Municipal wastewater as a population measure of hidden health behaviors
Many health behaviors are difficult to measure. Estimates of illegal drug use are subject to substantial self-report and sampling biases. Municipal wastewater samples are routinely collected for 24-hour periods at the point of inflow to treatment plants, providing insights into substance consumption upstream that is anonymous, near real time, and relatively inexpensive. Analytic chemistry can identify specific compounds at the level of parts per billion in wastewater with very good accuracy and precision. Findings from several large-scale sampling campaigns across the Northwest for prescription and illegal drugs of abuse will be shared. Approaches to dealing with measurement and analytical issues including measuring actual population in a municipality in a 24-hour period will be discussed. The possibilities and limits of this approach for other health behaviors will be discussed.
Caleb Banta-Green is an epidemiologist and health services researcher. Since 2001 he has served as the Seattle representative to a national NIH workgroup that tracks local drug trends. As methamphetamine, then prescription drugs, and now heroin have expanded to non-metro areas, he has worked to expand the epidemiological toolset. He speaks regularly to diverse communities across the state to share data on drug trends but also to hear about emergent drug abuse issues. “Local data!” is the constant cry from communities, tribes, and cities across the state. “We don’t care about the county average, what about our community?” they ask. Wastewater may be the ideal data source.
In 2012, Dr. Banta-Green also served as the senior science advisor to the “drug czar,” aka the director of the White House Office of National Drug Control Policy. In other areas of his work he is running an overdose prevention trial at the Harborview ER and analyzing a dataset of all controlled substance prescriptions for the Washington State Department of Health.