Opportunities and limits of wastewater-based epidemiology for tracking global health and attainment of UN sustainable development goals

Adhikari, Sangeet; Halden, Rolf U.

doi:10.1016/j.envint.2022.107217

Cited by 69 publications

(40 citation statements)

References 69 publications

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“…This is a crucial step in preparing for future epidemics and pandemics. This approach can also be used to monitor an array of public health indicators, e.g., obesity ( 77 ), consumption of alcohol, illicit drugs and tobacco, exposure to hazardous chemicals and pharmaceuticals ( 23 , 24 ), and detection of sexually transmitted disease etiological agents ( 78 , 79 ). In the meantime, SMS can be usefully applied to clinical and WS practices directed at both community and global public health.…”

Section: Discussionmentioning

confidence: 99%

“…Proposed as a complement to clinical testing, wastewater surveillance (WS; also known as wastewater monitoring or wastewater-based epidemiology) of samples collected from treatment systems of communities has been used for early detection of community-wide disease prevalence, notably for poliovirus ( 17 – 19 ), noroviruses ( 20 ), flu ( 21 ), and recently COVID-19 ( 22 ). WS has also been employed to assess diverse factors influencing communitywide health, such as monitoring consumption of local diets, alcohol, illicit drugs, and tobacco, and evaluating exposure to hazardous chemicals and pharmaceuticals ( 23 , 24 ). WS of confined populations, e.g., inhabitants of a single building ( 25 ) or university dormitory ( 26 ) or small community sewage collection systems (SCS) of a neighborhood ( 27 ), can be considered less biased, because the evaluation is pooled contributions of all individuals served by a given catchment area, compared with clinical testing, where only a minority of consenting individuals are tested routinely.…”

Section: Introductionmentioning

confidence: 99%

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Microbiome Analysis for Wastewater Surveillance during COVID-19

Brumfield

Leddy

Usmani

et al. 2022

mBio

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Microbiome Analysis for Wastewater Surveillance during COVID-19

Brumfield

Leddy

Usmani

et al. 2022

mBio

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“…It has also recently been suggested that WBE could be used to track progress toward meeting the United Nations Sustainable Development Goals, with several potential biomarkers for monitoring the various goals proposed (e.g., the hunger hormone ghrelin to assess the prevalence of undernourishment). 50 …”

Section: Discussionmentioning

confidence: 99%

A Framework for Public Health Authorities to Evaluate Health Determinants for Wastewater-Based Epidemiology

Eaton

Coxon

Pattis

et al. 2022

Environ Health Perspect

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Background: Wastewater-based epidemiology (WBE) is rapidly developing as a powerful public health tool. It can provide information about a wide range of health determinants (HDs), including community exposure to environmental hazards, trends in consumption of licit and illicit substances, spread of infectious diseases, and general community health. As such, the list of possible candidate HDs for WBE is almost limitless. Consequently, a means to evaluate and prioritize suitable candidates for WBE is useful, particularly for public health authorities, who often face resource constraints. Objectives: We have developed a framework to assist public health authorities to decide what HDs may be appropriate for WBE and what biomarkers could be used. This commentary reflects the experience of the authors, who work at the interface of research and public health implementation. Discussion: To be suitable for WBE, a candidate HD should address a public health or scientific issue that would benefit from better understanding at the population level. For HDs where information on individual exposures or stratification by population subgroups is required, WBE is less suitable. Where other methodologies are already used to monitor the candidate HD, consideration must be given to whether WBE could provide better or complementary information to the current approach. An essential requirement of WBE is a biomarker specific for the candidate HD. A biomarker in this context refers to any human-excreted chemical or biological that could act as an indicator of consumption or exposure to an environmental hazard or of the human health state. Suitable biomarkers should meet several criteria outlined in this commentary, which requires background knowledge for both the biomarker and the HD. An evaluation tree summarizing key considerations for public health authorities when assessing the suitability of candidate HDs for WBE and an example evaluation are presented. https://doi.org/10.1289/EHP11115

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“…Unlike WBE, traditional approaches can miss cases of infected individuals who intentionally do not want to be tested due to the social stigma associated with some diseases, including mpox. WBE also allows for the tracing of asymptomatic infections and the cryptic transmission of pathogens (1)(2)(3). The effectiveness of WBE as an indicator of pathogen infection and its prevalence in the population has already been demonstrated for poliovirus, measles virus, enteroviruses, hepatitis A and E viruses, noroviruses, influenza A virus, dengue virus, and SARS-CoV-2 (1-3).…”

Section: (Which Was Not Certified By Peer Review) Preprintmentioning

confidence: 99%