Reporting population size in wastewater-based epidemiology: A scoping review.

Knowledge of the number of people present in a catchment is fundamental for the assessment of spatio-temporal trends in wastewater-based epidemiology (WBE). Accurately estimating the number of people connected to wastewater catchments is challenging however, because populations are dynamic. Methods used to estimate population size can significantly influence the calculation and interpretation of population-normalised wastewater data (PNWD). This paper systematically reviews the reporting of population data in 339 WBE studies. Studies were evaluated based on their reporting of population size, the source of population data, the population calculation methods, and the uncertainties in population estimates. Most papers reported population size (96 %) and the source of population data (60 %). Fewer studies reported the uncertainties in their population data (50 %) and the methods used to calculate these estimates (28 %). This is relevant because different methods have unique strengths and limitations which can affect the accuracy of PNWD. Only 64 studies (19 %) reported all four components of population data. The reporting of population data has remained consistent in the past decade. Based on the findings, we recommend generalised reporting criteria for population data in WBE. As WBE is further mainstreamed and applied, the clear and comprehensive reporting of population data will only become increasingly important.

Testing methods to estimate population size for wastewater treatment plants using census data: Implications for wastewater-based epidemiology.

In wastewater-based epidemiology (WBE), wastewater loads are commonly reported as a per capita value. Census population counts are often used to obtain a population size to normalise wastewater loads. However, the methods used to calculate the population size of wastewater treatment plants (WWTPs) from census data are rarely reported in the WBE literature. This is problematic because the geographical extents of wastewater catchments and census area units rarely align perfectly with each other and exist at different spatial scales. This complicates efforts to estimate the number of people serviced by WWTPs in these census area units. This study compared four geospatial methods to combine wastewater catchment areas and census area units to calculate the census population size of wastewater treatment plants. These methods were applied nationally to WWTPs across New Zealand. Population estimates varied by up to 73 % between the methods, which could skew comparisons of per capita wastewater loads between sites. Variability in population estimates (relative standard deviation, RSD) was significantly higher in smaller catchments (rs = -0.727, P < .001), highlighting the importance of method selection in smaller sites. Census population estimates were broadly similar to those provided by wastewater operators, but significant variation was observed for some sites (ranging from 42 % lower to 78 % higher, RSD = 262 %). We present a widely applicable method to calculate population size from census, which involves disaggregating census area units by individual properties. The results reinforce the need for transparent reporting to maintain confidence in the comparison of WBE across sites and studies.

Exploring indoor and outdoor dust as a potential tool for detection and monitoring of COVID-19 transmission.

This study investigated the potential of using SARS-CoV-2 viral concentrations in dust as an additional surveillance tool for early detection and monitoring of COVID-19 transmission. Dust samples were collected from 8 public locations in 16 districts of Bangkok, Thailand, from June to August 2021. SARS-CoV-2 RNA concentrations in dust were quantified, and their correlation with community case incidence was assessed. Our findings revealed a positive correlation between viral concentrations detected in dust and the relative risk of COVID-19. The highest risk was observed with no delay (0-day lag), and this risk gradually decreased as the lag time increased. We observed an overall decline in viral concentrations in public places during lockdown, closely associated with reduced human mobility. The effective reproduction number for COVID-19 transmission remained above one throughout the study period, suggesting that transmission may persist in locations beyond public areas even after the lockdown measures were in place.

Tracing the transmission of mpox through wastewater surveillance in Southeast Asia.

High population density and tourism in Southeast Asia increase the risk of mpox due to frequent interpersonal contacts. Our wastewater surveillance in six Southeast Asian countries revealed positive signals for Monkeypox virus (MPXV) DNA, indicating local transmission. This alerts clinicians and helps allocate resources like testing, vaccines and therapeutics in resource-limited countries.

COVID-19 monitoring with sparse sampling of sewered and non-sewered wastewater in urban and rural communities.

Equitable SARS-CoV-2 surveillance in low-resource communities lacking centralized sewers is critical as wastewater-based epidemiology (WBE) progresses. However, large-scale studies on SARS-CoV-2 detection in wastewater from low-and middle-income countries is limited because of economic and technical reasons. In this study, wastewater samples were collected twice a month from 186 urban and rural subdistricts in nine provinces of Thailand mostly having decentralized and non-sewered sanitation infrastructure and analyzed for SARS-CoV-2 RNA variants using allele-specific RT-qPCR. Wastewater SARS-CoV-2 RNA concentration was used to estimate the real-time incidence and time-varying effective reproduction number (Re). Results showed an increase in SARS-CoV-2 RNA concentrations in wastewater from urban and rural areas 14-20 days earlier than infected individuals were officially reported. It also showed that community/food markets were "hot spots" for infected people. This approach offers an opportunity for early detection of transmission surges, allowing preparedness and potentially mitigating significant outbreaks at both spatial and temporal scales.

Sensitivity of wastewater-based epidemiology for detection of SARS-CoV-2 RNA in a low prevalence setting.

To assist public health responses to COVID-19, wastewater-based epidemiology (WBE) is being utilised internationally to monitor SARS-CoV-2 infections at the community level. However, questions remain regarding the sensitivity of WBE and its use in low prevalence settings. In this study, we estimated the total number of COVID-19 cases required for detection of SARS-CoV-2 RNA in wastewater. To do this, we leveraged a unique situation where, over a 4-month period, all symptomatic and asymptomatic cases, in a population of approximately 120,000, were precisely known and mainly located in a single managed isolation and quarantine facility (MIQF) building. From 9 July to 6 November 2020, 24-hr composite wastewater samples (n = 113) were collected daily from the sewer outside the MIQF, and from the municipal wastewater treatment plant (WWTP) located 5 km downstream. New daily COVID-19 cases at the MIQF ranged from 0 to 17, and for most of the study period there were no cases outside the MIQF identified. SARS-CoV-2 RNA was detected in 54.0% (61/113) at the WWTP, compared to 95.6% (108/113) at the MIQF. We used logistic regression to estimate the shedding of SARS-CoV-2 RNA into wastewater based on four infectious shedding models. With a total of 5 and 10 COVID-19 infectious cases per 100,000 population (0.005% and 0.01% prevalence) the predicated probability of SARS-CoV-2 RNA detection at the WWTP was estimated to be 28 and 41%, respectively. When a proportional shedding model was used, this increased to 58% and 87% for 5 and 10 cases, respectively. In other words, when 10 individuals were actively shedding SARS-CoV-2 RNA in a catchment of 100,000 individuals, there was a high likelihood of detecting viral RNA in wastewater. SARS-CoV-2 RNA detections at the WWTP were associated with increasing COVID-19 cases. Our results show that WBE provides a reliable and sensitive platform for detecting infections at the community scale, even when case prevalence is low, and can be of use as an early warning system for community outbreaks.

Spatial, temporal and socioeconomic patterns of illicit drug use in New Zealand assessed using wastewater-based epidemiology timed to coincide with the census.

AIMS: A discrete experiment in wastewater-based epidemiology (WBE) timed to coincide with the census was used to investigate the spatial, temporal and socioeconomic patterns of illicit drug consumption in Auckland, Bay of Plenty and Canterbury. METHODS: For seven consecutive days over census week (6 March 2018), wastewater was sampled from seven wastewater treatment plants and analysed for methamphetamine, cocaine (as benzoylecgonine) and 3,4-methylenedioxymethamphetamine (MDMA). Detailed sewer catchment maps were developed and, together with the data, were used to analyse drug consumption. RESULTS: Methamphetamine (mean 22.9 ± 9.9 doses/day/1000 people) was the most consumed drug, followed by MDMA (mean 1.7 ± 1.5 doses/day/1000 people) and cocaine (mean 0.5 ± 0.3 doses/day/1000 people). Methamphetamine consumption (and to a lesser extent MDMA) was high compared to that reported for Western nations, while cocaine consumption was extremely low. Cocaine and MDMA consumption were higher in cities compared to towns. In contrast, methamphetamine was typically higher in towns. Cocaine and MDMA were consumed more at weekends. Methamphetamine use was more consistent throughout the week. MDMA and cocaine were correlated with socioeconomic advantage, whereas methamphetamine was correlated with disadvantage. CONCLUSIONS: This paper contextualises illicit drug use in three New Zealand regions containing 18.3% of the national population and confirms the pervasiveness of methamphetamine consumption in New Zealand towns. This work demonstrates how WBE can be used to explore the socioeconomic dimensions of drug use when duly combined with other data sources like censuses.

Quantifying nicotine and alcohol consumption in New Zealand using wastewater-based epidemiology timed to coincide with census.

INTRODUCTION: Accurate and timely information about nicotine and alcohol consumption is needed to inform effective policy. Wastewater-based epidemiology provides an opportunity to quantify consumption, which can complement traditional data collection methods. METHODS: Wastewater samples were collected from seven wastewater treatment plants on seven consecutive days in three regions of New Zealand during the same week as the national census (6 March 2018). Samples were analysed for nicotine and alcohol metabolites using liquid chromatography-tandem mass spectrometry. Detailed catchment maps were developed and per capita consumption calculated. RESULTS: Observed nicotine consumption (mean 1528 ± 412 cigarettes/day/1000 people) was similar to national sales data. Observed alcohol consumption (mean 1155 ± 764 standard drinks/day/1000 people) was lower than estimated using alcohol availability data. Consumption of nicotine and alcohol was generally higher in the Bay of Plenty and Canterbury compared to Auckland, mirroring trends in the New Zealand Health Survey. Intra-regional differences were observed and the patterns could not be attributed to urbanisation alone. Nicotine consumption was consistent throughout the week whereas alcohol consumption often peaked at the weekend. Nicotine consumption was correlated with neighbourhood-deprivation. There was little correlation for alcohol. DISCUSSION AND CONCLUSIONS: Wastewater-based epidemiology provides a quantitative dataset that complements traditional methods of investigating nicotine and alcohol consumption. Timing data collection to coincide with the census helps to account for the influence of population mobility when normalising consumption.

Politics, water management and infrastructure.

While modern water management has been central to the achievement of a range of beneficial social outcomes, it has increasingly drawn criticism for its disconnection from democratic decision-making, hindering efforts to develop more resilient systems. This paper examines how an experiment with more resilient water infrastructure politicized centralized water management focusing, in particular, on a stormwater re-use 'third-pipe' system at a large residential development in Auckland, New Zealand. Through analysis of resident and expert views on safety, cost and security, the paper attends (1) to the ways in which techno-managerial water management was contested and, thus, politicized through the implementation of the third pipe, and (2) how the mobilization of techno-managerial discourses by water management authorities delegitimized the third-pipe system, rendering it ultimately inoperable. While our case study was thwarted by the de-politicizing apparatus of water management authorities, such experiments offer precedents, resources and hope for more democratic systems of water management. This article is part of the theme issue 'Urban flood resilience'.

Mandatory urban rainwater harvesting: learning from experience.

Rainwater harvesting is effectively mandated in several urban areas of New Zealand. To understand the costs and benefits of rainwater harvesting from an end-user perspective, semistructured interviews were conducted with 14 homeowners in northern Auckland affected by these regulations. Residents report differences in four aspects of urban rainwater infrastructure - security of supply, water quality, the learning process and financial costs - that could represent key values for public acceptance. When responses are examined from the perspective of experience that has built empirical knowledge, participants explained how their satisfaction with rainwater harvesting increased over time. We hypothesise that for those lacking experience, urban rainwater consumption is a function of empirical knowledge and has initially rising marginal utility. Regulation that recognises the costs of social learning is likely to be a more effective pathway towards maximising the social benefits associated with integrated urban water management.

A modelling approach to determine the origin of urban ground water.

A simple modelling approach was developed to link patterns of urban land-use with ground water flow and chemistry in three dimensions and was applied to characterize the origin of recharge in the aquifer beneath the old industrial city of Nottingham, UK. The approach involved dividing land uses into types, and times into periods, and assigning the recharge from each an individual tracer-solute with a unit concentration. The computer code MT3DMS was used to track the multiple tracer-solutes in transient, three-dimensional simulations of the important urban aquifer. A depth-specific hydrochemical dataset collected in parallel supported the model predictions. At depth under the industrial area studied, a large component of ground water originated of older agricultural origin, with relatively low nitrate concentrations. Shallower ground water originated mainly from residential and industrial areas, with higher nitrate concentrations probably arising from leaking sewers and contaminated land. The results highlighted the spectrum of ground water from different origins that amalgamate even at short well screens in a non-pumped borehole and remind us that the non-point-source pollution of ground water from anthropogenic activities will involve more years of slow degradation of quality.

Microbial contamination of two urban sandstone aquifers in the UK.

Development of urban groundwater has historically been constrained by concerns about its quality. Rising urban water tables and overabstraction from rural aquifers in the UK have led to a renewed interest in urban groundwater, particularly the possibility of finding water of acceptable quality at depth. This study assessed the microbial quality of groundwater collected from depth-specific intervals over a 15-month period within the Permo-Triassic Sherwood Sandstone aquifers underlying the cities of Nottingham and Birmingham. Sewage-derived bacteria (thermotolerant coliforms, faecal streptococci and sulphite-reducing clostridia) and viruses (enteroviruses, Norwalk-like viruses, coliphage) were regularly detected to depths of 60 m in the unconfined sandstone and to a depth of 91 m in the confined sandstone. Microbial concentrations varied temporally and spatially but increased frequency of contamination with depth coincided with geological heterogeneities such as fissures and mudstone bands. Significantly, detection of Norwalk-like viruses and Coxsackievirus B4 in groundwater corresponded with seasonal variations in virus discharge to the sewer system. The observation of low levels of sewage-derived microbial contaminants at depth in the Triassic Sandstone aquifer is explained by the movement of infinitesimal proportions of bulk (macroscopic) groundwater flow along preferential pathways (e.g., fissures, bedding planes). The existence of very high microbial populations at source (raw sewage) and their extremely low detection limits at the receptor (multilevel piezometer) enable these statistically extreme (microscopic) flows to be traced. Rapid penetration of microbial contaminants into sandstone aquifers, not previously reported, highlights the vulnerability of sandstone aquifers to microbial contamination.