Comparison of pharmaceutical, illicit drug, alcohol, nicotine and caffeine levels in wastewater with sale, seizure and consumption data for 8 European cities

Abstract

BackgroundMonitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys.MethodThis study aims to compare and correlate the consumption estimates of pharmaceuticals, illicit drugs, alcohol, nicotine and caffeine from wastewater analysis and other sources of information. Wastewater samples were collected in 2015 from 8 different European cities over a one week period, representing a population of approximately 5 million people. Published pharmaceutical sale, illicit drug seizure and alcohol, tobacco and caffeine use data were used for the comparison.ResultsHigh agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data. Most of the poor correlations were explained as part of the uncertainties related with the use estimates and were improved with other complementary sources of data.ConclusionsThis work confirms the promising future of WBE as a complementary approach to obtain a more accurate picture of substance use situation within different communities. Our findings suggest further improvements to reduce the uncertainties associated with both sources of information in order to make the data more comparable.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3686-5) contains supplementary material, which is available to authorized users.

Potential impact of the sewer system on the applicability of alcohol and tobacco biomarkers in wastewater‐based epidemiology

“…The potential rapid degradation of EtS and EtG, especially EtG (Figures a and b), in the sewer system may limit their applicability as biomarkers for the estimation of alcohol consumption in the population, although both of them are still currently used in urinalysis to detect alcohol consumption in individuals . With a complete loss after only 2 hours in both RM and GS reactors, EtG is not recommended to be used to estimate alcohol consumption in WBE studies, which supports the practice in all WBE studies related to alcohol after the initial assessment of Reid et al (Table ). In general, as found in this and other studies, glucuronide compounds are very quickly transformed in wastewater, and hence are not suitable to be used as biomarkers in WBE.…”

“…Cot satisfies this set of 4 criteria to be used for population estimation purpose while HCot does not meet the average 10% loss threshold. The caveat for Cot here is that it should not be used as a single population marker as there are differences in tobacco consumption among regions or countries . Moreover, a recent study by Tscharke et al also suggested to monitor two alkaloids – anabasine and anatabine – which are specific to dried tobacco in addition to nicotine and cotinine to obtain a better picture of the tobacco consumption situation.…”

Increased levels of the oxidative stress biomarker 8-iso-prostaglandin F2α in wastewater associated with tobacco use

“…In WBE studies, tobacco use can be estimated by the analysis of two urinary metabolites of nicotine; cotinine and trans-3′-hydroxycotinine3233343536. While enzymatic deconjugation is necessary to quantify total cotinine in wastewater, there has been no significant difference observed between measurements made with and without the enzyme treatment for trans-3′-hydroxycotinine32.…”

A comparison of trends in wastewater‐based data and traditional epidemiological indicators of stimulant consumption in three locations

“…Other studies that have used a multi-indicator approach [12][13][14][15][16][17][18][19][20] have also found a general agreement between trends in drug target residues in wastewater and trends in other indicators of drug consumption. Our study was conducted over a much longer time-frame and accounts for multiple sources of uncertainty, such as the concentration measurements, the daily flow estimates and the estimated population sizes, through our Bayesian hierarchical regression model.…”

“…No single measure can provide a full picture of regional drug use and current trends [10,11]. A multi-indicator approach is required, incorporating commensurate data such as population surveys and police data [12][13][14][15][16][17][18][19][20]. Several of the previous comparisons of wastewater data with other indicators of drug consumption have been limited by the single week of sampling issue.…”