APOLLO · Assessing population health from exposure to tobacco-specific carcinogens in Belgium using an innovative wastewater-based epidemiology approach

Assessing population health from exposure to tobacco-specific carcinogens in Belgium using an innovative wastewater-based epidemiology approach

Tobacco use is the major cause of many chronic diseases, especially cancer. National questionnaire surveys are currently the main source of population tobacco smoking for characterising public health. But, it has clear limitations as it depends on true self-reported data. An additional approach allowing more objective assessment is essential to address this important societal issue. The overall objective of the APOLLO project (MSC IF Project no.: 749845) was to develop an innovative approach, wastewater-based epidemiology (WBE), for assessing community exposure to tobacco and related carcinogens. This involved wastewater analysis from several European communities for tobacco-specific chemicals of usage (tobacco alkaloids) and cancer risk (tobacco-specific nitrosamines (TSNAs)). Three key aims were achieved: (1) establishment of WBE methodology for tobacco-specific chemicals; (2) evaluation of tobacco alkaloid and TSNA levels in wastewater from different European communities; (3) assessment of population health from use of and exposure to tobacco-specific chemicals in the populations. The completion of the project resulted in advanced knowledge. A novel analytical procedure that allows the simultaneous measurement of various tobacco-related toxic and carcinogenic compounds in wastewater was developed. The methodology was successfully applied to wastewater from the communities in Belgium, Greece and Switzerland, where policies of tobacco control are different. This exploratory study assessed for the first time the occurrence and relationship between tobacco-related toxicants and carcinogens over four European cities. Geographic patterns of tobacco markers suggested higher levels of tobacco use in Geneva and Athens than Geraardsbergen and Ninove over the studied period. Relationships between the levels of tobacco markers and nicotine biomarkers reflected substantial use of non-tobacco nicotine items besides tobacco products. The detection of carcinogens was linked to environmental third-hand smoke, with elevated levels noticed in Athens where indoor smoking is not strictly prohibited, and therefore widespread of third-hand smoke. Our novel outcome highlights the future need of intervention strategies in reducing exposure to third-hand smoke in the population. WBE is a useful tool to assess population-wide tobacco use and examine exposure to tobacco carcinogens associated with third-hand smoke at the population level. Given that third-hand smoke is an emerging dimension of concern, this study based on WBE provides a new perspective that evaluates the extent of this problem and also an additional knowledge on a newly recognised threat to human and population health.

Data: CORDIS, © European Union