Even the early medical experts of the renaissance period already knew that the fecal and urinal excrement of an individual human were useful for the evaluation of the individual's health status. Today's patients are also often asked to bring a stool or/and urine sample for detailed medical examination. Recently experts have applied actively comprehensive chemical analysis of sewage for the demographic epidemiological examination of populations. Sewage today is considered a versatile tool for population studies and as a direct information link between heath, societal factors and cultural behavior of human populations if appropriate scientific methods are applied for such a multidisciplinary investigation.
During the past years, modern quantitative trace analytical methods have been refined and optimized to a technological level allowing for multi-component quantification of trace levels of pharmaceuticals and other indicator compounds for individual and population health. Many thousands of modern households are usually connected to a sewage system collecting brown- (washing and cleaning) and black water (excrements, etc.) for subsequent cleaning in an appropriate waste water treatment facility. Sewage can, thus, be considered as integrated information source containing health, societal and behavioral information from a specific part of a human population (households connected to the respective treatment system). Appropriately translated by chemical analytical methods in combination with modelling and medical interpretation, this information can be used for appropriate regulation, health associated community-based decisions and political prioritizations.
Upon completion of the lecture, students will be able to explain:
- The multidisciplinary interpretation of the content of micropollutants and other indicator classes in sewage (biogenic substances, pathogens, microbiota, etc.) used for epidemiology studies of human populations.
- How pharmaceutical residues in centralized sewage are considered indicators for collectives’ stress in a population.
- How these information sources can help evaluate the illegal usage and application patter of illicit drugs in various population groups and how appropriate counter measures can be developed.
- Performing a population based exposure assessment for specific chemicals (i.e. response to dedicated regulatory measures).
- Validation and assessment of microbiome of a specific population group is possible with already available methods.
- The currently available and applied analytical technology allowing a comprehensive assessment of population indicators and that is will be actively used for community and population-based health assessments
Sewage Epidemiology — A real-time Approach to estimate the Consumption of illicit Drugs in Brussels, Belgium
The sewage epidemiology approach was applied to a one-year sampling campaign in the largest wastewater treatment plant (WWTP) in Belgium to estimate the consumption of illicit drugs (e.g. cocaine). This manuscript shows that sewage epidemiology provides consistent and logical results and that it is a promising tool that can be used in addition to classical studies to estimate illicit drug use in populations.VAN NUIJS, A. L.N. et al. (2011): Sewage Epidemiology — A real-time Approach to estimate the Consumption of illicit Drugs in Brussels, Belgium. In: Environment International: Volume 37 , 612-621. URL [Accessed: 02.08.2018]
This online article summarizes the study of NEWTON, R. J. et al., 2015: Sewage Reflects the Microbiomes of Human Populations, In: mBio, Vol. 6 (2).PENNISIS, E. (2015): Pollution, Human Health tracked with Sewage Microbes. Science Online URL [Accessed: 02.08.2018]
This review summarizes the current contamination status of different environment media, including sewage, surface water, sludge, sediments, soil, and wild animals, in China by PPCPs. The human body burden and adverse effects derived from PPCPs are also evaluated.LIU, JL. and WONG, M.H. (2013): Pharmaceuticals and Personal Care Products (PPCP): A Review on environmental Contamination in China. In: Environment International: Volume 59 , 208-224. URL [Accessed: 02.08.2018]