دانلود رایگان مقاله انگلیسی نظارت بر فاضلاب برای ارزیابی سلامت جامعه: کاوش اطلاعات فاضلاب شیمیایی شهری (SCIM) - الزویر 2018

abstract

Timely assessment of the aggregate health of small-area human populations is essential for guiding the optimalinvestment of resources needed for preventing, avoiding, controlling, or mitigating human exposure risks, as well as for maintaining or promoting health. Seeking those interventions yielding the greatest benefit with respect to the allocation of resources is critical for making progress toward community sustainability, reducing health disparities, promoting social justice, and maintaining or improving collective health andwell-being.Moreinformative, faster, andless-costly approaches are needed for guiding investigation of cause-effect linkages involving communities and stressors originating from both the built and natural environments. One such emerging approach involves the continuous monitoring of sewage for chemicals that serve as indicators of the collective status of human health (or stress/disease) or any other facet relevant to gauging time-trends in community-wide health. This nascent approach can be referred to as Sewage Chemical-Information Mining (SCIM) and involves the monitoring of sewage for the information that resides in the form of natural and anthropogenic chemicals that enter sewers as a result of the everyday actions, activities, and behaviors of humans. Of particular interest is a specific embodiment of SCIM that would entail the targeted monitoring of a broad suite of endogenous biomarkers of key physiologic processes (as opposed to xenobiotics or their metabolites). This application is termed BioSCIM—an approach roughly analogous to a hypothetical community-wide collective clinical urinalysis, or to a hypothetical en masse human biomonitoring program. BioSCIM would be used for gauging the status or time-trends in community-wide health on a continuous basis. This paper presents an update on the progress made with the development of the BioSCIM concept in the period of time since its original publication in 2012, as well as the next steps required for its continued development.

8. The future

Beyond the articles cited at the beginning of this paper (those published since 2012), the prospects of monitoring sewage for endogenous biomarkers for gauging the status of community-wide health has begun to attract additional interest with respect to smart and sustainable cities (e.g., Poletti and Treville, 2016)—one example being the “Underworlds” project at MIT's Senseable City Lab (Fitzgerald, 2015; Graber, 2017; Reis-Castro, 2017). It has also become a focus of transdisciplinary research under the European COoperation in Scientific and Technology (COST) program (COST, 2013). The European COST program is a natural extension of the research conducted primarily in Europe since 2005 on the measurement of illicit drugs in sewage to gauge community-wide consumption (i.e., “sewage epidemiology”). The following are some additional points regarding the future of BioSCIM.

8.1. Personalized community health

The ultimate value or power of BioSCIM in serving as a gauge for collective community-wide health will be a function primarily of the numbers of endogenous biomarkers (and to a lesser degree, exogenous markers) that can be reliably monitored in sewage. Given a suite of orthogonal biomarkers with sufficient diagnostic or prognostic power, BioSCIM might serve as a major tool simply for alerting and motivating communities and individuals to the need for design and implementation of interventions that promote healthy behaviors tailored to their geographic locales. BioSCIM could eventually serve as a tool for the integration of medical-based monitoring approaches such as P4H (Sagner et al., 2016) into everyday living—even if solely for improving a population's overall health literacy and to promote health vigilance. Other examples of existing programs with which BioSCIM could interact or inform include the Healthy People 2020 initiative and the large-scale health assessment program “Community Health Status Indicators” (CHSI), a program managed by the Centers for Disease Control and Prevention (CDC, 2013, 2015).