Wastewater surveillance emerged during the COVID-19 pandemic as an important tool for tracking infectious diseases at the community level. As public health agencies explore its potential for monitoring other health threats, including opioids and other drugs, new research in Public Health Reports, “Public Awareness and Acceptance of Wastewater Surveillance in the United States, June 2024”, offers insights into public awareness, acceptance, and concerns.

Researchers surveyed more than 2,000 U.S. adults about their comfort with wastewater surveillance. More than half were comfortable with its use to monitor respiratory diseases (54%), mosquito-borne diseases (57%), and opioids or other drugs (51%). Acceptance was considerably higher among people already familiar with wastewater surveillance—suggesting that greater public awareness may play an important role in building support.

The findings also highlight concerns as wastewater surveillance expands beyond infectious diseases. Participants cited privacy, the potential use of drug-monitoring data by law enforcement, and possible negative consequences for communities, with concerns more pronounced for monitoring opioids and other drugs.

The study underscores the importance of pairing advances in surveillance science with public education and community engagement. Clear communication about how wastewater data are collected, protected, interpreted, and used will be critical to building trust and realizing the full public health potential of this growing surveillance tool.