Evaluation of different smoking habits during music festivals through wastewater analysis

Characterising differences between self-reported and wastewater-identified drug use at two consecutive years of an Australian music festival

BACKGROUND

In the context of drug prohibition, potential adulteration and variable purity pose additional health risks for people who use drugs, with these risks often compounded by the outdoor music festival environment. Ahead of the imminent implementation of drug checking services in Queensland, Australia, this study aims to characterise this problem using triangulated survey and wastewater data to understand self-reported and detected drug use among attendees of a multi-day Queensland-based music festival in 2021 and 2022.

METHODS

We administered an in-situ survey focusing on drug use at the festival to two convenience samples of 136 and 140 festival attendees in 2021 and 2022 respectively. We compared survey findings to wastewater collected concurrently from the festival's site-specific wastewater treatment plant, which was analysed using Liquid Chromatography Tandem Mass Spectrometry.

RESULTS

Most survey respondents (82 % in 2021, 92 % in 2022) reported using or intending to use an illicit drug at the festival. Some respondents reported potentially risky drug use practices such as using drugs found on the ground (2 % in 2021, 4 % in 2022). Substances detected in wastewater but not surveys include MDEA, mephedrone, methylone, 3-MMC, alpha-D2PV, etizolam, eutylone, and N,N-dimethylpentylone.

CONCLUSION

Many substances detected in wastewater but not self-reported in surveys likely represent substitutions or adulterants. These findings highlight the benefits of drug checking services to prevent harms from adulterants and provide education on safer drug use practices. These findings also provide useful information on socio-demographic characteristics and drug use patterns of potential users of Queensland's future drug checking service.

Monitoring of changes in illicit drugs, alcohol, and nicotine consumption during Ramadan via wastewater analysis

Illicit drug use is a global problem imposing social, economic, and health burdens on society. Wastewater-based epidemiology is an approach based on calculating the consumption of substances in the target population by analyzing the concentrations of human metabolic excretion products of licit and illicit substances in wastewater. This study estimated the changes in illicit drugs (cocaine, amphetamine, methamphetamine, ecstasy (3,4-Methylenedioxymethamphetamine), heroin, and marijuana (THC)), alcohol, and nicotine consumption in Adana Province during Ramadan compared to normal periods using wastewater-based epidemiology. An overall decrease was observed during the Ramadan Period, most strongly for ecstasy (29%) followed by heroin (19%). For cocaine, the variation was the slightest (8.6%). The differences were statistically significant for ecstasy, heroin, nicotine, and alcohol but not for cocaine, amphetamine, methamphetamine, and marijuana. This study is the first to show changes in the use of illicit drugs, alcohol, and nicotine under the influence of religious beliefs. In addition, there is limited data about illicit drugs, alcohol and nicotine abusers/users in Ramadan. This study provides information on the literature on this subject.

Assessing changes in nicotine consumption over two years in a population of Hanoi by wastewater analysis with benchmarking biomarkers

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.

Reprint of: The effect of the Music Day event on community drug use

Illicit drugs consumption can be back-calculated based on the analysis of drug residues in wastewater using the wastewater-based epidemiology method. The Music Day, held on June 21 in France since 1982, has grown to global proportions and is now celebrated as World Music Day. This large outdoor event takes place in many cities with people allowed to play music in the streets. As psychotropic drugs are often associated with music events, the goal of this study is to investigate the use of illicit drugs on this day in Bordeaux, the fifth largest urban area in France. Daily sampling campaigns of composite wastewater were carried out for seven days in two wastewater treatment plants in Bordeaux in 2017 (Music Day) and 2018. World Music Day in Bordeaux has no observable effect on illicit drug consumption even if this event has massive public participation: this is the first report of the absence of an illicit drug consumption increase in a festival of such magnitude, corroborating the effect of others' views and opinions, because this event takes place publicly in the street and not among peers. Different hypothesizes are put forward to explain this fact: inappropriate type of event for drug consumption, effect of other festivals, and influence of the event's timing on a weekday.

Non-antimicrobial pharmaceuticals can affect the development of antibiotic resistance in hospital wastewater

Within this study, we were interested in the effects of wastewater on the development of antimicrobial resistance. Microorganisms can relatively promptly adapt to evolutionary pressures of the environment, including antibiotics. Therefore, we tested how the adaptability of the model microorganism Salmonella enterica is affected by wastewater full of pharmaceuticals, illicit drugs, and other micropollutants. Wastewater samples had been taken from effluent of hospitals and from wastewater treatment plant (WWTP) Petržalka influent and effluent. In these samples, presence of 38 substances was monitored. The highest concentration was observed in case of tramadol, citalopram, venlafaxine, cotinine, atenolol, valsartan, carbamazepine, azithromycin, and ciprofloxacin. According to this data, we focused also on individual pharmaceutical compounds presented in wastewater samples in elevated concentrations. Effect on resistance development of two pain relief medications (carbamazepine, tramadol), hypotensive medications (atenolol, valsartan), and the nicotine metabolite (cotinine) was also investigated. For this study, we employed concentrations presented in wastewater as well as in urine of patients and/or users. To determine the frequency of mutations leading to ciprofloxacin resistance, we applied the modified Ames test employing the strain Salmonella Typhimurium. Resistance index increased in the case of all wastewater samples from conventional hospitals where we observed a 1.22-1.69-fold increase of mutations leading to ciprofloxacin resistance. Tested compounds caused rise of resistance index in lower concentrations found in wastewater. The most significant increase of resistance index was detected after carbamazepine treatment.

Music festivals and drugs: Wastewater analysis

Drug consumption in individual cities, regions, and at various music events and festivals across the EU has generally been monitored via questionnaires, patients' medical data, and police reports. However, an overview of drug consumption obtained from these methods can be negatively affected by various subjective factors. We aimed to investigate an association between levels of target drugs in wastewater, music genres, and festival courses. The occurrence of illicit drugs, their metabolites, and psychoactive compounds was investigated in the influent of six wastewater treatment plants in the Czech and Slovak Republic during seven large-scale music festivals from different music genres: metal, rock, pop, country and folk, ethnic, multi-genre, dance, and trance. The total number of participants included >130,000 active festival attendees. The association between music genre and illicit drug and/or psychoactive pharmaceutical consumptions is discussed on the basis of the results obtained through wastewater analyses. The observed trend was similar to worldwide published data with a specific local phenomenon of methamphetamine prevalence that did not significantly change between music events. Increased specific loads of cocaine (measured as its metabolite benzoylecgonine) and Ecstasy, along with some cannabis, were mainly observed during pop/rock and dance music festivals. However, there was no significant increase observed in the specific loads of all monitored psychoactive pharmaceuticals. This study demonstrates that the abuse of some illicit drugs is closely associated with specific music preferences.

Alcohol and nicotine consumption trends in three U.S. communities determined by wastewater-based epidemiology

Wastewater-based epidemiology (WBE), an emerging tool for monitoring public health in near real-time, is used extensively in Europe but applications to U.S. populations are still scarce. In this longitudinal study, raw wastewater was collected monthly from three U.S. cities as 24-h weekday composites and analyzed for evidence of alcohol and tobacco consumption. Over the 11-month sampling period, biomarkers of stimulant use were detected in wastewater by isotope dilution liquid chromatography tandem mass spectrometry in units of μg/L (ethyl sulfate, 1.6-25.1; nicotine, 0.6-26.7; cotinine, 0.2-3.8; and 3‑hydroxycotinine, 0.3-3.8). Average consumption rates in the three communities were calculated using detected biomarker levels in conjunction with wastewater flow rates, metabolic excretion factors, and population size data. Computed average per-capita consumption rates estimated for the sub-population aged 15 and above for alcohol (13.4 ± 5.6 L/y/person) and daily consumption of nicotine by smokers (14.2 ± 3.6 cigarettes/d/person) were in good agreement with U.S. survey data (9.0 L/y/person; 14.2 cigarettes/d/smoker). The WBE approach also captured impacts of temporal population influx on substance consumption patterns. This first U.S. WBE study to track recreational use of stimulants longitudinally and concurrently in multiple American cities highlights opportunities for collecting robust public health information from wastewater anonymously, economically and in near real-time.

Potential impact of the sewer system on the applicability of alcohol and tobacco biomarkers in wastewater-based epidemiology

Understanding the actual consumption of alcohol and tobacco in the population is important for forming public health policy. For this purpose, wastewater-based epidemiology has been applied as a complementary method to estimate the overall alcohol and tobacco consumption in different communities. However, the stability of their consumption biomarkers - ethyl sulfate, ethyl glucuronide, cotinine, and trans-3'-hydroxycotinine - in the sewer system has not yet been assessed. This study aimed to conduct such assessment using sewer reactors mimicking conditions of rising main, gravity sewer, and wastewater alone, over a 12-hour period. The results show that cotinine and trans-3'-hydroxycotinine are relatively stable under all sewer conditions while ethyl sulfate was only stable in wastewater alone and gradually degraded in rising main and gravity sewer conditions. Ethyl glucuronide quickly degraded in all reactors. These findings suggest that cotinine and trans-3'-hydroxycotinine are good biomarkers to estimate tobacco consumption; ethyl sulfate may be used as a biomarker to estimate alcohol consumption, but its in-sewer loss should be accounted for in the calculation of consumption estimates. Ethyl glucuronide, and probably most of glucuronide compounds, are not suitable biomarkers to be used in wastewater-based epidemiology due to their in-sewer instability.

Nicotine enhances an auditory Event-Related Potential component which is inversely related to habituation

Nicotine is a psychoactive substance that is commonly consumed in the context of music. However, the reason why music and nicotine are co-consumed is uncertain. One possibility is that nicotine affects cognitive processes relevant to aspects of music appreciation in a beneficial way. Here we investigated this possibility using Event-Related Potentials. Participants underwent a simple decision-making task (to maintain attentional focus), responses to which were signalled by auditory stimuli. Unlike previous research looking at the effects of nicotine on auditory processing, we used complex tones that varied in pitch, a fundamental element of music. In addition, unlike most other studies, we tested non-smoking subjects to avoid withdrawal-related complications. We found that nicotine (4.0 mg, administered as gum) increased P2 amplitude in the frontal region. Since a decrease in P2 amplitude and latency is related to habituation processes, and an enhanced ability to disengage from irrelevant stimuli, our findings suggest that nicotine may cause a reduction in habituation, resulting in non-smokers being less able to adapt to repeated stimuli. A corollary of that decrease in adaptation may be that nicotine extends the temporal window during which a listener is able and willing to engage with a piece of music.

Mass spectrometric fragmentation and photocatalytic transformation of nicotine and cotinine

RATIONALE

Nicotine and cotinine are, respectively, alkaloids produced mainly by the Solanaceae plant family, especially tobacco, and its most important human metabolite. These compounds are frequently found as contaminants in wastewater or landfill samples and they could be used to evaluate pollution by tobacco use. The aim of this study is to improve the knowledge about possible transformation pathways of nicotine and cotinine. This would help the identification of degradants by using HPLC coupled with a high resolving power mass analyzer (LTQ-Orbitrap). In addition, we evaluated toxicity on bioluminescent photobacteria to indicate possible relationships between the formation of transformation products and their toxic effects.

METHODS

The transformation of nicotine and cotinine and the formation of intermediate products were evaluated adopting titanium dioxide as photocatalyst. The structural identification of photocatalytic transformation products of these two alkaloids was based on LC/multistage MS experiments. High-resolution MS allowed the elemental composition of these products to be hypothesized. The evolution of toxicity as a function of the irradiation time was also studied using a bioluminescent photobacterium (Vibrio fischeri) test.

RESULTS

Several products were formed and characterized using HPLC/HRMSn . The main photocatalytic pathways involving nicotine and cotinine appear to be hydroxylation, demethylation and oxidation. Nine degradants were formed from nicotine, including cotinine. Seven degradants were generated from cotinine. There is no transformation product in common between the two studied molecules.

CONCLUSIONS

The study of photocatalytic degradation allowed us to partially simulate human metabolism and the environmental transformation of the bioactive alkaloid nicotine. We searched for some of the identified transformation products in river water and landfill percolate by solid-phase extraction and HPLC/HRMS and eventually their presence was confirmed. These new findings could be of interest in further metabolism and environmental pollution studies. Copyright © 2016 John Wiley & Sons, Ltd.