Journal of Public Health

, Volume 24, Issue 3, pp 165–174 | Cite as

A nuanced picture of illicit drug use in 17 Italian cities through functional principal component analysis of temporal wastewater data

  • Stefania SalvatoreEmail author
  • Kathrine Frey Frøslie
  • Jo Røislien
  • Ettore Zuccato
  • Sara Castiglioni
  • Jørgen G. Bramness
Original Article



Wastewater-based epidemiology is a novel approach in drug use epidemiology, which may provide more objective estimates of illicit drug use in a community. Functional data analysis (FDA) is a statistical framework specifically developed for analysing curves. We applied FDA to study weekly temporal patterns in wastewater curves for six different drugs in Italy.


Wastewater samples were collected over seven consecutive days in November 2013, from the inlet of 17 wastewater treatment plants in 17 Italian cities. The weekly temporal features of the drug loads throughout the week were extracted using functional principal component analysis (FPCA), obtaining functional principal component (FPC) curves and corresponding FPC score variables. The FPC score variables were used as outcome variables in linear regression analyses.


The most important weekly features of the drug loads were captured by the first three FPCs. The first FPC represented the general level of drug in the wastewater, while the second and third FPCs represented the discrepancy between the weekend peak and midweek level, and the weekend peak timing respectively. Cannabis was the predominant drug in the Italian wastewater, while ecstasy (MDMA) was the drug with the highest discrepancy between the weekend peak and midweek level. The Italian cities showed different patterns of drug use depending on several characteristics of the cities.


FPCA extracted detailed features of the weekly temporal patterns of the use of drugs derived from the wastewater analysis. This may help in understanding and monitoring the profile of drug use in a specific community.


Wastewater-based epidemiology Illicit drugs Functional principal component analysis Pattern of drug use 



We gratefully acknowledge the European Union and the Norwegian Centre for Addiction Research (SERAF) for the financial support. We would also like to thank all colleagues from the SEWPROF team and SCORE group (


All authors have contributed to this scientific work and have approved the final version of the manuscript. EZ and SC have provided the wastewater data and revised the paper. SS, KFF, JR and JGB designed the study, the data analysis and revised the paper. SS analysed the data and drafted the manuscript.

Data sharing statement

The data used in this study are freely available:

Compliance with ethical standards


The study is funded by the EU-International Training Network SEWPROF (Marie Curie-FP7-PEOPLE Grant #317205) and the Norwegian Centre for Addiction Research (SERAF). The analytical campaign in Italy (“Aqua Drugs” Project) was supported by Dipartimento Politiche Antidroga (Presidenza del Consiglio dei Ministri, Rome, Italy).

Competing interests

The authors declare that they have no competing interests.

Supplementary material

10389_2016_717_MOESM1_ESM.doc (40 kb)
Table S1 Summary statistics among cities for each drug per each day (DOC 40 kb)
10389_2016_717_Fig3_ESM.jpg (115 kb)
Fig. S1

Results from the FPCA of the supplementary analysis. Plots a and b show the mean of the fitted curves of the standardised data (solid line) and how the shape of a temporal curve differs from the mean curve if a multiple of the SFPC curve is added to (+ +) or subtracted from (- -) the mean curve. The multiples correspond to one SD of the SFPC1 and SFPC2 scores, respectively. Plot c shows the bivariate scatter plot of SFPCs’ scores. In the scatter plot, each city is identified by a number, while each drug is identified by a colour (JPG 114 kb)

10389_2016_717_MOESM2_ESM.eps (8 kb)
High Resolution Image (EPS 7 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Stefania Salvatore
    • 1
    Email author
  • Kathrine Frey Frøslie
    • 2
    • 3
  • Jo Røislien
    • 1
    • 2
  • Ettore Zuccato
    • 4
  • Sara Castiglioni
    • 4
  • Jørgen G. Bramness
    • 1
  1. 1.Norwegian Centre for Addiction ResearchUniversity of OsloOsloNorway
  2. 2.Oslo Centre for Biostatistics and EpidemiologyInstitute of Basic Medical SciencesOsloNorway
  3. 3.Norwegian Resource Centre for Women’s Health, Division of Obstetrics and GynaecologyOslo University Hospital, RikshospitaletOsloNorway
  4. 4.Department of Environmental Health SciencesIRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”MilanItaly

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