{"id":2710,"date":"2016-12-06T14:28:28","date_gmt":"2016-12-06T14:28:28","guid":{"rendered":"http:\/\/www.vtei.cz\/?p=2710"},"modified":"2024-07-16T11:51:05","modified_gmt":"2024-07-16T10:51:05","slug":"use-of-wastewater%c2%ad%e2%80%91based-epidemiology-for-monitoring-of-illicit-drugs-consumption-in-czech-and-international-context","status":"publish","type":"post","link":"https:\/\/www.vtei.cz\/en\/2016\/12\/use-of-wastewater%c2%ad%e2%80%91based-epidemiology-for-monitoring-of-illicit-drugs-consumption-in-czech-and-international-context\/","title":{"rendered":"Use of wastewater\u00ad\u2011based epidemiology for monitoring of illicit drugs consumption in Czech and international context"},"content":{"rendered":"<h4><i class=\"fa fa-exclamation-circle fa-3x pull-left\"><\/i> This article is available in Czech only. For translation or more information on this topic, please contact author.<\/h4>\n<p>&nbsp;<\/p>\n<h2>Souhrn<\/h2>\n<p>P\u0159\u00edsp\u011bvek p\u0159in\u00e1\u0161\u00ed stru\u010dnou souhrnnou informaci o\u00a0projektu Stanoven\u00ed mno\u017estv\u00ed neleg\u00e1ln\u00edch drog a\u00a0jejich metabolit\u016f v\u00a0komun\u00e1ln\u00edch odpadn\u00edch vod\u00e1ch\u00a0\u2013 n\u00e1stroj pro dopln\u011bn\u00ed \u00fadaj\u016f o\u00a0spot\u0159eb\u011b drog v\u00a0\u010cesk\u00e9 republice (identifika\u010dn\u00ed \u010d\u00edslo projektu VG 20122015101) se zkr\u00e1cen\u00fdm n\u00e1zvem DRAGON a\u00a0o\u00a0mezin\u00e1rodn\u00ed konferenci 2<sup>nd<\/sup> International Conference on \u201eWastewater\u00ad\u2011based drug epidemiology\u201c, kter\u00e1 se konala ve dnech 11.\u201315.\u00a010.\u00a02015 ve \u0161v\u00fdcarsk\u00e9 Ascon\u011b.<\/p>\n<a href=\"http:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/C\u2560\u00eeeladenka_zima_2012.jpg\" rel=\"shadowbox[sbpost-2710];player=img;\"><img decoding=\"async\" width=\"800\" height=\"636\" class=\"alignnone size-full wp-image-2627 lazyload\" data-src=\"https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/C\u2560\u00eeeladenka_zima_2012.jpg\" alt=\"c%e2%95%a0ieladenka_zima_2012\" data-srcset=\"https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/C\u2560\u00eeeladenka_zima_2012.jpg 800w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/C\u2560\u00eeeladenka_zima_2012-300x239.jpg 300w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/C\u2560\u00eeeladenka_zima_2012-768x611.jpg 768w\" data-sizes=\"(max-width: 800px) 100vw, 800px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 800px; --smush-placeholder-aspect-ratio: 800\/636;\" \/><\/a>\n<h2>\u00davod<\/h2>\n<p>P\u0159esto\u017ee slovo droga m\u00e1 v\u00edce v\u00fdznam\u016f, v\u011bt\u0161inou se v\u0161em vybav\u00ed spojen\u00ed s\u00a0n\u011b\u010d\u00edm nez\u00e1konn\u00fdm. U\u017e\u00edv\u00e1n\u00ed neleg\u00e1ln\u00edch drog je celospole\u010densky ne\u017e\u00e1douc\u00ed z\u00e1le\u017eitost, hledaj\u00ed se cesty k\u00a0omezen\u00ed jejich spot\u0159eby. Tato spot\u0159eba se obvykle monitoruje prost\u0159ednictv\u00edm dotazn\u00edkov\u00fdch akc\u00ed, \u00fadaji zji\u0161t\u011bn\u00fdmi p\u0159i policejn\u00ed pr\u00e1ci\u00a0\u2013 krimin\u00e1ln\u00ed \u010diny spojen\u00e9 s\u00a0po\u017eit\u00edm nebo z\u00edsk\u00e1v\u00e1n\u00edm drog a\u00a0\u00fadaji ze zdravotnictv\u00ed\u00a0\u2013 choroby vznikl\u00e9 na z\u00e1klad\u011b zneu\u017e\u00edv\u00e1n\u00ed drog.<\/p>\n<p>Jako dopl\u0148kov\u00e1 metoda se v\u00a0sou\u010dasnosti vyu\u017e\u00edv\u00e1 anal\u00fdza komun\u00e1ln\u00edch odpadn\u00edch vod\u00a0\u2013 epidemiologie odpadn\u00edch vod (WBE\u00a0\u2013 wastewater\u00ad\u2011based epidemiology). Epidemiologii odpadn\u00edch vod byl polo\u017een z\u00e1klad na p\u0159elomu let 1999 a\u017e 2000 [1] a\u00a0poprv\u00e9 byla aplikov\u00e1na v\u00a0povod\u00ed \u0159eky P\u00e1d [2]. Od dob sv\u00e9ho vzniku se stala plnohodnotnou rozv\u00edjej\u00edc\u00ed se discipl\u00ednou, kter\u00e1 spojuje pr\u00e1ci expert\u016f z\u00a0mnoha obor\u016f.<\/p>\n<p>Zpo\u010d\u00e1tku byla epidemiologie odpadn\u00edch vod vyu\u017e\u00edv\u00e1na p\u0159edev\u0161\u00edm pro sledov\u00e1n\u00ed nez\u00e1konn\u00fdch l\u00e1tek (drog), l\u00e9\u010div\u00a0atd. v\u00a0odpadn\u00edch vod\u00e1ch, a\u00a0t\u00edm ke zji\u0161\u0165ov\u00e1n\u00ed stavu spot\u0159eby drog, p\u0159\u00edpadn\u011b l\u00e9\u010div ve sledovan\u00fdch lokalit\u00e1ch, p\u0159edev\u0161\u00edm m\u011bstsk\u00fdch aglomerac\u00edch. V\u00a0dne\u0161n\u00ed dob\u011b je tento zp\u016fsob sledov\u00e1n\u00ed spot\u0159eby drog v\u00a0dan\u00e9 lokalit\u011b vyu\u017e\u00edv\u00e1n na cel\u00e9m sv\u011bt\u011b. Z\u00e1rove\u0148 v\u0161ak doch\u00e1z\u00ed k\u00a0roz\u0161i\u0159ov\u00e1n\u00ed spektra sledovan\u00fdch l\u00e1tek o\u00a0dal\u0161\u00ed markery, kter\u00e9 umo\u017e\u0148uj\u00ed zjistit dal\u0161\u00ed informace o\u00a0populaci\u00a0\u2013 zdravotn\u00ed stav, spot\u0159ebu alkoholu\u00a0atd.<\/p>\n<p>O\u00a0tom, jak roz\u0161\u00ed\u0159en\u00fd obor epidemiologie odpadn\u00edch vod je, sv\u011bd\u010dila i\u00a02<sup>nd<\/sup> International Conference on \u201eWastewater\u00ad\u2011based drug epidemiology\u201c, kter\u00e1 se konala ve dnech 11.\u201315.\u00a010.\u00a02015 ve \u0161v\u00fdcarsk\u00e9 Ascon\u011b.<\/p>\n<p>V\u00a0prvn\u00ed \u010d\u00e1sti tohoto p\u0159\u00edsp\u011bvku je prezentov\u00e1n projekt DRAGON realizovan\u00fd v\u00a0letech 2012 a\u017e 2015 ve V\u00daV TGM,\u00a0v.\u00a0v.\u00a0i., druh\u00e1 \u010d\u00e1st je v\u011bnov\u00e1na v\u00fd\u0161e zm\u00edn\u011bn\u00e9 konferenci.<\/p>\n<h2>Projekt DRAGON<\/h2>\n<p>V\u00a0\u010cesk\u00e9 republice byl epidemiologick\u00fd p\u0159\u00edstup ke sledov\u00e1n\u00ed spot\u0159eby drog aplikov\u00e1n v\u00a0projektu Stanoven\u00ed mno\u017estv\u00ed neleg\u00e1ln\u00edch drog a\u00a0jejich metabolit\u016f v\u00a0komun\u00e1ln\u00edch odpadn\u00edch vod\u00e1ch\u00a0\u2013 n\u00e1stroj pro dopln\u011bn\u00ed \u00fadaj\u016f o\u00a0spot\u0159eb\u011b drog v\u00a0\u010cesk\u00e9 republice (identifika\u010dn\u00ed \u010d\u00edslo projektu VG 20122015101) se zkr\u00e1cen\u00fdm n\u00e1zvem DRAGON. Tento projekt byl \u0159e\u0161en v\u00a0r\u00e1mci Programu bezpe\u010dnostn\u00edho v\u00fdzkumu \u010cesk\u00e9 republiky v\u00a0letech 2010\u20132015 (BII\/2\u00a0\u2013 VS) a\u00a0byl financovan\u00fd formou dotace z\u00a0rozpo\u010dtov\u00e9 kapitoly Ministerstva vnitra \u010cesk\u00e9 republiky. C\u00edlem projektu bylo zav\u00e9st vhodnou analytickou metodu pro m\u011b\u0159en\u00ed koncentrac\u00ed vybran\u00fdch l\u00e1tek v\u00a0komun\u00e1ln\u00edch odpadn\u00edch vod\u00e1ch, pomoc\u00ed t\u00e9to metody analyzovat odebran\u00e9 vzorky a\u00a0zp\u011btnou kalkulac\u00ed spo\u010d\u00edtat l\u00e1tkov\u00e9 odnosy u\u00a0jednotliv\u00fdch drog. Sou\u010d\u00e1st\u00ed projektu byla i\u00a0Sociodemografick\u00e1 studie v\u010detn\u011b anal\u00fdz prostorov\u00e9ho rozlo\u017een\u00ed obyvatelstva a\u00a0identifikace rizikov\u00fdch skupin u\u017eivatel\u016f n\u00e1vykov\u00fdch l\u00e1tek (drog). Tuto studii zpracovala spole\u010dnost Accendo\u00a0\u2013 Centrum pro v\u011bdu a\u00a0v\u00fdzkum,\u00a0o.\u00a0p.\u00a0s., se s\u00eddlem v\u00a0Ostrav\u011b [3].<\/p>\n<p>\u0158e\u0161itelsk\u00fd t\u00fdm pro\u0161el b\u011bhem \u0159e\u0161en\u00ed projektu mnoha zm\u011bnami, kl\u00ed\u010dov\u00fdmi osobami byli V\u011bra O\u010den\u00e1\u0161kov\u00e1, Petr Tu\u0161il, Alena Svobodov\u00e1, Danica Posp\u00edchalov\u00e1 a\u00a0Petra Kol\u00e1\u0159ov\u00e1.<\/p>\n<p>Hlavn\u00edm v\u00fdstupem projektu byla Metodika aplikace epidemiologie odpadn\u00edch vod pro stanoven\u00ed odnosu nez\u00e1konn\u00fdch l\u00e1tek (drog) v\u00a0\u010cesk\u00e9 republice (http:\/\/www.vuv.cz\/files\/pdf\/220\/221_certifikovana_metodika_pro_stanoveni_<br \/>\nodnosu_drog_stanoveni_def.pdf).<\/p>\n<p>P\u016fvodn\u00ed po\u010det aglomerac\u00ed zapojen\u00fdch do projektu (deset) se d\u00edky v\u00fdborn\u00e9 spolupr\u00e1ci s\u00a0m\u00edstn\u00edmi \u010dist\u00edrnami odpadn\u00edch vod postupn\u011b poda\u0159ilo roz\u0161\u00ed\u0159it na dvacet p\u011bt, jejich lokalizace je zn\u00e1zorn\u011bna na <em>obr.\u00a01<\/em>. V\u00a0jednotliv\u00fdch m\u011bstech prob\u011bhly sedmidenn\u00ed, v\u00a0Ostrav\u011b pak 14denn\u00ed odb\u011brov\u00e9 kampan\u011b, p\u0159i kter\u00fdch byly odeb\u00edr\u00e1ny 24hodinov\u00e9 sl\u00e9van\u00e9 vzorky. Ka\u017ed\u00fd rok byly kampan\u011b realizov\u00e1ny ve \u010dty\u0159ech term\u00ednech, a to v\u00a0dubnu, \u010dervnu, z\u00e1\u0159\u00ed a\u00a0listopadu. V\u00a0Praze, Brn\u011b, Ostrav\u011b, \u00dast\u00ed nad Labem, Plzni, Fr\u00fddku\u00ad\u2011M\u00edstku, Orlov\u00e9, Hav\u00ed\u0159ov\u011b, Karvin\u00e9 a\u00a0\u010cesk\u00e9m T\u011b\u0161\u00edn\u011b prob\u00edhal monitoring dva roky (celkem tedy 8 odb\u011brov\u00fdch kampan\u00ed), v\u00a0ostatn\u00edch lokalit\u00e1ch byl jejich po\u010det ni\u017e\u0161\u00ed. Hlavn\u00ed odb\u011brov\u00e1 m\u00edsta byla na p\u0159\u00edtoku na \u010dist\u00edrnu odpadn\u00edch vod po hrub\u00e9m p\u0159ed\u010di\u0161t\u011bn\u00ed. Tam, kde to umo\u017e\u0148ovala stokov\u00e1 s\u00ed\u0165, byla dal\u0161\u00ed odb\u011brov\u00e1 m\u00edsta situov\u00e1na i\u00a0v\u00a0uzlov\u00fdch bodech stokov\u00e9 s\u00edt\u011b. P\u0159\u00edklad z\u00a0Brna je na <em>obr.\u00a02<\/em>.<\/p>\n<a href=\"http:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-1.jpg\" rel=\"shadowbox[sbpost-2710];player=img;\"><img decoding=\"async\" width=\"800\" height=\"507\" class=\"alignnone size-full wp-image-2624 lazyload\" data-src=\"https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-1.jpg\" alt=\"ocenaskova-1\" data-srcset=\"https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-1.jpg 800w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-1-300x190.jpg 300w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-1-768x487.jpg 768w\" data-sizes=\"(max-width: 800px) 100vw, 800px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 800px; --smush-placeholder-aspect-ratio: 800\/507;\" \/><\/a>\n<h6>Obr.\u00a01. Lokalizace sledovan\u00fdch \u010dist\u00edren odpadn\u00edch vod v\u00a0\u010cesk\u00e9 republice<br \/>\nFig. 1. Localization of monitored WWTP in the Czech Republic<\/h6>\n<p>Odebran\u00e9 vzorky odpadn\u00edch vody byly analyzov\u00e1ny metodou on\u00ad\u00ad\u2011line SPE\u00a0\u2013 LC\u00ad\u2011MS\/MS po ionizaci elektrosprejem v\u00a0pozitivn\u00edm nebo negativn\u00edm modu [4].<\/p>\n<p>Ve vzorc\u00edch odpadn\u00edch vod byly sledov\u00e1ny p\u016fvodn\u00ed drogy a\u00a0z\u00a0d\u016fvodu jejich p\u0159em\u011bny v\u00a0organizmu i\u00a0jejich v\u00fdznamn\u00e9 metabolity, kter\u00e9 jsou tak\u00e9 vylu\u010dov\u00e1ny do odpadn\u00edch vod. Ke zp\u011btn\u00e9 kalkulaci se u\u00a0n\u011bkter\u00fdch drog vych\u00e1z\u00ed pr\u00e1v\u011b z\u00a0t\u011bchto metabolit\u016f a\u00a0nikoliv z\u00a0l\u00e1tek p\u016fvodn\u00edch. Sledov\u00e1ny byly tyto slou\u010deniny:<\/p>\n<ul>\n<li>amfetaminy (metamfetamin (pervitin), amfetamin, 3,4-methylen\u00ad\u2011dioxy\u00ad\u2011N\u00ad\u2011methylamfetamin (MDMA, ext\u00e1ze));<\/li>\n<li>kokain a\u00a0jeho metabolity benzoylekgonin a\u00a0kokaethylen;<\/li>\n<li>opioidy (heroin, morfin, metabolit 6-acetylmorfin);<\/li>\n<li>LSD;<\/li>\n<li>buprenorfin;<\/li>\n<li>metadon a\u00a0jeho hlavn\u00ed metabolit EDDP;<\/li>\n<li>efedrin a\u00a0pseudoefedrin;<\/li>\n<li>tramadol;<\/li>\n<li>THC\u00ad\u2011COOH (hlavn\u00ed metabolit marihuany).<\/li>\n<\/ul>\n<p>Vedle neleg\u00e1ln\u00edch drog byly sledov\u00e1ny i\u00a0l\u00e1tky pou\u017e\u00edvan\u00e9 pro substitu\u010dn\u00ed l\u00e9\u010dbu\u00a0\u2013 metadon a\u00a0buprenorfin, prekurzory vyu\u017e\u00edvan\u00e9 pro v\u00fdrobu drog (efedrin a\u00a0pseudoefedrin) a\u00a0\u00fa\u010dinn\u00e1 l\u00e1tka l\u00e9\u010div p\u0159edepisovan\u00fdch na bolesti opioid tramadol, kter\u00fd je \u010dasto zneu\u017e\u00edv\u00e1n [5].<\/p>\n<h2>V\u00fdsledky projektu a\u00a0porovn\u00e1n\u00ed s\u00a0Evropou<\/h2>\n<p>Celkem bylo v\u00a0pr\u016fb\u011bhu projektu odebr\u00e1no a\u00a0zanalyzov\u00e1no v\u00edce ne\u017e 2\u2009500 vzork\u016f odpadn\u00edch vod, ve v\u0161ech vzorc\u00edch byly nez\u00e1konn\u00e9 drogy, jejich metabolity a\u00a0dal\u0161\u00ed sledovan\u00e9 l\u00e1tky nalezeny. Koncentrace jednotliv\u00fdch analyt\u016f (ng\/l) byla zp\u011btnou kalkulac\u00ed p\u0159epo\u010dtena na mg\/den\/1\u2009000 obyvatel [6]. D\u00edky tomuto p\u0159epo\u010dtu lze mezi sebou porovn\u00e1vat jednotliv\u00e9 sledovan\u00e9 lokality.<\/p>\n<p>Krom\u011b porovn\u00e1n\u00ed jednotliv\u00fdch sledovan\u00fdch lokalit v\u00a0r\u00e1mci \u010cesk\u00e9 republiky bylo provedeno tak\u00e9 srovn\u00e1n\u00ed s\u00a0evropskou studi\u00ed realizovanou v\u00a0letech 2011\u20132013 [7].<\/p>\n<p>Ext\u00e1ze (MDMA) je typickou \u201eparty\u201c drogou. Jej\u00ed spot\u0159eba v\u00fdrazn\u011b stoup\u00e1 o\u00a0v\u00edkendech a\u00a0hudebn\u00edch akc\u00edch. V\u00a0\u010cesk\u00e9 republice byla nejvy\u0161\u0161\u00ed spot\u0159eba t\u00e9to drogy v\u00a0Praze, n\u00e1sledovalo Brno, Plze\u0148 a\u00a0Ostrava. Po dobu kon\u00e1n\u00ed hudebn\u00edho festivalu Summer City Fest v\u00a0Plzni a\u00a0festivalu Colours of Ostrava stoupla spot\u0159eba ext\u00e1ze proti pr\u016fm\u011bru v\u00a0uveden\u00fdch m\u011bstech a\u017e \u0161estkr\u00e1t. Ve srovn\u00e1n\u00ed s\u00a0Evropou se \u010cesk\u00e1 republika pohybuje na evropsk\u00e9m pr\u016fm\u011bru.<\/p>\n<p>Nejvy\u0161\u0161\u00ed spot\u0159eba kokainu, jeho\u017e u\u017e\u00edv\u00e1n\u00ed m\u00e1 tak\u00e9 v\u00edkendov\u00fd charakter, byla op\u011bt v\u00a0Praze, d\u00e1le potom v\u00a0Plzni, \u00dast\u00ed nad Labem a\u00a0v\u00a0Brn\u011b. V\u00a0mnoha evropsk\u00fdch m\u011bstech je spot\u0159eba n\u011bkolikan\u00e1sobn\u011b vy\u0161\u0161\u00ed, \u010cesk\u00e1 republika se pohybuje t\u011bsn\u011b pod pr\u016fm\u011brem.<\/p>\n<p>Spot\u0159eba metamfetaminu (pervitinu) v\u00a0\u010cesk\u00e9 republice je naopak n\u011bkolikan\u00e1sobn\u011b vy\u0161\u0161\u00ed ne\u017e v\u00a0Evrop\u011b. Na prvn\u00edm m\u00edst\u011b v\u00a0\u010cesk\u00e9 republice je \u00dast\u00ed nad Labem. N\u011bkter\u00e9 zji\u0161t\u011bn\u00e9 koncentrace byly extr\u00e9mn\u011b vysok\u00e9, a\u00a0byly ze statistick\u00e9ho hodnocen\u00ed vylou\u010deny. Proto\u017ee ve stejn\u00fdch vzorc\u00edch byly nam\u011b\u0159eny i\u00a0velmi vysok\u00e9 koncentrace efedrinu, kter\u00fd slou\u017e\u00ed k\u00a0v\u00fdrob\u011b t\u00e9to drogy, a\u00a0n\u00e1lezy byly v\u00a0lokalit\u00e1ch, ve kter\u00fdch lze p\u0159edpokl\u00e1dat v\u00fdskyt nez\u00e1konn\u00fdch varen pervitinu, je nanejv\u00fd\u0161 pravd\u011bpodobn\u00e9, \u017ee do\u0161lo ke kontaminaci odpadn\u00edch vod pr\u00e1v\u011b z\u00a0t\u011bchto varen. Dal\u0161\u00edmi m\u011bsty s\u00a0vysokou spot\u0159ebou metamfetaminu jsou Plze\u0148, Praha a\u00a0Ostrava.<\/p>\n<p>Rovn\u011b\u017e spot\u0159eba marihuany je v\u00a0\u010cesk\u00e9 republice vysok\u00e1. Po\u0159ad\u00ed \u010desk\u00fdch m\u011bst podle jej\u00ed spot\u0159eby je Praha, Plze\u0148, Ostrava a\u00a0Brno. Srovn\u00e1n\u00ed s\u00a0Evropou nebylo mo\u017en\u00e9, proto\u017ee nebylo z\u0159ejm\u00e9, jak\u00fdm zp\u016fsobem byla provedena zp\u011btn\u00e1 kalkulace. Ve studii, s\u00a0kterou byly v\u00fdsledky porovn\u00e1v\u00e1ny [7], nebyl uveden pou\u017eit\u00fd p\u0159epo\u010d\u00edt\u00e1vac\u00ed faktor.<\/p>\n<p>Na rozd\u00edl od Evropy je v\u00a0\u010cesk\u00e9 republice relativn\u011b n\u00edzk\u00e1 spot\u0159eba amfetaminu\u00a0\u2013 nejvy\u0161\u0161\u00ed n\u00e1lezy jsou p\u0159ibli\u017en\u011b 15\u00d7 ni\u017e\u0161\u00ed ne\u017e nejvy\u0161\u0161\u00ed n\u00e1lezy v\u00a0Evrop\u011b. Po\u0159ad\u00ed v\u00a0\u010cR je \u00dast\u00ed nad Labem, Praha, Ostrava a\u00a0Plze\u0148.<\/p>\n<p>Tramadol je \u00fa\u010dinn\u00e1 l\u00e1tka \u0159ady l\u00e9k\u016f p\u0159edepisovan\u00fdch na bolest (Tramal, Mabron, Noax). \u0158ad\u00ed se mezi opioidy a\u00a0m\u016f\u017ee na n\u011bj vzniknout z\u00e1vislost. \u010casto je tak\u00e9 zneu\u017e\u00edv\u00e1n. Jeho spot\u0159eba o\u00a0v\u00edkendech nar\u016fst\u00e1 a\u017e t\u0159ikr\u00e1t. Detailn\u011bji jsou v\u00fdsledky uvedeny ve sborn\u00edku z\u00a0konference\u00a0Hydroch\u00e9mia 2016 [8]. Pr\u016fb\u011b\u017en\u00e9 v\u00fdsledky projektu byly prezentov\u00e1ny tak\u00e9 na n\u011bkolika mezin\u00e1rodn\u00edch konferenc\u00edch, zejm\u00e9na pak na konferenci v\u00a0Ascon\u011b.<\/p>\n<h2>2. mezin\u00e1rodn\u00ed konference Wastewater\u00ad\u2011bassed drug epidemiology, 10.\u201315.\u00a010. Ascona, \u0160v\u00fdcarsko<\/h2>\n<p>Konference se z\u00fa\u010dastnilo 80 expert\u016f z\u00a023 zem\u00ed ze \u010dty\u0159 sv\u011btad\u00edl\u016f. Bylo p\u0159edneseno 44 \u00fastn\u00edch prezentac\u00ed, v\u00a0plak\u00e1tov\u00e9 sekci bylo prezentov\u00e1no 18 poster\u016f, 9 z\u00a0nich bylo p\u0159edstaveno formou bleskov\u00e9 prezentace. \u00dastn\u00ed p\u0159\u00edsp\u011bvky byly rozd\u011bleny do osmi sekc\u00ed. \u010ceskou republiku zastupovaly t\u0159i p\u0159\u00edsp\u011bvky autor\u016f z\u00a0V\u00daV TGM,\u00a0v.\u00a0v.\u00a0i. (jedna p\u0159edn\u00e1\u0161ka (O\u010den\u00e1\u0161kov\u00e1), dv\u011b plak\u00e1tov\u00e1 sd\u011blen\u00ed (Tu\u0161il, Kv\u00ed\u010dalov\u00e1)).<\/p>\n<p>P\u0159edn\u00e1\u0161ky v\u00a0sekci Monitoring informovaly o\u00a0vyu\u017eit\u00ed epidemiologick\u00e9ho p\u0159\u00edstupu k\u00a0monitorov\u00e1n\u00ed spot\u0159eby nez\u00e1konn\u00fdch l\u00e1tek. Bezesporu jednou z\u00a0nejv\u00fdznamn\u011bj\u0161\u00edch byla prezentace Kevina Thomase. Informoval o\u00a0v\u00fdsledc\u00edch celoevropsk\u00e9 studie, kter\u00e1\u00a0prob\u00edhala v\u00a0letech 2011 a\u017e 2015 celkem ve 42 evropsk\u00fdch zem\u00edch. Z\u00a0t\u00e9to studie jasn\u011b vypl\u00fdv\u00e1, \u017ee je nanejv\u00fd\u0161 vhodn\u00e9 doplnit st\u00e1vaj\u00edc\u00ed metody zji\u0161\u0165ov\u00e1n\u00ed spot\u0159eby drog anal\u00fdzou odpadn\u00edch vod [7]. Dal\u0161\u00edmi zaj\u00edmav\u00fdmi p\u0159\u00edsp\u011bvky p\u0159in\u00e1\u0161ej\u00edc\u00edmi informace z\u00a0mimoevropsk\u00e9ho prost\u0159ed\u00ed byly prezentace Xiqing Li z\u00a0\u010c\u00edny a\u00a0Cobuse Gerbera z\u00a0Ji\u017en\u00ed Austr\u00e1lie. Jak v\u00a0\u010c\u00edn\u011b, tak v\u00a0Ji\u017en\u00ed Austr\u00e1lii je p\u0159evl\u00e1daj\u00edc\u00ed drogou metamfetamin. V\u00a0Evrop\u011b dominuje metamfetamin jen v\u00a0n\u011bkter\u00fdch oblastech\u00a0\u2013 seversk\u00e9 zem\u011b, \u010d\u00e1st N\u011bmecka (Sasko), \u010cesk\u00e1 republika.<\/p>\n<p>Odb\u011bry odpadn\u00ed vody jsou realizov\u00e1ny v\u011bt\u0161inou na p\u0159\u00edtoku na \u010dist\u00edrnu. V\u00a0sekci Transformace byly p\u0159\u00edsp\u011bvky zab\u00fdvaj\u00edc\u00ed se chov\u00e1n\u00edm jednotliv\u00fdch l\u00e1tek p\u0159i pr\u016ftoku kanaliza\u010dn\u00edm syst\u00e9mem. Nap\u0159\u00edklad v\u00a0p\u0159\u00edsp\u011bvku Ann\u00ad\u2011Kathrin McCall (Swiss Federal Institute of Aquatic Science and Technology) bylo \u0159e\u0161eno rozd\u00edln\u00e9 chov\u00e1n\u00ed jednotliv\u00fdch l\u00e1tek v\u00a0p\u0159\u00edtomnosti \u010di nep\u0159\u00edtomnosti biofilmu. Nap\u0159\u00edklad benzoylekgonin (metabolit kokainu) a\u00a0MDMA (ext\u00e1ze) se za ur\u010dit\u00fdch podm\u00ednek v\u00a0p\u0159\u00edtomnosti biofilmu transformuj\u00ed. Tato transformace obecn\u011b m\u016f\u017ee m\u00edt vliv na p\u0159esnost zp\u011btn\u00e9ho v\u00fdpo\u010dtu spot\u0159eby nez\u00e1konn\u00fdch drog.<\/p>\n<p>P\u0159i zp\u011btn\u00e9 kalkulaci je velmi d\u016fle\u017eit\u00fd korek\u010dn\u00ed faktor, kter\u00fd vyjad\u0159uje pom\u011br molekul\u00e1rn\u00edch hmotnost\u00ed zvolen\u00e9 drogy a\u00a0specifick\u00e9 l\u00e1tky (metabolitu nebo nezm\u011bn\u011bn\u00e9 drogy) n\u00e1soben\u00fd pr\u016fm\u011brnou procentu\u00e1ln\u00ed metabolizac\u00ed drogy na zvolen\u00fd metabolit, pop\u0159.\u00a0p\u016fvodn\u00ed drogu, proch\u00e1z\u00ed\u00ad\u00ad\u2011li droga organismem \u010d\u00e1ste\u010dn\u011b nezm\u011bn\u011bna. Emma Gracia\u00ad\u2011Lor z\u00a0italsk\u00e9ho Instituto di Ricerche Farmacologiche \u201eMario Negri\u201c p\u0159edstavila studii, na jej\u00edm\u017e z\u00e1klad\u011b navrhuje up\u0159esn\u011bn\u00ed korek\u010dn\u00edch faktor\u016f pro zp\u011btn\u00fd v\u00fdpo\u010det spot\u0159eby drog. Pro porovn\u00e1n\u00ed spot\u0159eby drog v\u00a0jednotliv\u00fdch lokalit\u00e1ch je velmi d\u016fle\u017eit\u00e9 pou\u017e\u00edvat stejn\u00fd korek\u010dn\u00ed faktor.<\/p>\n<p>Rychle se vyv\u00edjej\u00edc\u00ed p\u0159\u00edstrojov\u00e1 technika umo\u017e\u0148uje analyzovat l\u00e1tky ve st\u00e1le ni\u017e\u0161\u00edch koncentrac\u00edch, s\u00a0lep\u0161\u00edm rozli\u0161en\u00edm jednotliv\u00fdch l\u00e1tek, p\u0159esn\u011bj\u0161\u00ed identifikac\u00ed. V\u00a0sekc\u00edch Analytika\/NPS (nov\u00e9 psychoaktivn\u00ed substance), Enanciometrick\u00e9 profilov\u00e1n\u00ed a\u00a0Alkohol\/festivaly\/NPS byly zaj\u00edmav\u00e9 p\u0159\u00edsp\u011bvky z\u00a0t\u00e9to oblasti.<\/p>\n<p>P\u0159edn\u00e1\u0161ka Wayna Halla z\u00a0University of Qeensland, Centre for Youth Substance Abuse Research z\u00a0Austr\u00e1lie uvedla sekci, kter\u00e1 se zab\u00fdvala \u0159e\u0161en\u00edm etick\u00fdch a\u00a0leg\u00e1ln\u00edch probl\u00e9m\u016f spojen\u00fdch s\u00a0vyu\u017eit\u00edm monitoringu spot\u0159eby drog prost\u0159ednictv\u00edm anal\u00fdzy odpadn\u00edch vod. P\u0159i vyu\u017eit\u00ed tohoto postupu v\u00a0mal\u00fdch lokalit\u00e1ch (z\u00e1bavn\u00ed centra, \u0161koly, v\u011bze\u0148sk\u00e1 za\u0159\u00edzen\u00ed) je nutn\u00e9 prezentaci v\u00fdsledk\u016f v\u011bnovat zvl\u00e1\u0161tn\u00ed pozornost, aby nedo\u0161lo nap\u0159.\u00a0k\u00a0nevhodn\u00e9 interpretaci prost\u0159ednictv\u00edm m\u00e9dii.<\/p>\n<p>Sledov\u00e1n\u00ed zp\u016fsobu u\u017e\u00edv\u00e1n\u00ed drog se v\u011bnovala ve sv\u00e9 studii Lisa Benaglia (Ecole des Sciences Criminelles, University of Lausanne, \u0160v\u00fdcarsko). V\u00a0pr\u016fb\u011bhu trv\u00e1n\u00ed t\u00fddenn\u00edho hudebn\u00edho festivalu byly odeb\u00edr\u00e1ny vzorky tak, aby byly zachyceny rozd\u00edly v\u00a0aplikaci drog v\u00a0pr\u016fb\u011bhu jednoho festivalov\u00e9ho dne i\u00a0cel\u00e9ho festivalu. Spot\u0159eba kokainu, marihuany a\u00a0metamfetaminu v\u00a0pr\u016fb\u011bhu cel\u00e9ho festivalu m\u00edrn\u011b stoupala, ale byla stejn\u00e1 jako pr\u016fm\u011brn\u00e1 spot\u0159eba ve \u0160v\u00fdcarsku, spot\u0159eba ext\u00e1ze (MDMA) a\u00a0amfetaminu byla v\u00a0pr\u016fb\u011bhu festivalu n\u011bkolikan\u00e1sobn\u011b vy\u0161\u0161\u00ed. B\u011bhem jednoho dne pr\u016fb\u011b\u017en\u011b stoupala spot\u0159eba ext\u00e1ze (MDMA), zat\u00edmco kokain byl pravd\u011bpodobn\u011b konzumov\u00e1n p\u0159ed za\u010d\u00e1tkem festivalov\u00e9ho dne.<\/p>\n<p>N\u011bkolik dal\u0161\u00edch p\u0159edn\u00e1\u0161ek bylo v\u011bnov\u00e1no vyu\u017eit\u00ed epidemiologick\u00e9ho p\u0159\u00edstupu ke sledov\u00e1n\u00ed konzumace alkoholu a\u00a0nikotinu.<\/p>\n<a href=\"http:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-2.jpg\" rel=\"shadowbox[sbpost-2710];player=img;\"><img decoding=\"async\" width=\"800\" height=\"1091\" class=\"alignnone size-full wp-image-2625 lazyload\" data-src=\"https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-2.jpg\" alt=\"ocenaskova-2\" data-srcset=\"https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-2.jpg 800w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-2-220x300.jpg 220w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-2-768x1047.jpg 768w, https:\/\/www.vtei.cz\/wp-content\/uploads\/2016\/12\/Ocenaskova-2-751x1024.jpg 751w\" data-sizes=\"(max-width: 800px) 100vw, 800px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 800px; --smush-placeholder-aspect-ratio: 800\/1091;\" \/><\/a>\n<h6>Obr.\u00a02. Sp\u00e1dov\u00e9 oblasti a\u00a0odb\u011brov\u00e1 m\u00edsta na kanaliza\u010dn\u00ed s\u00edti m\u011bsta Brno<br \/>\nFig. 2. Catchment areas and sampling places of Brno sewerage system<\/h6>\n<p>Nov\u00e9mu sm\u011b\u0159ov\u00e1n\u00ed vyu\u017eit\u00ed epidemiologick\u00e9ho p\u0159\u00edstupu byla v\u011bnov\u00e1na posledn\u00ed sekce Nov\u00e9 metody, dal\u0161\u00ed l\u00e1tky. Prost\u0159ednictv\u00edm sledov\u00e1n\u00ed r\u016fzn\u00fdch biomarker\u016f a\u00a0specifick\u00fdch metabolit\u016f v\u00a0odpadn\u00edch vod\u00e1ch je a\u00a0bude mo\u017eno sledovat zdravotn\u00ed stav populace.<\/p>\n<p>Konference byla velmi zaj\u00edmav\u00e1 a\u00a0p\u0159\u00ednosn\u00e1 a\u00a0je z\u0159ejm\u00e9, \u017ee epidemiologie odpadn\u00edch vod se bude i\u00a0nad\u00e1le rozv\u00edjet.<\/p>\n<p>Dal\u0161\u00ed mo\u017enosti vyu\u017eit\u00ed epidemiologick\u00e9ho p\u0159\u00edstupu k\u00a0anal\u00fdze odpadn\u00edch vod jasn\u011b definuje Kasprzyk\u00ad\u2011Hordern. Komun\u00e1ln\u00ed odpadn\u00ed vody obsahuj\u00ed komplexn\u00ed sm\u011bs chemick\u00fdch l\u00e1tek v\u010detn\u011b hum\u00e1nn\u00edch metabolit\u016f\u00a0\u2013 biomarker\u016f. Kvantitativn\u00ed m\u011b\u0159en\u00ed t\u011bchto specifick\u00fdch l\u00e1tek poskytne informaci nap\u0159.\u00a0o\u00a0zp\u016fsobu stravov\u00e1n\u00ed, zdravotn\u00edm stavu, v\u00fdskytu chorob, spot\u0159eb\u011b alkoholu, l\u00e9\u010div \u010di expozici populace environment\u00e1ln\u00edm a\u00a0potravinov\u00fdm kontaminant\u016fm [9].<\/p>\n<h2>Z\u00e1v\u011br<\/h2>\n<p>Projekt Stanoven\u00ed mno\u017estv\u00ed neleg\u00e1ln\u00edch drog a\u00a0jejich metabolit\u016f v\u00a0komun\u00e1ln\u00edch odpadn\u00edch vod\u00e1ch\u00a0\u2013 n\u00e1stroj pro dopln\u011bn\u00ed \u00fadaj\u016f o\u00a0spot\u0159eb\u011b drog v\u00a0\u010cesk\u00e9 republice splnil sv\u016fj \u00fa\u010del a\u00a0p\u0159inesl \u00fadaje o\u00a0spot\u0159eb\u011b nez\u00e1konn\u00fdch drog a\u00a0dal\u0161\u00edch l\u00e1tek v\u00a025 m\u011bstech \u010cesk\u00e9 republiky. Celkov\u011b v\u00a0t\u011bchto m\u011bstech \u017eije v\u00edce ne\u017e t\u0159etina obyvatel \u010ceska. Byla certifikov\u00e1na metodika, kter\u00e1 je pln\u011b kompatibiln\u00ed s\u00a0postupy pou\u017e\u00edvan\u00fdmi v\u00a0Evrop\u011b i\u00a0v\u00a0dal\u0161\u00edch mimoevropsk\u00fdch lokalit\u00e1ch.<\/p>\n<p>Modifikace metodiky pro mal\u00e9 lokality byla a\u00a0je ji\u017e vyu\u017e\u00edv\u00e1na ve spolupr\u00e1ci s\u00a0polici\u00ed \u010cesk\u00e9 republiky p\u0159edev\u0161\u00edm v\u00a0Moravskoslezsk\u00e9m kraji. V\u00a0n\u011bkter\u00fdch \u0161kol\u00e1ch v\u00a0tomto kraji byly ve stejn\u00e9m \u010dasov\u00e9m \u00faseku provedeny dotazn\u00edkov\u00e9 akce, slinn\u00e9 testy na p\u0159\u00edtomnost drog a\u00a0odb\u011bry a\u00a0anal\u00fdza p\u0159\u00edslu\u0161n\u00fdch odpadn\u00edch vod. Uk\u00e1zala se v\u00fdznamn\u00e1 shoda mezi slinn\u00fdmi testy a\u00a0rozbory odpadn\u00edch vod. Epidemiologick\u00fd p\u0159\u00edstup k\u00a0anal\u00fdze odpadn\u00edch vod m\u00e1 velk\u00fd potenci\u00e1l a\u00a0bylo by p\u0159\u00ednosn\u00e9, kdyby tento p\u0159\u00edstup byl i\u00a0nad\u00e1le aplikov\u00e1n, rozv\u00edjen a\u00a0vyu\u017e\u00edv\u00e1n jak ve V\u00daV TGM,\u00a0v.\u00a0v.\u00a0i., tak v\u00a0r\u00e1mci \u010cesk\u00e9 republiky.<\/p>\n<h3>Pod\u011bkov\u00e1n\u00ed<\/h3>\n<p><em>V\u0161echny odebran\u00e9 vzorky byly zpracov\u00e1ny v\u00a0Referen\u010dn\u00ed laborato\u0159i slo\u017eek \u017eivotn\u00edho prost\u0159ed\u00ed a\u00a0odpad\u016f V\u00daV TGM,\u00a0v.\u00a0v.\u00a0i.<\/em><\/p>\n<p><em>Projekt by nebylo mo\u017eno realizovat bez \u00fazk\u00e9 spolupr\u00e1ce s\u00a0n\u00e1sleduj\u00edc\u00edmi kl\u00ed\u010dov\u00fdmi institucemi a\u00a0subjekty v\u00a0oblasti vodovod\u016f a\u00a0kanalizac\u00ed: Pra\u017esk\u00e9 vodovody a\u00a0kanalizace,\u00a0a.\u00a0s., Vod\u00e1rna Plze\u0148, Ostravsk\u00e9 vod\u00e1rny a\u00a0kanalizace,\u00a0a.\u00a0s., Severo\u010desk\u00e9 vodovody a\u00a0kanalizace,\u00a0a.\u00a0s., Brn\u011bnsk\u00e9 vod\u00e1rny a\u00a0kanalizace,\u00a0a.\u00a0s., VEOLIA Voda \u010cesk\u00e1 republika,\u00a0a.\u00a0s., Severomoravsk\u00e9 vodovody a\u00a0kanalizace,\u00a0a.\u00a0s., CHEVAK Cheb,\u00a0a.\u00a0s., Moravsk\u00e1 vod\u00e1rensk\u00e1,\u00a0a.\u00a0s., Severo\u010desk\u00e1 vod\u00e1rensk\u00e1 spole\u010dnost,\u00a0a.\u00a0s., Vod\u00e1rny a\u00a0kanalizace Karlovy Vary,\u00a0a.\u00a0s., \u010cEVAK,\u00a0a.\u00a0s.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This paper presents a brief summary of information about the project Determination of the amount of illicit drugs and their metabolites in municipal wastewater \u2013 new tool for obtaining of complementary data on illicit drug consumption in the Czech Republic and about the 2nd International Conference on \u201cWastewater\u2011based drug epidemiology\u201c, which was held from 11.\u201315. 10. 2015 in Ascona, Switzerland.<\/p>\n","protected":false},"author":8,"featured_media":2627,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[87,89],"tags":[667,668,665,669,663,664,666,662],"coauthors":[599],"class_list":["post-2710","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hydrochemistry-radioecology-microbiology","category-water-technology-water-supply-waste-water-treatment","tag-amphetamine","tag-cocaine","tag-ecstasy","tag-ephedrine","tag-illicit-drugs","tag-lcms-ms","tag-methamphetamine","tag-wastewaterbased-epidemiology"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/posts\/2710","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/comments?post=2710"}],"version-history":[{"count":2,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/posts\/2710\/revisions"}],"predecessor-version":[{"id":30362,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/posts\/2710\/revisions\/30362"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/media\/2627"}],"wp:attachment":[{"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/media?parent=2710"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/categories?post=2710"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/tags?post=2710"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.vtei.cz\/en\/wp-json\/wp\/v2\/coauthors?post=2710"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}