Abstract:
Wastewater-based epidemiology (WBE) and wastewater surveillance have become a valuable complementary data source to collect information on community-wide exposure through the measurement of human biomarkers in influent wastewater (IWW). In WBE, normalization of data with the de facto population that corresponds to a wastewater sample is crucial for a correct interpretation of spatio-temporal trends in exposure and consumption patterns. However, knowledge gaps remain in identifying and validating suitable de facto population biomarkers (PBs) for refinement of WBE back-estimations. WBE studies that apply de facto PBs (including hydrochemical parameters, utility consumption data sources, endo- and exogenous chemicals, biological biomarkers and signalling records) for relative trend analysis and absolute population size estimation were systematically reviewed from three databases (PubMed, Web of Science, SCOPUS) according to the PRISMA guidelines. We included in this review 81 publications that accounted for daily variations in population sizes by applying de facto population normalization. To date, a wide range of PBs have been proposed for de facto population normalization, complicating the comparability of normalized measurements across WBE studies. Additionally, the validation of potential PBs is complicated by the absence of an ideal external validator, magnifying the overall uncertainty for population normalization in WBE. Therefore, this review proposes a conceptual tier-based cross-validation approach for identifying and validating de facto PBs to guide their integration for i) relative trend analysis, and ii) absolute population size estimation. Furthermore, this review also provides a detailed evaluation of the uncertainty observed when comparing different de jure and de facto population estimation approaches. This study shows that their percentual differences can range up to ±200 %, with some exceptions showing even larger variations. This review underscores the need for collaboration among WBE researchers to further streamline the application of de facto population normalization and to evaluate the robustness of different PBs in different socio-demographic communities.
摘要:
基于废水的流行病学(WBE)和废水监测已成为有价值的补充数据源,可通过测量进水废水(IWW)中的人类生物标志物来收集有关社区范围内暴露的信息。在WBE,与废水样本相对应的事实人口的数据标准化对于正确解释暴露和消费模式的时空趋势至关重要。然而,在确定和验证合适的事实上的人群生物标志物(PBs)以完善WBE回溯估计方面仍然存在知识差距。应用事实上的PB的WBE研究(包括水化学参数,公用事业消费数据源,内源性和外源性化学物质,从三个数据库(PubMed,WebofScience,SCOPUS)根据PRISMA指南。我们在这篇评论中纳入了81篇出版物,这些出版物通过应用事实上的人口正常化来解释人口规模的每日变化。迄今为止,已经提出了广泛的PB用于事实上的人口正常化,使WBE研究中归一化测量的可比性变得复杂。此外,由于缺乏理想的外部验证器,潜在PB的验证变得复杂,放大了WBE人口正常化的总体不确定性。因此,这篇综述提出了一种基于概念层的交叉验证方法,用于识别和验证事实上的PB,以指导它们在i)相对趋势分析中的整合,和ii)绝对人口规模估计。此外,这篇综述还对比较不同的法律上和事实上的人口估计方法时观察到的不确定性进行了详细的评估。这项研究表明,它们的百分比差异可以达到±200%,除了一些例外,显示出更大的变化。这篇评论强调了WBE研究人员之间合作的必要性,以进一步简化事实上的人口正常化的应用,并评估不同社会人口统计学社区中不同PB的稳健性。