Hamant Rachel, Mao Yuzhu, Liu Chunfu, Torrents Alba, Kjellerup Birthe
Department of Civil and Environmental Engineering, University of Maryland, College Park, Maryland, USA.
Department of Health Human Services, Montgomery County, Rockville, Maryland, USA.
Water Environ Res. 2025 Jun;97(6):e70112. doi: 10.1002/wer.70112.
Wastewater Surveillance (WBS) is an approach for disease surveillance involving the screening of wastewater for RNA/DNA originating from infectious agents. In recent years, WBS has expanded to include analytes from pharmaceuticals (such as SSRI) or illicit drugs, referred to as "High-risk Substances" (HRS). The University of Maryland enacted in partnership with a local county public health department and water utility, a surveillance program to assess wastewater twice weekly for the presence of SARS-CoV-2 and other viral targets. WBS can provide rapid data showing where the location of clustered outbreaks may be occurring (specifically. The county public health department also requested that screening of high-risk substances (fentanyl, ketamine, Narcan, heroine, etc.) to be included in WBS, thus expanding the purview of the initial surveillance project focusing solely biological agents. A concern for any surveillance program is adhering to ethical standards, regulations, and protocols. In WBS, there is no single standardized "list of rules" to guide researchers in determining risk of privacy or community stigmatization. In an effort to counter the variation in WBS as it pertains to ethical standards, we propose utilizing an ethical scoring framework tailored for WBS. This framework includes a scoresheet that can assist scientists determine the privacy and ethical risks associated with their study by introducing a quantifiable process to assess ethical compliance. Furthermore, we include a flow map outlining standard laboratory practices under the lens of how each step assists in maintaining sample fidelity, thus increasing the robustness and reliability of the data generated. SUMMARY: It is important to balance ethical standards, public health and research strategies. Application of the tools listed in this document will ensure this balance. Application of the developed ethical guidelines (Score sheet) is a practical approach. It is important to integrate vigorous data management practices. Utilization of a robust and holistic structure of the wastewater surveillance program will ensure successful outcomes.
废水监测（WBS）是一种疾病监测方法，涉及对废水进行筛查，以检测来自传染源的RNA/DNA。近年来，WBS已扩展到包括来自药品（如选择性5-羟色胺再摄取抑制剂）或非法药物的分析物，这些被称为“高风险物质”（HRS）。马里兰大学与当地县公共卫生部门和自来水公司合作制定了一项监测计划，每周对废水进行两次检测，以确定是否存在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）和其他病毒靶点。WBS可以提供快速数据，显示可能发生聚集性疫情的地点（具体而言）。县公共卫生部门还要求将高风险物质（芬太尼、氯胺酮、纳洛酮、海洛因等）的筛查纳入WBS，从而扩大了最初仅专注于生物制剂的监测项目的范围。任何监测项目都需要关注遵守道德标准、法规和协议。在WBS中，没有单一的标准化“规则清单”来指导研究人员确定隐私或社区污名化风险。为了应对WBS在道德标准方面的差异，我们建议使用专门为WBS量身定制的道德评分框架。该框架包括一个评分表，通过引入可量化的过程来评估道德合规性，帮助科学家确定与其研究相关的隐私和道德风险。此外，我们还包括一个流程图，概述了标准实验室操作，从每个步骤如何有助于保持样本保真度的角度进行阐述，从而提高所生成数据的稳健性和可靠性。总结：平衡道德标准、公共卫生和研究策略很重要。应用本文列出的工具将确保这种平衡。应用已制定的道德准则（评分表）是一种切实可行的方法。整合严格的数据管理实践很重要。利用强大而全面的废水监测计划结构将确保取得成功结果。
