Monitoring caffeine and nicotine use in a nationwide study in Italy using wastewater-based epidemiology

Impact of physicochemical parameters on nicotine metabolites and Bisphenol A in municipal wastewater: A pilot study in a German metropolitan area

Wastewater-based epidemiology (WBE) is a promising approach for assessing population-level exposures to toxicants and lifestyle factors. Our pilot investigated the spatial variability of biomarkers indicating exposure to nicotine and endocrine disrupting chemicals in municipal wastewater, taking into account important covariates, i.e. physicochemical wastewater parameters and sewershed characteristics. We also tested normalization by an endogenous population marker. Twenty-four-hour composite samples (n = 24) were collected in a volume-proportional manner using automated samplers from four wastewater treatment plants in Essen, Germany, over three weeks in late 2023. Substances of public health concern, previously already quantified in wastewater and expected to be present in high concentrations, were analyzed using SPE-LC-HRMS. Concentrations were normalized to the reported population (de jure) and the daily mass load of the catecholamine metabolite vanillylmandelic acid (VMA) as a proxy for the de facto population. Spatial variations were analyzed using multiple linear regression. Nicotine metabolites (cotinine, hydroxycotinine) and the industrial chemical Bisphenol A (BPA) were quantifiable in all wastewater samples. The population-normalized daily mass load of nicotine metabolites (median range: 0.6-1.6 g/d/1000 inh) and BPA (2.5-4.0 g/d/1000 inh) varied between the WWTPs, but the observed variation disappeared when adjusting for wastewater temperature (nicotine) and wastewater pH (BPA). Normalization to the VMA daily mass load resulted in different spatial patterns and increased the variance considerably. Our findings highlight the importance of adjusting for physicochemical characteristics when analyzing community-wide differences in exposure to toxicants and lifestyle factors via wastewater, to ensure accurate interpretations of the underlying drivers of these differences.

Emerging threat of marine microplastics: Cigarette butt contamination on Yellow Sea beaches and the potential toxicity risks to rotifer growth and reproduction

Cigarette butts have become one of the most common and persistent forms of debris in marine coastal areas, where they pose significant toxicity risks. This study investigated cigarette butt pollution along beaches of the Yellow Sea and used laboratory experiments to assess the toxicity of their leachate and fibers on the euryhaline rotifer Brachionus plicatilis. A pollution index confirmed pollution by this debris across all eight beaches surveyed, where the density of cigarette butts averaged 0.23 butts/m2. In controlled laboratory experiments, both the fibers and leachates from cigarette butts exhibited negative impacts on the development, reproduction, and population growth of rotifers. Unique abnormalities observed under different exposure treatments indicated toxicity specific to certain chemicals and particles. Continuous exposure to cigarette butts initially reduced rotifer fecundity, but this effect diminished over successive generations. However, the exposure induced transgenerational reproductive toxicity in the rotifers. Adaptive responses in rotifers after repeated exposure led to relative reduction in reproductive inhibition in the F3 and F4 generations. Furthermore, rotifers were capable of ingesting and accumulating cigarette butts, and maternal transfer emerged as an alternative pathway for uptake of this material in the offspring. These results increase our understanding of the ecological risks posed by cigarette butts in aquatic environments.

Are we using more sugar substitutes? Wastewater analysis reveals differences and rising trends in artificial sweetener usage in Swedish urban catchments

The market for artificial sweeteners as substitutes for conventional sugar (sucrose) is growing, despite potential health risks associated with their intake. Estimating population usage of artificial sweeteners is therefore crucial, and wastewater analysis can serve as a complement to existing methods. This study evaluated spatial and temporal usage of artificial sweeteners in five Swedish communities based on wastewater analysis. We further compared their levels measured in wastewater with the restrictions during the COVID-19 pandemic in Sweden and assessed health risks to the Swedish population. Influent wastewater samples (n = 194) collected in March 2019-February 2022 from communities in central and southern Sweden were analyzed for acesulfame, saccharin, and sucralose using liquid-chromatography coupled with tandem mass spectrometry. Spatial differences in loads for individual artificial sweetener were observed, with sucralose being higher in Kalmar (southern Sweden), and acesulfame and saccharin in Enköping and Östhammar (central Sweden). Based on sucrose equivalent doses, all communities showed a consistent prevalence pattern of sucralose > acesulfame > saccharin. Four communities with relatively short monitoring periods showed no apparent temporal changes in usage, but the four-year monitoring in Uppsala revealed a significant (p < 0.05) annual increase of ∼19 % for sucralose, ∼9 % for acesulfame and ∼8 % for saccharin. This trend showed no instant or delayed effects from COVID-19 restrictions, reflecting positively on the studied population which retained similar exposure to the artificial sweeteners despite potential pandemic stresses. Among the three artificial sweeteners, only acesulfame's levels were at the lower end of the health-related threshold for consumption of artificially sweetened beverages; yet, all were far below the acceptable daily intake, indicating no appreciable health risks. Our study provided valuable, pilot insights into the spatio-temporal usage of artificial sweeteners in Sweden and their associated health risks. This shows the usefulness of wastewater analysis for public health authorities wishing to assess future relevant interventions.

Retrospective spatiotemporal study of antidepressants in Slovenian wastewaters

This study utilizes wastewater-based epidemiology (WBE) to evaluate spatiotemporal changes in the consumption of antidepressants before and during the COVID-19 pandemic in Slovenia. Composite 24-h influent wastewater samples (n = 210) were collected from six wastewater treatment plants between summer 2019 and spring 2021. The samples were extracted using 96-well solid-phase extraction and analysed by liquid chromatography-tandem mass spectrometry. The measured concentrations of target antidepressant biomarkers were then converted to population-normalised mass loads (PNMLs), taking into account flow rate and catchment population. Ten biomarkers, including amitriptyline, bupropion, bupropion-OH, citalopram, norcitalopram, normirtazapine, venlafaxine, O-desmethylvenlafaxine, trazodone, and moclobemide, were above the lower limit of quantification and were included in the spatiotemporal temporal assessment. The highest PNMLs were detected for O-desmethylvenlafaxine (mean ± SD: 82.1 ± 21.2 mg/day/1000 inhabitants) and venlafaxine (38.0 ± 10.6 mg/day/1000 inhabitants), followed by citalopram (27.0 ± 10.7 mg/day/1000 inhabitants). In addition, the mean metabolite/parent compound ratios were comparable with other WBE studies indicating consumption rather than direct disposal. Overall, the results indicated significant spatiotemporal variations depending on the location, and the PNMLs of most biomarkers increased during the first wave of the COVID-19 pandemic (spring of 2020). However, no clear spatial patterns were revealed related to the pandemic.

Nicotine consumption rate through wastewater-based epidemiology: a systematic review, meta-analysis and probabilistic risk assessment

Wastewater-based epidemiology (WBE), as a rapid tool, is used to measure and monitor illicit drug consumption in the population. This method is also used to bridge biomarkers of exposure, contaminants, and human health. Smoking cigarettes and tobacco use are everyday habits in nowadays community. This systematic review and meta-analysis aimed to calculate nicotine consumption globally. The related studies were retrieved within international databases including Scopus, Google Scholar, and Web of Science, up to February 2021. It included twenty-one articles containing 87 measurements covering 275.3 million people with total wastewater samples of 2250. Results showed that the highest and lowest nicotine consumption rate (mg/1000 inh./day) was in Portugal (5860) and Vietnam (1201), respectively. The global pooled nicotine consumption rate was 2476 mg/1000 inh./day (95% CI (2289-2663). Based on WBE results, the average daily cigarette smoked per smoker is 14 (95% CI: 10-18 cigarettes/inh./day), close to the value of 14.2 reported by the survey and interview studies. Risk assessment of the nicotine consumption rate through WBE was calculated by the margin of exposure (MOE) approach. In total, 82% of nicotine consumption measurements were located in the "risk" level (MOE < 100), and 18% of the MOE values were between 100-1000. The results reveal that nicotine consumption risks need immediate global and local action strategies. Finally, these findings are helpful for healthcare agencies and policy-makers to take action against tobacco use prevalence.

Occurrence of primary aromatic amines and nicotine in sediments collected from the United States

Despite extensive use of primary aromatic amines (AAs) in consumer products, little is known about their occurrence in the environment. In this study, we investigated the occurrence of 14 AAs and nicotine in 75 sediment samples collected from seven estuarine and freshwater ecosystems in the Unites States. Additionally, risk quotients (RQs) were calculated to assess potential risks of these chemicals to aquatic organisms. Of the 14 AAs analyzed, seven of them were found in sediments. The sum concentrations of seven AAs in sediments were in the range of 10.2 to 1810 ng/g, dry wt (mean: 388 ng/g). Aniline was the most abundant compound, accounting for, on average, 53 % of the total concentrations. Nicotine was found in sediments at a concentration range of <LOQ to 1340 ng/g, dry wt (mean: 119 ng/g). Among the seven sampling locations studied, AAs and nicotine concentrations were the highest in sediment from Altavista wastewater lagoon in Virginia (AV, mean: 1700 ng/g) followed in descending order by Chicago Sanitary and Ship Canal (CSSC, mean: 807 ng/g), Indiana Harbor and Ship Canal (IHSC, mean: 698 ng/g) and New Bedford Harbor (NBH, mean: 482 ng/g). Sediments from the upper Mississippi River (MISS, mean: 63.4 ng/g) and Tittabawassee River (TBR, mean: 52.3 ng/g) contained the lowest concentrations. The RQ values for AAs in sediment ranged from 0 to 733 and that for nicotine ranged from 0 to 2060. Among AAs, the highest RQ value was found for 4-chloroaniline. Nicotine exhibited notable RQ values, which suggested risk from this chemical to aquatic organisms. This is the first study to report the occurrence of AAs in sediments and our results suggest the need for further investigations on the sources and ecological impacts of these chemicals in aquatic ecosystems.

Long-term monitoring of drug consumption patterns during the COVID-19 pandemic in a small-sized community in Brazil through wastewater-based epidemiology

The abuse of legal and illegal drugs is a global public health problem, also affecting the social and economic well-being of the population. Thus, there is a significant interest in monitoring drug consumption. Relevant epidemiological information on lifestyle habits can be obtained from the chemical analysis of urban wastewater. In this work, passive sampling using polar organic chemical integrative samplers (POCIS) was used to quantify licit and illicit drugs biomarkers in wastewater for the application of wastewater-based epidemiology (WBE). In this WBE study, a small urban community of approximately 1179 inhabitants was monitored from 18 March 2020 to 3 March 2021, covering the mobility restriction and flexibilization periods of the COVID-19 pandemic in Brazil. Consumption was estimated for amphetamine, caffeine, cocaine, MDMA, methamphetamine, nicotine, and THC. The highest estimated consumption among illicit drugs was for THC (2369 ± 1037 mg day-1 1000 inh-1) followed by cocaine (353 ± 192 mg day-1 1000 inh-1). There was a negative correlation between consumption of caffeine, cocaine, MDMA, nicotine, and THC with human mobility, expressed by cellular phone mobility reports (P-value = 0.0094, 0.0019, 0.0080, 0.0009, and 0.0133, respectively). Our study is the first long-term drug consumption evaluation during the COVID-19 pandemic, with continuous sampling for almost a whole year. The observed reduction in consumption of both licit and illicit drugs is probably associated with stay-at-home orders and reduced access, which can be due to the closure of commercial facilities during some time of the evaluated period, smaller drug supply, and reduced income of the population due to the shutdown of companies and unemployment. The assay described in this study can be used as a complementary and cost-effective tool to the long-term monitoring of drug use biomarkers in wastewater, a relevant epidemiological strategy currently limited to short collection times.

Analysis of synthetic cannabinoids in wastewater of major cities in China

Synthetic cannabinoids (SCs) could pose serious health risks to its users. It is necessary to monitor its community consumption. Wastewater-based epidemiology is a potentially useful approach in this regard. However, limited research has been conducted to investigate the occurrence of SCs in wastewater. In this study, liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was optimized to analyze 8 SCs and metabolites (in total 16 analytes) in wastewater. The limit of quantification for this method for certain analytes in wastewater was as low as 0.03 ng L^-1. The validated method was used to examine the stability of the analytes under different conditions and to examine their occurrence in wastewater collected from 31 major cities across China. The overwhelming majority of the analytes were stable within 24 h, even at room temperature. However, 5-fluoro MDMB-PICA and MDMB-4en-PINACA butanoic acid metabolite showed significant degradation within 120 days even when stored at -20 °C or -80 °C. At least one cannabinoid or their metabolite was detected in 21 cities. In the city with the highest detection rate, at least one synthetic cannabinoid or metabolite was detected in 95% of samples of the city. MDMB-4en-PINACA butanoic acid metabolite had the highest detection frequency (in 13.4% of the samples). These results indicated that SCs were used in a significant number of Chinese cities. A few parent drugs (MDMB-4en-PINACA, ADB-BUTINACA, 5-fluoro MDMB-PICA, 4-fluoro MDMB-BUTINACA) were detected in a small fraction of wastewater samples, possibly due to release from manufacturing of these cannabinoids or illegal addition of electronic cigarettes.

Tobacco Waste Liquid-Based Organic Fertilizer Particle for Controlled-Release Fulvic Acid and Immobilization of Heavy Metals in Soil

Every year, a large amount of tobacco waste liquid (TWL) is discharged into the environment, resulting in serious pollution for the environment. In this work, a TWL-based particle (OACT) was fabricated by CaO, attapulgite (ATP), and TWL, and, then, OACT was coated by amino silicon oil (ASO) to form OACT@ASO. Therein, OACT@ASO had high controlled-release ability for fulvic acid (FA), because of the nanonetworks structure for ATP and the high content of FA in TWL. The release ratio (RR) of FA from OACT@ASO reached 94% at 75 h in deionized water, and 23% at 32 d in silica sand. Furthermore, the release mechanism of FA from OACT@ASO was consistent with the First-order law. Additionally, OACT@ASO also possessed high immobilization capacity for Cu(II), Cd(II), and Pb(II) (CCP) in soil. Notably, a pot experiment indicated that OACT@ASO could facilitate the growth of pakchoi seedlings and decrease the absorption of CCP by pakchoi seedlings. Thus, this study provides a new kind of organic fertilizer which could not only release FA, but also immobilize CCP in soil.

Implementing wastewater monitoring on American Indian reservations to assess community health indicators

Healthcare access and health-related information for American Indian/Alaska Native (AIAN) communities is often limited. A potential solution to acquire additional population level health data is through wastewater-derived measurements, a method termed wastewater-based epidemiology (WBE), however, due to often remote locations with rudimentary wastewater infrastructure, the feasibility of implementing WBE on an AIAN reservation is unclear. In this study, we i) performed a preliminary assessment of percent connectivity of the top 10 most populous tribal reservations using available wastewater treatment facility information from the Environmental Protection Agency Enforcement and Compliance History Online database and satellite imagery, and ii) performed a sampling campaign on a select tribal reservation to measure common WBE indicators of health and behavior. Results indicate that, on average, approximately 81 ± 23% of tribal residents are connected to some form of aggregated wastewater collection system. On the sampled reservation, 6 communities comprising 7500 people were sampled across 160 km of reservation land using active samplers successfully deployed within the sewer network upstream of terminal lagoon systems. Results showed detectable levels of 7 opioids, 1 opioid maintenance medication, 5 stimulants, 1 hallucinogen, and chemical indicators of alcohol, nicotine, caffeine, and an over-the-counter cough suppressant. These results illustrated the feasibility in implementing WBE in rural and remote communities where information on community health may be lacking.

Assessment of a wide array of organic micropollutants of emerging concern in wastewater treatment plants in Greece: Occurrence, removals, mass loading and potential risks

Exploring the contamination profile of multi-class emerging contaminants (ECs) in wastewater is highly desirable. To this end, the occurrence, removal, mass loading and risks associated with a large panel of pharmaceuticals and personal care products, illicit drugs, perfluorinated compounds and organophosphate flame retardants in two wastewater treatment plants (WWTPs) in the region of Thessaloniki (Greece) after a survey is illustrated. Influent and effluent wastewaters were submitted to solid phase extraction on Oasis HLB cartridges, followed by ultra-high-performance liquid chromatography Orbitrap high-resolution mass spectrometry (UHPLC-Orbitrap MS). Influent concentrations in both WWTPs were notably higher than effluent, with caffeine, acetaminophen, irbesartan and valsartan being the most ubiquitous compounds, exhibiting elevated concentrations. Average effluent concentrations ranged from below the method quantification limits (<MQL) to remarkably high values (μg L^-1 scale), such as for caffeine, acetaminophen, diclofenac, irbesartan and valsartan, among others. Removal efficiencies ranged between -273% for lamotrigine and 100%, i.e., for the UV filter BP1. Notably, the polar compounds such as cytarabine, methotrexate and capecitabine were removed at a rate >80% in both WWTPs, allowing the correlation between logK_ow and removals. Interesting trends for the illicit drugs were revealed by means of mass loading estimation, as in the case of benzoylecgonine (71.6 mg/day/1000 inhabitants). Ecotoxicological risk assessment was evaluated for both single components and mixture, using three approaches: risk quotient (RQ), risk quotient considering frequency (RQ_f) and toxic units (TU). Irbesartan and telmisartan posed a high risk in all trophic levels, while fish was the most sensitive taxa for diclofenac. This work aspires to intensify the surveillance programs for the receiving water bodies, as well as to motivate the investigation of toxicity to non-target organisms.

Identification of biomarkers in wastewater-based epidemiology: Main approaches and analytical methods

Wastewater-based epidemiology (WBE) has become popular to estimate the use of drugs of abuse and recently to establish the incidence of CoVID 19 in large cities. However, its possibilities have been expanded recently as a technique that allows to establish a fingerprint of the characteristics of a city, such as state of health/disease, healthy/unhealthy living habits, exposure to different types of contaminants, etc. with respect to other cities. This has been thanks to the identification of human biomarkers as well as to the fingerprinting and profiling of the characteristics of the wastewater catchment that determine these circumstances. The purpose of this review is to analyze the different methodological schemes that have been developed to perform this biomarker identification as well as the most characteristic analytical techniques in each scheme, their advantages and disadvantages and the knowledge gaps identified. We also discussed the future scope for development.

Monitoring geographical differences in illicit drugs, alcohol, and tobacco consumption via wastewater-based epidemiology: Six major cities in Turkey

A national wastewater-based epidemiology (WBE) monitoring campaign has been initiated to determine the trends in drug consumption in Turkey since 2019. This study aimed to present the wastewater monitoring results for four periods in 2019 for six major cities with 17 wastewater treatment plants. The study investigated heroin (HER), amphetamine (AMP), methamphetamine (METH), cocaine (COC), 3,4-methylenedioxymethamphetamine (MDMA), cannabis, alcohol, and tobacco to understand the temporal and geographical drug consumption trends. The results indicated a trend of regular cannabis use in all the cities. Considering geographical variations, the drug usage trends were not homogeneous within the country for any of the investigated drugs, except cannabis. HER consumption was predominant in Denizli (1042.48 mg/1000 inh/day), while İzmir and Antalya (154.10 and 79.56 mg/1000 inh/day, respectively) topped for COC consumption. Aydın had the highest consumption levels of AMP (90.03 mg/1000 inh/day) and METH (358.13 mg/1000 inh/day), while MDMA consumption was the highest in Samsun (157.64 mg/1000 inh/day). Tobacco consumption was high in Aydın (8791.69 mg/1000 inh/day) and Antalya (5375.17 mg/1000 inh/day), whereas alcohol consumption was higher in Bursa than in the other cities (53434.61 mL/1000 inh/day). There were no statistically significant differences in the weekend consumption levels of the investigated drugs among these six cities. Although this study included the results of 1 year of consumption monitoring, the data confirms internationally published information on the drug trafficking routes of conventional drugs in this region, especially the Heroin-Balkan route. Results from further sampling will enable accurate evaluation of global drug consumption and trafficking, in addition to alcohol and tobacco use.

Comparison of tobacco use in a university town and a nearby urban area in China by intensive analysis of wastewater over one year period

Understanding smoking patterns in the population is essential for formulating public health and tobacco control policies. Wastewater-based epidemiology (WBE) is a valuable complementary approach to conventional survey methods to measure tobacco use, providing non-invasive information in an objective and cost-effective manner. This study estimates tobacco use in an urban population at daily resolution and in a university town at weekly resolution in China. Wastewater samples were collected daily in an urban catchment (n = 279) and every week from a university town located within 13 km of the urban catchment (n = 43) in 2017-2018. The tobacco-related biomarkers, cotinine and hydroxycotinine, and nicotine were analyzed via direct injection liquid chromatography tandem mass spectrometry (LC-MS/MS). Per capita daily tobacco use was back-estimated based on cotinine in wastewater. Over the year of sampling, we observed an increasing trend in tobacco use in the urban catchment that corroborated with sales statistics in 2017-2018. Tobacco use in the urban area was estimated to be 1.16 cigarettes/person aged 15+/day, while it was estimated to be 0.60 cigarettes/person aged 15+/day in the university town. The level of tobacco use in the university town remained stable over the year in contrast to the urban area. The difference of tobacco use in the two catchments may be attributed to their demographic differences. Furthermore, the Tobacco-Free Campus Policy would be a possible reason for the lower level of tobacco use in the university town.

Occurrence of areca alkaloids in wastewater of major Chinese cities

Areca nut is a widely used psychoactive product that can cause multiple health problems, such as oral and pharyngeal cancers. Therefore, it is important to estimate areca nut use and the exposure levels of areca alkaloids that are responsible for its health effects. China is a major producer of areca nut and has a large number of areca nut chewers. In this study, occurrence of areca alkaloids and metabolites in wastewater of major cities across China was examined via wastewater-based epidemiology (WBE). Arecoline, arecaidine, and their metabolite, N-methylnipecotic acid (NMNA) were detected in the overwhelming majority of wastewater samples, with concentrations up to several μg/L. In contrast, guvacoline was only occasionally detected and guvacine was below detection limit in all samples, possibly due to their low contents in areca nut products, low excretion rates, and/or low stability in sewer systems. Strong positive correlations existed between arecoline, arecaidine, and NMNA concentrations. In addition, their loads were much higher in Central and Southern China. This geographic pattern is consistent with previous survey results on prevalence of areca nut chewing. These results indicate that WBE is a potentially useful method to monitor areca nut consumption and to estimate the exposure levels of areca alkaloids.

Two-dimensional liquid chromatography - mass spectrometry as an effective tool for assessing a wide range of pharmaceuticals and biomarkers in wastewater-based epidemiology studies

The biomarkers used in wastewater-based epidemiology studies have a wide range of physicochemical properties, making simultaneous analysis extremely challenging or even impossible. So far, the majority of analytical procedures employed in this field have focused on specific classes or a limited number of analytes. The heart-cutting two-dimensional liquid chromatography tandem mass spectrometry technique (2D-LC-MS/MS) has enabled the incorporation of compounds with significantly different polarities in a single analytical method. In this study, a 2D-LC-MS/MS method has been developed and optimized for the simultaneous analysis of various biomarkers in wastewater, providing relevant information about lifestyle habits (the usage of alcohol, tobacco, and caffeine), health and well-being (pharmaceuticals), and a population size biomarker (5-HIAA) that is useful for correct calculation of human population during wastewater-based epidemiology studies. A single-laboratory validation procedure showed satisfactory analytical performance, with the mean trueness for most compounds falling in the range of 80÷110 % and the mean repeatability being less than 20 %. The applicability of the method was evaluated by testing 28 wastewater samples collected at different wastewater treatment plants in Latvia. The obtained results revealed the occurrence of 44 out of 62 selected biomarkers, with the lowest quantified concentration at 1.1 ng L^-1 in the case of xylometazoline and up to 148 μg L^-1 in the case of metformin and 156 μg L^-1 for caffeine.