[Estimation of the consumption level of four drugs in Beijing using wastewater-based epidemiology].

Objective: To estimate the consumption level of four drugs in Beijing using wastewater-based epidemiology (WBE). Methods: The primary sludge from one large wastewater treatment plants (WWTPs) was collected in Beijing from July 2020 to February 2021. The concentrations of codeine, methadone, ketamine and morphine in the sludge were detected through solid-phase extraction-liquid chromatography-tandem mass spectrometry. The consumption, prevalence and number of users of four drugs were estimated by using the WBE approach. Results: Among 416 sludge samples, codeine had the highest detection rate (82.93%, n=345) with a concentration [M (Q1, Q3)] of 0.40 (0.22-0.8) ng·g-1, and morphine had the lowest detection rate (28.37%,n=118) with a concentration [M (Q1, Q3)] of 0.13 (0.09, 0.17) ng·g-1. There was no significant difference in the consumption of the four drugs on working days and weekends (all P values>0.05). Drug consumption was significantly higher in winter than that in summer and autumn (all P values <0.05). The consumption [M (Q1, Q3)] of codeine, methadone, ketamine and morphine in winter was 24.9 (15.58, 38.6), 9.39 (4.57, 26.72), 9.84 (5.18, 19.45) and 5.67 (3.57, 13.77) μg·inhabitant-1·day-1, respectively. For these drugs, there was an upward trend in the average drug consumption during summer, autumn and winter (the Z values of the trend test were 3.23, 3.16, 2.19, and 3.32, respectively and all P values<0.05). The prevalence [M (Q1, Q3)] of codeine, methadone, ketamine and morphine were 0.0056% (0.003 4%, 0.009 2%), 0.0148% (0.009 6%, 0.026 7%),0.0333% (0.0210%, 0.0710%) and 0.0072% (0.003 8%, 0.011 7%), respectively. The estimated number of drug users [M (Q1, Q3)] was 918 (549, 1 511), 2 429 (1 578, 4 383), 5 451 (3 444, 11 642) and 1 173 (626, 1 925),respectively. Conclusion: Codeine, methadone, ketamine and morphine have been detected in the sludge of WWTPs in Beijing, and the consumption level of these drugs varies in different seasons.目的： 基于污水流行病学估算北京市四种毒品的消费水平。 方法： 于2020年7月至2021年2月，采集北京市某大型污水处理厂初级污泥，采用固相萃取-液相色谱-串联质谱法检测污泥中可待因、美沙酮、氯胺酮和吗啡的浓度，通过污水流行病学方法估算四种毒品的消费量、流行率和消费人数。 结果： 416份污泥样品中，可待因检出率最高（82.93%，n=345），检出浓度M（Q1，Q3）为0.40（0.22，0.8）ng·g-1；吗啡检出率最低（28.37%，n=118），检出浓度M（Q1，Q3）为0.13（0.09，0.17）ng·g-1。四种毒品在工作日和休息日的消费量差异无统计学意义（P值均>0.05）；季节差异存在统计学意义，冬季消费量较高（P值均<0.05），冬季可待因、美沙酮、氯胺酮、吗啡的消费量M（Q1，Q3）分别为24.9（15.58，38.6）、9.39（4.57，26.72）、9.84（5.18，19.45）、5.67（3.57，13.77）μg·人-1·d-1。可待因、美沙酮、氯胺酮、吗啡在夏、秋、冬三季的消费量均呈上升趋势（趋势检验Z值分别为3.23、3.16、2.19、3.32，P值均<0.05）。可待因、美沙酮、氯胺酮和吗啡流行率M（Q1，Q3）分别为0.005 6%（0.003 4%，0.009 2%）、0.014 8%（0.009 6%，0.026 7%）、0.033 3%（0.021 0%，0.071 0%）和0.007 2%（0.003 8%，0.011 7%）；消费人数M（Q1，Q3）分别为918（549，1 511）、2 429（1 578，4 383）、5 451（3 444，11 642）和1 173（626，1 925）人。 结论： 北京市污水处理厂污泥中可待因、美沙酮、氯胺酮和吗啡均被检出，且人群消费量具有季节性差异。.