Sewage Analyses as an Early Detection System for Diseases and Indicator of Various Public Health Aspects with a Focus on Illicit Drugs

If you were asked whether you had consumed illicit drugs recently, would you admit it? Maybe. If yes, could you precisely recall the types of drug, times and amounts consumed? Possibly. If you were the person commissioned with the task to objectively quantify drug use in your country, what approach would you use, given the social stigma attached with such behaviour? A complementary approach to traditional methods – including interview surveys, crime records, hospitalization data – is the analysis of sewage. Quantitative measurements of drug target residues in urban sewage deliver near-real-time data on the drug use of thousands of people that contributed to the sewage samples. For selected European cities, covering over 14 million people, weekly profiles and trends over the years 2011 to 2013 will be presented along with unique data from the United States, Australia, Germany and Switzerland. Sewage is not only an increasingly important resource – i.e. water reuse in regions suffering from water scarcity – it also contains a wealth of information. Therefore, sewage analysis will be further developed and applied to other excreted biomarkers of endogenous human metabolism. As such, it will serve as an early detection system (e.g. pandemics)and indicator of various public health aspects that goes far beyond illicit drugs only. At relatively low cost, it covers entire communities and it is thought to be faster than online data gathering techniques, such as quantifying individual Google searches from people checking online for symptoms of any kind of disease.