Date of Award

Spring 2026

Document Type

Open Access Dissertation

Department

Environmental Health Sciences

First Advisor

R. Sean Norman

Abstract

Wastewater and wastewater treatment plants can both positively and negatively influence public health, due to their central role in socio-ecological systems in many communities. This dissertation aimed to fill key gaps in understanding their roles: as possible sources of occupational exposure and as tools for community disease monitoring and control. The three projects in this work examined these roles, focusing on how WWTPs can impact and inform public health at both occupational and community levels. Specifically, the study investigated the effects of chronic low-dose exposure to ARGs on WWTP workers' resistomes, evaluated the potential of WBE for building-level surveillance as a public health mitigation tool, and explored the detection limits for M. tuberculosis in wastewater using various methodologies for low-prevalence settings. Nasal samples from WWTP workers were analyzed and compared to those from drinking water treatment plant workers to assess ARG exposure. Wastewater surveillance for SARS-CoV-2 was carried out in 11 university residence halls to evaluate transmission patterns and compare viral concentrations with reported cases, demonstrating the effectiveness of WBE as a predictive tool. Additionally, multiple methods were tested for tuberculosis detection in wastewater, showing the practicality and benefits of employing WBE for TB monitoring in areas with low prevalence. By integrating occupational risk assessments with viral and bacterial pathogen monitoring, this work highlights the importance of incorporating wastewater systems into broader public health strategies to address emerging health threats.

Rights

© 2026, Sarah Catherine Sellers

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