Wastewater-based epidemiology in low Human Development Index states: bias in consumption monitoring of illicit drugs.
Environmental science and pollution research international – October 01, 2018
Source: PubMed
Summary
Monitoring community drug use via wastewater is a powerful tool, but its accuracy can be surprisingly skewed in global south countries. This is because factors like drug processing (pharmacokinetics) vary, and infrastructure issues like sewer porosity can impact data. A review emphasizes adapting methods for locally prevalent substances, such as crack, ayahuasca, or ibogaine, and understanding unique human excretion patterns. Successfully accounting for these local nuances ensures reliable public health insights.
Abstract
Wastewater-based epidemiology is a promising approach worldwide, and its application is currently being developed in non-advanced economies. This technology, based on known toxicokinetic data initially used to detect illicit drugs in well-managed and maintained local sewer networks, has been extended to assess other products such as pesticides, alcohol, flame retardants, nicotine, and other substances. This technology is also used in countries with non-advanced economies. The present review aims to support future wastewater-based epidemiology in such countries by providing toxicokinetic data for locally used narcotic drugs that are expected or known to be emerging in developed countries, outlining the excretion differences due to human polymorphism, and summarising the practical obstacles due to the coverage, maintenance efficiency, or type of local sewage network.Case study feedback from Martinique is presented as an example; the Martinique field study complies with the Organisation for Economic Co-operation and Development standards for health issues, but not with regard to population and urban dynamics.