Science of the Total Environment 487 (2014) 611–612
Contents lists available at ScienceDirect
Science of the Total Environment journal homepage: www.elsevier.com/locate/scitotenv
Preface
Special Issue. Testing the waters: A selection of papers from the first international multidisciplinary conference on detecting illicit drugs in wastewater
The chemical analysis of illicit drug excretion products in wastewater is rapidly establishing itself as a valuable new method for complementing existing approaches in monitoring patterns and trends of illicit drug use. These methods referred to as ‘wastewater analysis’ or ‘wastewater-based epidemiology’ were proposed as a New Non-Intrusive Tool to evaluate the use of illicit and misused drugs in a community by Christian Daughton in 2001. In 2005 it was implemented for the first time by Zuccato and coworkers in Italy, when cocaine use was estimated in several cities through measuring the urinary metabolite, benzoylecgonine, in wastewater. Later, the approach was rapidly extended to also include the main illicit drugs such as heroin, cannabis, and amphetamine-like stimulants. Since then this approach has been applied internationally in many countries to assess the use of illicit drugs in both local and national populations. It is remarkable to note that it is less than a decade since the feasibility of this method was first demonstrated, and yet during this time we have seen the emergence of a new scientific discipline. The potential of which is truly exciting as it provides a new and much needed tool for addressing a range of pressing information needs in this area which include: rapidly reporting on population level trends in illicit drug use, providing objective estimates of consumption, identifying the use of novel substances, and providing a ‘hard’ pre- and post-intervention measure for outcome studies. This development is celebrated in this issue of Science of the Total Environment where for the first time a learned journal has dedicated an entire issue to this area of rapidly developing science. In 2007 although wastewater analysis was still in its infancy, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) began to become actively interested in exploring the potential of wastewater analysis to complement and extend the existing epidemiologically based approaches to illicit drug monitoring. In 2007, the EMCDDA organised the first expert meeting on this subject, ‘assessing drugs in wastewater’ which was followed by an EMCDDA publication detailing the exciting prospects of a new method for drug monitoring [http:// www.emcdda.europa.eu/attachements.cfm/att_139185_EN_emcddainsights-wastewater.pdf]. It was recognised quite quickly that coordination and standardisation work was essential if this area was going to be developed as a credible complementary approach. This was provided in 2010, when a Europewide network (Sewage analysis CORE group — SCORE) was initiated with the aim of standardizing the approaches used for wastewater analysis and coordinating international studies through the establishment of a common protocol of action. The first coordinated monitoring study was performed in 2011 and included 19 European cities. This provided the first ever comparative information on the regional and temporal
http://dx.doi.org/10.1016/j.scitotenv.2014.03.130 0048-9697/© 2014 Elsevier B.V. All rights reserved.
differences in illicit drug use in Europe based upon wastewater analysis. The SCORE collaboration efforts have continued and the group now also performs regular inter-calibration exercises for quality control purposes, and critically assesses the global uncertainty related to the wastewaterbased estimates. A best practice protocol which has now been widely adopted by European studies, was also developed to reduce the uncertainty of the procedure and to improve the reliability of estimates. Overall, the methodological progress made has been impressive and this is recognised in the fact that the work of the SCORE collaboration will continue through the COST Action ES1307 “Sewage biomarker analysis for community health assessment” [http://www.cost.eu/domains_actions/ essem/Actions/ES1307]. These activities paved the way in 2012 for an EMCDDA supported demonstration programme that was conducted in 25 European cities. The results of this pioneering work were subsequently discussed by an international consortium of researchers during a Workshop: “The determination of illicit drug consumption in populations through wastewater biomarker analysis” held in December 2012 in Lisbon [http://www. emcdda.europa.eu/news/2012/wastewater]. Following this meeting the EMCDDA hosted another event, the kick-off meeting for a Marie Curie Initial Training Network entitled: ‘A new paradigm in drug use and human health risk assessment: Sewage profiling at the community level’. SEWPROF is funded from the People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme. The network links 16 leading European institutions from 12 countries combining European expertise in wastewater-based epidemiology and related areas. It is now playing a major role in improving the competencies of researchers entering this field and contributing to the continued advancement of methods in this area. As the potential of wastewater analysis became clearer, and more studies came on stream it became important to bring together the expertise and knowledge in this emerging area with that of researchers working in more established areas of drug monitoring. The challenge was to bring together the divers disciplines that on the one hand included epidemiologists and pharmacologists, and on the other chemists and water system engineers. In 2012, communication between these different groups of experts was virtually non-existent, despite a multidisciplinary approach being a central requirement for developing this new field of research. To address this need, in May 2013, the EMCDDA organised, in collaboration with the SEWPROF network, ‘Testing the Waters’, the first international multidisciplinary conference on detecting illicit drugs in wastewater. Ninety external experts from 20 different countries attended the event which provided a unique and valuable
612
Preface
opportunity for experts from areas that included: analytical chemistry, physiology, biochemistry, sewage engineering, spatial epidemiology, statistics and conventional drug epidemiology to come together. By uniting diverse disciplines, the conference created a forum to discuss future opportunities for bringing together wastewater analysis and drug epidemiology. Attendance by the UNODC and international participants from across the globe also demonstrated that wastewater analysis had arrived on the international stage. This Special Issue includes a number of papers developed from presentations delivered during this ground breaking conference. It emphasises rapid advances in the field and provides a comprehensive overview of the area. Firstly, the current ‘state of the art’ is reviewed together with a discussion on potentials and research needs. The challenges and opportunities for future studies to bring together wastewater analysis and drug epidemiology are also explored further. Several papers report improvements regarding specific technical aspects of the approach such as finding biomarkers to better define population dynamics during sampling campaigns, applying properly chemical analysis and the procedures to estimate drug use by using correct back-calculation factors, studying stability, occurrence and behaviour of target residues in wastewater. Back-calculation of cocaine use was also analysed in a formal statistical framework using the Monte Carlo simulation approach in order to address the related uncertainty. Results from monitoring campaigns to study both local and regional variability of illicit drug use are also discussed with examples from countries as diverse as Finland, Canada, England, and China. The presence of analgesics, psycholeptics, and antidepressants together with illicit drugs is also reported in aquatic environments in the Czech Republic. New approaches utilising wastewater analysis to detect the use of new psychoactive substances are among the most recent advances in wastewater-based epidemiology. This is particularly critical because these substances are a heterogeneous group, made exclusively by synthetic products which are extremely interchangeable, and very little is known about their use and prevalence. Thus, a conceptual approach for dealing with new psychoactive substances using biomarkers in wastewater is also presented here. Novel analytical techniques such as enantiomeric profiling of some specific drugs have been presented as a tool to distinguish between the amounts of substances coming from human consumption and those coming from direct discharge in wastewater. Finally, an epidemiological study is also reported dealing with self-reports of use from a survey in marginalized drug users.
The conference, first of its kind, sets the agenda for further development of wastewater-based epidemiology. This Special Issue bridges gaps in current knowledge, emphasises challenges and provides new directions in further development of this innovative epidemiology tool. Further advances are anticipated in widening the application of this cutting edge interdisciplinary approach within more holistic epidemiological studies of societal health. In summary, this Special Issue provides a comprehensive window on the emerging scientific discipline of wastewater analysis. As co-editors we are confident that this review provides the reader of an up to date understanding of the exciting developments in this area and their potential to transform current approaches to drug monitoring. Given the speed of progress in this area we are also confident that it will not be long before a revision work is also required. Sara Castiglioni IRCCS — Istituto di Ricerche Farmacologiche “Mario Negri”, Environmental Biomarkers Unit, Department of Environmental Health Sciences, Via La Masa 19, 20156 Milan, Italy Paul Griffiths European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Praça Europa 1, Cais do Sodré, 1249-289 Lisbon, Portugal Barbara Kasprzyk-Hordern Department of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, UK Angela Me Statistics and Survey Section Trends Monitoring and Analysis Programme, United Nations Office on Drugs and Crime PO Box 500 1400 Vienna Austria Kevin V. Thomas Norwegian Institute for Water Research (NIVA), Gaustadalleéen 21, 0349 Oslo, Norway Corresponding author at: NIVA, Gaustadalléen 21, 0349 Oslo, Norway. Tel.: +47 92265694. E-mail address: [email protected].
Contents lists available at ScienceDirect
Science of the Total Environment journal homepage: www.elsevier.com/locate/scitotenv
Preface
Special Issue. Testing the waters: A selection of papers from the first international multidisciplinary conference on detecting illicit drugs in wastewater
The chemical analysis of illicit drug excretion products in wastewater is rapidly establishing itself as a valuable new method for complementing existing approaches in monitoring patterns and trends of illicit drug use. These methods referred to as ‘wastewater analysis’ or ‘wastewater-based epidemiology’ were proposed as a New Non-Intrusive Tool to evaluate the use of illicit and misused drugs in a community by Christian Daughton in 2001. In 2005 it was implemented for the first time by Zuccato and coworkers in Italy, when cocaine use was estimated in several cities through measuring the urinary metabolite, benzoylecgonine, in wastewater. Later, the approach was rapidly extended to also include the main illicit drugs such as heroin, cannabis, and amphetamine-like stimulants. Since then this approach has been applied internationally in many countries to assess the use of illicit drugs in both local and national populations. It is remarkable to note that it is less than a decade since the feasibility of this method was first demonstrated, and yet during this time we have seen the emergence of a new scientific discipline. The potential of which is truly exciting as it provides a new and much needed tool for addressing a range of pressing information needs in this area which include: rapidly reporting on population level trends in illicit drug use, providing objective estimates of consumption, identifying the use of novel substances, and providing a ‘hard’ pre- and post-intervention measure for outcome studies. This development is celebrated in this issue of Science of the Total Environment where for the first time a learned journal has dedicated an entire issue to this area of rapidly developing science. In 2007 although wastewater analysis was still in its infancy, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) began to become actively interested in exploring the potential of wastewater analysis to complement and extend the existing epidemiologically based approaches to illicit drug monitoring. In 2007, the EMCDDA organised the first expert meeting on this subject, ‘assessing drugs in wastewater’ which was followed by an EMCDDA publication detailing the exciting prospects of a new method for drug monitoring [http:// www.emcdda.europa.eu/attachements.cfm/att_139185_EN_emcddainsights-wastewater.pdf]. It was recognised quite quickly that coordination and standardisation work was essential if this area was going to be developed as a credible complementary approach. This was provided in 2010, when a Europewide network (Sewage analysis CORE group — SCORE) was initiated with the aim of standardizing the approaches used for wastewater analysis and coordinating international studies through the establishment of a common protocol of action. The first coordinated monitoring study was performed in 2011 and included 19 European cities. This provided the first ever comparative information on the regional and temporal
http://dx.doi.org/10.1016/j.scitotenv.2014.03.130 0048-9697/© 2014 Elsevier B.V. All rights reserved.
differences in illicit drug use in Europe based upon wastewater analysis. The SCORE collaboration efforts have continued and the group now also performs regular inter-calibration exercises for quality control purposes, and critically assesses the global uncertainty related to the wastewaterbased estimates. A best practice protocol which has now been widely adopted by European studies, was also developed to reduce the uncertainty of the procedure and to improve the reliability of estimates. Overall, the methodological progress made has been impressive and this is recognised in the fact that the work of the SCORE collaboration will continue through the COST Action ES1307 “Sewage biomarker analysis for community health assessment” [http://www.cost.eu/domains_actions/ essem/Actions/ES1307]. These activities paved the way in 2012 for an EMCDDA supported demonstration programme that was conducted in 25 European cities. The results of this pioneering work were subsequently discussed by an international consortium of researchers during a Workshop: “The determination of illicit drug consumption in populations through wastewater biomarker analysis” held in December 2012 in Lisbon [http://www. emcdda.europa.eu/news/2012/wastewater]. Following this meeting the EMCDDA hosted another event, the kick-off meeting for a Marie Curie Initial Training Network entitled: ‘A new paradigm in drug use and human health risk assessment: Sewage profiling at the community level’. SEWPROF is funded from the People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme. The network links 16 leading European institutions from 12 countries combining European expertise in wastewater-based epidemiology and related areas. It is now playing a major role in improving the competencies of researchers entering this field and contributing to the continued advancement of methods in this area. As the potential of wastewater analysis became clearer, and more studies came on stream it became important to bring together the expertise and knowledge in this emerging area with that of researchers working in more established areas of drug monitoring. The challenge was to bring together the divers disciplines that on the one hand included epidemiologists and pharmacologists, and on the other chemists and water system engineers. In 2012, communication between these different groups of experts was virtually non-existent, despite a multidisciplinary approach being a central requirement for developing this new field of research. To address this need, in May 2013, the EMCDDA organised, in collaboration with the SEWPROF network, ‘Testing the Waters’, the first international multidisciplinary conference on detecting illicit drugs in wastewater. Ninety external experts from 20 different countries attended the event which provided a unique and valuable
612
Preface
opportunity for experts from areas that included: analytical chemistry, physiology, biochemistry, sewage engineering, spatial epidemiology, statistics and conventional drug epidemiology to come together. By uniting diverse disciplines, the conference created a forum to discuss future opportunities for bringing together wastewater analysis and drug epidemiology. Attendance by the UNODC and international participants from across the globe also demonstrated that wastewater analysis had arrived on the international stage. This Special Issue includes a number of papers developed from presentations delivered during this ground breaking conference. It emphasises rapid advances in the field and provides a comprehensive overview of the area. Firstly, the current ‘state of the art’ is reviewed together with a discussion on potentials and research needs. The challenges and opportunities for future studies to bring together wastewater analysis and drug epidemiology are also explored further. Several papers report improvements regarding specific technical aspects of the approach such as finding biomarkers to better define population dynamics during sampling campaigns, applying properly chemical analysis and the procedures to estimate drug use by using correct back-calculation factors, studying stability, occurrence and behaviour of target residues in wastewater. Back-calculation of cocaine use was also analysed in a formal statistical framework using the Monte Carlo simulation approach in order to address the related uncertainty. Results from monitoring campaigns to study both local and regional variability of illicit drug use are also discussed with examples from countries as diverse as Finland, Canada, England, and China. The presence of analgesics, psycholeptics, and antidepressants together with illicit drugs is also reported in aquatic environments in the Czech Republic. New approaches utilising wastewater analysis to detect the use of new psychoactive substances are among the most recent advances in wastewater-based epidemiology. This is particularly critical because these substances are a heterogeneous group, made exclusively by synthetic products which are extremely interchangeable, and very little is known about their use and prevalence. Thus, a conceptual approach for dealing with new psychoactive substances using biomarkers in wastewater is also presented here. Novel analytical techniques such as enantiomeric profiling of some specific drugs have been presented as a tool to distinguish between the amounts of substances coming from human consumption and those coming from direct discharge in wastewater. Finally, an epidemiological study is also reported dealing with self-reports of use from a survey in marginalized drug users.
The conference, first of its kind, sets the agenda for further development of wastewater-based epidemiology. This Special Issue bridges gaps in current knowledge, emphasises challenges and provides new directions in further development of this innovative epidemiology tool. Further advances are anticipated in widening the application of this cutting edge interdisciplinary approach within more holistic epidemiological studies of societal health. In summary, this Special Issue provides a comprehensive window on the emerging scientific discipline of wastewater analysis. As co-editors we are confident that this review provides the reader of an up to date understanding of the exciting developments in this area and their potential to transform current approaches to drug monitoring. Given the speed of progress in this area we are also confident that it will not be long before a revision work is also required. Sara Castiglioni IRCCS — Istituto di Ricerche Farmacologiche “Mario Negri”, Environmental Biomarkers Unit, Department of Environmental Health Sciences, Via La Masa 19, 20156 Milan, Italy Paul Griffiths European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Praça Europa 1, Cais do Sodré, 1249-289 Lisbon, Portugal Barbara Kasprzyk-Hordern Department of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, UK Angela Me Statistics and Survey Section Trends Monitoring and Analysis Programme, United Nations Office on Drugs and Crime PO Box 500 1400 Vienna Austria Kevin V. Thomas Norwegian Institute for Water Research (NIVA), Gaustadalleéen 21, 0349 Oslo, Norway Corresponding author at: NIVA, Gaustadalléen 21, 0349 Oslo, Norway. Tel.: +47 92265694. E-mail address: [email protected].
