Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation (original) (raw)
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Environmental Science and Pollution Research
The concentrations and distribution of β-blockers, lipid regulators, and psychiatric and cancer drugs in the influent and effluent of the municipal wastewater treatment plant (WWTP) and the effluent of 16 hospitals that discharge into the wastewater treatment plant mentioned in this study at two sampling dates in summer and winter were examined. The pharmaceutical contribution of hospitals to municipal wastewater was determined. The removal of target pharmaceuticals was evaluated in a WWTP consisting of conventional biological treatment using activated sludge. Additionally, the potential environmental risk for the aquatic receiving environments (salt lake) was assessed. Beta-blockers and psychiatric drugs were detected in high concentrations in the wastewater samples. Atenolol (919 ng/L) from β-blockers and carbamazepine (7008 ng/L) from psychiatric pharmaceuticals were detected at the highest concentrations in hospital wastewater. The total pharmaceutical concentration determined at the WWTP influent and effluent was between 335 and 737 ng/L in summer and between 174 and 226 ng/L in winter. The concentrations detected in hospital effluents are higher than the concentrations detected in WWTP. The total pharmaceutical contributions from hospitals to the WWTP in summer and winter were determined to be 2% and 4%, respectively. Total pharmaceutical removal in the WWTP ranged from 23 to 54%. According to the risk ratios, atenolol could pose a high risk (risk quotient > 10) for fish in summer and winter. There are different reasons for the increase in pharmaceutical consumption in recent years. One of these reasons is the COVID-19 pandemic, which has been going on for 2 years. In particular, hospitals were operated at full capacity during the pandemic, and the occurrence and concentration of pharmaceuticals used for the therapy of COVID-19 patients has increased in hospital effluent. Pandemic conditions have increased the tendency of people to use psychiatric drugs. It is thought that beta-blocker consumption has increased due to cardiovascular diseases caused by COVID-19. Therefore, the environmental risk of pharmaceuticals for aquatic organisms in hospital effluent should be monitored and evaluated.
The Science of the total environment, 2015
The fates of psychoactive pharmaceuticals, including two antischizophrenics, six sedative-hypnotic-anxiolytics, four antidepressants, four antihypertensives, and their select metabolites, were determined in two wastewater treatment plants (WWTPs) in the Albany area of New York. All target psychoactive pharmaceuticals and their metabolites were found at a mean concentration that ranged from 0.98 (quetiapine) to 1220ng/L (atenolol) in wastewater and from 0.26 (lorazepam) to 1490ng/g dry weight (sertraline) in sludge. In this study, the fraction of psychoactive pharmaceuticals that was sorbed to suspended particulate matter (SPM) was calculated for the first time. Over 50% of the total mass of aripiprazole, norquetiapine, norsertraline, citalopram, desmethyl citalopram, propranolol, verapamil, and norverapamil was found sorbed to SPM in the influent. The mass loadings, i.e., influx, of target psychoactive pharmaceuticals in WWTPs ranged from 0.91 (diazepam) to 347mg/d/1000 inhabitants ...
A Human Health Risk Assessment of Pharmaceuticals in the Aquatic Environment
Human and Ecological Risk Assessment, 2002
Analyses were conducted on four pharmaceutical compounds, representing different therapeutic classes, to evaluate the presence and potential adverse human health effects of trace levels of these substances in aqueous environmental media. Acetylsalicylic acid, clofibrate, cyclophosphamide, and indomethacin have been detected in aqueous environmental media including sewage treatment plant effluent, surface water, drinking water, and groundwater. An extensive literature search and chemical-specific risk assessments were performed to assess the potential human health significance of each compound's individual presence in environmental media. Safe water quality limits were estimated for each pharmaceutical by following the USEPA Methodology for Deriving Ambient Water Quality Criteria for the Protection of Human Health and were compared to the concentrations found in the environment. The calculation of the provisional ambient water quality criteria involved estimation of human exposure to contaminated water, including intake via bioaccumulation in fish, and calculation of cancer risk and non-cancer hazard indices. Parameters detailing the toxicological and pharmacological nature, exposure assessment, and environmental fate and transport of each pharmaceutical were also considered. The overall conclusion was that based on available data, no appreciable risk to humans exists, as the detected concentrations of each of these pharmaceutical compounds found in aqueous media were far below the derived safe limits.
Ranking and prioritization of environmental risks of pharmaceuticals in surface waters
Regulatory Toxicology and Pharmacology, 2004
Pharmaceuticals have been reported in surface waters, prompting legitimate public concern, as pharmaceuticals are biologically active compounds used daily by the public. Currently there are ecotoxicological data available for <1%, thus, the European Union CommissionÕs Scientific committee on Toxicity, Ecotoxicity, and Environment (CSTEE) recommended use of (Q)SAR models and precaution to prioritize further risk assessment of $4500 compounds and their adjuvants. We ranked 2986 different pharmaceutical compounds in 51 classes relative to hazard toward algae, daphnids, and fish using the EPIWIN program. This ranking cannot be used to acquit a compound based on predicted relative ranking. Modifying additives were the most toxic classes. Cardiovascular, gastrointestinal, antiviral, anxiolytic sedatives hypnotics and antipsychotics, corticosteroid, and thyroid pharmaceuticals were the predicted most hazardous therapeutic classes. The overall relative order of susceptibility was estimated to be daphnids > fish > algae. Expert judgment is needed to assess specific hazards for classes like microbial resistance and antibiotics, sex hormones, and endocrine disruptors. As human health and the function of ecological systems are interconnected and subject to the precautionary principle, harmonization of evidence for correlation and causality of adverse effects seems sensible in an ethical and cost-effective context to facilitate substitution of hazardous compounds. Data available: http://www.uoguelph.ca/\~hsander/.
Pharmaceuticals in the surface water of the USA: A review
This review investigates the occurrence of pharmaceuticals in the surface waters (including rivers, lakes, oceans, and aquifers) of the USA, discusses various pathways of pharmaceutical contamination from different point sources, assesses the potential risk of pharmaceutical contamination for aquatic organisms, and provides a discussion on the opportunities for a sustainable management of pharmaceutical contamination. We found a total of 93 pharmaceuticals that have been reported to contaminate the surface water, including: 27 antibiotics; 15 antidepressants; 9 antihypertensives; 7 analgesics; 7 anticonvulsants; 6 antilipidemics; 3 contraceptives; 3 stimulants; and 2 each of antihistamines, blood thinners, disinfectants, antacids, antitussives, anti-anxiety, antiinflammatory, and diuretic agents. The pharmaceuticals that are assessed to be at high risk (risk quotient RQ ≥1.0) include acetaminophen (analgesic), caffeine (stimulant), sulfadimethoxine (antibiotic), as well as triclocarban and triclosan (both used in disinfectants). Such drugs require detailed evaluation as to the frequency of their occurrence and the risks for aquatic organisms and humans. Opportunities for sustainable control of pharmaceutical contamination include source control (proper disposal of leftover pharmaceuticals; careful monitoring of hospital wastes), and improvements to treatment facilities for the efficient removal and safe transformation of pharmaceutical contaminants.
Risks to aquatic organisms posed by human pharmaceutical use
Science of The Total Environment, 2008
In order to help prioritize future research efforts within the US, risks associated with exposure to human prescription pharmaceutical residues in wastewater were estimated from marketing and pharmacological data. Masses of 371 active pharmaceutical ingredients (APIs) dispensed in the US in 2004 were estimated from marketing data, and then divided by therapeutic dose rate to normalize for potency. Metabolic inactivation of the 50 most dispensed APIs was estimated from published data, and active metabolites were tabulated.
Human health risk assessment from the presence of human pharmaceuticals in the aquatic environment
Regulatory Toxicology and Pharmacology, 2009
Analyses were conducted on four pharmaceutical compounds, representing different therapeutic classes, to evaluate the presence and potential adverse human health effects of trace levels of these substances in aqueous environmental media. Acetylsalicylic acid, clofibrate, cyclophosphamide, and indomethacin have been detected in aqueous environmental media including sewage treatment plant effluent, surface water, drinking water, and groundwater. An extensive literature search and chemical-specific risk assessments were performed to assess the potential human health significance of each compound's individual presence in environmental media. Safe water quality limits were estimated for each pharmaceutical by following the USEPA Methodology for Deriving Ambient Water Quality Criteria for the Protection of Human Health and were compared to the concentrations found in the environment. The calculation of the provisional ambient water quality criteria involved estimation of human exposure to contaminated water, including intake via bioaccumulation in fish, and calculation of cancer risk and non-cancer hazard indices. Parameters detailing the toxicological and pharmacological nature, exposure assessment, and environmental fate and transport of each pharmaceutical were also considered. The overall conclusion was that based on available data, no appreciable risk to humans exists, as the detected concentrations of each of these pharmaceutical compounds found in aqueous media were far below the derived safe limits.
Environmental Toxicology and Chemistry, 2007
The occurrence of 28 pharmaceuticals of major human consumption in Spain, including analgesics and anti-inflammatories, lipid regulators, psychiatric drugs, antibiotics, antihistamines, and -blockers, was assessed along the Ebro river basin, one of the biggest irrigated lands in that country. Target compounds were simultaneously analyzed by off-line solid-phase extraction, followed by liquid chromatography-tandem mass spectrometry. The loads of detected pharmaceuticals and their removal rates were studied in seven wastewater treatment plants (WWTPs) located in the main cities along the basin. Total loads ranged from 2 to 5 and from 0.5 to 1.5 g/d/1,000 inhabitants in influent and effluent wastewaters, respectively. High removal rates (60-90%) were achieved mainly for analgesics and anti-inflammatories. The other groups showed lower rates, ranging from 20 to 60%, and in most cases, the antiepileptic carbamazepine, macrolide antibiotics, and trimethoprim were not eliminated at all. Finally, the contribution of WWTP effluents to the presence of pharmaceuticals in receiving river waters was surveyed. In receiving surface water, the most ubiquitous compounds were the analgesics and anti-inflammatories ibuprofen, diclofenac, and naproxen; the lipid regulators bezafibrate and gemfibrozil; the antibiotics erythromycin, azithromycin, sulfamethoxazole, trimethoprim, and less frequently, ofloxacin; the antiepileptic carbamazepine; the antihistamine ranitidine; and the -blockers atenolol and sotalol. Although levels found in WWTP effluents ranged from low g/L to high ng/L, pharmaceuticals in river waters occurred at levels at least one order of magnitude lower (low ng/L range) because of dilution effect. From the results obtained, it was proved that WWTP are hot spots of aquatic contamination concerning pharmaceuticals of human consumption.
Environmental toxicology and risk assessment of pharmaceuticals from hospital wastewater
Water Research, 2011
In this paper, we evaluated the ecotoxicological potential of the 100 pharmaceuticals expected to occur in highest quantities in the wastewater of a general hospital and a psychiatric center in Switzerland. We related the toxicity data to predicted concentrations in different wastewater streams to assess the overall risk potential for different scenarios, including conventional biological pretreatment in the hospital and urine source separation. The concentrations in wastewater were estimated with pharmaceutical usage information provided by the hospitals and literature data on human excretion into feces and urine. Environmental concentrations in the effluents of the exposure scenarios were predicted by estimating dilution in sewers and with literature data on elimination during wastewater treatment. Effect assessment was performed using quantitative structure-activity relationships because experimental ecotoxicity data were only available for less than 20% of the 100 pharmaceuticals with expected highest loads. As many pharmaceuticals are acids or bases, a correction for the speciation was implemented in the toxicity prediction model.The lists of Top-100 pharmaceuticals were distinctly different between the two hospital types with only 37 pharmaceuticals overlapping in both datasets. 31 Pharmaceuticals in the general hospital and 42 pharmaceuticals in the psychiatric center had a risk quotient above 0.01 and thus contributed to the mixture risk quotient. However, together they constituted only 14% (hospital) and 30% (psychiatry) of the load of pharmaceuticals. Hence, medical consumption data alone are insufficient predictors of environmental risk. The risk quotients were dominated by amiodarone, ritonavir, clotrimazole, and diclofenac. Only diclofenac is well researched in ecotoxicology, while amiodarone, ritonavir, and clotrimazole have no or very limited experimental fate or toxicity data available. The presented computational analysis thus helps setting priorities for further testing.Separate treatment of hospital wastewater would reduce the pharmaceutical load of wastewater treatment plants, and the risk from the newly identified priority pharmaceuticals. However, because high-risk pharmaceuticals are excreted mainly with feces, urine source separation is not a viable option for reducing the risk potential from hospital wastewater, while a sorption step could be beneficial.