Public awareness and perceptions of wastewater-based epidemiological health monitoring in the United Kingdom

Knight, Margaret E., Grimsley, Jasmine M. S., J. Wade, Matthew, Cross, Gareth, Lewis-Borell, Luke, Rimmer, Charlotte, Weightman, Andrew J. ORCID: https://orcid.org/0000-0002-6671-2209, Feilzer, Martina and Jones, Davey L. 2026. Public awareness and perceptions of wastewater-based epidemiological health monitoring in the United Kingdom. BMC Public Health 10.1186/s12889-026-29783-y

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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.

Item Type:	Article
Date Type:	Publication
Status:	In Press
Schools:	Schools > Biosciences
Publisher:	BioMed Central
ISSN:	1471-2458
Date of First Compliant Deposit:	2 November 2026
Last Modified:	02 Nov 2026 11:16
URI:	https://orca.cardiff.ac.uk/id/eprint/190568

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