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Research needs for optimising wastewater-based epidemiology monitoring for public health protection

Lookup NU author(s): Dr Katie Robins, Professor David GrahamORCiD, Dr Josh Bunce, Dr Matthew WadeORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Wastewater-based epidemiology (WBE) is an unobtrusive method used to observe patterns in illicit drug use, poliovirus, and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The pandemic and need for surveillance measures have led to the rapid acceleration of WBE research and development globally. With the infrastructure available to monitor SARS-CoV-2 from wastewater in 58 countries globally, there is potential to expand targets and applications for public health protection, such as other viral pathogens, antimicrobial resistance (AMR), pharmaceutical consumption, or exposure to chemical pollutants. Some applications have been explored in academic research but are not used to inform public health decision-making. We reflect on the current knowledge of WBE for these applications and identify barriers and opportunities for expanding beyond SARS-CoV-2. This paper critically reviews the applications of WBE for public health and identifies the important research gaps for WBE to be a useful tool in public health. It considers possible uses for pathogenic viruses, AMR, and chemicals. It summarises the current evidence on the following: (1) the presence of markers in stool and urine; (2) environmental factors influencing persistence of markers in wastewater; (3) methods for sample collection and storage; (4) prospective methods for detection and quantification; (5) reducing uncertainties; and (6) further considerations for public health use.


Publication metadata

Author(s): Robins K, Leonard AFC, Farkas K, Graham DW, Jones DL, Kasprzyk-Hordern B, Bunce JT, Grimsley JMS, Wade MJ, Zealand AM, McIntyre-Nolan S

Publication type: Article

Publication status: Published

Journal: Journal of Water & Health

Year: 2022

Volume: 20

Issue: 9

Pages: 1284–1313

Print publication date: 01/09/2022

Online publication date: 12/08/2022

Acceptance date: 28/07/2022

Date deposited: 13/11/2022

ISSN (print): 1477-8920

ISSN (electronic): 1996-7829

Publisher: IWA Publishing

URL: https://doi.org/10.2166/wh.2022.026

DOI: 10.2166/wh.2022.026


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Funding

Funder referenceFunder name
Building an Early Warning System for community-wide infectious disease spread: SARS-CoV-2 tracking in Africa via environment fingerprinting’ (EP/V028499/1)
EP/V028499/1
GCRF/Newton Fund (B.K.-H.).
National COVID-19 Wastewater Epidemiology Surveillance programme (NE/V010441/1)
NE/V010441/1
UKRI-NERC COVID Response (D.W.G., D.L.J., B.K.-H.

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