Utilizing a National Wastewater Monitoring Program to Address the U.S. Opioid Epidemic: A Focus on Metro Atlanta, Georgia.

The opioid epidemic has continued to be an ongoing public health crisis within Metro Atlanta for the last three decades. However, estimating opioid use and exposure in a large population is almost impossible, and alternative methods are being explored, including wastewater-based epidemiology. Wastewater contains various contaminants that can be monitored to track pathogens, infectious diseases, viruses, opioids, and more. This commentary is focusing on two issues: use of opioid residue data in wastewater as an alternative method for opioid exposure assessment in the community, and the adoption of a streamlined approach that can be utilized by public health officials. Opioid metabolites travel through the sanitary sewer through urine, fecal matter, and improper disposal of opioids to local wastewater treatment plants. Public health officials and researchers within various entities have utilized numerous approaches to reduce the impacts associated with opioid use. National wastewater monitoring programs and wastewater-based epidemiology are approaches that have been utilized globally by researchers and public health officials to combat the opioid epidemic. Currently, public health officials and policy makers within Metro Atlanta are exploring different solutions to reduce opioid use and opioid-related deaths throughout the community. In this commentary, we are proposing a new innovative approach for monitoring opioid use and analyzing trends by utilizing wastewater-based epidemiologic methods, which may help public health officials worldwide manage the opioid epidemic in a large metro area in the future.

Lag Effects of Ozone, PM2.5, and Meteorological Factors on COVID-19 New Cases at the Disease Epicenter in Queens, New York

The influences of environmental factors on COVID-19 may not be immediate and could be lagged for days to weeks. This study investigated the choice of lag days for calculating cumulative lag effects of ozone, PM2.5, and five meteorological factors (wind speed, temperature, relative humidity, absolute humidity, and cloud percentages) on COVID-19 new cases at the epicenter of Queens County, New York, before the governor’s executive order on wearing of masks in public places (1 March to 11 April 2020). Daily data for selected air pollutants and meteorological factors were collected from the US EPA Air Quality System, weather observation station of the NOAA National Centers for Environmental Information at John F. Kennedy Airport, and World Weather Online. Negative binomial regression models were applied, including the autocorrelations and trend of the time series, as well as the effective reproductive number as confounders. The effects of ozone, PM2.5, and five meteorological factors were significant on COVID-19 new cases with lag9-lag13 days. Incidence rate ratios (IRRs) were consistent for any lag day choice between lag0 and lag14 days and started fluctuating after lag15 days. Considering moving averages >14 days yielded less reliable variables for summarizing the cumulative lag effects of environmental factors on COVID-19 new cases and considering lag days from 9 to 13 would yield significant findings. Future studies should consider this approach of lag day checks concerning the modeling of COVID-19 progression in relation to meteorological factors and ambient air pollutants.