Queensland Alliance for Environmental Health Sciences (QAEHS), formerly National Research Centre for Environmental Toxicology (Entox), The University of Queensland, Coopers Plains, QLD, Australia.
Toxicological Centre, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium.
Addiction. 2018 Jun;113(6):1127-1136. doi: 10.1111/add.14157. Epub 2018 Feb 26.
Tobacco and alcohol consumption remain priority public health issues world-wide. As participation in population-based surveys has fallen, it is increasingly challenging to estimate accurately the prevalence of alcohol and tobacco use. Wastewater-based epidemiology (WBE) is an alternative approach for estimating substance use at the population level that does not rely upon survey participation. This study examined spatio-temporal patterns in nicotine (a proxy for tobacco) and alcohol consumption in the Australian population via WBE.
Daily wastewater samples (n = 164) were collected at 18 selected wastewater treatment plants across Australia, covering approximately 45% of the total population. Nicotine and alcohol metabolites in the samples were measured using liquid chromatography-tandem mass spectrometry. Daily consumption of nicotine and alcohol and its associated uncertainty were computed using Monte Carlo simulations. Nation-wide daily average and weekly consumption of these two substances were extrapolated using ordinary least squares and mixed-effect models.
Nicotine and alcohol consumption was observed in all communities. Consumption of these substances in rural towns was three to four times higher than in urban communities. The spatial consumption pattern of these substances was consistent across the monitoring periods in 2014-15. Nicotine metabolites significantly reduced by 14-25% (P = 0.001-0.008) (2014-15) in some catchments. Alcohol consumption remained constant over the studied periods. Strong weekly consumption patterns were observed for alcohol but not nicotine. Nation-wide, the daily average consumption per person (aged 15-79 years) was estimated at approximately 2.5 cigarettes and 1.3-2.0 standard drinks (weekday-weekend) of alcohol. These estimates were close to the sale figure and apparent consumption, respectively.
Wastewater-based epidemiology is a feasible method for objectively evaluating the geographic, temporal and weekly profiles of nicotine and alcohol consumption in different communities nationally.
烟草和酒精消费仍然是全球优先的公共卫生问题。由于参与基于人群的调查人数减少，准确估计酒精和烟草使用的流行率变得越来越具有挑战性。基于污水的流行病学（WBE）是一种替代方法，可以在人群水平上估计物质使用情况，而不需要依赖调查参与。本研究通过 WBE 研究了澳大利亚人群中尼古丁（烟草的代表）和酒精消费的时空模式。
在澳大利亚的 18 个选定的污水处理厂每天收集 164 个污水样本，覆盖了总人口的约 45%。使用液相色谱-串联质谱法测量样品中的尼古丁和酒精代谢物。使用蒙特卡罗模拟计算尼古丁和酒精的日消耗量及其相关不确定性。使用普通最小二乘法和混合效应模型推断这两种物质的全国日平均和周消耗量。
在所有社区都观察到了尼古丁和酒精的消耗。农村城镇的这些物质消耗是城市社区的三到四倍。在 2014-15 年的监测期间，这些物质的空间消耗模式是一致的。在一些集水区，尼古丁代谢物的浓度显著降低了 14-25%（P=0.001-0.008）（2014-15 年）。在研究期间，酒精消耗保持不变。观察到酒精的强烈的周消耗模式，但尼古丁没有。全国范围内，估计每个（15-79 岁）年龄组的人每天平均消耗约 2.5 支香烟和 1.3-2.0 标准饮料（工作日-周末）的酒精。这些估计值分别接近销售数据和实际消费数据。
基于污水的流行病学是一种可行的方法，可以客观地评估不同社区的尼古丁和酒精消费的地理、时间和周模式。
