Wastewater-based Epidemiology: An Approach for Evaluating the Behavioral and Health Status of the Community Through Wastewater Sample Analysis

Abstract

Background: The increased consumption of pharmaceuticals and chemicals, changes in infectious disease patterns, and the emergence of novel diseases have raised public health concerns. Wastewater-based epidemiology (WBE) enables the extraction of epidemiological information related to lifestyle, health/disease status, and exposure to chemical agents within the target population through wastewater analysis. This study aimed to explore the applications of WBE and identify its challenges. Methods: This study reviewed articles on WBE from three databases (PubMed, Science Direct, and Scopus) and the Google Scholar search engine. Findings: The results showed that chemical and microbial analysis of wastewater can provide extensive epidemiological information, both spatially and temporally, on the behavioral and health status of the target population. These data include indicators such as the use of illicit drugs, alcohol, and tobacco, the consumption of over-the-counter medications, and the burden of viral diseases, particularly the novel coronavirus, within the population covered by the wastewater network. Conclusion: WBE serves as a powerful tool linking environmental sciences, public health, and epidemiology. The findings obtained through this approach provide valuable information for policymakers and public health authorities, aiding in informed decision-making for improving public health and controlling diseases. However, the application of this approach faces challenges, such as markers instability in wastewater, non-human sources of infectious agents, and the lack of standard sampling and analysis protocols in many cases. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved.