Could sewage epidemiology be a strategy to assess lifestyle and wellness of a large scale population?

The use of sewage epidemiology to estimate the behavior of a large scale population has mainly been used to assess illicit drug use within a community. The systemic oxidative stress marker, 8-isoprostane, is a wildly accepted biomarker for various diseases such as diabetes, and cardiovascular and renal diseases. 8-Isoprostane is detected in urine and, as with illicit drugs, is excreted into urban sewer networks. Initially, we tested the hypothesis that differential 8-isoprostane levels are detected in wastewater of different communities and that 8-isoprostane values adjusted for the flow rate and population size will remain constant over a 2 months period. Sewage samples were collected from three sewage collection points supplied by different communities located in the Detroit metropolitan area and concentration of 8-isoprostane and synthetic plastic component, bisphenol A (BPA), were measured. Levels of 8-isoprostane were constant during the two measured months at each collection point in oppose to BPA levels. When the levels were compared among communities, 8-isoprostane levels in 24h flow and their concentrations per capita in each community varied by more than 5-fold among them. Considering the fact that 8-isoprostane is a biomarker of several diseases, we hypothesize that measurement of 8-isoprostane levels in sewage may serve as a risk assessment tool of oxidative stress-related diseases in a large scale population. Thus, sewage epidemiology can be utilized to obtain an early warning in a community to facilitate intervention for improvement of the community health.