Ni Krystal, Korfmacher Katrina Smith
Author Affiliations: Department of Environmental Medicine, University of Rochester, Rochester, New York, USA (Ms Ni and Dr Korfmacher).
J Public Health Manag Pract. 2025 Aug 19. doi: 10.1097/PHH.0000000000002206.
Wastewater surveillance (WWS) emerged as a tool to monitor public health during the COVID-19 pandemic. Wastewater surveillance is generally undertaken voluntarily by public health and wastewater treatment agencies. Therefore, public trust and support is essential to its sustainability. Development and implementation of ethically informed practices may contribute to public support for expansion of WWS to other public health applications.
We conducted a scoping review of existing publications on the ethics of WWS for COVID-19. We characterized these publications and identified research gaps.
This scoping review was based on searches through Scopus and PubMed for the period January 2020 to December 2023 focusing on four concepts: wastewater, surveillance, ethics, and COVID-19. We included studies published in journals, reports, and books and identified 31 publications. Publications were coded thematically as well as by approach, region, discipline, and publication type.
The majority of publications focused on the need to develop ethical guidelines that promote long-term public support for WWS. A number of publications proposed ethical guidelines and also emphasized that these considerations are context-specific and dynamic, requiring an ongoing system for input as new situations, endpoints, and technologies evolve. Themes included protection of privacy, potential to stigmatize communities with high COVID-19 signals, the importance of effective communication, equitable application of WWS, community engagement, and high standards for data quality. There were few empirical studies of diverse populations' preferences for WWS. Ethical considerations may vary across communities and countries and as new applications of wastewater surveillance emerge.
We provide an overview of the emerging principles for ethical practice of WWS and identify gaps in knowledge. These findings may guide future research and consideration of ethics as decisionmakers consider new monitoring endpoints (eg, pharmaceuticals, illegal drugs, infectious diseases, and indicators of population health).
废水监测（WWS）在新冠疫情期间成为监测公众健康的一种工具。废水监测通常由公共卫生机构和废水处理机构自愿开展。因此，公众的信任和支持对其可持续性至关重要。制定和实施符合伦理的做法可能有助于公众支持将废水监测扩展到其他公共卫生应用领域。
我们对现有的关于新冠疫情废水监测伦理的出版物进行了范围综述。我们对这些出版物进行了特征描述，并确定了研究空白。
本范围综述基于2020年1月至2023年12月期间通过Scopus和PubMed进行的检索，重点关注四个概念：废水、监测、伦理和新冠疫情。我们纳入了发表在期刊、报告和书籍中的研究，并确定了31篇出版物。出版物按主题以及方法、地区、学科和出版类型进行编码。
大多数出版物关注制定促进公众对废水监测长期支持的伦理准则的必要性。一些出版物提出了伦理准则，并强调这些考虑是因地制宜且动态变化的，随着新情况、终点和技术的发展，需要一个持续的输入系统。主题包括隐私保护、给新冠疫情信号高的社区带来污名化的可能性、有效沟通的重要性、废水监测的公平应用、社区参与以及数据质量的高标准。关于不同人群对废水监测偏好的实证研究很少。伦理考量可能因社区和国家而异，并且随着废水监测新应用的出现而有所不同。
我们概述了废水监测伦理实践的新兴原则，并确定了知识空白。这些发现可能会指导未来的研究以及决策者在考虑新的监测终点（如药品、非法药物、传染病和人群健康指标）时对伦理的考量。
