Evaluating the suitability of wastewater analysis for the detection and monitoring of performance- and image-enhancing drug use

Performance- and image-enhancing drugs (PIEDs) are being used by athletes and non-athletes to improve physical appearance and performance, despite well documented negative health side effects. While for many decades steroidal androgens have been the most widely used PIEDs, recent research indicates that nonsteroidal androgens e.g., selective androgen receptor modulators (SARMs) are gaining popularity among PIED users. Currently, PIED use is being estimated and monitored by combining data from surveys, needle syringe programs, anti-doping testing, and seizures. As an emerging exposure and health monitoring tool for the general population, wastewater-based epidemiology (WBE) may be able to overcome limitations of traditional monitoring sources, adding to existing data. However, research on the analysis of PIEDs in wastewater is limited, and little is known about its suitability to monitor PIED use in the community. The aim of this project is to evaluate the suitability by identifying relevant biomarkers, developing analytical methods to investigate pre- and post-collection stability, and finally, to investigate temporal and spatial trends of PIED use in the Australian community.