DOI: 10.3886/icpsr39248.v1
title: Wastewater Epidemiology to Examine Stimulant Trends, Kentucky, 2019-2023
title: Version 1

description: Wastewater-based epidemiology (WBE) is a scientific approach that allows researchers to monitor population drug exposures by analyzing trace drug residues in untreated wastewater. The Wastewater Epidemiology to Examine Stimulant Trends (WeTEST) project used WBE to develop a wastewater surveillance system at seven traffic rest areas and truck stops along interstate highways passing through Kentucky. This data collection includes one dataset reporting the results of the WeTEST highway surveillance system and four additional datasets reporting trends in stimulant use and related incidents in Kentucky.
description: The overall purpose of this study was to improve the speed and accuracy of identifying substance use in U.S. communities by testing wastewater-based epidemiology (WBE) as a surveillance method for stimulant drug use in Kentucky. Specific goals included building a temporary wastewater surveillance system along interstate highways in Kentucky, examining stimulant use trends in populations traversing "hot spot" areas along these highways, and comparing stimulant use results from the interstate highways to other indicators of drug-use in Kentucky. Researchers aimed to address the following research questions:


What stimulant drugs are present in the general driving population along I-24, I-64, and I-75 in Kentucky, and are any of these drugs novel?


Do the stimulant drugs detected at roadside facilities align with drug use in surrounding communities and drugs detected from nearby municipal waste water treatment facilities?


Does stimulant drug prevalence in facilities correlate with the other reported public health and safety indicators such as road accidents, associated drug crime and/or controlled substance prescribing patterns?

What stimulant drugs are present in the wastewater of truck stops or weigh stations along interstate highways, and do these drugs differ from those found at rest areas serving the general driving population?

Do stimulant drug types differ based on traffic entering/leaving the state along the
Tennessee (TN) border or based on travel direction?

Are there daily, monthly, and seasonal variations in stimulant drug types in the general
population and/or truck drivers?
description: Researchers developed a temporary surveillance system at five rest areas and two commercial truck weigh stations along I-24, I-64, and I-75 in Kentucky, using wastewater-based epidemiology (WBE) to monitor the presence of stimulant drugs at locations across the state. Sites were selected based on (1) accessibility to staff commuting from the two universities involved in the study and (2) variability in drug arrest rates to evaluate wastewater drug measurements in both high and low drug activity counties. The sampling schedule was designed to capture seven consecutive days each month for one year, although some sampling periods varied in length. The final sampling schedule is included in this study as a documentation file with sampling days marked by colored boxes. Sampling procedures for raw wastewater samples were documented in this training video.
The data collected from the WBE system are reported in the Calculated Mass Loads by Location and Stimulant Drug Type Data (DS1). The additional datasets included in this data collection were developed using existing data sources for comparison with the WBE data.
description: Calculated Mass Loads by Location and Stimulant Drug Type Data (DS1): This dataset reports Wastewater-based epidemiology (WBE) results including sampling location, date, drug name, drug type, and mass load.
Motor Vehicle Crash Data (DS2): Variables include county, date, total number of fatal motor vehicle crashes, and a yes/no indicator of whether a crash involved a large truck.
Hospital Utilization Data (DS3): Variables include county, overdose category (fatal, nonfatal emergency department visits, nonfatal inpatient hospitalization), an indicator of the drug involved, three and five-year overdose-related hospital use totals, and which facility type is located in the county (rest area vs weigh station). 
Quarterly Stimulant Rates by County Data (DS4): Variables include county, year and quarter, and stimulants dispensed per 100 people in each county.
Drug-Related Offenses Data (DS5): Variables include county, year, total offenses, and crime or violation type.
description: The Calculated Mass Loads by Location and Stimulant Drug Type Data (DS1) sampled five facilities servicing the general driving population and two facilities servicing commercial truck drivers.
description: Datasets: 
DS0: Study-Level Files
DS1: Calculated Mass Loads by Location and Stimulant Drug Type Data
DS2: Motor Vehicle Crash Data
DS3: Hospital Utilization Data
DS4: Quarterly Stimulant Rates by County Data
DS5: Drug-Related Offences Data
description: The general driving population along interstate highways in Kentucky. Smallest Geographic Unit: county
description: The following codes were used to create the Hospital Utilization Data (DS3): Nonfatal cocaine overdoses include events with any diagnostic code of T40.5. Nonfatal psychostimulant overdoses include events with any diagnostic code of T43.6. (Data Source: Kentucky Outpatient Services Database Files and Inpatient Hospitalization Claims Files, Office of Data and Analytics, Cabinet for Health and Family Services)
Drug overdose deaths include events with an underlying cause of
death code of X40-X44, X60-X64, X85, or Y10-Y14. Cocaine overdose deaths also
include any supplemental cause of death of T40.5. Psychostimulant overdose
deaths also include any supplemental cause of death code of T43.6. (Data
source: Kentucky Death Certificate Database, Kentucky Office of Vital
Statistics, Cabinet for Health and Family Services)