A new paradigm in public health assessment: Water fingerprinting for protein markers of public health using mass spectrometry

Public health monitoring cannot currently provide real time and comprehensive information about the health of a community as it depends on individual data collection (e.g. surveys) and is limited by the cost of biomonitoring campaigns. To allow for better monitoring of public health the burden of accuracy must move from the participant, whose accuracy cannot always be determined, to an assay or model whose accuracy can be determined either mathematically or scientifically. Additionally, new techniques should reduce overall costs in data collection and collation, whilst also expanding the number of individuals included in a study. Water fingerprinting that originated from wastewater based epidemiology (WBE) has a strong potential to revolutionise public health monitoring. WBE is a tool used for the analysis of drugs of abuse in populations worldwide, and future developments in this field are currently focussed on an expanding range of molecular biomarkers such as pharmaceuticals. However there also exists the possibility to adapt this approach for the analysis of proteins, which are currently clinically limited to the analysis of individual patients. By combing the techniques of WBE and clinical proteomics there exists the possibility for near-real time, population wide, human biomonitoring of disease. This manuscript details the considerations and stepping stones needed to allow for water proteome fingerprinting, as well as giving an overview of WBE and its applications; including the range of biomarkers, methods and populations currently examined.