Could drugs found in sewage provide an early warning?

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To study drugs in wastewater, UB scientists use the equipment and techniques shown here to isolate chemical compounds from water samples. (Photo credit: Meredith Forrest Kulwicki/University at Buffalo)

Tue July 5, 2022 6:55 AM

Wastewater research finds large spike in acetaminophen preceded by spike in viral RNA during wave of COVID-19 in Western New York

By University at Buffalo

In a pilot project exploring ways to monitor COVID-19, University at Buffalo scientists simultaneously searched for pharmaceuticals and viral RNA in sewage from Western New York.

The results of their study, published May 18 in the journal Environmental Science & Technology Letters, suggest that measuring drug concentrations in wastewater could add an extra layer to disease surveillance efforts.

“Sewage-based disease surveillance is done worldwide through viral RNA monitoring,” says lead scientist Diana Aga, Ph.D., director of the UB RENEW Institute and professor of chemistry Henry M. Woodburn at UB College of Arts and Sciences. . “The potential to complement existing efforts with drug detection is exciting. There are plenty of opportunities here, although more research is needed.

An interesting finding in the new study involves acetaminophen, a pain reliever and fever reducer that serves as an active ingredient in over-the-counter medications such as Tylenol, Theraflu and other brands.

At the four wastewater treatment plants included in the project, research found that wastewater acetaminophen concentrations increased before other COVID-19 measures in the community in early 2021, including COVID-19 viral RNA concentrations in wastewater and the estimated number of confirmed cases. Case of covid19.

For example, at the Bird Island Wastewater Treatment Plant, which serves Buffalo and some surrounding suburbs, sewage acetaminophen levels increased about two weeks earlier than SARS-CoV RNA levels. -2 in wastewater. The peak in viral RNA, in turn, preceded the peak in the estimated number of confirmed COVID-19 cases by about a week, the scientists said.

“Our biggest finding is that there is a huge increase in the concentration of acetaminophen, which is used in over-the-counter drugs, that predates the peak in viral RNA in sewage and the peak in clinical detections. in our area during the study period,” says Aga.

“This was very interesting, as it suggests that detection of pharmaceuticals could act as an early warning of a possible disease outbreak in a community,” Aga said. “Our group is one of the first to complement detection of SARS-CoV-2 RNA in wastewater with pharmaceutical levels.”

The research, conducted over several months in 2021, was funded by the US National Science Foundation and the SUNY Prepare Innovation and Internship Program, designed to engage students in developing solutions to pandemic-related challenges. Lahiruni M. Halwatura, Ph.D. student in Aga’s lab, was the study’s first author.

Potential for improving wastewater studies for public health

Sewage data is becoming a crucial part of COVID-19 surveillance as home testing has become more popular, resulting in many positive cases going unreported.

During the pandemic, UB engineering researchers Ian M. Bradley and Yinyin Ye worked with partners, including Erie County, to monitor COVID-19 viral RNA in wastewater.

The new study published in Environmental Science & Technology Letters is exciting because it suggests detecting pharmaceuticals could add another layer to these efforts, say Bradley and Ye. Their labs contributed data to the research, and they are co-authors.

Acetaminophen is not a perfect substitute for COVID-19: People take the drug to treat many types of aches, pains, and fevers, and some fluctuation of the drug in sewage over the course of the period. study were not correlated with viral RNA data.

However, the spike in acetaminophen that seemed to correspond with the local wave of COVID-19 was large, and this finding points to the use of over-the-counter drugs as a potential early signal of an impending outbreak, the researchers say.

“What’s really exciting is that there’s so much information in the wastewater. How can we use this to track diseases for public health? All of this data is complementary,” says Bradley, Ph.D., assistant professor of civil, structural, and environmental engineering at the UB School of Engineering and Applied Sciences, and a core faculty member at the UB RENEW Institute.

“We’re focusing on public health studies of wastewater, and we want to see if we can integrate more data to get a sense of what’s going on in the community,” says Ye, Ph.D., assistant professor of Civil, Structural and Environmental Sciences and an affiliate faculty of RENEW. “We can extract information from wastewater, but there are still a lot of unknowns about how to interpret the data for public health. We want to test not only biological markers, but also chemical markers and all kinds of different layers of information.

In addition to identifying acetaminophen spikes, the study found pandemic-associated prescription drug residues in the wastewater, including drugs with emergency use authorization for the treatment of COVID. -19 has been revoked by the United States Food and Drug Administration.

Other study co-authors included Isabella S. Mclerran, a master’s student in Bradley’s lab who recently graduated; Daniel L. Weglarski, an undergraduate student in Aga’s lab who recently graduated; and Zia U. Ahmed, Ph.D., Database/Visualization Specialist at the UB RENEW Institute.

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