A new one PLUS One The journal paper by University of Louisville researchers highlighted public perceptions of sewer monitoring and safety issues related to wastewater monitoring that can be modified through educational programs. These findings will provide vital information for refining policy, application and regulatory measures related to wastewater-based epidemiology and improving public acceptance.
Study: Nationwide public perceptions of acceptance of wastewater use for community health monitoring in the United States. Image credit: Daniel Jedzura / Shutterstock
Sewage monitoring has emerged as a potentially new and cost-effective component of public health surveillance. Wastewater monitoring involves collecting samples collected from wastewater systems at the community or institutional level. Sewage serves as an aggregate for community-level human waste and a model for community surveillance.
Sewage monitoring can provide valuable insight into the pathogenic viruses, bacteria and protozoa that are prevalent in a community. In terms of public health, wastewater monitoring programs detect infections and diseases that may have escaped or are underreported by standard surveillance systems and may fuel outbreaks.
For example, wastewater monitoring has been used to detect and track outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). During the earlier stages of the coronavirus disease 2019 (COVID-19) pandemic, changes in social restrictions were implemented according to levels of infection in the community. There were concerns about whether sewage monitoring data could be used as evidence to change social behavior and isolation protocols.
The current study investigated whether public perceptions of wastewater monitoring can be used as a public health surveillance tool—through a survey administered to a sample of individuals across the United States.
The study aimed to assess knowledge, awareness, acceptability, confidentiality and variables that influence an individual’s awareness of wastewater monitoring agreement.
The findings provided insights into the acceptance of sewage monitoring and can guide policy formulation to expand sewage monitoring applications at the national and local levels.
Participants were recruited online through Qualtrics XM – a national research panel provider randomly invited to participate in the survey. This survey consisted of three components – questions about knowledge of sewage monitoring and its acceptance; demographic questions, such as age, gender identity, geography, race, ethnicity, education level, and income; and a Privacy Attitude Questionnaire (PAQ) to assess general privacy boundaries.
Location of Respondents
Overall, 3,083 participants answered questionnaires about sewage monitoring as a public health surveillance tool that assessed their knowledge, perceptions, and privacy concerns.
Approximately half of the respondents had no idea whether COVID-19 could be detected in wastewater. People across the United States (US) were generally less aware of sewage monitoring than other types of public health surveillance.
Respondents ––as measured by the PAQ–– indicated moderate levels of privacy concerns, with higher levels of concern regarding personal information and lower levels for financial information.
The majority of respondents supported sewage monitoring, particularly for the identification of toxins, disease and terrorist threats, with a decreasing level of preference in the given sequence. While support appeared to be deteriorating for assessing behaviors and population health status, such as lifestyle, diet and mental illness.
There were no significant privacy concerns associated with nationwide sewage monitoring. In particular, sampling at the city scale received greater support than that at a narrower scale.
Sewage monitoring is an emerging technology, so in areas where public health surveillance is relatively unknown, educational programs may be helpful in modifying public perceptions. The findings of this survey illustrate that while knowledge and awareness of sewage monitoring is low, the US population is specific about what is and is not suitable for monitoring; public opinion must be taken into account.
The study had some caveats – the fact that participants were self-selected and the nature of the survey was concealed until participants met the inclusion requirements. Additionally, survey researchers may have had self-selection bias; respondents were older, wealthier, more educated and from the suburbs; residents of rural areas were excluded and the search was restricted to the USA
More research is needed to assess public attitudes towards sanitation use for community health monitoring worldwide.