Environmental proteomics: a potential tool in wastewater-based epidemiology

Wastewater-based epidemiology (WBE) is a new complementary alternative to traditional epidemiological surveillance approaches for community health surveys. It provides objective, flexible, and comprehensive data on diseases, exposure to toxicants and pathogens, social habits, and lifestyle. Wastewater is regarded as an integrated pooled sample of the entire population served by a certain wastewater system, thus providing an average picture of its health status. WBE relies on the extraction, analysis, and subsequent interpretation of appropriate health status indicators, including both chemical and biological components, either exogenous or endogenous, altogether constituting the exposome. Instrumental development, especially mass spectrometry (MS) for the chemical analysis of small and large molecules, has been critical to the success achieved through WBE. Whereas all previous studies have been restricted to small molecules, the use of proteomics in WBE is an obvious extension of the intensive ongoing pursuit of biomarkers for community surveillance of diseases and health status. The relevance of human proteins present in wastewater as potential WBE indicators of population-prevalent diseases has been previously postulated, although no real examples to demonstrate their feasibility have been available until recently. These findings provide new insights into the characterization of wastewater proteomics useful for practical purposes related not only to WBE applications but also to environmental monitoring and wastewater treatment plant management.