{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:31:07Z","timestamp":1790775067323,"version":"4.1.0"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T00:00:00Z","timestamp":1580428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["41701543"],"award-info":[{"award-number":["41701543"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["41877508"],"award-info":[{"award-number":["41877508"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["2018NTST20"],"award-info":[{"award-number":["2018NTST20"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["2017XTCX02"],"award-info":[{"award-number":["2017XTCX02"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013314","name":"111 Project","doi-asserted-by":"publisher","award":["B18006"],"award-info":[{"award-number":["B18006"]}],"id":[{"id":"10.13039\/501100013314","id-type":"DOI","asserted-by":"publisher"}]},{"name":"International Partnership Program of Chinese Academy of Sciences","award":["132744KYSB20170002"],"award-info":[{"award-number":["132744KYSB20170002"]}]},{"name":"Institution Centre of Excellence (HiCOE) Phase II Fund, Ministry of Higher Education Malaysia","award":["IOES-2014D"],"award-info":[{"award-number":["IOES-2014D"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Southeast Asian countries including Malaysia play a major role in global drug trade and abuse. Use of amphetamine-type stimulants has increased in the past decade in Malaysia. This study aimed to apply wastewater-based epidemiology for the first time in Kuala Lumpur, Malaysia, to estimate the consumption of common illicit drugs in urban population. Influent wastewater samples were collected from two wastewater treatment plants in Kuala Lumpur in the summer of 2017. Concentrations of twenty-four drug biomarkers were analyzed for estimating drug consumption. Fourteen drug residues were detected with concentrations of up to 1640 ng\/L. Among the monitored illicit drugs, 3,4-methylenedioxy-methamphetamine (MDMA) or ecstasy had the highest estimated per capita consumptions. Consumption and dose of amphetamine-type stimulants (methamphetamine and MDMA) were both an order of magnitude higher than those of opioids (heroin and codeine, methadone and tramadol). Amphetamine-type stimulants were the most prevalent drugs, replacing opioids in the drug market. The prevalence trend measured by wastewater-based epidemiology data reflected the shift to amphetamine-type stimulants as reported by the Association of Southeast Asian Nations Narcotics Cooperation Center. Most of the undetected drug residues were new psychoactive substances (NPSs), suggesting a low prevalence of NPSs in the drug market.<\/jats:p>","DOI":"10.3390\/ijerph17030889","type":"journal-article","created":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T11:55:56Z","timestamp":1580471756000},"page":"889","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Monitoring Consumption of Common Illicit Drugs in Kuala Lumpur, Malaysia, by Wastewater-Cased Epidemiology"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-7089","authenticated-orcid":false,"given":"Peng","family":"Du","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory of Urban Hydrological Cycle and Sponge City Technology, College of Water Sciences, Beijing Normal University, Beijing 100875, China"},{"name":"Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangcai","family":"Zhong","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret William","family":"Thomes","sequence":"additional","affiliation":[{"name":"Institute of Biological Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon Weng","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Biological Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia"},{"name":"Institute of Ocean and Earth Sciences (IOES), University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chui Wei","family":"Bong","sequence":"additional","affiliation":[{"name":"Institute of Biological Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia"},{"name":"Institute of Ocean and Earth Sciences (IOES), University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Urban Hydrological Cycle and Sponge City Technology, College of Water Sciences, Beijing Normal University, Beijing 100875, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanghua","family":"Hao","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Urban Hydrological Cycle and Sponge City Technology, College of Water Sciences, Beijing Normal University, Beijing 100875, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiqing","family":"Li","sequence":"additional","affiliation":[{"name":"Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gan","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phong K.","family":"Thai","sequence":"additional","affiliation":[{"name":"Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane 4102, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,31]]},"reference":[{"key":"ref_1","unstructured":"UNODC (United Nations Office on Drugs and Crime) (2018). World Drug Report 2018, Executive Summary Conclusions and Policy Implications, United Nations Office on Drugs and Crime."},{"key":"ref_2","unstructured":"UNODC (United Nations Office on Drugs and Crime) (2019). Synthetic Drugs in East and South-East Asia-Trends and Patterns of Amphetamine-Type Stimulants and New Psychoactive Substances, United Nations Office on Drugs and Crime."},{"key":"ref_3","unstructured":"UNODC (United Nations Office on Drugs and Crime) (2019). Transnational Organized Crime in Southeast Asia: Evolution, Growth and Impact, United Nations Office on Drugs and Crime."},{"key":"ref_4","unstructured":"UNODC (United Nations Office on Drugs and Crime) (2017). World Drug Report 2017, United Nations Office on Drugs and Crime."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1016\/j.jfda.2013.09.033","article-title":"Substance abuse and the HIV situation in Malaysia","volume":"21","author":"Singh","year":"2013","journal-title":"J. Food Drug Anal."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.scitotenv.2018.04.192","article-title":"Association between purity of drug seizures and illicit drug loads measured in wastewater in a South East Queensland catchment over a six year period","volume":"635","author":"Bruno","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.scitotenv.2012.06.069","article-title":"Comparing illicit drug use in 19 European cities through sewage analysis","volume":"432","author":"Thomas","year":"2012","journal-title":"Sci. Total Environ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1111\/add.12570","article-title":"Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis","volume":"109","author":"Ort","year":"2014","journal-title":"Addiction"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.watres.2017.11.051","article-title":"Enantiomeric profiling of chiral illicit drugs in a pan-European study","volume":"130","author":"Yang","year":"2018","journal-title":"Water Res."},{"key":"ref_10","first-page":"109","article-title":"Spatio-temporal assessment of illicit drug use at large scale: Evidence from 7 years of international wastewater monitoring","volume":"115","author":"Alygizakis","year":"2019","journal-title":"Addiction"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.scitotenv.2013.11.094","article-title":"Analysis of drugs of abuse in wastewater from two Canadian cities","volume":"487","author":"Yargeau","year":"2014","journal-title":"Sci. Total Environ."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6661","DOI":"10.1021\/es501709a","article-title":"Mass loading and removal of select illicit drugs in two wastewater treatment plants in New York State and estimation of illicit drug usage in communities through wastewater analysis","volume":"48","author":"Subedi","year":"2014","journal-title":"Environ. Sci. Technol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.scitotenv.2016.05.181","article-title":"Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009\u20132015) in South East Queensland, Australia","volume":"568","author":"Lai","year":"2016","journal-title":"Sci. Total Environ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1021\/acs.estlett.8b00673","article-title":"Analyzing Wastewater Samples Collected during Census To Determine the Correction Factors of Drugs for Wastewater-Based Epidemiology: The Case of Codeine and Methadone","volume":"6","author":"Thai","year":"2019","journal-title":"Environ. Sci. Techol. Lett."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.envint.2018.12.003","article-title":"A National Wastewater Monitoring Program for a better understanding of public health: A case study using the Australian Census","volume":"122","author":"Grant","year":"2019","journal-title":"Environ. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.scitotenv.2018.02.309","article-title":"Assessment of drugs and personal care products biomarkers in the influent and effluent of two wastewater treatment plants in Ho Chi Minh City, Vietnam","volume":"631","author":"Nguyen","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"107532","DOI":"10.1016\/j.drugalcdep.2019.06.034","article-title":"Monitoring consumption of methadone and heroin in major Chinese cities by wastewater-based epidemiology","volume":"205","author":"Du","year":"2019","journal-title":"Drug Alcohol Depend."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"134207","DOI":"10.1016\/j.scitotenv.2019.134207","article-title":"Use of legal and illegal substances in Male (Republic of Maldives) assessed by wastewater analysis","volume":"698","author":"Fallati","year":"2020","journal-title":"Sci. Total Environ."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1038\/d41586-018-05728-3","article-title":"Chinese cities scan sewers for signs of illegal drug use","volume":"559","author":"Cyranoski","year":"2018","journal-title":"Nature"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.coesh.2019.05.003","article-title":"Wastewater: A new resource for the war against illicit drugs","volume":"9","author":"Li","year":"2019","journal-title":"Curr. Opin. Environ. Sci. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.scitotenv.2017.12.269","article-title":"Wastewater-based epidemiology and enantiomeric profiling for drugs of abuse in South African wastewaters","volume":"625","author":"Archer","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.scitotenv.2017.04.202","article-title":"Occurrence and fate of illicit drugs and pharmaceuticals in wastewater from two wastewater treatment plants in Costa Rica","volume":"599","author":"Causanilles","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2882","DOI":"10.1016\/j.jece.2015.09.031","article-title":"Mass loading and removal of pharmaceuticals and personal care products, including psychoactive and illicit drugs and artificial sweeteners, in five sewage treatment plants in India","volume":"3","author":"Subedi","year":"2015","journal-title":"J. Environ. Chem. Eng."},{"key":"ref_24","unstructured":"Kanato, M., Choomwattana, C., Sarasiri, R., and Leyatikul, P. (2018). ASEAN Drug Monitoring Report 2017, ASEAN Narcotics Cooperation Center."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1111\/j.1360-0443.2012.03887.x","article-title":"An analysis of ethical issues in using wastewater analysis to monitor illicit drug use","volume":"107","author":"Hall","year":"2012","journal-title":"Addiction"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Pardo, B., Kilmer, B., and Huang, W. (2019). Contemporary Asian Drug Policy: Insights and Opportunities for Change, RAND Corporation.","DOI":"10.7249\/RR2733"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.envpol.2016.02.036","article-title":"Occurrence of illicit drugs in surface waters in China","volume":"213","author":"Li","year":"2016","journal-title":"Environ. Pollut."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.scitotenv.2016.09.152","article-title":"Occurrence of new psychoactive substances in wastewater of major Chinese cities","volume":"575","author":"Gao","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1016\/j.scitotenv.2018.06.325","article-title":"Estimating population exposure to phthalate esters in major Chinese cities through wastewater-based epidemiology","volume":"643","author":"Du","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.scitotenv.2014.05.042","article-title":"Estimation of amphetamine and methamphetamine uses in Beijing through sewage-based analysis","volume":"490","author":"Li","year":"2014","journal-title":"Sci. Total Environ."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.scitotenv.2017.05.262","article-title":"Estimating heroin abuse in major Chinese cities through wastewater-based epidemiology","volume":"605","author":"Du","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1289\/ehp.11022","article-title":"Estimating community drug abuse by wastewater analysis","volume":"116","author":"Zuccato","year":"2008","journal-title":"Environ. Health Perspect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.scitotenv.2018.06.242","article-title":"Enantiomeric profiling of amphetamine and methamphetamine in wastewater: A 7-year study in regional and urban Queensland, Australia","volume":"643","author":"Gao","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/j.chemosphere.2012.05.110","article-title":"Investigation of drugs of abuse and relevant metabolites in Dutch sewage water by liquid chromatography coupled to high resolution mass spectrometry","volume":"89","author":"Bijlsma","year":"2012","journal-title":"Chemosphere"},{"key":"ref_35","unstructured":"EMCDDA (European Monitoring Centre for Drugs and Drug Addiction) (2019). Wastewater Analysis and Drugs\u2014A European Multi-City Study."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"8841","DOI":"10.1021\/es802309v","article-title":"Eliminating solid phase extraction with large-volume injection LC\/MS\/MS: Analysis of illicit and legal drugs and human urine indicators in US wastewaters","volume":"42","author":"Chiaia","year":"2008","journal-title":"Environ. Sci. Technol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.watres.2015.07.025","article-title":"Methamphetamine and ketamine use in major Chinese cities, a nationwide reconnaissance through sewage-based epidemiology","volume":"84","author":"Du","year":"2015","journal-title":"Water Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.scitotenv.2018.03.175","article-title":"Estimation of the consumption of illicit drugs during special events in two communities in Western Kentucky, USA using sewage epidemiology","volume":"633","author":"Foppe","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.scitotenv.2008.02.057","article-title":"Occurrence of psychoactive stimulatory drugs in wastewaters in north-eastern Spain","volume":"397","author":"Galceran","year":"2008","journal-title":"Sci. Total Environ."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.scitotenv.2015.04.065","article-title":"The first application of wastewater-based drug epidemiology in five South Korean cities","volume":"524","author":"Kim","year":"2015","journal-title":"Sci. Total Environ."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.forsciint.2013.09.003","article-title":"Estimating daily and diurnal variations of illicit drug use in Hong Kong: A pilot study of using wastewater analysis in an Asian metropolitan city","volume":"233","author":"Lai","year":"2013","journal-title":"Forensic Sci. Int."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Subedi, B., Burgard, D.A., and Loganathan, B.G. (2019). Application of Wastewater-Based Epidemiology in China\u2014From Wastewater Monitoring to Drug Control Efforts. Wastewater-Based Epidemiology: Estimation of Community Consumption of Drugs and Diets, American Chemical Society.","DOI":"10.1021\/bk-2019-1319"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1016\/j.envpol.2010.07.002","article-title":"Illicit drugs in Canadian municipal wastewater and estimates of community drug use","volume":"158","author":"Metcalfe","year":"2010","journal-title":"Environ. Pollut."},{"key":"ref_44","unstructured":"SCORE (Sewage Analysis CORe Group Europe) (2019). Wastewater Monitoring Data 2011\u20132018 Sewage Analysis CORe Group Europe, Sewage Analysis CORe Group Europe."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1016\/j.scitotenv.2018.03.060","article-title":"Contamination profiles, mass loadings, and sewage epidemiology of neuropsychiatric and illicit drugs in wastewater and river waters from a community in the Midwestern United States","volume":"631","author":"Skees","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1002\/dta.1460","article-title":"Optimization, validation, and the application of liquid chromatography-tandem mass spectrometry for the analysis of new drugs of abuse in wastewater","volume":"6","author":"Gheorghe","year":"2014","journal-title":"Drug Test Anal."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Castiglioni, S., Zuccato, E., and Fanelli, R. (2011). Illicit Drugs in the Environment: Occurrence, Analysis, and Fate Using Mass Spectrometry, John Wiley & Sons, Inc.","DOI":"10.1002\/9781118000816"},{"key":"ref_48","unstructured":"UNODC (United Nations Office on Drugs and Crime) (2017). The Challenge of Synthetic Drugs in East and South-East Asia, Trends and Patterns of Amphetamine-Type Stimulants and New Psychoactive Substances."},{"key":"ref_49","unstructured":"EMCDDA (European Monitoring Centre for Drugs and Drug Addiction) (2016). Assessing Illicit Drugs in Wastewater: Advances in Wastewater-Based Drug Epidemiology, Publications Office of the European Union."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1039\/c0em00686f","article-title":"A one year investigation of the occurrence of illicit drugs in wastewater from Brussels, Belgium","volume":"13","author":"Mougel","year":"2011","journal-title":"J. Environ. Monit."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1021\/es302722f","article-title":"Evaluation of uncertainties associated with the determination of community drug use through the measurement of sewage drug biomarkers","volume":"47","author":"Castiglioni","year":"2013","journal-title":"Environ. Sci. Technol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/3\/889\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:53:26Z","timestamp":1760172806000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/3\/889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,31]]},"references-count":51,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["ijerph17030889"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17030889","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,31]]}}}