Correlations between China's socioeconomic status, disease burdens, and pharmaceuticals and personal care product levels in wastewater

The presence of pharmaceutical and personal care products (PPCPs) in domestic wastewater can potentially indicate socioeconomic status and disease burdens. However, current knowledge is limited to the correlation between specific pharmaceuticals and diseases. This study aims to explore the associations between socioeco-nomic status, disease burdens, and PPCP levels in domestic wastewater at a national level. Samples from 171 wastewater influents across China were used to measure PPCPs, and the per capita consumption of PPCPs was calculated. Results showed that the 31 targeted PPCPs were widely present in wastewater with varying occur-rence characteristics. The mean consumption levels of different PPCPs varied greatly, ranging from 0.03 to 110723.15 mu g/d/capita. While there were no significant regional differences in the overall pattern of PPCP consumption, 22 PPCPs showed regional variations between Northern China and Southern China. PPCPs with similar usage purposes exhibited similar distribution patterns. Disease burden (70.1%) was the main factor affecting most PPCP consumption compared to socioeconomic factors (26.4%). Through correlation analyses, specific types of PPCPs were identified that were highly associated with socioeconomic status and disease bur-dens, such as hypertension-bezafibrate, brucellosis-quinolones, sulfonamides, hepatitis-triclosan, triclocarban, socioeconomic development-fluoxetine, and people's living standards-gemfibrozil. Despite some uncertainties, this study provides valuable insights into the relationship between PPCPs in domestic wastewater and socio-economic status and human health.

Automated summary

This study aims to explore the associations between socio-economic status, disease burdens, and PPCP levels in domestic wastewater at a national level. Results showed that different types of PPCPs were widely present in wastewater across China, with significant variations in consumption levels. Disease burden was found to be the main factor affecting PPCP consumption, and specific types of PPCPs were identified that were highly associated with socioeconomic status and disease burdens.