Smart Sanitation—Biosensors as a Public Health Tool in Sanitation Infrastructure
Abstract
:1. Introduction
2. Materials and Methods
2.1. Inclusion and Exclusion Criteria
2.2. Data Sources, Search Terms and Screening for Inclusion
2.3. Information Extraction and Quality Assessment
3. Results
3.1. Study Characteristics
3.2. Effectiveness of Biosensors as Described in Included Papers
“Compared to conventional analytical tools, biosensors can provide rapid response times, ultrasensitive detection of biomolecules and the potential to be miniaturized for portable assays requiring minimal sample processing.”[11]
“The intersection of continuous health monitoring and the valuable clinical information obtained from analyzing human excreta lies in the smart toilet. This toilet system is expected to have a major impact on health monitoring research, as the toilet enables longitudinal monitoring of human health with minimal interference of human behavior. It enables patients to reliably obtain data for their own health as well as enabling investigators to conduct large clinical trials.”[26]
3.3. Bias and Study Quality
4. Discussion
4.1. Strengths and Weaknesses of Biosensors in Sanitation Infrastructure
“Infectious diseases require rapid or even real-time detection to assess whether there is a need for the containment of the disease carriers to certain areas and prevent the development of an epidemic. To this end, there is a need to develop novel analytical tools that are able to accurately and rapidly monitor low levels of biomarkers/pathogens with minimal sample processing by unskilled personnel at the site of sample collection.”[11]
4.2. Population- and Individual-Level Health Considerations of Smart Sanitation
4.3. The Covid-19 Era: Furthering the Case for Increased Smart Sanitation Research
4.4. Limitations of this Review
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix
Author, Publication Year, Country [ref] | Technology Used | Setting of Use in Study |
---|---|---|
Yang et al., 2015, Europe (multiple) [11] | Multiple (review paper) | Wastewater |
Jaatinen et al., 2016, Finland [21] | Whole cell sensor | Urine samples |
Lucarelli et al., 2002, Italy [30] | Carbon electrode sensor | Wastewater |
Webster et al., 2014, United States [39] | Carbon electrode sensor | Urine samples |
Hirayama et al., 2010, Japan [22] | Infrared | Toilet |
Soh, 2005, Singapore [23] | Electric biosensor | Toilet |
Kawanami et al., 2012, Japan [24] | Thermocouple sensor | Toilet |
Delea et al., 2017, Bangladesh [25] | Motion sensor | Toilet |
Park et al., 2020, United States [26] | Smart toilet, DNA biosensor | Toilet |
Masemola et al., 2020, South Africa [31] | Electric biosensor | Water |
Chapron et al., 2019, Canada [38] | Infrared | Toilet |
Ghosh et al., 2020, India [27] | Smart toilet, Transducer | Toilet |
Porecha, 2015, United States [28] | Smart toilet | Toilet |
Nakagawa et al., 2018, Japan [29] | Electrocardiogram | Toilet |
Mao et al., 2019, China [32] | Colorimetric biosensor | Wastewater |
Yang et al., 2015, United Kingdom [33] | DNA biosensor | Wastewater |
Timur et al., 2004, Turkey [34] | Whole cell sensor | Wastewater |
Gao et al., 2017, China [35] | Whole cell sensor | Wastewater |
Pham et al., 2015, Germany [36] | Whole cell sensor | Wastewater |
Gagnon & Lajeunesse, 2008, Portugal [37] | Whole cell sensor | Wastewater |
Bunyakul et al., 2015, Thailand [40] | Microfluidic immunosensor | Stool samples |
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Category | Included | Excluded |
---|---|---|
Publication Language | English | |
Study types and designs | Systematic reviews, random controlled trials, product pilots/trials (non-random), program reports, news articles describing the use of biosensors by organizations | |
Publication Type | Peer-reviewed articles and gray literature (including program reports and reputable news articles about product pilots) | Textbooks, product manufacturer documents such as schematics, patents |
Intervention type | WASH interventions involving biosensors aimed at improving human health either at a public health (e.g., biosensors used in wastewater treatment plants to evaluate effectiveness of filtration systems) or personal health (e.g., biosensors in toilets in participant’s homes to alert the presence of a certain bacteria) level | Interventions that do not utilize a biosensor, do not relate to human waste and sanitation (e.g., environmental/ecological monitoring as the sole use of biosensors, sensors used in industrial wastewater or sensors applied to drinking water) or were not directly related to a human health outcome |
Publication dates | 2000 to the present | Literature dated 1999 and prior |
Codes | Frequency | Reference Number |
---|---|---|
Intended Setting for Use of Biosensor | ||
Toilet | 8 | [22,23,24,25,26,27,28,29] |
Wastewater | 8 | [11,30,31,32,33,34,35,36,37] |
Bathroom | 1 | [38] |
Patient Stool/Urine Sample in clinical setting | 3 | [39,40] |
Agriculture | 1 | [21] |
Purpose of Sensor/Health Outcome Measured | ||
(Biosensors that measured multiple health outcomes are repeated) | ||
Diagnosis of a health condition (e.g., diabetes) | 4 | [23,26,39,40] |
Measure temperature | 1 | [24] |
Measure gut health (CO2 or microorganisms) | 2 | [22,28] |
Measure blood sugar | 1 | [27] |
Detect presence or quantify of medications or illicit drugs | 4 | [31,32,36] |
Detect Biomarkers of Disease | 4 | [11,30,39,40] |
Determine latrine/toilet usage | 3 | [25,29,38] |
Detect chemicals/heavy metals | 3 | [34,35,37] |
Detect Estrogen | 1 | [21] |
Estimate population size by detecting human population biomarkers | 1 | [33] |
Study Type | ||
Lab/experiment | 16 | [21,23,26,27,28,29,30,31,32,33,34,35,36,37,40] |
Pilot study | 4 | [11,22,24,25,38] |
Editorial | 1 | [11] |
Population of Interest | ||
Individual | 10 | [22,23,24,27,28,29,31,38,39,40] |
Community | 11 | [11,21,25,26,30,32,33,34,35,36,37] |
Samples Tested | ||
Artificially prepared sample (e.g., chemical added to purified water) | 5 | [9,14,15,18,21] |
Unmodified sample collected from the field or test subject (e.g., wastewater or sewage samples) | 13 | [1,2,3,4,6,7,10,11,13,16,17,19,20] |
No samples taken (e.g., motion detection for latrine use) | 3 | [5,8,12] |
Article Type | ||
Peer-reviewed | 18 | [21,22,24,25,26,27,29,30,31,32,33,34,35,36,37,38,39,40] |
Gray Literature | 3 | [11,23,28] |
Author’s Stated Next Steps | ||
Improve sensor and/or resolve errors | 9 | [1,2,4,5,8,10,16,18,20] |
Clinical Trials | 2 | [9,13] |
Ready for use in toilets or wastewater systems | 6 | [7,11,14,15,17,21] |
Unspecified/no next steps stated by the author | 4 | [3,6,12,19] |
Codes | Frequency | Reference Number |
---|---|---|
Biosensor Characteristics | ||
Portable | 11 | [11,22,23,24,25,30,33,34,35,38,40] |
Remote/Hands-off | 7 | [11,24,25,26,28,36,38] |
On-site analysis (no separate lab test needed) | 12 | [11,22,23,24,26,27,28,29,34,35,36,40] |
Continuously gathering data/longitudinal data collection | 7 | [11,24,25,27,28,31,38] |
Easy to use without extensive technical knowledge, time or money involved | 9 | [21,22,24,27,30,32,37,38,40] |
Comparison to Current Methods | ||
More Rapid than conventional data collection methods | 8 | [11,23,26,32,33,34,35,39] |
Less Rapid than conventional data collection methods | None mentioned | n/a |
Higher user acceptability/less invasive | 7 | [22,23,24,25,26,27,38] |
Less user acceptability due to obstruction of their daily behaviors, feeling discomfort from being surveyed, etc. | 1 | [26] |
Low Cost | 14 | [11,21,23,24,25,30,31,32,33,34,35,37,38,39] |
High Cost | None mentioned | n/a |
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Share and Cite
Rary, E.; Anderson, S.M.; Philbrick, B.D.; Suresh, T.; Burton, J. Smart Sanitation—Biosensors as a Public Health Tool in Sanitation Infrastructure. Int. J. Environ. Res. Public Health 2020, 17, 5146. https://doi.org/10.3390/ijerph17145146
Rary E, Anderson SM, Philbrick BD, Suresh T, Burton J. Smart Sanitation—Biosensors as a Public Health Tool in Sanitation Infrastructure. International Journal of Environmental Research and Public Health. 2020; 17(14):5146. https://doi.org/10.3390/ijerph17145146
Chicago/Turabian StyleRary, Emma, Sarah M. Anderson, Brandon D. Philbrick, Tanvi Suresh, and Jasmine Burton. 2020. "Smart Sanitation—Biosensors as a Public Health Tool in Sanitation Infrastructure" International Journal of Environmental Research and Public Health 17, no. 14: 5146. https://doi.org/10.3390/ijerph17145146