WASTEWATER-BASED EPIDEMIOLOGY METHODS FOR ASSESSING POPULATION HEALTH

20240159775

18/496832

October 27, 2023

Disclosed herein are methods of assessing a population's health using wastewater samples. For example, the methods assess exposure to pathogens, plasticizers, volatile organic compounds, surfactant, hazardous chemical, nicotine, and/or other environmental toxins. In some aspects, the methods determine the concentration of disease biomarkers, chemical biomarker, certain human hormones, certain genes, pharmaceuticals, illicit drugs, personal care product, pathogens, and/or endogenous mental health markers. In some aspects, the methods assess population health at a neighborhood level. The methods may also be used to assess population health at a larger regional level, for example at a state level or a national level.

Arizona Board of Regents on Behalf of Arizona State University (Scottsdale, AZ, US)

1. A method of assessing a population's health comprising: providing a wastewater sample from the population; and determining the concentration of at least one analyte in the wastewater sample, wherein the at least one analyte is selected from the group consisting of: a hunger hormone, a stress hormone, a cardiovascular disease biomarker, a pulmonary disease biomarker, a cancer biomarker, an illicit drug, a personal care product, a surfactant, a hazardous chemical, a disease resistant pathogen, an antimicrobial resistance gene, a psychotropic drug, an alcohol-related chemical biomarker, a metabolite of volatile organic compounds (VOCs), an environmental toxin, a nicotine-related metabolite, a plastic component, and an endogenous mental health marker.

2. The method of claim 1, wherein the wastewater sample is composited to a neighborhood level and the population is a neighborhood.

3. The method of claim 2, wherein the wastewater sample from the sewage source is composited to a building level and the population is a building's occupants.

4. The method of claim 2, wherein the wastewater sample from the sewage source is composited to a household level and the population is a household.

5. The method of claim 1, further comprising normalizing the concentration of the at least one analyte in the wastewater sample with at least one normalization agent.

6. The method of claim 1, further comprising: freezing the composited wastewater sample; and thawing the composited wastewater sample to provide the wastewater sample.

7. The method of claim 5, wherein the concentration of at least one analyte is determined in the thawed fluid sample within two weeks of collecting the fluid sample.

8. The method of claim 1, wherein the plastic component is selected from the group consisting of: bisphenol A (BPA), BPA monosulfate, Bisphenol S, monobenzyl phthalate (MBzP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-2-ethylhexyl phthalate (MEHP), monoethyl phthalate (MEP), monobutyl phthalate (MMP), mono-n-octyl phthalate (MnOP), terephthalic acid (TPA), monobutyl phthalate (MBP), monoisobutyl phthalate (MiBP), and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP).

9. The method of claim 1, wherein: the cardiovascular disease biomarker is cystatin C; and the cancer biomarker is microtubule assisted serine/threonine kinase 4 (MAST4); the method further comprises identifying the population as containing a significant portion of subjects with cardiovascular disease and/or cancer upon detection of the cancer biomarker at a concentration of at least 0.1 ng/L/10,000 population or of the cardiovascular disease biomarker at a concentration of at least 1.2×103 ng/L/10,000 population.

10. The method of claim 9, wherein the cardiovascular disease biomarker further comprises a biomarker selected from cardiac troponin I (cTnI), α-fetoprotein, and normetanephrine, the method further comprises identifying the population as containing a significant portion of subjects with cardiovascular disease upon detection of cTnI, α-fetoprotein, or normetanephrine at a concentration of at least 0.1 ng/L/10,000 population.

11. The method of claim 1, wherein the metabolite of VOCs is selected from the group consisting of: N-acetyl-S-(2-carboxyethyl)-L-cysteine (2CoEMA), N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA), N-acetyl-S-(2-cyanoethyl)-L-cysteine (2CyEMA), N-acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (34HBMA), N-acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine ((E)-4HBeMA), N-acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (3HMPMA), N-acetyl-S-(N-methylcarbamoyl)-L-cysteine (MCaMA), phenylglyoxylic acid (PhGA), nicotine (NIC), cotinine (COT), 3-hydroxycotinine (3HC), N-acetyl-S-(2-hydroxypropyl)-L-cysteine (2HPMA), N-acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine (2HPhEMA), N-Acetyl-S-(trichlorovinyl)-L-cysteine (122CVMA), N-acetyl-S-(benzyl)-L-cysteine (BzMA), 2-methylhippuric acid (2MHA), 3-methylhippuric acid (3MHA), and 4-methylhippuric acid (4MHA).

12. The method of claim 1, wherein the analyte concentration determined in the wastewater sample is the metabolite of VOCs, the method further comprises: separating components of the wastewater sample using liquid chromatography (LC) or gas chromatography (GC); detecting the separated components of the wastewater sample using a detector; wherein the detector is selected from the group consisting of: mass spectrometry (MS), flame ionization detection (FID), and electron capture detection (ECD); spiking the wastewater sample with a mixture of stable isotype-labeled international standards to produce a spiked wastewater sample; and diluting the spiked wastewater sample prior to detecting the concentration of the metabolite of VOCs.

13. The method of claim 11, further comprising normalizing the concentration of the at least one VOC analyte in the wastewater sample with at least one normalization agent.

14. The method of claim 13, wherein the at least one normalization agent comprises cotinine.

15. The method of claim 13, further comprising normalizing the concentration of the at least one VOC analyte in the wastewater sample for nicotine consumption variability.

16. The method of claim 15, wherein cotinine is used to normalize the concentration of the at least one VOC analyte in the wastewater sample for nicotine consumption variability.

17. The method of claim 1, wherein the concentration of the at least one analyte is determined using at least one method selected from the group consisting of: liquid chromatography (LC), gas chromatography (LC), mass spectrometry (MS), flame ionization detection (FID), and electron capture detection (ECD).

18. The method of claim 17, wherein the concentration of the at least one analyte is determined using LC and one other method.

19. The method of claim 18, wherein the concentration of the at least one analyte is determined using LC-MS.

20. A method of assessing a population's health comprising: providing a first wastewater sample from the population; detecting the concentration of at least one analyte in the first wastewater sample, wherein the at least one analyte is selected from the group consisting of: a hunger hormone, a stress hormone, a cardiovascular disease biomarker, a pulmonary disease biomarker, a cancer biomarker, an illicit drug, a personal care product, a surfactant, a hazardous chemical, a disease resistant pathogen, an antimicrobial resistance gene, a psychotropic drug, an alcohol-related chemical biomarker, a metabolite of volatile organic compounds (VOCs), an environmental toxin, a nicotine-related metabolite, a plastic component, and an endogenous mental health marker; providing a second wastewater sample from the population, wherein the second wastewater sample is collected from a same location as the first wastewater sample and is collected at least two days after collecting the wastewater fluid sample; detecting the concentration of at least one analyte in the second wastewater sample; and identifying a change in the population's health upon detection that the concentration of the at least one biomarker is changed between the first wastewater sample and the second wastewater sample.

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