sewage analyses as an early detection system for diseases and indicator of various public health...

2nd GRF One Health Summit Davos, 17‐20 November 2013

Christoph Ort, Eawag 1

Christoph ORT

2nd GRF One Health Summit

Davos 17‐20 November 2013

Eawag: Swiss Federal Institute of Aquatic Science and Technology

Sewage Analyses as an Early Detection System for Diseases and Indicator of Various Public Health Aspects

Caleb BANTA‐GREEN, Frédéric BÉEN, Lubertus BIJLSMA, Sara CASTIGLIONI, Erik EMKE, Jennifer FIELD, Coral GARTNER, Barbara KASPRZYK‐HORDERN, Foon Yin LAI, Jeremy PRICHARD, Malcolm REID, Martina KINZIG, Alexander VAN NUIJS

GPS?

wastewater

Is

better

than

a



GPS = Global Population Survey



Concept, approach

Drug consumption Dose d

Metabolism alcohol/other drugs

Excretion e

Sewer pipes losses ? system-dependent

transformation/adsorption ? current research t

dynamics hydraulics

Sewage treatm. plant sampling analytics C

flow measurements volume Q

Catchment number of people normalization P

C(S)·QP ·

1e ·1d ·1t

Substance load in sewer[mg 1000p-1 d-1]

analytical chemist

env. engineerSTP operator

censuspharmacologist

forensic sc.

env. engineer

Transdisciplinary



Sampling from a very dynamic system («sum» of toilet flushes/pumps)

ST

P [

L/s]

0

100

200

300

400

500

600

09

:00

09

:10

09

:20

09

:30

09

:40

09

:50

10

:00

10

:10

10

:20

10

:30

10

:40

10

:50

11

:00

11

:10

11

:20

11

:30

11

:40

11

:50

12

:00

ST

P [

L/s]

0

100

200

300

400

500

600

0

5

10

15

20

25

30

35

BZ

E [m

g/2

min

]B

E [m

g/2m

in]

flow

[l/s]

Ort et al. (in preparation)Castiglioni et al. (2013) Environmental Science and Technology 47 (3) , pp. 1452‐1460

Collect samples at high frequency (i.e. every 5‐10 minutes)

Pool samples for analysis (typically 24h) Get information about catchment

t=2min

Diurnal variations (caffeine and creatinine)

Brewer et al. (2012) Environmental Science and Technology 46 (15) , pp. 8305‐8314

Collect samples in a flow/volume proportional manner



van Nuijs et al. (2009) Environmental Pollution 157 (1) , pp. 123‐129

Wednesday

WINTER 2007‐2008

Cocaine consumption* in Belgium (individual days in 2007/08)

* back‐calculated from benzoylecgonine

Sunday

WINTER 2007‐2008

van Nuijs et al. (2009) Environmental Pollution 157 (1) , pp. 123‐129

Cocaine consumption* in Belgium (individual days in 2007/08)


Weekend effect depending on use pattern and pharmacokinetics



Thomas et al. (2012) Science of the Total Environment 432 , pp. 432‐439Ort and van Nuijs et al. (in preparation)

Benzoylecgonine (one 1‐week period)

EU: 355kg cocaine/d30% purityCHF 100/g 43 Mrd. CHF/y

MDMA (one 1‐week period)

Thomas et al. (2012) Science of the Total Environment 432 , pp. 432‐439Ort and van Nuijs et al. (in preparation)

Emke et al. (accepted) Science of the Total Environment



Asia (2009‐2011)

Lai et al. (2013) Forensic Science International 233 (1‐3) , pp. 126‐132graph Covaci et al. (in preparation)

other substances epidemiological data

not available to the same extent

Cocaine* consumption in small community (~7000 people, n=1369 days)

Working days 605mgCOC/d

Weekend (p < 10-4)

+161mgCOC/d

Frost (p = 0.039)

+114mgCOC/d

Snow (p = 0.005)

+150mgCOC/d

Ort et al. (asap) Addiction


monitoring design external factors annual average



Antihistamine Cetirizine

Harman et al. (2011) Environmental Science and Technology 45 (13) , pp. 5676‐5682

[…] corresponds almost exactly to the period when 95% of the yearly total for the two most significant sources of pollen was registered in the Oslo region and associated seasonal allergic rhinitis amongthe population.

[…] total amount of cetirizine that passed through the system in 2010 (∼30 kg). As 50% of cetirizine is excreted unchanged and the dose rate is 10 mg per person per day, then this results in an estimation in the total number of defined daily doses (DDD) of 5 947 327 in 2010, which is within 10% of the known DDD (SI Table S2).

Is wastewater better than GPS?

Neither yes nor no: different, complementary

Anonymous

No selection bias

Substance‐specific

Near real‐time

No number of users

No type of users

No prevalence

+

-



Take home messages

• No ethical issues in large populations i.e. negligible risk of (in)direct harm to residents; not monitoring individuals!

• Quantifying baseline and trends and effects of interventions and also special events, e.g. festivals …

• Valuable complementary tool providing quantitative aggregate, near real‐time information

• Early warning system for new drugs and potentially for diseases

• Transdisciplinary research involving engineer, chemists, pharmacologists, epidemiologists, sociologists, police, forensic scientists, etc.)

Hall et al. (2012) Addiction 107 (10) , pp. 1767‐1773

Network expanded in 2013 (and further expanding)

Ort and van Nuijs et al. (in preparation)

21 countries 42 cities 47 sewage treatm. plants 24.74m people

New COST action: Sewage biomarker analysis forcommunity health assessment



Adriano Joss, Adrian Covaci, Alan Kleinschmidt, Alex Brewer, Alex Heisele, Alexander Van Nuijs, Ana Deletic, Ana Esposo,Andreas Hartmann, Andreas Scheidegger, Andreas Schiller, Anja Herlyn, Arthur Wanner, AWMC, Axel Meierjohann, Axel Wahl,Barbara Kasprzik‐Hordern, Beat Rohrbach, Beate Escher, Beatrice Gadmer, Benjamin Tan, Bernard Cloetta, Bernd Nowack,Brigitte Pfister, Caleb Banta‐Green, Canan Aglamaz, Carsten Uemann, Christa McArdell, Christian Abegglen, Christian Braun,Christian Fux, Christian Götz, Christian Schaffner, Christian Stamm, Claude‐Alain Jaquerod, Claudi Bänninger‐Werfeli, CoralGartner, Cornelia Buchwalder, Damian Dominguez, Daniel Braun, Daniel Field, Daniel Pfund, Daniel Probst, Daniel Rensch,Daniel Streit, Daniele Scrugli, David Dürrenmatt, David Fillmore, David Makaz, David McCarthy, David Sedlak, DieterSennhauser, Dirk Muschalla, Dominic Sydler, Don Begbie, Dongbin Huang, Doris Jermann, Eawag, Erik Emke, ETH, EtienneVermeirssen, Fadri Gottschalk, Felix Buehler, Félix Hernández, Foon Yin Lai, Frank Blumensaat, Fredi Bichsel, Frédéric Béen,Frederik Verdonck, Fritz Sörgel, Geoff Eaglesham, Gerd Hüttmann, Geri Koch, Geri Ryhiner, Glen Daigger, Greg Jackson, HansLamp, Hanspeter Bauer, Hansruedi Siegrist, Heather Chapman, Heinz Frömelt, Heinz Singer, Helen Stratton, Helge Daebel,Hugo Koller, Irene Steimen, Irene Wittmer, Jack Eugster, Jaqueline Traber, Jakob Helbing, Jan Mazacek, Janet Cumming, JanetHering, Jean‐Daniel Berset, Jean‐Daniel Rosselet, Jean‐Luc Bertrand‐Krajewski, Jelena Radjenovic, Jennifer Field, JeremeyPrichard, Jessica Nott, Jimmy Coonan, Jo Martens, Jochen Mueller, John Doonan, John Elec, John Paulger, Jonas Maria Eppler,Jörg Rieckermann, José Quintana, Josef Asmin, Juliane Hollender, Julien Reungoat, Jurg Keller, Kai Udert, Karin Rottermann,Kathrin Fenner, Kevin Thomas, Klaus Heimburger, Kristell Le Corre, Leiv Rieger, Lieven Clement, Lluís Corrominas, LoïcLombard, Lubertus Bijlsma, Luc Demontigny, Luca Rossi, Malcolm Reid, Marc Böhler, Marc Neumann, Marc Suter, MarcelDettling, Maria José Farré‐Olalla, Marja Furrer, Marina Peter, Mario Keusen, Mariska Ronteltap, Markus Boller, Markus Gresch,Markus Koch, Martin Krauss, Martina Kinzig, Mary Donlevy, Mary Hodge, Max Maurer, Maxime Rattier, Michael Burkhard,Michael Eugster, Michael Lawrence, Michael Schärer, Michael Thomann, Michele Steiner, Miren Lopez de Alda, MiriamMünchbach, Oliver Kracht, Olivier Delémont, Oskar Wanner, Paul Liechti, Pascal Wunderlin, Peter Bühlmann, Peter Gäumann,Peter Krebs, Peter Liechti, Peter Reichert, Peter Schär, Peter Schwilch, Peter Steen Mikkelsen, Peter Vanrolleghem, PhilippBeutler, Philipp Staufer, Philippe Vioget, Pim de Voogt, Pierre Esseiva, Pius Niederhauser, Ralf Kägi, Ralf Rosenstiel, René Gälli,Reto Manser, Richard Lindberg, Röbi Schmid, Roger Küenzi, Roman Grabic, Rosi Sieber, Ross Kleinschmidt, Ruedi Moser,Sabine Burger, Saskia Zimmermann, Samuel Twerenbold, Sandra, Hall, Sara Castiglioni, Sara Karolak, Senka Terzic, SeppPoreccia, Shane Batchler, Shaun Corrie, Silvana Velten, Simon Toze, Stefan Truong, Stefano Gianella, Steve Carter, StevenKenway, SNF, Thomas Hug, Thomas Néfau, Tony Wong, Torsten Wind, Ueli Sieber, UWSRA, Urs von Gunten, UrsiSchönenberger, Veronique Vandeberghe, Vivienne Clayton, Walter Giger, Wayne Batchler, Wayne Hall, Wendy Mahon, WernerPletscher, Willi Gujer, Wolfgang Gernjak, Wolfgang Rauch, Xavier Flores, Yolanda Pico

Acknowledgments

[email protected]

Skype: christoph.ort

Phone: +41 (0)58 765 52 77

Thank you

http://sewprof-itn.eu/A new paradigm in drug use and human health risk assessment: Sewage profiling at the community level

Sewage biomarker analysis forcommunity health assessment

sewage analyses as an early detection system for diseases and indicator of various public health...

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