评价右旋芬作为止咳药使用的废水生物标志物：中国的一项纵向研究

IF 11.4 1区环境科学与生态学 Q1 ENGINEERING, ENVIRONMENTAL

Water Research Pub Date : 2025-06-27 DOI:10.1016/j.watres.2025.124119

Xue-Ting Shao , Xin-Dong Ma , Jing-Long Li , Jake W. O’Brien , Kevin Thomas , De-Gao Wang

{"title":"评价右旋芬作为止咳药使用的废水生物标志物：中国的一项纵向研究","authors":"Xue-Ting Shao , Xin-Dong Ma , Jing-Long Li , Jake W. O’Brien , Kevin Thomas , De-Gao Wang","doi":"10.1016/j.watres.2025.124119","DOIUrl":null,"url":null,"abstract":"<div><div>Coughing often signals respiratory health issues. The use of dextromethorphan, available as an over-the-counter opioid antitussive in China, is largely undocumented. This study evaluates the feasibility of dextromethorphan and its metabolite dextrorphan, as wastewater-based epidemiology (WBE) biomarkers for monitoring dextromethorphan use. To determine their suitability, key criteria including urinary excretion, detectability in wastewater, unique human metabolic source, and stability were applied. Both dextromethorphan and its metabolite dextrorphan are excreted via urine (62.5 % as dextrorphan and 0.5 % as dextromethorphan) hence meet the “excreted in urine” criteria. Both biomarkers were also measured in wastewater meeting the “detectable in wastewater” criteria, and dextrorphan’s concentration ratio to dextromethorphan was consistent with its excretion profile suggesting that dextrorphan also meet’s the criteria of “unique source: human metabolism”. In-sample stability was assessed over 72 h and both biomarkers were deemed as stable. Consequently, employing dextrorphan as a WBE biomarker enables the assessment of temporal and spatial usage trends of dextromethorphan, underscoring its practicality. Additionally, a spatio-temporal investigation across 30 Chinese cities revealed an average dextrorphan consumption of 13 mg/d/1000 inh, closely aligning with China’s reported annual production estimate of 12 mg/d/1000 inh. This strong concordance supports the validity of using dextrorphan as a WBE biomarker for estimating dextromethorphan consumption. The consumption of dextromethorphan was higher in northern regions compared to southern regions. Temporally, the consumption of dextromethorphan decreased from 233 mg/d/1000 inh in 2015 to 12.3 mg/d/1000 inh in 2021, but with a notable increase in 2022 (24 mg/d/1000 inh) attributed to the COVID-19 outbreak in China in December 2022. Seasonally, the consumption of dextromethorphan in winter was higher compared to spring. This study confirms the suitability of dextrorphan as a biomarker for assessing dextromethorphan usage, and supports the application of WBE for monitoring population-level use of respiratory OTC medications.</div></div>","PeriodicalId":443,"journal":{"name":"Water Research","volume":"285 ","pages":"Article 124119"},"PeriodicalIF":11.4000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating dextrorphan as a wastewater biomarker for cough suppressant use: A longitudinal study in China\",\"authors\":\"Xue-Ting Shao , Xin-Dong Ma , Jing-Long Li , Jake W. O’Brien , Kevin Thomas , De-Gao Wang\",\"doi\":\"10.1016/j.watres.2025.124119\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Coughing often signals respiratory health issues. The use of dextromethorphan, available as an over-the-counter opioid antitussive in China, is largely undocumented. This study evaluates the feasibility of dextromethorphan and its metabolite dextrorphan, as wastewater-based epidemiology (WBE) biomarkers for monitoring dextromethorphan use. To determine their suitability, key criteria including urinary excretion, detectability in wastewater, unique human metabolic source, and stability were applied. Both dextromethorphan and its metabolite dextrorphan are excreted via urine (62.5 % as dextrorphan and 0.5 % as dextromethorphan) hence meet the “excreted in urine” criteria. Both biomarkers were also measured in wastewater meeting the “detectable in wastewater” criteria, and dextrorphan’s concentration ratio to dextromethorphan was consistent with its excretion profile suggesting that dextrorphan also meet’s the criteria of “unique source: human metabolism”. In-sample stability was assessed over 72 h and both biomarkers were deemed as stable. Consequently, employing dextrorphan as a WBE biomarker enables the assessment of temporal and spatial usage trends of dextromethorphan, underscoring its practicality. Additionally, a spatio-temporal investigation across 30 Chinese cities revealed an average dextrorphan consumption of 13 mg/d/1000 inh, closely aligning with China’s reported annual production estimate of 12 mg/d/1000 inh. This strong concordance supports the validity of using dextrorphan as a WBE biomarker for estimating dextromethorphan consumption. The consumption of dextromethorphan was higher in northern regions compared to southern regions. Temporally, the consumption of dextromethorphan decreased from 233 mg/d/1000 inh in 2015 to 12.3 mg/d/1000 inh in 2021, but with a notable increase in 2022 (24 mg/d/1000 inh) attributed to the COVID-19 outbreak in China in December 2022. Seasonally, the consumption of dextromethorphan in winter was higher compared to spring. This study confirms the suitability of dextrorphan as a biomarker for assessing dextromethorphan usage, and supports the application of WBE for monitoring population-level use of respiratory OTC medications.</div></div>\",\"PeriodicalId\":443,\"journal\":{\"name\":\"Water Research\",\"volume\":\"285 \",\"pages\":\"Article 124119\"},\"PeriodicalIF\":11.4000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Water Research\",\"FirstCategoryId\":\"93\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0043135425010267\",\"RegionNum\":1,\"RegionCategory\":\"环境科学与生态学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ENVIRONMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Water Research","FirstCategoryId":"93","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0043135425010267","RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ENVIRONMENTAL","Score":null,"Total":0}

引用次数: 0

摘要

咳嗽通常是呼吸道健康问题的信号。在中国，右美沙芬是一种非处方阿片类止咳药，但它的使用基本上没有记录。本研究评估了右美沙芬及其代谢物右美沙芬作为废水流行病学（WBE）生物标志物监测右美沙芬使用的可行性。为了确定其适用性，采用了尿排泄、废水可检出性、独特的人体代谢源和稳定性等关键标准。右美沙芬及其代谢物右美沙芬均通过尿液排出体外（右美沙芬占62.5%，右美沙芬占0.5%），因此符合“尿中排泄”标准。两种生物标志物在废水中的检测结果均符合“废水中可检测”的标准，右旋醌与右美沙芬的浓度比与其排泄曲线一致，表明右旋醌也符合“独特来源：人体代谢”的标准。在72小时内评估样品内稳定性，两种生物标志物被认为是稳定的。因此，采用右美沙芬作为WBE生物标志物，可以评估右美沙芬的时空使用趋势，强调其实用性。此外，一项对中国30个城市的时空调查显示，右旋糖酐的平均消费量为13毫克/天/1000英寸小时，与中国报告的年产量估计12毫克/天/1000英寸小时密切相关。这种强烈的一致性支持使用右美沙芬作为WBE生物标志物来估计右美沙芬用量的有效性。与南方地区相比，北方地区右美沙芬的消费量较高。从时间上看，右美沙芬的消费量从2015年的233mg /d/1000 inh下降到2021年的12.3 mg/d/1000 inh，但由于2022年12月中国爆发COVID-19，消费量在2022年显著增加（24mg /d/1000 inh）。季节性上，冬季右美沙芬用量高于春季。本研究证实了右美沙芬作为评估右美沙芬使用情况的生物标志物的适用性，并支持WBE用于监测人群水平的呼吸道非处方药使用情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Evaluating dextrorphan as a wastewater biomarker for cough suppressant use: A longitudinal study in China

查看原文本刊更多论文

Evaluating dextrorphan as a wastewater biomarker for cough suppressant use: A longitudinal study in China

Coughing often signals respiratory health issues. The use of dextromethorphan, available as an over-the-counter opioid antitussive in China, is largely undocumented. This study evaluates the feasibility of dextromethorphan and its metabolite dextrorphan, as wastewater-based epidemiology (WBE) biomarkers for monitoring dextromethorphan use. To determine their suitability, key criteria including urinary excretion, detectability in wastewater, unique human metabolic source, and stability were applied. Both dextromethorphan and its metabolite dextrorphan are excreted via urine (62.5 % as dextrorphan and 0.5 % as dextromethorphan) hence meet the “excreted in urine” criteria. Both biomarkers were also measured in wastewater meeting the “detectable in wastewater” criteria, and dextrorphan’s concentration ratio to dextromethorphan was consistent with its excretion profile suggesting that dextrorphan also meet’s the criteria of “unique source: human metabolism”. In-sample stability was assessed over 72 h and both biomarkers were deemed as stable. Consequently, employing dextrorphan as a WBE biomarker enables the assessment of temporal and spatial usage trends of dextromethorphan, underscoring its practicality. Additionally, a spatio-temporal investigation across 30 Chinese cities revealed an average dextrorphan consumption of 13 mg/d/1000 inh, closely aligning with China’s reported annual production estimate of 12 mg/d/1000 inh. This strong concordance supports the validity of using dextrorphan as a WBE biomarker for estimating dextromethorphan consumption. The consumption of dextromethorphan was higher in northern regions compared to southern regions. Temporally, the consumption of dextromethorphan decreased from 233 mg/d/1000 inh in 2015 to 12.3 mg/d/1000 inh in 2021, but with a notable increase in 2022 (24 mg/d/1000 inh) attributed to the COVID-19 outbreak in China in December 2022. Seasonally, the consumption of dextromethorphan in winter was higher compared to spring. This study confirms the suitability of dextrorphan as a biomarker for assessing dextromethorphan usage, and supports the application of WBE for monitoring population-level use of respiratory OTC medications.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Water Research 环境科学-工程：环境

CiteScore

20.80

自引率

9.40%

发文量

1307

审稿时长

38 days

期刊介绍： Water Research, along with its open access companion journal Water Research X, serves as a platform for publishing original research papers covering various aspects of the science and technology related to the anthropogenic water cycle, water quality, and its management worldwide. The audience targeted by the journal comprises biologists, chemical engineers, chemists, civil engineers, environmental engineers, limnologists, and microbiologists. The scope of the journal include: •Treatment processes for water and wastewaters (municipal, agricultural, industrial, and on-site treatment), including resource recovery and residuals management; •Urban hydrology including sewer systems, stormwater management, and green infrastructure; •Drinking water treatment and distribution; •Potable and non-potable water reuse; •Sanitation, public health, and risk assessment; •Anaerobic digestion, solid and hazardous waste management, including source characterization and the effects and control of leachates and gaseous emissions; •Contaminants (chemical, microbial, anthropogenic particles such as nanoparticles or microplastics) and related water quality sensing, monitoring, fate, and assessment; •Anthropogenic impacts on inland, tidal, coastal and urban waters, focusing on surface and ground waters, and point and non-point sources of pollution; •Environmental restoration, linked to surface water, groundwater and groundwater remediation; •Analysis of the interfaces between sediments and water, and between water and atmosphere, focusing specifically on anthropogenic impacts; •Mathematical modelling, systems analysis, machine learning, and beneficial use of big data related to the anthropogenic water cycle; •Socio-economic, policy, and regulations studies.