Universitat Rovira i Virgili, Department of Analytical Chemistry and Organic Chemistry, Tarragona, Spain.
Universitat Rovira i Virgili, Department of Analytical Chemistry and Organic Chemistry, Tarragona, Spain.
Sci Total Environ. 2024 Nov 25;953:176108. doi: 10.1016/j.scitotenv.2024.176108. Epub 2024 Sep 10.
Wastewater-based epidemiology (WBE) is a well-established approach that can provide objective and real-time data on the consumption of substances such as pharmaceuticals. However, most of the studies reported so far compares consumption data obtained using WBE with those derived from prescription data from public health systems, which is often incomplete and might represent a source of uncertainty. This study aims to compare the measured pharmaceutical consumption back calculated with the WBE approach with consumption derived from dispensed pharmaceuticals in two regions of Spain, managed by two different Health Systems. To do so, a group of 17 pharmaceuticals, including the most representative ones of every therapeutic family, were monitored in influent wastewater (IWW) samples collected over a week campaign in spring 2022 at four different wastewater treatment plants (WWTPs) in Spain: two WWTPs in Madrid city (center of Spain) and two WWTPs in Catalonia (Northeast of Spain). Population-normalized daily loads (PNDL) revealed that the patterns of pharmaceutical occurrence in the different WWTPs are very similar, being acetaminophen, 4-acetamidoantipyrine and valsartan the pharmaceuticals with the highest PNDL values: 17162 ± 1457 mg day 1000 inh for acetaminophen, 2365 ± 696 and 2429 ± 263 mg day 1000 inh for 4-acetamidoantipyrine, 2006 ± 541 and 2041 ± 352 mg day 1000 inh for valsartan. Pharmaceutical PNLDs were then transformed into measured pharmaceutical consumption (MC) and compared with dispensed consumption (DC) data obtained from the pharmacies in the catchment area where the WWTPs are located. A ratio MC/DC within 0.8 to 1.2 was obtained for 11 out of the 17 studied pharmaceuticals. Highlighting a match in all the cardiovascular system pharmaceuticals, with the exception of losartan (1.29-1.39 ratio) and valsartan (1.35-1.43) in all WWTPs. In summary, the degree of correlation between MC/DC is higher than those previously reported comparing with the prescribed pharmaceutical consumption.
基于污水的流行病学（WBE）是一种成熟的方法，可提供有关药物等物质消耗的客观和实时数据。然而，迄今为止报告的大多数研究都将使用 WBE 获得的消耗数据与公共卫生系统的处方数据得出的消耗数据进行比较，而这些数据通常是不完整的，并且可能是不确定性的来源。本研究旨在比较通过 WBE 方法反推得出的测量药物消耗与西班牙两个地区管理的两种不同卫生系统的配药药物消耗。为此，在 2022 年春季进行的为期一周的活动中，在西班牙的四个不同污水处理厂（WWTP）中收集了包括每个治疗家族中最具代表性的 17 种药物的污水样本，以监测一组 17 种药物。在西班牙马德里市（西班牙中部）的两个 WWTP 和加泰罗尼亚（西班牙东北部）的两个 WWTP 收集的污水样本中，我们发现不同 WWTP 中药物出现的模式非常相似，其中对乙酰氨基酚、4-乙酰氨基安替比林和缬沙坦是 PNDL 值最高的药物：对乙酰氨基酚的 PNDL 值为 17162±1457mg·day -1000 inh ，4-乙酰氨基安替比林和缬沙坦的 PNDL 值分别为 2365±696 和 2429±263mg·day -1000 inh 。然后，将药物的 PNDL 转化为测量的药物消耗（MC），并与位于 WWTP 集水区的药店获得的配药消耗（DC）数据进行比较。在所研究的 17 种药物中，有 11 种药物的 MC/DC 比值在 0.8 到 1.2 之间。所有心血管系统药物都匹配，除了氯沙坦（比值为 1.29-1.39）和缬沙坦（比值为 1.35-1.43）在所有 WWTP 中都匹配。总之，MC/DC 的相关性程度高于以前报道的与处方药物消耗进行比较的程度。
