Wiktoria Kurzeja, Jan Matysiak, Agnieszka Klupczyńska-Gabryszak

Wastewater-based epidemiology in the monitoring of community health and environmental exposure

2026-06-01

Wastewater-based epidemiology (WBE) has emerged as a powerful and rapidly evolving approach for assessing population-level exposure to chemical and biological agents through the analysis of municipal wastewater. By providing aggregated, objective data, WBE enables evaluation of community-wide consumption patterns and exposure trends without relying on self-reported information. This review summarizes the fundamental principles and key applications of WBE, with particular emphasis on the monitoring of illicit drugs, pharmaceuticals, biomarkers of infectious diseases, environmental pollutants, and other indicators of lifestyle and population health. A wide range of target compounds, including drug metabolites, endogenous biomarkers, and pathogen-specific genetic material (DNA/RNA), can be detected using advanced analytical techniques. The advantages of WBE, including its objectivity and capability for near real-time monitoring, are highlighted alongside key limitations related to analytical sensitivity, matrix complexity, environmental variability, and uncertainties associated with back-calculation models. Particular attention is given to ethical considerations, including data governance, privacy concerns, and the responsible communication and interpretation of results, especially in the context of potentially sensitive public health information. Furthermore, challenges related to the lack of methodological standardization, population normalization, and analyte stability in sewer systems are discussed as critical factors influencing data quality and comparability. Future perspectives of WBE are discussed, focusing on the expansion of its applications toward infectious disease surveillance, assessment of population exposure to environmental factors, and the integration of advanced analytical approaches for comprehensive public health evaluation. Continued methodological advancements, along with the development of harmonized protocols and international collaborative frameworks, are expected to further enhance the reliability and applicability of WBE as a comprehensive tool for public health and environmental monitoring.

Keywords: wastewater-based epidemiology, wastewater, sewage, public health.

© Farm Pol, 2025, 81(11): 645–654