Nadine Kotlarz

Per- and polyfluoroalkyl substances (PFAS) are emerging as a major public health problem in North Carolina and across the United States. PFAS comprise a class of over 5,000 compounds. Their unique chemical properties have been harnessed to make consumer and industrial products more water, stain, and grease resistant; they are found in products as diverse as cosmetics and flame-retardants. PFAS are resistant to degradation, move easily through the environment, and accumulate in living organisms. Exposure to PFAS has been associated with health effects including cancer and toxicity to the liver, reproductive development, and thyroid and immune systems. Despite widespread detection in the environment and evidence of increasing human exposure, understanding about PFAS toxicity, its bioaccumulative potential in dietary sources such as aquatic organisms, and effective remediation remain notably understudied. The recent discovery by this proposed Center������������������s Deputy Director, Dr. Detlef Knappe, of widespread PFAS contamination in the Cape Fear River watershed in NC underscores that these compounds are in need of immediate investigation.. The goal of our Center is to advance understanding about the environmental and health impacts of PFAS. To meet this goal we are employing a highly trans-disciplinary approach that will integrate leaders in diverse fields (epidemiology, environmental science and engineering, biology, toxicology, immunology, data science, and advanced analytics); all levels of biological organization (biomolecule, pathway, cell, tissue, organ, model organism, human, and human population); state-of-the-art analytical technologies; cutting-edge data science approaches; a recognized track record in interdisciplinary, environmental health science (EHS) training; and well-established partnerships with government and community stakeholders.

The primary goal of the proposed research is to elucidate COVID-19 infection dynamics by monitoring for SARS-CoV-2 RNA in wastewater and sewage in four major metropolitan areas of the US. Influent wastewater (~500 mL) and primary solids (~40 mL) will be collected at wastewater treatment plants serving populations > 100,000 in Los Angeles, Raleigh, Houston and Washington DC. Whenever possible, we will also collect sewage samples within the sewerage network to provide greater resolution of infection dynamics across a city. Samples will be stored at -80 C and analyzed by RT-qPCR when labs are open again. Normalization of SARS-CoV-2 RNA concentrations in wastewater to per capita mass loads using daily flow and population served will provide community-scale information on COVID-19 infection.This coordinated effort across four cities is a unique strength of this work. We hypothesize that the value of wastewater monitoring to track infection dynamics will be influenced by local factors (e.g., whether there is a combined or separate sewerage system, weather events, and wastewater strength) and therefore we chose four cities that represent a wide range of those parameters. There is also a wide range in diagnostic testing capacity across the four cities, with DC having done the most tests per capita and Houston the fewest. The value added of sewage surveillance to clinical diagnostic testing is likely greater in cities with lower testing capacity; we will use our data to test this hypothesis.

Results from two recent studies have highlighted the value of analyzing wastewater sludge in addition to influent wastewater for tracking SARS-CoV-2 community spread. In a wastewater treatment plant in New Haven, CT, viral RNA concentrations in primary sludge samples were significantly higher than what has been reported in the literature for influent wastewater, even after accounting for a typical concentration factor in primary clarifiers (Peccia et al. 2020). Thickened activated sludge from a wastewater treatment plant in Ourense, Spain was a more sensitive measure of increases in SARS-CoV-2 concentrations than influent wastewater (Balboa et al. 2020). Therefore, the City of Houston may benefit from collecting and analyzing waste activated sludge samples for SARS-CoV-2 in addition to their ongoing monitoring of the virus in influent wastewater.