Wastewater-based Epidemiology: An Approach for Evaluating the Behavioral and Health Status of the Community Through Wastewater Sample Analysis

Document Type : Review Article

Authors

1 MSc, Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

2 PhD Candidate, Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

3 Professor, Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The increased consumption of pharmaceuticals and chemicals, changes in infectious disease patterns, and the emergence of novel diseases have raised public health concerns. Wastewater-based epidemiology (WBE) enables the extraction of epidemiological information related to lifestyle, health/disease status, and exposure to chemical agents within the target population through wastewater analysis. This study aimed to explore the applications of WBE and identify its challenges.
Methods: This study reviewed articles on WBE from three databases (PubMed, Science Direct, and Scopus) and the Google Scholar search engine.
Findings: The results showed that chemical and microbial analysis of wastewater can provide extensive epidemiological information, both spatially and temporally, on the behavioral and health status of the target population. These data include indicators such as the use of illicit drugs, alcohol, and tobacco, the consumption of over-the-counter medications, and the burden of viral diseases, particularly the novel coronavirus, within the population covered by the wastewater network.
Conclusion: WBE serves as a powerful tool linking environmental sciences, public health, and epidemiology. The findings obtained through this approach provide valuable information for policymakers and public health authorities, aiding in informed decision-making for improving public health and controlling diseases. However, the application of this approach faces challenges, such as markers instability in wastewater, non-human sources of infectious agents, and the lack of standard sampling and analysis protocols in many cases.

Highlights

Sahar Gholipour: Google Scholar

Mahnaz Nikaeen: Google Scholar

Keywords

References

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Journal of Isfahan Medical School
Volume 43, Issue 820
4th Week, August
July and August 2025
Pages 728-742

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  • Receive Date: 05 October 2024
  • Accept Date: 26 May 2025

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