Wastewater-based epidemiology has taken a step forward after the onset of the global pandemic. It also has provoked new ethical and legal questions and considerations with its latest applications. Wastewater-based epidemiology is not merely a part of engineering (environmental science or analytical chemistry) and public health, but it expands into the social sciences, ethico-political issues, and data privacy. As the tool moves beyond the mere measurement of chemical markers to include genetic information, prominently on viruses such as SARS-CoV-2 first but also other genetic fragments, including those co-extracted and containing human RNA or DNA, caution is warranted. Various high throughput molecular omnics of sewage pose an essential question concerning ethical and legal considerations in applying different applications of WBE, with the monitoring capacity and adoption rate potentially outpacing the speed at which ethical and legal frameworks can evolve and are being developed. While the WBE approach is being heralded as a noninvasive tool that is not and cannot be linked to individuals, the work described in the existing literature points the way to scenarios where the distinguishing line between clinical studies and population health monitoring are getting blurred. Furthermore, there is the issue of stigma which can affect individuals, neighborhoods, and entire cities alike. In the ongoing discussions regarding the potential stigmatization of a population monitored within a given catchment area, an awareness is building for how chemicals and biological indicators potentially can lead to painting a picture of a community that is ridden by adverse conditions, from the occurrence of infectious diseases (including sexually transmittable diseases) to widespread use of licit and illicit drugs. Some WBE researchers argue that there is no possible re-identification of an individual. However, others believe that anonymity is a function of population size, where for example the last maintenance hole on a cul-de-sac may reflect the chemistry of a single occupant of a single-person household at the end of the street. For this reason, WBE researchers are strongly encouraged if not morally obligated to periodically review their monitoring campaigns on a case-by-case basis depending on the specific applications planned.

Wastewater-based epidemiology and ethical considerations

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ACS Fall 2022

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