Knowledge discovery by analysis of community wastewater reveals factors driving public health risks

Barbara Kasprzyk-Hordern; Natalie Sims; Kata Farkas; Matthew J Wade; Davey L. Jones

doi:10.1016/j.watres.2025.124370

Knowledge discovery by analysis of community wastewater reveals factors driving public health risks

Barbara Kasprzyk-Hordern
, Natalie Sims
, Kata Farkas
, Matthew J Wade
, Davey L. Jones

Bangor University
UK Health Security Agency
Centre of Excellence in Water Based Early Warning Systems for Health Protection

Research output: Contribution to journal › Article › peer-review

3 Citations (SciVal)

Abstract

This study tested a wide range of biological and chemical biomarker groups (BCIs) in wastewater from 10 cities in England to gain a better understanding of community exposure to chemicals and health outcomes and to unravel potential associations between disease prevalence, lifestyle choices and key risk factors. For example, viral BCIs showed relatively few correlations, except for norovirus gene abundance which correlated with antibiotic concentrations. Positive correlations between nicotine/cotinine and pharma BCIs indicated smoking as widely reported risk factor in diabetes, asthma/allergies and cardiovascular diseases. Antidiabetics showed complex relationships with various BCIs, e.g. with antibiotics possibly due to diabetes being a risk factor in e.g. respiratory tract, urinary tract and skin infections. Illicit drugs correlated mainly with lifestyle indicators and other recreational substances, including alcohol metabolites and nicotine. This exploratory paper shows the enormous potential of wastewater-based epidemiology (WBE) to enhance our understanding of factors driving public health and wellbeing risks. While WBE correlations cannot imply causation, they can serve as early warning for identification of possible health risks, providing much needed community-health screening aimed at informing patient-focussed interventions.

Original language	English
Article number	124370
Journal	Water Research
Volume	287
Issue number	Part A
Early online date	9 Aug 2025
DOIs	https://doi.org/10.1016/j.watres.2025.124370
Publication status	Published - 1 Dec 2025

Data Availability Statement

Data will be made available on request.

Funding

The work was supported under the C215.3 Wastewater Based Epidemiology Programme within the UK Government Accelerated Capability Environment (ACE), funded by the Environmental Monitoring for Health Protection (EMHP) programme, UK Health Security Agency. We thank Daphne Beniston and Andrew Singer (Accelerated Capability Environment, Homeland Security, UK) for their help organizing the project. We thank Public Health Wales for providing enterovirus primer and probe sequences and the staff at Anglian Water, Northumbrian Water, Southern Water, Thames Water, United Utilities, Yorkshire Water, and Welsh Water/D\u0175r Cymru for their support with wastewater sampling. The support of EPSRC Impact Acceleration Account ( EP/R51164X/1 , ENTRUST IAA ) and GCRF EWS-C19 ( EP/V028499/1 ) is greatly appreciated.

Funders	Funder number
Welsh Water
Public Health Wales
Dŵr Cymru
Health Security Agency
Engineering and Physical Sciences Research Council	GCRF EWS-C19, EP/R51164X/1, EP/V028499/1

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Chemical and viral biomarkers
Lifestyle
Pharmaceuticals
Public health
Viruses
Wastewater-based epidemiology

ASJC Scopus subject areas

Environmental Engineering
Civil and Structural Engineering
Ecological Modelling
Water Science and Technology
Waste Management and Disposal
Pollution

Access to Document

10.1016/j.watres.2025.124370Licence: CC BY

Cite this

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title = "Knowledge discovery by analysis of community wastewater reveals factors driving public health risks",

abstract = "This study tested a wide range of biological and chemical biomarker groups (BCIs) in wastewater from 10 cities in England to gain a better understanding of community exposure to chemicals and health outcomes and to unravel potential associations between disease prevalence, lifestyle choices and key risk factors. For example, viral BCIs showed relatively few correlations, except for norovirus gene abundance which correlated with antibiotic concentrations. Positive correlations between nicotine/cotinine and pharma BCIs indicated smoking as widely reported risk factor in diabetes, asthma/allergies and cardiovascular diseases. Antidiabetics showed complex relationships with various BCIs, e.g. with antibiotics possibly due to diabetes being a risk factor in e.g. respiratory tract, urinary tract and skin infections. Illicit drugs correlated mainly with lifestyle indicators and other recreational substances, including alcohol metabolites and nicotine. This exploratory paper shows the enormous potential of wastewater-based epidemiology (WBE) to enhance our understanding of factors driving public health and wellbeing risks. While WBE correlations cannot imply causation, they can serve as early warning for identification of possible health risks, providing much needed community-health screening aimed at informing patient-focussed interventions.",

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AU - Wade, Matthew J

AU - Jones, Davey L.

PY - 2025/12/1

Y1 - 2025/12/1

N2 - This study tested a wide range of biological and chemical biomarker groups (BCIs) in wastewater from 10 cities in England to gain a better understanding of community exposure to chemicals and health outcomes and to unravel potential associations between disease prevalence, lifestyle choices and key risk factors. For example, viral BCIs showed relatively few correlations, except for norovirus gene abundance which correlated with antibiotic concentrations. Positive correlations between nicotine/cotinine and pharma BCIs indicated smoking as widely reported risk factor in diabetes, asthma/allergies and cardiovascular diseases. Antidiabetics showed complex relationships with various BCIs, e.g. with antibiotics possibly due to diabetes being a risk factor in e.g. respiratory tract, urinary tract and skin infections. Illicit drugs correlated mainly with lifestyle indicators and other recreational substances, including alcohol metabolites and nicotine. This exploratory paper shows the enormous potential of wastewater-based epidemiology (WBE) to enhance our understanding of factors driving public health and wellbeing risks. While WBE correlations cannot imply causation, they can serve as early warning for identification of possible health risks, providing much needed community-health screening aimed at informing patient-focussed interventions.

AB - This study tested a wide range of biological and chemical biomarker groups (BCIs) in wastewater from 10 cities in England to gain a better understanding of community exposure to chemicals and health outcomes and to unravel potential associations between disease prevalence, lifestyle choices and key risk factors. For example, viral BCIs showed relatively few correlations, except for norovirus gene abundance which correlated with antibiotic concentrations. Positive correlations between nicotine/cotinine and pharma BCIs indicated smoking as widely reported risk factor in diabetes, asthma/allergies and cardiovascular diseases. Antidiabetics showed complex relationships with various BCIs, e.g. with antibiotics possibly due to diabetes being a risk factor in e.g. respiratory tract, urinary tract and skin infections. Illicit drugs correlated mainly with lifestyle indicators and other recreational substances, including alcohol metabolites and nicotine. This exploratory paper shows the enormous potential of wastewater-based epidemiology (WBE) to enhance our understanding of factors driving public health and wellbeing risks. While WBE correlations cannot imply causation, they can serve as early warning for identification of possible health risks, providing much needed community-health screening aimed at informing patient-focussed interventions.

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ER -

Knowledge discovery by analysis of community wastewater reveals factors driving public health risks

Abstract

Data Availability Statement

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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