title: Comparison of pharmaceutical, illicit drug, alcohol, nicotine and caffeine levels in wastewater with sale, seizure and consumption data for 8 European cities.
abstract: Monitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys.
  
  
  
  This study aims to compare and correlate the consumption estimates of pharmaceuticals, illicit drugs, alcohol, nicotine and caffeine from wastewater analysis and other sources of information. Wastewater samples were collected in 2015 from 8 different European cities over a one week period, representing a population of approximately 5 million people. Published pharmaceutical sale, illicit drug seizure and alcohol, tobacco and caffeine use data were used for the comparison.
  
  
  
  High agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data. Most of the poor correlations were explained as part of the uncertainties related with the use estimates and were improved with other complementary sources of data.
  
  
  
  This work confirms the promising future of WBE as a complementary approach to obtain a more accurate picture of substance use situation within different communities. Our findings suggest further improvements to reduce the uncertainties associated with both sources of information in order to make the data more comparable.
authors.affiliation: Norwegian Institute for Water Research (NIVA), Gaustadalléen 21, Oslo, NO-0349, Norway. Joseantonio.baz@niva.no.|Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, PO box 1078, Blindern, Oslo, 0316, Norway. Joseantonio.baz@niva.no.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Baz-Lomba
authors.affiliation: Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, PO box 1078, Blindern, Oslo, 0316, Norway.
authors.forename: Stefania
authors.initials: S
authors.lastname: Salvatore
authors.affiliation: IRCCS-Istituto di Recerche Farmacologiche "Mario Negri", Via La Masa 19, Milan, 20156, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Gracia-Lor
authors.affiliation: Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, Castellón, E-12071, Spain.
authors.forename: Richard
authors.initials: R
authors.lastname: Bade
authors.affiliation: IRCCS-Istituto di Recerche Farmacologiche "Mario Negri", Via La Masa 19, Milan, 20156, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Castiglioni
authors.affiliation: Department of Chemistry, University of Bath, Faculty of Science, Bath, BA2 7AY, UK.
authors.forename: Erika
authors.initials: E
authors.lastname: Castrignanò
authors.affiliation: KWR Watercycle Research Institute, Chemical Water Quality and Health, P.O. Box 1072, Nieuwegein, 3430 BB, The Netherlands.
authors.forename: Ana
authors.initials: A
authors.lastname: Causanilles
authors.affiliation: Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, Castellón, E-12071, Spain.
authors.forename: Felix
authors.initials: F
authors.lastname: Hernandez
authors.affiliation: Department of Chemistry, University of Bath, Faculty of Science, Bath, BA2 7AY, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kasprzyk-Hordern
authors.affiliation: Department of Pharmaceutical Sciences, Toxicological Center, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp, 2610, Belgium.
authors.forename: Juliet
authors.initials: J
authors.lastname: Kinyua
authors.affiliation: Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, CH-8600, Switzerland.
authors.forename: Ann-Kathrin
authors.initials: AK
authors.lastname: McCall
authors.affiliation: Department of Pharmaceutical Sciences, Toxicological Center, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp, 2610, Belgium.
authors.forename: Alexander
authors.initials: A
authors.lastname: van Nuijs
authors.affiliation: Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, CH-8600, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ort
authors.affiliation: Department of Environmental Engineering, Technical University of Denmark, Miljøvej, Building 115, Kgs. Lyngby, DK-2800, Denmark.
authors.forename: Benedek G
authors.initials: BG
authors.lastname: Plósz
authors.affiliation: Department of Environmental Engineering, Technical University of Denmark, Miljøvej, Building 115, Kgs. Lyngby, DK-2800, Denmark.
authors.forename: Pedram
authors.initials: P
authors.lastname: Ramin
authors.affiliation: Norwegian Institute for Water Research (NIVA), Gaustadalléen 21, Oslo, NO-0349, Norway.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Reid
authors.affiliation: IRCCS-Istituto di Recerche Farmacologiche "Mario Negri", Via La Masa 19, Milan, 20156, Italy.
authors.forename: Nikolaos I
authors.initials: NI
authors.lastname: Rousis
authors.affiliation: Norwegian Institute for Water Research (NIVA), Gaustadalléen 21, Oslo, NO-0349, Norway.
authors.forename: Yeonsuk
authors.initials: Y
authors.lastname: Ryu
authors.affiliation: KWR Watercycle Research Institute, Chemical Water Quality and Health, P.O. Box 1072, Nieuwegein, 3430 BB, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: de Voogt
authors.affiliation: Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, PO box 1078, Blindern, Oslo, 0316, Norway.
authors.forename: Jorgen
authors.initials: J
authors.lastname: Bramness
authors.affiliation: Norwegian Institute for Water Research (NIVA), Gaustadalléen 21, Oslo, NO-0349, Norway.
authors.forename: Kevin
authors.initials: K
authors.lastname: Thomas
mesh_terms: D000428:Alcohol Drinking; D000662:Amphetamines / Q000008:administration & dosage / Q000032:analysis; D001628:Beverages; D002110:Caffeine / Q000008:administration & dosage / Q000032:analysis; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000032:analysis; D002947:Cities; D003042:Cocaine / Q000008:administration & dosage / Q000032:analysis; D003132:Commerce; D000431:Ethanol / Q000008:administration & dosage / Q000032:analysis; D005060:Europe; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D008694:Methamphetamine / Q000008:administration & dosage / Q000032:analysis; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000008:administration & dosage / Q000032:analysis; D009538:Nicotine / Q000008:administration & dosage / Q000032:analysis; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000032:analysis; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders; D014026:Nicotiana / Q000737:chemistry; D064424:Tobacco Use; D062065:Wastewater / Q000737:chemistry*; D014874:Water Pollutants, Chemical / Q000032:analysis*
chemical_list: D000662:Amphetamines; D002110:Caffeine; D000697:Central Nervous System Stimulants; D003042:Cocaine; D000431:Ethanol; D013287:Illicit Drugs; D008694:Methamphetamine; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D009538:Nicotine; D004364:Pharmaceutical Preparations; D062065:Wastewater; D014874:Water Pollutants, Chemical
keywords: Drug consumption, Correlation, Europe-wide study, Seizures, Sales statistics; Wastewater-based epidemiology