National Wastewater Reconnaissance of Analgesic Consumption in Australia

Abstract

A wastewater-based epidemiology (WBE) method is presented to estimate analgesic consumption and assess the burden of treated pain in Australian communities. Wastewater influent samples from 60 communities, representing ∼52% of Australia's population, were analyzed to quantify the concentration of analgesics used to treat pain and converted to estimates of the amount of drug consumed per day per 1000 inhabitants using pharmacokinetics and WBE data. Consumption was standardized to the defined daily dose per day per 1000 people. The population burden of pain treatment was classified as mild to moderate pain (for non-opioid analgesics) and strong to severe pain (for opioid analgesics). The mean per capita weighted total DDD of non-opioid analgesics was 0.029 DDD/day/person, and that of opioidbased analgesics was 0.037 DDD/day/person across Australia. A greater burden of pain (mild to moderate or strong to severe pain index) was observed at regional and remote sites. The correlation analysis of pain indices with different socioeconomic descriptors revealed that pain affects populations from high to low socioeconomic groups. Australians spent an estimated US $3.5 (AU $5) per day on analgesics. Our findings suggest that WBE could be an effective surveillance tool for estimating the consumption of analgesics at a population scale and assessing the total treated pain burden in communities.

Stochastic Dynamic Mass Spectrometric Quantitative and Structural Analyses of Pharmaceutics and Biocides in Biota and Sewage Sludge

“…There is an environmental effect of the pharmaceutics on physiological processes in wild animals. The same can be said for paracetamol (tylenol or acetaminophen), which is a commonly used anti-inflammatory, antipyretic, and analgesic medication [ 32 , 34 , 35 ]. It can be found in tap water from the pharmaceutical industry and in urban and hospital waste [ 36 ].…”

Hypoxia, NSAIDs, and autism: A biocultural analysis of stressors in gametogenesis

“…Since prescription and over‐the‐counter sales data can be difficult or expensive to access, alternative, population‐based perspectives on analgesic or NSAIDs consumption are being pursued with wastewater analyses (Escolà Casas et al, 2021). Even though such analyses cannot consider age‐ or gender‐related patterns of consumption, wastewater analyses may reveal something of “the burden of treated pain” within communities (Ahmed et al, 2023), perhaps quantifying the relative presence of specific metabolites (such as hydroxyibuprofen in the case of ibuprofen) (Kannan et al, 2023), or considering analgesics within the “wide range of chemical and biological markers of human activity” (Choi et al, 2018) or in evaluations of seasonal pharmaceutical use (Tomsone et al, 2022).…”

Water, Water Everywhere, but Every Drop Unique: Challenges in the Science to Understand the Role of Contaminants of Emerging Concern in the Management of Drinking Water Supplies

“…Epidemiology is an applied science that can provide insights into which exposures pose public health risks and thereby inform interventions to mitigate those risks (Galea, 2013 ; Susser, 1991 ). Observational epidemiology can complement experimental studies by looking at real‐world situations faced by human populations, rather than idealized and simplified exposure scenarios, and can evaluate putatively toxic exposures in human populations when conducting experimental studies would be unethical (F. Ahmed et al., 2023 ; Vlaanderen et al., 2008 ). To assess whether specific contaminants pose health risks in observational epidemiology studies, it is necessary to describe exposures to contaminants in populations and to assess the correspondence between exposure levels and health outcomes in those populations.…”