Sewage Epidemiology: What can Wastewater Tell Us About Kevin J. Bisceglia, Chemistry Public Health? Assistant Professor of Environmental Chemistry
Motivation
Relative to these approaches, wastewater monitoring is:
Much of our community-level public health data comes from voluntary surveys, crime, and hospital visits Survey Limitations:
Crime & Hospital Visit Limitations:
• Time and resource intensive • Spotty application • Intrusive Image: “Survey” by Robyn Lee. 2005. Creative Commons.
• • • •
• Emphasizes extreme cases • Requires presence of a health or law official • Measurement is often indirect
(Potentially) less biased More cost effective Less obtrusive Capable of greater spatial and temporal resolution Image: Bohannon, J., 2007. Science, v. 316, pp. 42-44.
Image: Palm Beach County Sherriff's Office, www.pbso.org. Accessed: May 2009
Case Study: Illicit Drug Abuse
• We can drug test a city!
Illicit Drugs
Licit Drugs
1,000
1,000
100
10
1
38
Sewer-Derived Estimates for the Utilization of Cocaine and Legal Drugs
35
Estimated Consumption (mg/inhab-d)
(SPE)-LC-MS/MS
40
10,000
Concentration (ng/L)
• Drugs (and metabolites) enter sewers
10,000
Concentration (ng/L)
• 22 million Americans have a drug dependency1
The occurrence and usage of licit and illicit drugs often are similar
100
10
30
25 20
16
15 10
8.6
5 1
3.0 0.17
0
0
1 2011
National Survey on Drug Use and Health: National Findings Image: Greg L. “Manhole Cover.” Wikimedia Commons, 2008. Creative Commons
Data from: Bisceglia, K. J. et al., Anal. Bioanal. Chem. 2010, 398(6): 2701-2712. and Bisceglia, K. J. et al., J. Chromatogr A. 2009, 1217(4): 558-564
Present Challenge: Quantifying Uncertainty Potential Metabolic and Environmental Transformation Pathways for Cocaine
Uncertainty depends heavily on the stability and metabolic variability of chosen biomarker(s): Transformation of Cocaine in Wastewater Concentration (nM)
Monitoring occurrence is straightforward… estimating rates of drug abuse is not! Some Sources of Uncertainty in Sewage Epidemiology
20
70
Benzoylecgonine
Cocaine
16 60
12 8 4 0
6
12
18
24
30
130
6
115
250
Ecgonine
Mass Balance
200
50
0
8
4
100
2
85
Ecgonine Methyl Ester
0
40 0
6
12
18
24
30
0
5 10 15 20 25 30
Time (h)
150
70 0
6
12
18
24
30
100 0
6
12
18
24
30
Condi'ons: Suspended wastewater cultures, aerobic, Temp = 23 °C, pH 7.3
Variability (RSD) in Metabolic Excretion of Cocaine Biomarkers a
Controlled Studies b Urine Samples
BE
COCtot
41.9 40.0
4.0 NA
Benzoylecgonine Total Cocaine
a
EChyd
Hydrolyzed Ecgonine
8.8 12.0
Data from Jeffcoat et al. (1989) Drug Metab Dispos 17:153–159 and Castiglioni et al. (2013) Environ Sci Technol 47:1452–60. b Data from Paul et al. (2005) Biomed Chromatogr 19:677–688.
The consensus biomarker is BE, but Echyd & COCtot are more stable and less variable!
Data from: Bisceglia, K. J. et al., Anal. Bioanal. Chem. 2012, 402(3): 1277-1287. and Bisceglia, K. J., Lippa, K. A., Environ Sci Pol Res., Submitted.
Image: Castiglioni, S. et al., 2013. Environmental Science & Technology, 47 (3), pp 1452–1460.
A Promising Approach Test: Smoking in Baltimore Cigarettes/smoker-d Sewer-derived1:
18 ± 5.2
Survey-based2:
17 ± 1.2
• Real-time information on drug treatment and intervention strategies • Effect of legalizing marijuana?
• Source-tracking of meth labs, drug hotspots, terrorist activity?
1 Mean WW concentration of cotinine: 2050 ± 84 ng/L Urinary fraction of nicotine excreted as cotinine : 10 – 15 % Deliverable does of nicotine per cigarette: 1 – 1.5 mg Prevalence of smoking in Baltimore: 28%
• Monitoring health of entire communities
2 Obtained from phone interviews in 2002.
Source: Center for Disease Control and Prevention. StateTobacco Activities Tracking and Evaluation (STATE) System. Tobacco Use Supplement to the Current Population Survey (2002).
Data from: Bisceglia, K. J. et al., Anal. Bioanal. Chem. 2010, 398(6): 2701-2712.
Future Applications
Image: iStockphoto/Mitar Gavric
• Biomarkers of stress and disease? • Changes in population size?
Collaborators: Katrice A. Lippa
Selected Publications: • Bisceglia, K. J., Roberts A. L., Lippa, K. A. Analytical and Bioanalytical Chemistry 2012, 402(3): 1277-1287. • Bisceglia, K. J., Roberts A. L., Lippa, K. A. Analytical and Bioanalytical Chemistry 2010, 398(6): 2701-2712. • Bisceglia, K. J., Yu, J. T., Coelhan, M., Bouwer, E. J., Roberts, A. L. 2009. Journal of Chromatography A 2009, 1217(4): 558-564. • Bisceglia, K. J., Lippa, K. A. Environmental Science and Pollution Research, submitted, September 7, 2013.
, A. Lynn Roberts