1. Development of a national wastewater
drug monitoring program in Australia
Jake O’Brien, on behalf of Ben Tscharke, Cobus Gerber, Sharon Grant, Jason White, Kevin Thomas, Richard Bade, Jochen Mueller AND Rachel Mackie, Phong Thai, Foon Yin Lai, Christoph Ort, Adrian Covaci, Raimondo Bruno, Jeremy Prichard, Coral Gartner, Wayne Hall, Paul Kirkbride, Melissa Humphries, Geoff Eaglesham, Andrew Banks, Steve Carter, Shalona Anuj, Guangming Jiang, Sarit Kaserzon, Jack Gao, Hue Ngyuen, Jenny Braunig, Alex van Nuijs, Dr Been, Saray Mckay, Elissa O’Malley and many more
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2. I declare no conflicts of interest related to this presentation
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3. How can wastewater tell us about what substances people have been using?
What the?
I didn’t have
any corn!!!
A bit of history on our research group. We began collecting wastewater for the purpose of illict drug assessment in 2009 which became Foon (the chair’s) PhD
In Foon’s first paper, we could see “weekly trends”, but how much is from “increase in use per person” or “increase in population”
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4. By measuring metabolites in the wastewater
A bit of history on our research group. We began collecting wastewater for the purpose of illict drug assessment in 2009 which became Foon
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5. Wastewater-based epidemiology for illicit drugs
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6. CATCHMENT POPULATION DOSES OF DRUG CONSUMED/1000 PEOPLE
(calculated)
(number of doses of drug consumed on average by 1000 people
in the catchment in 24 hours)
Community
Divide by the mass of
drug typically
consumed in one go
(i.e. the standard dose)
MASS OF DRUG CONSUMED/1000 PEOPLE
(calculated)
(grams of drug consumed on average by 1000 people
in the catchment in 24 hours)
Community-wide facilities
e.g. shopping malls/
hotels/events/
offices/
industry
Community services
e.g. hospitals/
universities/
prisons
Divide by excretion rate i.e. the mass of metabolite excreted for every unit of drug consumed, and multiply by the difference in molecular weight between the drug and its’ metabolite
CATCHMENT POPULATION
MASS OF METABOLITE EXCRETED/1000 PEOPLE
(calculated)
(grams of metabolite excreted on average by 1000 people
in the catchment in 24 hours)
CONCENTRATION OF EXCRETED METABOLITE
(measured)
(wastewater entering the WWTP is sampled over a 24 hour period. The average concentration of metabolite is measured,
i.e. grams of metabolite per litre of wastewater)
Divide by catchment population
(thousands of people)
Autosampler at
WWTP
inlet
TOTAL MASS OF METABOLITE EXCRETED
(calculated)
(total grams of excreted metabolite that reaches the WWTP from the catchment in 24 hours)
Wastewater treatment plant
(WWTP)
Multiply concentration by total volume of wastewater flowing into WWTP over 24 hours

7. CATCHMENT POPULATION DOSES OF DRUG CONSUMED/1000 PEOPLE
(calculated)
(number of doses of drug consumed on average by 1000 people
in the catchment in 24 hours)
Community
Divide by the mass of
drug typically
consumed in one go
(i.e. the standard dose)
MASS OF DRUG CONSUMED/1000 PEOPLE
(calculated)
(grams of drug consumed on average by 1000 people
in the catchment in 24 hours)
Community-wide facilities
e.g. shopping malls/
hotels/events/
offices/
industry
Community services
e.g. hospitals/
universities/
prisons
Divide by excretion rate i.e. the mass of metabolite excreted for every unit of drug consumed, and multiply by the difference in molecular weight between the drug and its’ metabolite
CATCHMENT POPULATION
MASS OF METABOLITE EXCRETED/1000 PEOPLE
(calculated)
(grams of metabolite excreted on average by 1000 people
in the catchment in 24 hours)
CONCENTRATION OF EXCRETED METABOLITE
(measured)
(wastewater entering the WWTP is sampled over a 24 hour period. The average concentration of metabolite is measured,
i.e. grams of metabolite per litre of wastewater)
Divide by catchment population
(thousands of people)
Autosampler at
WWTP
inlet
TOTAL MASS OF METABOLITE EXCRETED
(calculated)
(total grams of excreted metabolite that reaches the WWTP from the catchment in 24 hours)
Wastewater treatment plant
(WWTP)
Multiply concentration by total volume of wastewater flowing into WWTP over 24 hours

8. Estimated consumption (mg/day/1000 people)
Per Capita Daily Methamphetamine Consumption in 2015
41 % of population
7 consecutive days
Estimated consumption (mg/day/1000 people)
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9. Estimated consumption (mg/day/1000 people)
Per Capita Daily Methamphetamine Consumption in 2015
41 % of population
7 consecutive days
Estimated consumption (mg/day/1000 people)
Five fold increase from
Coastal metro catchment

10. Estimated consumption (mg/day/1000 people)
Per Capita Daily Methamphetamine Consumption in 2015
41 % of population
7 consecutive days
Estimated consumption (mg/day/1000 people)
Five fold increase from
Regional catchment

11. In contrast, METH use was ranked relatively higher in our cities than other EU cities. The use of METH in the urban area was even up over the roof.
Overall, you can see, we can apply wastewater analysis to obtain an insight of timely, quantitative and evidence-based estimates of illicit drug use across different communities and time scales, which can effectively complement to other existing epidemiology methods for better assessment of the effectiveness in health and law enforcement policies.
2014/15 – among highest MA consumption in 2 Australian cities that were in the lowest quartile in Australia
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12. National Wastewater Drug Monitoring Pilot Program (3 years)
C = capital city WWTP
Bimonthly sampling
r = regional WWTP
quarterly sampling
illicit drugs, alcohol
tobacco
Funded by Australian
Criminal
Intelligence
Commission
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13. Logistical Challenges….
Australian Capital Cities

14. First sample collection during Australian Census
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15. Census Project - 4000 bottles of wastewater
- Inf & Eff untreated, acidified & biocide treated
- Biosolids
- New walk-in freezer – full
> 30 K AUD in courier costs.
- Massive support from partners across Australia
- Toughest part of the project seems to be achieved

16. Per year…. ~3000 bottles of wastewater ~500 boxes to ship To and Back ~25,000 analytical measurements ~1500 flow measurements >50 catchment maps and sewer surveys required

17. Explain the graphs

18. Estimated Alcohol Consumption
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19. International Alcohol Consumption Comparison
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20. Estimated Tobacco Consumption
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21. International Tobacco Consumption Comparison
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22. Estimated Cocaine Consumption
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23. Estimated MDMA Consumption
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24. Estimated Oxycodone Consumption
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25. Estimated Fentanyl Consumption
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26. Summarised data at state level

27. Location specific time trend data
MDMA
Methamphetamine
Cocaine

28. Take home messages
National drug monitoring using wastewater analysis can provide timely data on population consumption of chemicals
It is not an easy task when you have to work across multiple jurisdictions/companies
You must give ADVANCED warning and DEADLINES for everything
Instructions, sample packs, data collection must be simple
Colour coordinate where possible and present the same data multiple ways
Archiving wastewater samples and extracts allows for measuring other chemicals once methods are developed and/or chemicals become a priority
Don’t underestimate your data size and data management
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30. Thanks for listening!
National Wastewater Drug Monitoring Program reports:
Queensland Alliance for Environmental Health Sciences
European Wastewater Analysis
Contact:
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