Best Practices
The following is a list of best practices for effective wastewater surveillance, covering the entire process from sampling to safety rules, sample storage and analysis, including ethical considerations in communicating results. These references have been used to develop all the educational modules available on this platform.
Before accessing these resources, a brief description is provided to help you quickly identify the relevant information.
The first module serves as an introduction to wastewater surveillance and focuses entirely on the theoretical aspects. Unlike the other modules, it does not cover specific methods or technical best practices. Instead, it provides the fundamental knowledge needed to understand the principles and context of wastewater surveillance. This theoretical grounding ensures a comprehensive understanding before delving into the technical details in subsequent modules.
Introduction to Epidemiology. Centers for Disease Control and Prevention (CDC). Introduction to Epidemiology. In: Public Health 101 Series. Atlanta, GA: U.S. Department of Health and Human. Services, CDC; 2014.
Abstract:
This epidemiology course offers a comprehensive introduction to the field, addressing essential concepts such as key terminology, data sources, and study designs. Through real-life case examples and practical exercises in calculating disease rates, learners are guided through the fundamental steps of conducting an outbreak investigation. Beyond providing a foundational understanding of epidemiology, this CDC course serves as a valuable technical resource for initiating disease outbreak investigations. The course was offered in a variety of formats, from e-learning to recorded webinars and slide presentations.
Available at:https://www.cdc.gov/training-publichealth101/php/training/introduction-to-epidemiology.html
2) Reference:
Epidemiology: The Basic Science of Public Health by The University of North. Carolina at Chapel Hill taught by Dr. Karin Yeatts and Dr. Lorraine Alexander.
Abstract:
This course connects current public health challenges to the practical application of epidemiology, helping learners understand how the field relates to real-world issues. Concrete examples, such as cardiovascular and infectious diseases, are explored from both local and global perspectives. Delivered as an e-learning program, the course provides an in-depth introduction to the fundamentals of epidemiology and includes numerous summary sheets covering key concepts, study designs, and measurement techniques.
Available at: https://www.coursera.org/learn/epidemiology/home/info
1) Reference:
International Organization for Standardization - ISO 5667-1:2023 Water
quality - Sampling
Part 1: Guidance on the design of sampling programs and sampling techniques.
Abstract:
This document outlines the general principles of water sampling and provides recommendations on the design of sampling programmes and techniques.
Available at: https://www.iso.org/standard/84099.html
2) Reference:
International Organization for Standardization - ISO 5667-10:2020 Water
quality – Sampling
Part 10: Guidance on sampling of wastewater.
Abstract:
This document provides details on the sampling of domestic and industrial wastewater. It covers all forms of wastewater, such as industrial wastewater, radioactive wastewater, cooling water, and raw and treated domestic wastewater. It addresses various sampling techniques and the rules to be followed to ensure that the samples are representative..
Available at: https://www.iso.org/standard/70934.html
3) Reference:
International Organization for Standardization - ISO 19458:2006 Water quality - Sampling for microbiological analysis
Abstract:
This document focuses on water sampling for microbiological investigations. It provides guidance on the planning of sampling programmes, sampling procedures for microbiological analysis, and the transport, handling and storage of samples until analysis.
Available at: https://www.iso.org/standard/33845.html
4) Reference:
EPA Guidelines Regulatory monitoring and testing water and wastewater sampling - U.S. Environmental Protection Agency
Abstract:
This guideline focuses on the proper procedures for sampling waters and wastewaters in various contexts, including natural receiving waters (such as oceans, rivers, creeks, and estuaries) and industrial sources (such as effluents, cooling waters, and process wastewaters). While offering essential instructions for sample collection, it does not delve into analytical methods or data interpretation.
Available at: https://www.epa.sa.gov.au/files/8494_guide_wws.pdf
1) Reference:
International Organization for Standardization - ISO 5667-3:2024 Water
quality - Sampling
Part 3: Preservation and handling of water samples.
Abstract:
This document specifies the general requirements for the preservation, handling, transport, and storage of all water samples for physicochemical, chemical, hydrobiological, and microbiological analyses, as well as for the determination of radiochemical analytes and activities. It is particularly relevant when samples cannot be analysed on-site and must be transported to a laboratory for analysis.
Available at: https://www.iso.org/standard/82273.html
1) Reference:
International Organization for Standardization - ISO 21676:2018 Water
quality
Determination of
the dissolved fraction of selected active pharmaceutical ingredients,
transformation products
and other organic substances in water and treated wastewater - Method using
high performance
liquid chromatography and mass spectrometric detection (HPLC-MS/MS or -HRMS)
after direct
injection
Abstract:
This document outlines a method for determining the dissolved fraction of selected pharmaceuticals, transformation products, and other organic substances in various water types, including drinking water, groundwater, surface water, and treated wastewater. It can also be applied to other organic compounds or water types, such as process water, provided accuracy and storage conditions are validated.
Available at: https://www.iso.org/standard/71340.html
This section refers specifically to the detection of SARS-CoV-2 in wastewater, although the methods can be adapted for other viruses. There are currently no guidelines for the detection of non-viral pathogens such as bacteria or protozoa in wastewater surveillance. Despite similarities in methodology between different pathogens, the detection of larger and heavier pathogens requires special attention. There are scientific articles that address the detection of other non-viral pathogens and genetic targets, but none provide guidance.
1) Reference:
The International cookbook for wastewater practitioners - Vol. 1
SARS-CoV-2
Authors:
European Commission, Joint Research Centre and Global Water Research
Coalition, Gawlik, B.M.,
Comero, S., Deere, D.A., Medema, G., Remonnay, I., Loret, J., De
Roda
Husman, A.M., Rinck-Pfeiffer,
S., Agrawal, S., Anzaldi, G., Arizzi, M.C., Bastian, D., Bausa
Lopez,
L.,
Bosch, A., Cacciatori, C.,
Cáceres, D.A., Cao, R., Carducci, A., Carollo, A., Casado Poblador,
T.,
Cocuzza, C., Dahly, D., De
Graaf, M., Drewes, J.E., Duvallet, C., Echeverria Rovira, L.,
Elelman,
R.,
FattaKassinos, D.,
Federigi, I., Gamst, J., Georgakilas, G., Glowacka, N., Greiner, T.,
Grimsley, J.,
Gutierrez-Aguirre, I., Hadjichristodoulou, C., Haidich, A., Haque,
R.,
Helmrich, M., Ho, J.,
Hokajärvi, A., Hommes, A., Janssens, R., Jessome, M., Jex, A.,
Karaolia,
P.,
Keenum, I., Kirby, A.,
Kiviharju, O., Kocamemi, B.A., Koureas, M., La Rosa, G., Lacroix,
S.,
Lazuka, A., Lesenfants, M.,
Lin, N.J., Lodder, W., Losio, M.N., Lousada Ferreira, M.,
Maffettone,
R.,
Mansfeldt, C., Manuel, D.,
Marchini, A., Mariani, G., Medlicott, K., Monteiro, S.,
Nikolopoulos,
G.,
Nolan, M., Ntzani, E.,
Ottaviano, C., Palau, M., Pierannunzi, F., Pines, A., Pitkänen, T.,
Pütz,
P., Quattrocchi, A.,
Reichert, H., Ricci, M., Rossmann, K., Saatci, A.M., Santos, R.,
Saul,
B.,
Schlosser, O., Schoth,
J., Shevchenko, O., Sibenberg, K., Sion, S., Soyeux, E., Strahwald,
B.,
Stüger, H., Tarrío, J.,
Tavazzi, S., Therrien, J., Tiehm, A., van Der Beek, R., van Der
Zaan,
B.,
Vargha, M., Verani, M.,
Wade, M.J. and Wurzbacher, C.,
Gawlik, B.M., Comero, S., Deere, D.A., Medema, G., Remonnay, I.,
Loret,
J.,
De Roda Husman, A.M. and
RinckPfeiffer, S. editor(s), Publications Office of the European
Union,
Luxembourg, 2024, JRC138489.
Abstract:
The aim of this "cookbook" is to provide practical, proven "recipes" for wastewater-based surveillance (WBS) for SARS-CoV-2 to support the development and expansion of WBS programmes. It also captures key lessons from the 2020-2023 Covid-19 pandemic to inform future WBS initiatives for pandemic response and surveillance of other public health threats. The cookbook aims to standardise best practices in sampling, analytical techniques and interpretation of results to ensure data reliability and comparability. It also promotes transparent communication strategies to build trust with the public and stakeholders through clear dissemination of WBS results and advocates the integration of WBS data into public health policy to improve evidence-based decision making.
The cookbook is divided into eight sections: 1. Introduction; 2. High-level Overview; 3. Health Sector Perspectives; 4. Methods and Methodologies - From data to action; 5. Methods and Methodologies - Measurement and testing; 6. Methods and Methodologies - Sampling; 6. Methods and Methodologies - Transportation protocols; and 8. Conclusions.
Written by a global consortium and rigorously peer-reviewed, this guide not only provides practical advice in an easy-to-understand format, covering everything from programme design to technical implementation and use of results, but also acts as a historical record of the development of the field, setting a benchmark for future pandemic responses.
While this cookbook focuses on the detection of SARS-CoV-2 in wastewater, many of the methods can be adapted for the monitoring of other viruses.
Available at: https://data.europa.eu/doi/10.2760/995967
1) Reference:
Guidance for reducing health risks to workers handling human waste or sewage. Centers for Disease Control and Prevention (CDC). Last Reviewed: 2021, November 9.
Abstract:
Workers who handle sewage or wastewater are at increased risk of waterborne diseases. To reduce this risk and protect themselves from illnesses such as diarrhoea, they can adopt basic hygiene practices, use personal protective equipment (PPE), participate in training programmes and receive vaccinations. The web page “Reducing health risks to workers handling human waste or sewage” provides detailed guidance on hygiene measures, PPE requirements and training recommendations for workers in wastewater treatment plants or sewerage systems. It also highlights the important role of vaccination in protecting workers in these environments.
Available at: https://www.cdc.gov/healthywater/global/sanitation/workers_handlingwaste.html
1) Reference:
WHO guidelines on ethical issues in public health surveillance. Geneva: World Health Organization (WHO); 2017. Licence: CC BY-NC-SA 3.0 IGO.
Abstract:
This guideline aims to outline key ethical considerations for resolving controversies that may arise in public health surveillance, which is itself an ethical obligation of governments. It addresses ethical challenges in different cultural, political and institutional contexts, taking into account differences in values, resources and traditions. The guideline sets out 17 principles to guide appropriate surveillance, data sharing and community involvement in a transparent manner, while recognising the limits of the surveillance mandate. Although this WHO guideline does not specifically address wastewater surveillance, it focuses on public health surveillance more broadly. These principles are interrelated and should be considered together when making decisions about the collection, analysis, sharing and use of surveillance data. Despite being developed in 2017 - before the increased focus on wastewater surveillance brought about by the COVID-19 pandemic - this guidance remains relevant and up to date. Countries are encouraged to implement it as a robust framework for addressing ethical challenges in surveillance. In addition, subsequent analyses have been published to evaluate this guideline in the context of wastewater surveillance, confirming that its key principles remain applicable and foundational to this emerging field. For example, the Canadian Water Network in 2020 developed an Ethics and communications guidance for wastewater surveillance to inform public health decision-making about COVID-19 (https://cwn-rce.ca/wp-content/uploads/COVID19-Wastewater-Coalition-Ethics-and-Communications-Guidance-v4-Sept-2020.pdf) based on the WHO guidelines and tailored to the specific challenges of wastewater surveillance. 14 of the original 17 WHO principles were found to be directly applicable to wastewater surveillance. These adapted guidelines are intended to assist researchers in generating SARS-CoV-2 data from wastewater and to support the ethical and informed further development of this surveillance technique.
Available at: https://iris.who.int/bitstream/handle/10665/255721/9789241512657-eng.pdf?sequence=1
2) Reference:
Ethical research guidelines for wastewater-based epidemiology and related fields. Prichard J., Hall W., Zuccato E., De Voogt P., et al.; 2015.
Abstract:
The purpose of these guidelines is to identify key ethical risks associated with wastewater surveillance research and to suggest strategies for mitigating these risks. Mitigation involves either reducing the likelihood of adverse events or minimising their potential consequences. Developed by researchers in Europe and Australia, these guidelines are based on internationally recognised ethical principles. They are designed to be interdisciplinary and to reflect the international nature of wastewater surveillance. Like other ethical frameworks, these guidelines offer principles and approaches that can be adapted to a wide range of situations that researchers may encounter. However, it is beyond their scope to provide an exhaustive list of all potential risks or scenarios that may arise in different countries.
Available at: https://qaehs.centre.uq.edu.au/files/880/WBEEthicalGuidelines.pdf
Guidance for aircraft and airport wastewater surveillance
1) Reference:
European Commission. Adhoc guidance: Wastewater sampling of aircrafts and airports for SARS-CoV-2 surveillance. 10 January 2023. European Commission Brussels 2023
Abstract:
This document reviews research up to early 2023 on strategies for monitoring SARS-CoV-2 in aircraft wastewater. During the COVID-19 pandemic, the EU Health Security Committee (HSC) and Integrated Political Crisis Response (IPRC) recommended monitoring wastewater from aircraft arriving from non-EU/EEA countries and associated airports. While wastewater analysis methods have been validated, large-scale implementation requires significant coordination among stakeholders, and no standardized international procedure exists. This guidance supports health authorities in developing locally adapted protocols for aircraft and airport wastewater monitoring, aiming to harmonize practices across the EU and enhance result comparability. Each step in establishing aircraft and airport wastewater monitoring was covered, including identification of stakeholders, recommendation and selection of sampling approaches with detailed descriptions, sample collection methods, analytical techniques and data reporting practices. It also highlights the unique challenges of sampling aircraft and airport wastewater compared to fixed sites such as wastewater treatment plants, and provides considerations for interpreting monitoring results.
Available at: https://wastewater-observatory.jrc.ec.europa.eu/media/guidance_files/Sampling_Aircrafts_JRC_2023.pdf