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Moallef S, Balasubramanian R, Krieger N, Tabb LP, Chen JT, Hanage WP, Bassett MT, Cowger TL. Advancing health equity in wastewater-based epidemiology: A global critical review and conceptual framework. SSM Popul Health 2025; 30:101786. [PMID: 40248458 PMCID: PMC12005304 DOI: 10.1016/j.ssmph.2025.101786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 03/12/2025] [Accepted: 03/18/2025] [Indexed: 04/19/2025] Open
Abstract
Population health data from wastewater-based epidemiology (WBE) are being used at unprecedented scales worldwide, yet there is limited focus on how to advance health equity in the field. Addressing this gap, we conducted a critical review of published literature in PubMed, targeting studies at the intersection of WBE and health equity. Of 145 articles assessed in full-text screening, we identified 68 studies with health equity considerations. These studies spanned various spatial scales and biochemical targets, addressing domains such as study design and methodologies, ethical and social considerations, and the feasibility and implementation of WBE monitoring. We summarize and synthesize health equity-oriented considerations across the identified domains. We further propose five key considerations to advance health equity in WBE research and practice, and integrate these considerations into a conceptual framework to illustrate how they apply to major steps in the process of conducting WBE. These considerations include global inequities in WBE access, the need to prevent potential harms and stigma via data misuse (inappropriate reporting of data and potential use of WBE for criminal surveillance), and the importance of regulation and community engagement, particularly amidst the growing privatization of WBE, especially in the United States.
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Affiliation(s)
- Soroush Moallef
- François–Xavier Bagnoud (FXB) Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ruchita Balasubramanian
- François–Xavier Bagnoud (FXB) Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Loni P. Tabb
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jarvis T. Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - William P. Hanage
- Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mary T. Bassett
- François–Xavier Bagnoud (FXB) Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tori L. Cowger
- François–Xavier Bagnoud (FXB) Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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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; 16:1295-1305. [PMID: 38296259 DOI: 10.1002/dta.3646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Bernier-Turpin G, Thiebault T, Alliot F, Mebold E, Guérin-Rechdaoui S, Oliveira M, Le Roux J, Moilleron R. Target and non-target screening of biomarkers in wastewater: towards a unique analytical methodology for sample preparation. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024; 16:6241-6256. [PMID: 39211955 DOI: 10.1039/d4ay00843j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
This study aims to optimize a single preparation methodology based on solid-phase extraction (SPE) that could fit both target and non-target screening of organic biomarkers in raw wastewater, allowing the cross-comparison of results obtained from a same dataset. The efficiency of SPE sorbents used alone (HLB) or in combination in a multilayer cartridge was evaluated based on (i) the extraction recovery and matrix effect in environmental samples (surface water and wastewater) for a list of biomarkers (pharmaceuticals, licit and illicit drugs, artificial sweeteners, isoprostanes, polyphenols) and (ii) a number of detected features and their intensity in HRMS. The selected method uses a combination of three SPE sorbents mixed together (HLB, X-AW and X-CW) and seems to take full advantage of each, providing satisfactory validation parameters (recovery, instrumental limit of detection, linearity range and limit of quantification) over a large range of physico-chemical properties while ensuring promising results for non-target screening applications. Of the 65 targeted compounds, nearly all of them (47) were detected in wastewater influent samples with concentration above the limit of quantification, while at the same time over 10 000 features were recorded according to the high resolution mass spectrometry (HRMS) fingerprint, holding out the promise that a common protocol for these two analyses, with their very contrasting constraints and objectives, is possible.
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Affiliation(s)
- Gauthier Bernier-Turpin
- Leesu - Univ Paris Est Creteil, Ecole des Ponts, Creteil, F-94010, France.
- METIS, Sorbonne Univ, CNRS, EPHE, PSL Univ, UMR 7619, F-75005 Paris, France
| | - Thomas Thiebault
- METIS, Sorbonne Univ, CNRS, EPHE, PSL Univ, UMR 7619, F-75005 Paris, France
| | - Fabrice Alliot
- METIS, Sorbonne Univ, CNRS, EPHE, PSL Univ, UMR 7619, F-75005 Paris, France
| | | | | | | | - Julien Le Roux
- Leesu - Univ Paris Est Creteil, Ecole des Ponts, Creteil, F-94010, France.
| | - Régis Moilleron
- Leesu - Univ Paris Est Creteil, Ecole des Ponts, Creteil, F-94010, France.
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Sadia M, Boudguiyer Y, Helmus R, Seijo M, Praetorius A, Samanipour S. A stochastic approach for parameter optimization of feature detection algorithms for non-target screening in mass spectrometry. Anal Bioanal Chem 2024:10.1007/s00216-024-05425-3. [PMID: 38995405 DOI: 10.1007/s00216-024-05425-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/05/2024] [Accepted: 06/18/2024] [Indexed: 07/13/2024]
Abstract
Feature detection plays a crucial role in non-target screening (NTS), requiring careful selection of algorithm parameters to minimize false positive (FP) features. In this study, a stochastic approach was employed to optimize the parameter settings of feature detection algorithms used in processing high-resolution mass spectrometry data. This approach was demonstrated using four open-source algorithms (OpenMS, SAFD, XCMS, and KPIC2) within the patRoon software platform for processing extracts from drinking water samples spiked with 46 per- and polyfluoroalkyl substances (PFAS). The designed method is based on a stochastic strategy involving random sampling from variable space and the use of Pearson correlation to assess the impact of each parameter on the number of detected suspect analytes. Using our approach, the optimized parameters led to improvement in the algorithm performance by increasing suspect hits in case of SAFD and XCMS, and reducing the total number of detected features (i.e., minimizing FP) for OpenMS. These improvements were further validated on three different drinking water samples as test dataset. The optimized parameters resulted in a lower false discovery rate (FDR%) compared to the default parameters, effectively increasing the detection of true positive features. This work also highlights the necessity of algorithm parameter optimization prior to starting the NTS to reduce the complexity of such datasets.
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Affiliation(s)
- Mohammad Sadia
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.
| | - Youssef Boudguiyer
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Rick Helmus
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Marianne Seijo
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Antonia Praetorius
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Saer Samanipour
- Van'T Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, Amsterdam, The Netherlands
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Li Z, Li J, Hu Y, Yan Y, Tang S, Ma R, Li L. Evaluation of pharmaceutical consumption between urban and suburban catchments in China by wastewater-based epidemiology. ENVIRONMENTAL RESEARCH 2024; 250:118544. [PMID: 38408630 DOI: 10.1016/j.envres.2024.118544] [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: 11/17/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 02/28/2024]
Abstract
Wastewater-based epidemiology (WBE) is amply used for estimating human consumption of chemicals, yet information on regional variation of pharmaceuticals and their environmental fate are scarce. Thus, this study aims to estimate the consumption of three cardiovascular, four non-steroidal anti-inflammatory pharmaceuticals (NSAIDs), and four psychoactive pharmaceuticals between urban and suburban catchments in China by WBE, and to explore their removal efficiencies and ecological risks. Eleven analytes were detected in both influent and effluent samples. The estimated consumptions ranged from
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Affiliation(s)
- Zongrui Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510655, China
| | - Jincheng Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510655, China
| | - Yongxia Hu
- West Center, Guangzhou Institute of Chemistry, Chinese Academy of Sciences, Chongqing, 400714, China
| | - Yile Yan
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510655, China
| | - Shaoyu Tang
- Research Center for Eco-Environmental Engineering, School of Environment and Civil Engineering, Dongguan University of Technology, Dongguan, 523808, China
| | - Ruixue Ma
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510655, China
| | - Liangzhong Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510655, China; CAS Key Laboratory of Renewable Energy, Guangdong Provincial Key Laboratory of New and Renewable Energy Research and Development, Guangzhou Institute of Energy Conversion, Chinese Academy of Sciences, Guangzhou, 510640, China.
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6
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Wang H, Gao R, Liang W, Zhou Y, Wang Z, Lan L, Chen J, Zeng F. Feasibility of sulfated BPA and BPS as wastewater-based epidemiology biomarkers: Insights from wastewater and reported human urine analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:171870. [PMID: 38531444 DOI: 10.1016/j.scitotenv.2024.171870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/28/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024]
Abstract
In wastewater-based epidemiology (WBE), the selection of appropriate biomarkers presents a significant challenge. Recently, sulfated bisphenols have garnered attention as potential WBE biomarkers due to their increased stability in wastewater compared to glucuronide conjugates. This study aims to comprehensively assess the feasibility of employing sulfated BPA and BPS as WBE biomarkers by analyzing both WBE and human biomonitoring data. To conduct this research, wastewater samples were collected from six domestic wastewater treatment plants in Guangzhou, China, and urinary concentration of BPA and BPS were obtained from peer-reviewed literature. The results revealed that mean urinary concentrations of BPA and BPS, calculated using Monte Carlo simulations, significantly exceeded those reported in human biomonitoring studies. Furthermore, the per capita mass load ratio of sulfated BPA and BPS in human urine to the mass load in wastewater was found to be below 10 %. This outcome suggests that the excretion of BPA-S and BPS-S in urine does not make a substantial contribution to wastewater, hinting at the existence of other notable sources. Consequently, our study concludes that sulfated BPA-S and BPS-S are not suitable candidates as WBE biomarkers. This work provides a referenceable analytical framework for evaluating the feasibility of WBE biomarkers and emphasizes the necessity for caution when utilizing WBE to assess human exposure to chemicals.
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Affiliation(s)
- Hao Wang
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Rui Gao
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Weiqian Liang
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Yingyue Zhou
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Zhuo Wang
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Longxia Lan
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Jinfeng Chen
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China
| | - Feng Zeng
- School of Chemistry, Sun Yat-sen University, Guangzhou 510275; Guangdong, China.
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Bade R, van Herwerden D, Rousis N, Adhikari S, Allen D, Baduel C, Bijlsma L, Boogaerts T, Burgard D, Chappell A, Driver EM, Sodre FF, Fatta-Kassinos D, Gracia-Lor E, Gracia-Marín E, Halden RU, Heath E, Jaunay E, Krotulski A, Lai FY, Löve ASC, O'Brien JW, Oh JE, Pasin D, Castro MP, Psichoudaki M, Salgueiro-Gonzalez N, Gomes CS, Subedi B, Thomas KV, Thomaidis N, Wang D, Yargeau V, Samanipour S, Mueller J. Workflow to facilitate the detection of new psychoactive substances and drugs of abuse in influent urban wastewater. JOURNAL OF HAZARDOUS MATERIALS 2024; 469:133955. [PMID: 38457976 DOI: 10.1016/j.jhazmat.2024.133955] [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: 12/19/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
The complexity around the dynamic markets for new psychoactive substances (NPS) forces researchers to develop and apply innovative analytical strategies to detect and identify them in influent urban wastewater. In this work a comprehensive suspect screening workflow following liquid chromatography - high resolution mass spectrometry analysis was established utilising the open-source InSpectra data processing platform and the HighResNPS library. In total, 278 urban influent wastewater samples from 47 sites in 16 countries were collected to investigate the presence of NPS and other drugs of abuse. A total of 50 compounds were detected in samples from at least one site. Most compounds found were prescription drugs such as gabapentin (detection frequency 79%), codeine (40%) and pregabalin (15%). However, cocaine was the most found illicit drug (83%), in all countries where samples were collected apart from the Republic of Korea and China. Eight NPS were also identified with this protocol: 3-methylmethcathinone 11%), eutylone (6%), etizolam (2%), 3-chloromethcathinone (4%), mitragynine (6%), phenibut (2%), 25I-NBOH (2%) and trimethoxyamphetamine (2%). The latter three have not previously been reported in municipal wastewater samples. The workflow employed allowed the prioritisation of features to be further investigated, reducing processing time and gaining in confidence in their identification.
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Affiliation(s)
- Richard Bade
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia.
| | - Denice van Herwerden
- Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands
| | - Nikolaos Rousis
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Sangeet Adhikari
- School of Sustainable Engineering and Built Environment, Arizona State University, Tempe, AZ 85281, United States; Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States
| | - Darren Allen
- Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
| | - Christine Baduel
- Université Grenoble Alpes, CNRS, IRD, Grenoble INP, Institute of Environmental Geosciences (IGE), Grenoble, France
| | - Lubertus Bijlsma
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Tim Boogaerts
- Toxicological Centre, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Dan Burgard
- Department of Chemistry and Biochemistry, University of Puget Sound, Tacoma, WA 98416, United States
| | - Andrew Chappell
- Institute of Environmental Science and Research Limited (ESR), Christchurch Science Centre, 27 Creyke Road, Ilam, Christchurch 8041, New Zealand
| | - Erin M Driver
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States
| | | | - Despo Fatta-Kassinos
- Nireas-International Water Research Centre and Department of Civil and Environmental Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Emma Gracia-Lor
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain
| | - Elisa Gracia-Marín
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Rolf U Halden
- School of Sustainable Engineering and Built Environment, Arizona State University, Tempe, AZ 85281, United States; Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States; OneWaterOneHealth, Arizona State University Foundation, 1001 S. McAllister Avenue, Tempe, AZ 85287-8101, United States
| | - Ester Heath
- Jožef Stefan Institute and International Postgraduate School Jožef Stefan, Jamova 39, 1000 Ljubljana, Slovenia
| | - Emma Jaunay
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia
| | - Alex Krotulski
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, PA 19090, United States
| | - Foon Yin Lai
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), SE-75007 Uppsala, Sweden
| | - Arndís Sue Ching Löve
- University of Iceland, Department of Pharmacology and Toxicology, Hofsvallagata 53, 107 Reykjavik, Iceland; University of Iceland, Faculty of Pharmaceutical Sciences, Hofsvallagata 53, 107 Reykjavik, Iceland
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Jangjeon-dong, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Daniel Pasin
- Forensic Laboratory Division, San Francisco Office of the Chief Medical Examiner, 1 Newhall St, San Francisco, CA 94124, United States
| | | | - Magda Psichoudaki
- Nireas-International Water Research Centre and Department of Civil and Environmental Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Noelia Salgueiro-Gonzalez
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156 Milan, Italy
| | | | - Bikram Subedi
- Department of Chemistry, Murray State University, Murray, KY 42071-3300, United States
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Nikolaos Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece
| | - Degao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, PR China
| | - Viviane Yargeau
- Department of Chemical Engineering, McGill University, Montreal, QC, Canada
| | - Saer Samanipour
- Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands; UvA Data Science Center, University of Amsterdam, the Netherlands
| | - Jochen Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
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Price M, Tscharke B, Chappell A, Kah M, Sila-Nowicka K, Morris H, Ward D, Trowsdale S. Testing methods to estimate population size for wastewater treatment plants using census data: Implications for wastewater-based epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 922:170974. [PMID: 38360313 DOI: 10.1016/j.scitotenv.2024.170974] [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: 11/30/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
In wastewater-based epidemiology (WBE), wastewater loads are commonly reported as a per capita value. Census population counts are often used to obtain a population size to normalise wastewater loads. However, the methods used to calculate the population size of wastewater treatment plants (WWTPs) from census data are rarely reported in the WBE literature. This is problematic because the geographical extents of wastewater catchments and census area units rarely align perfectly with each other and exist at different spatial scales. This complicates efforts to estimate the number of people serviced by WWTPs in these census area units. This study compared four geospatial methods to combine wastewater catchment areas and census area units to calculate the census population size of wastewater treatment plants. These methods were applied nationally to WWTPs across New Zealand. Population estimates varied by up to 73 % between the methods, which could skew comparisons of per capita wastewater loads between sites. Variability in population estimates (relative standard deviation, RSD) was significantly higher in smaller catchments (rs = -0.727, P < .001), highlighting the importance of method selection in smaller sites. Census population estimates were broadly similar to those provided by wastewater operators, but significant variation was observed for some sites (ranging from 42 % lower to 78 % higher, RSD = 262 %). We present a widely applicable method to calculate population size from census, which involves disaggregating census area units by individual properties. The results reinforce the need for transparent reporting to maintain confidence in the comparison of WBE across sites and studies.
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Affiliation(s)
- Mackay Price
- School of Environment, University of Auckland, 23 Symonds Street, Auckland 1010, New Zealand.
| | - Ben Tscharke
- Queensland Alliance for Environmental Health Sciences, University of Queensland, 20 Cornwall Street, Queensland 4102, Australia
| | - Andrew Chappell
- Institute of Environmental Science and Research Ltd., 27 Creyke Road, Christchurch 8041, New Zealand
| | - Melanie Kah
- School of Environment, University of Auckland, 23 Symonds Street, Auckland 1010, New Zealand
| | - Katarzyna Sila-Nowicka
- School of Environment, University of Auckland, 23 Symonds Street, Auckland 1010, New Zealand
| | - Helen Morris
- Institute of Environmental Science and Research Ltd., 27 Creyke Road, Christchurch 8041, New Zealand
| | - Daniel Ward
- Environment Canterbury, 200 Tuam Street, Christchurch 8011, New Zealand
| | - Sam Trowsdale
- School of Environment, University of Auckland, 23 Symonds Street, Auckland 1010, New Zealand
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Mullin A, Scott M, Vaccaro G, Floresta G, Arillotta D, Catalani V, Corkery JM, Stair JL, Schifano F, Guirguis A. Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques. PHARMACY 2024; 12:13. [PMID: 38251407 PMCID: PMC10801481 DOI: 10.3390/pharmacy12010013] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION The designer benzodiazepine (DBZD) market continues to expand whilst evading regulatory controls. The widespread adoption of social media by pro-drug use communities encourages positive discussions around DBZD use/misuse, driving demand. This research addresses the evolution of three popular DBZDs, etizolam (E), flubromazepam (F), and pyrazolam (P), available on the drug market for over a decade, comparing the quantitative chemical analyses of tablet samples, purchased from the internet prior to the implementation of the Psychoactive Substances Act UK 2016, with the thematic netnographic analyses of social media content. METHOD Drug samples were purchased from the internet in early 2016. The characterisation of all drug batches were performed using UHPLC-MS and supported with 1H NMR. In addition, netnographic studies across the platforms X (formerly Twitter) and Reddit, between 2016-2023, were conducted. The latter was supported by both manual and artificial intelligence (AI)-driven thematic analyses, using numerous.ai and ChatGPT, of social media threads and discussions. RESULTS UHPLC-MS confirmed the expected drug in every sample, showing remarkable inter/intra batch variability across all batches (E = 13.8 ± 0.6 to 24.7 ± 0.9 mg; F = 4.0 ± 0.2 to 23.5 ± 0.8 mg; P = 5.2 ± 0.2 to 11.5 ± 0.4 mg). 1H NMR could not confirm etizolam as a lone compound in any etizolam batch. Thematic analyses showed etizolam dominated social media discussions (59% of all posts), with 24.2% of posts involving sale/purchase and 17.8% detailing new administration trends/poly-drug use scenarios. Artificial intelligence confirmed three of the top five trends identified manually. CONCLUSIONS Purity variability identified across all tested samples emphasises the increased potential health risks associated with DBZD consumption. We propose the global DBZD market is exacerbated by surface web social media discussions, recorded across X and Reddit. Despite the appearance of newer analogues, these three DBZDs remain prevalent and popularised. Reporting themes on harm/effects and new developments in poly-drug use trends, demand for DBZDs continues to grow, despite their potent nature and potential risk to life. It is proposed that greater controls and constant live monitoring of social media user content is warranted to drive active regulation strategies and targeted, effective, harm reduction strategies.
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Affiliation(s)
- Anthony Mullin
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - Mark Scott
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - Giorgia Vaccaro
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - Giuseppe Floresta
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
- Department of Drug and Health Sciences, University of Catania, 95131 Catania, Italy
| | - Davide Arillotta
- School of Clinical Pharmacology and Toxicology, University of Florence, 50121 Florence, Italy;
| | - Valeria Catalani
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - John M. Corkery
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - Jacqueline L. Stair
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK; (A.M.); (M.S.); (G.V.); (G.F.); (V.C.); (J.M.C.); (J.L.S.); (F.S.)
| | - Amira Guirguis
- Pharmacy, Medical School, The Grove Extension, Swansea University, Swansea SA2 8PP, UK
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10
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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: 9] [Impact Index Per Article: 4.5] [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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11
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Amin V, Bowes DA, Halden RU. Systematic scoping review evaluating the potential of wastewater-based epidemiology for monitoring cardiovascular disease and cancer. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:160103. [PMID: 36370774 PMCID: PMC9643312 DOI: 10.1016/j.scitotenv.2022.160103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
Cardiovascular disease (CVD) and cancer are collectively responsible for tens of millions of global deaths each year. These rates are projected to intensify as the COVID-19 pandemic has caused delays in individualized diagnostics, or exacerbated prevalence due to Post Acute Coronavirus (COVID-19) Syndrome. Wastewater-based epidemiology (WBE) has successfully been employed as a useful tool for generating population-level health assessments, and was examined here in this systematic scoping literature review to (i) identify endogenous human biomarkers reported to indicate CVD or cancer in clinical practice, (ii) assess specificity to the indicated diseases, (iii) evaluate the utility for estimating population-level disease prevalence in community wastewater, and (iv) contextualize the obtained information for monitoring CVD and cancer presence via WBE. A total of 48 peer-reviewed papers were critically examined identifying five urinary protein biomarkers: cardiac troponin I (cTnI) (heart attack/heart failure), cystatin C (atherosclerosis), normetanephrine (tumor presence), α-fetoprotein (prostate and liver cancer), and microtubule assisted serine/threonine kinase 4 (MAST4) (breast cancer). Next, urinary excretion information was utilized to predict biomarker concentrations extant in community wastewater, resulting in average healthy concentrations ranging from 0.02 to 1159 ng/L, and disease-indicating thresholds from 0.16 to 3041 ng/L. Finally, estimating prevalence-adjusted wastewater measurements was explored in order to assess community-level CVD and cancer presence utilizing U.S. reported prevalence rates. Results obtained suggest that WBE can serve as a viable tool in support of current methods for CVD and cancer assessment to reduce morbidities and mortalities worldwide.
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Affiliation(s)
- Vivek Amin
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA
| | - Devin A Bowes
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA
| | - Rolf U Halden
- The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA; School for Sustainable Engineering and the Built Environment, Arizona State University, 1001 S. McAllister Ave, AZ 85287-8101, USA; OneWaterOneHealth, The Arizona State University Foundation, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85281, USA; Global Futures Laboratory, Arizona State University, 800 S. Cady Mall, Tempe, AZ 85281, USA.
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