Recent trends in wastewater-based epidemiology of pharmaceuticals. Methods and applications

Carlos Pernas-Fraguela; Rosa Montes; Rosario Rodil; Verónica Castro; José Benito Quintana; Andrea Estévez-Danta

doi:10.1016/j.trac.2026.118746

Recent trends in wastewater-based epidemiology of pharmaceuticals. Methods and applications

Carlos Pernas-Fraguela, Rosa Montes, Rosario Rodil, Verónica Castro, José Benito Quintana, Andrea Estévez-Danta

Research output: Contribution to journal › Review article › peer-review

Abstract

This review article discusses the latest research on wastewater-based epidemiology (WBE) of pharmaceuticals since 2020. It covers the analytical methods that have been used to measure pharmaceuticals and their metabolites, mostly relying on off-line solid-phase extraction followed by liquid chromatography-tandem mass spectrometry. Then, we focus on general considerations related to WBE, such as biomarkers stability or back-calculation of drug use by using correction factors. We found that over 130 drugs have been analyzed and their wastewater concentrations converted to pharmaceutical use estimations, of which those related with the nervous system (ATC level 1 code N) have been by far the most frequently investigated. Subsequently the review focusses on studies related to the spatio-temporal assessment of drug use, with a specific section devoted to the impact of COVID-19 pandemic. Then, it covers studies which contrast WBE estimations of drug use with pharmaceutical dispensing data and how they complement each other.

Original language	English
Article number	118746
Journal	Trac - Trends in Analytical Chemistry
Volume	198
Early online date	13 Feb 2026
DOIs	https://doi.org/10.1016/j.trac.2026.118746
Publication status	E-pub ahead of print - 13 Feb 2026
Externally published	Yes

Data Availability Statement

No data was used for the research described in the article.

Acknowledgements

This review article is dedicated to the memory of Yolanda Picó, Professor at the University of Valencia (Spain), who sadly passed away on February 2025. Prof. Picó was an outstanding researcher who greatly contributed to the development of wastewater-based epidemiology. We will always appreciate your collaborative spirit and friendship and will live on in our memories!

Funding

This work was funded by Instituto de Salud Carlos III/ERDF/FEDER (RD24/0003/0020, RIAPAd network), Spanish Agencia Estatal de Investigación MCIN/AEI/10.13039/501100011033 /ERDF/FEDER (PID2024-156804OB-C32) and Xunta de Galicia (ED431C 2025/21 and ED481B-2025/042). C. Pernas-Fraguela thanks the Spanish Ministerio de Educación, Formación Profesional y Deportes for his predoctoral contract (FPU23/01870).

Keywords

Drug metabolism
SARS-CoV-2
Sewage
Wastewater analysis
Wastewater environmental surveillance (WES)

ASJC Scopus subject areas

Analytical Chemistry
Spectroscopy

Access to Document

10.1016/j.trac.2026.118746Licence: CC BY

Cite this

@article{a5c35651fadb47b9aff45a7396bcbef1,

title = "Recent trends in wastewater-based epidemiology of pharmaceuticals. Methods and applications",

abstract = "This review article discusses the latest research on wastewater-based epidemiology (WBE) of pharmaceuticals since 2020. It covers the analytical methods that have been used to measure pharmaceuticals and their metabolites, mostly relying on off-line solid-phase extraction followed by liquid chromatography-tandem mass spectrometry. Then, we focus on general considerations related to WBE, such as biomarkers stability or back-calculation of drug use by using correction factors. We found that over 130 drugs have been analyzed and their wastewater concentrations converted to pharmaceutical use estimations, of which those related with the nervous system (ATC level 1 code N) have been by far the most frequently investigated. Subsequently the review focusses on studies related to the spatio-temporal assessment of drug use, with a specific section devoted to the impact of COVID-19 pandemic. Then, it covers studies which contrast WBE estimations of drug use with pharmaceutical dispensing data and how they complement each other.",

keywords = "Drug metabolism, SARS-CoV-2, Sewage, Wastewater analysis, Wastewater environmental surveillance (WES)",

author = "Carlos Pernas-Fraguela and Rosa Montes and Rosario Rodil and Ver{\'o}nica Castro and Quintana, \{Jos{\'e} Benito\} and Andrea Est{\'e}vez-Danta",

year = "2026",

month = feb,

day = "13",

doi = "10.1016/j.trac.2026.118746",

language = "English",

volume = "198",

journal = "Trac - Trends in Analytical Chemistry",

issn = "0165-9936",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Recent trends in wastewater-based epidemiology of pharmaceuticals. Methods and applications

AU - Pernas-Fraguela, Carlos

AU - Montes, Rosa

AU - Rodil, Rosario

AU - Castro, Verónica

AU - Quintana, José Benito

AU - Estévez-Danta, Andrea

PY - 2026/2/13

Y1 - 2026/2/13

N2 - This review article discusses the latest research on wastewater-based epidemiology (WBE) of pharmaceuticals since 2020. It covers the analytical methods that have been used to measure pharmaceuticals and their metabolites, mostly relying on off-line solid-phase extraction followed by liquid chromatography-tandem mass spectrometry. Then, we focus on general considerations related to WBE, such as biomarkers stability or back-calculation of drug use by using correction factors. We found that over 130 drugs have been analyzed and their wastewater concentrations converted to pharmaceutical use estimations, of which those related with the nervous system (ATC level 1 code N) have been by far the most frequently investigated. Subsequently the review focusses on studies related to the spatio-temporal assessment of drug use, with a specific section devoted to the impact of COVID-19 pandemic. Then, it covers studies which contrast WBE estimations of drug use with pharmaceutical dispensing data and how they complement each other.

AB - This review article discusses the latest research on wastewater-based epidemiology (WBE) of pharmaceuticals since 2020. It covers the analytical methods that have been used to measure pharmaceuticals and their metabolites, mostly relying on off-line solid-phase extraction followed by liquid chromatography-tandem mass spectrometry. Then, we focus on general considerations related to WBE, such as biomarkers stability or back-calculation of drug use by using correction factors. We found that over 130 drugs have been analyzed and their wastewater concentrations converted to pharmaceutical use estimations, of which those related with the nervous system (ATC level 1 code N) have been by far the most frequently investigated. Subsequently the review focusses on studies related to the spatio-temporal assessment of drug use, with a specific section devoted to the impact of COVID-19 pandemic. Then, it covers studies which contrast WBE estimations of drug use with pharmaceutical dispensing data and how they complement each other.

KW - Drug metabolism

KW - SARS-CoV-2

KW - Sewage

KW - Wastewater analysis

KW - Wastewater environmental surveillance (WES)

UR - https://www.scopus.com/pages/publications/105030439701

U2 - 10.1016/j.trac.2026.118746

DO - 10.1016/j.trac.2026.118746

M3 - Review article

AN - SCOPUS:105030439701

SN - 0165-9936

VL - 198

JO - Trac - Trends in Analytical Chemistry

JF - Trac - Trends in Analytical Chemistry

M1 - 118746

ER -

Recent trends in wastewater-based epidemiology of pharmaceuticals. Methods and applications

Abstract

Data Availability Statement

Acknowledgements

Funding

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this