GRF 2nd One Health Summit 2013: Presentation by Christoph ORT, Swiss Federal Institute of Aquatic Science and Technology (Eawag) Switzerland

1. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Sewage Analyses as an Early Detection System for Diseases
and Indicator of Various Public Health Aspects
Caleb BANTA‐GREEN, Frédéric BÉEN, Lubertus BIJLSMA, Sara CASTIGLIONI, Erik EMKE, Jennifer FIELD, Coral GARTNER,
Barbara KASPRZYK‐HORDERN, Foon Yin LAI, Jeremy PRICHARD, Malcolm REID, Martina KINZIG, Alexander VAN NUIJS
Christoph ORT
2nd GRF One Health Summit
Davos 17‐20 November 2013
Eawag: Swiss Federal Institute of Aquatic Science and Technology
Is
wastewater
better
than
a
GPS?
Christoph Ort, Eawag
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2. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
GPS = Global Population Survey
Christoph Ort, Eawag
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3. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Concept, approach
Drug consumption
Dose
d
Metabolism
e
losses
? system-dependent
transformation/adsorption
Sewer pipes
alcohol/other drugs
Excretion
? current research  t
dynamics
hydraulics
Sewage treatm. plant
sampling
analytics  C
flow measurements
volume  Q
Catchment
number of people
normalization P
env. engineer
analytical chemist
 Transdisciplinary
STP operator
C(S)·Q 1 1 1
· · ·
e d t
P
census
pharmacologist
env. engineer
forensic sc.
Substance load in sewer
[mg 1000p-1 d-1]
Christoph Ort, Eawag
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4. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Sampling from a very dynamic system («sum» of toilet flushes/pumps)
t=2min
30
400
25
20
300
15
200
10
0
10:10
10:20
10:30
10:40
10:50
11:00
11:10
11:20
11:30
11:40
11:50
12:00
5
0
09:00
09:10
09:20
09:30
09:40
09:50
10:00
100
BZE [mg/2min]
BE [mg/2min]
35
500
flow [l/s]
STP [L/s]
600
 Collect samples at high frequency
(i.e. every 5‐10 minutes)
 Pool samples for analysis (typically 24h)
 Get information about catchment
Ort et al. (in preparation)
Castiglioni et al. (2013) Environmental Science and Technology 47 (3) , pp. 1452‐1460
Diurnal variations (caffeine and creatinine)
 Collect samples in a flow/volume
proportional manner
Brewer et al. (2012) Environmental Science and Technology 46 (15) , pp. 8305‐8314
Christoph Ort, Eawag
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5. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Cocaine consumption* in Belgium (individual days in 2007/08)
Wednesday
WINTER 2007‐2008
van Nuijs et al. (2009) Environmental Pollution 157 (1) , pp. 123‐129
* back‐calculated from benzoylecgonine
Cocaine consumption* in Belgium (individual days in 2007/08)
Sunday
WINTER 2007‐2008
 Weekend effect
depending on use
pattern and
pharmacokinetics
van Nuijs et al. (2009) Environmental Pollution 157 (1) , pp. 123‐129
* back‐calculated from benzoylecgonine
Christoph Ort, Eawag
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6. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Benzoylecgonine (one 1‐week period)
 EU: 355kg cocaine/d
30% purity
CHF 100/g
 43 Mrd. CHF/y
Thomas et al. (2012) Science of the Total Environment 432 , pp. 432‐439
Ort and van Nuijs et al. (in preparation)
MDMA (one 1‐week period)
Thomas et al. (2012) Science of the Total Environment 432 , pp. 432‐439
Ort and van Nuijs et al. (in preparation)
Emke et al. (accepted) Science of the Total Environment
Christoph Ort, Eawag
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7. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Asia (2009‐2011)
 other substances
 epidemiological data
not available to the
same extent
Lai et al. (2013) Forensic Science International 233 (1‐3) , pp. 126‐132
graph Covaci et al. (in preparation)
Cocaine* consumption in small community (~7000 people, n=1369 days)
Working days
 605mgCOC/d
Weekend (p < 10-4)
+161mgCOC/d
Frost (p = 0.039)
+114mgCOC/d
Snow (p = 0.005)
+150mgCOC/d
 monitoring design
 external factors
 annual average
Ort et al. (asap) Addiction
* back‐calculated from benzoylecgonine
Christoph Ort, Eawag
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8. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Antihistamine Cetirizine
[…] corresponds almost exactly to the period when
95% of the yearly total for the two most significant
sources of pollen was registered in the Oslo
region and associated seasonal allergic rhinitis among
the population.
[…] total amount of cetirizine that passed through
the system in 2010 (∼30 kg). As 50% of cetirizine is
excreted unchanged and the dose rate is 10 mg per
person per day, then this results in an estimation in the
total number of defined daily doses (DDD) of 5 947
327 in 2010, which is within 10% of the known DDD
(SI Table S2).
Harman et al. (2011) Environmental Science and Technology 45 (13) , pp. 5676‐5682
Is wastewater better than GPS?
Neither yes nor no: different, complementary
+
-
Christoph Ort, Eawag
Anonymous
No selection bias
Substance‐specific
Near real‐time
No number of users
No type of users
No prevalence
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9. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Take home messages
• No ethical issues in large populations i.e.
negligible risk of (in)direct harm to residents; not
monitoring individuals!
• Quantifying baseline and trends and effects of
interventions and also special events, e.g.
festivals …
• Valuable complementary tool providing
quantitative aggregate, near real‐time
information
• Early warning system for new drugs and
potentially for diseases
• Transdisciplinary research involving engineer,
chemists, pharmacologists, epidemiologists,
sociologists, police, forensic scientists, etc.)
Hall et al. (2012) Addiction 107 (10) , pp. 1767‐1773
Network expanded in 2013 (and further expanding)




21 countries
42 cities
47 sewage treatm. plants
24.74m people
New COST action:
Sewage biomarker analysis for
community health assessment
Ort and van Nuijs et al. (in preparation)
Christoph Ort, Eawag
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10. 2nd GRF One Health Summit
Davos, 17‐20 November 2013
Acknowledgments
Adriano Joss, Adrian Covaci, Alan Kleinschmidt, Alex Brewer, Alex Heisele, Alexander Van Nuijs, Ana Deletic, Ana Esposo,
Andreas Hartmann, Andreas Scheidegger, Andreas Schiller, Anja Herlyn, Arthur Wanner, AWMC, Axel Meierjohann, Axel Wahl,
Barbara Kasprzik‐Hordern, Beat Rohrbach, Beate Escher, Beatrice Gadmer, Benjamin Tan, Bernard Cloetta, Bernd Nowack,
Brigitte Pfister, Caleb Banta‐Green, Canan Aglamaz, Carsten Uemann, Christa McArdell, Christian Abegglen, Christian Braun,
Christian Fux, Christian Götz, Christian Schaffner, Christian Stamm, Claude‐Alain Jaquerod, Claudi Bänninger‐Werfeli, Coral
Gartner, Cornelia Buchwalder, Damian Dominguez, Daniel Braun, Daniel Field, Daniel Pfund, Daniel Probst, Daniel Rensch,
Daniel Streit, Daniele Scrugli, David Dürrenmatt, David Fillmore, David Makaz, David McCarthy, David Sedlak, Dieter
Sennhauser, Dirk Muschalla, Dominic Sydler, Don Begbie, Dongbin Huang, Doris Jermann, Eawag, Erik Emke, ETH, Etienne
Vermeirssen, Fadri Gottschalk, Felix Buehler, Félix Hernández, Foon Yin Lai, Frank Blumensaat, Fredi Bichsel, Frédéric Béen,
Frederik Verdonck, Fritz Sörgel, Geoff Eaglesham, Gerd Hüttmann, Geri Koch, Geri Ryhiner, Glen Daigger, Greg Jackson, Hans
Lamp, Hanspeter Bauer, Hansruedi Siegrist, Heather Chapman, Heinz Frömelt, Heinz Singer, Helen Stratton, Helge Daebel,
Hugo Koller, Irene Steimen, Irene Wittmer, Jack Eugster, Jaqueline Traber, Jakob Helbing, Jan Mazacek, Janet Cumming, Janet
Hering, Jean‐Daniel Berset, Jean‐Daniel Rosselet, Jean‐Luc Bertrand‐Krajewski, Jelena Radjenovic, Jennifer Field, Jeremey
Prichard, Jessica Nott, Jimmy Coonan, Jo Martens, Jochen Mueller, John Doonan, John Elec, John Paulger, Jonas Maria Eppler,
Jörg Rieckermann, José Quintana, Josef Asmin, Juliane Hollender, Julien Reungoat, Jurg Keller, Kai Udert, Karin Rottermann,
Kathrin Fenner, Kevin Thomas, Klaus Heimburger, Kristell Le Corre, Leiv Rieger, Lieven Clement, Lluís Corrominas, Loïc
Lombard, Lubertus Bijlsma, Luc Demontigny, Luca Rossi, Malcolm Reid, Marc Böhler, Marc Neumann, Marc Suter, Marcel
Dettling, Maria José Farré‐Olalla, Marja Furrer, Marina Peter, Mario Keusen, Mariska Ronteltap, Markus Boller, Markus Gresch,
Markus Koch, Martin Krauss, Martina Kinzig, Mary Donlevy, Mary Hodge, Max Maurer, Maxime Rattier, Michael Burkhard,
Michael Eugster, Michael Lawrence, Michael Schärer, Michael Thomann, Michele Steiner, Miren Lopez de Alda, Miriam
Münchbach, Oliver Kracht, Olivier Delémont, Oskar Wanner, Paul Liechti, Pascal Wunderlin, Peter Bühlmann, Peter Gäumann,
Peter Krebs, Peter Liechti, Peter Reichert, Peter Schär, Peter Schwilch, Peter Steen Mikkelsen, Peter Vanrolleghem, Philipp
Beutler, Philipp Staufer, Philippe Vioget, Pim de Voogt, Pierre Esseiva, Pius Niederhauser, Ralf Kägi, Ralf Rosenstiel, René Gälli,
Reto Manser, Richard Lindberg, Röbi Schmid, Roger Küenzi, Roman Grabic, Rosi Sieber, Ross Kleinschmidt, Ruedi Moser,
Sabine Burger, Saskia Zimmermann, Samuel Twerenbold, Sandra, Hall, Sara Castiglioni, Sara Karolak, Senka Terzic, Sepp
Poreccia, Shane Batchler, Shaun Corrie, Silvana Velten, Simon Toze, Stefan Truong, Stefano Gianella, Steve Carter, Steven
Kenway, SNF, Thomas Hug, Thomas Néfau, Tony Wong, Torsten Wind, Ueli Sieber, UWSRA, Urs von Gunten, Ursi
Schönenberger, Veronique Vandeberghe, Vivienne Clayton, Walter Giger, Wayne Batchler, Wayne Hall, Wendy Mahon, Werner
Pletscher, Willi Gujer, Wolfgang Gernjak, Wolfgang Rauch, Xavier Flores, Yolanda Pico
Thank you
http://sewprof-itn.eu/
A new paradigm in drug use and
human health risk assessment:
Sewage profiling at the community level
Christoph Ort, Eawag
Sewage biomarker analysis for
community health assessment
christoph.ort@eawag.ch
Skype: christoph.ort
Phone: +41 (0)58 765 52 77
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