CARY, N.C., — Spatial epidemiologist Noriko Endo says she feels pressure — pressure “to do good” — because of the enormous potential of the work she and her colleagues are doing.
That’s why she’s made a career out of monitoring something most of us would never choose to spend our time around: sewage.
“I wanted to use engineering and science to advance public health in a city,” Endo says.
She works for a company called Biobot Analytics, a startup born out of an MIT research project from a few years back. They’ve built a filter device that takes raw wastewater and collects metabolized opioids, or metabolites.
They’ve completed a first round of data collection in their hometown of Cambridge, MA—think of it like a beta test—but their first official customer is the town of Cary, North Carolina, which recently received a $100,000 grant to fund the initial round.
Mike Bajorek, Cary’s deputy town manager, who calls this partnership “the most satisfying” project he’s worked on in his three decades of public service, says the data they gather could be “transformative.”
“[The opioid epidemic] is just tearing apart our country, family by family,” Bajorek said.
“And if we can make a difference--even a small difference--to start the trend line going down, then that’s our place; that’s why we’re doing this.”
Cary hasn’t been hit quite as hard by the crisis as other cities in the state, but they also haven't been spared: the town has seen a number of fatalities resulting from overdoses. He’s hoping this filter device that they call a sampler can lead the way to fixing the issue in Cary and possibly nationwide.
Cary and Biobot worked together to choose ten manholes that would give them the best representation of their community. Each manhole includes waste from up to 15,000 residents.
To collect the data, Biobot’s sampler device—built inside a small Pelican hard case--is lowered into a sewer through a manhole and suspended a few feet above the stream of wastewater that flows below. Over the course of 24 hours, an intake tube from one side of the device pulls dirty water inside, where it passes through a series of filters. Bacteria and the metabolites collect in a plastic tube, and the (now cleaner) water is pumped back into the stream.
Only opioids that have have been metabolized by the human body would be picked up by the filter, meaning any opioid pills improperly flushed down a toilet would not register in the tests.
Endo says the broader implications from this kind of testing—if successful on a city level—are huge and that opioids could be just the tip of the iceberg in terms of what they could eventually look for by combing through human waste.
“All this information goes into sewage but that information has been largely untapped,” she says. “So if you can mine sewage for that information we can do a lot to advance public health.
Even though the initial data collected won’t tell them much because they won’t have any other numbers--from their town or elsewhere—to give it context. But in time, he says, this could change the game by giving them a more precise understanding of the scope of the epidemic.
But in the short term — even more they have any hard numbers — it’s also having an impact, Bajorek says, by combating the stigma that has traditionally gone hand in hand with the crisis.
“People don’t talk about [opioid usage],” Bajorek said, adding that as soon as they announced this project it opened a dialogue.
“That community conversation is really what we’re all in this for.”