Structured Ethical Review for Wastewater-Based Testing in Support of Public Health

Devin A Bowes^{1

2}, Amanda Darling³, Erin M Driver¹, Devrim Kaya^{4

5}, Rasha Maal-Bared⁶, Lisa M Lee⁷, Kenneth Goodman⁸, Sangeet Adhikari¹, Srijan Aggarwal⁹, Aaron Bivins¹⁰, Zuzana Bohrerova¹¹, Alasdair Cohen^{3

12}, Claire Duvallet¹³, Rasha A Elnimeiry¹⁴, Justin M Hutchison¹⁵, Vikram Kapoor¹⁶, Ishi Keenum¹⁷, Fangqiong Ling¹⁸, Deborah Sills¹⁹, Ananda Tiwari^{20

21}, Peter Vikesland³, Ryan Ziels²², Cresten Mansfeldt^{23

24}

Affiliations

¹ Biodesign Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, Arizona 85287, United States.
² Center on Forced Displacement, Boston University, 111 Cummington Mall, Boston, Massachusetts 02215, United States.
³ Department of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street, 415 Durham Hall; Blacksburg, Virginia 24061, United States.
⁴ School of Chemical, Biological, and Environmental Engineering, Oregon State University, 105 26th St, Corvallis, Oregon 97331, United States.
⁵ School of Public Health, San Diego State University, San Diego and Imperial Valley, California 92182, United States.
⁶ Quality Assurance and Environment, EPCOR Water Services Inc., EPCOR Tower, 2000-10423 101 Street NW, Edmonton, Alberta T5H 0E7, Canada.
⁷ Department of Population Health Sciences and Division of Scholarly Integrity and Research Compliance, Virginia Tech, 300 Turner St. NW, Suite 4120 (0497), Blacksburg, Virginia 24061, United States.
⁸ Institute for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Miami, Florida 33101, United States.
⁹ Department of Civil, Geological, and Environmental Engineering, University of Alaska Fairbanks, 1764 Tanana Loop, Fairbanks, Alaska 99775, United States.
¹⁰ Department of Civil & Environmental Engineering, Louisiana State University, 3255 Patrick F. Taylor Hall, Baton Rouge, Louisiana 70803, United States.
¹¹ The Ohio State University, Department of Civil, Environmental and Geodetic Engineering, 2070 Neil Avenue, 470 Hitchcock Hall, Columbus, Ohio 43210, United States.
¹² Department of Population Health Sciences, Virginia Tech, 205 Duck Pond Drive, Blacksburg, Virginia 24061, United States.
¹³ Biobot Analytics, Inc., 501 Massachusetts Avenue; Cambridge, Massachusetts 02139, United States.
¹⁴ Public Health Outbreak Coordination, Informatics, Surveillance (PHOCIS) Office─Surveillance Section, Division of Disease Control and Health Statistics, Washington State Department of Health, 111 Israel Rd SE, Tumwater, Washington 98501, United States.
¹⁵ Department of Civil, Environmental, and Architectural Engineering, University of Kansas, 1530 W 15th St, Lawrence, Kansas 66045, United States.
¹⁶ School of Civil & Environmental Engineering, and Construction Management, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, Texas 78249, United States.
¹⁷ Complex Microbial Systems Group, National Institute of Standards and Technology, 100 Bureau Dr, Gaithersburg, Maryland 20899, United States.
¹⁸ Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, Missouri 63130, United States.
¹⁹ Department of Civil and Environmental Engineering, Bucknell University, Lewisburg, Pennsylvania 17837, United States.
²⁰ Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Agnes Sjöberginkatu 2, P.O. Box 66, FI 00014 Helsinki, Finland.
²¹ Expert Microbiology Unit, Finnish Institute for Health and Welfare, FI 70600 Kuopio, Finland.
²² Department of Civil Engineering, The University of British Columbia, 6250 Applied Science Ln #2002, Vancouver, BC V6T 1Z4, Canada.
²³ Department of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder, UCB 428, Boulder, Colorado 80309, United States.
²⁴ Environmental Engineering Program, University of Colorado Boulder, UCB 607, Boulder, Colorado 80309, United States.

PMID: 37611169
PMCID: PMC10484207
DOI: 10.1021/acs.est.3c04529

Structured Ethical Review for Wastewater-Based Testing in Support of Public Health

Devin A Bowes et al. Environ Sci Technol. 2023.

. 2023 Sep 5;57(35):12969-12980.

doi: 10.1021/acs.est.3c04529. Epub 2023 Aug 23.

Authors

Affiliations

¹ Biodesign Center for Environmental Health Engineering, The Biodesign Institute, Arizona State University, 1001 S. McAllister Ave, Tempe, Arizona 85287, United States.
² Center on Forced Displacement, Boston University, 111 Cummington Mall, Boston, Massachusetts 02215, United States.
³ Department of Civil and Environmental Engineering, Virginia Tech, 1145 Perry Street, 415 Durham Hall; Blacksburg, Virginia 24061, United States.
⁴ School of Chemical, Biological, and Environmental Engineering, Oregon State University, 105 26th St, Corvallis, Oregon 97331, United States.
⁵ School of Public Health, San Diego State University, San Diego and Imperial Valley, California 92182, United States.
⁶ Quality Assurance and Environment, EPCOR Water Services Inc., EPCOR Tower, 2000-10423 101 Street NW, Edmonton, Alberta T5H 0E7, Canada.
⁷ Department of Population Health Sciences and Division of Scholarly Integrity and Research Compliance, Virginia Tech, 300 Turner St. NW, Suite 4120 (0497), Blacksburg, Virginia 24061, United States.
⁸ Institute for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Miami, Florida 33101, United States.
⁹ Department of Civil, Geological, and Environmental Engineering, University of Alaska Fairbanks, 1764 Tanana Loop, Fairbanks, Alaska 99775, United States.
¹⁰ Department of Civil & Environmental Engineering, Louisiana State University, 3255 Patrick F. Taylor Hall, Baton Rouge, Louisiana 70803, United States.
¹¹ The Ohio State University, Department of Civil, Environmental and Geodetic Engineering, 2070 Neil Avenue, 470 Hitchcock Hall, Columbus, Ohio 43210, United States.
¹² Department of Population Health Sciences, Virginia Tech, 205 Duck Pond Drive, Blacksburg, Virginia 24061, United States.
¹³ Biobot Analytics, Inc., 501 Massachusetts Avenue; Cambridge, Massachusetts 02139, United States.
¹⁴ Public Health Outbreak Coordination, Informatics, Surveillance (PHOCIS) Office─Surveillance Section, Division of Disease Control and Health Statistics, Washington State Department of Health, 111 Israel Rd SE, Tumwater, Washington 98501, United States.
¹⁵ Department of Civil, Environmental, and Architectural Engineering, University of Kansas, 1530 W 15th St, Lawrence, Kansas 66045, United States.
¹⁶ School of Civil & Environmental Engineering, and Construction Management, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, Texas 78249, United States.
¹⁷ Complex Microbial Systems Group, National Institute of Standards and Technology, 100 Bureau Dr, Gaithersburg, Maryland 20899, United States.
¹⁸ Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, Missouri 63130, United States.
¹⁹ Department of Civil and Environmental Engineering, Bucknell University, Lewisburg, Pennsylvania 17837, United States.
²⁰ Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Agnes Sjöberginkatu 2, P.O. Box 66, FI 00014 Helsinki, Finland.
²¹ Expert Microbiology Unit, Finnish Institute for Health and Welfare, FI 70600 Kuopio, Finland.
²² Department of Civil Engineering, The University of British Columbia, 6250 Applied Science Ln #2002, Vancouver, BC V6T 1Z4, Canada.
²³ Department of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder, UCB 428, Boulder, Colorado 80309, United States.
²⁴ Environmental Engineering Program, University of Colorado Boulder, UCB 607, Boulder, Colorado 80309, United States.

PMID: 37611169
PMCID: PMC10484207
DOI: 10.1021/acs.est.3c04529

Abstract

Wastewater-based testing (WBT) for SARS-CoV-2 has rapidly expanded over the past three years due to its ability to provide a comprehensive measurement of disease prevalence independent of clinical testing. The development and simultaneous application of WBT measured biomarkers for research activities and for the pursuit of public health goals, both areas with well-established ethical frameworks. Currently, WBT practitioners do not employ a standardized ethical review process, introducing the potential for adverse outcomes for WBT professionals and community members. To address this deficiency, an interdisciplinary workshop developed a framework for a structured ethical review of WBT. The workshop employed a consensus approach to create this framework as a set of 11 questions derived from primarily public health guidance. This study retrospectively applied these questions to SARS-CoV-2 monitoring programs covering the emergent phase of the pandemic (3/2020-2/2022 (n = 53)). Of note, 43% of answers highlight a lack of reported information to assess. Therefore, a systematic framework would at a minimum structure the communication of ethical considerations for applications of WBT. Consistent application of an ethical review will also assist in developing a practice of updating approaches and techniques to reflect the concerns held by both those practicing and those being monitored by WBT supported programs.

Keywords: SARS-CoV-2; Wastewater-based epidemiology; building-scale; ethics; structured review; sub-sewershed.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing financial interest.

Figures

**Figure 1**
Distribution of assigned flags (“minimal review required”, “review suggested”, “review strongly suggested”, “not available in the main text”, “not applicable”) for the top 11 categories in the structured ethical review, represented as a fraction percent of all publications analyzed (n = 53) with multiple reviewers providing reports for select individual studies, resulting in more reviews than studies (n = 79).^,−,− In total, 56 publications were represented by these studies, with 3 having two publications describing the same monitoring campaign and considered in concert. The categories are sorted by ascending proportion of “minimal review required”.

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Update of

Structured Ethical Review for Wastewater-Based Testing.
Bowes DA, Darling A, Driver EM, Kaya D, Maal-Bared R, Lee LM, Goodman K, Adhikari S, Aggarwal S, Bivins A, Bohrerova Z, Cohen A, Duvallet C, Elnimeiry RA, Hutchison JM, Kapoor V, Keenum I, Ling F, Sills D, Tiwari A, Vikesland P, Ziels R, Mansfeldt C. Bowes DA, et al. medRxiv [Preprint]. 2023 Jun 14:2023.06.12.23291231. doi: 10.1101/2023.06.12.23291231. medRxiv. 2023. Update in: Environ Sci Technol. 2023 Sep 5;57(35):12969-12980. doi: 10.1021/acs.est.3c04529. PMID: 37398480 Free PMC article. Updated. Preprint.

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Structured Ethical Review for Wastewater-Based Testing in Support of Public Health

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Structured Ethical Review for Wastewater-Based Testing in Support of Public Health

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