I have posted a number of previous notes about screening urine samples for illegal drugs, particularly in the workplace. A new approach to urine testing now presents itself that I think will be of interest to clinical lab professionals: testing the waste water in cities for traces of drugs (see: Community Urinalysis). No need to wait for someone to fill a cup. No supervised specimen collection. Below is an excerpt from the article:
Everyone knows how a drug test works: You urinate into a cup and your employer (or prospective employer) has the sample tested to see if you’ve been using any illegal substances. This year, though, Jennifer Field, an environmental chemist at Oregon State University, experimented with an unusual variation on this process. She found out what illicit drugs the population of an entire city was ingesting. How? By collecting and then testing water from the city’s sewage-treatment plant....[W]hen Field’s team tested a mere teaspoonful of water from a sewage plant ...the sample revealed the presence of 11 different drugs, including cocaine and methamphetamine.The research team called this technique community urinalysis....Because it allows for sampling on a daily basis, community urinalysis can track a drug epidemic in real time, showing the police and doctors how the popularity of a particular drug is waxing or waning. For instance, Field says that the use of methamphetamine was constant from day to day ...whereas the usage of cocaine sometimes peaked on weekends. One affluent community that Field tested showed very few drugs except cocaine; by contrast, methamphetamine levels varied widely from city to city. And the single most popular drug? Caffeine.
Great idea! However, why stop at community urinalysis for drugs of abuse. Why not move on to other urine analytes such as creatinine, ketones, or leukocyte esterase. Or perhaps it might be of interest to quantify titers of prescription drugs, or the metabolic products of them, to determine the prevalence of their use in a community. Mash these data together, using the appropriate algorithms, and it may be possible to calculate some sort of health index for an entire community including the extent to which the various conditions are being treated.
The only thing I am a little confused about is who to bill for all of this testing. Would the officials of the waste water treatment plant in the community be a good place to start?
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