A nationwide wastewater-based assessment of metformin consumption across Australia
Metformin is the most widely used drug to treat type 2 diabetes. Monitoring spatial patterns of metformin use could provide new insights into treatment of type 2 diabetes and the distribution among populations. This study applied a wastewater-based epidemiological (WBE) approach to estimate metformi...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Environment International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412022002094 |
| _version_ | 1818555639649009664 |
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| author | Dan Yang Qiuda Zheng Phong K. Thai Fahad Ahmed Jake W. O'Brien Jochen F. Mueller Kevin V. Thomas Ben Tscharke |
| author_facet | Dan Yang Qiuda Zheng Phong K. Thai Fahad Ahmed Jake W. O'Brien Jochen F. Mueller Kevin V. Thomas Ben Tscharke |
| author_sort | Dan Yang |
| collection | DOAJ |
| description | Metformin is the most widely used drug to treat type 2 diabetes. Monitoring spatial patterns of metformin use could provide new insights into treatment of type 2 diabetes and the distribution among populations. This study applied a wastewater-based epidemiological (WBE) approach to estimate metformin use in different populations across Australia and compared these estimates with traditional approaches of surveys and prescription data. Twenty-four-hour influent samples were collected from 75 wastewater treatment plants (WWTPs) across Australia in 2016 and analysed for metformin. Metformin was detected in all samples ranging in concentration from 8.2 to 191 µg/L (median 58 µg/L). Concentrations were converted to population-weighted average consumption at the national level, resulting in an average consumption of 28.6 g/day/1000 people across Australia, which was within 7% of estimates from national prescription statistics. In addition, results for five out of seven states had an estimated prevalence of type 2 diabetes within 20% compared to the traditional epidemiology surveys. Spatial patterns were also observed between urban and rural settings, with higher consumption rates of metformin found in Major Cities (22.5 ± 10.9 g/d/1000 people) and Inner Regional cities (25.4 ± 13.4 g/d/1000 people) than in Outer Regional (17.0 ± 8.1 g/d/1000 people) and Remote areas (15.1 ± 7.4 g/d/1000 people). Consumption estimates were also correlated against socioeconomic factors of the specific catchment areas. Greater metformin use was correlated with populations of lower education and income levels, while positive correlations were found between metformin consumption and consumption of allopurinol, caffeine and venlafaxine. Our study provides more evidence on the distribution of metformin use across Australia, which can be used to develop public health strategies to reduce the overall burden of type 2 diabetes in specific regions. |
| first_indexed | 2024-12-12T09:56:15Z |
| format | Article |
| id | doaj.art-d6f94ba756424440a1187ad633a79b7a |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-12-12T09:56:15Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-d6f94ba756424440a1187ad633a79b7a2022-12-22T00:28:08ZengElsevierEnvironment International0160-41202022-07-01165107282A nationwide wastewater-based assessment of metformin consumption across AustraliaDan Yang0Qiuda Zheng1Phong K. Thai2Fahad Ahmed3Jake W. O'Brien4Jochen F. Mueller5Kevin V. Thomas6Ben Tscharke7Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing 400030, ChinaQueensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Corresponding author.Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, AustraliaQueensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, AustraliaQueensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, AustraliaQueensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, AustraliaQueensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, AustraliaQueensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, AustraliaMetformin is the most widely used drug to treat type 2 diabetes. Monitoring spatial patterns of metformin use could provide new insights into treatment of type 2 diabetes and the distribution among populations. This study applied a wastewater-based epidemiological (WBE) approach to estimate metformin use in different populations across Australia and compared these estimates with traditional approaches of surveys and prescription data. Twenty-four-hour influent samples were collected from 75 wastewater treatment plants (WWTPs) across Australia in 2016 and analysed for metformin. Metformin was detected in all samples ranging in concentration from 8.2 to 191 µg/L (median 58 µg/L). Concentrations were converted to population-weighted average consumption at the national level, resulting in an average consumption of 28.6 g/day/1000 people across Australia, which was within 7% of estimates from national prescription statistics. In addition, results for five out of seven states had an estimated prevalence of type 2 diabetes within 20% compared to the traditional epidemiology surveys. Spatial patterns were also observed between urban and rural settings, with higher consumption rates of metformin found in Major Cities (22.5 ± 10.9 g/d/1000 people) and Inner Regional cities (25.4 ± 13.4 g/d/1000 people) than in Outer Regional (17.0 ± 8.1 g/d/1000 people) and Remote areas (15.1 ± 7.4 g/d/1000 people). Consumption estimates were also correlated against socioeconomic factors of the specific catchment areas. Greater metformin use was correlated with populations of lower education and income levels, while positive correlations were found between metformin consumption and consumption of allopurinol, caffeine and venlafaxine. Our study provides more evidence on the distribution of metformin use across Australia, which can be used to develop public health strategies to reduce the overall burden of type 2 diabetes in specific regions.http://www.sciencedirect.com/science/article/pii/S0160412022002094WastewaterMetforminType 2 diabetesSocio-economic factorsSpatial pattern |
| spellingShingle | Dan Yang Qiuda Zheng Phong K. Thai Fahad Ahmed Jake W. O'Brien Jochen F. Mueller Kevin V. Thomas Ben Tscharke A nationwide wastewater-based assessment of metformin consumption across Australia Environment International Wastewater Metformin Type 2 diabetes Socio-economic factors Spatial pattern |
| title | A nationwide wastewater-based assessment of metformin consumption across Australia |
| title_full | A nationwide wastewater-based assessment of metformin consumption across Australia |
| title_fullStr | A nationwide wastewater-based assessment of metformin consumption across Australia |
| title_full_unstemmed | A nationwide wastewater-based assessment of metformin consumption across Australia |
| title_short | A nationwide wastewater-based assessment of metformin consumption across Australia |
| title_sort | nationwide wastewater based assessment of metformin consumption across australia |
| topic | Wastewater Metformin Type 2 diabetes Socio-economic factors Spatial pattern |
| url | http://www.sciencedirect.com/science/article/pii/S0160412022002094 |
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