-parameter population model was established based on the population biomarkers equivalent population and flow volume-population with the weight factors calculated by the analytic hierarchy process (AHP). 4-Pyridoxic acid (4-PA), cotinine, trans-3'-hydroxycotinine (trans-3'-OH-Cot) and 1,4-methylimidazole acetic acid (MIAA) were selected as population biomarkers. The estimated model population showed the highest correlations (r2 = 0.97, p < 0.01) and lowest variation (one way-ANOVA, p = 0.82, mean variation: -0.1%) comparing to the census data, suggestion better population estimation. The estimated consumption of acesulfame, caffeine, paracetamol and amantadine was 6.7 ± 2.4 mg/day/inh, 50.5 ± 38.5 mg/day/inh, 61.5 ± 52.7 mg/day/inh and 0.52 ± 0.33 mg/day/inh, respectively. Meanwhile, the prevalence of paracetamol and amantadine was calculated to be 5.3% ± 4.5% and 0.28% ± 0.18%, respectively. The estimated results were consistent with that of previous researches in China and were also in accordance with the consumption calculated by sales data (acesulfame and paracetamol). Moreover, uncertainty study showed decrease in population-associated uncertainties by using a multi-parameter population model. The results demonstrated that the multi-parameter population model constructed in this research is feasible to apply in WBE and might lead to lower uncertainties in population estimation.
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Affiliation(s)
- Chenzhi Hou
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Tingting Chu
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Mengyi Chen
- China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Zhendong Hua
- China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, China
| | - Peng Xu
- China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, China
| | - Hui Xu
- China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Youmei Wang
- China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, China
| | - Jun Liao
- China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China; School of Science, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Bin Di
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission - China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China.
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Bade R, White JM, Gerber C. How the recreational stimulant market has changed: Case study in Adelaide, Australia 2016-2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143728. [PMID: 33277018 DOI: 10.1016/j.scitotenv.2020.143728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
The human consumption of stimulant drugs is known to increase over festive periods. In this work, four illicit stimulants: 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), cocaine and methamphetamine and three new psychoactive substances (NPS): ethylone, mephedrone and N-ethylpentylone were monitored in influent wastewater over the Christmas-New Year period in South Australia from 2016 to 2019 using liquid chromatography-mass spectrometry. The differences in Christmas - New Year consumption between years were evaluated and daily mass loads were compared to the average for that year to determine drug levels over the festive period. Although MDMA, MDA and cocaine showed year-on-year increases, the use over the New Year period was far higher than over the rest of the year, consistent with recreational drug use. These were also the drugs that were used predominantly on weekends during the year. Methamphetamine, which does not have a pattern of predominant weekend use, and the NPS showed variable trends. These results suggest that during holiday periods there are increases in the use of a limited set of drugs only and these can be predicted from patterns of use during the non-holiday periods.
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Affiliation(s)
- Richard Bade
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Jason M White
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia
| | - Cobus Gerber
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5000, South Australia, Australia.
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Shao XT, Cong ZX, Liu SY, Wang Z, Zheng XY, Wang DG. Spatial analysis of metformin use compared with nicotine and caffeine consumption through wastewater-based epidemiology in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111623. [PMID: 33396143 DOI: 10.1016/j.ecoenv.2020.111623] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 05/08/2023]
Abstract
Monitoring the consumption of pharmaceuticals and licit drugs is important for assessing the needs of public health owing to the impact on individuals as well as society. The present work applied wastewater-based epidemiology to profile the spatial patterns of metformin, nicotine, and caffeine use and their correlations. Influent wastewater samples were collected from 27 wastewater treatment plants in 22 typical Chinese cities that covered all geographic regions of the country. The consumption of metformin ranged from 0.02 g/d/1000 inh to 8.92 g/d/1000 inh, whereas caffeine and nicotine consumption ranged from 4.33 g/d/1000 inh to 394 g/d/1000 inh and 0.17 g/d/1000 inh to 1.88 g/d/1000 inh, respectively. There were significant regional differences in the consumption of caffeine, with the highest consumption in East China and the lowest consumption in Northeast China. The consumption and concentration of caffeine were related to the gross domestic product and per capita disposable income of urban residents, respectively. There was a correlation between the concentrations of caffeine and cotinine (a nicotine metabolite), thereby indicating that individuals that use one of these substances are likely to use the other substance. A significant relationship was found between the concentration of metformin and cotinine, thereby implying that the use of tobacco may be correlated with type 2 diabetes. Co-analysis of these substances in wastewater may provide a more accurate picture of substance use situations within different communities and provide more information on human health, human behavior, and the economy. This report describes the newest study related to the consumption of metformin among the general population in China.
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Affiliation(s)
- Xue-Ting Shao
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Zi-Xiang Cong
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Si-Yu Liu
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Zhuang Wang
- Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, No. 219 Ningliu Road, Nanjing 210044, China
| | - Xiao-Yu Zheng
- Institute of Forensic Science, Ministry of Public Security, China
| | - De-Gao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China.
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