Public awareness and perceptions of wastewater-based epidemiological health monitoring in the United Kingdom
Abstract
Introduction: Wastewater-based epidemiology (WBE), the monitoring of human pathogens and biomarkers in sewage, has grown rapidly worldwide in both uptake and scope, yet remains largely unregulated, leaving researchers to develop frameworks for its ethical application. Ensuring WBE is used in line with societal values and public consent is a key consideration. We assessed the UK public’s awareness and perceptions of environmental monitoring and public health surveillance in wastewater.
Methods: We conducted a nationally representative cross-sectional survey of UK adults ( n = 1157) via the ESOMAR-accredited panel provider YouGov in June 2022. Participants were quota-sampled by age, gender and Government Office Region, and responses were post-stratification weighted to UK population demographics. Support and comfort were measured on 5-point Likert scales (and awareness on a 3-point scale) across a range of WBE applications, sampling locations and potential data users.
Results: While fewer than half of participants (37%) were aware that SARS-CoV-2 could be detected in faeces, the majority supported WBE (92%). Support for public health monitoring by government agencies was greater for health risks such as toxins (92%) and infectious diseases (92%) than for lifestyle factors such as mental wellbeing (83%) and smoking habits (82%). Participants were more comfortable with surveillance of larger populations and near-source locations (e.g. hospitals, care homes, prisons, schools, airports); only around half (47–56%) were comfortable with household-level surveillance. Trust in data use differed significantly between end users, being highest for public health and research institutions and lower for private businesses and the police.
Conclusions: Our findings demonstrate broad public support for WBE, with important caveats around privacy, spatial resolution and data use. Transparent communication and citizen engagement will be central to maintaining trust and ensuring ethical implementation as WBE programmes expand.
Related
- Over-the-Counter Painkiller Use in the United Kingdom and Taiwan, A Cross-Cultural Analysis of Self-Medication, Pain Perceptions, and Dependency Considerations
- Perceptions of Undergraduate Ophthalmology Teaching: A Survey of Medical Students in the United Kingdom
- Career-Choice Regret Among Medical Students in the United Kingdom: An Exploratory Mixed-Methods Study of Occupational and Organizational Perceptions.
- Understanding Obesity in Individuals with Down Syndrome: Caregiver Perceptions, Awareness, and Motivation
- Latent tuberculosis infection in focus: Evaluating public concerns, treatment perceptions, and awareness in King Sabatha Dalindyebo Local Municipality, Eastern Cape, South Africa
BibTeX
@article{knight2026public,
title = {{Public awareness and perceptions of wastewater-based epidemiological health monitoring in the United Kingdom}},
author = {Margaret E. Knight and Jasmine M. S. Grimsley and Matthew J. Wade and Gareth Cross and Luke Lewis-Borell and Charlotte Rimmer and Andrew J. Weightman and Martina Feilzer and Davey L. Jones},
journal = {BMC Public Health},
year = {2026},
month = oct,
doi = {10.1186/s12889-026-29783-y},
url = {https://link.springer.com/article/10.1186/s12889-026-29783-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Public awareness and perceptions of wastewater-based epidemiological health monitoring in the United Kingdom
AU - Margaret E. Knight
AU - Jasmine M. S. Grimsley
AU - Matthew J. Wade
AU - Gareth Cross
AU - Luke Lewis-Borell
AU - Charlotte Rimmer
AU - Andrew J. Weightman
AU - Martina Feilzer
AU - Davey L. Jones
PY - 2026
DA - 2026/10/26
JO - BMC Public Health
DO - 10.1186/s12889-026-29783-y
UR - https://link.springer.com/article/10.1186/s12889-026-29783-y
AB - Introduction: Wastewater-based epidemiology (WBE), the monitoring of human pathogens and biomarkers in sewage, has grown rapidly worldwide in both uptake and scope, yet remains largely unregulated, leaving researchers to develop frameworks for its ethical application. Ensuring WBE is used in line with societal values and public consent is a key consideration. We assessed the UK public’s awareness and perceptions of environmental monitoring and public health surveillance in wastewater. Methods: We conducted a nationally representative cross-sectional survey of UK adults ( n = 1157) via the ESOMAR-accredited panel provider YouGov in June 2022. Participants were quota-sampled by age, gender and Government Office Region, and responses were post-stratification weighted to UK population demographics. Support and comfort were measured on 5-point Likert scales (and awareness on a 3-point scale) across a range of WBE applications, sampling locations and potential data users. Results: While fewer than half of participants (37%) were aware that SARS-CoV-2 could be detected in faeces, the majority supported WBE (92%). Support for public health monitoring by government agencies was greater for health risks such as toxins (92%) and infectious diseases (92%) than for lifestyle factors such as mental wellbeing (83%) and smoking habits (82%). Participants were more comfortable with surveillance of larger populations and near-source locations (e.g. hospitals, care homes, prisons, schools, airports); only around half (47–56%) were comfortable with household-level surveillance. Trust in data use differed significantly between end users, being highest for public health and research institutions and lower for private businesses and the police. Conclusions: Our findings demonstrate broad public support for WBE, with important caveats around privacy, spatial resolution and data use. Transparent communication and citizen engagement will be central to maintaining trust and ensuring ethical implementation as WBE programmes expand.
SN - 1471-2458
ER -