Experts who study wastewater believe periodic inspections at sewage treatment facilities might serve as an effective early warning system for the next influenza or norovirus pandemic, alerting hospitals to make preparations and giving public health agencies crucial health data.
Scientists from the University of Bath, Bangor University, and the UK Health Security Agency analyzed wastewater from 10 cities for both chemical and biological markers of health, including pesticides, pharmaceuticals, and disease-causing viruses, as part of the first extensive wastewater-based epidemiology (WBE) study in the UK.
Over the course of nine days in November 2021, they took samples at hourly intervals from each location for a total of 24 hours. The samples from each day were combined before processing and mass spectrometry methods were used to look for trace chemical indicators.
The samples were also examined to look for any virus genetic material (SARS-CoV-2, norovirus and adenovirus). The population of the entire sampling catchment area was equivalent to almost 7 million persons.
Trace chemicals detection
The researchers were able to determine whether medications had been directly disposed of into the wastewater system or had traveled through the human body using highly sensitive chemical analysis that could distinguish between very similar signals.
Also, they could determine whether pesticides, for example, had been consumed through food or had gotten into the sewerage system from agricultural land.
Although there were occasional outliers, the team found that variations in chemical marker levels were primarily influenced by the catchment area’s population density.
For instance, ibuprofen was found in considerably higher concentrations in one city’s water than in other areas, indicating that industrial waste was being directly disposed of there.
Disease outbreaks identification
The researchers found localized flu, norovirus, and Covid-19 outbreaks and were able to link these to increases in the use of over-the-counter medications like paracetamol.
The findings suggest that wastewater-based epidemiology, or the wide-scale analysis of wastewater, may detect new illness outbreaks in communities early on, before a huge number of people were taken into hospitals.
The project’s chemistry team was led by Professor Barbara Kasprzyk-Hordern of the Water Innovation Research Centre and Institute for Sustainability at the University of Bath. “Most individuals try to treat their diseases at home when they first get unwell, reaching for the paracetamol when necessary,” she said.
Hence, seeing large increases in paracetamol consumption may serve as a warning sign of a potential infectious illness outbreak in a certain area.
As a result, we search for any evidence of correlations between ill health and exposure to dangerous chemicals, such as pesticides found in food or chemicals produced in factories, by looking for signs of inflammation.
“Our work has demonstrated that, compared to any clinical screening technique, only 10 daily samples from 10 wastewater treatment plants are required to offer anonymous and unbiased information on the health of 7 million individuals.
This has the potential to be a very effective instrument for providing a comprehensive understanding of public health in many places.
“Norovirus and seasonal flu have always been a significant problem in hospitals each winter; now Covid-19 has contributed to this problem,” said Professor Davey Jones, who led a team at Bangor University that examined the wastewater for viruses.
Wastewater Based Epidemiology has the potential to offer an early warning surveillance system for these and other diseases, enabling hospitals to get ready for local epidemics, as demonstrated by our proof-of-concept study.
“This has been a remarkable partnership of chemists, biologists, and Government agencies, working with several water providers to collect crucial data on both chemical and biological markers from diverse parts of the UK,” said Matthew Wade of the UK Health Security Agency.
We are thrilled to be involved in this effort and look forward to expanding the potential of this public health tool in the future.
Source: University of Bath
